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A Holistic Examination of Program Impact on Active School Travel School Travel Planning in Canada: A Holistic Examination of Program Impact on Active School Travel by George Mammen A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy Graduate Department of Exercise Sciences University of Toronto © Copyright by George Mammen 2016 School Travel Planning in Canada: A Holistic Examination of Program Impact on Active School Travel George Mammen Doctor of Philosophy Graduate Department of Exercise Sciences University of Toronto 2016 Abstract School Travel Planning (STP) is an intervention designed to increase Active School Travel (AST) among elementary school children (i.e., age 6-14 years). With limited evidence on program effectiveness, the purpose of this dissertation was i) to determine if STP can increases AST levels in Canadian elementary schools and ii) to identify school contextual and program factors influencing STP implementation and AST change. These objectives were addressed through four distinct studies entailing varied methodological approaches. Studies 1 and 2 quantitatively examined predictors of AST change following one-year of implementation using a sample of 106 schools across Canada and different outcome measures. Study 3 qualitatively explored enablers and barriers to implementation among 34 pan-Canadian STP facilitators. Study 4 employed a multisite mixed-methods case study design to provide insight into the STP process and key factors influencing implementation and AST change in two downtown Toronto schools. Across studies, results revealed that STP can facilitate increases in AST after the first year of implementation, though the degree of change can vary according to contextual and program factors. Contextual factors found to influence implementation and mode change included the school’s geographical location, distance from students’ homes, socioeconomic status, and transportation policies. Program factors included the school-specific and systematic STP model, ii multidisciplinary stakeholder involvement, designated facilitator, range of AST strategies, and length of implementation time. Overall, STP can promote increases in AST following one year of implementation. This dissertation informs future practice by identifying key factors to consider when implementing STP. The broader program of research also identifies the necessity of stakeholder involvement in initiatives promoting AST to help address a range of socio- ecological factors. Future evaluations should examine the sustainability of STP intervention impact and assess its cost-effectiveness. iii Acknowledgments I would like to express my sincere gratitude to those who have played a significant role in helping me achieve this milestone. To my supervisor, Dr. Guy Faulkner, thank you for providing me with unique opportunities during my doctoral studies. Along with the wealth of knowledge I gained on physical activity, active school travel, and various research methods, working under your supervision has taught me attributes of a productive academic including responsibility, multi-tasking, economical writing, and a persistent work ethic. I feel well prepared to begin my post-doctoral research and I owe much of this to you. To my committee members, Dr. Ron Buliung and Dr. Michelle Stone, thank you for consistently providing insightful feedback and helping strengthen the dissertation’s quality. Both of your roles on this committee have helped widen my philosophical views regarding children’s physical activity. I would also like to thank the Ontario Graduate Scholarship fund, Canadian Institute for Health Research, and the Department of Exercise Sciences at the University of Toronto in supporting my doctoral studies over the last four years. Last but certainly not least, I would like to thank my family. To my parents and two older brothers, thank you all for your continued curiosity, love, and support during my PhD. Without you all I would not be in this position today. To my son Lucas, I hope you read this one day to know that your first 15 months of life provided me with infinite smiles and laughs, which eased the demanding process of wrapping up this dissertation. To my wife, Amy, thank you for being so understanding, so supportive, so patient, so interested, and so encouraging. I will forever reflect on this PhD experience and associate it with your helping hand. Thank you to all. iv Abbreviations AST: Active School Travel BE: Built Environment BMI: Body Mass Index CDN: Canadian CIP: Capital Improvement Project CLASP: Coalition Linking Action and Science for Prevention GCC: Green Communities Canada GIS: Geographic Information System GTHA: Greater Toronto and Hamilton Area HAT: Health Action Team IM: Independent Mobility MVPA: Moderate to Vigorous Physical Activity NGO: Non-Government Organization PA: Physical Activity SRTS: Safe Routes to School STP: School Travel Planning TCDSB: Toronto Catholic District School Board TDSB: Toronto District School Board TPB: Theory of Planned Behaviour v WHO: World Health Organization WSB: Walking School Bus WTSD: Walk to School Day vi Table of Contents Acknowledgments .......................................................................................................................... iv Abbreviations .................................................................................................................................. v Table of Contents .......................................................................................................................... vii List of Tables ............................................................................................................................... xiii List of Figures .............................................................................................................................. xiv List of Appendices ....................................................................................................................... xvi Chapter 1 ......................................................................................................................................... 1 1 Introduction ................................................................................................................................ 1 1.1 The Issue: The Physical Inactivity Pandemic ..................................................................... 1 1.2 Active School Travel: A Promising Strategy? .................................................................... 2 1.3 What is School Travel Planning? ........................................................................................ 4 1.4 Rationale for School Travel Planning Research & Dissertation Objectives ....................... 4 1.5 Significance and Implications of the Dissertation Research ............................................... 5 1.6 Overview of Dissertation .................................................................................................... 6 Chapter 2 ......................................................................................................................................... 7 2 Literature Review ....................................................................................................................... 7 2.1 Health Benefits of AST ....................................................................................................... 7 2.1.1 Physical Benefits ..................................................................................................... 7 2.1.2 Cognitive Benefits .................................................................................................. 8 2.1.3 Psychosocial Development and Independent Mobility ........................................... 8 2.2 International Trends in AST ............................................................................................... 9 2.3 A Sociological lens on Children’s Mobility Practices ...................................................... 10 2.3.1 The Physical Environment .................................................................................... 10 2.3.2 Technology and its Impact on Societal Fears ....................................................... 11 vii 2.3.3 Changes in Family Dynamics ............................................................................... 12 2.3.4 Family Ethnicity and SES ..................................................................................... 13 2.4 Understanding AST through an Ecological Framework ................................................... 14 2.5 Individual level Factors Influencing AST ......................................................................... 15 2.5.1 Age, Gender, and Disability .................................................................................. 15 2.5.2 Psychosocial Factors ............................................................................................. 17 2.6 Interpersonal Level Factors Influencing AST ................................................................... 18 2.6.1 Parent Perceptions Regarding AST Safety ........................................................... 18 2.6.2 Parent Habits and Values Around Active Travel .................................................. 19 2.6.3 Family Characteristics .......................................................................................... 19 2.7 Organization Level Factors Influencing AST ................................................................... 20 2.7.1 School Culture .....................................................................................................
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