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      Socio-Ecological Intervention to Promote Active Commuting to Work: Protocol and Baseline Findings of a Cluster Randomized Controlled Trial in Finland

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          Abstract

          Active commuting to work (ACW) is beneficial to traffic, environment and population health. More evidence is needed on effective ways to promote ACW. This paper describes the protocol and baseline findings of a cluster-randomized controlled study, which aims to promote ACW with multilevel strategies in two large workplace areas in Tampere, Finland. In Phase 1, the impacts of environmental strategies (trail improvements) were evaluated in 11 workplaces within Area 1. In Phase 2, five more workplaces were recruited from Area 2 to evaluate the impacts of social and behavioral strategies customized for each workplace. For this purpose, the workplaces in both areas were randomly assigned into experimental group (EXP, n = 6 + 2), which promoted ACW with social and behavioral strategies or into comparison group (COM, n = 5 + 3), which participated in the data collection only. The primary indicator in both phases is the change in employees’ ACW. Secondary indicators are e.g., changes in employees’ self-rated health, wellbeing at work, restrictions to and motivation for ACW, adverse effects due to ACW and the use and quality of the main walking and cycling trails. Also process, efficiency and environmental evaluation is included. The study is the first one in Finland to combine interdisciplinary collaboration between practitioners and researchers working in the fields of transportation, urban design, physical activity and sustainable development to promote ACW. The findings benefit all stakeholders interested in promoting ACW in urban context.

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          Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

          In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            City planning and population health: a global challenge

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              Health benefits of cycling: a systematic review.

              The purpose of this study was to update the evidence on the health benefits of cycling. A systematic review of the literature resulted in 16 cycling-specific studies. Cross-sectional and longitudinal studies showed a clear positive relationship between cycling and cardiorespiratory fitness in youths. Prospective observational studies demonstrated a strong inverse relationship between commuter cycling and all-cause mortality, cancer mortality, and cancer morbidity among middle-aged to elderly subjects. Intervention studies among working-age adults indicated consistent improvements in cardiovascular fitness and some improvements in cardiovascular risk factors due to commuting cycling. Six studies showed a consistent positive dose-response gradient between the amount of cycling and the health benefits. Systematic assessment of the quality of the studies showed most of them to be of moderate to high quality. According to standard criteria used primarily for the assessment of clinical studies, the strength of this evidence was strong for fitness benefits, moderate for benefits in cardiovascular risk factors, and inconclusive for all-cause mortality, coronary heart disease morbidity and mortality, cancer risk, and overweight and obesity. While more intervention research is needed to build a solid knowledge base of the health benefits of cycling, the existing evidence reinforces the current efforts to promote cycling as an important contributor for better population health. © 2011 John Wiley & Sons A/S.
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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                20 October 2017
                October 2017
                : 14
                : 10
                : 1257
                Affiliations
                [1 ]UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland; johanna.tiilikainen@ 123456uta.fi (J.T.); kari.tokola@ 123456uta.fi (K.T.); jaana.h.suni@ 123456uta.fi (J.S.); harri.sievanen@ 123456uta.fi (H.S.); henri.vaha-ypya@ 123456uta.fi (H.V.-Y.); tommi.vasankari@ 123456uta.fi (T.V.)
                [2 ]Department of Transport and Streets, City of Tampere, P.O. Box 487, 33101 Tampere, Finland; timo.seimela@ 123456tampere.fi
                [3 ]School of Architecture, Tampere University of Technology, P.O. Box 600, 33101 Tampere, Finland; satu.sarjala@ 123456tut.fi (S.-M.S.); ari.hynynen@ 123456tut.fi (A.H.)
                [4 ]WSP Finland Ltd., Kelloportinkatu 1 D, 33100 Tampere, Finland; pasi.metsapuro@ 123456wspgroup.fi (P.M.); kalle.vaismaa@ 123456wspgroup.fi (K.V.)
                [5 ]Ecofellows Ltd., Valssipadonraitti 3, 33100 Tampere, Finland; olli.vakkala@ 123456tampere.fi
                [6 ]Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, UK; charlie.foster@ 123456bristol.ac.uk
                [7 ]Institute of Sport Science, University of Graz, Mozartgasse 14, 8010 Graz, Austria; sylvia.titze@ 123456uni-graz.at
                Author notes
                [* ]Correspondence: minna.aittasalo@ 123456uta.fi ; Tel.: +358-3-282-9267
                Author information
                https://orcid.org/0000-0003-3032-2994
                https://orcid.org/0000-0003-3172-248X
                Article
                ijerph-14-01257
                10.3390/ijerph14101257
                5664758
                2cca3199-d667-4083-a682-cf8f03c38b47
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 September 2017
                : 17 October 2017
                Categories
                Protocol

                Public health
                walking,cycling,workplace,health promotion,environment,multilevel,intervention,protocol
                Public health
                walking, cycling, workplace, health promotion, environment, multilevel, intervention, protocol

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