title: Exploring walking path quality as a factor for urban elementary school children's active transport to school.
abstract: BACKGROUND
  Path quality has not been well studied as a correlate of active transport to school. We hypothesize that for urban-dwelling children the environment between home and school is at least as important as the environment immediately surrounding their homes and/or schools when exploring walking to school behavior.
  
  
  METHODS
  Tools from spatial statistics and geographic information systems (GIS) were applied to an assessment of street blocks to create a walking path quality measure based on physical and social disorder (termed "incivilities") for each child. Path quality was included in a multivariate regression analysis of walking to school status for a sample of 362 children.
  
  
  RESULTS
  The odds of walking to school for path quality was 0.88 (95% CI: 0.72-1.07), which although not statistically significant is in the direction supporting our hypothesis. The odds of walking to school for home street block incivility suggests the counter intuitive effect (OR = 1.10, 95% CI: 1.08-1.19).
  
  
  CONCLUSIONS
  Results suggest that urban children living in communities characterized by higher incivilities are more likely to walk to school, potentially placing them at risk for adverse health outcomes because of exposure to high incivility areas along their route. Results also support the importance of including path quality when exploring the influence of the environment on walking to school behavior.
authors.affiliation: Dept of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Frank C
authors.initials: FC
authors.lastname: Curriero
authors.forename: Nathan T
authors.initials: NT
authors.lastname: James
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Shields
authors.forename: Caterina
authors.initials: C
authors.lastname: Gouvis Roman
authors.forename: C Debra M
authors.initials: CD
authors.lastname: Furr-Holden
authors.forename: Michele
authors.initials: M
authors.lastname: Cooley-Strickland
authors.forename: Keshia M
authors.initials: KM
authors.lastname: Pollack
mesh_terms: D015142:Baltimore; D002648:Child; D004779:Environment Design; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D015233:Models, Statistical; D012574:Schools; D012931:Social Environment; D012940:Social Problems; D014505:Urban Population; D016138:Walking / Q000706:statistics & numerical data*