Associations between physical activity and the built environment in patients with schizophrenia: a multi-centre study

Objective This study investigated the variance in walking, moderate and vigorous physical activity (PA), explained by neighbourhood design and other environmental variables above and beyond the variance accounted for by demographical variables. Method A total of 138 patients (46♀) with schizophrenia (mean age = 41.2±12.5 years) from 13 different centres in Belgium were included in this 4-month cross-sectional study. The built environment was rated using the Instruments for Assessing Levels of Physical Activity and Fitness (ALPHA) environmental questionnaire, which was validated first. PA levels were assessed with the International Physical Activity Questionnaire. Results Validity coefficients for the ALPHA ranged between 0.44 and 0.86 and test-retest reliability intraclass correlation coefficients ranged between 0.64 and 0.84. Regression analyses showed that environmental variables were related to all types of PA. The variance explained by the models including demographic and environmental variables ranged from 20% for vigorous PA up to 68% for walking. Minutes of walking (r= 0.63, P< .001) and of moderate-intensity PA (r = 0.43, P< .001) were related to emotional satisfaction with the environment. Moderate-intensity PA was also related to the presence of PA supplies at home (r= 0.49, P< .001). Conclusion Neighbourhood design and other environmental variables show significant associations with multiple types of PA in patients with schizophrenia.