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A mixed methods analysis of environmental and household chaos: considerations for early-childhood obesity research. BMC Public Health 2021; 21:1867. [PMID: 34654393 PMCID: PMC8520198 DOI: 10.1186/s12889-021-11936-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Chaos has implications for child health that may extend to childhood obesity. Yet, results from studies describing associations between chaos and childhood obesity are mixed. New approaches to studying the environments of young children may help to clarify chaos-obesity relationships. METHODS We conducted a concurrent mixed methods analysis of quantitative and qualitative data describing home and neighborhood chaos among a diverse cohort of 283 caregiver-toddlers dyads from Ohio. We examined the underlying structure of environmental and household chaos using exploratory factor analysis then sought to validate the structure using qualitative field notes. We generated total scores for factors of chaos and described their distributions overall and according to cohort characteristics. Additionally, we conducted a thematic content analysis of brief ethnographies to provide preliminary construct validity for our indicators of chaos. RESULTS Dyads varied according to household composition, income, education, and race/ethnicity. We found evidence for a multi-factor structure for chaos, which included disorganization and neighborhood noise. Household disorganization scores ranged from 0 to 7.3 and were on average 2.1 (SD = 1.8). Neighborhood noise scores ranged from 0 to 4 and were on average 1.1 (SD = 1.1). Both disorganization and neighborhood noise were associated with indicators of socioeconomic disadvantage, such as lower educational attainment and household income. Qualitative data from households with high and low scores on the two identified factors were aligned in ways that were supportive of construct validity and further contextualized the social and material environments in which chaos occurred. CONCLUSIONS Chaos represents a complex construct with implications spanning various disciplines, including childhood obesity research. Previous studies suggest challenges associated with measuring chaos may limit the conclusions that can be drawn about which aspect of chaos (if any) matter most of early childhood weight development. We advance the literature by demonstrating chaos may be comprised of conceptually distinct subdomains. Future childhood obesity prevention research may benefit from more contemporary measure of chaos, such as those relying on direct observations that account for a multifaceted underlying structure.
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Christman ZJ, Wilson-Genderson M, Heid A, Pruchno R. The Effects of Neighborhood Built Environment on Walking for Leisure and for Purpose Among Older People. THE GERONTOLOGIST 2020; 60:651-660. [PMID: 31513712 DOI: 10.1093/geront/gnz093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Characteristics of a neighborhood's built environment affect the walking behavior of older people, yet studies typically rely on small nonrepresentative samples that use either subjective reports or aggregate indicators from administrative sources to represent neighborhood characteristics. Our analyses examine the usefulness of a novel method for observing neighborhoods-virtual observations-and assess the extent to which virtual-based observations predict walking among older adults. RESEARCH DESIGN AND METHODS Using Google Street View, we observed the neighborhoods of 2,224 older people and examined how characteristics of the neighborhood built environments are associated with the amount of time older people spend walking for leisure and purpose. RESULTS Multilevel model analyses revealed that sidewalk characteristics had significant associations with both walking for purpose and leisure. Land use, including the presence of multifamily dwellings, commercial businesses, and parking lots were positively associated with walking for purpose and single-family detached homes were negatively associated with walking for purpose, but none of these characteristics were associated with leisure walking. Gardens/flowers were associated with walking for leisure but not purpose. Garbage/litter was not associated with either type of walking behavior. DISCUSSION AND IMPLICATIONS Virtual observations are a useful method that provides meaningful information about neighborhoods. Findings demonstrate how neighborhood characteristics assessed virtually differentially impact walking for leisure and purpose among older adults and are interpreted within a social-ecological model.
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Affiliation(s)
- Zachary J Christman
- Department of Geography, Planning, and Sustainability, Rowan University, Glassboro, New Jersey
| | | | - Allison Heid
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
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Sullivan SM, Peters ES, Trapido EJ, Oral E, Scribner RA, Rung AL. Neighborhood Environment Measurements and Anthropometric Indicators of Obesity: Results from the Women and Their Children's Health (WaTCH) Study. ENVIRONMENT AND BEHAVIOR 2018; 50:1032-1055. [PMID: 31571678 PMCID: PMC6768073 DOI: 10.1177/0013916517726827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We compared geographic information system (GIS)- and Census-based approaches for measuring the physical and social neighborhood environment at the census tract-level versus and audit approach on associations with body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR). Data were used from the 2012-2014 Women and Their Children's Health (WaTCH) Study (n=940). Generalized linear models were used to obtain odds ratios (ORs) for BMI (≥30 kg/m2), WC (>88 cm), and WHR (>0.85). Using an audit approach, more adverse neighborhood characteristics were associated with a higher odds of WC (OR: 1.10; 95% CI: 1.05, 1.15) and WHR (OR: 1.09; 95% CI: 1.05, 1.14) after adjustment for age, race/ethnicity, income, and oil spill exposure. There were no significant associations between GIS- and Census- based measures with obesity in adjusted models. Quality aspects of the neighborhood environment captured by audits at the individual-level may be more relevant to obesity than physical or social aspects at the census-tract level.
