Regular articleAn environmental intervention to promote walking and cycling—the impact of a newly constructed Rail Trail in Western Sydney
Introduction
To achieve population-wide increases in physical activity, broader approaches to health promotion and community strategies are suggested to be complementary to the commonly used individual-based approaches such as changes in the social and physical environment, in community norms as well as policy and regulation [1], [2], [3]. These approaches have theoretical support from ecological models for health behavior suggesting that environments may encourage or discourage ranges of behaviors and understanding these environmental influences may help in planning more effective interventions to promote health [4], [5], [6].
During the past decade several cross-sectional analytic studies have included environmental factors in addition to individual and social variables in order to test their independent associations with levels of physical activity (PA) [7], [8], [9], [10], [11]. With the exception of one study [8], all indicated that availability and proximity of exercise facilities were associated either with level of activity for certain population subgroups [7], [9], [10] or with level of usage of these facilities [11], [12]. Increased usage of facilities was associated with more frequent physical activity participation [11], [12].
The published literature on interventions to promote PA in different settings revealed few studies that included ecological approaches [2], [3], [6], [13]. A recent systematic review of interventions to increase PA identified only 12 studies that included the creation of or enhancement of access to places for PA, all conducted in the United States. The authors concluded that these interventions were effective; however, most [8] were at worksites and incorporated other components, such as training, health education, and risk screening, which make it difficult to separate the unique benefits of each component [13].
A previous article, specifically on environmental and policy interventions [6], identified only three studies that examined how changes in policies and in the physical attributes of community, analogs to an ecological approach, affect activity levels [13], [14], [15]. These studies demonstrated small [13] to moderate effects [14], [15], but shortcomings in evaluation design, in implementation, or methodological flaws make it difficult to establish their effectiveness and illustrate the challenges in evaluating such complex interventions [6].
Despite the lack of evidence from rigorous evaluations on the benefits of infrastructure changes, the importance of creating supportive environments has became one of the central elements in health promotion strategies. The Australian Year 2000 strategy recommended structural changes that encourage people to walk or cycle instead of using motor transport [16]. Bicycle or pedestrian facilities have been funded and constructed across all states in the United States [17] but the recent published studies used cross-sectional designs, thus providing limited evidence for their effects [9], [10], [11].
The inherent complexity and the high costs that are involved in controlled trials of macro-level interventions, such as infrastructure change in community environments, will continue to constrain formal studies of their effectiveness [6]. More rigorous quasi-experimental evaluation studies are feasible and needed [6], [18], [19]. This should encompass collaboration between researchers and agencies involved in the implementation of the interventions and targeted evaluation in geographic settings where outcomes can be measured by direct observation or unobtrusive measures [6].
The NSW Road and Traffic Authority (RTA) completed the construction of a 16.5-km-long Rail Trail cycleway in Western Sydney in December 2000, as part of their statewide “Bike Plan” to encourage alternative modes of transport to cars [20]: The RTA undertook a short-term local promotional campaign around the Rail Trail, and monitored cycling activity before, during, and after the official opening in collaboration with NSW State Health Department and four Local Governmental Areas (LGAs). The main objectives of this evaluation were to assess the campaign reach and to detect changes in awareness, in Trail usage, and in walking and cycling activity. In addition, monitoring of daily bike use on the Trail was used to assess usage patterns over time.
Section snippets
Campaign objectives and components
The campaign target groups were potential cyclists and pedestrians living within 5 km of the Rail Trail in four Local Government Areas (LGAs). The campaign aimed to develop community awareness of the facility and its location and encourage its use by promoting the recreational and potential health benefits. Media components included local press advertisements about the newly constructed Rail Trail, including a map of the Trail in the English language and the six main community language
Results
At the baseline survey, 65% of the sampled households were contacted and agreed to participate in the second stage to identify eligible respondents. A total of 774 eligible respondents were identified in those households and 568 (73%) completed the baseline interview. Seventy-nine percent of the cohort (n = 450) completed both interviews.
Discussion
The main focus of this study was to evaluate the impact of the RTA campaign. Our findings indicate that after the short-term media campaign, awareness of the trail was slightly increased. This positive impact was demonstrated only for unprompted recall of the new local bike trail. At post-campaign, two-thirds of the local population still did not know about it. Although 50,000 brochures were distributed, only 9% at post-campaign reported receiving a brochure.
The campaign reached cyclists in the
Implications
The campaign seemed to affect only cyclists living close to the Trail. Further promotional and educational programs focusing on walking targeting residents near the Trail (1.5 km) may be needed to produce greater population levels of awareness and usage. Local activities such as walking events or activities with local schools may help in developing greater patronage of the Trail. Although the creation of, or enhanced access to, places for physical activity has been strongly recommended by the
Acknowledgements
Thanks go to NSW Health (data collection), the NSW Roads and Traffic Authority (RTA), and to South Western and Western Sydney Area health services.
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