| Literature DB >> 33297467 |
Sandra Mandic1,2,3, Erika Ikeda4, Tom Stewart5, Nicholas Garrett6, Debbie Hopkins7, Jennifer S Mindell8, El Shadan Tautolo9, Melody Smith10.
Abstract
Travelling to school by car diminishes opportunities for physical activity and contributes to traffic congestion and associated noise and air pollution. This meta-analysis examined sociodemographic characteristics and built environment associates of travelling to school by car compared to using active transport among New Zealand (NZ) adolescents. Four NZ studies (2163 adolescents) provided data on participants' mode of travel to school, individual and school sociodemographic characteristics, distance to school and home-neighbourhood built-environment features. A one-step meta-analysis using individual participant data was performed in SAS. A final multivariable model was developed using stepwise logistic regression. Overall, 60.6% of participants travelled to school by car. When compared with active transport, travelling to school by car was positively associated with distance to school. Participants residing in neighbourhoods with high intersection density and attending medium deprivation schools were less likely to travel to school by car compared with their counterparts. Distance to school, school level deprivation and low home neighbourhood intersection density are associated with higher likelihood of car travel to school compared with active transport among NZ adolescents. Comprehensive interventions focusing on both social and built environment factors are needed to reduce car travel to school.Entities:
Keywords: adolescents; built environment; driving; meta-analysis; school; transport
Mesh:
Year: 2020 PMID: 33297467 PMCID: PMC7730892 DOI: 10.3390/ijerph17239138
Source DB: PubMed Journal: Int J Environ Res Public Health ISSN: 1660-4601 Impact factor: 3.390
Figure 1Locations, number of participants, and rates of travelling to school by car across four cities and four studies included in this meta-analysis. Distance is shown as median (25th–75th percentiles) except for the city of Christchurch where the range of distance (minimum–maximum) is displayed due to the small sample size (n = 3).
Bivariate correlates of travelling to school by car.
| Total Sample | Car Transport | Active Transport | OR 1 | ||
|---|---|---|---|---|---|
| Age (years) | |||||
| 13 | 197 | 124 (62.9) | 73 (37.1) | 0.80 (0.55, 1.16) | |
| 14 | 848 | 512 (60.4) | 336 (39.6) | 0.71 (0.53, 0.95) | |
| 15 | 491 | 280 (57.0) | 211 (43.0) | 0.64 (0.47, 0.86) | |
| 16 | 277 | 151 (54.5) | 126 (45.5) | 0.60 (0.43, 0.84) | |
| 17 or older (Reference) | 349 | 232 (66.5) | 117 (33.5) | 0.02 | |
| Sex | |||||
| Male (Reference) | 1056 | 611 (57.9) | 445 (42.1) | ||
| Female | 1107 | 688 (62.1) | 419 (37.9) | 1.12 (0.94, 1.34) | 0.20 |
| Ethnicity | |||||
| New Zealand European (Reference) | 1176 | 719 (61.1) | 457 (38.9) | ||
