Adewale L Oyeyemi1, Terry L Conway, Rufus A Adedoyin, Kingsley K Akinroye, Richmond Aryeetey, Felix Assah, Kelli L Cain, Kavita A Gavand, Sandra S Kasoma, Tracy L Kolbe-Alexander, Estelle V Lambert, Richard Larouche, Sarah J Moss, Reginald Ocansey, Vincent O Onywera, Antonio Prista, Mark S Tremblay, James F Sallis. 1. 1Department of Physiotherapy, University of Maiduguri, Maiduguri, NIGERIA; 2Physical Activity, Sport and Recreation, Faculty of Health Sciences, North-West University, Potchefstroom, SOUTH AFRICA; 3Department of Family Medicine and Public Health, University of California, San Diego, CA; 4Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, NIGERIA; 5Nigerian Heart Foundation, Lagos, NIGERIA; 6School of Public Health, University of Ghana, Legon Accra, GHANA; 7Faculty of Medicine and Biomedical Sciences, Department of Public Health, University of Yaoundé I, Yaoundé, CAMEROON; 8Department of Biochemistry and Sports Science, School of Biosciences, Makerere University, Kampala, UGANDA; 9Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, AUSTRALIA; 10Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, SOUTH AFRICA; 11Children's Hospital of Eastern Ontario Research Institute, Ottawa, CANADA; 12Active Living and Wellness Alliance Group, Nungua, GHANA; 13Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, KENYA; 14Physical Activity and Health Research Group, CIDAF-FEFF, Universidade Pedagogica, Maputo, MOZAMBIQUE; and 15Department of Pediatrics, University of Ottawa, Ottawa, CANADA.
Abstract
PURPOSE: The development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries. METHODS: NEWS was systematically adapted to assess urban, periurban, and rural environments in sub-Saharan Africa. Adults (n = 469, 18-85 yr, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. RESULTS: The overall "walkability" index had a positive relationship with both walking for transportation (η = 0.020, P = 0.005) and recreation (η = 0.013, P = 0.028) in the pooled analyses. The mixed-use access and stranger danger scales were positively related with transport walking (η = 0.020, P = 0.006 and η = 0.021, P = 0.040, respectively). Proximity of recreational facilities (η = 0.016, P = 0.015), road/path connectivity (η = 0.025, P = 0.002), path infrastructure (η = 0.021, P = 0.005), and overall places for walking and cycling (η = 0.012, P = 0.029) scales were positively related to recreational walking. Country-specific results were mostly nonsignificant except for South Africa and Uganda. CONCLUSIONS: Of 14 NEWS-Africa scales, 7 were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other continents. Further study with larger and more diverse samples is needed to determine whether the instrument performs well in each country.
PURPOSE: The development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries. METHODS: NEWS was systematically adapted to assess urban, periurban, and rural environments in sub-Saharan Africa. Adults (n = 469, 18-85 yr, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. RESULTS: The overall "walkability" index had a positive relationship with both walking for transportation (η = 0.020, P = 0.005) and recreation (η = 0.013, P = 0.028) in the pooled analyses. The mixed-use access and stranger danger scales were positively related with transport walking (η = 0.020, P = 0.006 and η = 0.021, P = 0.040, respectively). Proximity of recreational facilities (η = 0.016, P = 0.015), road/path connectivity (η = 0.025, P = 0.002), path infrastructure (η = 0.021, P = 0.005), and overall places for walking and cycling (η = 0.012, P = 0.029) scales were positively related to recreational walking. Country-specific results were mostly nonsignificant except for South Africa and Uganda. CONCLUSIONS: Of 14 NEWS-Africa scales, 7 were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other continents. Further study with larger and more diverse samples is needed to determine whether the instrument performs well in each country.
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