Associations of perceived community environmental attributes with walking in a population-based sample of adults with type 2 diabetes.

BACKGROUND No studies have yet examined the associations of physical environmental attributes specifically with walking in adults with type 2 diabetes. PURPOSE The purpose of this study was to examine associations of perceived community physical environmental attributes with walking for transport and for recreation among adults living with type 2 diabetes. METHODS Participants were 771 adults with type 2 diabetes who completed a self-administered survey on perceived community physical environmental attributes and walking behaviors. RESULTS Based on a criterion of a minimum of 120-min/week, some 29% were sufficiently active through walking for transport and 33% through walking for recreation. Significantly higher proportions of those actively walking for transport and for recreation had shops or places to buy things close by (67.8% and 60.9%); lived within a 15-min walk to a transit stop (70.6% and 71.0%); did not have dead-end streets close by (77.7% and 79.8%); reported interesting things to look at (84.8% and 84.4%); and lived close to low-cost recreation facilities (81.3% and 78.8%). In addition, those actively walking for transport reported living in a community with intersections close to each other (75.6%) and with sidewalks on their streets (88.1%). When these variables were entered simultaneously into logistic regression models, living close by to shops was positively related to walking for transport (OR = 1.92, 99% CI = 1.11-3.32). CONCLUSIONS Consistent with findings from studies of healthy adult populations, positive perceptions of community environmental attributes are associated with walking for transport among adults with type 2 diabetes. The now-strong public health case for environmental innovations to promote more walking for transport is further reinforced by the potential to benefit those living with diabetes.