R E S E A R C H A R T I C L E
Open Access
Perceptions of activity-supportive
environment and motorcycle use
among urban Taiwanese adults
Chien-Yu Lin
1and Yung Liao
2*Abstract
Background: Although research has shown that numerous perceived environmental factors are supportive of physical activity, little is known about their associations with sedentary transport in motorcycle-oriented countries. This study examined the association between perceptions of Taiwan’s environmental factors and urban adults’ motorcycle use.
Methods: Cross-sectional data from 1003 Taiwanese adults aged 20–64 years from three urban cities were collected through telephonic surveys in 2015. Data on motorcycle use, sociodemographic variables, and perceived environmental attributes were obtained. Logistic regression analyses were performed.
Results: In Model 1, adults who perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night were less likely to use motorcycles. In Model 2, in which potential covariates were additionally adjusted for, the same four environmental attributes (perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night; odds ratio [OR] = 0.46, 0.65, 0.63, 0.64, respectively) were significantly associated with motorcycle use.
Conclusion: The investigated perceived environmental factors, which have previously been associated with facilitating active transportation, discourage sedentary modes of transport, such as motorized vehicles.
Keywords: Motorcycle use, Perception of environment, Urban adults, Sedentary behavior, Transportation, Supportive environments
Background
Excessive sitting is associated with increased risks of car-diometabolic diseases, Type 2 diabetes, specific types of cancer, and premature mortality [1]. Sitting, especially while commuting or traveling, is a common sedentary behavior known to adversely affect human health [2, 3]. More than 70% of adults in Taiwan use private motor-ized vehicles as their main mode of daily travel [4], which is comparable with the rates in Australia and the United States [5, 6]. In addition, Taiwan has a consider-ably high motorcycle ownership rate (608.5 per 1000 people) [7], and nearly half of Taiwan’s adult population (49.6%) use motorcycles as their main transportation
mode to travel to work and other destinations. The health risks associated with sedentary transport [8–10] renders critical the development of effective strategies to reduce motorcycle use through initiatives in urban plan-ning and design.
To be effective, according to ecological models of health behavior, such urban planning and design initia-tives should be based on a comprehensive understanding of local perceptions of neighborhood environmental fac-tors associated with motorcycle use [3, 11, 12]. Research from car-oriented countries have not adequately exam-ined walkability- and driving-related problems [13–15]. Moreover, the mechanism through which perceived neigh-borhood environmental factors effectively induce motor-cycle use among urban Taiwanese adults remains unclear. The residents’ experience of their neighborhood environ-ment is critical to understanding their transportation
* Correspondence:liaoyung@ntnu.edu.tw
2Department of Health Promotion and Health Education, National Taiwan
Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan Full list of author information is available at the end of the article
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
choices. However, several specific perceptions of the neighborhood environment, such as the sense of safety or aesthetics, are difficult to measure objectively [16]. Fur-thermore, although numerous studies have examined the associations between perceptions of the neighborhood environment with overall sitting time [17, 18], domain-specific sedentary behavior such as television viewing [19], and transport-related sitting [17], fewer studies have focused on specific forms of transport-related sedentary behavior, such as motorcycle use, in Asia. Research from motorcycle-oriented countries can strengthen evidence for the associations of perceived neighborhood environ-mental factors with motorcycle use. These perceptions have been found to be related to higher levels of walking and cycling [20–22], and conversely, tended to engage lower levels of motorcycle use. In this study, therefore, we examined perceived neighborhood environmental factors associated with motorcycle use among Taiwan’s urban adults.
