A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study

Palma Chillón, Patricia Gálvez-Fernández, Francisco Javier Huertas-Delgado, Manuel Herrador-Colmenero, Yaira Barranco-Ruiz, Emilio Villa-González, María Jesús Aranda-Balboa, Romina Gisele Saucedo-Araujo, Pablo Campos-Garzón, Daniel Molina-Soberanes, José Manuel Segura-Díaz, Fernando Rodríguez-Rodríguez, Amador Jesús Lara-Sánchez, Ana Queralt, Javier Molina-García, Enrique García Bengoechea, Sandra Mandic, Palma Chillón, Patricia Gálvez-Fernández, Francisco Javier Huertas-Delgado, Manuel Herrador-Colmenero, Yaira Barranco-Ruiz, Emilio Villa-González, María Jesús Aranda-Balboa, Romina Gisele Saucedo-Araujo, Pablo Campos-Garzón, Daniel Molina-Soberanes, José Manuel Segura-Díaz, Fernando Rodríguez-Rodríguez, Amador Jesús Lara-Sánchez, Ana Queralt, Javier Molina-García, Enrique García Bengoechea, Sandra Mandic

Abstract

This manuscript describes the rationale and protocol of a school-based randomized controlled trial called "Cycling and Walk to School" (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1-2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents.

Keywords: active transport; bicycle; exercise; school intervention; youth.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The “Pedalea y Anda al COle” (PACO) study logic model. Note: RCT: randomized controlled trial; ACS: active commuting to and from school; PA: physical activity; SDT: self-determination theory; SEM: social-ecological model; RE-AIM: reach, effectiveness, adoption, implementation, maintenance.
Figure 2
Figure 2
Cities, schools, and adolescent participants in the PACO study.
Figure 3
Figure 3
Plan flow chart of the PACO study.
Figure 4
Figure 4
Structure and duration of the school-based intervention to promote cycling to school.
Figure 5
Figure 5
The measurement procedure of the PACO study.

References

    1. Poitras V.J., Gray C.E., Borghese M.M., Carson V., Chaput J.P., Janssen I. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl. Physiol. Nutr. Metab. 2016;41:S197–S239. doi: 10.1139/apnm-2015-0663.
    1. Guthold R., Stevens G.A., Riley L.M., Bull F.C. Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 1·6 million participants. Lancet Child Adolesc. Health. 2020;4:23–35. doi: 10.1016/S2352-4642(19)30323-2.
    1. Telama R., Yang X., Leskinen E., Kankaanpää A., Hirvensalo M., Tammelin T., Viikari J.S.A., Raitakari O.T. Tracking of Physical Activity from Early Childhood through Youth into Adulthood. Med. Sci. Sports Exerc. 2014;46:955–962. doi: 10.1249/MSS.0000000000000181.
    1. Bull F.C., Al-Ansari S.S., Biddle S., Borodulin K., Buman M.P., Cardon G., Carty C., Chaput J.-P., Chastin S., Chou R., et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br. J. Sports Med. 2020;54:1451–1462. doi: 10.1136/bjsports-2020-102955.
    1. Chillón P., Hales D., Vaughn A., Gizlice Z., Ni A., Ward D.S. A cross-sectional study of demographic, environmental and parental barriers to active school travel among children in the United States. Int. J. Behav. Nutr. Phys. Act. 2014;11:61. doi: 10.1186/1479-5868-11-61.
    1. Larouche R., Saunders T.J., Faulkner G., Colley R., Tremblay M. Associations between active school transport and physical activity, body composition, and cardiovascular fitness: A systematic review of 68 studies. J. Phys. Act. Health. 2014;11:206–227. doi: 10.1123/jpah.2011-0345.
    1. Martin A., Boyle J., Corlett F., Kelly P., Reilly J.J. Contribution of Walking to School to Individual and Population Moderate-Vigorous Intensity Physical Activity: Systematic Review and Meta-Analysis. Pediatr. Exerc. Sci. 2016;28:353–363. doi: 10.1123/pes.2015-0207.
    1. Kek C.C., Bengoechea E.G., Spence J.C., Mandic S. The relationship between transport-to-school habits and physical activity in a sample of New Zealand adolescents. J. Sport Health Sci. 2019;8:463–470. doi: 10.1016/j.jshs.2019.02.006.
