摘要：Objectives . We tested the reliability of 3 instruments that assessed social and physical environments. Methods . We conducted a test–retest study among US adults (n = 289). We used telephone survey methods to measure suitableness of the perceived (vs objective) environment for recreational physical activity and nonmotorized transportation. Results . Most questions in our surveys that attempted to measure specific characteristics of the built environment showed moderate to high reliability. Questions about the social environment showed lower reliability than those that assessed the physical environment. Certain blocks of questions appeared to be selectively more reliable for urban or rural respondents. Conclusions . Despite differences in content and in response formats, all 3 surveys showed evidence of reliability, and most items are now ready for use in research and in public health surveillance. An estimated 200 000 to 300 000 premature deaths occur each year in the United States because of physical inactivity. 1– 4 Accordingly, the goal of increasing physical activity is one of 10 “leading indicator” areas within the national health objectives of Healthy People 2010 . 5 Even with the known health benefits of physical activity, more than one quarter of the American population remains completely inactive, and US trends in activity showed little improvement from 1990 to 1998. 6 More than 60% of the world’s population is not physically active enough to achieve health benefits. 7 The physical, or built, environment is important in providing cues and opportunities for activity, 8 and it is associated with rates of physical activity in intervention studies and in large population-based surveys. 9 Support for the importance of the environment is derived from 2 distinct literatures. A review of 19 studies in the physical activity and health literature showed consistent associations of accessibility of recreational facilities, opportunities to be active, and certain aesthetic qualities with physical activity in adults. 10 Researchers in the transportation and urban planning fields have examined the relationship between community design variables and walking or cycling for transportation. Fourteen studies have consistently shown that people walk and cycle more when their neighborhoods have higher residential density, a mixture of land uses (e.g., shops are within walking distance of homes), and connected streets (e.g., gridlike pattern instead of many cul-de-sacs). 11 Other community design characteristics, such as the condition of sidewalks, the presence of bike paths, street design, traffic volume and speed, and crime, are hypothesized to be related to physical activity 12, 13 but have not been systematically examined. In addition, rural areas have important differences from urban areas in their activity-related design features 14– 16 and are generally understudied. 11 Multiple questionnaires have been developed to assess physical activity—measurement properties (i.e., reliability/validity) are documented for many of these. For example, Ainsworth et al. 17 reported on the measurement properties of 39 questionnaires, and Kriska and Caspersen 18 described the validity, reliability, and comprehensiveness of 32 instruments. In contrast, considering the apparent importance of the built environment, there is limited information in the literature on how best to measure various aspects, such as the presence of well-maintained sidewalks or whether shopping venues are within walking distance. 19 One method of measuring the perceived physical environment is through population-based surveys and surveillance systems. 20 Individual responses from these surveys can be aggregated to identify patterns in important design/neighborhood features (e.g., lack of access to sidewalks in rural areas) and to determine associations between these design features and behavior. 21– 23 As yet, it is unclear whether the objective environment (e.g., actual counts of traffic) or the perceived environment (e.g., an individual’s self-reported perception of crime in his/her neighborhood) is more important in explaining physical activity. 10, 11 As measures of perceived environments are developed, it is important to ensure that they can be administered by multiple modes (e.g., self and interviewer administered) and are reliable for broad populations. Our study reports the results of reliability testing of 3 instruments among urban and rural residents across the United States. A major focus of the instruments tested was the assessment of environmental characteristics that are believed to be related to recreational physical activity and nonmotorized transportation, although some instruments assessed other related variables.
