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; 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
Mooney, Stephen J.; Bobb, Jennifer F.; Hurvitz, Philip M.; Anau, Jane; Theis, Mary Kay; Drewnowski, Adam; Aggarwal, Anju; Gupta, Shilpi; Rosenberg, Dori E.; Cook, Andrea J.; Shi, Xiao; Lozano, Paula; Moudon, Anne Vernez; Arterburn, David. (2020). Impact of Built Environments on Body Weight (The Moving to Health Study): Protocol for a Retrospective Longitudinal Observational Study. Jmir Research Protocols, 9(5).
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Abstract
Background: Studies assessing the impact of built environments on body weight are often limited by modest power to detect residential effects that are small for individuals but may nonetheless comprise large attributable risks. Objective: We used data extracted from electronic health records to construct a large retrospective cohort of patients. This cohort will be used to explore both the impact of moving between environments and the long-term impact of changing neighborhood environments. Methods: We identified members with at least 12 months of Kaiser Permanente Washington (KPWA) membership and at least one weight measurement in their records during a period between January 2005 and April 2017 in which they lived in King County, Washington. Information on member demographics, address history, diagnoses, and clinical visits data (including weight) was extracted. This paper describes the characteristics of the adult (aged 18-89 years) cohort constructed from these data. Results: We identified 229,755 adults representing nearly 1.2 million person-years of follow-up. The mean age at baseline was 45 years, and 58.0% (133,326/229,755) were female. Nearly one-fourth of people (55,150/229,755) moved within King County at least once during the follow-up, representing 84,698 total moves. Members tended to move to new neighborhoods matching their origin neighborhoods on residential density and property values. Conclusions: Data were available in the KPWA database to construct a very large cohort based in King County, Washington. Future analyses will directly examine associations between neighborhood conditions and longitudinal changes in body weight and diabetes as well as other health conditions.
Keywords
Residential Location Choice; Physical-activity; Risk-factors; Food Desert; Neighborhood; Obesity; Association; Outcomes; Bmi; Accelerometer; Electronic Health Records; Built Environment; Washington; Geography; Longitudinal Studies
Rehm, Colin D.; Moudon, Anne V.; Hurvitz, Philip M.; Drewnowski, Adam. (2012). Residential Property Values are Associated with Obesity among Women in King County, WA, USA. Social Science & Medicine, 75(3), 491 – 495.
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Abstract
Studies of social determinants of weight and health in the US have typically relied on self-reported education and incomes as the two primary measures of socioeconomic status (SES). The assessed value of one's home, an important component of wealth, may be a better measure of the underlying SES construct and a better predictor of obesity. The Seattle Obesity Study (SOS), conducted in 2008-9, was a cross-sectional random digit dial telephone survey of 2001 adults in King County, Washington State, US. Participants' addresses were geocoded and residential property values for each tax parcel were obtained from the county tax assessor's database. Prevalence ratios of obesity by property values, education, and household income were estimated separately for women and men, after adjusting for age, race/ethnicity, household size, employment status and home ownership. Among women, the inverse association between property values and obesity was very strong and independent of other SES factors. Women in the bottom quartile of property values were 3.4 times more likely to be obese than women in the top quartile. No association between property values and obesity was observed for men. The present data strengthen the evidence for a social gradient in obesity among women. Property values may represent a novel and objective measure of SES at the individual level in the US. Measures based on tax assessment data will provide a valuable resource for future health studies. (C) 2012 Elsevier Ltd. All rights reserved.
Keywords
Communities; Employment; Income; Obesity; Poisson Distribution; Probability Theory; Research Funding; Self-evaluation; Sex Distribution; Social Classes; Statistics; Surveys; Data Analysis; Educational Attainment; Cross-sectional Method; Data Analysis Software; Descriptive Statistics; Washington (state); Health Status Disparities; Health Surveys; Social Class; Socioeconomic Factors; Usa; Women; Body-mass Index; Socioeconomic-status; Aged Men; Health; Weight; Disparities; Overweight; Disease; Poverty; Height
Stewart, Orion; Moudon, Anne Vernez; Claybrooke, Charlotte. (2014). Multistate Evaluation of Safe Routes to School Programs. American Journal Of Health Promotion, 28, S89 – S96.
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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.
Keywords
Transportation Of School Children; Physical Activity Measurement; Health Promotion; Cycling; Walking; School Children -- United States; Bicycling; Children; Commuting; Health Focus: Fitness/physical Activity; Manuscript Format: Research; Outcome Measure: Behavioral; Prevention Research; Research Purpose: Program Evaluation; Schools; Setting: School; Strategy: Skill Building/behavior Change, Built Environment; Study Design: Quasi-experimental; Target Population Age: Youth; Target Population Circumstances: Geographic Location; Physical-activity; Mental-health; Travel; Association; Validity; Mode; Bus
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; Littman, Alyson J.; Seto, Edmund; Saelens, Brian E. (2018). Why Neighborhood Park Proximity Is Not Associated with Total Physical Activity. Health & Place, 52, 163 – 169.
