Construct Validity of the Neighborhood Environment Walkability Scale for Africa

Abstract

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.

Associations of the Built Environment With Physical Activity and Sedentary Time in Ugandan Outpatients With Mental Health Problems

“…International data indicate that built environments play important roles in physical activity in general populations of adults 41 There are limited data showing that built environments also are relevant to physical activity in LMICs 41 and specifically in Africa 33 , though there may be some distinct findings in LMICs 33 . The present study adds important evidence that recreation facilities, mixed land use, informal walking paths, and presence and quality of sidewalks are significantly related to physical activity and/or sedentary time in the heretofore unstudied population of African adults with mental or behavioral health disorders.…”

“…Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda) study demonstrated that the NEWS-Africa is a reliable 32 and valid 33 questionnaire to measure built and social environment attributes with relevance to physical activity. It has been tailored to the African context through extensive local input 33 (strongly agree). The one question on residential density reflected common housing patterns in urban and rural areas of Africa, and responses ranged from 1 (lowest density; e.g., few residential buildings/dwellings) to 6 (highest density; e.g., densely packed small houses, settlements, slums).…”

“…A previous multi-country (i.e. Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda) study demonstrated that the NEWS-Africa is a reliable 32 and valid 33 questionnaire to measure built and social environment attributes with relevance to physical activity. It has been tailored to the African context through extensive local input 33 (strongly agree).…”

Exploring the Associations of Walking Behavior with Neighborhood Environments by Different Life Stages: A Cross-Sectional Study in a Smaller Chinese City

“…The Neighborhood Environment Walkability Scale-Abbreviated version (NEWS-A) is one of the most commonly used self-evaluation questionnaires aiming at measuring people's perceived neighborhood environmental attributes related to physical activity. It was initially applied in developed countries, including the USA and Australia [49,50], and has been widely validated in different countries and cities [51][52][53][54]. The pilot study we first undertook initially adapted the NEWS-A questionnaire on the basis of literature review and on-site observations.…”

Objective measurement of physical activity: improving the evidence base to address non-communicable diseases in Africa

“… 9 Our knowledge of the social, biological and environmental determinants of physical activity in Africa, including the impact of urbanisation and economic development, is limited by the need for context-specific measures for these determinants and the paucity of longitudinal data to determine causation. 21 Smart phone ownership in Africa is accelerating: a median of 33% reported owning a smart phone in 2018, with a 14%–15% increase in ownership reported in Senegal, South Africa and Ghana between 2015 and 2017. 22 This and the increasing availability of commercial physical activity monitors presents an opportunity to harness physical activity data collected as users carry out their daily lives.…”