Going Places: An Active Transportation Intervention to Increase Youth Physical Activity, Durham, North Carolina, 2023–2024

Abstract

Routine youth physical activity (PA) fosters healthy habits and lasting cardiometabolic benefits into adulthood; however, significant disparities in PA persist by race, ethnicity, and income. Active transportation is an optimal intervention target to promote youth PA equity by building transportation self-efficacy skills. Going Places, a multilevel transportation self-efficacy intervention, aims to increase underserved youth PA and cardiometabolic health. We demonstrate preliminary efficacy, based on increased levels of PA, improved transportation self-efficacy, and reduced barriers to transportation use and PA to support positive patterns for lifelong health. (Am J Public Health. 2025;115(5):693–697. https://doi.org/10.2105/AJPH.2025.308012)

Youth physical activity (PA) supports healthy habits early in life, with lasting benefits into adulthood, including protection against cardiometabolic risk factors like high blood pressure, obesity, and diabetes. However, only 26% of White adolescents meet the World Health Organization’s PA guidelines (60 minutes of daily moderate-to-vigorous PA [MVPA]), compared with just 21% of Black and Hispanic adolescents. Low-income youths are also less likely than high-income youths to meet PA guidelines.¹ Minoritized and low-income youths have fewer opportunities for PA through community-based programs, such as sports clubs and accessible, age-appropriate adolescent programs,² which may in part explain disparities in PA. Moreover, limited transportation is a major barrier for high-priority youths to access PA programs and spaces.³ The American Academy of Pediatrics states that youth active transportation (e.g., walking, running, and biking) is an optimal target to increase MVPA⁴ through improved access to youth programs and the activity required to reach recreation sites.⁵ Given that active transportation accounts for less than 20% of total MVPA among US adolescents, there is a prime opportunity for programs to promote active transportation.⁶ A key component of routine active transportation among minoritized adolescents is transportation self-efficacy skills,³ or belief in one’s ability to effectively use transportation systems. Although prior interventions have targeted youth self-efficacy skills more generally,⁷ we are unaware of other programs targeting youth transportation self-efficacy.

INTERVENTION AND IMPLEMENTATION

Going Places is a multilevel transportation self-efficacy intervention (Appendix Table A, available as a supplement to the online version of this article at http://www.ajph.org) designed to increase PA among underserved youths and improve their cardiometabolic health. Going Places is informed by the Socioecological Framework and Bandura’s Self-efficacy Theory and includes the following components: weekly workshops on navigating transportation systems (individual level), community field trips and participatory mapping activities (recreation center level), and local transportation advocacy (environment level).⁸ Going Places was codeveloped under the joint leadership of Duke University and Durham Parks and Recreation (DPR; Durham, NC).

Going Places was offered to individual youths as part of DPR’s no-cost adolescent afterschool program for youths aged 13 to 19 years. Going Places provided weekly workshops co-led by Duke and DPR that aimed to promote transportation self-efficacy (e.g., how to use local transportation systems, including biking and walking path trail maps, acquiring a free bus pass, using the bus and rail system, pedestrian and biking safety). Workshops also included engaging in active games and recreation.

Monthly field trips organized with the recreation center provided opportunities for youth to navigate transportation systems and engage in PA, primarily in outdoor settings (Appendix Figure A). Youths also participated in a series of participatory mapping exercises⁹ to identify safe routes to reach neighborhood sites for active recreation.

The intervention’s environmental components focused on promoting equitable access to transportation and PA for youths. The Going Places study team, youth participants, and the program’s Steering Committee collaborated with local organizations that oversee recreation and transportation programs and policy in Durham. These organizations are involved in ongoing advocacy to promote safe, affordable, and sustainable transportation and recreation, including park renovation and restoration projects, public mural contests, and social activism (web; social media).

PLACE, TIME, AND PERSONS

Going Places is offered in areas with high social vulnerability (Appendix Figure B).¹⁰ The study was held at two DPR recreation centers in Durham, North Carolina during 2023 and 2024. In the last full year, DPR enrolled more than 1257 adolescents across its six centers in youth programs (55% Black, 18% Hispanic; $19 000 mean per capita household income). Going Places participants (n = 70) were enrolled by DPR staff through typical DPR recruitment methods (e.g., on-site information sessions and word-of-mouth). Neighborhood audits using the Microscale Audit of Pedestrian Streetscapes (MAPS) abbreviated tool¹¹ showed that built environment infrastructure at all six youth recreation centers is conducive to active transit, with access to sidewalks, public transit, and the extensive Durham trails system (Appendix Table B).

PURPOSE

This single-arm study aimed to demonstrate the preliminary efficacy of Going Places, based on PA, transportation self-efficacy, and reduced personal and environmental barriers to transportation use and PA. It was conducted January 2023 to June 2024.

