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Stewart OT, Moudon AV, Littman AJ, Seto E, Saelens BE. Why neighborhood park proximity is not associated with total physical activity. Health Place 2018; 52:163-169. [DOI: 10.1016/j.healthplace.2018.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/18/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
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Baek SR, Moudon AV, Saelens BE, Kang B, Hurvitz PM, Bae CHC. Comparisons of Physical Activity and Walking Between Korean Immigrant and White Women in King County, WA. J Immigr Minor Health 2018; 18:1541-1546. [PMID: 26514149 DOI: 10.1007/s10903-015-0290-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Immigrant and minority women are less physically active than White women particularly during leisure time. However, prior research demonstrates that reported household physical activity (PA) and non-leisure time walking/biking were higher among the former. Using accelerometers, GPS, and travel logs, transport-related, home-based, and leisure time PA were measured objectively for 7 days from a convenience sample of 60 first-generation Korean immigrant women and 69 matched White women from the Travel Assessment and Community Project in King County, Washington. Time spent in total PA, walking, and home-based PA was higher among Whites than Korean immigrants regardless of PA type or location. 58 % of the White women but only 20 % of the Korean women met CDC's PA recommendations. Socio-economic status, psychosocial factors, and participants' neighborhood built environmental factors failed to account for the observed PA differences between these groups.
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Doescher MP, Lee C, Saelens BE, Lee C, Berke EM, Adachi-Mejia AM, Patterson DG, Moudon AV. Utilitarian and Recreational Walking Among Spanish- and English-Speaking Latino Adults in Micropolitan US Towns. J Immigr Minor Health 2017; 19:237-245. [PMID: 26993115 PMCID: PMC5027171 DOI: 10.1007/s10903-016-0383-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Walking among Latinos in US Micropolitan towns may vary by language spoken. METHODS In 2011-2012, we collected telephone survey and built environment (BE) data from adults in six towns located within micropolitan counties from two states with sizable Latino populations. We performed mixed-effects logistic regression modeling to examine relationships between ethnicity-language group [Spanish-speaking Latinos (SSLs); English-speaking Latinos (ESLs); and English-speaking non-Latinos (ENLs)] and utilitarian walking and recreational walking, accounting for socio-demographic, lifestyle and BE characteristics. RESULTS Low-income SSLs reported higher amounts of utilitarian walking than ENLs (p = 0.007), but utilitarian walking in this group decreased as income increased. SSLs reported lower amounts of recreational walking than ENLs (p = 0.004). ESL-ENL differences were not significant. We identified no statistically significant interactions between ethnicity-language group and BE characteristics. DISCUSSION Approaches to increase walking in micropolitan towns with sizable SSL populations may need to account for this group's differences in walking behaviors.
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Stewart OT, Moudon AV, Saelens BE. The Causal Effect of Bus Rapid Transit on Changes in Transit Ridership. JOURNAL OF PUBLIC TRANSPORTATION 2017; 20:91-103. [PMID: 28989271 PMCID: PMC5627619 DOI: 10.5038/2375-0901.20.1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Numerous studies have reported ridership increases along routes when Bus rapid transit (BRT) replaces conventional bus service, but these increases could be due simply to broader temporal trends in transit ridership. To address this limitation, we compared changes in ridership among routes where BRT was implemented to routes where BRT was planned or already existed in King County, Washington. Ridership was measured at 2010, 2013, and 2014. Ridership increased by 35% along routes where BRT was implemented from 2010 to 2013 compared to routes that maintained conventional bus service. Ridership increased by 29% along routes where BRT was implemented from 2013 to 2014 compared to consistent existing BRT service. These results provide stronger evidence for a causal relationship between BRT and increased transit ridership and a more accurate estimate of the independent effect of BRT on ridership.
