Moudon, Anne Vernez; Huang, Ruizhu; Stewart, Orion T.; Cohen-Cline, Hannah; Noonan, Carolyn; Hurvitz, Philip M.; Duncan, Glen E. (2019). Probabilistic Walking Models Using Built Environment and Sociodemographic Predictors. Population Health Metrics, 17(1).
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Abstract
BackgroundIndividual sociodemographic and home neighborhood built environment (BE) factors influence the probability of engaging in health-enhancing levels of walking or moderate-to-vigorous physical activity (MVPA). Methods are needed to parsimoniously model the associations.MethodsParticipants included 2392 adults drawn from a community-based twin registry living in the Seattle region. Objective BE measures from four domains (regional context, neighborhood composition, destinations, transportation) were taken for neighborhood sizes of 833 and 1666 road network meters from home. Hosmer and Lemeshow's methods served to fit logistic regression models of walking and MVPA outcomes using sociodemographic and BE predictors. Backward elimination identified variables included in final models, and comparison of receiver operating characteristic (ROC) curves determined model fit improvements.ResultsBuilt environment variables associated with physical activity were reduced from 86 to 5 or fewer. Sociodemographic and BE variables from all four BE domains were associated with activity outcomes but differed by activity type and neighborhood size. For the study population, ROC comparisons indicated that adding BE variables to a base model of sociodemographic factors did not improve the ability to predict walking or MVPA.ConclusionsUsing sociodemographic and built environment factors, the proposed approach can guide the estimation of activity prediction models for different activity types, neighborhood sizes, and discrete BE characteristics. Variables associated with walking and MVPA are population and neighborhood BE-specific.
Keywords
Walking; Confidence Intervals; Research Funding; Transportation; Logistic Regression Analysis; Built Environment; Socioeconomic Factors; Predictive Validity; Receiver Operating Characteristic Curves; Data Analysis Software; Descriptive Statistics; Psychology; Washington (state); Active Travel; Home Neighborhood Domains; Physical Activity; Physical-activity; United-states; Life Stage; Adults; Attributes; Health; Associations; Destination; Pitfalls
Moudon, Anne Vernez; Drewnowski, Adam; Duncan, Glen E.; Hurvitz, Philip M.; Saelens, Brian E.; Scharnhorst, Eric. (2013). Characterizing the Food Environment: Pitfalls and Future Directions. Public Health Nutrition, 16(7), 1238 – 1243.
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Abstract
Objective: To assess a county population's exposure to different types of food sources reported to affect both diet quality and obesity rates. Design: Food permit records obtained from the local health department served to establish the full census of food stores and restaurants. Employing prior categorization schemes which classified the relative healthfulness of food sources based on establishment type (i.e. supermarkets v. convenience stores, or full-service v. fast-food restaurants), food establishments were assigned to the healthy, unhealthy or undetermined groups. Setting: King County, WA, USA. Subjects: Full census of food sources. Results: According to all categorization schemes, most food establishments in King County fell into the unhealthy and undetermined groups. Use of the food permit data showed that large stores, which included supermarkets as healthy food establishments, contained a sizeable number of bakery/delis, fish/meat, ethnic and standard quick-service restaurants and coffee shops, all food sources that, when housed in a separate venue or owned by a different business establishment, were classified as either unhealthy or of undetermined value to health. Conclusions: To fully assess the potential health effects of exposure to the extant food environment, future research would need to establish the health value of foods in many such common establishments as individually owned grocery stores and ethnic food stores and restaurants. Within-venue exposure to foods should also be investigated.
Keywords
Food Chemistry; Obesity; Health Boards; Dietary Supplements; Food Cooperatives; Restaurant Reviews; Coffee Shops; Food Consumption; Food Quality; Census Of Food Sources; Exposure; Health Value; Neighborhood Characteristics; Store Availability; Racial Composition; Physical-activity; Weight Status; Restaurants; Association; Proximity; Access; Business Enterprises; Fast Food Restaurants; Fish; Grocery Stores; Healthy Diet; Meat; Nutritional Adequacy; Supermarkets
Huang, R.; Moudon, A. V.; Cook, A. J.; Drewnowski, A. (2015). The Spatial Clustering of Obesity: Does the Built Environment Matter? Journal Of Human Nutrition & Dietetics, 28(6), 604 – 612.
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Abstract
BackgroundObesity 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. MethodsThe 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. ResultsBoth 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. ConclusionsUsing 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.