| Māori | 145 | 76 (52.4) | 69 (47.6) | 0.66 (0.46, 0.94) | |
| Pacific | 567 | 360 (63.5) | 207 (36.5) | 1.31 (0.86, 1.99) | |
| Asian | 105 | 55 (52.4) | 50 (47.6) | 0.98 (0.65, 1.50) | |
| Other | 166 | 87 (52.4) | 79 (47.6) | 0.74 (0.53, 1.04) | 0.03 |
| Weight status category | |||||
| Underweight | 14 | 10 (71.4) | 4 (28.6) | 1.99 (0.58, 6.77) | |
| Normal weight (Reference) | 1174 | 682 (58.1) | 492 (41.9) | ||
| Overweight | 455 | 283 (62.2) | 172 (37.8) | 1.14 (0.90, 1.43) | |
| Obese | 428 | 264 (61.7) | 164 (38.3) | 1.10 (0.84, 1.44) | 0.50 |
| New Zealand Deprivation score | |||||
| Low deprivation (Reference) | 726 | 488 (67.2) | 238 (32.8) | ||
| Medium deprivation | 677 | 365 (53.9) | 312 (46.1) | 0.55 (0.44, 0.69) | |
| High deprivation | 739 | 430 (58.2) | 309 (41.8) | 0.46 (0.35, 0.61) | <0.0001 |
| Number of individuals living in a household | |||||
| 2 (Reference) | 72 | 37 (51.4) | 35 (48.6) | ||
| 3 | 345 | 185 (53.6) | 160 (46.4) | 1.01 (0.60, 1.70) | |
| 4 | 676 | 422 (62.4) | 254 (37.6) | 1.55 (0.94, 2.55) | |
| 5 | 483 | 294 (60.9) | 189 (39.1) | 1.42 (0.85, 2.36) | |
| 6 or more | 578 | 355 (61.4) | 223 (38.6) | 1.51 (0.90, 2.53) | 0.02 |
| Number of siblings | |||||
| 0 (Reference) | 214 | 108 (50.5) | 106 (49.5) | ||
| 1 | 693 | 428 (61.8) | 265 (38.2) | 1.33 (0.97, 1.84) | |
| 2 | 555 | 332 (59.8) | 223 (40.2) | 1.14 (0.82, 1.58) | |
| 3 or more | 701 | 431 (61.5) | 270 (38.5) | 1.11 (0.80, 1.54) | 0.22 |
| School decile | |||||
| Low deprivation | 950 | 625 (65.8) | 325 (34.2) | 2.00 (1.60, 2.42) | |
| Medium deprivation (Reference) | 716 | 369 (51.5) | 347 (48.5) | ||
| High deprivation | 494 | 302 (61.1) | 192 (38.9) | 1.30 (0.87, 1.94) | <0.0001 |
| Distance from home to school | |||||
| Q1 < 1.48 km (Reference) | 539 | 121 (22.4) | 418 (77.6) | ||
| Q2 1.48–2.60 km | 540 | 264 (48.9) | 276 (51.1) | 3.62 (2.76, 4.73) | |
| Q3 2.61–4.99 km | 539 | 412 (76.4) | 127 (23.6) | 11.86 (8.88, 15.83) | |
| Q4 ≥ 5.00 km | 540 | 501 (92.8) | 39 (7.2) | 42.97 (29.23, 63.19) | <0.0001 |
| Home neighbourhood dwellings density (per km2) | |||||
| [400 m buffer] | |||||
| Q1 < 743 (Reference) | 539 | 419 (77.7) | 120 (22.3) | ||
| Q2 743–970 | 540 | 333 (61.7) | 207 (38.3) | 0.47 (0.36, 0.62) | |
| Q3 971–1139 | 540 | 291 (53.9) | 249 (46.1) | 0.35 (0.27, 0.46) | |
| Q4 ≥ 1140 | 540 | 255 (47.2) | 285 (52.8) | 0.28 (0.21, 0.36) | <0.0001 |
| [1 km buffer] | |||||
| Q1 < 643 (Reference) | 539 | 437 (81.1) | 102 (18.9) | ||
| Q2 643–903 | 540 | 326 (60.4) | 214 (39.6) | 0.38 (0.28, 0.50) | |
| Q3 904–1028 | 540 | 291 (53.9) | 249 (46.1) | 0.29 (0.22, 0.39) | |
| Q4 ≥ 1029 | 540 | 244 (45.2) | 296 (54.8) | 0.22 (0.16, 0.29) | <0.0001 |
| Home neighbourhood intersection density (per km2) | |||||
| [400 m buffer] | |||||
| Q1 < 26.7 (Reference) | 540 | 390 (72.2) | 150 (27.8) | ||
| Q2 26.7–39.0 | 539 | 329 (61.0) | 210 (39.0) | 0.64 (0.49, 0.84) | |
| Q3 39.1–52.4 | 543 | 313 (57.6) | 230 (42.4) | 0.52 (0.40, 0.68) | |