Methods
Participants
Cross-sectional survey data used in this study were ob-tained through a random-digit dialing telephone-based survey conducted over a period of one month from September to October 2015 by a telephone research company in three Taiwanese cities: Taipei City, the cap-ital of Taiwan (area: 271.7 km2; population: 2,702,315); New Taipei City, the largest city in Taiwan (area: 2052.6 km2; population: 3,966,818); and Kaohsiung City, the second largest city in Taiwan (area: 2947.6 km2; population: 2,778,992). Those three cities have compre-hensive transport infrastructure, including public bicycle system, public transportation, and pedestrian sidewalks. Respondents were selected through a stratified random sampling process. The eligible respondents were Mandarin-speaking adults aged 20–64 years with private household telephones. We categorized the respondents according to their cities of residence as Taipei City, New Taipei City, and Kaohsiung City. Furthermore, the respondents were strati-fied by age (20–29, 30–39, 40–49, 50–59, and 60–64 years) and gender. For each city, the telephone numbers were selected at random by a computer-assisted system. The in-terviewers, who received two days of training before the survey period, used a standardized questionnaire and were experienced in administering population-based telephonic surveys. For ensuring data reliability, the length of each interview was restricted to 20 min to maintain the respon-dent’s interest [23]. Of the 5333 adults contacted, 1069 completed the survey (response rate: 20.04%). After data cleaning, 1003 valid responses were obtained. Respondents were offered no rewards for participation in the survey. According to Research Ethics Committee (REC) of National Taiwan Normal University, telephone survey targeting
adults has been considered to be minimal-risk for respon-dents and qualify for a verbal consent process. According to the approved procedure and template, verbal consent was obtained and recorded before the start of each inter-view. The study protocols were reviewed and approved by the REC of National Taiwan Normal University (REC num-ber: 201504HM005).
Outcome variable
The outcome variable was self-reported motorcycle use (riders and passengers were both included); data for this variable were acquired through the question“How many times have you used a motorcycle in the past 7 days?” The frequency distribution was skewed; hence, the vari-able of motorcycle use was dichotomized as indicators of use (yes) and nonuse (no) in the previous 7 days.
Perceptions of the neighborhood environment
The variables comprising perceived neighborhood envir-onmental factors were determined and measured using the Taiwanese version of the International Physical Ac-tivity Questionnaire Environmental Module (IPAQ-E). The IPAQ-E was developed as part of the International Physical Activity Prevalence Study to investigate the re-lationship between perceptions of the environment and walking or cycling in several countries [24–26]. The Taiwanese version of the IPAQ-E was used in a previous study on the association between perceptions of the en-vironment and active transportation [22]. The IPAQ-E questionnaire comprises three categories of items, with seven core items, four recommended items, and six op-tional items [27]. Of these 17 items, our study utilized the following seven, based on previous studies [12, 28]; the definitions of the items are provided within paren-theses: (1) residential density (main type of housing in the neighborhood); (2) access to public transportation (10–15 min to a transit stop); (3) presence of sidewalks (presence of sidewalks on most streets); (4) safety from crime at night (crime rate, which may render night-time walks unsafe); (5) aesthetic experiences (the presence of interesting elements that make walking outside attract-ive); (6) street connectivity (the presence of numerous four-way intersections); and (7) destinations (the pres-ence of numerous places of interest within easy walking distance). One personal item (vehicle ownership), three core items (access to shops, presence of bicycle lanes, access to recreational facilities), two recommended items (traffic safety, visibly active people), and four optional items (sidewalk maintenance, bicycle-lane maintenance, safety from crime during day time, and the safety of cyclists in traffic) were not included as environmental variables. Each question was answered on a 4-point Likert scale ranging from“strongly disagree” to “strongly agree.” An additional option, unknown/uncertain, was
also provided; responses with this option were treated as missing data in the analysis. Following previous studies [22, 25], the seven perceived environmental factors were transformed into binary items. Residential density was dichotomized as “detached single-family housing” and “other” (e.g., townhouses, row houses, apartments, and condominiums); the other eight items were dichotomized as “agree” (“strongly agree” and “somewhat agree”) and “disagree” (“somewhat disagree” and “strongly disagree”).