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Affiliation(s)
- Samaah M. Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Edward S. Peters
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Edward J. Trapido
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Evrim Oral
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Richard A. Scribner
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Ariane L. Rung
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Gaston SA, Volaufova J, Peters ES, Ferguson TF, Robinson WT, Nugent N, Trapido EJ, Rung AL. Individual-level exposure to disaster, neighborhood environmental characteristics, and their independent and combined associations with depressive symptoms in women. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1183-1194. [PMID: 28656451 PMCID: PMC5709223 DOI: 10.1007/s00127-017-1412-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 06/18/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE The severity of the stress response to experiencing disaster depends on individual exposure and background stress prior to the event. To date, there is limited research on the interaction between neighborhood environmental stress and experiencing an oil spill, and their effects on depression. The objective of the current study was to assess if the association between exposure to the Deepwater Horizon Oil Spill (DHOS) and depressive symptoms varied by neighborhood characteristics. METHODS US Census data (2010) and longitudinal data collected in two waves (2012-2014 and 2014-2016) from female residents [N = 889 (Wave I), 737 (Wave II)] of an area highly affected by the DHOS were analyzed. Multilevel and individual-level negative binomial regressions were performed to estimate associations with depressive symptoms in both waves. An interaction term was included to estimate effect modification of the association between DHOS exposure and depressive symptoms by neighborhood characteristics. Generalized estimating equations were applied to the negative binomial regression testing longitudinal associations. RESULTS Census tract-level neighborhood characteristics were not associated with depressive symptoms. Exposure to the DHOS and neighborhood physical disorder were associated with depressive symptoms cross-sectionally. There was no evidence of effect modification; however, physical/environmental exposure to the DHOS was associated with increased depressive symptoms only among women living in areas with physical disorder. Exposure to the DHOS remained associated with depressive symptoms over time. CONCLUSIONS Findings support the enduring consequences of disaster exposure on depressive symptoms in women and identify potential targets for post-disaster intervention based on residential characteristics.
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Affiliation(s)
- Symielle A Gaston
- , 109 T.W. Alexander Drive, MD E205-09, Research Triangle Park, NC, 27711, USA.
- Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA.
| | - Julia Volaufova
- Biostatistics Program, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - Edward S Peters
- Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - Tekeda F Ferguson
- Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - William T Robinson
- Behavioral Health and Community Sciences Program, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - Nicole Nugent
- Departments of Pediatrics and Psychiatry and Human Behavior, Brown University Warren Alpert School of Medicine, Rhode Island Hospital, Coro West Building, 1 Hoppin Street, Suite 204, Providence, RI, 02903, USA
| | - Edward J Trapido
- Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - Ariane L Rung
- Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
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Peters ES, Rung AL, Bronson MH, Brashear MM, Peres LC, Gaston S, Sullivan SM, Peak K, Abramson DM, Fontham ETH, Harrington D, Oral E, Trapido EJ. The Women and Their Children's Health (WaTCH) study: methods and design of a prospective cohort study in Louisiana to examine the health effects from the BP oil spill. BMJ Open 2017; 7:e014887. [PMID: 28698324 PMCID: PMC5734424 DOI: 10.1136/bmjopen-2016-014887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The Deepwater Horizon Oil Spill is the largest marine oil spill in US history. Few studies have evaluated the potential health effects of this spill on the Gulf Coast community. The Women and Their Children's Health (WaTCH) study is a prospective cohort designed to investigate the midterm to long-term physical, mental and behavioural health effects of exposure to the oil spill. PARTICIPANTS Women were recruited by telephone from pre-existing lists of individuals and households using an address-based sampling frame between 2012 and 2014. Baseline interviews obtained information on oil spill exposure, demographics, physical and mental health, and health behaviours. Women were also asked to provide a household roster, from which a child between 10 and 17 years was randomly selected and recruited into a child substudy. Telephone respondents were invited to participate in a home visit in which blood samples, anthropometrics and neighbourhood characteristics were measured. A follow-up interview was completed between 2014 and 2016. FINDINGS TO DATE 2852 women completed the baseline interview, 1231 of whom participated in the home visit, and 628 children participated in the child's health substudy. The follow-up interview successfully reinterviewed 2030 women and 454 children. FUTURE PLANS WaTCH continues to conduct follow-up surveys, with a third wave of interviews planned in 2017. Also, we are looking to enhance the collection of spatially related environmental data to facilitate assessment of health risks in the study population. In addition, opportunities to participate in behavioural interventions for subsets of the cohort have been initiated. There are ongoing studies that examine the relationship between genetic and immunological markers with mental health.
