Research papers

Background

Public transport (PT) users typically accumulate more physical activity (PA) than private motor vehicle users yet redressing physical inactivity through transport-related PA (TRPA) interventions has received limited attention. Further, incentive-based strategies can increase leisure-time PA but their impact on TRPA, is unclear. This study's objective is to determine the impact of an incentive-based strategy on TRPA in a regional Australian setting.

Methods

trips4health is a single-blinded randomised controlled trial with a four-month intervention phase and subsequent six-month maintenance phase. Participants will be randomised to: an incentives-based intervention (bus trip credit for reaching bus trip targets, weekly text messages to support greater bus use, written PA guidelines); or an active control (written PA guidelines only). Three hundred and fifty adults (≥18 years) from southern Tasmania will be recruited through convenience methods, provide informed consent and baseline information, then be randomised. The primary outcome is change in accelerometer measured average daily step count at baseline and four- and ten-months later. Secondary outcomes are changes in: measured and self-reported travel behaviour (e.g. PT use), PA, sedentary behaviour; self-reported and measured (blood pressure, waist circumference, height, weight) health; travel behaviour perspectives (e.g. enablers/barriers); quality of life; and transport-related costs. Linear mixed model regression will determine group differences. Participant and PT provider level process evaluations will be conducted and intervention costs to the provider determined.

Discussion

trips4health will determine the effectiveness of an incentive-based strategy to increase TRPA by targeting PT use. The findings will enable evidence-informed decisions about the worthwhileness of such strategies.

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Issue addressed

Physical activity is lower and rates of preventable common diseases are higher in regional/rural than urban Australia. Active commuting (walking/bicycling to get from one place to another) may benefit health through increased physical activity, but most evidence of its correlates come from urban studies. This study aimed to investigate associations between active commuting, socio-demographic characteristics, behaviours, total physical activity and health in a regional/rural Australian state.

Methods

This study used data from the 2016 Tasmanian Population Health Survey, a representative cross-sectional self-report survey of 6,300 adults in Tasmania, Australia. Logistic regression modelling investigated associations between socio-demographic, behavioural and health characteristics and past week active commuting frequency.

Results

In multivariable models, being younger, having tertiary qualifications, living in a socio-economically advantaged area, being physically active, having a healthy body mass index and good/excellent self-rated health were associated with engaging in more active commuting. Inner regional dwellers were no more likely than outer regional dwellers to actively commute after covariate adjustment.

Conclusion

Strategies to promote active commuting in regional/rural areas might consider targeting older adults, those less educated, those living in socio-economically disadvantaged areas, those less physically active, those with poorer health and those with higher body mass index. Research could further investigate why these groups appear to be less active for commuting purposes.

So what?

Increasing physical activity and active commuting may help to reduce rates of preventable common diseases in regional/remote areas.

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Background and aims

There is untapped potential for public transport-related physical activity to make an important contribution to total physical activity and hence improve health. This study aimed to determine the willingness of public transport users to walk further than necessary to a stop, and the characteristics of those willing to do so.

Methods

This study used data from three waves (2016, 2017, 2018) of the Metro Tasmania Customer Satisfaction Survey (CSS), an annual cross-sectional survey of bus passengers in Tasmania, Australia. Linear and logistic regression modelled associations between socio-demographic and transport behaviour characteristics with willingness to travel further to usual bus stop if frequency was improved (yes/no), and if willing, the extra distance (metres) prepared to travel. Analyses were restricted to those reporting walking to their bus stop (n = 1402).

Results

Half of 1402 bus passengers were prepared to walk further (average 521 m) to their usual bus stop if frequency was improved. A range of characteristics were positively (residential location) and negatively (age, female sex, retired/on pension, no regular motor vehicle access, intermittent public transport use, higher public transport-related physical activity) associated with willingness to walk further to the bus stop. Distance willing to walk varied by a range of demographic characteristics (sex, household income, age, employment status, bus use, public transport-related physical activity). Only age was consistently associated across all three surveys: younger bus passengers were more willing to walk further and recorded greater distances willing to walk.

Conclusions

The characteristics identified provide insights into which population groups may be more amenable to strategies to increase public transport-related physical activity, and which groups may require further investigation to identify reasons for lack of willingness to walk further to bus stops. Improving bus service frequency may increase public transport-related physical activity and confer health benefits.

