active travel to school literature review

Active travel to school: literature review Dr Jan Garrard July 2011 Contents Executive summary _ Introduction _ Physical activity, active transport and children’s health Health risks associated with active transport to school _ Active travel to and from school in Australia and the ACT _ Effectiveness of interventions aimed at increasing children’s rates of active travel to school Future directions/innovations for promoting active travel for children in Australia and the ACT Conclusions Active travel to school: literature review _ 11 Introduction _ 11 Physical activity, active transport and children’s health 13 2.1 Health benefits of physical activity and active transport 15 2.1.1 Physical health 15 2.1.2 Mental health 18 2.1.3 Intelligence quotient and educational attainment _ 18 2.1.4 Demographic distribution of active transport _ 19 2.2 Health benefits of reduced car use _ 20 2.2.1 Air quality _ 20 2.2.2 Noise pollution _ 20 2.2.3 Climate change _ 21 2.2.4 Community liveability 21 2.2.5 Children’s independent mobility _ 22 2.2.6 Traffic congestion _ 23 Health risks associated with active transport to school 25 3.1 Traffic injuries 25 3.2 Exposure to air pollutants 26 Rates of active travel to school in Australia and the ACT _ 27 4.1 Active travel to school in Australia and internationally _ 27 4.2 Active travel to school in the ACT 28 4.2.1 Children’s overall physical activity levels _ 28 4.2.2 Children’s participation in active transport _ 29 Potential for mode shift to active travel to school: the role of trip distance 29 Effectiveness of interventions aimed at increasing children’s rates of active travel to school _ 32 6.1 Evidence reviews _ 32 6.2 Recent evaluations of active school travel interventions 33 6.2.1 Australia _ 33 6.2.2 International AST programs _ 36 6.3 Summary of the impacts of active transport initiatives in schools 36 6.4 Aggregate level change 37 Understanding the influences on active travel to school _ 38 7.1 Social-ecological model of active school travel 38 7.2 Perceived benefits/barriers model of active school travel _ 40 Future directions/innovations for promoting active travel for children in Australia and the ACT 42 Conclusions _ 45 References _ 46 List of acronyms and abbreviations ABS Australian Bureau of Statistics AT Active transport LTPA Leisure-time physical activity MET Metabolic equivalent of task ACT Australian Capital Territory MVPA Moderate to vigorous physical activity WSB Walking school bus Executive summary Introduction Physically active children are healthier, happier and more socially connected than children who have more sedentary lifestyles, yet many Australian children not meet recommended levels of physical activity ‘Incidental’ exercise, including active transport, can substantially contribute to overall levels of physical activity yet it has declined markedly in recent decades Current levels among children and young people in Australia (and the ACT) are now less than half the 1970 levels The current focus on ‘active living’ has led to a growing recognition of the potential for incidental forms of physical activity Active transport provides an activity that is continuous, expends sufficient energy, can be performed by most children, does not appear to displace other forms of physical activity and is not principally performed by children who are already active Increasing children’s active travel is likely to result in net gains in the overall levels of physical activity, and in the proportion of children achieving the recommended levels of physical activity A number of high-income countries and cities have successfully reversed the trend of steadily increasing car travel by children and young people, while a range of Australian government policies and programs at federal, state, territory and local levels to increase active travel for children and adults have been developed and implemented Evaluation of these initiatives in Australia and overseas indicates variable effectiveness, and highlights the learning curve required to achieve the high levels of active travel among children in several European and Asian countries and cities To assist the evaluation process, this report provides an evidence-based summary of:     The relationships between physical activity, active transport and children’s health Rates of active travel to and from school in Australia and the ACT The effectiveness of interventions aimed at increasing children’s rates of active travel to school Future directions for promoting active travel for children in Australia and the ACT Physical activity, active transport and children’s health The child health benefits of moderate-to-vigorous physical activity (MVPA), including active transport, encompass physical, mental and social health in the form of:  Healthy child development (bone, muscle, joint health): Moderate to vigorous weight-bearing physical activity during childhood is essential for optimal skeletal, joint and muscle growth While no studies were found that focused specifically on active transport, walking is a weight-bearing form of physical activity with cycling less so (depending on cycling style and the terrain covered)     Aerobic fitness: Cycling and walking to school improves cardiovascular fitness among young people, particularly girls Healthy weight: Indirect evidence points to a relationship between active transport and overweight/obese children, but the available evidence is not definitive Evidence indicates that the contribution of active transport to maintaining healthy weight depends on walking or cycling trip distances Mental health: There is evidence of an inverse association between physical activity and some measures of child mental health, but there appear to be no studies of active transport and mental health Intelligence quotient and educational attainment: There is consistent evidence of a significant positive relationship between physical activity and cognitive function, and more recently between aerobic power, intelligence quotient (IQ) and educational attainment Studies were not specifically of active transport The co-benefits of active transport not associated with leisure-time physical activity (LTPA) include:  More equitable distribution of physical activity across some key population demographic segments Adolescents, particularly females, are more likely to meet physical activity guidelines if they travel actively to school  A range of physical, psychological and social health benefits associated with reduced motor vehicle use (due to replacing car trips with active trips) These include reduced air and noise pollution, and reduced traffic injuries  Improvements in community liveability, traffic congestion, environmental sustainability, climate-change abatement and reduced dependency on nonrenewable energy sources that impact on all community members, including children Health risks associated with active transport to school The health risks associated with active transport are (i) the risk of traffic injury, (ii) exposure to air pollutants and (iii) risk of injury (in common with other forms of physical activity such as sport and play) Pedestrian and cyclist injuries are often compared with risk of injury as a car passenger as they are alternative forms of transport Absolute levels of risk of child pedestrian and cyclist fatalities in Australia are low,1 although child pedestrians and cyclists have a greater risk of injury than car passengers per unit of