We examined dose-response relations between a Japan Postcode-level Walkability Index (JPWI) and total walking, walking for leisure; and walking for transport, among adults living in 95 cities across the country. This nationwide cross-sectional study included 40,286 adults (males 50.5%, 49.4 +/- 15.6 years) residing in a wide range of urban and rural settings, who responded to a web-based survey conducted in 2021 using quota sampling. The JPWI was calculated by generating a 1000 m road network buffer from a representative point within each postcode boundary using the mean of z-scores summarizing the population density, intersection density and number of destinations within this buffer. JPWI scores ranged from -1.848 to 2.590. There was a non-linear positive association between JPWI and total walking, with an inflection point at a JPWI of 0.78 (95% CI: 0.69, 0.87), below which the association with walking time was minimal (B = 22 [11,32]), but above which walking time increased significantly (B = 118 [106, 129]). Similar patterns of associations were observed in both leisure walking and walking for transport, with inflection points at JPWI values of 0.78 (95% CI: 0.69, 0.86) and 0.64 (95% CI: 0.42, 0.86), respectively. Findings highlight the potential utility of considering how the JPWI (and potentially related measures for other countries) of local areas compare with such empirically-identified inflection points when developing strategies for improving the built environment to promote physical activity.

Physical inactivity is a major public health priority for older Latinos with mild cognitive impairment (MCI). MCI considered a pre-dementia stage of Alzheimer’s disease (AD), increases the risk of AD and related dementias (ADRD). Evidence suggests physical activity (PA) enhances cognition indirectly by improving sleep and reducing chronic conditions like cardiovascular disease that affect neurocognitive function. Older Latinos, the fastest-growing minority group in the US., experience a disproportionate burden of cognitive disease, partly to inactivity and sleep-wake disturbances associated with obesity, diabetes, and cardiovascular risk. Latinos also faculty-level barriers to PA – including cost, neighborhood safety, and limited social support. Yet, few PA interventions are designed for older Latinos with MCI. Tiempo Juntos por Nuestra Salud (Time Together for Our Health) is a socio-ecological framework integrating education, social support, and community walking resources. As a randomized controlled trial, Tiempo Juntos will evaluate effects on moderate-intensity PA; theoretical mediators; and secondary outcomes like cognition, CV health, and sleep at 3, 6 and 12 months. 234 Spanish-speaking Latinos aged ≥55 with MCI (Montreal Cognitive assessment score 23-26) will be assigned to Tiempo Juntos or an attention control group. Participants in Tiempo Juntos will attend a 1-hour twice weekly walking session for 3 months led by a trained community health worker (CHW) followed by mobile health (mHealth) booster sessions. The control group will receive Spanish-language health education from the National Institute on Aging resources for seniors. Findings will establish groundwork for a Stage IV pragmatic trial of Tiempo Juntos serving senior Latinos nationwide.

Addressing today’s public health challenges requires learning from past successes while adapting to emerging threats. Here we focus on two pressing, interconnected issues: physical inactivity and climate change. We present the Physical Activity and Climate Change (PACC) model, a conceptual framework illustrating how well-designed physical activity initiatives can simultaneously contribute to climate mitigation, support adaptation, and promote health and equity. We provide insights on Indigenous knowledge and contemporary sport, re-imagined urban design, behavioural and equity synergies, and opportunities to develop co-benefit metrics, innovative governance models and cross-sector solutions. We emphasize the need for systems-based, co-designed approaches that prioritize environmental sustainability, health equity and cultural relevance while avoiding unintended consequences. Aligning physical activity and climate change agendas is more powerful than addressing them separately, offering greater combined benefits for population and environmental health. The PACC model offers a practical foundation for advancing integrated, equitable and sustainable solutions. A physical activity and climate change framework integrates climate mitigation, adaptation, health equity and Indigenous knowledge into public health campaigns for physical activity promotion.