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Stewart OT, Carlos HA, Lee C, Berke EM, Hurvitz PM, Li L, Moudon AV, Doescher MP. Secondary GIS built environment data for health research: guidance for data development. JOURNAL OF TRANSPORT & HEALTH 2016; 3:529-539. [PMID: 28459001 PMCID: PMC5404746 DOI: 10.1016/j.jth.2015.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Built environment (BE) data in geographic information system (GIS) format are increasingly available from public agencies and private providers. These data can provide objective, low-cost BE data over large regions and are often used in public health research and surveillance. Yet challenges exist in repurposing GIS data for health research. The GIS data do not always capture desired constructs; the data can be of varying quality and completeness; and the data definitions, structures, and spatial representations are often inconsistent across sources. Using the Small Town Walkability study as an illustration, we describe (a) the range of BE characteristics measurable in a GIS that may be associated with active living, (b) the availability of these data across nine U.S. small towns, (c) inconsistencies in the GIS BE data that were available, and (d) strategies for developing accurate, complete, and consistent GIS BE data appropriate for research. Based on a conceptual framework and existing literature, objectively measurable characteristics of the BE potentially related to active living were classified under nine domains: generalized land uses, morphology, density, destinations, transportation system, traffic conditions, neighborhood behavioral conditions, economic environment, and regional location. At least some secondary GIS data were available across all nine towns for seven of the nine BE domains. Data representing high-resolution or behavioral aspects of the BE were often not available. Available GIS BE data - especially tax parcel data - often contained varying attributes and levels of detail across sources. When GIS BE data were available from multiple sources, the accuracy, completeness, and consistency of the data could be reasonable ensured for use in research. But this required careful attention to the definition and spatial representation of the BE characteristic of interest. Manipulation of the secondary source data was often required, which was facilitated through protocols.
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Drewnowski A, Aggarwal A, Tang W, Hurvitz PM, Scully J, Stewart O, Moudon AV. Obesity, diet quality, physical activity, and the built environment: the need for behavioral pathways. BMC Public Health 2016; 16:1153. [PMID: 27832766 PMCID: PMC5105275 DOI: 10.1186/s12889-016-3798-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The built environment (BE) is said to influence local obesity rates. Few studies have explored causal pathways between home-neighborhood BE variables and health outcomes such as obesity. Such pathways are likely to involve both physical activity and diet. METHODS The Seattle Obesity Study (SOS II) was a longitudinal cohort of 440 adult residents of King Co, WA. Home addresses were geocoded. Home-neighborhood BE measures were framed as counts and densities of food sources and physical activity locations. Tax parcel property values were obtained from County tax assessor. Healthy Eating Index (HEI 2010) scores were constructed using data from food frequency questionnaires. Physical activity (PA) was obtained by self-report. Weights and heights were measured at baseline and following 12 months' exposure. Multivariable regressions examined the associations among BE measures at baseline, health behaviors (HEI-2010 and physical activity) at baseline, and health outcome both cross-sectionally and longitudinally. RESULTS None of the conventional neighborhood BE metrics were associated either with diet quality, or with meeting PA guidelines. Only higher property values did predict better diets and more physical activity. Better diets and more physical activity were associated with lower obesity prevalence at baseline and 12 mo, but did not predict weight change. CONCLUSION Any links between the BE and health outcomes critically depend on establishing appropriate behavioral pathways. In this study, home-centric BE measures, were not related to physical activity or to diet. Further studies will need to consider a broader range of BE attributes that may be related to diets and health.
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Abstract
Purpose. This paper reviews existing environmental audit instruments used to capture the walkability and bikability of environments. The review inventories and evaluates individual measures of environmental factors used in these instruments. It synthesizes the current state of knowledge in quantifying the built environment. The paper provides health promotion professionals an understanding of the essential aspects of environments influencing walking and bicycling for both recreational and transportation purposes. It serves as a basis to develop valid and efficient tools to create activity-friendly communities. Data Sources. Keyword searches identified journal articles from the computer-based Academic Citation Databases, including the National Transportation Library, the Web of Science Citation Database, and MEDLINE. Governmental publications and conference proceedings were also searched. Study Inclusion and Exclusion Criteria. All instruments to audit physical environments have been included in this review, considering both recreation- and transportation-related walking and bicycling. Excluded are general methods devised to estimate walking and cycling trips, those used in empirical studies on land use and transportation, and research on walking inside buildings. Data Extraction Methods. Data have been extracted from each instrument using a template of key items developed for this review. The data were examined for quality assurance among three experienced researchers. Data Synthesis. A behavioral model of the built environment guides the synthesis according to three components: the origin and destination of the walk or bike trip, the characteristics of the road traveled, and the characteristics of the areas surrounding the trip's origin and destination. These components, combined with the characteristics of the instruments themselves, lead to a classification of the instruments into the four categories of inventory, route quality assessment, area quality assessment, and approaches to estimating latent demand for walking and bicycling. Furthermore, individual variables used in each instrument to measure the environment are grouped into four classes: spatiophysical, spatiobehavioral, spatiopsychosocial, and policy-based. Major Conclusions. Individually, existing instruments rely on selective classes of variables and therefore assess only parts of built environments that affect walking and bicycling. Most of the instruments and individual measures have not been rigorously tested because of a lack of available data on walking and bicycling and because of limited research budgets. Future instrument development will depend on the acquisition of empirical data on walking and bicycling, on inclusion of all three components of the behavioral model, and on consideration of all classes of variables identified.