exposure (ie distance or time travelled) Child pedestrian and cyclist fatality rates (per km travelled) in OECD countries with high rates of walking and cycling are about one-quarter of the rates in countries with low rates of these activities (such as Australia) This data indicates the considerable potential to improve child pedestrian and cyclist safety in Australia Child pedestrian fatalities 0.86 per 100,000 child population; and child cyclist fatalities 0.39 per 100,000 child population Modelling studies show that if a substantial share of trips by motorised transport is transferred to walking or cycling, the total number of road traffic crashes (including multivehicle and single-vehicle car crashes, as well as pedestrian-car and cyclist-car crashes) is reduced More commonly, rates of pedestrian, cyclist and overall road traffic injuries are observed to decline as active travel mode share increases While risk-benefit analyses demonstrate the health benefits of cycling for adults outweigh the risks, no comparable studies for children or for walking were found Active travel to and from school in Australia and the ACT In contrast to several European and Asian countries, children’s rates of active travel to school and other destinations in Australia and the ACT are low and declining In the ACT in 1970, more students travelled to school or university by bicycle (13.1%) or walking (46.8%) than by car (12.1%)2 (Australian Bureau of Statistics 1975) By 1997, only 29.7% of students walked (22.2%) or cycled (7.5%) to full-time education (Brown and Nairn 1997) The decline over time, and current rates of active travel to school, are similar to those in Victoria (27% of students aged 5-12 years), although higher than in the Greater Sydney Metropolitan Area (22% of primary school students) (Garrard 2010) In 2006, 30.5% of Year students in the ACT3 walked or cycled to school4 (Population Health Research Centre ACT Health 2007) Care needs to taken in comparing this rate of active travel to school with the 1997 figure (29.7%) due to differences in the study population and the measure of active transport Preliminary analysis of 2009 data indicates a statistically significant decline between 2006 and 2009 (30.5% and 24.3% respectively) in the proportion of Year students walking or cycling to school every day (ACT Health, preliminary analysis of 2009 ACTPANS data) Cross-country comparative data show large differences in active travel to school which are not accounted for by greater trip distances to school in countries with low rates of active travel In many high active travel countries, children walk and cycle to school for trip distances that are predominantly made by car in countries such as Australia There is also greater international variation in cycling rates than in walking rates which may account for a large part of the international variations in overall rates of active transport In countries such as Australia, car trips largely replace walking trips for distances greater than km, while bicycle trips are more common than car trips for distances up to about km in high active transport countries Full-time students aged years and over These data are for grade students only, but levels of active travel among young people in Australia show little variation between grades and (ref) Five times in a typical week For example, 86% in the Netherlands, 71% in Denmark, 71% in Germany compared with 13% in the USA, 15% in Canada and 48% in the UK Active school travel programs in Australia have also been more successful in increasing walking rather than cycling to school This trend indicates that cycling to school will require additional attention if Australia is to move towards the high rates of active travel to school for short to medium distance trips that occur in several affluent European and Asian countries Effectiveness of interventions aimed at increasing children’s rates of active travel to school Active school travel programs typically include some combination of:  Special walking or cycling promotion days  A program of pedestrian and cycle training for children  Secure bicycle parking  Activities as part of the curriculum to promote the benefits of sustainable transport  Physical changes to the streets around the school, such as 40 km/h limits, traffic calming, pedestrian crossings and bicycle lanes  Developing a school travel policy and/or home-school agreement Recent evidence reviews indicate that not all programs achieve small-to-moderate increases in rates of active travel to school There has been little systematic assessment of the reasons for variable program impacts although, based on limited process evaluation data to date, the determinants of success are likely to include factors associated with schools and their social, cultural and built environments, program type and quality of implementation Active travel programs are often successful in participating schools, although there is little evidence of an overall mode shift to active travel to school in countries with low rates of active travel Future directions/innovations for promoting active travel for children in Australia and the ACT The evidence reviewed in this report indicates that in several countries and regions (England, Scotland, Victoria, NSW and the ACT), population levels of active travel to school have not changed despite programs with impressive impacts in some participating schools and for special events (eg walk/ride to school days and the Brisbane City Council Active School Travel program) It is therefore evident that carefully planned and well-implemented behaviour change programs are a necessary but not sufficient condition for population-level change in school travel modes Strategic planning and a systems approach are required to move towards the levels of active travel to school enjoyed by a number of other high-income countries Denmark, Germany, the Netherlands and Japan provide models of implementing broad-based policy packages that make active travel to school a convenient, safe travel mode Effective active transport policy models are not restricted to the high active travel countries in Europe and Asia Relatively high rates of active travel to school have been achieved in a small number of towns and cities in the USA The greatest potential for increasing rates of active travel to school lies in encouraging more young people to walk up to about km and to cycle up to about km With the right conditions, policies, education and encouragement, more children would walk or cycle to school and to other neighbourhood destinations Strategies to increase active travel to school, which incorporate school-based programs with area-wide and population-wide strategies for increasing active travel in the wider community, could include the following elements:      Setting goals and targets (eg an increase of percentage points in the walking and cycling mode share of travel to education in a 5-year period6,7) Specifying components of the strategy (eg incorporating the 4Es of Education, Encouragement, Engineering, and Enforcement) Well-defined ‘program logic’ (ie Are we doing the right things? Is the intervention ‘dose’ appropriate? Is the program reach adequate?) Identify partners, responsibilities and resources (eg who is responsible for each component?) Evaluation/monitoring (eg including measures of travel to school in school data collection systems) The key health promotion strategies of community participation, advocacy and intersectoral