Global physical inactivity has remained high and unchanged for the past two decades. We assessed global political priority for physical activity. An analysis of national policy documents from 200 countries revealed notable progress in policy adoption since 2004, but we found limited evidence of implementation. A qualitative case study design, including insights from 46 key informants, confirmed low political priority. Four key challenges emerged: (1) domination of health-centric approaches; (2) limited recognition of benefits beyond non-communicable disease prevention; (3) interest across sectors but lack of clarity defining physical activity policy and of leadership; and (4) limited multisectoral partnerships. Proposed solutions include: (1) building consensus on physical activity policy with consideration of context; (2) acknowledging the scope of benefits; (3) clarifying multisectoral leadership and responsibilities; and (4) increasing partnerships beyond obvious proponents. Prioritizing physical activity policy is essential for improving human, societal and planetary health. A qualitative analysis of two decades of policy documents from 200 countries and interviews with 46 key informants found that adoption of policies to promote physical activity has increased since 2004, but implementation remains weak because physical activity is still a low, albeit gradually increasing, political priority in most countries.

City climate policy is one of the most powerful levers that can address environmental, health and equity challenges simultaneously. Yet large gaps exist in research and evaluation of city Climate Action Plans (CAPs) to guide and improve their impact, especially regarding public health and equity. We propose a conceptual framework and a global, interdisciplinary research agenda to ensure CAPs deliver on their full potential for climate, health, and justice.

Despite widespread development of national physical activity policies over the past 20 years, global levels of physical activity have been largely unchanged (with around one in three adults and four in five adolescents not meeting recommended physical activity levels since 2012). This gap between policy development and real‑world impact highlights the need for stronger political prioritization, clearer leadership and effective multisectoral implementation.

Introduction: There are mixed findings on the relation between built environment attributes and active commuting to and from school (ACS). In addition to methodological differences in assessing the built environment, some of these mixed findings may be due to moderating variables in the associations between built environment and ACS. Hence, the present study aimed to analyze whether the perception of psychosocial variables and neighborhood safety moderated associations between built environment attributes and ACS among female and male adolescents. Methods: This cross-sectional study was conducted in Valencia, Spain, among 465 adolescents (aged 14-18 years). Built environment attributes of the home neighborhood were evaluated using geographic information system data. Socio-demographic characteristics, psychosocial factors, neighborhood perceived safety, and ACS were self-reported by adolescents using validated scales. Mixed effects regression models were used to estimate associations. The analyses were carried out separately in girls and boys. Results: The strongest associations of residential density, public transportation density, and greenspace area with ACS were found among those adolescents with the highest level of decisional balance, social support from siblings/peers, and safety related to pedestrian infrastructure. However, there were substantial sex differences found in patterns of moderation. Conclusions: Present findings support the ecological model principle of interactions across levels of influence when analyzing ACS correlates in adolescents. These findings suggest multilevel interventions may be needed to promote ACS, and the different needs of girls and boys should be considered.

Self Determination Theory posits that individuals may be more likely to initiate and maintain behaviors tied to intrinsic (vs. extrinsic) motivations and may provide a useful framework for understanding youth participation in novel sports. Using the Intrinsic Motivation Inventory (IMI) and Patient-Centered Assessment and Counseling for Exercise Plus Nutrition (PACE+) surveys, motivation and physical activity habits were explored in 27 children/adolescents (ages 7–16) enrolled in Parkour, an individual, non-competitive youth sport. Fifteen Parkour participants were also interviewed to gain an understanding of their motivations for participating. Study participants had high median IMI subscale scores related to interest/enjoyment (6.71/7) and perceived choice (6.40/7) compared to the whole scale. Similarly median sub-scale Pros and Self-Efficacy scores for physical activity from the PACE+ were high (4.25/5 and 3.91/5, respectively). The themes of autonomy and enjoyment were consistently reported in the qualitative interviews, expanding on the quantitative results. Other themes included appreciation for camaraderie, creativity, and a drive for improvement. These results provide early evidence that Parkour, and similar lifestyle sports, may be tied more to intrinsic than extrinsic motivations and could have potential for adoption and maintenance by youth with low motivation to engage in physical activity to promote healthy behaviors.