    1. Uddin R., Mandic S., Khan A. Active commuting to and from school among 106,605 adolescents in 27 Asia-Pacific countries. J. Transp. Health. 2019;15:100637. doi: 10.1016/j.jth.2019.100637.
    1. Waygood E., Friman M., Olsson L.E., Taniguchi A. Transport and child well-being: An integrative review. Travel Behav. Soc. 2017;9:32–49. doi: 10.1016/j.tbs.2017.04.005.
    1. Gössling S., Choi A., Dekker K., Metzler D. The Social Cost of Automobility, Cycling and Walking in the European Union. Ecol. Econ. 2019;158:65–74. doi: 10.1016/j.ecolecon.2018.12.016.
    1. Willumsen J., Bull F. Development of WHO Guidelines on Physical Activity, Sedentary Behavior, and Sleep for Children Less Than 5 Years of Age. J. Phys. Act. Health. 2020;17:96–100. doi: 10.1123/jpah.2019-0457.
    1. United Nations . Transforming Our World: The 2030 Agenda for Sustainable Development. General Assembly 70 Session. United Nations; New York, NY, USA: 2015.
    1. Aubert S., Barnes J.D., Abdeta C., Abi Nader P., Adeniyi A.F., Aguilar-Farias N., Tenesaca D.S.A., Bhawra J., Brazo-Sayavera J., Cardon G., et al. Global Matrix 3.0 Physical Activity Report Card Grades for Children and Youth: Results and Analysis From 49 Countries. J. Phys. Act. Health. 2018;15:251–273. doi: 10.1123/jpah.2018-0472.
    1. Herrador-Colmenero M., Escabias M., Ortega F.B., McDonald N.C., Chillón P. Mode of Commuting TO and FROM School: A Similar or Different Pattern? Sustainability. 2019;11:1026. doi: 10.3390/su11041026.
    1. Gabinet d’Estudis Socials i Opinió Pública SL. Barómetro de la Bicicleta en España. Informe de Resultados 2019. [(accessed on 15 September 2020)]; Available online: .
    1. Chillón P., Martínez-Gómez D., Ortega F.B., Pérez-López I.J., Díaz L.E., Veses A.M., Veiga O.L., Marcos A., Delgado-Fernández M. Six-Year Trend in Active Commuting to School in Spanish Adolescents. Int. J. Behav. Med. 2012;20:529–537. doi: 10.1007/s12529-012-9267-9.
    1. Martínez-Gómez D., Veiga O.L., Gomez-Martinez S., Zapatera B., Calle M.E., Marcos A. Behavioural correlates of active commuting to school in Spanish adolescents: The AFINOS (Physical Activity as a Preventive Measure Against Overweight, Obesity, Infections, Allergies, and Cardiovascular Disease Risk Factors in Adolescents) study. Public Health Nutr. 2011;14:1779–1786.
    1. Te Velde S.J., Haraldsen E., Vik F.N., De Bourdeaudhuij I., Jan N., Kovacs E. Associations of commuting to school and work with demographic variables and with weight status in eight European countries: The ENERGY-cross sectional study. Prev. Med. 2017;99:305–312. doi: 10.1016/j.ypmed.2017.03.005.
    1. Cardon G.M., Maes L.R., Haerens L.L., De Bourdeaudhuij I.M. Bicycling to school during the transition from childhood into adolescence: A six-year longitudinal study. Pediatr. Exerc. Sci. 2012;24:369–383. doi: 10.1123/pes.24.3.369.
    1. Sevil J., García-González L., Abós Á., Generelo E., Aibar A. Can high schools be an effective setting to promote healthy lifestyles? Effects of a multiple behavior change intervention in adolescents. J. Adolesc. Health. 2019;64:478–486. doi: 10.1016/j.jadohealth.2018.09.027.
    1. Chillón P., Evenson K.R., Vaughn A., Ward D.S. A systematic review of interventions for promoting active transportation to school. Int. J. Behav. Nutr. Phys. Act. 2011;8:10. doi: 10.1186/1479-5868-8-10.
    1. Larouche R., Mammen G., Rowe D.A., Faulkner G. Effectiveness of active school transport interventions: A systematic review and update. BMC Public Health. 2018;18:1–18. doi: 10.1186/s12889-017-5005-1.
    1. Pang B., Kubacki K., Rundle-Thiele S. Promoting active travel to school: A systematic review (2010–2016) BMC Public Health. 2017;17:1–15. doi: 10.1186/s12889-017-4648-2.
