title: NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries.
abstract: BACKGROUND
  Built environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa).
  
  
  METHODS
  The original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries.
  
  
  RESULTS
  The original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs > .75 %) or "good" (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated "excellent" agreement and the other six had "good" agreement. No items or scales demonstrated "poor" reliability (ICCs < .40).
  
  
  CONCLUSIONS
  The systematic adaptation and initial psychometric evaluation of NEWS-Africa indicates the instrument is feasible and reliable for use with adults of diverse demographic characteristics in Africa. The measure is likely to be useful for research, surveillance of built environment conditions for planning purposes, and to evaluate physical activity and policy interventions in Africa.
authors.affiliation: Department of Physiotherapy, University of Maiduguri, Maiduguri, Nigeria. alaoyeyemi@yahoo.com.|Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa. alaoyeyemi@yahoo.com.
authors.forename: Adewale L
authors.initials: AL
authors.lastname: Oyeyemi
authors.affiliation: Department of Biochemistry and Sports Science, School of Biosciences, College of Natural Science, Makerere University, Kampala, Uganda. sandkasoma@yahoo.com.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Kasoma
authors.affiliation: Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya. vonywera@gmail.com.
authors.forename: Vincent O
authors.initials: VO
authors.lastname: Onywera
authors.affiliation: Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. kembeassah@yahoo.com.
authors.forename: Felix
authors.initials: F
authors.lastname: Assah
authors.affiliation: Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria. radedoyi@yahoo.com.
authors.forename: Rufus A
authors.initials: RA
authors.lastname: Adedoyin
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, California, USA. tlconway@ucsd.edu.
authors.forename: Terry L
authors.initials: TL
authors.lastname: Conway
authors.affiliation: Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa. Hanlie.moss@nwu.ac.za.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Moss
authors.affiliation: Active Living and Wellness Alliance Group (ALWAG), ALWAG Legacy, Nungua, Ghana. rocansey@gmail.com.
authors.forename: Reginald
authors.initials: R
authors.lastname: Ocansey
authors.affiliation: Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia. t.kolbealexander@uq.edu.au.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Kolbe-Alexander
authors.affiliation: Nigerian Heart Foundation, Lagos, Nigeria. k.akinroye@nigerianheart.org.
authors.forename: Kingsley K
authors.initials: KK
authors.lastname: Akinroye
authors.affiliation: Faculty of Physical Education and Sport Sciences, Universidade Pedagogica, Maputo, Mozambique. aprista1@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Prista
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada. rlarouche@cheo.on.ca.
authors.forename: Richard
authors.initials: R
authors.lastname: Larouche
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, California, USA. kgavand@ucsd.edu.
authors.forename: Kavita A
authors.initials: KA
authors.lastname: Gavand
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, California, USA. kcain@ucsd.edu.
authors.forename: Kelli L
authors.initials: KL
authors.lastname: Cain
authors.affiliation: Division of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. Vicki.lambert@uct.ac.za.
authors.forename: Estelle V
authors.initials: EV
authors.lastname: Lambert
authors.affiliation: School of Public Health, University of Ghana, Legon Accra, Ghana. rnokai@gmail.com.
authors.forename: Richmond
authors.initials: R
authors.lastname: Aryeetey
authors.affiliation: Division of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. clare.bartels@gmail.com.
authors.forename: Clare
authors.initials: C
authors.lastname: Bartels
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada. mtremblay@cheo.on.ca.|Department of Pediatrics, University of Ottawa, Ottawa, Canada. mtremblay@cheo.on.ca.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Tremblay
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, California, USA. jsallis@ucsd.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Sallis
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D002648:Child; D004779:Environment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D012111:Residence Characteristics / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires / Q000592:standards*; D016138:Walking / Q000706:statistics & numerical data; D055815:Young Adult