partnerships will also be important in achieving these goals Many government sectors and levels have a role in increasing children’s use of healthy and sustainable transport modes for the many short-to-medium trips that typify children’s travel in urban areas Conclusions This report demonstrates that increasing levels of car use are the predictable outcome of transportation policies that promote car use and constrain walking and cycling, and not the inevitable by-product of low-density suburban living in affluent countries Changes can be achieved through programs such as Safe Routes to School, Walking School Bus, School Travel Planning and Walk/Ride to School events These initiatives need to be complemented by area-wide improvements that create supportive environments for active travel The experiences of overseas countries, cities and municipalities provide a model for sustainable transport planning aimed at increasing active travel to school in the ACT This is approximately the rate at which walking and cycling to education have declined in the last 40 years in Victoria The recent White House Task Force on Childhood Obesity Report to the President (Solving the problem of childhood obesity) set a target of an increase in bike/walk trips to school in the USA of 6.5 percentage points by 2015 While implementing and assessing active travel initiatives in participating schools is important, key questions to consider include (i) the program and contextual factors that shape the effectiveness of interventions; (ii) the sustainability of change; (iii) the reach of active travel initiatives; and (iv) the role of supportive community-wide measures Public health strategies in areas such as tobacco control, road safety and child immunisation are successful because they achieved measurable improvements at the population level and not just in selected schools or communities Consequently, the well-documented benefits of active travel will be realised when measurable change occurs at the population level 10 limited process/implementation evaluation data to date, the determinants of success are likely to include factors associated with schools and their social, cultural and built environments, program type and quality of program implementation Evaluation designs and methods also impact on evaluation findings Programs have generally been more successful in increasing walking than cycling in countries such as Australia, the UK and the USA This discrepancy needs to be addressed to reduce car use and increase active transport for the considerable number of trip distances to school greater than km 6.4 Aggregate level change Active school travel programs often lead to increased levels of active travel to school in participating program schools, but there is little evidence of an overall mode shift to active travel in countries like Australia with low rates of active travel A recent analysis of school travel data found few statistically significant changes in young people’s modes of travel to and from school in Victoria between 2006 and 2009, and in the greater Sydney Metropolitan area between 2005 and 2008 (Garrard 2010) Similar findings of increased cycling in program schools, but little community-wide increase, have been reported for Cycling England’s ‘Cycling Demonstration Towns’ project Pooled data from Hands Up surveys (conducted in 2006-07 and 2007-08) of students in Bike It schools, which received the intensive support of a ‘Bike It’ officer, showed an increase in the proportion of students cycling to school every day or ‘once or twice a week’ of 20.4% (from 8.7% to 29.1%) School census data (all schools, students up to 15 years old, 2006-07 to 2007-08) reported an increase of 0.1% (1.5% to 1.6%) in the number of students for whom cycling is the usual mode of travel to school (Sloman et al 2009) Similar findings have been reported in Scotland A survey in September 2009 of about 415,000 children (approximately 59% of all pupils in Scotland), conducted by ‘Hands-Up!’ Scotland in partnership with Sustrans and local authority School Travel Coordinators, found a 1.3% drop in the number of children walking to school and a 0.5% decrease in the number of children cycling on the same journey However, the number of children who travelled to school by car increased by just over one percent These aggregate data disguise improvements in some localities, and 13 of the 31 local authorities that took part in the survey reported an increase in some modes of active travel In contrast to Australia, England and Scotland, high area-level rates of active travel to school have been achieved in countries such as Denmark and the Netherlands Analysis of school travel mode by trip distance demonstrates that these differences in school travel mode are not primarily due to greater travel distances in Australia and the UK (see Section 5) These findings suggest that achieving the multiple and substantial benefits of active travel at the population level requires implementing behaviour change programs with demonstrated 37 efficacy with commitment and wide program reach, which is supported by environmental and policy changes that help to make active travel choices easy choices Understanding the influences on active travel to school The factors that influence children’s modes of travel to school are complex, but some useful models have been developed that aid understanding and guide practice Two models are described: (i) a social-ecological model of active transport derived from models of children’s physical activity behaviour; and (ii) a perceived benefits/barriers model derived from the community-based social marketing (CBSM) approach for fostering sustainable behaviour (McKenzie-Mohr and Smith 1999) 7.1 Social-ecological model of active school travel The social-ecological model shown in Figure provides a framework for summarising the multi-faceted influences on children’s school travel behaviour While the model appears relatively straightforward, in reality the factors are complex For example, many of the environmental influences on active travel have both a perceptual and an objective element (eg ’too far to walk/cycle‘) The multiple intra-individual factors (eg knowledge, beliefs, attitudes and preferences) apply to both young people and parents, as both are involved in the choice of school travel modes As in all ecological models of behaviour, component factors are mutually interactive For example, the built environment both shapes and is shaped by the social/cultural environment Physical environment (natural and built) Intra-individual factors Social/cultural environment Travel behaviour Policy/regulatory environment Figure 8: Influences on children’s active travel behaviour (Adapted from Gebel et al 2005) It is well established that most children prefer to walk or cycle to school yet parental preferences often over-ride those of children (Garrard et al 2009) The main reasons 38 children give for preferring to walk or cycle to school are enjoyment, health and exercise, socialising with friends and quick travel time The main reasons for parents preferring to drive their children to school centre on the convenience, speed, comfort and safety of car travel (Garrard et al 2009) These issues have both a ‘perceptual’ and ‘actual’ element, and are strongly influenced by social/cultural values and behavioural norms For example, ‘too far to walk/cycle’ varies between countries and within Australia over time Concerns about traffic and child safety (as