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Record Count: 8
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header (Title, Principal Investigator, Institution, City, ST, Award Code, or
Pubs).
DESCRIPTION (provided by applicant)
The prevalence of obesity, a major risk factor for four of the ten leading causes of death (cardiovascular disease, diabetes, dietary cancers, and stroke), has risen dramatically over the past 20 years in the United States. In neighborhoods with few economic resources, aspects of the built environment may be less conducive to physical activity and healthy diets, placing residents disproportionately at risk. The growing health burden of obesity and co-morbidities highlight the need to identify effective measures of the means by which the built environment influences health, as well as effective interventions to create healthier environments. The longitudinal study proposed here will contribute to both of these goals. Specifically, the proposed initiative is to: 1) Assess independent and collective scientific contributions of five methods of assessing characteristics of the built environment (measures of accessibility; mapping; typologies of neighborhood characteristics; observation; and residents' perceptions) for understanding the means by which the built environment influences behavioral and biological factors associated with obesity and related co-morbidities among African American, Hispanic and white residents of Detroit; 2) Develop and implement additional components of a multilevel, multi-site intervention that incorporates modifications of the built environment and that builds on ongoing social and behavioral approaches to promote physical activity and access to healthy foods in eastside, northwest and southwest Detroit; 3) Conduct longitudinal analyses to evaluate the independent and cumulative effects of modifications of the built environment, alone and in conjunction with multilevel, multi-site social, informational and behavioral approaches to promote physical activity and access to healthy foods among African American, Hispanic and white residents of eastside, northwest and southwest Detroit; and 4) Disseminate knowledge gained about the implications of changes in the built environment alone, and in conjunction with behavioral and social interventions, for behavioral and biological indicators of obesity and related co-morbidities to community members and to local, regional and national decision makers.
DESCRIPTION (provided by applicant)
Childhood obesity rates continue to increase in the U.S. and internationally, particularly among youth in middle childhood and adolescence, with alarming anticipated health consequences. Such increasing prevalence of obesity requires a systematic evaluation of the factors contributing to this epidemic, particularly environmental factors that are amenable to policy change. Recent empirical evidence, paired with emerging concepts that integrate urban planning and public health, suggests that adult obesity and weight-related behaviors are related to neighborhood built environment characteristics. Very few studies have evaluated the association between built environmental and child weight status or change in child weight status. The present study aims to 1) evaluate the association of neighborhood-level physical activity and nutrition environment with children's weight status after controlling for known individual and familial risk factors, and 2) evaluate the ability of neighborhood-level environmental factors to predict the change in children's weight status over a 2-year period. This will be a multi-level observational study. Census block groups in two distinct regions in the U.S. (Cincinnati, OH & San Diego, CA) will be screened, clustered to form neighborhoods, and selected for study based on the built environment constructs of walkability (combination of street connectivity, residential density, land use mix, and retail floor area ratio), public recreation space quality, and nutrition environment quality. Walkability indices will be created through existing parcel-level and street network information in these regions. Public recreation space and nutrition environment quality indices will be created using established psychometrically sound direct observation instruments. Forty neighborhoods (n=20 per region) with socioeconomic diversity will be selected for study based on these built environment constructs, with additional environmental variables also collected (e.g., crime). Twenty children 6-10 years old and a parent will be randomly selected from each of the study neighborhoods (n=800 total pairs). Child weight status, physical activity, and dietary intake will be directly assessed at baseline and 2 years following baseline. Home and school environment factors related to their child's weight status will be reported by parents, and parental weight status, early child feeding experiences, and demographics will be obtained. The proposed trans-disciplinary project team combines expertise in studying obesity, physical activity, nutrition, and their relation to built environment factors. The proposed study addresses critical unanswered questions regarding associations of neighborhood built environment with childhood obesity and related behaviors. The proposed detailed evaluations of multiple dimensions of the built environment and use of best-available measures will advance science and provide information that can be used by policymakers to contribute to controlling the epidemic of childhood obesity.
