Socioecological correlates of active transportation in Ghana

Background Active transportation (AT) offers a sustainable and equitable means of increasing population physical activity levels. Yet, evidence of its determinants among adult populations in Africa remains limited. This study examined the correlates of AT among a cadre of healthcare professionals in Ghana. Methods A cross-sectional analysis was conducted using data from a 2024 survey of 439 Physician Assistants. Guided by the socioecological model, potential correlates were assessed across individual, social, built, and natural environment levels. Hierarchical binary logistic regression with likelihood ratio tests examined the association between AT and potential correlates. Results AT prevalence was 34.4%. In the final model, male sex (aOR = 1.68, 95% CI: 1.10, 2.65) and sidewalk on commute routes (aOR = 1.84, 95% CI : 1.20, 2.82) were positively associated with AT. Higher education (aOR = 0.43, 95% CI : 0.19, 0.97), car ownership (aOR = 0.59, 95% CI : 0.37, 0.94), and perceiving AT as time-consuming (aOR = 0.41, 95% CI : 0.23, 0.74) were inversely associated with AT. Climatic factors such as temperature (aOR = 2.12, 95% CI : 1.13, 4.01) and relative humidity (aOR = 1.03, 95% CI : 1.01, 1.05) increased the odds of AT, while wind speed reduced them (aOR = 0.62, 95% CI : 0.47, 0.81). Discussion About one in three Physician Assistants in Ghana commute actively, shaped by individual, social, and environmental factors. Promoting AT will require multi-level interventions and policies that integrate infrastructure improvements, climate resilience, and sex-sensitive approaches to sustain the physical and mental health benefits of active commuting.