title: Adaptation and Evaluation of the Neighborhood Environment Walkability Scale in India (NEWS-India).
abstract: Physical inactivity is the fourth leading risk factor for global mortality, with most of these deaths occurring in low and middle-income countries (LMICs) like India. Research from developed countries has consistently demonstrated associations between built environment features and physical activity levels of populations. The development of culturally sensitive and reliable measures of the built environment is a necessary first step for accurate analysis of environmental correlates of physical activity in LMICs. This study systematically adapted the Neighborhood Environment Walkability Scale (NEWS) for India and evaluated aspects of test-retest reliability of the adapted version among Indian adults. Cultural adaptation of the NEWS was conducted by Indian and international experts. Semi-structured interviews were conducted with local residents and key informants in the city of Chennai, India. At baseline, participants (N = 370; female = 47.2%) from Chennai completed the adapted NEWS-India surveys on perceived residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure and safety for walking and cycling, aesthetics, traffic safety, and safety from crime. NEWS-India was administered for a second time to consenting participants (N = 62; female = 53.2%) with a gap of 2-3 weeks between successive administrations. Qualitative findings demonstrated that built environment barriers and constraints to active commuting and physical activity behaviors intersected with social ecological systems. The adapted NEWS subscales had moderate to high test-retest reliability (ICC range 0.48-0.99). The NEWS-India demonstrated acceptable measurement properties among Indian adults and may be a useful tool for evaluation of built environment attributes in India. Further adaptation and evaluation in rural and suburban settings in India is essential to create a version that could be used throughout India.
authors.affiliation: Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University-Belfast, Belfast BT7 1NN, UK. d.adlakha@qub.ac.uk.
authors.forename: Deepti
authors.initials: D
authors.lastname: Adlakha
authors.affiliation: Department of Parks, Recreation, and Tourism Management and Center for Geospatial Analytics, College of Natural Resources, North Carolina State University, Raleigh, NC 27695, USA. jahipp@ncsu.edu.
authors.forename: J Aaron
authors.initials: JA
authors.lastname: Hipp
authors.affiliation: Prevention Research Center, Brown School, Division of Public Health Sciences and Siteman Cancer Center, School of Medicine, Washington University in St. Louis, St. Louis, MO 63130, USA. rbrownson@wustl.edu.
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002947:Cities; D003415:Crime; D017753:Ecosystem; D004779:Environment Design; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015203:Reproducibility of Results; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012449:Safety; D011795:Surveys and Questionnaires; D014186:Transportation; D016138:Walking / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: India; built environment; measurement; physical activity; walkability