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Jiao J, Drewnowski A, Moudon AV, Aggarwal A, Oppert JM, Charreire H, Chaix B. The impact of area residential property values on self-rated health: A cross-sectional comparative study of Seattle and Paris. Prev Med Rep 2016; 4:68-74. [PMID: 27413663 PMCID: PMC4929065 DOI: 10.1016/j.pmedr.2016.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 04/09/2016] [Accepted: 05/16/2016] [Indexed: 11/29/2022] Open
Abstract
This study analyzed the impact of area residential property values, an objective measure of socioeconomic status (SES), on self-rated health (SRH) in Seattle, Washington and Paris, France. This study brings forth a valuable comparison of SRH between cities that have contrasting urban forms, population compositions, residential segregation, food systems and transportation modes. The SOS (Seattle Obesity Study) was based on a representative sample of 1394 adult residents of Seattle and King County in the United States. The RECORD Study (Residential Environment and Coronary Heart Disease) was based on 7131 adult residents of Paris and its suburbs in France. Socio-demographics, SRH and body weights were obtained from telephone surveys (SOS) and in-person interviews (RECORD). All home addresses were geocoded using ArcGIS 9.3.1 (ESRI, Redlands, CA). Residential property values were obtained from tax records (Seattle) and from real estate sales (Paris). Binary logistic regression models were used to test the associations among demographic and SES variables and SRH. Higher area property values significantly associated with better SRH, adjusting for age, gender, individual education, incomes, and BMI. The associations were significant for both cities. A one-unit increase in body mass index (BMI) was more detrimental to SRH in Seattle than in Paris. In both cities, higher area residential property values were related to a significantly lower obesity risk and better SRH. Ranked residential property values can be useful for health and weight studies, including those involving social inequalities and cross-country comparisons. We studied the impact of area property values on health in Seattle and Paris. Higher area property values associated with better SRH in both cities Ranked area property values can be useful for health and weight studies. BMI was more detrimental to SRH in Seattle than in Paris.
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Tang W, Aggarwal A, Moudon AV, Drewnowski A. Self-reported and measured weights and heights among adults in Seattle and King County. BMC OBESITY 2016; 3:11. [PMID: 26918195 PMCID: PMC4757992 DOI: 10.1186/s40608-016-0088-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 01/30/2016] [Indexed: 11/10/2022]
Abstract
Background Self-reported weights and heights can be subject to gender, socio-economic, and other biases. On the other hand, obtaining measured anthropometric data can pose a significant respondent burden. Methods Seattle Obesity Study II (SOS II) participants (n = 419) provided self-reported height, weight, and demographic data through an interviewer-assisted behavior survey. Participants were then weighed and measured by trained staff. The entire process was repeated 12 months later. At the follow up visit, participants were also asked to recall their weight from 12 months ago. The concordance between measured and self-reported data was assessed using Bland-Altman plots. Results Some weight underreporting by obese individuals was observed. Gender or socio-economic status (SES) did not affect self-reports. Bland-Altman plots provided 95 % limits of agreement of −3.13 to 5.83 for weight (kg), and 1.21 to 2.52 for BMI (kg/m2). The concordance between measured and self-reported BMI categories was excellent (Kappa = 0.82 for men, and 0.86 for women). At the follow up visit, participants estimated their weight 12 months ago more accurately than their current weight. Conclusions Self-reported heights and weights were highly correlated with objective measures at two points in time. No gender or SES biases were observed. Minor, yet statistically significant under-reporting (<1.5 kg) was observed for obese participants. Caution should be used when using self-reported data in obese populations. Electronic supplementary material The online version of this article (doi:10.1186/s40608-016-0088-2) contains supplementary material, which is available to authorized users.