DESCRIPTION (provided by applicant)
Project Summary: The impact of the built environment on health in rural areas has been understudied and virtually nothing is known about the influence of the rural built environment on overweight in adolescents. Our overarching goal for this study is to examine the influence of the built environment on adolescent overweight in the predominantly rural communities of Northern New England. Our multidisciplinary team will use quantitative and qualitative methods to conduct multi-level assessments of risk factors for adolescent overweight. We will accomplish our aims by studying an established cohort of 2567 adolescents and their parents, representing 26 stable and largely rural communities in Vermont and New Hampshire. When adolescents (8-13 years of age) were first surveyed in 2002-2003, the prevalence of overweight by community ranged from 9.7% to 34.1%, indicating substantial variation at the community level. Relevant individual and family characteristics of this cohort will be assessed through three annual telephone surveys, beginning in January 2006. We will use GIS data and on-site mapping, to characterize the built environment of each community. The community level data will include assessments of recreational resources and food (including fast food) availability, as well as standard measures of density, diversity and design. We will use an ethnographic approach to assess and describe the 'culture' surrounding physical activity and food within each of the schools attended by our cohort. The assessment of multi-level data will allow us to investigate how individual and family characteristics interact with the built environment to influence adolescent overweight. Our primary outcome will be adolescent overweight (defined as body mass index (BMI) equal to or greater than the 95th percentile of the sex-specific BMI-for-age growth curves. Intermediate outcomes will include adolescent physical activity levels and dietary intake patterns, including consumption of high fat and high calorie foods. The multi-disciplinary expertise of our investigative group and the availability of a well-established cohort ensure the feasibility, efficiency, and success of the proposed effort. Relevance: Our study includes children and low SES communities, two populations targeted by RFA-04-003 because of their vulnerability. In addition, our study focuses on rural communities, meeting the expressed need for studies of rural populations. Results from this study will help to identify risk factors that could be targeted through specific interventions to prevent adolescent overweight.
We propose to investigate the impact of the built environment characteristics on body size, physical activity and diet in residents of New York City (NYC). We will use data from three large human health studies. The first data set will be from 1000 Black and Hispanic children enrolled in prospective cohort study of Head Start families. From all of the children we will have complete demographic data, and mother's reports on the height and weight and physical activity of the child. From 500 of the children data will be available on skin fold thickness, body mass index (BMI) and 6 days of physical activity monitoring. Data will be available at baseline and from two annual follow-ups of the cohort. The second data set will be from 18,000 adult New Yorkers from whom we will have demographic data and objectively measured BMI. The third will be from 2,400 healthy Black and Caucasian. From these women we will have demographic data,
questionniare data on diet and physical activity and objective measures of BMI, waist and hip circumference and body fat by bio-impedence. From all of these subjects we will have a home address which we will geocode into a CIS model of New York City. Multi-level modeling approaches will be used to determine whether neighborhoods characterisitcs (for example; land use, street design, availability and quality of parks and retail food stores, zoning, public transport, farmers markets) predict body size, physical activity and diet.
Because of the very large immigrant population in NYC we will conduct qualitative research on how acculturation to the built environment of NYC impacts body size. Prior work suggests that acculturation to main stream American norms leads to weight increases in immigrants and their children. We do not see this effect in our data and propose that NYC is not "main stream America". We propose to conduct qualitative research on Hispanic mothers and children in the Head Start study and investigate how they relate to the built environment of NYC. Our goal is to develop a new measure of acculturation that includes adaption to the built environment of NYC and will be useful in studies of obesity. The quantitative research will also be used to develop new GIS based measures of aspects of the City that are important to the mothers.
This research on the phsyical environment and adaption to it, will identify strategies for building and organizing communites that increase physical activity, improve diets and reduce obesity.
