BackgroundBuilt environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa).MethodsThe original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 – 17 years] and 59 adults [22 – 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries.ResultsThe original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of “excellent” (ICCs > .75 %) or “good” (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated “excellent” agreement and the other six had “good” agreement. No items or scales demonstrated "poor" reliability (ICCs < .40).ConclusionsThe systematic adaptation and initial psychometric evaluation of NEWS-Africa indicates the instrument is feasible and reliable for use with adults of diverse demographic characteristics in Africa. The measure is likely to be useful for research, surveillance of built environment conditions for planning purposes, and to evaluate physical activity and policy interventions in Africa.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0357-y) contains supplementary material, which is available to authorized users.

Purpose Development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries. Methods NEWS was systematically adapted to assess urban, peri-urban and rural environments in sub-Saharan Africa. Adults (n=469, 18-85 years, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. Results The overall ‘walkability’ index had a positive relationship with both walking for transportation (eta2=0.020, p=0.005) and recreation (eta2=0.013, p=0.028) in the pooled analyses. The mixed-use access and stranger-danger scales were positively related with transport walking (eta2=0.020, p=0.006 and eta2=0.021, p=0.040, respectively). Proximity of recreational facilities (eta2=0.016, p=0.015), road/path connectivity (eta2=0.025, p=0.002), path infrastructure (eta2=0.021, p=0.005), and overall places for walking and cycling (eta2=0.012, p=0.029) scales were positively related to recreational walking. Country-specific results were mostly non-significant except for South Africa and Uganda. Conclusions Seven of 14 NEWS-Africa scales were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other continents. Further study with larger and more diverse samples is needed to determine whether the instrument performs well in each country.