Active Transportation to School Among Canadian Youth: an Exploration of Correlates and Associated Injury
Gropp, Kathleen Mary
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Background: Active transportation refers to methods of travel that involve physical activity, such as walking and bicycling. For students, characteristics of both individual and contextual environments are likely associated with active transportation to school. Furthermore, injury is one possible but overlooked outcome of active transportation to school. Objectives: To examine among urban Canadian youth in grades 6-10: 1) associations between individual- and area-level factors and active transportation to school and 2) the relationship between active transportation to school and active transportation injury. Methods: Individual-level data were obtained from the 2009/2010 Canadian Health Behaviour in School-Aged Children (HBSC) survey. Active transportation to school was measured via student’s report of their usual method of travel to school. Active transportation injury was assessed via self-report for a one-year recall period. Area-level data were obtained from a school administrators’ survey and from various geographical sources. Multi-level logistic regression was used to examine the associations of interest. Results: Multiple correlates of active transportation to school were identified from the individual/family, school, and neighbourhood. Correlates possessing a potential for intervention and a relatively high population impact were identified: gender (female: relative risk, RR=0.86, 95% CI: 0.80-0.91, population attributable risk, PAR: 7.1%), perception of neighbourhood safety (disagree vs. strongly agree: RR=0.83, 95% CI: 0.70-0.95, PAR: 2.3%), percentage of roads with sidewalks (quartile 3 vs. quartile 1: RR=1.17, 95% CI: 0.96-1.34, PAR: 9.5%), and the total length of streets (quartile 4 vs. quartile 1: RR=1.23, 95% CI: 1.00-1.42, PAR: 6.9%). A positive association between active transportation to school and active transportation injury was identified; the risk for injury increased as walking or bicycling increased (short distance: OR=1.17, 95% CI: 0.92-1.50; long distance: OR=1.56, 95% CI: 1.10-2.21). Conclusions: Many factors are associated with active transportation to school. While active transportation is associated with the potential for improved health, it also likely increases the risk for active transportation injuries. Interventions to increase active transportation to school should also consider potential negative outcomes. Future studies in this research area could focus on qualitative measures of the environment and school programs, in addition to the etiology of injuries experienced during school travel.