Keywords
Real Property; Ecology; Age Distribution; Anthropometry; Black People; Cluster Analysis (statistics); Communities; Computer Software; Epidemiological Research; Geographic Information Systems; Hispanic Americans; Mathematics; Obesity; Population Geography; Probability Theory; Race; Regression Analysis; Research Funding; Restaurants; Statistical Sampling; Self-evaluation; Sex Distribution; Shopping; Surveys; Telephones; Transportation; White People; Socioeconomic Factors; Body Mass Index; Data Analysis Software; Medical Coding; Statistical Models; Descriptive Statistics; Odds Ratio; Economics; Washington (state); Built Environment; Local Moran's I; Spatial Scan Statistic; Body-mass Index; Physical-activity; United-states; Risk-factors; Neighborhood; Association; Density; Disease; Disparities; Prevalence
Quistberg, D. Alex; Howard, Eric J.; Hurvitz, Philip M.; Moudon, Anne V.; Ebel, Beth E.; Rivara, Frederick P.; Saelens, Brian E. (2017). The Relationship between Objectively Measured Walking and Risk of Pedestrian–Motor Vehicle Collision. American Journal Of Epidemiology, 185(9), 810 – 821.
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Abstract
Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian-motor vehicle collision is unknown. We examined associations between individuals' walking bouts and walking risk, measured as mean exposure to the risk of pedestrian-vehicle collision. Walking bouts were ascertained through integrated accelerometry and global positioning system data and from individual travel-diary data obtained from adults in the Travel Assessment and Community Study (King County, Washington) in 2008-2009. Walking patterns were superimposed onto maps of the historical probabilities of pedestrian-vehicle collisions for intersections and midblock segments within Seattle, Washington. Mean risk of pedestrian-vehicle collision in specific walking locations was assessed according to walking exposure (duration, distance, and intensity) and participant demographic characteristics in linear mixed models. Participants typically walked in areas with low pedestrian collision risk when walking for recreation, walking at a faster pace, or taking longer-duration walks. Mean daily walking duration and distance were not associated with collision risk. Males walked in areas with higher collision risk compared with females, while vehicle owners, residents of single-family homes, and parents of young children walked in areas with lower collision risk. These findings may suggest that pedestrians moderate collision risk by using lower-risk routes.
Keywords
Traffic Accidents; Confidence Intervals; Geographic Information Systems; Health Promotion; Maps; Research Funding; Walking; Accelerometry; Physical Activity; Data Analysis Software; Diary (literary Form); Descriptive Statistics; Risk Factors; Washington (state); Accidents; Environment Design; Global Positioning Systems; Pedestrians; Risk Assessment; Traffic; Physical-activity; Built Environment; Traffic Safety; Accident Risk; Injury Rates; Route-choice; Exposure; Gps; Travel; Accidents, Traffic
Scully, Jason Y.; Moudon, Anne Vernez; Hurvitz, Philip M.; Aggarwal, Anju; Drewnowski, Adam. (2019). A Time-Based Objective Measure of Exposure to the Food Environment. International Journal Of Environmental Research And Public Health, 16(7).
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Abstract
Exposure to food environments has mainly been limited to counting food outlets near participants' homes. This study considers food environment exposures in time and space using global positioning systems (GPS) records and fast food restaurants (FFRs) as the environment of interest. Data came from 412 participants (median participant age of 45) in the Seattle Obesity Study II who completed a survey, wore GPS receivers, and filled out travel logs for seven days. FFR locations were obtained from Public Health Seattle King County and geocoded. Exposure was conceptualized as contact between stressors (FFRs) and receptors (participants' mobility records from GPS data) using four proximities: 21 m, 100 m, 500 m, and 1/2 mile. Measures included count of proximal FFRs, time duration in proximity to 1 FFR, and time duration in proximity to FFRs weighted by FFR counts. Self-reported exposures (FFR visits) were excluded from these measures. Logistic regressions tested associations between one or more reported FFR visits and the three exposure measures at the four proximities. Time spent in proximity to an FFR was associated with significantly higher odds of FFR visits at all proximities. Weighted duration also showed positive associations with FFR visits at 21-m and 100-m proximities. FFR counts were not associated with FFR visits. Duration of exposure helps measure the relationship between the food environment, mobility patterns, and health behaviors. The stronger associations between exposure and outcome found at closer proximities (<100 m) need further research.
Keywords
Global Positioning Systems; Physical-activity; Health Research; Land-use; Neighborhood; Gps; Obesity; Tracking; Validity; Mobility; Fast Food; Spatio-temporal Exposure; Mobility Patterns; Selective Mobility Bias
Perry, Cynthia K.; Herting, Jerald R.; Berke, Ethan M.; Nguyen, Huong Q.; Moudon, Anne Vernez; Beresford, Shirley A. A.; Ockene, Judith K.; Manson, Joann E.; Lacroix, Andrea Z. (2013). Does Neighborhood Walkability Moderate the Effects of Intrapersonal Characteristics on Amount of Walking in Post-Menopausal Women? Health & Place, 21, 39 – 45.
