An examination and application of methods for assessing the neighborhood environment and its association with physical activity behavior

Physical activity promotes physical and mental health and represents a leading health priority in the United States. However, only a small proportion of Americans engage in leisure-time physical activity or walk and bicycle for transportation. Increases in sedentary behaviors and escalating rates of obesity and its consequences create urgency for broad-based public health interventions to increase physical activity in the United States. Enhancing neighborhood environments to support walking and bicycling represents a promising approach to increase population rates of physical activity. Although mounting cross-sectional studies point to a relationship between physical activity and neighborhood environmental characteristics, relatively little research exists on the precise nature, importance, and measurement of these factors. This dissertation examines and applies different methods for measuring the neighborhood environment and its association with physical activity behavior.; To begin, this dissertation reviews public health and urban planning research methods and discusses ways these fields can collaborate to improve conceptual frameworks, behavioral and environmental measures, and study designs. Next, the development and inter-rater reliability testing of two neighborhood audit instruments (an "analytic" version for research purposes and a "checklist" version for public health practitioners and community members) are described. The results suggest that the audit instruments are well suited for capturing elements in the transportation and land use environments. The dissertation also presents results from a cross-sectional study conducted in four urban areas. This study examines the association between transportation- and recreational-based physical activity and perceived (derived from telephone survey) and objective (derived from neighborhood audits) environmental measures, including recreational facilities, land use patterns, transportation systems, aesthetics, and the social environment. The findings indicate that transportation and recreational physical activity behaviors are associated with different perceived and objective environmental characteristics. The dissertation concludes by discussing important research gaps and key policies to promote physical activity in the United States.