Mismatch between perceived and objectively assessed neighborhood walkability attributes: prospective relationships with walking and weight gain.

We examined prospectively whether persons who perceive their objectively measured high walkable environment as low walkable decrease their walking more and gain more weight than those with matched perceptions. Walkability was measured objectively using GIS. Corresponding perceptions were collected using the Neighborhood Environment Walkability Scale from 1027 urban Australian adults. Objective and perceived measures were dichotomized and categories of match and mismatch were created. Overall, walking levels decreased and BMI increased significantly over the four year follow-up period. Those who perceived high walkability, dwelling density or land use mix as low decreased their walking for transport significantly more than those with matched perceptions. Those who perceived high walkability, land use mix or retail density as low increased their BMI significantly more than those with concordant perceptions. These prospective findings corroborate recommendations from previous cross-sectional studies. Interventions to improve negative perceptions of walkability among those living in high walkable areas may be a relevant public health intervention to increase physical activity and support weight maintenance.