Questions to ask before you research natural experiments in transit & physical activity

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Questions to ask before you research natural experiments in transit & physical activity Illustrations from the Moving Across Places Study (MAPS) Barbara B. Brown ( & MAPS team: Werner, Miller, Smith, et al.) Funding: Research reported in this publication was supported (in part) by grant number CA157509 from the National Cancer Institute at the National Institutes of Health and the Robert Wood Johnson Foundation. 1

Overview Quick description of the Moving Across Places Study (MAPS) in Salt Lake City, Utah Then transportationrelated questions you might want to ask Then tips from the field 2

Does a Complete Street intervention support increased physical activity? Before After (same place) No TRAX light rail No bike lane Narrow sidewalk 3 lanes, each direction No pedestrian lighting Overhead power lines TRAX light rail Bike lane Wide sidewalk 2 lanes, each direction Landscaping Pedestrian lights No overhead power lines 3

MAPS panel has 536 adults in the North Temple complete street corridor To compare Near: exposed to intervention Far: adjacent controls At 2 times Time 1 = Prestreet completion Time 2 = Post street completion Map by GeoStats 4

Activity & travel measures: GPS (GlobalSat DG- 100 data logger) & accelerometry (Actigraph GT3x+) Wearable GPS GPS tracks physical activity locations, especially for travel outdoors where GPS signals reach Accelerometer measures physical activity intensity Activity Monitor 5

More PA over time for those who begin transit use; less PA for stopping transit (Brown, et al., AJPH, 2015) 2013-2012 accelerometer counts per minute (all wear time) 75 50 25 0-25 n= 393 n=51 n=41 n=52 11.97-14.13 * 47.81 ** -50-75 -43.12 **p<.01 Never = control group; contrasts significant, controlling for Age, female, Hispanic, college grad, married, self-reported health, days between measures, temperature differences **

Do you need accelerometer measures? NHANES self-reported vs. accelerometermeasured PA attainment (Troiano, 08 MSSE) 60 % meet 150 min. 50 40 30 20 10 0 Self-report Accelerometer 7

Do you need GPS measures? If knowing outdoor locations is important Example (Miller, 2015, H&P): Is more PA in transit neighborhoods due to transit use? Or walking to shops near transit? GPS data can tie activities to places or routes Ideal for new infrastructure evaluation 8

Can you do this in-house? GPS & accelerometry data flood in! 3-second readings for GPS; 10-second epochs accelerometers We chose GeoStats (Westat) to take advantage of their experience Data integration and mode designation takes time No mid-course corrections possible between Time 1 & 2 9

Will your target intervention increase PA? Get to know your possible sites We vetoed some prospective rail stops With big park & ride lots Or fenced off transit stations You will spend lots of time on your project Find a site that you believe translates your research goals well 10

How do you select Near vs. Far areas? (AKA exposed/not exposed; experimental/control ) We had 3 active modes to consider Walk to TRAX light rail Walk for non-transit Bicycling We defined Near/Far for walks to light rail, likely to be most popular Several suggested ½ mile distance ( 800M; O Sullivan, 1996) Some suggested 1km (1000M; Canepa,2007) 11

We chose <1km = Near, which provided similar Near/Far samples Near & Far not different on: Gender Age Hispanic ethnicity Education (coll. grad) Nears were: Lower income Less likely to be married Less likely to be white Less likely employed Education (h.s. grad) Renter/owner Years residence Children in home Household size Student status 12

But even Nears show lots of variability in transit stop access due to layout of area 13

How much variation is there in walk distances to transit across one line? A lot! Calgary walk distances vary 2-fold across stops (O Sullivan & Morrall, 1996) Reflects sparser transit stop spacing on periphery 14

How much variation in walk to rail globally? 326m to 1000m+ Perth Portland & S.F. 933 1000 Sydney 805 Montreal 564 Calgary 326 0 500 1000 1500 Meters Distance Mean or Md 15

So your choice of Near/Far boundary matters If Far set too distant, Near effect could dissipates If Far set too close, Near effect may seep into control area You define Far to plan your sampling but expect to test multiple distances 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 Proportion walk to rail 1 2 3 4 5 6 7 8 9 10 Distance to rail (100ms) Proportion walk to rail Far Far 1 2 3 4 5 6 7 8 9 10 Distance to rail (100ms) 16

Distance effects vary across types of active transport What were distance effects for walks to transit? Peak within about 300m Prop. w. transit walks in area.70.60.50.40.30.20.10.00 Pre Post 1 2 3 4 5 6 7 8 9 1011121314151617181920 Distance from complete street (100ms) 17

What were distance effects for non-transit walks? Non-transit walking falls off less sharply Prop. w. non-transit walks in area.90.80.70.60.50.40.30.20.10.00 Non-transit walkers by distance of complete street from home (in 100 meters) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Pre Post Distance from complete street (100ms) 18

Are Near effects a slam-dunk in prepost- walking path studies? No Only 3 of 52 path studies reviewed had pre- and post-data (Starnes, 2011) And no increase for Near pedestrians in intervention studies (Evenson et al., 2005; Brownson et al., 2004; Merom et al., 2001) But proximity to trails was correlated with more use (4 studies) We need to tease out correlational vs. longitudinal findings 19

What special challenges exist for research on new bike lanes? U.S. biking is rare & sporadic Only 0.6% of commuters bike to work (2008-2012 American Community Survey, McKenzie, 2014) Biking is often not stable over time Only 13% of cyclists biked in past week (Schroeder & Wilbur, 2013) Few studies find hoped for Near effects (Burbidge & Goulias, 2009; Evenson et al., 2005) Although riders Near a new Sydney path were more likely to use it, they did not increase their biking (Rissel et al., 2015) 20

