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Project Context and Objectives:
Reducing sedentary behaviour and enhancing the level of physical activity (PA) in the population is one of the key goals of the 2007 EU Strategy for Europe on Nutrition, Overweight and Obesity related health issues (Commission of the European Communities 2007). More recently, in its Innovation Partnership “Active and Healthy Ageing” the European Commission sets out the ambitious goal to increase the number of healthy life years by two years on average by 2020.
Increasing PA is one of the key approaches to address non-communicable diseases. In the face of myriad challenges, increasing PA through traditional approaches such as public health advocacy, sports and leisure time PA alone, would not be sufficient. Integrating PA into daily life through routine behaviour is a key. Active mobility (AM), namely walking, cycling and the use of public transport, is practicable for most individuals. In contrast to sports or exercise, AM requires less time and motivation, since it provides both convenience as a mode of transport and exercise, and is economically affordable for most people, providing an equitably accessible form of PA. As such, it has the potential to reach parts of the population, which are not receptive to appeals and benefits of sports and exercise, or cannot afford them. Empowering individuals to engage in active life styles will require empowering policy makers, health professionals and planners with the knowledge and tools to create the environments in which individuals can easily take up healthy behaviours.
PASTA will systematically develop and apply new strategies, concepts and models addressing some of the most pressing needs of the promotion of AM, thereby linking such diverse areas as urban and transport planning, empirical epidemiological research, health and economic impact assessment and practice and policy relevant dissemination of good practices and tools. The main aim of PASTA is the identification and better understanding of established and innovative approaches for increasing PA and decreasing sedentary behaviour through AM, through:
• A systematic review of state-of-the-art of AM and assessments in 7 case study cities (CSC)
• The identification and understanding of correlates of AM, PA and associated injury risk
• The development of user-friendly integrated tools for HIA and prediction models for AM policies and interventions
• The integration of a wide range of stakeholders and broad dissemination of the results
These objectives will be pursued by broad reviews of the state-of-the-art, as well as by empirical research in 7 CSC: Barcelona, Antwerp, London, Oerebro, Rome, Vienna and Zurich. PASTA will investigate best practices on the promotion of AM by looking at both sectors of urban and transport planning and health promotion. PASTA will focus on innovative, systematic approaches and intersectoral collaboration, and on how they can be implemented elsewhere. In order to address these questions, PASTA will conduct research on the promotion of AM in several key areas:
• Review evidence and good practices in the area of urban and transport planning in order to identify effective measures and key framework factors of increasing AM and assess these in depth in the CSC.
• Conduct a longitudinal study across the CSC to a) evaluate selected AM initiatives; b) to improve the understanding and scientific evidence of correlates of AM, PA and injury risk, and c) to derive parameters missing in current HIA approaches.
• Develop and apply an enhanced WHO Health Economic Assessment Tool for walking and cycling (HEAT), using the vast experience of the PASTA consortium on HIA.
• Findings and progress reports will be communicated to diverse target audiences, including policy makers, practitioners, researchers and end-users, through a number of media, i.e. reports, journals, brochures, web-content, workshops and presentations.
The PASTA consortium (Table1) brings together a broad variety of disciplines and experts.