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Stewart OT, Moudon AV, Fesinmeyer MD, Zhou C, Saelens BE. The association between park visitation and physical activity measured with accelerometer, GPS, and travel diary. Health Place 2016; 38:82-8. [PMID: 26798965 DOI: 10.1016/j.healthplace.2016.01.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/04/2016] [Accepted: 01/08/2016] [Indexed: 11/25/2022]
Abstract
Public parks are promoted as places that support physical activity (PA), but evidence of how park visitation contributes to overall PA is limited. This study observed adults living in the Seattle metropolitan area (n=671) for one week using accelerometer, GPS, and travel diary. Park visits, measured both objectively (GPS) and subjectively (travel diary), were temporally linked to accelerometer-measured PA. Park visits occurred at 1.4 per person-week. Participants who visited parks at least once (n=308) had an adjusted average of 14.3 (95% CI: 8.9, 19.6)min more daily PA than participants who did not visit a park. Even when park-related activity was excluded, park visitors still obtained more minutes of daily PA than non-visitors. Park visitation contributes to a more active lifestyle, but is not solely responsible for it. Parks may best serve to complement broader public health efforts to encourage PA.
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Drewnowski A, Aggarwal A, Cook A, Stewart O, Moudon AV. Geographic disparities in Healthy Eating Index scores (HEI-2005 and 2010) by residential property values: Findings from Seattle Obesity Study (SOS). Prev Med 2016; 83:46-55. [PMID: 26657348 PMCID: PMC4724229 DOI: 10.1016/j.ypmed.2015.11.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/16/2015] [Accepted: 11/21/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Higher socioeconomic status (SES) has been linked with higher-quality diets. New GIS methods allow for geographic mapping of diet quality at a very granular level. OBJECTIVE To examine the geographic distribution of two measures of diet quality: Healthy Eating Index (HEI 2005 and HEI 2010) in relation to residential property values in Seattle-King County. METHODS The Seattle Obesity Study (SOS) collected data from a population-based sample of King County adults in 2008-09. Socio-demographic data were obtained by 20-min telephone survey. Dietary data were obtained from food frequency questionnaires (FFQs). Home addresses were geocoded to the tax parcel and residential property values were obtained from the King County tax assessor. Multivariable regression analyses using 1116 adults tested associations between SES variables and diet quality measured (HEI scores). RESULTS Residential property values, education, and incomes were associated with higher HEI scores in bivariate analyses. Property values were not collinear with either education or income. In adjusted multivariable models, education and residential property were better associated with HEI, compared to than income. Mapping of HEI-2005 and HEI-2010 at the census block level illustrated the geographic distribution of diet quality across Seattle-King County. CONCLUSION The use of residential property values, an objective measure of SES, allowed for the first visual exploration of diet quality at high spatial resolution: the census block level.
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Jiao J, Moudon AV, Kim SY, Hurvitz PM, Drewnowski A. Health Implications of Adults' Eating at and Living near Fast Food or Quick Service Restaurants. Nutr Diabetes 2015; 5:e171. [PMID: 26192449 PMCID: PMC4521173 DOI: 10.1038/nutd.2015.18] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/25/2015] [Accepted: 05/03/2015] [Indexed: 11/30/2022] Open
Abstract
Background: This paper examined whether the reported health impacts of frequent eating at a fast food or quick service restaurant on health were related to having such a restaurant near home. Methods: Logistic regressions estimated associations between frequent fast food or quick service restaurant use and health status, being overweight or obese, having a cardiovascular disease or diabetes, as binary health outcomes. In all, 2001 participants in the 2008–2009 Seattle Obesity Study survey were included in the analyses. Results: Results showed eating ⩾2 times a week at a fast food or quick service restaurant was associated with perceived poor health status, overweight and obese. However, living close to such restaurants was not related to negative health outcomes. Conclusions: Frequent eating at a fast food or quick service restaurant was associated with perceived poor health status and higher body mass index, but living close to such facilities was not.
