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International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures
  1. Kelli L Cain1,2,
  2. Jo Salmon3,
  3. Terry L Conway1,2,
  4. Ester Cerin2,4,
  5. Erica Hinckson5,
  6. Josef Mitáš6,
  7. Jasper Schipperijn7,
  8. Lawrence D Frank8,9,
  9. Ranjit Mohan Anjana10,
  10. Anthony Barnett2,
  11. Jan Dygrýn6,
  12. Mohammed Zakiul Islam11,
  13. Javier Molina-García12,
  14. Mika Moran13,14,
  15. Wan Abdul Manan Wan Muda15,
  16. Adewale L Oyeyemi16,
  17. Rodrigo Reis17,18,
  18. Maria Paula Santos19,
  19. Tanja Schmidt7,
  20. Grant M Schofield5,
  21. Anna Timperio3,
  22. Delfien Van Dyck20,
  23. James F Sallis1,2
  1. 1Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
  2. 2Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
  3. 3Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
  4. 4School of Public Health, University of Hong Kong, Hong Kong
  5. 5School of Sport & Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
  6. 6Institute of Active Lifestyle, Palacky University Olomouc, Olomouc, Olomoucký, Czech Republic
  7. 7Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  8. 8Urban Design 4 Health, Seattle, Washington, USA
  9. 9Department of Urban Studies and Planning, University of California San Diego, La Jolla, California, USA
  10. 10Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
  11. 11Department of Architecture, Bangladesh University of Engineering and Technology, Dhaka, Dhaka District, Bangladesh
  12. 12AFIPS research group, Department of Musical, Visual and Corporal Expression Teaching, University of Valencia, Valencia, Spain
  13. 13Institute of Urban and Regional Development, University of California Berkeley, Berkeley, California, USA
  14. 14School of Public Health, University of Haifa, Haifa, Israel
  15. 15Khazanah Research Institute, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  16. 16Department of Physiotherapy, University of Maiduguri, Maiduguri, Borno, Nigeria
  17. 17Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri, USA
  18. 18Graduate Program in Urban Management, Pontifical Catholic University of Parana, Curitiba, Paraná, Brazil
  19. 19Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
  20. 20Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
  1. Correspondence to Kelli L Cain; kcain{at}health.ucsd.edu

Abstract

Introduction Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese).

Methods and analysis The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11–19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status.

Ethics and dissemination Ethical approval was received from each study site’s Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.

  • epidemiology
  • preventive medicine
  • public health
  • statistics & research methods
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Twitter @ehinckson

  • Contributors KLC contributed to IPEN Adolescent data collection protocols, coordinates the management of the pooled datasets at the international Coordinating Center, contributed to data collection in the USA, and drafted the manuscript. JS is a member of the IPEN Adolescent publications committee, contributed to data collection in Australia, and drafted the manuscript. TLC contributed to IPEN Adolescent study design, has oversight of data management at the international Coordinating Center, is a member of the IPEN Adolescent publications committee, contributed to data collection in the USA, and drafted the manuscript. EC contributed to IPEN Adolescent study design, has oversight of data analysis and data interpretation at the international Coordinating Center, is a member of the IPEN Adolescent publications committee, contributed to data collection in Hong Kong, and drafted the manuscript. EH contributed to IPEN Adolescent study design, leads the IPEN Adolescent publications committee, contributed to data collection in New Zealand, and drafted the manuscript. JM is a member of the IPEN Adolescent publications committee, contributed to data collection in the Czech Republic and drafted the manuscript. JS contributed to data collection in Denmark and drafted the manuscript. LDF is a member of the IPEN Adolescent publications committee, coordinated IPEN Adolescent GIS data collection, led development of the walkability and regional accessibility measures, contributed to data collection in the USA, and drafted the manuscript. AT contributed to data collection in Australia, reviewed the manuscript and provided feedback. MZI contributed to data collection in Bangladesh, reviewed the manuscript, and provided feedback. DVD is a member of the IPEN Adolescent publications committee, contributed to data collection in Belgium, reviewed the manuscript and provided feedback. RR is a member of the IPEN Adolescent publications committee, contributed to data collection in Brazil, reviewed the manuscript, and provided feedback. JD contributed to data collection in the Czech Republic, reviewed the manuscript, and provided feedback. TS contributed to data collection in Denmark, reviewed the manuscript, and provided feedback. AB contributed to data collection in Hong Kong, reviewed the manuscript and provided feedback. RMA contributed to data collection in India, reviewed the manuscript, and provided feedback. MM contributed to data collection in Israel, reviewed the manuscript and provided feedback. WAMWM contributed to data collection in Malaysia, reviewed the manuscript, and provided feedback. GMS contributed to data collection in New Zealand, reviewed the manuscript, and provided feedback. ALO contributed to data collection in Nigeria, reviewed the manuscript, and provided feedback. MPS contributed to data collection in Portugal, reviewed the manuscript, and provided feedback. JM-G contributed to data collection in Spain, reviewed the manuscript, and provided feedback. JS is the principal investigator of, and secured funding for, the IPEN Adolescent study, is a member of the IPEN Adolescent publications committee, directs the international Coordinating Center, participated in data collection in the USA, and drafted the manuscript. All authors approved the final version of this manuscript.

  • Funding Funding for the International Physical Activity and Environment Network Adolescent study was made possible by a grant from the National Institutes of Health (NIH) grant: R01 HL111378. Data collection in Belgium was supported partially by the Research Foundation Flanders (FWO) grant: FWO12/ASP/102. Data collection in Brazil was supported partially by the Brazilian National Council for Scientific and Technological Development grant: 306836/2011-4. Data collection in the Czech Republic was funded by the Czech Science Foundation grants: GA14-26896S and GA17-24378S. Data collection in Denmark was supported partially by the University of Southern Denmark. The Hong Kong study (iHealt(H) was supported by the Health and Medical Research Fund (Food and Health Bureau, Government of the Hong Kong SAR, PR of China) grant:10111501. Data collection in India (BE ACTIV India! study) was supported by an in-house grant from Madras Diabetes Research Foundation (MDRF), Chennai. The Israeli study was supported by a grant from the Israel Science Foundation – ISF grant: 916/12. Data collection in Malaysia was supported partially by a Universiti Sains Malaysia International Research Collaboration Grant. Data collection in New Zealand (BEANZ study) was funded by the Health Research Council (HRC) of New Zealand grant: HRC12/329. Data collection in Portugal was supported by the Portuguese Foundation for Science and Technology. Data collection in Spain was supported partially by Generalitat Valenciana, Spain grant: GV-2013-087. Data collection in the USA (TEAN) was supported by NIH grant: R01 HL083454. AT was supported by a Future Leader Fellowship from the National Health Foundation of Australia (grant: ID100046) during the conduct of this study. EC was supported by an Australian Research Council Future Fellowship grant: FT140100085. JS is supported by a Leadership Level 2 Fellowship, National Health and Medical Research Council Australia (APP 1176885).

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  • Competing interests JFS receives honoraria and royalties from Gopher Sport Inc for SPARK physical activity programs. LDF is president of Urban Design 4 Health.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.

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