Background: A significant majority of adolescents from lower-middle-income countries do not meet recommendations for daily physical activity. THANDAV (Taking High-Intensity Interval Training [HIIT] ANd Dance to Adolescents for Victory over noncommunicable diseases [NCDs]) is a 10-minute dance intervention incorporating principles of HIIT. The present study evaluated the effect of THANDAV on cardiovascular risk factors and lifestyle behavior in Asian Indian adolescent girls.Methods: THANDAV was delivered as a 12-week pilot cluster randomized controlled trial (cRCT) in two schools, involving 108 schoolgirls aged 13 to 15 years in Chennai, India. The primary outcome was step counts, while secondary outcomes included metabolic, clinical, and lifestyle parameters. Focus group discussions and interviews were held to assess barriers to and acceptability of THANDAV intervention.Results: In the intention-to-treat analysis, the intervention group had significantly favorable changes in step counts (+1073 steps/day), skeletal muscle mass (+0.9 kg), body weight (-0.7 kg), body fat percentage (-2.0%), body mass index (-0.3 kg/m2), waist circumference (-1.0 cm), systolic (-4 mm Hg) and diastolic blood pressure (-4 mm Hg), resting heart rate (-3 bpm) and body fat mass (-1.7 kg), moderate -to-vigorous physical activity (+29.5 minutes/day), sleep (+46.4 minutes/day), sedentary time (-199.7 minutes/day), Adolescence Stress Scale (-6.6), and junk food consumption (-2.7) scores compared with controls. Qualitative interviews revealed that THANDAV routines were time-efficient, enjoyable, and easily fit into adolescents' busy schedules enabling feasible engagement in active leisure time.Conclusions: THANDAV is a culturally acceptable HIIT-based dance intervention that improves leisure-time physical activity and reduces cardiometabolic risk in Asian Indian adolescent girls.Trial Registration: The trial is registered with the Central Trials Registry-India (CTRI/2020/02/023384; URL: https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzgyMTQ=&Enc=&userName=).

Background Reliable and valid measures to assess environmental features that can support walking and bicycling in neighborhoods are useful for developing future interventions for physical activity (PA). This study aimed to develop the Chinese version of the Physical Activity Neighborhood Environment Scale (PANES-CHN) and assess its test-retest reliability, factor structure, and construct validity. Methods This study was conducted from August to November 2020, involving 1 307 adults in China. The adaptation and translation of PANES-CHN followed a forward and backward procedure. The PANES-CHN survey was administered to a subsample twice, one month apart. Test-retest reliability was assessed using Intraclass Correlation Coefficients (ICC) and Cohen's κ. Factor structure was examined through confirmatory factor analysis (CFA). Individual physical activity was measured using the International Physical Activity Questionnaire long version (IPAQ-L) to evaluate the construct validity of PANES-CHN. Results Test-retest reliability was generally good (ICCs ranged from 0.87 to 0.99), except for one item with an ICC of 0.42. Most metrics from the CFA showed satisfactory fit. Correlation tests with the IPAQ-L indicated the PANES-CHN total score was significantly correlated with leisure physical activity (r = 0.12, p < 0.001) and virtually no associations with transport physical activity. Conclusion The PANES-CHN demonstrated acceptable test-retest reliability and factor structure, as well as moderate construct validity for the total score. Associations may have been suppressed because the study was conducted during worldwide activity restrictions during the COVID—19 pandemic. The PANES-CHN is a promising instrument for assessing neighborhood environmental features associated with PA that is tailored to Chinese urban environments.

Neighbourhood walkability is known to be positively associated with self-reported and device-based measures of overall physical activity. However, relations of walkability with specific active and sedentary behaviour patterns are not well understood. We investigated cross-sectional associations of neighbourhood walkability with time spent stepping, standing, sitting, and their pattern metrics using data from 505 participants (mean age 59.2 years) from the AusDiab3 study. Neighbourhood walkability (a composite measure of residential, destination, and intersection densities) was calculated within 1 km street-network buffers around participants’ homes. Thigh-worn device data (activPAL, 7-day, 24 h/day protocol) were used to derive stepping, sitting and standing minutes per day and their pattern metrics. Two-level linear mixed models assessed relevant associations, adjusting for potential confounders. Higher walkability was associated with higher cadences (β [95