reflected in the levels of independent mobility that parents permit their children) also vary between countries and over time in Australia Traffic safety has improved over time in Australia, and there appears to be no evidence of an increase over time in abduction, robbery, assault and homicide committed against children by strangers in Australia (Zubrick et al 2010) Research in the field of risk assessment/communication can assist in understanding, and perhaps addressing, the perceived risks of children’s independent travel Risk perceptions are often based on emotional responses to situations rather than rational analyses (Slovic et al 2004) In turn, emotional responses are shaped by a range of psychological and social processes Risk perception research has identified a number of ‘biases’ that contribute to misjudging of risk in general (Slovic et al 2004), and may foster inordinate parental ‘fear of independent mobility among children’ In particular, familiarity bias and control bias may reduce the perceived risks associated with car travel and increase the perceived risks for active transport For example, familiarity bias can arise in low-cycling countries because driving is a familiar activity but cycling for transport is relatively unusual We adjust to the everyday risks of driving, but are relatively more fearful of the ‘unknowns’ of cycling for transport Control bias arises when cyclists and motor vehicles share road space forcing parents to largely surrender control for the safety of their children to the children themselves and to unknown car drivers Although little research has been conducted, ‘trust in others’ might be an important determinant of children’s independent mobility (Garrard 2009; Zubrick et al 2010) The Netherlands in the 1970s, the risks posed by motor vehicles to child cyclists and pedestrians were a major factor for the introduction of traffic safety measures that prioritised cyclist and pedestrian safety over motor vehicle mobility Examples include 30 km/hr speed limits in most urban areas, and the legal responsibility of car drivers to avoid collisions with cyclists The Dutch approach is: “Cyclists are not dangerous; car drivers are: so car drivers should take the responsibility for avoiding collisions with cyclists” (Ministry of Transport Public Works and Water Management 2009) These measures have contributed to a cycling environment that both is, and is perceived to be, safe and pleasant, and where parents feel comfortable allowing their children to move 39 about independently In the Netherlands, measures are taken to increase the perceived safety and desirability of cycling, as well as the actual safety and convenience In contrast, motor vehicle mobility is prioritised in Australia where the road environment feels (and to some extent is) unsafe for walking and cycling Parents have responded by driving their children for increasingly short distances that are feasible to walk or cycle Another constraint on active travel to school is the trend in car-oriented countries to effectively blame parents for permitting their children to participate in ‘risk-taking behaviour’, such as travelling independently to school, should the child be injured in a collision with a car (Jacobsen et al 2009; Skenazy 2009) Concerns about social blame and personal guilt are less of a constraint in high active travel countries because (a) the responsibility for avoiding collisions with child pedestrians and cyclists clearly rests with car drivers (and collisions are less likely to occur); and (b) independent travel to school is not deemed to be ‘risk-taking behaviour’ when ‘everybody does it’ Similarly, travelling long distances with children in cars (which contributes to Australia having a relatively high rate of child road traffic fatalities per 100,000 children – see Section 3.1) is not viewed as ‘risk-taking behaviour’ in Australia (provided they are appropriately seated), partly because it is common practice The natural and built environments and policy/regulatory environments (see Figure 8) also influence children’s travel behaviour both directly and interactively via social, cultural and individual factors More detailed reviews of these influences on children’s active travel can be found in Garrard (2009), Pont et al (2009) and Davison et al (2008) 7.2 Perceived benefits/barriers model of active school travel The community-based social marketing (CBSM) approach developed by McKenzie-Mohr and Smith (1999) involves fostering voluntary behaviour change by identifying and addressing the perceived benefits and barriers to the targeted behaviour (active travel to school) and the competing behaviour (driving to school).This frequently involves assisting people to the things are they already predisposed to do, but are constrained by barriers to action For example, about two-thirds of parents of grades 4-6 students in 13 primary schools in Victoria stated that regular walking or cycling to school was a possibility for their child, but less than half of students’ trips were by walking and cycling (Garrard et al 2009) The aim of the CBSM approach is to turn the possibility into reality by addressing the real and perceived barriers to action These barriers (figure 8) can be personal, environmental, social/cultural or policy/regulatory which can all impact on active travel behaviour The CBSM approach also highlights the importance of recognising that travel mode choices involve choosing between multiple transportation options (principally driving, walking or cycling), which have their own set of perceived and actual benefits and barriers This distinguishes promoting active travel to school for children and adolescents from other 40 forms of physical activity promotion Active travel to school is a travel choice as well as a physical activity choice that involves both parents and children Key elements of the CBSM model include using a range of research and consultation processes with program stakeholders and target groups to identify the perceived benefits and barriers to the ‘new behaviour’ (active travel to school) and the ‘alternative behaviour’ (car travel to school) This information contributes to the development of strategies aimed at increasing the perceived benefits and reducing the perceived barriers of active travel to school, while simultaneously reducing the perceived benefits of car travel and increasing the perceived barriers to car travel Identification of benefits and barriers should be based on evidence from the research and evaluation literature, and from qualitative and quantitative research conducted with the program’s target group(s) Similarly, choice of strategies is both evidence-based and locally adapted Table illustrates the benefit/barrier matrix with examples of possible perceived benefits and barriers for active and inactive travel to school Table 4: Perceived benefits and barriers of active and inactive modes of travel to school Target behaviour (active travel to school) Competing behaviour (travelling to school by car) Perceived benefits Improves health Saves time Perceived barriers Poor access to direct, safe walking/cycling routes Difficult to park car at school The CBSM model stresses the pattern of perceived benefits and barriers will differ for population subgroups, and for different active travel modes For example, boys may have different perceived benefits and barriers from girls, the benefits and barriers are likely to differ for parents in paid employment compared