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Abstract
PURPOSE State Safe Routes to School (SRTS) programs provide competitive grants to local projects that support safe walking, bicycling, and other modes of active school travel (AST). This study assessed changes in rates of AST after implementation of SRTS projects at multiple sites across four states. DESIGN One-group pretest and posttest. SETTING Florida, Mississippi, Washington, and Wisconsin. SUBJECTS Convenience sample of 48 completed SRTS projects and 53 schools affected by a completed SRTS project. INTERVENTION State-funded SRTS project. MEASURES AST was measured as the percentage of students walking, bicycling, or using any AST mode. SRTS project characteristics were measured at the project, school, and school neighborhood levels. ANALYSIS Paired-samples t-tests were used to assess changes in AST. Bivariate analysis was used to identify SRTS project characteristics associated with increases in AST. Data were analyzed separately at the project (n = 48) and school (n = 53) levels. RESULTS Statistically significant increases in AST were observed across projects in all four states. All AST modes increased from 12.9% to 17.6%; walking from 9.8% to 14.2%; and bicycling from 2.5% to 3.0%. Increases in rates of bicycling were negatively correlated with baseline rates of bicycling. CONCLUSION State-funded SRTS projects are achieving one of the primary program goals of increasing rates of AST. They may be particularly effective at introducing bicycling to communities where it is rare. The evaluation framework introduced in this study can be used to continue tracking the effect of state SRTS programs as more projects are completed.
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Drewnowski A, Aggarwal A, Tang W, Moudon AV. Residential property values predict prevalent obesity but do not predict 1-year weight change. Obesity (Silver Spring) 2015; 23:671-6. [PMID: 25684713 PMCID: PMC4340814 DOI: 10.1002/oby.20989] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/04/2014] [Accepted: 11/08/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Lower socio economic status (SES) has been linked with higher obesity rates but not with weight gain. This study examined whether SES can predict short-term weight change. METHODS The Seattle Obesity Study II was based on an observational cohort of 440 adults. Weights and heights were measured at baseline and at 1 year. Self-reported education and incomes were obtained by questionnaire. Home addresses were linked to tax parcel property values from the King County, Washington, tax assessor. Associations among SES variables, prevalent obesity, and 1-year weight change were examined using multivariable linear regressions. RESULTS Low residential property values at the tax parcel level predicted prevalent obesity at baseline and at 1 year. Living in the top quartile of house prices reduced obesity risk by 80% at both time points. At 1 year, about 38% of the sample lost >1 kg body weight; 32% maintained (± 1 kg); and 30% gained >1 kg. In adjusted models, none of the baseline SES measures had any impact on 1-year weight change. CONCLUSIONS SES variables, including tax parcel property values, predicted prevalent obesity but did not predict short-term weight change. These findings, based on longitudinal cohort data, suggest other mechanisms are involved in short-term weight change.
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Barrington WE, Beresford SAA, Koepsell TD, Duncan GE, Moudon AV. Worksite neighborhood and obesogenic behaviors: findings among employees in the Promoting Activity and Changes in Eating (PACE) trial. Am J Prev Med 2015; 48:31-41. [PMID: 25442234 PMCID: PMC4418796 DOI: 10.1016/j.amepre.2014.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 07/22/2014] [Accepted: 08/19/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Understanding mechanisms linking neighborhood context to health behaviors may provide targets for increasing lifestyle intervention effectiveness. Although associations between home neighborhood and obesogenic behaviors have been studied, less is known about the role of worksite neighborhood. PURPOSE To evaluate associations between worksite neighborhood context at baseline (2006) and change in obesogenic behaviors of adult employees at follow-up (2007-2009) in a worksite randomized trial to prevent weight gain. METHODS Worksite property values were used as an indicator of worksite neighborhood SES (NSES). Worksite neighborhood built environment attributes associated with walkability were evaluated as explanatory factors in relationships among worksite NSES, diet, and physical activity behaviors of employees. Behavioral data were collected at baseline (2005-2007) and follow-up (2007-2009). Multilevel linear and logistic models were constructed adjusting for covariates and accounting for clustering within worksites. Product-of-coefficients methods were used to assess mediation. Analyses were performed after study completion (2011-2012). RESULTS Higher worksite NSES was associated with more walking (OR=1.16, 95% CI=1.03, 1.30, p=0.01). Higher density of residential units surrounding worksites was associated with more walking and eating five or more daily servings of fruits and vegetables, independent of worksite NSES. Residential density partially explained relationships among worksite NSES, fruit and vegetable consumption, and walking. CONCLUSIONS Worksite neighborhood context may influence employees' obesogenic behaviors. Furthermore, residential density around worksites could be an indicator of access to dietary and physical activity-related infrastructure in urban areas. This may be important given the popularity of worksites as venues for obesity prevention efforts.