    1. Villa-González E., Barranco-Ruiz Y., Evenson K.R., Chillón P. Systematic review of interventions for promoting active school transport. Prev. Med. 2018;111:115–134. doi: 10.1016/j.ypmed.2018.02.010.
    1. Verhoeven H., Simons D., Van Dyck D., Van Cauwenberg J., Clarys P., De Bourdeaudhuij I., De Geus B., Vandelanotte C., Deforche B. Psychosocial and Environmental Correlates of Walking, Cycling, Public Transport and Passive Transport to Various Destinations in Flemish Older Adolescents. PLoS ONE. 2016;11:e0147128. doi: 10.1371/journal.pone.0147128.
    1. Rahman M.L., Moore A., Smith M., Lieswyn J., Mandic S. A Conceptual Framework for Modelling Safe Walking and Cycling Routes to High Schools. Int. J. Environ. Res. Public Health. 2020;17:3318. doi: 10.3390/ijerph17093318.
    1. Jones P. The Impact of Cycle Skills Training on Skills, Confidence, Attitudes and Rates of Cycling. Waterford Institute of Technology; Waterford, Ireland: 2017.
    1. Sersli S., Devries D., Gislason M., Scott N., Winters M. Changes in bicycling frequency in children and adults after bicycle skills training: A scoping review. Transp. Res. Part A Policy Practice. 2019;123:170–187. doi: 10.1016/j.tra.2018.07.012.
    1. Hatfield J., Boufous S., Maharaj P., Patton D., Eveston T. An Evaluation of the Effects of a School-Based Cycling Education Program on Participation and Safety. NRMA-ACT Road Safety Trust; Sydney, Australia: 2015.
    1. Chillón P., Mandic S. Active transport to and from school. Adv. Transp. Health. 2020:267–290. doi: 10.1016/b978-0-12-819136-1.00012-7.
    1. Sallis J.F., Owen N., Fisher E.B. Ecological models of health behavior. In: Glanz K., Rimer B.K., Viswanath K., editors. Health Behavior and Health Education: Theory, Research, and Practice. Jossey-Bass Inc.; San Francisco, CA, USA: 2008.
    1. Deci E.L., Ryan R.M. The general causality orientations scale: Self-determination in personality. J. Res. Personal. 1985;19:109–134. doi: 10.1016/0092-6566(85)90023-6.
    1. Kwasnicka D., Dombrowski S.U., White M., Sniehotta F. Theoretical explanations for maintenance of behaviour change: A systematic review of behaviour theories. Health Psychol. Rev. 2016;10:277–296. doi: 10.1080/17437199.2016.1151372.
    1. Larouche R., Ghekiere A. An Ecological Model of Active Transportation. Child. Act. Transp. 2018:93–103. doi: 10.1016/b978-0-12-811931-0.00006-5.
    1. Smith M., Ikeda E., Hawley G., Mavoa S., Hosking J., Egli V., Zhao J., Mackay L., Donnellan N., Amann R., et al. An integrated conceptual model of environmental needs for New Zealand children’s active travel to school. J. Transp. Health. 2020;16:100814. doi: 10.1016/j.jth.2019.100814.
    1. Mitra R., Manaugh K. A social-ecological conceptualization of children’s mobility. Transp. Child. Well Being. 2020:81–100. doi: 10.1016/b978-0-12-814694-1.00005-1.
    1. Ntoumanis N., Ng J.Y., Prestwich A., Quested E., Hancox J.E., Thøgersen-Ntoumani C., Deci E.L., Ryan R.M., Lonsdale C., Williams G.C. A meta-analysis of self-determination theory-informed intervention studies in the health domain: Effects on motivation, health behavior, physical, and psychological health. Health Psychol. Rev. 2020:1–31. doi: 10.1080/17437199.2020.1718529.
    1. Ikeda E., Stewart T., Garrett N., Egli V., Mandic S., Hosking J., Witten K., Hawley G., Tautolo E.S., Rodda J., et al. Built environment associates of active school travel in New Zealand children and youth: A systematic meta-analysis using individual participant data. J. Transp. Health. 2018;9:117–131. doi: 10.1016/j.jth.2018.04.007.
    1. Molina-García J., García-Massó X., Estevan I., Queralt A. Built Environment, Psychosocial Factors and Active Commuting to School in Adolescents: Clustering a Self-Organizing Map Analysis. Int. J. Environ. Res. Public Health. 2018;16:83. doi: 10.3390/ijerph16010083.