with those who are not while walking to school might have different barriers to cycling These differences require a degree of strategic ‘market segmentation’ The CBSM model also recommends addressing individual component ‘steps’ in the desired overall behaviour Parents in 13 primary schools in Victoria identified getting up earlier, being more organised and planning for walking or cycling to school as steps in the process of changing from car travel to active travel Cycling to school also requires preparation in terms of bicycle maintenance and appropriate school clothes and bags Other steps might include organising to travel with a school friend, familiarity with a safe route to school, ensuring students have the road skills to walk or cycle and establishing an informal network of adult neighbours or friends to share accompanying children on the trip to school Deciding which behaviours to promote by what means depends on the potential to bring about the desired 41 change and to what extent resources are available to overcome identified barriers and enhance perceived benefits (McKenzie-Mohr and Smith 1999) The promotion of active travel to school also includes reducing the perceived benefits and increasing the barriers to car travel Reduced speed limits in school zones, car parking restrictions near schools and giving pedestrians and cyclists priority are examples of increasing barriers to car travel used successfully overseas (Pucher and Buehler 2008) There is also potential to change drivers’ perceptions of the speed and cost of car travel, as research demonstrates that people consistently underestimate the cost and overestimate the speed of car travel (Tranter 2004; Vanderbilt 2008; Litman and Doherty 2009) Future directions/innovations for promoting active travel for children in Australia and the ACT The multiple health and social benefits of active travel for children have led many countries, cities and communities to implement policies and programs aimed at increasing children’s rates of active transport to school and other neighbourhood destinations Two broad areas of evidence can be used to inform active transport interventions: (a) program evaluation findings (eg evaluation of TravelSmart-type programs in community or school settings); and (b) policy evaluation (eg monitoring changes in transport mode share in regions, cities, towns or communities that have implemented an integrated package of measures aimed at increasing active travel and decreasing car use) Program evaluation can provide information about what is effective in existing programs Policy evaluation provides guidance for establishing an ‘active transport place’30where children walk or cycle to school because active transport is established as a convenient, fast and safe mode of transport for the whole community Macro-level policy evaluation is less precise than program evaluation in terms of quantifying the impacts of specific components of a multi-component strategy, but it provides a better assessment of the reach, effectiveness and sustainability of holistic efforts to achieve change at the societal level A review by Pucher et al (2010) of the effectiveness of interventions to increase cycling incorporated both program evaluation findings (eg infrastructure measures, social marketing programs) and policy evaluation findings (eg what packages of measures have been implemented in cities and towns that have increased bicycle mode share of travel?) The authors stated it is difficult to isolate the separate impacts of individual interventions designed to promote cycling as they are expected to be interactive and synergistic For example, marketing programs are likely to be influenced by the extent and quality of the bicycle network 30 A ‘place’ can be a country, city, town or suburb 42 Case studies provide an opportunity to examine the impacts of packages of mutually supportive cycling promotion policies The review by Pucher et al (2010) included case studies of 14 cities and towns, which were diverse in terms of geography, size and preintervention levels of transportation cycling,that have implemented a wide range of measures to increase cycling and improve cycling safety These measures typically included:   Decent walking and cycling infrastructure Transportation policies that address the needs of all road users and facilitate the linking of active trips with public transport use  Policies and programs that improve the safety of pedestrians and cyclists  Programs that promote active transport  Disincentives for car use including fewer provisions for car use and parking, and lower subsidies for car purchase, operation and parking These measures are consistent with those identified by Christie et al (2004; 2007) derived from policy evaluation in 26 OECD countries which improved the safety of child pedestrians and cyclists (see Section 3.1) Overlapping findings from Pucher et al (2010) for cycling promotion, and Christie et al (2004; 2007) for child pedestrian and cyclist safety, highlight the well-established links between the prevalence and safety of active transport – strategies that improve safety also improve participation, and vice versa Carefully planned and well-implemented behaviour change programs are a necessary but not sufficient condition for population-level change in school travel modes The evidence reviewed in this report indicates that in several countries and regions (England, Scotland, Victoria, NSW and ACT), population levels of active travel to school have not changed despite programs with impressive impacts in some schools and for special events (eg walk/ride to school days) Strategic planning and a systems approach are required to move towards the levels of active travel to school that have been achieved in a number of other high-income countries Programs such as the Brisbane City Council Active School Travel provide a model for an active school travel program, while cities and towns in countries such as Denmark, Germany, the Netherlands and Japan provide models for implementing more broadly-based policy packages Effective active transport policy models are not restricted to the high active travel countries in Europe and Asia The USA cities of Davis, California and Portland have achieved high levels of active transport, including among children In Davis, 43.4% of boys and 30% of girls cycle to high school in stark contrast to the USA as a whole (Emond and Handy 2010) Active travel choices can be easy choices, including within urban environments similar to the low population density suburbs surrounding Australian cities (van Dyck et al 2009) 43 Differences in travel mode share over time (in Australia/Victoria) and geographically (among OECD countries) broken down by trip distance indicate that transportation policies and infrastructure are more important determinants of young people’s active travel than urban form Social norms of travel that shape perceptions of feasible walking and cycling distances, personal and traffic safety and ‘responsible parenting’ are also important (Thomson 2009) These factors are amenable to change in the short-term, in contrast to longer-term developments aimed at creating more compact urban environments Data summarised in this report suggest the greatest potential for increasing rates of active travel to school lies in encouraging more young people to walk up to about km and cycle up to about km With the right conditions, policies, education and encouragement, more children