Little is known about neighborhood retail food environments and cardiometabolic health among Hispanic/Latino adults, who experience significant health inequities. This study aimed to examine associations of the neighborhood retail food environment with cardiometabolic health of Hispanic/Latino adults over a 6-year period. Participants from the Hispanic Community Health Study/Study of Latinos San Diego Field Center (n = 3851) underwent assessments of cardiometabolic risk factors at baseline (2008–2011) and approximately 6 years later (2014–2017). Weight (body mass index [BMI] and overweight/obesity), hypertension (normotensive, prehypertensive, or hypertensive), and diabetes (normoglycemia, prediabetes, or diabetes) status were considered cardiometabolic risk factors. Participants’ home addresses at baseline and 6 years later were geocoded. The neighborhood retail environment was quantified using the Modified Retail Food Environment Index (mRFEI) within 800-m circular buffers around these two addresses. Complex survey regression analyses quantified associations between both baseline and changes in neighborhood retail food environment and cardiometabolic health of Hispanic/Latino adults over 6 years. A one standard deviation higher baseline standardized mRFEI score was associated with approximately 14.3

Neighbourhoods with good access to various destinations facilitate engagement in physical activity. Because spatial indicators of destination accessibility can be operationalised in numerous ways, it is important to evaluate their ability to explain physical activity in various geographical and cultural contexts. We evaluated established as well as novel spatial indicators of destination accessibility using data from 12 cities/regions participating in an international study on adolescents' physical activity. Twelve spatial indicators of destination accessibility were developed using land use data. Five indicators represented measures of destination intensity (density), two were indicators of destination heterogeneity [land use mix (LUM) indices], and the remaining five were novel measures of combined destination intensity and heterogeneity. To evaluate these spatial indicators, we examined their performance as correlates of parent-perceived destination accessibility and adolescents' physical activity, and the extent to which the findings were generalisable across cities/regions. Substantial differences in ability to explain physical activity and comparability across geographical locations were observed across the indicators. The best performing indicator, defined as being a consistent correlate of parental perceptions of destination accessibility and adolescents' physical activity in the expected direction and across cities/regions, was a novel hybrid intensity + heterogeneity indicator: gross density of non-residential destinations weighted by a novel parcel-count-based LUM index. Indicators based on ratios of non-residential land/parcels to residential land/dwelling units performed poorly on most criteria, while LUM indices performed well in relation to transport-related physical activity. We provide recommendations regarding the usage of spatial destination accessibility indicators in physical activity research.

BACKGROUND:Public health and clinical guidelines identify the importance of sedentary behaviors for cardiovascular diseases, particularly among postmenopausal women. The goal of this trial was to compare the behavioral and physiological impacts of 2 distinct approaches to changing sedentary behaviors. METHODS:Overweight or obese sedentary postmenopausal women (N=407) were randomly assigned to 1 of 3 study conditions for 3 months: (1) healthy living (control), (2) reduce sitting time (sit less), and (3) increase sit-to-stand transitions (STSTs; sit-to-stand). Each study arm received 7 individual health coach sessions across 12 weeks. At baseline and 3 months, participants had fasting blood drawn, had blood pressure measured, and wore thigh (activPAL) and hip (ActiGraph) accelerometers for 7 days. Linear mixed models evaluated each intervention arm compared with the control (healthy living) arm. RESULTS:A total of 388 women (95%) completed the 3-month trial. The sit less arm reduced total sitting time by 58 minutes per day more than the healthy living arm (95% CI, -82.9 to -33.6; P<0.001) but did not change STSTs (-1 STST/day [95% CI, -9.4 to 6.5]; P=0.72). Conversely, the sit-to-stand arm significantly increased STST by 26 STST per day more than the healthy living arm (95% CI, 17.71 to 33.64; P<0.001) but did not differ in change to sitting time (-10 min/day [95% CI, -34.6 to 14.9]; P=0.44). The sit-to-stand arm had significant decreases in diastolic blood pressure compared with the healthy living arm (-2.24 mm Hg [95% CI, -4.08 to -0.40]; P=0.02) and similar decreases in systolic blood pressure compared with the healthy living arm (-3.33 mm Hg [95% CI, -6.32 to -0.33]; P=0.03), although it did not reach the a priori significance threshold of P<0.025. There were no significant intervention effects on blood pressure for the sit less arm and no intervention effects for the glucoregulatory outcomes for either arm. CONCLUSIONS:This trial demonstrated the feasibility of changing sedentary behaviors as well as the distinct nature of sitting time and STST. Increasing STST improved blood pressure in overweight and obese postmenopausal women within 3 months. Focusing on increasing STST may be an achievable behavioral target to reduce cardiovascular disease risk in postmenopausal women. REGISTRATION:URL: https://www.clinicaltrials.gov; Unique identifier: NCT03473145.

