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. 2022 Jun 15:10:929331.
doi: 10.3389/fpubh.2022.929331. eCollection 2022.

Physical Activity Impacts of an Activity-Friendly Community: A Natural Experiment Study Protocol

Xuemei Zhu  1   2 , Marcia G Ory  3   4 , Minjie Xu  2   5 , Samuel D Towne Jr  3   4   6   7   8 , Zhipeng Lu  1   2 , Tracy Hammond  9 , Huiyan Sang  10 , J Timothy Lightfoot  11 , E Lisako J McKyer  12 , Hanwool Lee  2   5 , Ledric D Sherman  11 , Chanam Lee  2   5
Affiliations

Physical Activity Impacts of an Activity-Friendly Community: A Natural Experiment Study Protocol

Xuemei Zhu et al. Front Public Health. .

Abstract

Background: Stakeholders from multiple sectors are increasingly aware of the critical need for identifying sustainable interventions that promote healthy lifestyle behaviors. Activity-friendly communities (AFCs) have been known to provide opportunities for engaging in physical activity (PA) across the life course, which is a key to healthy living and healthy aging.

Purpose: Our purpose is to describe the study protocol developed for a research project that examines: (a) the short- and long-term changes in total levels and spatial and temporal patterns of PA after individuals move from non-AFCs to an AFC; and (b) what built and natural environmental factors lead to changes in PA resulting from such a move, either directly or indirectly (e.g., by affecting psychosocial factors related to PA).

Methods: This protocol is for a longitudinal, case-comparison study utilizing a unique natural experiment opportunity in Austin, Texas, USA. Case participants were those adults who moved from non-AFCs to an AFC. Matching comparison participants were residents from similar non-AFCs who did not move during the study period. Recruitment venues included local businesses, social and print media, community events, and individual referrals. Objectively measured moderate-to-vigorous PA and associated spatial and temporal patterns served as the key outcomes of interest. Independent (e.g., physical environments), confounding (e.g., demographic factors), and mediating variables (e.g., psychosocial factors) were captured using a combination of objective (e.g., GIS, GPS, Tanita scale) and subjective measures (e.g., survey, travel diary). Statistical analyses will be conducted using multiple methods, including difference-in-differences models, repeated-measures linear mixed models, hierarchical marked space-time Poisson point pattern analysis, and hierarchical linear mixed models.

Conclusion: Natural experiment studies help investigate causal relationships between health and place. However, multiple challenges associated with participant recruitment, extensive and extended data collection activities, and unpredictable intervention schedules have discouraged many researchers from implementing such studies in community-based populations. This detailed study protocol will inform the execution of future studies to explore how AFCs impact population health across the life course.

Keywords: active living; activity-friendly community; healthy aging; healthy community; natural experiment; obesity; physical activity; study protocol.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Logic model for the Active Living Austin study.
Figure 2
Figure 2
Land use map and photos of the Mueller Community in Austin, Texas, USA. [Source of images: Catellus Development Corporation. Note: An older version of the land use map was published earlier in the journal of World Health Design (71)].
Figure 3
Figure 3
Data collection process of the Active Living Austin study.
See this image and copyright information in PMC

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