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Table 5 Overview of moderators of neighbourhood physical environmental correlates of active travel in older adults

From: The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis

Moderators

Environmental attribute (E) – AT outcome (AT)

Findings

Individual: socio-demographics (self-reported)

Age (Barnes et al., in press) [62]

E: (1) Walkability; (2) Public transport

AT: (1) Total walking

• No significant moderating effects.

Age (Shigematsu et al., 2009) [63]

E: (1) Residential density; (2) Access to destinations/services; (3) Land use mix – destination diversity; (4) Street connectivity; (5) Pedestrian-friendly features; (6) Greenery and aesthetically pleasing scenery; (7) Traffic/pedestrian safety; (8) Public transport; (9) Crime/personal safety; (10) Parks/open space/recreation destinations

AT: (1) Total walking

• Positive associations with (10) Parks/open space/recreation (park near home) only in 75+ year olds.

Sex (Inoue et al., 2011) [35]

E: (1) Residential density; (2) Shops/commercial destinations; (3) Public transport; (4) Pedestrian-friendly features; (5) Traffic/pedestrian safety; (6) Crime/personal safety; (7) Park/open space/recreation; (8) Greenery and aesthetically pleasing scenery

AT: (1) Total walking

• Positive associations with (2) Shops/commercial destinations and (7) Park/open space/recreation destinations only in women.

• Positive associations with (4) Pedestrian-friendly features and (8) Greenery and aesthetically pleasing scenery only in men.

• Negative associations with (5) Traffic/pedestrian safety and (6) Crime/personal safety only in men.

Age

Sex

Education (Cerin et al., 2014) [58]

E: (1) Residential density; (2) Access to destinations/services; (3) Land use mix – destination diversity; (4) Street connectivity; (5) Pedestrian-friendly features; (6) Traffic/pedestrian safety; (7) Public transport; (8) Crime/personal safety; (9) Barriers to walking/cycling; (10) Easy access to building entrance; (11) Human or motorised traffic volume; (12) Benches/sitting facilities

AT: (1) Total walking; (2) Within-neighbourhood walking

• Positive associations of (3) Land use mix – destination diversity and (12) Benches/sitting facilities with (2) Within-neighbourhood walking only in 75+ year-olds.

• Negative associations of (8) Crime/personal safety and (2) Within-neighbourhood walking only in women.

Age

Sex (Van Cauwenberg et al., 2012) [25]

E: (1) Access to destinations/services; (2) Shops/commercial destinations; (3) Public transport; (4) Public toilets; (5) Benches/sitting facilities; (6) Traffic/pedestrian safety; (7) Pedestrian-friendly features; (8) Crime/personal safety; (9) Street lights; (10) Littering/vandalism/decay; (11) Pollution; (12) Greenery and aesthetically pleasing scenery

AT: (1) Total walking; (2) Cycling

• Positive associations with (10) Littering/vandalism/decay and (1) Total walking in all but 75+ year-old women.

• Complex Age by Sex interaction on (11) Pollution (1) Total walking associations. All associations positive.

• Significant Age by Sex interaction on (4) Public toilets, (6) Traffic/pedestrian safety and (2) Cycling associations. However, no significant associations in subgroups (public toilets; presence of crossings) or all associations negative (traffic safety).

• Positive associations of (9) Street lights with (2) Cycling only in <75-year old women.

• See also interactions of Urbanism by Age or Sex below.

Living arrangements (Tsai et al., 2013) [64]

E: (1) Traffic/pedestrian safety; (2) Barriers to walking/cycling; (3) Easy access to building entrance; (4) Land use mix – destination diversity

AT: (1) Total walking

• Positive association with (3) Easy access to building entrance only in those living alone.

Individual: psychosocial factors (perceived)

Social support for physical activity

Self-efficacy for physical activity

Perceived barriers to physical activity (Carlson et al., 2012) [65]

E: (1) Walkability; (2) Parks/open space/recreation destinations

AT: (1) Total walking

• Stronger associations with (1) Walkability in those with higher social support and self-efficacy, and lower perceived barriers to physical activity.

Individual: vehicle ownership/driving status (self-reported)

Driving status (Ding et al., 2014) [22]

E: (1) Residential density; (2) Access to destinations/services; (3) Land use mix – destination diversity; (4) Street connectivity; (5) Pedestrian-friendly features; (6) Greenery and aesthetically pleasing scenery; (7) Traffic/pedestrian safety; (8) Public transport; (9) Crime/personal safety; (10) Walkability; (11) Parks/open space/recreation destinations

AT: (1) Total walking

• No significant moderating effects.

Individual: health status/functionality

Frailty (self-reported) (Etman et al., 2014) [33]

E: (1) Greenery and aesthetically pleasing scenery; (2) Pedestrian-friendly features; (3) Traffic/pedestrian safety; (4) Crime/personal safety; (5) Land use mix – destination diversity

AT: (1) Total walking

• No significant moderating effects.