would walk or cycle to school and other neighbourhood destinations Elements of a strategy to increase active travel to school that includes school-based programs, together with area-wide and population-wide strategies for increasing active travel in the wider community, could include:      Setting goals and targets (eg an increase of 5% in the walking and cycling mode share of travel to education in a 5-year period31,32) Specifying components of the strategy (eg, incorporating the 4Es of Education, Encouragement, Engineering and Enforcement) Well-defined ‘program logic’ (ie Are we doing the right things? Is the intervention ‘dose’ appropriate? Is the program reach adequate?) Identifing partners, responsibilities and resources (eg who is responsible for each component?) Evaluation/monitoring (eg including measures of travel to school in school data collection systems) The key health promotion strategies of community participation, advocacy and intersectoral partnerships will also be important in achieving these goals Many sectors and levels of government have a role to play in increasing children’s and adults’ use of healthy and sustainable transport modes for the many short-to-medium trips that typify children’s travel in urban areas 31 This is approximately the rate at which walking and cycling to education have declined in the last 40 years in Victoria 32 The recent White House Task Force on Childhood Obesity Report to the President (Solving the problem of childhood obesity) set a target of an increase in bike/walk trips to school in the USA of 6.5 percentage points by 2015 44 Conclusions Active transport for children can contribute to a range of health and social benefits, but children’s active travel rates in Australia appear to be declining This report demonstrates that increasing levels of car use is not the inevitable by-product of low-density suburban living in affluent countries, but the predictable outcome of transportation policies that promote car use and (albeit unintentionally) constrain walking and cycling Changes can be achieved, at least in the short-term, through programs such as Safe Routes to School, Walking School Bus, School Travel Planning and Walk/Ride to School events These initiatives need to be complemented by area-wide improvements that create supportive environments for active travel The experiences of overseas countries, cities and municipalities provide a model for sustainable transport planning aimed at increasing active travel to school in the ACT Implementing active travel initiatives, and assessing their effectiveness in participating schools, is important, but key questions to also consider include (i) the program and contextual factors that shape the effectiveness of interventions; (ii) the sustainability of change; (iii) the reach of active travel initiatives; and (iv) the role of supportive communitywide measures Public health strategies in areas such as tobacco control, road safety and child immunisation are successful because they have achieved measurable improvements at the population level and not just in selected schools or communities The much-cited benefits of active travel will be realised when measurable change occurs at the population level 45 References Åberg, MAI, Pedersen, NL, Torén, K, Svartengren, M, Bäckstrand, B, Johnsson, T, Cooper-Kuhn, CM, Åberg, ND, Nilsson, M, Kuhn, HG (2009) Cardiovascular fitness is associated with cognition in young adulthood Proceedings of the National Academy of Sciences 106(49): 20906-209011 Ainsworth, B, Haskell, W, Whitt, M, Irwin, M, Swartz, A, Strath, S, O'Brien, W, Bassett, D, Schmitz, K, Emplaincourt, P, DRJRJacobs, Leon, A (2000) Compendium of physical activities: an update of activity codes and MET intensities Med Sci Sports Exerc 32(9 Suppl): S498-504 Andersen, LB, Schnohr, P, Schroll, M, Hein, HO (2000) All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work Arch Intern Med 160(11): 16211628 Andersen, L, Lawlor, D, Cooper, A, Froberg, K, Anderssen, S (2009) Physical fitness in relation to transport to school in adolescents: the Danish youth and sports study Scandinavian Journal of Medicine and Science in Sports 19(3): 406-411 Appleyard, D, Lintell, M (1980) The environmental quality of city streets: the residents' viewpoint Journal of the American Institute of Planners 38: 84-101 Australian Bureau of Statistics (1975) Journey to work and journey to school, August 1974 Canberra, ABS Australian Bureau of Statistics (2007) Health of Children in Australia: A Snapshot, 2004-05, Cat No 4829.0.55.001 Canberra, ABS Australian Bureau of Statistics (2009) National Health Survey: Summary of Results, 2007-08, Cat No 4364.0 Canberra, ABS Australian Bureau of Statistics (2009) Children's participation in cultural and leisure activities, Australia, April 2009 Cat No 4901.0 Canberra, ABS Australian Bureau of Statistics (2010) Crime Victimisation, Australia, 2008-09 Canberra, ABS Badland, H, Oliver, M, Duncan, M, Schantz, P (2011) Measuring children's independent mobility: comparing objective and self-report approaches Children's Geographies 9(2): 263-71 Booth, ML, Okely, AD, Denney-Wilson, E, Hardy, L, Yang, B, Dobbins, T (2006) NSW Schools Physical Activity and Nutrition Survey (SPANS) 2004: Full Report Sydney, NSW Department of Health Bosselmann, P, MacDonald, E (1999) Livable streets revisited Journal of the American Planning Association 65(2) Brisbane City Council (2009) Active School Travel Program: 2008 summary evaluation report Brisbane, Brisbane City Council Brown, W, Nairn, R (1997) Report on the analysis of the Canberra/Queanbeyan Household Interview Travel Survey - 1997 Canberra, ACT Government Department of Urban Services & Queanbeyan City Council Bureau of Transport and Regional Economics (2005) Health impacts of transport emissions in Australia: economic costs Canberra, Department of Transport and Regional Services Bureau of Transport and Regional Economics (2007) Estimating urban traffic and congestion cost trends for Australian cities, Working Paper 71 Canberrra, Department of Transport and Regional Services Burke, M, Brown, AL (2007) Distances people walk for transport Road & Transport Research 16(3) Carver, A, Timperio, A, Crawford, D (2008) Playing it safe: The influence of neighbourhood safety on children's physical activity A review Health & Place 14(2): 217-227 Carver, A, Timperio, A, Crawford, D (2008a) Perceptions of Neighborhood Safety and Physical Activity Among Youth: The CLAN Study Journal of Physical Activity and Health 5(3): 430-44 Chillon, P, Evenson, K, Vaughn, A, Ward, D (2011) A systematic review of interventions for promoting active transportation to school International Journal of Behavioural Nutrition and Physical Activity 8(Feb 14): 10 Christie, N, Cairns, S, Towner, E, Ward, H (2007) How exposure information can enhance our understanding of child traffic "death leagues" Injury Prevention 13(2): 125-129 46 Christie, N, Towner, E, Cairns, S, Ward, H (2004) Children's road traffic safety: an international survey of policy and practice Road Safety Research Report No 47 London, Department for Transport Cooper, A, Wedderkopp, N, Jago, R, Kristensen, P, Moller, N, Froberg, K, Page, A, Andersen, L (2008) Longitudinal associations of cycling to school with adolescent fitness Preventive Medicine 47(3): 342-328 Cooper, A, Wedderkopp, N, Wang, H, Andersen, L, Froberg, K, Page, A (2006) ACtive travel to school and cardiovascular fitness in Danish children and adolescents Medicine and Science in