Sampling Methodology and Reliability of a Representative Walkability Audit.

Background: Physical inactivity is a public health concern in the US Virgin Islands (USVI). A contributing factor may be a lack of pedestrian infrastructure and other environmental supports for walking. In this manuscript, we describe the methods used to conduct a walkability audit of environmental features related to physical activity in the USVI. Methods: In 2016, volunteer auditors conducted the audit using a modified version of the Microscale Audit of Pedestrian Streetscapes tool. A two-stage sampling method was developed using publicly available census data to select a sample of estates (n=46) and street segments (n=1,550; 99.2 km) across the USVI. A subset of segments was audited by two independent auditors, and inter-rater reliability was assessed using Cohen's kappa and percent agreement. Results: Audits were completed on 1,114 segments (94.6 km), and estimates were weighted to represent accessible public street length in the study area (1,155.9 km). Most items on the audit tool (62.7%) demonstrated good to excellent reliability. We found that it was feasible to conduct a reliable audit of environmental features related to physical activity across a large sample of streets in the USVI. Conclusions: These methods can be replicated in other settings to collect comprehensive data that can be used to guide strategies to improve the walkability of communities.