Physical activity environment inside and outside school and youth fitness: A spatial analysis at the level of elementary school attendance zone in Georgia

The present study investigates the spatial correlation between built and natural environments that promote physical activity (PA) and children’s fitness. Previous work has been conducted on various geographic scales such as from a county level. However, evaluations from a school attendance zone level, which are the policy and program administration units for schools, have yet to be investigated. Using a factor analysis, 24 PA-related environmental variables were reduced to six environmental factors and then run factors with geographically weighted regression (GWR) at the level of the elementary school attendance zones (ESAZ) in Georgia. The outside-school environmental factors (park, recreation, terrain, nature and camping) and inside school environmental factor (school PA time) were constructed by ESAZ. We found that of all the PA environment factors, the most highly associated with promoting PA and children’s fitness were inside-school PA environment. The outside factors of the park and terrain environment indicated strong local geographic variation in youth health. The result showed local variation in the association between PA environment and fitness among elementary school children in Georgia and highlighted the geographically customized efforts for different regions’ policy changes to improve child health.