    1. Zhang T., Solmon M. Integrating self-determination theory with the social ecological model to understand students’ physical activity behaviors. Int. Rev. Sport Exerc. Psychol. 2013;6:54–76. doi: 10.1080/1750984X.2012.723727.
    1. Glasgow R.E., Harden S.M., Gaglio B., Rabin B., Smith M.L., Porter G.C., Ory M.G., Estabrooks P.A. RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review. Front. Public Health. 2019;7:64. doi: 10.3389/fpubh.2019.00064.
    1. Glasgow R.E., Vogt T.M., Boles S.M. Evaluating the public health impact of health promotion interventions: The RE-AIM framework. Am. J. Public Health. 1999;89:1322–1327. doi: 10.2105/AJPH.89.9.1322.
    1. Cassar S., Salmon J., Timperio A., Naylor P.-J., Van Nassau F., Ayala A.M.C., Koorts H. Adoption, implementation and sustainability of school-based physical activity and sedentary behaviour interventions in real-world settings: A systematic review. Int. J. Behav. Nutr. Phys. Act. 2019;16:1–13. doi: 10.1186/s12966-019-0876-4.
    1. McGoey T., Root Z., Bruner M.W., Law B. Evaluation of physical activity interventions in youth via the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: A systematic review of randomised and non-randomised trials. Prev. Med. 2015;76:58–67. doi: 10.1016/j.ypmed.2015.04.006.
    1. Herlitz L., MacIntyre H., Osborn T., Bonell C. The sustainability of public health interventions in schools: A systematic review. Implement. Sci. 2020;15:1–28. doi: 10.1186/s13012-019-0961-8.
    1. Hagger M.S., Weed M. DEBATE: Do interventions based on behavioral theory work in the real world? Int. J. Behav. Nutr. Phys. Act. 2019;16:1–10. doi: 10.1186/s12966-019-0795-4.
    1. Demetriou Y., Bachner J. A school-based intervention based on self-determination theory to promote girls’ physical activity: Study protocol of the CReActivity cluster randomised controlled trial. BMC Public Health. 2019;19:519. doi: 10.1186/s12889-019-6817-y.
    1. Salmon J., Brown H., Hume C. Effects of strategies to promote children’s physical activity on potential mediators. Int. J. Obes. 2009;33:S66–S73. doi: 10.1038/ijo.2009.21.
    1. Lubans D.R., Foster C., Biddle S.J.H. A review of mediators of behavior in interventions to promote physical activity among children and adolescents. Prev. Med. 2008;47:463–470. doi: 10.1016/j.ypmed.2008.07.011.
    1. Faul F., Erdfelder E., Lang A.-G., Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods. 2007;39:175–191. doi: 10.3758/BF03193146.
    1. Bors P., Dessauer M., Bell R., Wilkerson R., Lee J., Strunk S.L. The Active Living by Design national program: Community initiatives and lessons learned. Am. J. Prev. Med. 2009;37:S313–S321. doi: 10.1016/j.amepre.2009.09.027.
    1. Schönbach D.M.I., Altenburg T.M., Chinapaw M.J.M., Marques A., Demetriou Y. Strategies and effects of promising school-based interventions to promote active school transportation by bicycle among children and adolescents: Protocol for a systematic review. Syst. Rev. 2019;8:1–6. doi: 10.1186/s13643-019-1216-0.
    1. Zeuwts L.H., Deconinck F.J., Vansteenkiste P., Cardon G., Lenoir M. Understanding the development of bicycling skills in children: A systematic review. Saf. Sci. 2020;123:104562. doi: 10.1016/j.ssci.2019.104562.
    1. Ley Orgánica 8/2013, de 9 de Diciembre, para la Mejora de la Calidad Educativa. Boletín Oficial del Estado 2013. [(accessed on 10 October 2020)]; Available online: .
    1. Salto-Ruiz C., Balboa M.J.A., Fernández P.G., Colmenero M.H., Garzón P.C. Proyecto de innovación educativa para la eso:“manual de intervención bikeability”. Habilid. Mot. Rev. Cienc. Act. Física Deporte. 2019;52:12–38.
    1. Goodman A., Van Sluijs E.M., Ogilvie D. Cycle training for children: Which schools offer it and who takes part? J. Transp. Health. 2015;2:512–521. doi: 10.1016/j.jth.2015.07.002.
