BACKGROUND: Studies of correlates of active transport to and from school (ATS) focus mainly on children, have a limited conceptualisation of ATS trips, lack heterogeneity in built environments, and rarely consider effect modifiers. This study aimed to estimate associations of parent-perceived neighbourhood environment characteristics with self-reported ATS among adolescents from 14 countries, and whether associations differ by sex, city/region, and distance to school. METHODS: Observational cross-sectional design. Data were from the International Physical activity and Environment Network (IPEN) Adolescent study and included 6302 adolescents (mean age 14.5 ± 1.7 years, 54% girls) and a caretaker from 16 diverse sites. Adolescents self-reported usual travel to and from school by walking and bicycling (days/week) and time it would take to walk. Parents completed the Neighbourhood Environment Walkability Scale for Youth (13 scores computed). Generalised additive mixed models estimated associations of parent neighbourhood perceptions with 1) any active transport to/from school, 2) regular walking (5-10 times/week), 3) regular cycling to/from school, and 4) profiles of ATS generated using latent profile analyses. Interactions were also explored. RESULTS: Overall, 58.7% reported any ATS, 39.9% regularly walked, 7.7% regularly cycled, and four profiles of ATS were identified: walk to and from school; walk from school; cycle to and from school; no ATS. Distance to school was negatively associated with all outcomes, though evidence was weak for regular cycling to/from school. Land use mix - diversity was positively related to all ATS outcomes except those related to cycling. Accessibility and walking facilities were associated with higher odds of any ATS, regular walking to/from school, and the profile walking to and from school. Residential density was negatively related to regular cycling to/from school. Positive associations were observed between traffic safety and any ATS, and between safety from crime, aesthetics, and odds of regular cycling to/from school. Distance to school, adolescent sex, and city moderated several associations. CONCLUSIONS: Parent perceptions of compact, mixed-use development, walking facilities, and both traffic and crime-related safety were important supportive correlates of a range of ATS outcomes among adolescents in high- and low-middle-income countries. Policies that achieve these attributes should be prioritised to support more widespread ATS.

College of Health Solutions Arizona State University Phoenix USA

Department of Architecture Bangladesh University of Engineering and Technology Dhaka Bangladesh

Department of Movement and Sports Sciences Faculty of Medicine and Health Sciences Ghent University Ghent Belgium

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

Department of Teaching of Physical Education Arts and Music AFIPS Research Group University of Valencia Valencia Spain

Epidemiology and Environmental Health Joint Research Unit FISABIO UJI UV Valencia Spain

Graduate School of Public Health Alma Ata University Yogyakarta Indonesia

Herbert Wertheim School of Public Health University of California San Diego San Diego USA

Hudson Institute of Medical Research Monash University Clayton Australia

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

Institute of Active Lifestyle Faculty of Physical Culture Palacký University Olomouc Czech Republic

Institute of Physical Education and Sport at P J Šafarik Košice Slovakia

Laboratory for Integrative and Translational Research in Population Healthporto Porto Portugal

Madras Diabetes Research Foundation Chennai India

Mary Mackillop Institute for Health Research Australian Catholic University Melbourne Australia

People Health and Place Unit Prevention Research Center School of Public Health Washington University in St Louis St Louis USA

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

School of Public Health Faculty of Social Welfare and Health Sciences University of Haifa Haifa Israel

School of Public Health the University of Hong Kong Hong Kong Hong Kong SAR China

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

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