Browsing by Author "Winters, Meghan"

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    Bicycling Injuries in Children: The Role of the Built Environment
    (2024-10-28) Aucoin, Janet; Hagel, Brent; Nettel-Aguirre, Alberto; Winters, Meghan; McCormack, Gavin
    Background: Bicycling has many health benefits for children but can result in injuries, some severe. Additionally, children’s perceptions of injury risk decrease participation. The built environment is associated with the risk of bicycling injury in adults, yet less is known about risks for children who have different bicycling behaviours and locations than adults. This dissertation improves understanding of child bicyclist injury risk factors and perceptions in Canada, with an emphasis on the role of the built environment. Methods: We recruited 333 injured child bicyclists (ages 5-17) who presented to pediatric emergency departments in Vancouver, Calgary, and Toronto from May 2018 - October 2021. Using data from participant interviews and in-person site audits of injury/control locations from the injured child’s route, Chapter 3 used a case-crossover study design to examine associations between built environment characteristics and child bicyclist injuries. Chapter 4 used data from the case-crossover study to explore injury circumstances and examine risk factors associated with severe child bicyclist injuries. In 2021, 40 participants also completed a qualitative interview to explore injured child bicyclists’ perceptions of risk factors and safety (Chapter 5). Results: The results in Chapter 3 provided evidence that unpaved off road locations, presence of debris, poor surface quality, surface grade, and construction were risk factors for child bicyclist injuries. In Chapter 4, motor vehicle involvement and intersections were associated with higher odds of severe injury in child bicyclists. In Chapter 5, child bicyclists shared that some of the factors that contribute to perceptions of safety included sharing spaces with motor vehicles, road design, debris, surface quality, and surface grade. Conclusions: This study adds to evidence suggesting built environment supports are important for increasing bicycling safety for Canadian children. There is a critical need to provide child bicyclists with safe spaces where they are physically separated from motor vehicles and to ensure that routes used by child bicyclists are properly maintained.
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    Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users
    (2023-12-07) Prince, Stephanie A.; Lang, Justin J.; de Groh, Margaret; Badland, Hannah; Barnett, Anthony; Littlejohns, Lori B.; Brandon, Nicholas C.; Butler, Gregory P.; Casu, Géna; Cerin, Ester; Colley, Rachel C.; de Lannoy, Louise; Demchenko, Iryna; Ellingwood, Holly N.; Evenson, Kelly R.; Faulkner, Guy; Fridman, Liraz; Friedenreich, Christine M.; Fuller, Daniel L.; Fuselli, Pamela; Giangregorio, Lora M.; Gupta, Neeru; Hino, Adriano A.; Hume, Clare; Isernhagen, Birgit; Jalaludin, Bin; Lakerveld, Jeroen; Larouche, Richard; Lemon, Stephenie C.; Loucaides, Constantinos A.; Maddock, Jay E.; McCormack, Gavin R.; Mehta, Aman; Milton, Karen; Mota, Jorge; Ngo, Victor D.; Owen, Neville; Oyeyemi, Adewale L.; Palmeira, António L.; Rainham, Daniel G.; Rhodes, Ryan E.; Ridgers, Nicola D.; Roosendaal, Inge; Rosenberg, Dori E.; Schipperijn, Jasper; Slater, Sandra J.; Storey, Kate E.; Tremblay, Mark S.; Tully, Mark A.; Vanderloo, Leigh M.; Veitch, Jenny; Vietinghoff, Christina; Whiting, Stephen; Winters, Meghan; Yang, Linchuan; Geneau, Robert
    Abstract Background The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). Methods Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin ‘top 10’ lists of the most important research needs. Results From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. Conclusions Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.
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    Rethinking walkability and developing a conceptual definition of active living environments to guide research and practice
    (2022-03-07) Tobin, Melissa; Hajna, Samantha; Orychock, Kassia; Ross, Nancy; DeVries, Megan; Villeneuve, Paul J.; Frank, Lawrence D.; McCormack, Gavin R.; Wasfi, Rania; Steinmetz-Wood, Madeleine; Gilliland, Jason; Booth, Gillian L.; Winters, Meghan; Kestens, Yan; Manaugh, Kevin; Rainham, Daniel; Gauvin, Lise; Widener, Michael J.; Muhajarine, Nazeem; Luan, Hui; Fuller, Daniel
    Abstract Background Walkability is a popular term used to describe aspects of the built and social environment that have important population-level impacts on physical activity, energy balance, and health. Although the term is widely used by researchers, practitioners, and the general public, and multiple operational definitions and walkability measurement tools exist, there are is no agreed-upon conceptual definition of walkability. Method To address this gap, researchers from Memorial University of Newfoundland hosted “The Future of Walkability Measures Workshop” in association with researchers from the Canadian Urban Environmental Health Research Consortium (CANUE) in November 2017. During the workshop, trainees, researchers, and practitioners worked together in small groups to iteratively develop and reach consensus about a conceptual definition and name for walkability. The objective of this paper was to discuss and propose a conceptual definition of walkability and related concepts. Results In discussions during the workshop, it became clear that the term walkability leads to a narrow conception of the environmental features associated with health as it inherently focuses on walking. As a result, we suggest that the term Active Living Environments, as has been previously proposed in the literature, are more appropriate. We define Active Living Environments (ALEs) as the emergent natural, built, and social properties of neighbourhoods that promote physical activity and health and allow for equitable access to health-enhancing resources. Conclusions We believe that this broader conceptualization allows for a more comprehensive understanding of how built, natural, and social environments can contribute to improved health for all members of the population.
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    The built environment and active transportation safety in children and youth: a study protocol
    (2019-06-11) Hagel, Brent E; Macpherson, Alison; Howard, Andrew; Fuselli, Pamela; Cloutier, Marie-Soleil; Winters, Meghan; Richmond, Sarah A; Rothman, Linda; Belton, Kathy; Buliung, Ron; Emery, Carolyn A; Faulkner, Guy; Kennedy, Jacqueline; Ma, Tracey; Macarthur, Colin; McCormack, Gavin R.; Morrow, Greg; Nettel-Aguirre, Alberto; Owens, Liz; Pike, Ian; Russell, Kelly; Torres, Juan; Voaklander, Donald; Embree, Tania; Hubka, Tate
    Abstract Background Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury. Methods First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist’s route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries. Discussion This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team’s national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.