Participants’ demographics were collected with self-report surveys. Frequency, type, and location of MVPA were assessed using the Web-Survey of Physical Activity and Nutrition (Web-SPAN) and the Teen Environment and Neighborhood (TEAN) measures, as previously described.¹² Transportation self-efficacy and personal and environmental barriers to MVPA were assessed using the TEAN measure and the Physical Activity Neighborhood Environment Scale.¹² Three focus groups were conducted to understand barriers to transportation use and PA, and to generate feedback on the intervention from youth participants, parents and guardians, and Parks and Recreation staff. Youth participants also were provided with Garmin accelerometers (VivoFit 4, Garmin International, Olathe, KS) to monitor step data over seven consecutive days.¹³ We used the threshold of 11 500 or more steps per day to evaluate whether participants met daily steps goals.¹⁴

EVALUATION AND ADVERSE EFFECTS

We enrolled 70 participants who completed all baseline surveys (Table 1). Community partner engagement was maintained with biweekly meetings held with four DPR staff and monthly Steering Committee meetings (shifting to quarterly meetings in January 2024). A total of 15 youth workshops were held approximately once per week. Six total field trips were offered once every one to two months.

TABLE 1—

Pilot Participant Characteristics: Durham, NC, 2023–2024

Pilot Participant Characteristics	Participants (n = 70), % or Mean (SD)
Age at enrollment, y	15.2 (1.9)
Race
Black	89
White	3
Other	8
Hispanic ethnicity	20
Male gender	78
Overweight or obese	50
Eligible for free/reduced price school meals	81

Survey Findings

Baseline survey data indicated that most participants did not use active transportation, had low PA levels, and demonstrated low transportation self-efficacy. Thirty-eight percent reported that they never engaged in MVPA during school day leisure time. More than half (56%) indicated that the most common site for engaging in MVPA was their home and 39% did not participate in any additional community programs. Forty-one percent indicated that they never used public transportation, 61% never walked or biked to school, and 33% spent no time biking, using walking paths, or using public transit each week without their parents.

Regarding barriers to MVPA and transportation use, less than half (42%) of participants knew where to obtain a free bus pass (available for all Durham youths). Almost half (43%) of participants strongly agreed or somewhat agreed that there was too much traffic in their neighborhood, and 55% strongly agreed or somewhat agreed that traffic made it difficult to walk.

Focus Group and Accelerometer Findings

Focus group participants (n = 20; 100% Black, 80% males, 3 adults, 17 youths) described concerns, such as violence, traffic, and access to paths or trails. Other MVPA barriers included transportation limitations, safety, resource scarcity, time constraints, and peer influence. Participants perceived Going Places as a catalyst for enhancing mobility by teaching adolescents how to navigate transportation systems, fostering access to recreation and raising safety awareness.

Step data were collected for seven consecutive days from 86% of devices. Mean seven-day step count across the participants was 8170 (SD = 3099) steps per day. Mean PA was 30% lower than the PA guidelines threshold.¹⁴

Pre–Post Data Findings

Based on the Web-SPAN and TEAN measures,¹² participants (n = 70 preintervention; n = 58 postintervention) showed improvements on the Getting Around Your Neighborhood, Places for Physical Activity, and reduced Barriers to Walking and Biking subscales (Figure 1). For example, the percentages of participants who reported never using public transportation, never walking or biking to school, and never biking, walking, or using public transit without their parents decreased by 12% (41% to 36%), 26% (61% to 45%), and 18% (33% to 27%), respectively.

FIGURE 1—

Pre- and Postintervention Web-SPAN and TEAN Group Mean (SD) Scores Across Subscale Questions for Participants: Durham, NC, 2023–2024

Note. Web-SPAN = Web-Survey of Physical Activity and Nutrition; TEAN = Teen Environment and Neighborhood. The number of participants was 70 preintervention and 58 postintervention. The mean value for pre- and postintervention scores was calculated by summing individual scores for all questions under each subscale and then taking the average score as the group mean.

SUSTAINABILITY

Our long-standing community-engaged partnership with DPR has fostered this codesigned, co-led, park-based multilevel transportation self-efficacy intervention to increase PA and cardiometabolic health among underserved youths. This partnership provides a unique and necessary opportunity to comanage this program in an applied setting, and inform sustainability and future dissemination through national Parks and Recreation channels. Going Places provides Parks and Recreation organizations with a novel intervention that was codeveloped with Parks and Recreation to be integrated into an ongoing youth programs infrastructure. Also, the curriculum and field trips are modifiable and designed to be led by Parks and Recreation staff based on their youth programming expertise, contextual factors, and lived experience of engaging with the youth populations served by the organizations.

PUBLIC HEALTH SIGNIFICANCE

Promoting equitable access to active transportation for youths can reduce MVPA disparities, which otherwise pose a significant disease burden across the lifespan.¹⁵ The Going Places multilevel transportation self-efficacy intervention aims to increase PA and cardiometabolic health among underserved youths. We demonstrate the preliminary efficacy of Going Places, based on PA, transportation self-efficacy, and reduced personal and environmental barriers to transportation use and PA. Next steps for this work include prospective trials to determine effectiveness to improve youth PA and blood pressure over 18 months and understand key implementation factors to promote the dissemination of Going Places. Given the urgent need for innovative solutions to address youth health disparities, this work will inform longer-term community-based cardiometabolic interventions and wider dissemination to promote access to PA programs and spaces for underserved youths.