Sociodemographic variables
The sociodemographic variables recorded in the survey were gender, age, city of residence, education level, occu-pation type, marital status, body mass index (BMI), and vehicle ownership (which included household motor-cycle and car ownership). These variables were further categorized as follows: Age was divided into five categor-ies: a) 20–29; b) 30–39; c) 40–49; d) 50–59; and e) 60– 64 years. Education level was categorized into a) high school degree or lower (including elementary school, junior high school, high school, and vocational school degree) and b) university degree or higher. Occupation type was divided into two categories: a) part-time and b) full-time. Marital status was divided into a) married and b) unmarried (including widowed, separated, and di-vorced). BMI was calculated from the self-reported weight and height and was categorized as a) not overweight (<24 kg/m2), or b) overweight or obese (≥24 kg/m2), ac-cording to the threshold for Taiwan [29]. In addition, the number of vehicles owned was recorded; accordingly, household motorcycle and car ownership was dichoto-mized as“yes” (if >0) and “no” (if 0).
Statistical analyses
We entered each of perceived environmental factors into logistic regression with adjusted to examine the associa-tions of the seven environmental factors with motorcycle use. Two statistical models were constructed for the analyses. Model 1 was an unadjusted model. The covari-ates of the sociodemographic variables of gender, age, education level, occupation, marital status, and BMI were adjusted for in Model 2. The odds ratio (ORs) and 95% confidence interval (CIs) were calculated for each variable. Inferential statistical analysis was performed using IBM SPSS 22.0 software (IBM, Armonk, NY, USA), and the level of significance was set atp < 0.05.
Results
Participant characteristics
Table 1 presents the respondent characteristics (mean age: 44.5 ± 12.2 years). The distribution of the three covariates of gender, age, and city of residence in this sample were balanced. Among all respondents, 62.9% had a university degree or a higher level of education,
69.3% had a full-time job, 66.9% were married, 40.2% were overweight or obese, and 87.4% and 79.8% owned one or more motorcycles and cars, respectively. In addition, 63.1% of the respondents had used a motor-cycle in the 7 days prior to the survey.
Perceived neighborhood environmental factors associated with motorcycle use seven days prior to the survey
Logistic regression analysis of Model 1, which was un-adjusted, demonstrated that four of the seven attributes of perceptions of the environment were significantly as-sociated with motorcycle use (Table 2). Respondents who perceived favorable access to public transport (OR = 0.45; 95% CI: 0.25–0.82), the presence of side-walks (OR = 0.67; 95% CI: 0.48–0.90), safety from crimes at night (OR = 0.64; 95% CI: 0.46–0.89), and convenient access to destinations (OR = 0.66; 95% CI: 0.47–0.95) were less likely to have used motorcycles in the past 7 days. After adjustment for potential confounders in Model 2, the same four attributes were significantly as-sociated with motorcycle use. Respondents who per-ceived favorable access to public transport (OR = 0.46; 95% CI: 0.26–0.84), the presence of sidewalks (OR = 0.63; 95% CI: 0.46–0.87), safety from crimes at night (OR = 0.64; 95% CI: 0.45–0.89), and good access to des-tinations (OR = 0.65; 95% CI: 0.45–0.94) were associated with lower levels of motorcycle use in the 7 days prior to the survey.
Discussion
To our knowledge, this is the first study conducted in an Asian city to examine the association between perceived activity-supportive environmental factors and a specific transport-related sedentary behavior, motorcycle use. Our findings have substantial implications for potential environmental and policy interventions in Taiwan for lowering motorcycle use. They suggest that improving perceptions of access to destinations and public trans-portation, presence of sidewalks, and safety from crimes at night would be effective in lowering motorcycle use among the urban adult population of Taiwan.
Our results are consistent with studies [17–19] in which certain perceived environmental factors were as-sociated with a specific form of sedentary behavior (i.e., motorcycle use) in urban areas of several developed countries, such as the United States, Australia, and Germany. The analyses revealed that four perceived en-vironmental factors—good access to destinations, public transportation, presence of sidewalks, and safety from crimes at night—were associated with less likelihood of motorcycle use. After adjustment for the sociodemo-graphic variables, the same four environmental factors were still significantly associated with motorcycle use.