What were distance effects for cycling? We did not even state a biking Aim Good thing! This is what we found in our exploratory tests Proportion biking in path area.18.16.14.12.10.08.06.04.02.00 Biking complete street by home distance (in 100 meters) Pre Post 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Distance to new bike lane (100ms) No strong pattern of proximity to new bike lane and biking 21

Solution? What other ways can you study biking? Sample only cyclists (Sydney; Merom, et al., 2003) Near cyclists (<1.5km) reported.24 hr/wk more biking Far (>1.5km) cyclists reported.24 hr less Screen for bike owners (Portland, Dill et al., 2014) Yielded 40% biking in a week (but no increase among Near cyclists) 22

What other ways to study biking? Study biking abroad where it is common 8/10 studies showing effects for adult cycling & health/weight were from Europe or China (Oja et al., 2011) Observe cyclists on new bike paths Increased cyclists counted on improved/better connected bike paths, compared to other sites (CA: Cohen, 2008) Limitation: Is this new biking? Or relocated biking? 23

Tips from the field: Intervention timing/control problems are rampant! Surprise interventions you don t hear about them til too late We were lucky to hear of a new stop over lunch (Brown & Werner, 2007, 2008, 2009) Alert your network of your interests Stalled interventions Ex: Busway construction 2-yr delay (Ogilvie, BMCPH, 2010) Can you test in staged phases? 24

Earlier than expected interventions Plan A, MAPS, rail start date a guess Time 1, 2012 Rail starts 9/2013 Avoid Winter data Time 2, Spring 2014 Reality: Time 2 follow-up moved up Time 1, 2012 Rail starts 4/2013 Time 2, Spring 2013 Choose your risks Avoid Winter data Little exposure time to intervention (Goodman, et al. AJPH, 2014) Or risk participants moving away 25

Incomplete interventions You hire the staff & train the students, then Interventions are cut back e.g., fewer street improvements than promised to encourage older person s PA (Ward-Thompson, 2014) 26

Other tips Door-to-door recruitment issues A letter from the police chief helped Locked condos/apartments require extra recruitment time Snack table outreach in some Denied access in another 27

Good resources Moudon, Saelens et al. A report on participant sampling and recruitment for travel and physical activity data collection. ntl.bts.gov/lib/31000/31700/31738/vernezmoudon_effectoflight_rail.p df Oakes JM, et al. Recruiting participants for neighborhood effects research: strategies and outcomes of the Twin Cities walking study. Environment & Behavior 2009;41(6):787-805 28

References Brown BB, Werner CM. A new rail stop: Tracking moderate physical activity bouts and ridership. Am. J. Prev. Med. 2007;33(4):306-309. Brown BB, Werner CM. Using accelerometer feedback to identify walking destinations, activity overestimates, and stealth exercise in obese and nonobese individuals. Journal of Physical Activity & Health. 2008;5:882-893. Brown BB, Werner CM. Before and after a new light rail stop: Resident attitudes, travel behavior, and obesity. J. Am. Plann. Assoc. 2009;75(1):5-12. Brown BB, Werner CM, Tribby CP, Miller HJ, Smith KR. Transit use, physical activity, and body mass index changes: Objective measures associated with complete street light-rail construction. Am. J. Public Health. 2015;105(7):1468-1474. Brownson RC, Baker EA, Boyd RL, et al. A community-based approach to promoting walking in rural areas. Am. J. Prev. Med. 2004;27(1):28-34. Burbidge SK, Goulias KG. Evaluating the impact of neighborhood trail development on active travel behavior and overall physical activity of suburban residents. Transportation Research Record. 2009;2135:78-86. Canepa B. Bursting the bubble: Determining the transit-oriented development's walkable limits. Transportation Research Record: Journal of the Transportation Research Board. 2007;1992:28-34. Cohen D, Sehgal A, Williamson S, et al. Impact of a new bicycle path on physical activity. Prev. Med. 2008;46(1):80-81. Dill J, McNeil N, Broach J, Ma L. Bicycle boulevards and changes in physical activity and active transportation: Findings from a natural experiment. Prev. Med. 2014;69(S):S74-S78. Evenson KR, Herring AH, Huston SL. Evaluating change in physical activity with the building of a multi-use trail. Am. J. Prev. Med. 2005;28(2, Supplement 2):177-185. Oja P, Titze S, Bauman A, et al. Health benefits of cycling: A systematic review. Scand. J. Med. Sci. Sports. 2011;21(4):496-509. O'Sullivan S, Morrall J. Walking distances to and from light rail transit stations. Transportation Research Record. 1996;1538:19-26. Ogilvie D, Griffin S, Jones A, et al. Commuting and health in Cambridge: A study of a 'natural experiment' in the provision of new transport infrastructure. BMC Public Health. 2010;10. Rissel C, Greaves S, Wen L, Crane M, Standen C. Use of and short-term impacts of new cycling infrastructure in inner-sydney, Australia: a quasi-experimental design. International Journal of Behavioral Nutrition and Physical Activity. 2015;12(1):129. Schroeder P, Wilbur M. 2012 National Survey of Bicyclist and Pedestrian Attitudes and Behavior. Volume 2: Findings Report. 2013. Starnes HA, Troped PJ, Klenosky DB, Doehring AM. Trails and physical activity: A review. Journal of Physical Activity and Health. 2011;8(8):1160-1174. Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med. Sci. Sports Exerc. 2008;40(1):181-188. Ward Thompson C. A longitudinal study of shared space street improvements and older people s activity and quality of life. International Congress of Applied Psychology; July 9, 2014, 2014; Paris. 29