INTRODUCTION: Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese). METHODS AND ANALYSIS: The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status. ETHICS AND DISSEMINATION: Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.

AFIPS research group Department of Musical Visual and Corporal Expression Teaching University of Valencia Valencia Spain

Department of Architecture Bangladesh University of Engineering and Technology Dhaka Dhaka District Bangladesh

Department of Movement and Sport Sciences Ghent University Ghent Belgium

Department of Physiotherapy University of Maiduguri Maiduguri Borno Nigeria

Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark

Department of Urban Studies and Planning University of California San Diego La Jolla California USA

Graduate Program in Urban Management Pontifical Catholic University of Parana Curitiba Paraná Brazil

Herbert Wertheim School of Public Health and Human Longevity Science University of California San Diego La Jolla California USA

Institute of Active Lifestyle Palacky University Olomouc Olomouc Olomoucký Czech Republic

Institute of Physical Activity and Nutrition School of Exercise and Nutrition Sciences Deakin University Geelong Victoria Australia

Institute of Urban and Regional Development University of California Berkeley Berkeley California USA

Khazanah Research Institute Kuala Lumpur Wilayah Persekutuan Malaysia

Madras Diabetes Research Foundation Chennai Tamil Nadu India

Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Victoria Australia

Prevention Research Center Brown School at Washington University in St Louis St Louis Missouri USA

Research Centre in Physical Activity Health and Leisure University of Porto Porto Portugal

School of Public Health University of Haifa Haifa Israel

School of Public Health University of Hong Kong Hong Kong

School of Sport and Recreation Faculty of Health and Environmental Sciences Auckland University of Technology Auckland New Zealand

Urban Design 4 Health Seattle Washington USA

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