Sports and Exercise 38(10): 1724-1731 Cozens, P, Saville, G, Hillier, D (2005) Crime prevention through environmental design (CPTED):a review and modern bibliography Property Management 23(5): 328-56 Davison, K, Werder, J, Lawson, C (2008) Children's active commuting to school: current knowledge and future directions Preventing Chronic Disease: Public Health Research, Practice and Policy 5(3): 1-11 De Hartog, JJ, Boogaard, H, Nijland, H, Hoek, G (2010) Do the health benefits of cycling outweigh the risks? Environmental Health Perspectives doi: 10.1289/ehp.0901747 Available Online 30 June 2010 Department for Transport (2008) Travel to school: personal travel factsheet London, [UK] Department for Transport Department of Climate Change and Energy Efficiency (2010) Australian National Greenhouse Accounts Canberra, Commonwealth of Australia Department of Health and Ageing (2004) Active kids are healthy kids: Australia's physical activity recommendations for 5-12 year olds http://www.health.gov.au/internet/wcms/publishing.nsf/Content/phd-physical-activity-kids-pdfcnt.htm/$FILE/kids-phys.pdf Department of Health and Ageing (2008) 2007 Australian National Children's Nutrition and Physical Activity Survey: main findings Canberra, Department of Health and Ageing Department of Human Services (2007) 2006 Victorian Child Health and Wellbeing Survey Technical Report Additional analysis of children's modes of travel to and from school conducted by Jan Garrard Melbourne, Victorian Department of Human Services Department of the Environment, Climate Change, Energy and Water (2010) ACT Greenhouse Gas Emissions, ACT Greenhouse Gas Inventory 2008 http://www.environment.act.gov.au/ data/assets/pdf_file/0015/200175/ACT_Greenhouse_Gas _Inventory_2008.pdf Accessed 06/07/2011 Dobbins, M, De Corby, K, Robeson, P, Husson, H, Tirilis, D (2009) School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18 Cochrane Database Syst Rev(1): CD007651 Dollman, J, Lewis, N (2007) Active transport to school as part of a broader habit of walking and cycling among South Australian Youth Pediatric Exercise Science 19(4): 436-43 Dora, C, Phillips, M (2000) Transport, environment and health Copenhagen, World Health Organisation Regional Office for Europe Elvik, R (2009) The non-linearity of risk and the promotion of environmentally sustainable transport Accident Analysis and Prevention 41(4): 849-55 Environmental Protection Authority (2007) Noise surveys 2007 Melbourne, EPA Ewing, R, Brownson, RC, Berrigan, D (2006) Relationship Between Urban Sprawl and Weight of United States Youth American Journal of Preventive Medicine 31(6): 464-474 Fry, D (2008) New South Wales Travelsmart Schools Program 2006-2007 Sydney, Sydney South West Area Health Service Garrard, G, Rissel, C, Bauman, A (2011, in press) Cycling and health Cycling for sustainable transport: international trends and policies J Pucher & PJ Buehler, MIT Press Garrard, J (2010) Active school travel research project: final report Melbourne, Unpublished report 47 Garrard, J (2009) Active transport: children and young people An overview of recent evidence Melbourne, Victorian Health Promotion Foundation Garrard, J, Crawford, S, Godbold, T (2009) Evaluation of the Ride2School Program: final report Melbourne, Deakin University Gauderman, WJ, Avol, E, Gilliland, F, Vora, H, Thomas, D, Berhane, K, McConnell, R, Kuenzli, N, Lurmann, F, Rappaport, E, Margolis, H, Bates, D, Peters, J (2004) The effect of air pollution on lung development from 10 to 18 years of age The New England Journal Of Medicine 351(11): 1057-1067 Gebel, K, King, L, Bauman, A, Vita, P, Gill, T, Rigby, A, Capon, A (2005) Creating healthy environments: A review of links between the physical environment, physical activity and obesity Sydney, NSW Health Department and NSW Centre for Overweight and Obesity Hamer, M, Stamatakis, E, Mishra, G (2009) Psychological Distress, Television Viewing, and Physical Activity in Children Aged to 12 Years Pediatrics 123(5): 1263-1268 Hart, J (2008) Driven to excess: impacts of motor vehicle traffic on residentail quality of life in Bristol, UK MSc in Transport Planning at the University of the West of England, Bristol Hillier, B, Sahbaz, O (2006) High resolution analysis of crime patterns in urban street networks: an initial statistical sketch from an ongoing study of a London Borough London, University College London Hillman, M (1993) One false move An overview of the findings and issues they raise Children, transport and the quality of life M Hillman London, Policy Studies Institute Hillman, M, Adams, J, Whitelegg, J (1990) One false move: a study of children's independent mobility London, Policy Studies Institute Hinkson, E, Duncan, S, Kearns, R, Badland, H (2008) 2008 School Travel Plan Evaluation: 2007 School Year Auckland, Auckland Regional Transport Authority Horton, D (2007) Fear of cycling Cycling and society D Horton, P Rosen and P Cox (Eds) Hampshire, Ashgate Publishing: 133-52 Hosking, J, Macmillan, A, Connor, J, Bullen, C, Ameratunga, S (2010) Organisational travel plans for improving health Cochrane Database of Systematic Reviews Mar 17;3:CD005575 Ironmonger, D, Norman, P (2007) Travel behaviour of women, men and children: what changes and what stays the same? Conference name Conference location From Jacobsen, PL, Racioppi, F, Rutter, H (2009) Who owns the roads? How motorised traffic discourages walking and cycling Injury Prevention 15(6): 369-73 Jensen, SU, Hummer, CH (2003) Safer routes to Danish schools Sustainable transport: planning for walking and cycling in urban environments R Tolley Cambridge, England, Woodhead Publishing Limited: 588-598 Kelty, SF, Giles-Corti, B, Zubrick, SR (2008) Physical activity and young people: the impact of the built environment in encouraging play, fun, and being active Physical activity and children: new research N P Beaulieu New York, Nova Science Publishers, Inc.: 7-33 Ker, I (2009) Review of the Western Australia Walking School Bus Program Perth, CATALYST FOR Department for Planning and Infrastructure Knox, EG (2006) Roads, railways, and childhood cancers J Epidemiol Community Health 60(2): 136141 Landsberg, B, Plachta-Danielzik, S, Much, D, Johannsen, M, Lange, D, Müller, M (2008) Associations between active commuting to school, fat mass and lifestyle factors in adolescents: the Kiel Obesity Prevention Study (KOPS)Associations between active commuting and fat mass European Journal of Clinical Nutrition 62: 739-747 Lee, MC, Orenstein, MR, Richardson, MJ (2008) Systematic Review of Active Commuting to School and Children’s Physical Activity and Weight Journal of Physical Activity and Health 5(6): 930-949 Litman, T (2009) Community cohesion as a transport planning objective, Victoria Transport Policy Institute 48 Litman, TA, Doherty, E (2009) Transportation cost and benefit analysis: techniques, estimates and implications Canada, Victorian Transport Policy Institute Malone, K (2007) The bubble-wrap generation: children growing up in walled gardens Environmental Education Research 13(4): 513-527 Matthews, B, Bennell, K, McKay, H, Khan, K, Baxter-Jones, A, Mirwald, R (2006) Dancing for bone health: a 3-year longitudinal study of bone mineral accrual across puberty in female non-elite dancers and controls Osteoporosis International 17: 1043-54 Matthews, C, Jurj, A, Shu, X, Li, H, Yang, G, Li, Q, Gao, Y, Zheng, W (2007) Influence of exercise, walking, cycling, and overall nonexercise physical activity on mortality in Chinese women American Journal