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Background

Public transport users often accumulate more physical activity than motor vehicle users, but most studies have been conducted in large metropolitan areas with multiple public transport options with limited knowledge of the relationship in regional and rural areas. In a regional city, this pilot study aimed to (1) test the feasibility of preliminary hypotheses to inform future research, (2) test the utility of survey items, and (3) establish stakeholder engagement.

Methods

Data were collected via a cross-sectional online survey of 743 Tasmanian adults. Physical activity outcomes were walking (min/week), total moderate- to vigorous-intensity physical activity (min/week) and attainment of physical activity guidelines (yes/no). Transport variables were frequency of public and private transport use per week. Truncated and log binomial regression examined associations between public/private transport use and physical activity.

Results

Neither frequency of public nor private transport use was associated with minutes of walking (public transport: B − 24.4, 95% CI: − 110.7, 61.9; private transport: B − 1.1, 95% CI: − 72.4, 70.1), minutes of total physical activity (public transport: B − 90.8, 95% CI: − 310.0, 128.5; private transport: B 0.4, 95% CI: − 134.0, 134.9) or not meeting physical activity guidelines (public transport: RR 1.02, 95%CI: 0.95, 1.09; private transport: RR 1.02, 95%CI: 0.96, 1.08).

Conclusions

The hypothesis that public transport users would be more physically active than private transport users was not supported in this pilot study. Stakeholders were engaged and involved in various phases of the research including development of research questions, participant recruitment, and interpretation of findings. Further studies using representative samples and refined measures are warranted to confirm or refute findings.

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Abstract

Walking to more distant public transport stops is commonly promoted for physical activity gain.

We examined the uptake of, and reasons for, this behaviour and its correlates through a cross-sectional survey (n = 944) and independent interview study (n = 22). Quantitative analysis examined correlates of frequency of walking to more distant bus stops, including demographic variables, past week bus use, bus stop accessibility, and physical activity. Interviews explored reasons for engaging in this behaviour.

Of participants (38%) who had used the bus the previous week, 13% had walked to a more distant bus stop every/most times. Median walking and total physical activity were highest (P = 0.003) among this group (210 and 465 min/week, respectively) compared to those who did sometimes (150 and 260 min/week, respectively) or not at all (150 and 270 min/week, respectively). Among interview participants who engaged in this behaviour (n = 12), over half did so for physical activity gain, with the remaining being driven by other co-benefits. Many interviewees overlooked the physical activity benefit of this behaviour.

This novel study integrated quantitative and qualitative data and discovered those who walk to more distant public transport stops were generally more physically active than those who do not. While some users were aware of the health benefits, many did so for other reasons.

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Issue addressed

Public transport (PT) users typically accumulate more physical activity (PA) than motor vehicle users. This mixed methods study aimed to determine acceptability and perceived effectiveness of strategies to increase bus use for PA gain in a regional Australian setting.

Methods

In a 2017 online survey, Tasmanian adults (n = 1091) rated the likelihood of increasing their bus use according to ten hypothetical strategies (fare-, incentives-, information- or infrastructure-based). Three focus groups and five interviews (n = 31) included infrequent bus users from the survey to determine reasons for strategy preferences and potential impact on PA.

Results

The top three strategies in the survey, with supporting rationale from qualitative data, were: provision of real-time bus information (“…because I can better plan…”); bus-only lanes (“…it just speeds the whole thing up…”) and employee incentives/rewards for example bus fare credits (“…it really comes down to money…”). Full-time students favoured cost-saving strategies most and residents in outer suburbs favoured infrastructure-based strategies most. Qualitative data indicated that potential for enhanced certainty, efficiency or cost-savings drove strategy preferences and some strategies may lead to PA gain (eg through the location of Park and Ride facilities).

Conclusions

Real-time information, bus-only lanes and employee incentives/rewards appear most promising for increasing bus use in this population, but tailoring strategies may be required. Discrete PT enhancement strategies may result in PA gain.

So what?

Increasing PA through transport behaviour has been underexplored. The potential for PA gain through greater PT use and discrete PT use enhancement strategies is an important public health consideration.

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