Moreover, a positive relationship has been reported between walking and cycling and these perceived neigh-borhood attributes [20–22, 30]. Our results suggest that positive perceptions of the neighborhood environment are associated with not only increased amounts of phys-ical activity, as previously evidenced, but also decreased sedentary time during transport. In addition, residents who perceived a safe neighborhood environment with the presence of sidewalks, good access to local destinations, and public transport might be encouraged to walk or cycle in their neighborhood rather than use motorcycles. In
other words, if residents who perceived a safe neighbor-hood environment with good public transport infrastruc-ture, they might be easier to select other transport mode, such as walking and cycling, instead of motorcycle use [31, 32]. The health risks of sedentary transport in various counties have been reported [8–10]. The findings from this study are unique and substantially contribute to the literature on health risks associated with sedentary trans-port (i.e., motorcycle use) in a non-Western country. Further research using longitudinal designs are necessary to validate these results.
Table 1 Basic characteristics of the respondents (N = 1003)
Basic Characteristics Total Motorcycle Use p-Value
Yes No N (%) 1003 633 (63.1%) 370 (36.9%) Gender <0.001** Men 497 (49.6%) 342 (54.0%) 155 (41.9%) Women 506 (50.4%) 291 (46.0%) 215 (58.1%) Age (year) 0.027* 20–29 138 (13.8%) 86 (13.6%) 52 (14.1%) 30–39 227 (22.6%) 153 (24.2%) 74 (20.0%) 40–49 249 (24.8%) 171 (27.0%) 78 (21.1%) 50–59 257 (25.6%) 145 (22.9%) 112 (30.3%) 60–64 132 (13.2%) 78 (12.3%) 54 (14.6%) Residential city <0.001** Taipei city 334 (33.3%) 155 (24.5%) 179 (48.4%)
New Taipei city 342 (34.1%) 211 (33.3%) 131 (35.4%)
Kaohsiung city 327 (32.6%) 267 (42.2%) 60 (16.2%)
Educational level 0.009*
High school degree and lower 372 (37.1%) 254 (40.1%) 118 (31.9%)
University and higher 631 (62.9%) 379 (59.9%) 252 (68.1%)
Occupational type 0.058 Not full-time 308 (30.7%) 181 (28.6%) 127 (34.3%) Full-time 695 (69.3%) 452 (71.4%) 243 (65.7%) Marital status 0.145 Not married 332 (33.1%) 220 (34.8%) 112 (30.3%) Married 671 (66.9%) 413 (65.2%) 258 (69.7%)
Body Mass Index 0.013*
Non-overweight 600 (59.8%) 360 (56.9%) 240 (64.9%)
Overweight/obese 403 (40.2%) 273 (43.1%) 130 (35.1%)
Household motorcycle ownership <0.001**
Yes 877 (87.4%) 631 (99.7%) 246 (66.5%) No 126 (12.6%) 2 (0.3%) 124 (33.5%) Car ownership 0.759 Yes 800 (79.8%) 503 (79.5%) 297 (80.3%) No 203 (20.2%) 130 (20.5%) 73 (19.7%) * p < 0.05;** p < 0.001
This study has some limitations. First, causality could not be determined primarily because of the cross-sectional design of this research. Second, the main mea-surements were self-reported and could be biased [33]. Third, a potential confounder—the self-selection of neighborhoods—was not examined in this study. For in-stance, those who prefer engaging in physical activities might choose a relatively activity-supportive neighbor-hood. The neighborhood selection depends on the attributes of the individual rather any association with motorcycle use. Fourth, one-third of the respondents who did not own a household motorcycle did not report riding a motorcycle in the past 7 days, which is likely re-lated with access to a motorcycle. However, because owning a motorcycle is relatively inexpensive and park-ing is convenient and possibly free, Taiwan has a high motorcycle ownership rate [7]. Therefore, we reasonably presumed that motorcycle ownership might not necessar-ily be related to the perceptions of activity-supportive en-vironment. Furthermore, although sole car users might be
correlated with similar environmental factors [34, 35], we selected non-motorcycle users as a reference group lim-ited by our sample size. Following previous studies [8–10], we presumed that the ORs for this group would be higher than those of our findings. Thus, we suggest that further large-scale research is necessary and encouraged. Finally, this study had a limited representative population sample because it relied on a telephonic survey. Hence, sections of the population without a household telephone (ap-proximately 5.3% in 2013) were not surveyed in this study [36]. Moreover, compared with the national average levels of education and BMI [37–39], the respondents in the present study were more educated and had a higher prevalence of being overweight. Thus, the results of this study cannot be generalized to the entire population of Taiwan.