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Affiliation(s)
- Edward S Peters
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - Ariane L Rung
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - Megan H Bronson
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - Meghan M Brashear
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - Lauren C Peres
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Symielle Gaston
- Office of Research and Development/National Exposure Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Samaah M Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kate Peak
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - David M Abramson
- Program on Population Impact, Recovery, and Resiliency, New York University College of Global Public Health, New York, NY, USA
| | - Elizabeth T H Fontham
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - Daniel Harrington
- Department of Environmental and Occupational Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - Evrim Oral
- Department of Biostatistics, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - Edward J Trapido
- Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
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Tabet M, Sanders EA, Schootman M, Chang JJ, Wolinsky FD, Malmstrom TK, Miller DK. Neighborhood Conditions and Psychosocial Outcomes Among Middle-Aged African Americans. J Prim Care Community Health 2016; 8:63-70. [PMID: 27799414 PMCID: PMC5932661 DOI: 10.1177/2150131916675350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We examined associations between observed neighborhood conditions (good/adverse) and psychosocial outcomes (stress, depressive symptoms, resilience, and sense of control) among middle-aged and older African Americans. METHODS The sample included 455 middle-aged and older African Americans examined in Wave 10 of the African American Health (AAH) study. Linear regression was adjusted for attrition, self-selection into neighborhoods, and potential confounders, and stratified by the duration at current address (<5 vs ≥5 years) because of its hypothesized role as an effect modifier. RESULTS Among individuals who lived at their current address for ≥5 years, residing in neighborhoods with adverse versus good conditions was associated with significantly less stress (standardized β = -0.18; P = .002) and depressive symptoms (standardized β = -0.12; P = .048). Among those who lived at their current address for <5 years, residing in neighborhoods with adverse versus good conditions was not significantly associated with stress (standardized β = 0.18; P = .305) or depressive symptoms (standardized β = 0.36; P = .080). CONCLUSION Neighborhood conditions appear to have significant, complex associations with psychosocial factors among middle-aged and older African Americans. This holds important policy implications, especially since adverse neighborhood conditions may still result in adverse physical health outcomes in individuals with >5 years at current residence despite being associated with better psychosocial outcomes.
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Affiliation(s)
- Maya Tabet
- 1 Saint Louis University, Saint Louis, MO, USA
| | | | | | | | | | | | - Douglas K Miller
- 3 Regenstrief Institute Inc, Indianapolis, IN, USA.,4 Indiana University School of Medicine, Indianapolis, IN, USA.,5 Indiana University Center for Aging Research, Indianapolis, IN, USA
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Sullivan SM, Peters ES, Trapido EJ, Oral E, Scribner RA, Rung AL. Assessing mediation of behavioral and stress pathways in the association between neighborhood environments and obesity outcomes. Prev Med Rep 2016; 4:248-55. [PMID: 27635379 PMCID: PMC5021920 DOI: 10.1016/j.pmedr.2016.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/12/2016] [Indexed: 01/24/2023] Open
Abstract
Although many studies have reported associations between characteristics of the neighborhood environment and obesity, little is understood about the pathways or mechanisms through which these associations operate. The purpose of this study was to examine possible behavioral and stress pathways hypothesized to mediate the association between neighborhood environments and obesity and whether pathways contribute to different obesity outcomes. Cross-sectional data were used from the 2012–2014 Women and Their Children's Health Study (WaTCH) in Louisiana (N = 909). Participants' neighborhoods, body mass index (BMI) and waist circumference (WC) were objectively measured. The causal inference approach to mediation analysis was used to obtain indirect estimates for self-reported measures of physical activity, low access to food, and depression. The mean BMI was 32.0 kg/m2 and the mean WC was 98.6 cm. The (adverse) neighborhood environment was significantly associated BMI (β = 0.17 kg/m2; 95% Confidence Interval (CI): 0.03, 0.31) and WC (β = 0.64; 95% CI: 0.34, 0.95, after adjusting for covariates. Neither depression, physical activity, nor low food access mediated those associations. Further research that investigates and uses better measures of the behavioral and stress pathways through which the neighborhood environment influences obesity is warranted. Used mediation to examine mechanisms between neighborhoods and obesity. The neighborhood environment was significantly associated with BMI and WC. Neither depression, physical activity, nor food access were significant mediators. Better measures of mediators are warranted in future research.
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Affiliation(s)
- Samaah M. Sullivan
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- College of Humanities & Social Sciences, Louisiana State University, Baton Rouge, LA, USA
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Correspondence to: S. M. Sullivan, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA.Pennington Biomedical Research Center6400 Perkins RoadBaton RougeLA70808USA
| | - Edward S. Peters
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Edward J. Trapido
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Evrim Oral
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Richard A. Scribner
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Ariane L. Rung
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Corresponding author at: Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, 2020 Gravier Street, 3rd Floor, New Orleans, LA 70112, USA.Epidemiology ProgramSchool of Public HealthLouisiana State University Health Sciences Center2020 Gravier Street3rd FloorNew OrleansLA70112USA
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