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How Environments Influence Children's Activities
Detail: Sandercock et al recently published a review synthesizing findings of studies which compare the physical activity (PA) levels of children living in different built environments classified according to land use within developed countries. The review compares PA in children from: rural, urban and where available suburban built environments. A second aim was to identify potential explanations for differences in PA with respect to this definition of built environment. The third aim was to critically evaluate the existing literature in order to guide future research.

A systematic review of published literature up to March 2009 was undertaken. Online searches of five databases yielded 18 studies which met inclusion criteria. Studies provided data on n = 129446, 518 years old (n = 117544 from the United States).

From 13 assessments of differences in physical activity between rural and urban children one showed that rural children were significantly more active than urban children. In studies where the built environment was sub-divided further, suburban and small town children showed the highest levels of physical activity, followed by rural, then urban children. Differences in types of physical activity undertaken were evident, showing that rural children spent more time outdoors, involved in unstructured play compared with urban children. These findings were mainly restricted to children < 13 years old.

The literature does not show major differences in the physical activity levels between children from rural or urban areas. The authors argue that such a finding may be an artifact of oversimplification while classifying the built environment into urban and rural. Where studied, the suburban built environment appears most conducive to promoting physical activity. Some authors have been transparent about grouping urban and suburban children together but others have not. Grouping the most active (suburban) children with the least active (urban) and comparing this heterogeneous group with those from rural areas should be avoided in future research.

Urban, suburban and rural built environments are also geographically heterogeneous between countries. For instance, walkability is likely to be lower in rural areas of the US than in Europe. This makes cross-study comparisons difficult and highlights the need for country-specific research.
There is clear association between sample size and the likelihood of significance. The effect sizes for most differences shown were small. It may be that many European studies lack the statistical power to detect the differences they aimed to explore. Finally, children's PA is difficult to measure. Most studies used self or parental report which is open to biases.

The authors recommend that further research should use at least a trilateral division of the built environment and should also account for socioeconomic status, racial factors and seasonal effects.
Source: Physical activity levels of children living in different built environments, Preventive Medicine, Volume 50, Issue 4, April 2010, Pages 193-198, Gavin Sandercock, Caroline Angus, Joanna Barton
Date: April 22 2010