of Epidemiology 165(12): 1343-1350 McDonald, N, Deakin, E, Aalborg, A (2010) Influence of the social environment on children's school travel Preventive Medicine 50: S65-S68 McKenzie-Mohr, D, Smith, W (1999) Fostering Sustainable Behavior: An Introduction to CommunityBased Social Marketing Canada, New Society Publishers Ministry of Transport Public Works and Water Management (2009) Cycling in the Netherlands Utrecht, Ministry of Transport Public Works and Water Management Moodie, M, Haby, M, Galvin, L, Swinburn, B, Carter, R (2009) Cost-effectiveness of active transport for primary school children - Walking School Bus program Int J Behav Nutr Phys Act 6: 63 Morris, J, Wang, F, Lilja, L (nd) School Children’s Travel Patterns – A Look Back and A Way Forward Melbourne, Transport Research Centre, RMIT University Möser, G, Bamberg, S (2008) The effectiveness of soft transport policy measures: A critical assessment and meta-analysis of empirical evidence Journal of Environmental Psychology 28(1): 10-26 Ogilvie, D, Foster, CE, Rothnie, H, Cavill, N, Hamilton, V, Fitzsimons, CF, Mutrie, N (2007) Interventions to promote walking: systematic review BMJ 334(7605): 1204 Olds, T, Ridley, K, Tomkinson, G (2007) Declines in aerobic fitness: are they due only to increasing fatness? Medicine and Sports Science 50: 226-240 Panis, LI, deGeus, B, Vandenbulcke, G, Willems, H, Degraeuwe, B, Bleux, N, Mishra, V, Thomas, I, Meeusen, R (2010) Exposure to particulate matter in traffic: A comparison of cyclists and car passengers Atmospheric Environment 44: 2263-70 Pont, K, Ziviani, J, Wadley, D, Bennett, S, Abbott, R (2009) Environmental correlates of children's active transportation: a systematic literature review Health & Place 15: 849-862 Population Health Research Centre ACT Health (2007) Report on the ACT Year Physical Activity and Nutrition Survey (ACTPANS), Health Series Number 43 Canberra, ACT Government Prezza, M, Alparone, F, Cristallo, C, Luigi, S (2005) Parental perception of social risk and of positive potentiality of outdoor autonomy for children: the development of two instruments Journal of Environmental Psychology 25: 437-453 Pucher, J, Buehler, R (2008) Making Cycling Irresistible: Lessons from The Netherlands, Denmark and Germany Transport Reviews 28(4): 495-528 Pucher, J, Dill, J, Handy, S (2010) Infrastructure, programs and policies to increase bicycling: an international review Preventive Medicine 50(Jan Suppl 1): S106-25 Rose, G (1999) A comprehensive evaluation of 'Safe Routes to School' implementation Melbourne, Institute of Transport Studies, Monash University Rosenbaum, M (1993) Independent mobility and children's rights Children, transport and the quality of life M Hillman London, Policy Studies Institute Sallis, JF, Cervero, RB, Ascher, W, Henderson, KA, Kraft, MK, Kerr, J (2006) An ecological approach to creating active living communities Annu Rev Public Health 27: 297-322 Salmon, J, Timperio, A, Cleland, V, Venn, A (2005) Trends in children's physical activity and weight status in high and low socio-economic status areas of Melbourne, Victoria, 1985-2001 Australian and New Zealand Journal of Public Health 29(4): 337-342 49 Sibley, B, Etnier, J (2003) The relationship between physical activity and cognition in children: a meta-analysis Pediatric Exercise Science 15: 243-256 Sirard, JR, Slater, ME (2008) Walking and bicycling to school: a review American Journal of Lifestyle Medicine 2(5): 372-396 Skenazy, L (2009) Free-range kids: how to raise safe, self-reliant children San Francisco, Jossey-Bass Sloman, L, Cavill, N, Cope, A, Muller, L, Kennedy, A (2009) Analysis and synthesis of evidence on the effects of investment in six Cycling Demonstration Towns., Department for Transport and Cycling England Slovic, P, Finucane, M, Peters, E, MacGregor, D (2004) Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality Risk Analysis 24(2): 311-322 Smith, A, McKenna, J, Duncan, R, Jonathan, L (2008) The impact of additional weekdays of active commuting on children achieving a criterion of 300+ minutes of moderate-to-vigorous physical activity Australasian Association for Exercise and Sports Science Conference Melbourne, March 2008 Social Exclusion Unit (2003) Making the connections: final report on transport and social exclusion London, Office of the Deputy Prime Minister Sullivan, P, Percy, A (2008) Evaluating changes associated with workplace and school travel plans something old, something borrowed, something new Conference name Conference location From www.patrec.org/atrf/index.php?forum The Obesity Society (nd) Obesity in Australian Children Thomson, L (2009) "How times have changed": active transport literature review Melbourne, VicHealth Tranter, P (1996) Children's independent mobility and urban form in Australasian, English and German cities World transport research proceedings of the 7th world conference on transport research D Hensher, J King and T H Oun Oxford, Pergamon Press Tranter, P (2004) Effective speeds: car costs are slowing us down Canberra, Australian Greenhouse Office, Department of the Environment and Heritage US Department of Health and Human Services (2008) Physical Activity Guidelines: Advisory Committee Report 2008, US Department of Health and Human Services USA Interagency Working Group on Climate Change and Health 2009 (nd) A human health perspective on climate change van der Ploeg, HP, Merom, D, Corpuz, G, Bauman, AE (2008) Trends in Australian children traveling to school 1971-2003: Burning petrol or carbohydrates? Preventive Medicine 46(1): 60-62 van Dyck, D, Cardon, G, Deforche, B, Bourdeaudhuij, ID (2009) Lower neighbourhood walkability and longer distance to school are related to physical activity in Belgian adolescents Preventive Medicine 48: 516-518 Vanderbilt, T (2008) Traffic: why we drive the way we (and what it says about us) New York, Alfred A Knopf Voss, C, Sandercock, G (2010) Aerobic fitness and mode of travel to school in English school children Medicine and Science in Sports and Exercise 42(2): 281-287 Wen, LM, Fry, D, Merom, D, Rissel, C, Dirkis, H, Balafas, A (2008) Increasing active travel to school: Are we on the right track? A cluster randomised controlled trial from Sydney, Australia Preventive Medicine 47(6): 612-618 WHO (2008) Physical activity and young people Geneva, World Health Organisation World Health Organisation: Regional Office for Europe (2011) Burden of disease from environmental noise: quantification of healthy life years lost in Europe Copenhagen, World Health Organisation Yang, L, Sahlqvist, S, McMinn, A, Griffin, SJ, Ogilvie, D (2010) Interventions to promote cycling: systematic review BMJ 341(c5293) 50 Zubrick, S, Wood, L, Villanueva, K, Wood, G, Giles-Corti, B, Christian, H (2010) Nothing but fear itself: parental fear as a determinant impacting on child physical activity and independent mobility Melbourne, Victorian Health Promotion Foundation 51 ... and barriers for active and inactive travel to school Table 4: Perceived benefits and barriers of active and inactive modes of travel to school Target behaviour (active travel to school) Competing... changes that help to make active travel choices easy choices Understanding the influences on active travel to school The factors that influence children’s modes of travel to school are complex,... Rates of active travel to school in Australia and the ACT 4.1 Active travel to school in Australia and internationally There is no current data available for children’s modes of travel to school