Chronic conditions (genitourinary, vision impairment, hearing impairment, musculoskeletal) (objective)(Barnett et al., 2016) [4]

E: (1) Residential density; (2) Access to destinations/services; (3) Land use mix – destination diversity; (4) Street connectivity; (5) Pedestrian-friendly features; (6) Greenery and aesthetically pleasing scenery; (7) Traffic/pedestrian safety; (8) Public transport; (9) Crime/personal safety; (10) Barriers to walking/cycling; (11) Parks/open space/recreation destinations; (12) Easy access to building entrance; (13) Human or motorised traffic volume; (14) Littering/vandalism/decay; (15) Benches/sitting facilities

AT: (1) Within-neighbourhood walking

• Stronger positive associations with (2) Access to destination/services, (5) Pedestrian-friendly features and (7) Traffic/pedestrian safety in those with than without genitourinary diseases.

• Stronger positive associations with (6) Greenery and aesthetically pleasing scenery in those without vision impairment.

• Stronger positive associations with (12) Easy access to building entrance in those with than without musculoskeletal diseases.

Mobility impairment (self-reported) (King et al., 2011) [34]

E: (1) Walkability

AT: (1) Walking + cycling

• Stronger positive associations in least mobility impaired.

Environmental: area-level income (objective)

Area-level household income (King et al. 2011) [34]

E: (1) Walkability

AT: (1) Walking + cycling

• No significant moderating effects.

Area-level socio-economic status (SES) (Kolbe-Alexander et al., 2015) [47]

E: (1) Residential density; (2) Access to destinations/services; (3) Land use mix – destination diversity; (4) Street connectivity; (5) Pedestrian-friendly features; (6) Greenery and aesthetically pleasing scenery; (7) Traffic/pedestrian safety; (8) Crime/personal safety

AT: (1) Walking + cycling

• Positive associations with (5) Pedestrian-friendly features only in high-SES areas.

Area-level household income (Van Holle et al. 2014) [6]

E: (1) Walkability

AT: (1) Total walking; (2) Cycling

• No significant moderating effects.

Area-level household income (Van Cauwenberg et al. 2016) [61]

E: (1) Walkability

AT: (1) Total walking

• No significant moderating effects.

Environmental: residential density/urbanisation (objective)

Urbanisation (Maisel, 2016) [48]

E: (1) Residential density; (2) Access to destinations/services; (3) Land use mix – destination diversity; (4) Street connectivity; (5) Pedestrian-friendly features; (6) Greenery and aesthetically pleasing scenery; (7) Traffic/pedestrian safety; (8) Crime/personal safety

AT: (1) Total walking

• No significant moderating effects.

Urbanisation (Van Cauwenberg et al., 2012) [25]

E: (1) Access to destinations/services; (2) Shops/commercial destinations; (3) Public transport; (4) Public toilets; (5) Benches/sitting facilities; (6) Traffic/pedestrian safety; (7) Pedestrian-friendly features; (8) Crime/personal safety; (9) Street lights; (10) Littering/vandalism/decay; (11) Pollution; (12) Greenery and aesthetically pleasing scenery

AT: (1) Total walking; (2) Cycling

• Positive associations of (2) Shops/commercial destinations with (1) Total walking in all participants but <75 year olds living in rural areas.

• Significant Urbanisation by Sex interaction on (4) Public toilets and (2) Cycling associations. However, no significant associations in subgroups.

• Significant positive associations between (5) Benches/sitting facilities and (2) Cycling only in rural women.

• Significant positive associations between (10) Littering/vandalism/decay and (2) Cycling only in urban <75 year-old men.

• Significant negative associations between (11) Pollution (noise) and (2) Cycling only in rural <75 year-old women.

Environmental: pedestrian infrastructure and streetscape (objective)

Sloping streets

Public facilities

Good path conditions

Path obstructions

Street lights

(Cerin et al., 2013) [57]

E: (1) Health and aged-care; (2) Religious destinations; (3) Public transport; (4) Parks/open space/recreation destinations; (5) Business/government/institutional/industrial); (6) Entertainment; (7) Shops/commercial; (8) Food outlets

AT: (1) Total walking; (2) Within-neighbourhood walking

• Stronger positive associations between (7) Shops/commercial destinations and (2) within-neighbourhood walking in areas with more path obstructions and fewer sloping streets.

• Stronger positive associations between (7) Food outlets (shops and grocery stores) and (2) within-neighbourhood walking in areas with fewer path obstructions and no sloping streets.

Environmental: safety and traffic

Stray animals (objective)

Signs of crime/disorder (objective)

Pedestrian safety (objective) (Cerin et al., 2013) [57]

E: (1) Health and aged-care; (2) Religious destinations; (3) Public transport; (4) Parks/open space/recreation destinations; (5) Business/government/institutional/industrial); (6) Entertainment; (7) Shops/commercial; (8) Food outlets

AT: (1) Total walking; (2) Within-neighbourhood walking

• Stronger positive associations between (3) Public transport and (1) Total walking; and (4) Parks/open space/recreation destinations and (2) Within-neighbourhood walking in areas with fewer stray animals.

• Stronger positive associations of (4) Parks/open space/recreation destinations and (6) Entertainment and (2) Within-neighbourhood walking in areas with fewer signs of crime/disorder.

Traffic safety (perceived)

Pedestrian safety (perceived)

Crime safety (perceived) (Bracy et al., 2014) [66]

E: (1) Walkability

AT: (1) Total walking

• No significant moderating effects.