In tandem with the noted increase in research-based activities, national and international programmatic activities supporting children's active commuting have expanded in recent years (Box
). These activities overlap and often are implemented simultaneously. For example, establishing a Walking School Bus has been encouraged as part of International Walk to School Month. The evidence base was limited when these programs were first established. Therefore, most programs were founded on the basis of what was thought to impact children's active commuting patterns at the time. However, the implementation and evaluation of such programs complements research efforts and provides additional insight into predictors of children's active commuting patterns and targets for future intervention efforts. The Safe Routes to School and the Walking School Bus programs are outlined in greater detail below to illustrate these points. We focused on these 2 programs, because they are national programs and have more complete evaluation data.
In the United States, state-level efforts to promote safe routes to school emerged during the 1990s and culminated in 2005 with the federally funded Safe Routes to School (SRTS) program, founded under the umbrella of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU) (38
). Although this type of program was new for the United States, it grew from existing international efforts to organize and promote active commuting (39
). The goals of the SRTS program are to 1) enable and encourage children, including those with disabilities, to walk and bicycle to school; 2) make walking and bicycling to school a safe and more appealing transportation alternative; and 3) facilitate the planning, development, and implementation of projects and activities that will improve and reduce traffic, fuel consumption, and air pollution in the vicinity of schools (38
). The SRTS program makes funds available to states through the Department of Transportation for a broad range of activities, including infrastructure-based (e.g., improvements in roads and sidewalks) and noninfrastructure-based (e.g., education, enforcement) activities, as well as coordinated dissemination of information through a state SRTS coordinator, a national SRTS clearinghouse, and a SRTS task force.
Although few evaluations of SRTS programs have been published, results are available from 3 such programs in California. Staunton et al relay the success story of Marin County, California, in implementing a program to increase the number of children walking to school while reducing the number of car trips to school (42
). Incorporating elements of classroom education, walking and biking days, mapping of routes, and walking trains and newsletters, the program resulted in a 64% increase in the number of children walking to school (42
). Using case studies to evaluate specific SRTS projects for their effects on active commuting, Boarnet et al (43
) concluded that sidewalk gap closure projects (i.e., connecting previously disconnected sections of sidewalk) and improvements in traffic signals (e.g., replacing a 4-way stop sign with traffic lights) were associated with increased rates of walking and increased pedestrian safety among children. Limited effects were noted for appropriate sidewalk signage, improvements in crosswalk signals (e.g., flashing warning light systems at crosswalks), and the presence of bike lanes. In a similar analysis, the presence of SRTS projects on students' behavioral patterns was assessed (44
). Findings suggested that children who passed an SRTS project on their route to school were more likely to increase their personal active commuting patterns. However, the authors noted an overall decrease in walking and bicycling rates after completion of the projects, potentially because of the pattern of increased driving during project construction that was difficult to break after construction was complete (44
As a national program, SRTS is being implemented throughout the United States. Although these programs and projects have yet to be evaluated comprehensively, the National Center for Safe Routes to School (www.saferoutesinfo.org
) is currently tracking the spending patterns by state programs participating in the federal funding strategy (45
). As of March 31, 2007, all 50 states and the District of Columbia had demonstrated some level of participation in the SRTS program. Nineteen states have spent approximately $24.3 million for SRTS on infrastructure and noninfrastructure (i.e., education, training) projects.
A second public health effort to promote active commuting to school is the Walking School Bus (WSB) program. In its simplest form, the WSB is a voluntary program that requires one or more adults to escort small groups of children, on foot or bicycle, to and from school each day. The group establishes a meeting point for participants, referred to as a "bus stop," and proceeds as a group in active commute mode. Although little formal evaluation is available on this grassroots strategy, many small-scale qualitative studies from New Zealand provide insight into the benefits of the WSB program and factors affecting its sustainability. Benefits of the WSB program, as reported by parents and other stakeholders, include eliminating the hassle of driving to school and finding a parking spot, knowing that children are safe, providing an opportunity for children to socialize with other children, gaining independence through walking, increasing health benefits through walking, raising awareness of children's road safety, and increasing civic participation (46
). In one of the few long-term follow-up studies, Kingham and Ussher (48
) examined factors impacting the sustainability of the WSB program in Christchurch, New Zealand, from its initiation in September 2000 to its follow-up in April 2003. During this time, the number of routes declined 54%, with few routes surviving beyond a year, and the average number of children on each route declined from 9 to 7.7. Barriers to the sustainability of the program reported by parents and program organizers included a lack of parent volunteers, weather (i.e., confusion about whether the WSB would operate during inclement weather), road safety, and lack of communication between schools and parent organizers. Thus, although parents and stakeholders readily identified the benefits of the WSB, the ability to sustain the program was compromised by many factors, ranging from organizational issues to road infrastructure.
In summary, both the SRTS and WSB programs are designed to promote active commuting to school. SRTS is a broad-scale effort that includes changes in transport infrastructure and school policies, as well as educational activities within and outside of school. SRTS programs now operate in all 50 states and the District of Columbia. Although these programs have a broad reach, they do not lend themselves readily to evaluation because of the breadth of changes, lack of standardized protocols, absence of control schools, and lack of information about children's behavior before program implementation. Evaluation data suggest that improvements in sidewalk infrastructure and traffic calming measures may be more effective than improvements in sidewalk signage and the installation of crossing signals and bike lanes. Furthermore, programs that couple infrastructure changes with classroom activities and parent involvement may be most effective. This last finding is supported by research highlighting the role of parents as gatekeepers to children's ability to walk or bicycle to school.
In contrast to the broad-scale approach of SRTS, the WSB program is a smaller-scale grassroots effort that can be incorporated into SRTS programs. The WSB program focuses on mobilizing groups of parents and stakeholders to create supervised walking routes for children and in general does not address structural changes to promote safe walking and bicycling. Although WSB programs are more focused — and therefore more amenable to evaluation — than SRTS, they generally are organized at the local level with few or no resources. Consequently, evaluation and dissemination of findings are not mandated or of central interest in these programs. Although parents and stakeholders readily identify benefits, WSB programs are difficult to sustain because of issues such as a lack of parent volunteers and unsafe road conditions.
The SRTS and WSB programs were established when little information had been published about predictors of active commuting among children. As a result, these programs generally are not evidence-based and reflect assumed predictors of children's walking and bicycling to school. The research base has since expanded rapidly to enhance these programs. The effectiveness of future efforts to promote children's active commuting to school will be enhanced by drawing on the burgeoning research on predictors of active commuting to school, incorporating plans for evaluation into the initial planning stages of programs, and disseminating the results from formal and informal evaluations in outlets accessible to public health scientists and practitioners. Parental involvement is one example of how findings from research and evaluations of practice-based activities can be integrated. Research supports parents' roles as primary stakeholders in efforts to increase children's active commuting to school but often have little time to devote to programmatic activities. Consequently, although parental guidance and buy-in is necessary to the success of any program, programs that rely heavily on parent volunteers may be compromised in terms of their long-term feasibility. Other groups need to be considered to take on this role. For example, in the WSB program in Auckland, New Zealand, a retired volunteer helped supervise the walking routes (46
). According to qualitative accounts, this was a role that the volunteer enjoyed, and his involvement facilitated continuity in the program (46
). Efforts to integrate findings from research and evaluations of programs will facilitate identification of best practices for promoting active commuting and efficient use of limited resources.