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Doescher MP, Lee C, Berke EM, Adachi-Mejia AM, Lee CK, Stewart O, Patterson DG, Hurvitz PM, Carlos HA, Duncan GE, Moudon AV. The built environment and utilitarian walking in small U.S. towns. Prev Med 2014; 69:80-6. [PMID: 25199732 PMCID: PMC4312190 DOI: 10.1016/j.ypmed.2014.08.027] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/19/2014] [Accepted: 08/24/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The role of the built environment on walking in rural United States (U.S.) locations is not well characterized. We examined self-reported and measured built environment correlates of walking for utilitarian purposes among adult residents of small rural towns. METHODS In 2011-12, we collected telephone survey and geographic data from 2152 adults in 9 small towns from three U.S. regions. We performed mixed-effects logistic regression modeling to examine relationships between built environment measures and utilitarian walking ("any" versus "none"; "high" [≥150min per week] versus "low" [<150min per week]) to retail, employment and public transit destinations. RESULTS Walking levels were lower than those reported for populations living in larger metropolitan areas. Environmental factors significantly (p<0.05) associated with higher odds of utilitarian walking in both models included self-reported presence of crosswalks and pedestrian signals and availability of park/natural recreational areas in the neighborhood, and also objectively measured manufacturing land use. CONCLUSIONS Environmental factors associated with utilitarian walking in cities and suburbs were important in small rural towns. Moreover, manufacturing land use was associated with utilitarian walking. Modifying the built environment of small towns could lead to increased walking in a sizeable segment of the U.S. population.
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Huang R, Moudon AV, Cook AJ, Drewnowski A. The spatial clustering of obesity: does the built environment matter? J Hum Nutr Diet 2014; 28:604-12. [PMID: 25280252 DOI: 10.1111/jhn.12279] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Obesity rates in the USA show distinct geographical patterns. The present study used spatial cluster detection methods and individual-level data to locate obesity clusters and to analyse them in relation to the neighbourhood built environment. METHODS The 2008-2009 Seattle Obesity Study provided data on the self-reported height, weight, and sociodemographic characteristics of 1602 King County adults. Home addresses were geocoded. Clusters of high or low body mass index were identified using Anselin's Local Moran's I and a spatial scan statistic with regression models that searched for unmeasured neighbourhood-level factors from residuals, adjusting for measured individual-level covariates. Spatially continuous values of objectively measured features of the local neighbourhood built environment (SmartMaps) were constructed for seven variables obtained from tax rolls and commercial databases. RESULTS Both the Local Moran's I and a spatial scan statistic identified similar spatial concentrations of obesity. High and low obesity clusters were attenuated after adjusting for age, gender, race, education and income, and they disappeared once neighbourhood residential property values and residential density were included in the model. CONCLUSIONS Using individual-level data to detect obesity clusters with two cluster detection methods, the present study showed that the spatial concentration of obesity was wholly explained by neighbourhood composition and socioeconomic characteristics. These characteristics may serve to more precisely locate obesity prevention and intervention programmes.
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Saelens BE, Vernez Moudon A, Kang B, Hurvitz PM, Zhou C. Relation between higher physical activity and public transit use. Am J Public Health 2014; 104:854-9. [PMID: 24625142 DOI: 10.2105/ajph.2013.301696] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We isolated physical activity attributable to transit use to examine issues of substitution between types of physical activity and potential confounding of transit-related walking with other walking. METHODS Physical activity and transit use data were collected in 2008 to 2009 from 693 Travel Assessment and Community study participants from King County, Washington, equipped with an accelerometer, a portable Global Positioning System, and a 7-day travel log. Physical activity was classified into transit- and non-transit-related walking and nonwalking time. Analyses compared physical activity by type between transit users and nonusers, between less and more frequent transit users, and between transit and nontransit days for transit users. RESULTS Transit users had more daily overall physical activity and more total walking than did nontransit users but did not differ on either non-transit-related walking or nonwalking physical activity. Most frequent transit users had more walking time than least frequent transit users. Higher physical activity levels for transit users were observed only on transit days, with 14.6 minutes (12.4 minutes when adjusted for demographics) of daily physical activity directly linked with transit use. CONCLUSIONS Because transit use was directly related to higher physical activity, future research should examine whether substantive increases in transit access and use lead to more physical activity and related health improvements.