Previous studies have demonstrated that the macro-level design of cities (e.g., walkability) and the micro-level pedestrian-oriented design of streetscapes are associated with physical activity; however, the benefits of combining these features have rarely been examined. Understanding potential synergies between these two components could provide guidance for optimizing health impacts, especially for older adults. This cross-sectional investigation examined interactions among 'macro-level' neighbourhood walkability and 'micro-level' pedestrian environment, sex, and neighbourhood income in relation to self-reported frequency of active transportation and device-measured physical activity (30 minutes per day) in 352 older adults recruited from economically and built environmentally diverse neighbourhoods in Seattle/King County. Results included positive interactions between neighbourhood walkability, pedestrian environment, and sex for the active transportation outcome. The synergy was more pronounced in women, in which there were significant interactions between neighbourhood walkability and sex with scores related to streetscape design features, walking routes, and street-crossing characteristics of the pedestrian environment. Our study highlights actionable policies to create age-friendly pedestrian environments by improving route connectivity, streetscape features, and crossing safety. Prioritizing well-connected walking routes, enhancing micro-level streetscape elements, and ensuring pedestrian-friendly crossings can significantly support elderly active travel and reduce reliance on motorized transport. These results provide evidence that the pedestrian environment may enhance the health potential of neighbourhood walkability for some population segments (i.e., older women).

This study is the first to examine whether neighbourhood, school and home food environments were associated with dietary behaviours in Hong Kong adolescents; and whether off-campus lunch school policy, bringing lunch from home and parental rules for eating behaviours moderated the associations. We used data from the international Healthy environments and active living in teenagers - (Hong Kong) [iHealt(H)] study. Participants were healthy adolescents aged 11-18 years (N = 1299; Mage = 14.7 years; 57 % girls) and their parent/primary caregivers. Participants completed surveys with validated scales to assess dietary behaviours and perceived food environments. The Microscale Audit of Pedestrian Streetscapes and Geographic Information Systems data and software were used to objectively assess food environments. A higher number of bakeries, coffee shops, cafes and convenience stores in the neighbourhood was associated with higher consumption of vegetables and lower consumption of sugar-sweetened drinks in adolescents. Adolescents who frequently brought lunch from home to school consumed fatty foods and sugar-sweetened drinks less frequently and were more likely to eat fruits and vegetables. Greater availability of unhealthy food outlets at the school was associated with higher consumption of sugar-sweetened drinks, whereas more restaurants around the school was associated with higher consumption of fruits and vegetables. Home-made lunches and restrictive parental eating rules moderated the effects of food environments on adolescents' dietary behaviours. All food environmental contexts were associated with Hong Kong adolescents' dietary behaviours; however, the home and school environment appeared to be the most influential and should be targeted in public health interventions.

Studies of correlates of active transport to and from school (ATS) focus mainly on children, have a limited conceptualisation of ATS trips, lack heterogeneity in built environments, and rarely consider effect modifiers. This study aimed to estimate associations of parent-perceived neighbourhood environment characteristics with self-reported ATS among adolescents from 14 countries, and whether associations differ by sex, city/region, and distance to school. Observational cross-sectional design. Data were from the International Physical activity and Environment Network (IPEN) Adolescent study and included 6302 adolescents (mean age 14.5 ± 1.7 years, 54