Causal pathways linking environmental change with health behaviour change: Natural experimental study of new transport infrastructure and cycling to work.
Published version
Peer-reviewed
Repository URI
Repository DOI
Change log
Authors
Abstract
BACKGROUND: Mechanisms linking changes to the environment with changes in physical activity are poorly understood. Insights into mechanisms of interventions can help strengthen causal attribution and improve understanding of divergent response patterns. We examined the causal pathways linking exposure to new transport infrastructure with changes in cycling to work. METHODS: We used baseline (2009) and follow-up (2012) data (N=469) from the Commuting and Health in Cambridge natural experimental study (Cambridge, UK). Exposure to new infrastructure in the form of the Cambridgeshire Guided Busway was defined using residential proximity. Mediators studied were changes in perceptions of the route to work, theory of planned behaviour constructs and self-reported use of the new infrastructure. Outcomes were modelled as an increase, decrease or no change in weekly cycle commuting time. We used regression analyses to identify combinations of mediators forming potential pathways between exposure and outcome. We then tested these pathways in a path model and stratified analyses by baseline level of active commuting. RESULTS: We identified changes in perceptions of the route to work, and use of the cycle path, as potential mediators. Of these potential mediators, only use of the path significantly explained (85%) the effect of the infrastructure in increasing cycling. Path use also explained a decrease in cycling among more active commuters. CONCLUSION: The findings strengthen the causal argument that changing the environment led to changes in health-related behaviour via use of the new infrastructure, but also show how some commuters may have spent less time cycling as a result.
Description
Keywords
Journal Title
Conference Name
Journal ISSN
1096-0260
Volume Title
Publisher
Publisher DOI
Sponsorship
null (unknown)
Medical Research Council (MR/K023187/1)
Economic and Social Research Council (ES/G007462/1)
Wellcome Trust (087636/Z/08/Z)
NETSCC (None)
TCC (None)
Medical Research Council (MC_UP_1001/1)
NIHR Evaluation Trials and Studies Coordinating Centre (09/3001/06)