Association between perceived access to public transport stops and physical activity among adults in Nanjing, Mainland China: A cross-sectional study

Background: The public transport access, an important dimension of neighborhood built environments and usually defined as the access to public transport stops/stations (PTS), has been revealed to be associated with more participation in physical activity (PA) in western countries. The perceptions of such features could have additional benefits to healthy behaviors. However, such research is lacking in developing countries. This study aimed to explore the association between perceived PTS access and PA participation among urban adults in China.

Methods: A population-based cross-sectional survey conducted in Nanjing in 2017 was used, where 1,568 participants aged 35–74 were recruited from eight randomly selected urban neighborhoods under a multi-stage sampling strategy. The individual's PTS access and PA participation were self-reported using the Physical Activity Neighborhood Environment Scale and the International Physical Activity Questionnaire, respectively. Mixed-effect logistic regression models were used to estimate the association between perceived PTS access and PA participation.

Results: Among 1,551 participants who completed the survey, 84.7% of participants achieved the World Health Organization (WHO) recommended PA level. After adjusting for potential individual- and neighborhood-level confounders, participants who perceived a PTS within 10–15 min’ walking distance from their residence were 3.18 (95%CI = [1.74, 5.80]) times more likely to meet WHO recommended PA guidelines than their counterparts who did not perceive any PTS in their neighborhoods. This association also held true in either men (OR = 2.71, 95%CI = [1.07, 6.86]) or women (OR = 3.50, 95%CI = [1.59, 7.70]), separately.

Conclusions: Such findings will provide health practitioners and urban planners evidence-based insights on potential health effects of expanding and improving public transport systems, and on how to incorporate these effects into strategies of PA promotion and chronic disease prevention.