Drewnowski, Adam; Aggarwal, Anju; Tang, Wesley; Hurvitz, Philip M.; Scully, Jason; Stewart, Orion; Moudon, Anne Vernez. (2016). Obesity, Diet Quality, Physical Activity, and the Built Environment: The Need for Behavioral Pathways. BMC Public Health, 16.
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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.
Keywords
Body-mass Index; Local Food Environment; Residential Property-values; Supermarket Accessibility; Park Proximity; Neighborhood Walkability; Vegetable Consumption; Atherosclerosis Risk; Restaurant Food; Associations; Built Environment; Physical Activity; Obesity; Diet Quality
Stewart, Orion T.; Carlos, Heather A.; Lee, Chanam; Berke, Ethan M.; Hurvitz, Philip M.; Li, Li; Moudon, Anne Vernez; Doescher, Mark P. (2016). Secondary GIS Built Environment Data for Health Research: Guidance for Data Development. Journal Of Transport & Health, 3(4), 529 – 539.
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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 9 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. (C) 2015 Elsevier Ltd. All rights reserved.
Keywords
Geographic Information-systems; Physical-activity; Land-use; Walking; Neighborhood; Associations; Density; Design; Adults; Travel; Active Travel; Pedestrian; Urban Design; Community Health; Rural
Stewart, Orion T.; Moudon, Anne Vernez; Fesinmeyer, Megan D.; Zhou, Chuan; Saelens, Brian E. (2016). The Association between Park Visitation and Physical Activity Measured with Accelerometer, GPS, and Travel Diary. Health & Place, 38, 82 – 88.
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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% Cl: 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. (C) 2016 Elsevier Ltd. All rights reserved.
Keywords
Physical Activity; Accelerometers; Geographic Information Systems; Park Use; Public Health; Built Environment; Gis; Leisure; Recreation; Substitution; Sedentary Behavior; Public-health; Accessibility; Prevention
Stewart, Orion T.; Moudon, Anne Vernez; Saelens, Brian E.; Lee, Chanam; Kang, Bumjoon; Doescher, Mark P. (2016). Comparing Associations between the Built Environment and Walking in Rural Small Towns and a Large Metropolitan Area. Environment And Behavior, 48(1), 13 – 36.
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Abstract
The association between the built environment (BE) and walking has been studied extensively in urban areas, yet little is known whether the same associations hold for smaller, rural towns. This analysis examined objective measures of the BE around participants' residence and their utilitarian and recreational walking from two studies, one in the urban Seattle area (n = 464) and the other in nine small U.S. towns (n = 299). After adjusting for sociodemographics, small town residents walked less for utilitarian purposes but more for recreational purposes. These differences were largely explained by differential associations of the BE on walking in the two settings. In Seattle, the number of neighborhood restaurants was positively associated with utilitarian walking, but in small towns, the association was negative. In small towns, perception of slow traffic on nearby streets was positively associated with recreational walking, but not in Seattle. These observations suggest that urban-rural context matters when planning BE interventions to support walking.
Keywords
Physical-activity; Utilitarian Walking; Transportation; Obesity; Adults; Travel; Urban; Prevalence; Strategies; Physical Activity; Walkability; City Planning; Urban Design; Community Health; Gis (geographic Information System); Gps (global Positioning System); Accelerometer; Effect Modification
Huang, Ruizhu; Moudon, Anne V.; Zhou, Chuan; Stewart, Orion T.; Saelens, Brian E. (2017). Light Rail Leads to More Walking Around Station Areas. Journal Of Transport & Health, 6, 201 – 208.
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Abstract
Areas around Light Rail Transit (LRT) stations offer ideal conditions for Transit-Oriented Development (TOD). Relatively dense, mixed-use neighborhoods can have positive impacts on mobility, health, and perceptions of neighborhood safety among nearby residents, primarily through walking activity for both transit and other purposes. To examine how station areas may attract new activity, this study analyzed changes in walking around station areas among people living close to an LRT station before and after the opening of a new transit system. This study examined walking behavior among the subset of 214 participants living within one mile of one of 13 LRT stations from among a sample of residents living close or further away from a new LRT line in Seattle. They completed a survey and a travel log and wore an accelerometer and a GPS for 7 days both before (2008) and after the opening of the Seattle area LRT (2010). Walking bouts were derived using a previously developed algorithm. The main outcome was the individual-level change in the proportion of daily walking within one quarter Euclidean mile of an LRT station. Overall walking decreased from before to after the LRT opening while station area walking did not change significantly, indicating a shift in walking activity to the station areas after the introduction of LRT. Increases in the proportion of station area walking were negatively related to participants' distance between home and the nearest LRT station, peaking at .0.75 mile. Male gender, college education, normal weight status, less access to cars, and frequent LRT use were also significantly associated with greater positive changes in the proportion of station area walking. The shift in walking to station areas after the completion of light rail provides evidence that the local proximate population is attracted to station areas, which may potentially benefit both transit use and TOD area economic activity. The residential catchment area for the shift in LRT area walking was < 0.75 mile of the LRT stations. (C) 2017 Elsevier Ltd All rights reserved.
Keywords
Body-mass Index; Physical-activity; Built Environment; Travel Behavior; Transit; Stop; Transit Oriented Development (tod); Behavior Change; Global Positioning Systems; Geographic Information Systems
Stewart, Orion T.; Moudon, Anne Vernez; Littman, Alyson J.; Seto, Edmund; Saelens, Brian E. (2018). The Association between Park Facilities and Duration of Physical Activity During Active Park Visits. Journal Of Urban Health, 95(6), 869 – 880.
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Abstract
Public parks provide places for urban residents to obtain physical activity (PA), which is associated with numerous health benefits. Adding facilities to existing parks could be a cost-effective approach to increase the duration of PA that occurs during park visits. Using objectively measured PA and comprehensively measured park visit data among an urban community-dwelling sample of adults, we tested the association between the variety of park facilities that directly support PA and the duration of PA during park visits where any PA occurred. Cross-classified multilevel models were used to account for the clustering of park visits (n=1553) within individuals (n=372) and parks (n=233). Each additional different PA facility at a park was independently associated with a 6.8% longer duration of PA bouts that included light-intensity activity, and an 8.7% longer duration of moderate to vigorous PA time. Findings from this study are consistent with the hypothesis that more PA facilities increase the amount of PA that visitors obtain while already active at a park.
Keywords
Park Facilities; Physical Activity; Park Use; Recreation; Built Environment; Global Positioning System; Accelerometer; Gis; Gps; Accelerometer Data; United-states; Adults; Proximity; Features; Walking; Size; Attractiveness; Improvements; Environment; Parks & Recreation Areas; Parks; Luminous Intensity; Clustering; Urban Areas