Project Results:
PASTA started in November 2013 with a literature review classifying AM measures and reviewing factors and indicators affecting AM. Based on this theoretical approach city profile factors and a total of 138 AM measures were collected in the seven case study cities (CSC).
To reveal challenges and barriers of promoting active mobility and to complete the city specific image on walking and cycling, a workshop with stakeholders from different city departments, PT operators, walking and cycling associations and health experts was organized in each CSC resulting in a total of 162 participants. In addition 75 interviews were carried out. The cross city analyses show that the cities are very different which makes it quite difficult to draw general conclusions. What they have in common is that in each city a big variety of different measures and interventions was implemented. More or less ambitious goals to reduce motorized traffic and to increase the share of walking and cycling are defined in the strategic policies, clearly directed towards more sustainable and healthy cities. Political will, often tied with a powerful politician, is the most important driving force and a cornerstone for promoting AM, while missing political will is one of the main barriers together with missing collaborations between the different administrative departments, planning sectors and stakeholders. More AM measures from other cities were collected as well to create a good practice compendium, which will be brought to decision makers, city authorities, civil society organizations and end users.
Decision makers are also the target group for a comprehensive and user-friendly health impact assessment (HIA) tool for AM and for WHO’s Health Economic Assessment Tool (HEAT), which will be improved during the project. Procedures to implement morbidity, carbon and traffic injuries in HEAT were developed; the new air pollution module will be presented at the final PASTA conference.
Main part of the project is a longitudinal study in all seven CSCs that was launched in the beginning of 2015 aiming for a better understanding of correlates of AM and their effects on overall PA, injury risk and exposure to air pollution. Recruitment was done individually by each city, based on a common recruitment strategy. A comprehensive baseline questionnaire and frequent short and long follow-up questionnaires form the core of the survey. An additional crash questionnaire records circumstances and injuries of reported walking or cycling incidents.
After 1 ½ years of recruitment in total more than 12,500 participants took part in the survey across the 7 cities, completing more than 82,000 questionnaires. More important than the total number is the fact that about 5,700 participants filled in 3 or more questionnaires in a row giving us a powerful dataset on PA and traffic. Recruitment efforts are lowered now, but participants continue to receive questionnaires until the end of 2016.
First analyses of preliminary PASTA survey data of about 11,000 participants led to a press release, showing that car drivers are on average 4kg heavier than cyclists: For the analysis a multivariate linear regression model was used taking into account a number of confounding variables.
In three selected CSCs a real life measurement of physical activity levels, black carbon exposure and subclinical health effects was done by 40 healthy volunteers. The measurements are finished and first results are expected at the beginning of 2017. A subsample of about 500 participants in all CSCs is tracked with a smartphone app (Moves) to help validating the PASTA travel diary and to assess the relevance of environmental attributes in determining route choices until the end of 2016.
The website is a very important instrument in the PASTA communication strategy, which aims at clear, consistent and targeted communication about the project and its findings to the outside world.

Potential Impact:
Sedentary behaviour and physical inactivity raise overweight related diseases tiptoeing inside cities all over the world. Planning policies that promote physical activity (PA) can contribute to a more healthy society with the potential for yielding further co-benefits. An important area in reducing sedentary behaviour is promoting active mobility (AM).
This project will impact the promotion of AM as an innovative approach to increase PA levels in a broad range of target areas.
PASTA will provide policy makers, transport and urban planners, public health authorities and practitioners as well as civil society with better knowledge about the link of PA and AM, AM measures (WP1, WP2, WP5) and with an enhanced HEAT tool (WP4). By supporting actions to increase PA in everyday life of the general population, PASTA will contribute to the prevention of major chronic diseases, whose risk factors are closely linked to the settings and environments in which people live.PASTA will explore and assess in seven case study cities (CSC) to which extent the availability of quantitative information on the effects of AM on health and through reduction of CO2 emissions can provide decision makers from different sectors with new, strong and convincing arguments to give serious consideration to investing in AM.
Through the empirical study (carried out in WP3) PASTA will provide a vast data base on mobility and activity behavior. The longitudinal study design allows the evaluation of selected top measures (e.g. personalized mobility campaign, bicycle and car sharing schemes, e-biking, neighbourhood revitalization and infrastructure projects) over time in the seven CSC, an in-depth analysis of a broad range of variables (including personal, environmental and cultural), as well as an assessment of injury risks and air pollution exposure. This will impact the field of non-communicable diseases prevention by contributing new quantitative findings essential for the advancement of health impact assessment (HIA) of AM and the understanding of how AM relates to total PA.
Through the development of an advanced and user friendly integrated HIA tool, PASTA will have a major impact on lowering the technical barriers that make the application of quantitative HIA of AM a complex and expensive challenge in most cities.
Through its broad dissemination and communication strategy (WP6) and the accessibility and transparency of the tools produced, which will be publicly and freely available through the web, PASTA will have an impact on the awareness of citizens of the important health benefits that could be achieved through AM. Specific impacts of this project on the European level include contributions supporting the aims of a number of European policies, where several documents link AM and health (e.g. Action 3 of the Urban Mobility Action Plan; the WHO European Charter on Counteracting Obesity). EC and WHO Member States have taken commitments to promote PA including AM.
The project and results will be presented within the PASTA final conference, which takes place on 20th September 2017 in Mannheim in cooperation with the International Cycling Conference (ICC) and THE PEP meeting aiming to bridge the gap between research and practice:

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