DESCRIPTION (provided by applicant)
There is growing optimism that adjusting the built environment can reverse the obesity trend through increased opportunities for physical activity and the reduced reliance on automobiles for basic transportation. The majority of research, however, on the influence of the built environment on health related outcomes have used cross-section designs. As a result, there is a limited amount of information on the causal impact of changes in the built environment on obesity levels. The proposed 24-month pilot study would provide a foundation for assessing the short-term causal influence of light rail mass transit on physical activity and obesity. The proposed study will consist of a natural experiment that examines the before and after effects of the introduction of a new light rail system in Charlotte, NC on obesity related factors.
The specific aims of the proposed pilot study are: (a) to test the impact of light rail on the daily physical activity levels and BMI of riders; and (b) to assess whether the use of light rail transit leads to significant increases in physical activity and reductions in BMI of study participants who use light rail compared to similarly situated participants who do not use light rail transit. Through a two-wave longitudinal panel design of interviews with 1,000 household residents living within a mile radius of the soon-to-open light rail transit system the study will assess pre and post-levels of daily physical activity and BMI. A propensity score matching approach will be used to match light rail riders and non-riders on all relevant health, social, and economic factors. The results from the propensity score matching will be used to compare the physical activity and BMI levels over time of participants who use the light rail system with participants who do not use light rail transit. Results from the research will provide a causal test of the impact of light rail on obesity and the potential positive economic impacts of integrating public health objectives in transportation decision-making.
Crisp Terms/Key Words: outcomes research, behavioral /social science research tag, clinical research, weight loss, travel, urban area, socioenvironment, socioeconomics, chordate locomotion, human population dynamics, longitudinal human study, data collection methodology /evaluation, interview, human subject, public health, physical fitness, body physical activity, exercise, environmental engineering, obesity, body composition
DESCRIPTION (provided by applicant)
The specific research goal of this study is to identify discriminatory environmental items in preschool play areas to be included in a pilot tool that will rate their potential to produce physical activity when three-to five- year-old children are exposed to them. Currently, no tool exists that links the amount of physical activity and preschool play areas, with the potential of affecting policy. This study will characterize behavior settings, their components and attributes, in terms of the physical activity patterns of understudied population preschool childcare centers. Research has shown that: a) time spent outdoors is an environmental determinant most strongly correlated with greater amounts of physical activity in children and opportunities for whole body exercise; b) children's physical activity is strongly motivated by diversity of outdoor environments; c) preschoolers with higher levels of outdoor physical activity retain higher levels as schoolage children; d) active outdoor childhood tracks into and influences the preference for outdoor experiences in adulthood; and e) the preschool and, more specifically the preschool outdoors is a strong determinant of physical activity. Fifteen childcare centers will be selected from respondents to the Baseline Survey of Environmental Conditions of Outdoor Areas in NC Childcare Centers. Sites range across urban, suburban, and rural contexts and diverse ethnic and socioeconomic groups. Research activities: 1. Behavior mapping (GIS coded) of preschool play areas to identify physical activity patterns in specific behavior settings (spatial location of subjects and physical activity amount); 2. Inventory of environmental components and attributes of behavior settings associated with different amounts of physical activity; 3. Identification of discriminatory environmental items to be included in a draft measuring tool; 4. Develop pilot measuring tool; 5. Preliminary test of reliability and validity. This study responds to the Strategic Plan for NIH Obesity Research, including the goals to "Assess children's environments...to determine barriers to increasing physical activity"; to "Identify...environmental and behavioral factors to obesity...prevention...and assess... environments such as...childcare...for specific barriers to increasing physical activity"; and to "Use prospective observational' studies to identify modifiable behavioral and environmental determinants of weight gain and obesity in children...[related to] critical periods for inappropriate weight gain" i.e., in childcare centers.