    1. Gálvez-Fernández P., Saucedo-Araujo R., Campos-Garzón P., Aranda-Balboa M.J., Molina-Soberanes D., Segura-Díaz J.M., Herrador-Colmenero M., Huertas-Delgado F.J., Villa-González E., Barranco-Ruiz Y., et al. El desplazamiento activo al centro educativo e indicadores de salud asociados: Protocolo de evaluación del estudio PACO “Pedalea y Anda al Colegio” y su aplicación en educación secundaria. Retos. 2021;39:649–657.
    1. Ritley K., Schlestein M., Dosch H. DataScan: An extensible program for image analysis in Java. Comput. Phys. Commun. 2001;137:300–311. doi: 10.1016/S0010-4655(01)00155-2.
    1. Chillón P., Herrador-Colmenero M., Migueles J.H., Cabanas-Sánchez V., Fernández-Santos J.R., Veiga Ó.L. Convergent validation of a questionnaire to assess the mode and frequency of commuting to and from school. Scand. J. Public Health. 2017;45:612–620. doi: 10.1177/1403494817718905.
    1. Segura-Díaz J.M., Rojas-Jiménez Á., Barranco-Ruiz Y., Murillo-Pardo B., Saucedo-Araujo R.G., Aranda-Balboa M.J., Herrador-Colmenero M., Villa-González E., Chillón P. Feasibility and Reliability of a Questionnaire to Assess the Mode, Frequency, Distance and Time of Commuting to and from School: The PACO Study. Int. J. Environ. Res. Public Health. 2020;17:5039. doi: 10.3390/ijerph17145039.
    1. Aranda-Balboa M.J., Fernández M., Villa-González E., Murillo-Pardo B., Segura-Díaz J.M., Saucedo-Araujo R.G., Barranco-Ruiz Y., Herrador-Colmenero M., Huertas-Delgado F.J., Chillón P. Psychometric Characteristics of a Commuting-to-School Behaviour Questionnaire for Families. Int. J. Environ. Res. Public Health. 2020;17:8584. doi: 10.3390/ijerph17228584.
    1. Segura-Díaz J.M., Barranco-Ruiz Y., Saucedo-Araujo R.G., Aranda-Balboa M.J., Cadenas-Sanchez C., Migueles J.H., Saint-Maurice P.F., Ortega F.B., Welk G.J., Herrador-Colmenero M., et al. Feasibility and reliability of the Spanish version of the Youth Activity Profile questionnaire (YAP-Spain) in children and adolescents. J. Sports Sci. 2020:1–7. doi: 10.1080/02640414.2020.1847488.
    1. Molina-García J., Queralt A., Estevan I., Álvarez O., Castillo I. Perceived barriers to active commuting to school: Reliability and validity of a scale. Gaceta Sanit. 2016;30:426–431. doi: 10.1016/j.gaceta.2016.05.006.
    1. Burgueño R., González-Cutre D., Sevil-Serrano J., Herrador-Colmenero M., Segura-Díaz J.M., Medina-Casaubón J., Chillón P. Validation of the Basic Psychological Need Satisfaction in Active Commuting to and from School (BPNS-ACS) scale in Spanish young people. J. Transp. Health. 2020;16:100825. doi: 10.1016/j.jth.2020.100825.
    1. Burgueño R., Medina-Casaubón J. Validity and Reliability of the Interpersonal Behaviors Questionnaire in Physical Education With Spanish Secondary School Students. Percept. Mot. Ski. 2021;128:522–545. doi: 10.1177/0031512520948286.
    1. Torsheim T., Cavallo F., Levin K.A., Schnohr C., Mazur J., Niclasen B. Psychometric Validation of the Revised Family Affluence Scale: A Latent Variable Approach. Child. Indic. Res. 2016;9:771–784. doi: 10.1007/s12187-015-9339-x.
    1. Huertas-Delgado F., Molina-García J., Van Dyck D., Chillon P. A questionnaire to assess parental perception of barriers towards active commuting to school (PABACS): Reliability and validity. J. Transp. Health. 2019;12:97–104. doi: 10.1016/j.jth.2018.12.004.
    1. Chillón P., Ortega F.B., Ruiz J.R., Pérez I.J., Martín-Matillas M., Valtueña J. Socio-economic factors and active commuting to school in urban Spanish adolescents: The AVENA study. Eur. J. Public. Health. 2009;19:470–476. doi: 10.1093/eurpub/ckp048.