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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. (C) 2013 Elsevier Ltd. All rights reserved.
Keywords
Self-talk; Postmenopause; Walking; Women's Health; Built Environment; Social Interaction; Regression Analysis; Postmenopausal Women; Walkability; Physical-activity; Older-adults; United-states; Us Adults; Exercise; Obesity; Transportation; Association; Attributes
Jiao, J.; Moudon, A. V.; Kim, S. Y.; Hurvitz, P. M.; Drewnowski, A. (2015). Health Implications of Adults’ Eating at and Living Near Fast Food or Quick Service Restaurants. Nutrition & Diabetes, 5.
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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.
Keywords
Body-mass Index; Socioeconomic-status; Built Environment; Obesity; Association; Consumption; Weight; Proximity; Outlets; Establishments
Scully, Jason Y.; Moudon, Anne Vernez; Hurvitz, Philip M.; Aggarwal, Anju; Drewnowski, Adam. (2017). GPS or Travel Diary: Comparing Spatial and Temporal Characteristics of Visits to Fast Food Restaurants and Supermarkets. Plos One, 12(4).
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Abstract
To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/-10 minutes, and +/-30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.
Keywords
Global Positioning System; Fast Food Restaurants; Self-evaluation; Public Health; Supermarkets; Geoinformatics; Comparative Studies; Biology And Life Sciences; Computer And Information Sciences; Diet; Earth Sciences; Eating; Engineering And Technology; Food; Food Consumption; Geographic Information Systems; Geography; Medicine And Health Sciences; Nutrition; Physiological Processes; Physiology; Public And Occupational Health; Research And Analysis Methods; Research Article; Research Design; Survey Research; Surveys; Transportation; Global Positioning Systems; Environment; Neighborhood; Exposure; Health; Consumption; Tracking; Adults; Associations; Dietary
Buszkiewicz, James; Rose, Chelsea; Gupta, Shilpi; Ko, Linda K.; Mou, Jin; Moudon, Anne, V; Hurvitz, Philip M.; Cook, Andrea; Aggarwal, Anju; Drewnowski, Adam. (2020). A Cross-Sectional Analysis of Physical Activity and Weight Misreporting in Diverse Populations: The Seattle Obesity Study III. Obesity Science & Practice, 6(6), 615 – 627.
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Abstract
Background: In-person assessments of physical activity (PA) and body weight can be burdensome for participants and cost prohibitive for researchers. This study examined self-reported PA and weight accuracy and identified patterns of misreporting in a diverse sample. Methods: King, Pierce and Yakima county residents, aged 21-59 years (n= 728), self-reported their moderate-to-vigorous PA (MVPA) and weight, in kilograms. Self-reports were compared with minutes of bout-level MVPA, from 3 days of accelerometer data, and measured weights. Regression models examined characteristics associated with underreporting and overreporting of MVPA and weight, the potential bias introduced using each measure and the relation between perceived and measured PA and weight. Results: MVPA underreporting was higher among males and college educated participants; however, there was no differential MVPA overreporting. Weight underreporting was higher among males, those age 40-49 years and persons with obesity. Weight overreporting was higher among Hispanic participants and those reporting stress, unhappiness and fair or poor health. The estimated PA-obesity relation was similar using measured and self-reported PA but not self-reported weight. Perceived PA and weight predicted measured values. Conclusion: Self-reported PA and weight may be useful should objective measurement be infeasible; however, though population-specific adjustment for differential reporting should be considered.
Keywords
Self-reported Weight; Sedentary Behavior; Validation; Accuracy; Height; Adults; Health Disparity; Obesity; Physical Activity; Self-reported Outcomes
Aggarwal, Anju; Cook, Andrea J.; Jiao, Junfeng; Seguin, Rebecca A.; Moudon, Anne Vernez; Hurvitz, Philip M.; Drewnowski, Adam. (2014). Access to Supermarkets and Fruit and Vegetable Consumption. American Journal Of Public Health, 104(5), 917 – 923.
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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.
Keywords
Confidence Intervals; Correlation (statistics); Fruit; Geographic Information Systems; Ingestion; Multivariate Analysis; Population Geography; Questionnaires; Regression Analysis; Research Funding; Sales Personnel; Shopping; Travel; Vegetables; Predictive Validity; Cross-sectional Method; Statistical Models; Descriptive Statistics; Null Hypothesis; Washington (state); Local Food Environment; Diet Quality; Socioeconomic Position; Atherosclerosis Risk; Stores; Associations; Obesity; Adults; Availability; Communities