Conclusion
Urban Taiwanese adults who perceived their neighbor-hood environment to have good access to destinations
Table 2 Perceived environmental factors associated with motorcycle use among Taiwanese adults
Perceived Environmental Factors Motorcycle Use
Model 1 Model 2
N % OR (95% CI) OR (95% CI)
Residential density
High 955 95.2% 0.69(0.37–1.31) 0.62(0.32–1.20)
Low 48 4.8% 1.00 1.00
Access to public transport
Good 934 93.1% 0.45(0.25–0.82)** 0.46(0.26–0.84)*
Poor 69 6.9% 1.00 1.00
Presence of sidewalks
Yes 767 76.5% 0.67(0.48–0.90)** 0.63(0.46–0.87)**
No 236 23.5% 1.00 1.00
Safety from crimes at night
Safe 207 20.6% 0.64(0.46–0.89)** 0.64(0.45–0.89)** Not safe 796 79.4% 1.00 1.00 Aesthetics Yes 601 59.9% 0.94(0.73–1.23) 0.99(0.75–1.29) No 402 40.1% 1.00 1.00 Connectivity of streets Yes 772 77.0% 1.02(0.75–1.38) 1.05(0.77–1.44) No 231 23.0% 1.00 1.00 Presence of destination Yes 829 82.7% 0.66(0.47–0.95)* 0.65(0.45–0.94)* No 174 17.3% 1.00 1.00
Abbreviation:OR odds ratio Model 1 was an unadjusted model
Model 2 was adjusted for gender, age, education level, occupation, marital status, and BMI
*
p < 0.05;**
and to public transportation, presence of sidewalks, and safety from crimes at night are less likely to use motor-cycles. These perceived neighborhood factors, which have previously been associated with facilitating active transportation, such as walking and cycling, also dis-courage sedentary transport, such as motorcycling.
Funding
This research was supported by a grant (MOST 104–2410-H-003-046) from the Ministry of Science and Technology of Taiwan.
Availability of data and materials
This study used data from a part of the‘Use of Public Bicycle in Taiwanese Adults Based on Behavioral Epidemiology Framework’ project. Data and material is available in Lab of Yung Liao, Department of Health Promotion and Health Education at National Taiwan Normal University (Address: 162, Heping East Road Section 1, Taipei, Taiwan).
Authors’ contributions
Conceived and designed the experiments: YL. Analyzed the data: YL, CYL. Wrote and revised the paper: YL, CYL. Both the authors have read and approved the final manuscript.
Ethics approval and consent to participate
Verbal consent was obtained from all respondents. This survey received prior approval from the Ethics Committee of National Taiwan University (201504HM005). Consent for publication
Our manuscript did not include any details, images, or videos relating to individual participants. All participants agreed with that their self-reported data will be used for publication.
Competing interests
The authors declare that they have no competing interests.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Author details
1Institute of Health Behaviors and Community Sciences, National Taiwan
University, 17, Xuzhou Road, Taipei 100, Taiwan.2Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Heping East Road Section 1, Taipei 106, Taiwan.
Received: 8 December 2016 Accepted: 14 August 2017
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