    1. Migueles J.H., Cadenas-Sanchez C., Ekelund U., Nyström C.D., Mora-Gonzalez J., Löf M., Labayen I., Ruiz J.R., Ortega F.B. Accelerometer Data Collection and Processing Criteria to Assess Physical Activity and Other Outcomes: A Systematic Review and Practical Considerations. Sports Med. 2017;47:1821–1845. doi: 10.1007/s40279-017-0716-0.
    1. Saint-Maurice P.F., Welk G.J. Validity and Calibration of the Youth Activity Profile. PLoS ONE. 2015;10:e0143949. doi: 10.1371/journal.pone.0143949.
    1. Saint-Maurice P.F., Kim Y., Hibbing P., Oh A.Y., Perna F.M., Welk G.J. Calibration and Validation of the Youth Activity Profile: The FLASHE Study. Am. J. Prev. Med. 2017;52:880–887. doi: 10.1016/j.amepre.2016.12.010.
    1. Murcia J.A.M., Coll D.G.C., Garzón M.C., Rojas N.P. Adaptación a la educación física de la escala de las necesidades psicológicas básicas en el ejercicio. Rev. Mex. Psicol. 2008;25:295–303.
    1. González-Cutre D., Sicilia Á., Fernández A. Toward a deeper understanding of motivation towards exercise: Measurement of integrated regulation in the Spanish context. Psicothema. 2010;22:841–847.
    1. Stewart A., Marfell-Jones M., Olds T., De Ridder H. International Society for the Advancement of Kinanthropometry: International Standards for Anthropometric Assessment. International Society for the Advancement of Kinanthropometry; Lower Hutt, New Zealand: 2001.
    1. Boyce W., Torsheim T., Currie C., Zambon A. The family affluence scale as a measure of national wealth: Validation of an adolescent self-report measure. Soc. Ind. Res. 2006;78:473–487. doi: 10.1007/s11205-005-1607-6.
    1. Molina-García J., Queralt A., Adams M.A., Conway T.L., Sallis J.F. Neighborhood built environment and socio-economic status in relation to multiple health outcomes in adolescents. Prev. Med. 2017;105:88–94. doi: 10.1016/j.ypmed.2017.08.026.
    1. Janssen E., Sugiyama T., Winkler E., De Vries H., Poel F.T., Owen N. Psychosocial correlates of leisure-time walking among Australian adults of lower and higher socio-economic status. Health Educ. Res. 2009;25:316–324. doi: 10.1093/her/cyp012.
    1. Rodríguez-López C., Salas-Fariña Z.M., Villa-González E., Borges-Cosic M., Herrador-Colmenero M., Medina-Casaubón J., Ortega F.B., Chillón P. The Threshold Distance Associated with Walking from Home to School. Health Educ. Behav. 2017;44:857–866. doi: 10.1177/1090198116688429.
    1. Chillón P., Molina-García J., Castillo I., Queralt A. What distance do university students walk and bike daily to class in Spain. J. Transp. Health. 2016;3:315–320. doi: 10.1016/j.jth.2016.06.001.
    1. Greiver M., Dahrouge S., O’Brien P., Manca D., Lussier M.T., Wang J., Burge F., Grandy M., Singer A., Twohig M., et al. Improving care for elderly patients living with polypharmacy: Protocol for a pragmatic cluster randomized trial in community-based primary care practices in Canada. Implement. Sci. 2019;14:55. doi: 10.1186/s13012-019-0904-4.
    1. Johnstone A., Hughes A.R., Janssen X., Reilly J.J. Pragmatic evaluation of the Go2Play Active Play intervention on physical activity and fundamental movement skills in children. Prev. Med. Rep. 2017;7:58–63. doi: 10.1016/j.pmedr.2017.05.002.
    1. Corder K., Sharp S.J., Jong S.T., Foubister C., Brown H.E., Wells E.K., Armitage S.M., Croxson C.H.D., Vignoles A., Wilkinson P.O., et al. Effectiveness and cost-effectiveness of the GoActive intervention to increase physical activity among UK adolescents: A cluster randomised controlled trial. PLoS Med. 2020;17:e1003210. doi: 10.1371/journal.pmed.1003210.
    1. Ogilvie D., Adams J., Bauman A., Gregg E.W., Panter J., Siegel K.R., Wareham N.J., White M. Using natural experimental studies to guide public health action: Turning the evidence-based medicine paradigm on its head. J. Epidemiol. Commun. Health. 2020;74:203–208. doi: 10.1136/jech-2019-213085.

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