Crisp Terms/Key Words: data quality /integrity, weight gain, behavioral /social science research tag, clinical research, method development, play, behavior test, human subject, body physical activity, disease /disorder prevention /control, environmental health, preschool child (1-5), day care center, child care, child behavior, obesity
DESCRIPTION (provided by applicant)
Reducing the population prevalence of obesity is a current major public health goal. Interventions to reduce the prevalence of obesity have generally focused on individual behavior and lifestyle but have met with limited success. Strategies that focus on the role of the built environment have been neglected. The purpose of this innovative pilot study is to evaluate, using a quasi-experimental design, the impact on diet and psychological health of a three-year $40 million state-government funded program - The Pennsylvania Fresh Food Financing Initiative - that aims to improve the local built food retail environment in Philadelphia. The project has four specific aims. 1) To describe and compare fruit and vegetable consumption patterns and measures of psychological health in an intervention neighborhood against a matched comparison neighborhood. 2) To evaluate whether these patterns change after the opening of a new food supermarket (the intervention) in the intervention neighborhood compared to a matched comparison site. 3) To explore impacts on defined subgroups of residents based on income, education and baseline consumption status. 4) To investigate changes in the retail economy in the intervention neighborhood and compare these with the comparison neighborhood. A telephone survey of residents of two Philadelphia neighborhoods (one intervention and one comparison) with an achieved sample size of four hundred and sixty-six men and women aged 18+ in each neighborhood at follow-up will be undertaken. At baseline, respondents will be contacted with a pre-notification letter which will then be followed by a telephone call designed to elicit responses to questions relating to diet, mental health, perceptions of food access, food shopping behavior, transport and a range of socio-demographic data. Respondents will then be followed-up at eight months in order to assess the effect of the intervention. In addition geographical information systems will be used to assess positive and negative changes in the local food retail economy and relate them to changes in physical access to food. Findings from the project will be used to prepare a proposal to NIH for a larger mixed-method, multi-site experimental study in a range of community settings (urban, small town, rural) throughout the USA.
Crisp Terms/Key Words: experimental design, outcomes research, behavioral /social science research tag, clinical research, socioenvironment, socioeconomics, health behavior, health survey, longitudinal human study, vegetable, fruit, nutrition related tag, dietary constituent, diet, nutrient intake activity, mental health, statistics /biometry, questionnaire, interview, human subject, public health, food resource, food chain, disease /disorder proneness /risk, obesity, body weight
DESCRIPTION (provided by applicant)
The prevalence and incidence of obesity is a serious threat to public health in the United States, and has reached epidemic proportions. Additional concerns are the associations of overweight and obesity with cardiovascular disease, diabetes, cancer, and other debilitating conditions. This proposed project responds to the call for efforts to identify and measure potential causal associations between the built environment and obesity, and related comorbidities. This investigation proposes a longitudinal, multilevel project to examine how the physical and built environment may influence levels of overweight and obesity, physical inactivity, and blood pressure in neighborhoods of older residents. The primary aims are to: (a) simultaneously examine neighborhood- and resident-level change in body mass index, physical activity, and blood pressure over a three-year period, and (b) identify neighborhood-level physical and built environment correlates of change in the proposed outcomes while controlling for covariates at the resident-level.
Using a multistage sampling design, the study will recruit 1,800 community residents aged 60 years and older from a random sample of 120 census-block groups (defined as a proxy for neighborhoods - the primary sampling unit) in Multinomial County, Oregon. Data to be gathered include surveys, assessments, census and Geographic Information Systems data, and dependent outcome measures of body mass index, physical activity, and blood pressure. Key physical and built environment measures will include hilly terrain, urban form, and density of fast-food restaurants. The resulting environmental and personal factors data will be integrated into a three-level statistical model involving temporal measures (Level 1), that are nested within residents (Level 2), who are themselves nested within neighborhoods (Level 3). The hierarchically structured data, to be analyzed through multilevel modeling methodologies, will examine both inter-neighborhood and inter-resident variability in change in the proposed outcomes, as well as the degree to which neighborhood-level built environment variables are related to variation in change in the outcomes over time.
This proposed investigation extends the current individual oriented paradigm to an ecological, multilevel paradigm for assessing the extent to which built environment factors influence obesity and obesity-related outcomes over time in the neighborhoods of older adults. The results of this study are likely to increase understanding of the unique influences of physical and built environment factors which directly and indirectly affect neighborhood-level overweight and obesity in older adults, and will provide information to guide future pubic health investigations to slow the pace of this growing epidemic.
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