| Q4 ≥ 52.5 | 541 | 267 (49.4) | 274 (50.6) | 0.30 (0.23, 0.40) | <0.0001 |
| [1 km buffer] | |||||
| Q1 < 26.2 (Reference) | 539 | 401 (74.4) | 138 (25.6) | ||
| Q2 26.2–35.2 | 540 | 329 (60.9) | 211 (39.1) | 0.65 (0.49, 0.86) | |
| Q3 35.3–45.4 | 543 | 312 (57.5) | 231 (42.5) | 0.48 (0.36, 0.63) | |
| Q4 ≥ 45.5 | 541 | 257 (47.5) | 284 (52.5) | 0.20 (0.15, 0.27) | <0.0001 |
| Home neighbourhood land use mix | |||||
| [400 m buffer] | |||||
| Q1 < 0.01 (Reference) | 545 | 336 (61.7) | 209 (38.3) | ||
| Q2 0.01–0.19 | 502 | 293 (58.4) | 209 (41.6) | 1.25 (0.95, 1.64) | |
| Q3 0.20–0.31 | 519 | 315 (60.7) | 204 (39.3) | 1.63 (1.22, 2.19) | |
| Q4 ≥ 0.32 | 578 | 342 (59.2) | 236 (40.8) | 1.51 (1.13, 2.03) | 0.008 |
| [1 km buffer] | |||||
| Q1 < 0.17 (Reference) | 522 | 319 (61.1) | 203 (38.9) | ||
| Q2 0.17–0.31 | 519 | 300 (57.8) | 219 (42.2) | 1.32 (1.00, 1.73) | |
| Q3 0.32–0.40 | 520 | 321 (61.7) | 199 (38.3) | 1.52 (1.14, 2.03) | |
| Q4 ≥ 0.41 | 588 | 348 (59.2) | 240 (40.8) | 1.49 (1.12, 1.99) | 0.02 |
1 OR = odds ratio; 2 CI = confidence interval; 3 Q = quartile.
Final multivariate model of correlates of travelling to school by car.
| OR 1 | 95% CI 2 | ||
|---|---|---|---|
| Age (years) | |||
| 13 | 0.73 | (0.46, 1.16) | |
| 14 | 0.71 | (0.50, 1.01) | |
| 15 | 0.55 | (0.38, 0.79) | |
| 16 | 0.61 | (0.41, 0.91) | |
| 17 or older (Reference) | 0.02 | ||
| Sex | |||
| Male (Reference) | |||
| Female | 1.24 | (1.00, 1.53) | 0.05 |
| Ethnicity * | |||
| New Zealand European (Reference) | |||
| Māori | 0.73 | (0.47, 1.15) | |
| Pacific | 1.59 | (0.97, 2.59) | |
| Asian | 1.01 | (0.61, 1.68) | |
| Other | 0.85 | (0.57, 1.28) | 0.12 |
| School decile | |||
| Low deprivation | 1.95 | (1.50, 2.53) | |
| Medium deprivation (Ref) | |||
| High deprivation | 2.85 | (1.73, 4.72) | <0.0001 |
| Distance from home to school | |||
| Q1 3 < 1.48 km (Reference) | |||
| Q2 1.48–2.60 km | 3.76 | (2.86, 4.96) | |
| Q3 2.61–4.99 km | 11.51 | (8.53, 15.53) | |
| Q4 ≥ 5.00 km | 39.71 | (26.21, 60.15) | <0.0001 |
| Home neighbourhood intersection density (per km2) [1 km buffer] | |||
| Q1 < 26.2 (Reference) | |||
| Q2 26.2–35.2 | 0.81 | (0.57, 1.14) | |
| Q3 35.3–45.4 | 0.74 | (0.53, 1.04) | |
| Q4 ≥ 45.5 | 0.49 | (0.34, 0.70) | 0.001 |
1 OR = odds ratio; 2 CI = confidence interval; 3 Q = quartile. * Note that ethnicity results are not significant but included as at least one study has a different ethnic mix (PIF Study) and as ethnicity is often a factor in similar studies.
Figure 2Forest plot comparing quartile 1 with quartiles 2, 3, and 4 for distance to school and home neighbourhood intersection density (1 km buffer) associations with car travel to school. BEANZ = Built Environment and Adolescent New Zealanders Study; BEATS = Built Environment and Active Transport to School Study; PIF = Pacific Islands Families Study; Q = quartile. Note: Due to small sample size, data from URBAN Study are not presented here.