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Aggarwal A, Cook AJ, Jiao J, Seguin RA, Vernez Moudon A, Hurvitz PM, Drewnowski A. Access to supermarkets and fruit and vegetable consumption. Am J Public Health 2014; 104:917-23. [PMID: 24625173 DOI: 10.2105/ajph.2013.301763] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether supermarket choice, conceptualized as a proxy for underlying personal factors, would better predict access to supermarkets and fruit and vegetable consumption than mere physical proximity. METHODS The Seattle Obesity Study geocoded respondents' home addresses and locations of their primary supermarkets. Primary supermarkets were stratified into low, medium, and high cost according to the market basket cost of 100 foods. Data on fruit and vegetable consumption were obtained during telephone surveys. Linear regressions examined associations between physical proximity to primary supermarkets, supermarket choice, and fruit and vegetable consumption. Descriptive analyses examined whether supermarket choice outweighed physical proximity among lower-income and vulnerable groups. RESULTS Only one third of the respondents shopped at their nearest supermarket for their primary food supply. Those who shopped at low-cost supermarkets were more likely to travel beyond their nearest supermarket. Fruit and vegetable consumption was not associated with physical distance but, with supermarket choice, after adjusting for covariates. CONCLUSIONS Mere physical distance may not be the most salient variable to reflect access to supermarkets, particularly among those who shop by car. Studies on food environments need to focus beyond neighborhood geographic boundaries to capture actual food shopping behaviors.
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Drewnowski A, Moudon AV, Jiao J, Aggarwal A, Charreire H, Chaix B. Food environment and socioeconomic status influence obesity rates in Seattle and in Paris. Int J Obes (Lond) 2014; 38:306-14. [PMID: 23736365 PMCID: PMC3955164 DOI: 10.1038/ijo.2013.97] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 03/09/2013] [Accepted: 04/04/2013] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To compare the associations between food environment at the individual level, socioeconomic status (SES) and obesity rates in two cities: Seattle and Paris. METHODS Analyses of the SOS (Seattle Obesity Study) were based on a representative sample of 1340 adults in metropolitan Seattle and King County. The RECORD (Residential Environment and Coronary Heart Disease) cohort analyses were based on 7131 adults in central Paris and suburbs. Data on sociodemographics, health and weight were obtained from a telephone survey (SOS) and from in-person interviews (RECORD). Both studies collected data on and geocoded home addresses and food shopping locations. Both studies calculated GIS (Geographic Information System) network distances between home and the supermarket that study respondents listed as their primary food source. Supermarkets were further stratified into three categories by price. Modified Poisson regression models were used to test the associations among food environment variables, SES and obesity. RESULTS Physical distance to supermarkets was unrelated to obesity risk. By contrast, lower education and incomes, lower surrounding property values and shopping at lower-cost stores were consistently associated with higher obesity risk. CONCLUSION Lower SES was linked to higher obesity risk in both Paris and Seattle, despite differences in urban form, the food environments and in the respective systems of health care. Cross-country comparisons can provide new insights into the social determinants of weight and health.
