title: Neighborhood built environment and transport and leisure physical activity: findings using objective exposure and outcome measures in New Zealand.
abstract: BACKGROUND
  Evidence of associations between neighborhood built environments and transport-related physical activity (PA) is accumulating, but few studies have investigated associations with leisure-time PA.
  
  
  OBJECTIVE
  We investigated associations of five objectively measured characteristics of the neighborhood built environment-destination access, street connectivity, dwelling density, land-use mix and streetscape quality-with residents' self-reported PA (transport, leisure, and walking) and accelerometer-derived measures of PA.
  
  
  METHODS
  Using a multicity stratified cluster sampling design, we conducted a cross-sectional survey of 2,033 adults who lived in 48 New Zealand neighborhoods. Multilevel regression modeling, which was adjusted for individual-level (sociodemographic and neighborhood preference) and neighborhood-level (deprivation) confounders, was used to estimate associations of built environment with PA.
  
  
  RESULTS
  We found that 1-SD increases in destination access, street connectivity, and dwelling density were associated with any versus no self-reported transport, leisure, or walking PA, with increased odds ranging from 21% [street connectivity with leisure PA, 95% confidence interval (CI): 0%, 47%] to 44% (destination accessibility with walking, 95% CI: 17%, 79%). Among participants who self-reported some PA, a 1-SD increase in street connectivity was associated with a 13% increase in leisure PA (95% CI: 0, 28%). SD increases in destination access, street connectivity, and dwelling density were each associated with 7% increases in accelerometer counts.
  
  
  CONCLUSIONS
  Associations of neighborhood destination access, street connectivity, and dwelling density with self-reported and objectively measured PA were moderately strong, indicating the potential to increase PA through changes in neighborhood characteristics.
authors.affiliation: Center for Social and Health Outcomes Research and Evaluation (SHORE) and Whariki Research Centre, School of Public Health, Massey University, Auckland, New Zealand. k.witten@massey.ac.nz
authors.forename: Karen
authors.initials: K
authors.lastname: Witten
authors.forename: Tony
authors.initials: T
authors.lastname: Blakely
authors.forename: Nasser
authors.initials: N
authors.lastname: Bagheri
authors.forename: Hannah
authors.initials: H
authors.lastname: Badland
authors.forename: Vivienne
authors.initials: V
authors.lastname: Ivory
authors.forename: Jamie
authors.initials: J
authors.lastname: Pearce
authors.forename: Suzanne
authors.initials: S
authors.lastname: Mavoa
authors.forename: Erica
authors.initials: E
authors.lastname: Hinckson
authors.forename: Grant
authors.initials: G
authors.lastname: Schofield
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004779:Environment Design; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012111:Residence Characteristics; D055815:Young Adult