Associations of built environmental characteristics and physical activity in neighbourhoods of Accra, Ghana

BACKGROUND: There is increasing evidence from observations in Western countries that the characteristics of the built environment can influence the physical activity levels of residents, but little data is available from low and middle-income countries. The aim of this study is to explore the association between neighborhood types, built environment characteristics and the physical activity in Accra, Ghana. METHODS: A cross-sectional study was conducted in Accra, with 12 neighborhoods randomly selected on the basis of high and low values of residential density and socioeconomic status. Sociodemographic, household and neighborhood information was collected with Neighborhood Environment Walkability Scale questionnaire adapted for Africa (NEWS-A). Physical activity was assessed with the modified WHO Global Physical Activity Questionnaire and social cohesion with the Perceived Neighborhood Social Cohesion Questionnaire. Generalized linear model was performed to determine the association between neighborhood characteristics and residents' physical activity. RESULTS: There were significant differences in the built environment characteristics and physical activity of residents in different neighborhood types. Residents of high residential density and high socioeconomic status neighborhoods had the highest levels of physical activity, mainly due to work-related physical activity. Closer proximity of destinations and recreational facilities, greater street connectivity, better aesthetics, greater safety when walking and cycling and safety from crime were associated with increased physical activity levels among residents. Conversely, social cohesion demonstrated no significant association with physical activity. CONCLUSION: The built environment of neighborhoods has been demonstrated to be strongly associated with the physical activity levels of residents of Accra, Ghana.