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Hurvitz PM, Moudon AV, Kang B, Saelens BE, Duncan GE. Emerging technologies for assessing physical activity behaviors in space and time. Front Public Health 2014; 2:2. [PMID: 24479113 PMCID: PMC3904281 DOI: 10.3389/fpubh.2014.00002] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 01/10/2014] [Indexed: 11/13/2022] Open
Abstract
Precise measurement of physical activity is important for health research, providing a better understanding of activity location, type, duration, and intensity. This article describes a novel suite of tools to measure and analyze physical activity behaviors in spatial epidemiology research. We use individual-level, high-resolution, objective data collected in a space-time framework to investigate built and social environment influences on activity. First, we collect data with accelerometers, global positioning system units, and smartphone-based digital travel and photo diaries to overcome many limitations inherent in self-reported data. Behaviors are measured continuously over the full spectrum of environmental exposures in daily life, instead of focusing exclusively on the home neighborhood. Second, data streams are integrated using common timestamps into a single data structure, the "LifeLog." A graphic interface tool, "LifeLog View," enables simultaneous visualization of all LifeLog data streams. Finally, we use geographic information system SmartMap rasters to measure spatially continuous environmental variables to capture exposures at the same spatial and temporal scale as in the LifeLog. These technologies enable precise measurement of behaviors in their spatial and temporal settings but also generate very large datasets; we discuss current limitations and promising methods for processing and analyzing such large datasets. Finally, we provide applications of these methods in spatially oriented research, including a natural experiment to evaluate the effects of new transportation infrastructure on activity levels, and a study of neighborhood environmental effects on activity using twins as quasi-causal controls to overcome self-selection and reverse causation problems. In summary, the integrative characteristics of large datasets contained in LifeLogs and SmartMaps hold great promise for advancing spatial epidemiologic research to promote healthy behaviors.
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Perry CK, Herting JR, Berke EM, Nguyen HQ, Vernez Moudon A, Beresford SAA, Ockene JK, Manson JE, Lacroix AZ. Does neighborhood walkability moderate the effects of intrapersonal characteristics on amount of walking in post-menopausal women? Health Place 2013; 21:39-45. [PMID: 23416232 DOI: 10.1016/j.healthplace.2012.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 12/15/2012] [Accepted: 12/21/2012] [Indexed: 10/27/2022]
Abstract
This study identifies factors associated with walking among postmenopausal women and tests whether neighborhood walkability moderates the influence of intrapersonal factors on walking. We used data from the Women's Health Initiative Seattle Center and linear regression models to estimate associations and interactions. Being white and healthy, having a high school education or beyond and greater non-walking exercise were significantly associated with more walking. Neighborhood walkability was not independently associated with greater walking, nor did it moderate influence of intrapersonal factors on walking. Specifying types of walking (e.g., for transportation) can elucidate the relationships among intrapersonal factors, the built environment, and walking.
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Drewnowski A, Aggarwal A, Hurvitz PM, Monsivais P, Rehm CD, Moudon AV. Drewnowski et al. respond. Am J Public Health 2012; 103:e2-3. [PMID: 23153157 DOI: 10.2105/ajph.2012.301098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Aggarwal A, Moudon AV, Cook A, Drewnowski A. Spatial Analyses of Healthy Eating Index Reveal a Relation between Diet Quality and Place. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.lb382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hurvitz PM, Moudon AV. Home versus nonhome neighborhood: quantifying differences in exposure to the built environment. Am J Prev Med 2012; 42:411-7. [PMID: 22424255 PMCID: PMC3318915 DOI: 10.1016/j.amepre.2011.11.015] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 10/19/2011] [Accepted: 11/30/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Built environment and health research have focused on characteristics of home neighborhoods, whereas overall environmental exposures occur over larger spatial ranges. PURPOSE Differences in built environment characteristics were analyzed for home and nonhome locations using GPS data. METHODS GPS data collected in 2007-2008 were analyzed for 41 subjects in the Seattle area in 2010. Environmental characteristics for 3.8 million locations were measured using novel GIS data sets called SmartMaps, representing spatially continuous values of local built environment variables in the domains of neighborhood composition, utilitarian destinations, transportation infrastructure, and traffic conditions. Using bootstrap sampling, CIs were estimated for differences in built environment values for home (<833 m of home address) and nonhome (>1666 m) GPS locations. RESULTS Home and nonhome built environment values were significantly different for more than 90% of variables across subjects (p<0.001). Only 51% of subjects had higher counts of supermarkets near than away from home. Different measures of neighborhood parks yielded varying results. CONCLUSIONS SmartMaps helped measure local built environment characteristics for a large set of GPS locations. Most subjects had significantly different home and nonhome built environment exposures. Considering the full range of individuals' environmental exposures may improve understanding of effects of the built environment on behavior and health outcomes.
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