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Abstract
This study explored how parks within the home neighborhood contribute to total physical activity (PA) by isolating park-related PA. Seattle-area adults (n = 634) were observed using time-matched accelerometer, Global Positioning System (GPS), and travel diary instruments. Of the average 42.3 min of daily total PA, only 11% was related to parks. Both home neighborhood park count and area were associated with park-based PA, but not with PA that occurred elsewhere, which comprised 89% of total PA. This study demonstrates clear benefits of neighborhood parks for contributing to park-based PA while helping explain why proximity to parks is rarely associated with overall PA.
Keywords
Physical Activity; Parks; Urban Planning; Environmental Health; Global Positioning System; Built Environment; Green Space; Recreation; Social Determinants Of Health; Health Research; Accelerometer Data; Self-selection; United-states; Public Parks; Older Women; Walking; Adults; Facilities
Mooney, Stephen J.; Hurvitz, Philip M.; Moudon, Anne Vernez; Zhou, Chuan; Dalmat, Ronit; Saelens, Brian E. (2020). Residential Neighborhood Features Associated with Objectively Measured Walking Near Home: Revisiting Walkability Using the Automatic Context Measurement Tool (ACMT). Health & Place, 63.
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Abstract
Many distinct characteristics of the social, natural, and built neighborhood environment have been included in walkability measures, and it is unclear which measures best describe the features of a place that support walking. We developed the Automatic Context Measurement Tool, which measures neighborhood environment characteristics from public data for any point location in the United States. We explored these characteristics in home neighborhood environments in relation to walking identified from integrated GPS, accelerometer, and travel log data from 681 residents of King Country, WA. Of 146 neighborhood characteristics, 92 (63%) were associated with walking bout counts after adjustment for individual characteristics and correction for false discovery. The strongest built environment predictor of walking bout count was housing unit count. Models using data-driven and a priori defined walkability measures exhibited similar fit statistics. Walkability measures consisting of different neighborhood characteristic measurements may capture the same underlying variation in neighborhood conditions.
Keywords
Built-environment; Physical-activity; Transit; Density; Obesity; Weight; Time; Gps; American Community Survey; Epa Walkability Index; Neighborhood Environment-wide Association; Study; Walking Bouts
Sohn, Dong Wook; Moudon, Anne Vernez; Lee, Jeasun. (2012). The Economic Value of Walkable Neighborhoods. Urban Design International, 17(2), 115 – 128.
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Abstract
This study investigated how the benefits of a walkable neighborhood were reflected in the American real estate market by examining the economic values of urban environmental factors supporting walking activities. Property values were used as a proxy measure for economic value and analyzed in relation to land use characteristics that have been known to correlate with walking at the neighborhood scale. Four aspects of the built environment supporting walking were included in the analyses: development density, land use mix, public open space and pedestrian infrastructure. Hedonic models were employed where the property value was regressed on the measures of the four sets of correlates of walking in a neighborhood. Models were estimated for four land use types - single-family residential, rental multi-family residential, commercial and office. The findings did not support previous arguments that increasing density weakens the quality of a neighborhood. To the contrary, the positive association of higher development density with the value of single-family residential properties detected in King County suggested that high development density might increase surrounding property values. The pedestrian infrastructure and land use mix significantly contributed to increases in rental multi-family residential property values. Higher development density with higher street and sidewalk coverage were also favored by retail service uses. In relation to land use mix, mixing retail service uses and rental multi-family residential uses helped make rental housings more attractive. URBAN DESIGN International (2012) 17, 115-128. doi:10.1057/udi.2012.1; published online 4 April 2012
Keywords
Land-use; Physical-activity; Travel Behavior; Smart Growth; Mode Choice; Urban Form; Walking; Gis; Transportation; Accessibility; Mixed Land Use; Neighborhood; Urban Design
Barrington, Wendy E.; Beresford, Shirley A. A.; Koepsell, Thomas D.; Duncan, Glen E.; Moudon, Anne Vernez. (2015). Worksite Neighborhood and Obesogenic Behaviors: Findings among Employees in the Promoting Activity and Changes in Eating (PACE) Trial. American Journal Of Preventive Medicine, 48(1), 31 – 41.
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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. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
Keywords
Health Behavior; Food Habits; Lifestyles & Health; Prevention Of Obesity; Employee Health Promotion; Follow-up Studies (medicine); Local Food Environment; Dietary Energy Density; Body-mass Index; Socioeconomic-status; Physical-activity; Built Environment; Longitudinal-associations; Walking Behavior; Restaurant Use; Weight-gain