Cross-sectional and prospective associations of neighbourhood environmental attributes with screen time in Japanese middle-aged and older adults

Objectives This study examined cross-sectional and 2-year prospective associations of perceived and objectively measured environmental attributes with screen time among middle-aged Japanese adults. Design Prospective cohort study. Setting Nerima and Kanuma cities of Japan. Participants Data were collected from adults aged 40-69 years living in two cities of Japan in 2011 (baseline: n=1011; 55.3 +/- 8.4 years) and again in 2013 (follow-up: n=533; 52.7% of baseline sample). Measures The exposure variables were five geographic information system-based and perceived attributes of neighbourhood environments (residential density, access to shops and public transport, footpaths, street connectivity), respectively. The outcome variables were baseline screen time (television viewing time and leisure-time Internet use) and its change over 2 years. Multilevel generalised linear modelling was used. Results On average, participants' screen time was not statistically different over 2 years (2.3 hours/day at baseline and 2.2 hours/day at follow-up; P=0.24). There were cross-sectional associations of objective (exp(beta): 1.11; 95% CI 1.01 to 1.22) and perceived (1.12; 1.02 to 1.23) good access to public transport, perceived good access to shop (1.18; 1.04 to 1.36) and perceived good street connectivity (1.11; 1.01 to 1.23) with higher time spent in screen time at baseline. No objective and perceived environmental attributes were significantly associated with change in screen time. Conclusions Activity-supportive neighbourhood environmental attributes appear to be related to higher levels of screen time cross-sectionally. Pattern of screen time might he maintained rather than changed over time under the same neighbourhood environments. Environmental interventions that promote physical activity may need to consider the potential negative health impact of screen time in Japan.