Kerfeld, Cheryl I.; Hurvitz, Philip M.; Bjornson, Kristie F. (2021). Physical Activity Measurement in Children Who Use Mobility Assistive Devices: Accelerometry and Global Positioning System. Pediatric Physical Therapy, 33(2), 92 – 99.
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Abstract
Purpose: To explore the usefulness of combining accelerometry, global positioning systems, and geographic information systems, to describe the time spent in different locations and physical activity (PA) duration/count levels by location for 4 children with cerebral palsy (CP) who use assistive devices (AD). Methods: A descriptive multiple-case study. Results: Combining the 3 instruments was useful in describing and differentiating duration by location, and amount and location of PA across differing functional levels and AD. For example, the child classified with a Gross Motor Function Classification System (GMFCS) level II exhibited large amounts of PA in community settings. In contrast, the child classified with a GMFCS level V had small amounts of PA and spent most measured time at home. Conclusions: Combined accelerometry, global positioning system, and geographic information system have potential to capture time spent and amount/intensity of PA relative to locations within daily environments for children with CP who use AD.
Keywords
Cerebral-palsy; Objective Measures; Fitness; Youth; Disabilities; Adolescents; Exercise; Adults; Accelerometer; Cerebral Palsy; Environment; Global Positioning System; Mobility Assistive Devices; Physical Activity
Drewnowski, Adam; Aggarwal, Anju; Rehm, Colin D.; Cohen-Cline, Hannah; Hurvitz, Philip M.; Moudon, Anne V. (2014). Environments Perceived as Obesogenic Have Lower Residential Property Values. American Journal Of Preventive Medicine, 47(3), 260 – 274.
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Abstract
Background: Studies have tried to link obesity rates and physical activity with multiple aspects of the built environment. Purpose: To determine the relation between residential property values and multiple perceived (self-reported) measures of the obesogenic environment. Methods: The Seattle Obesity Study (SOS) used a telephone survey of a representative, geographically distributed sample Of 2,001 King County adults, collected in 2008-2009 and analyzed in 2012-2013. Home addresses were geocoded. Residential property values at the tax parcel level were obtained from the King County tax assessor. Mean residential property values within a 10-minute walk (833-m buffer) were calculated for each respondent. Data on multiple perceived measures of the obesogenic environment were collected by self-report. Correlations and multi-variable linear regression analyses, stratified by residential density, were used to examine the associations among perceived environmental measures, property values, and BMI. Results: Perceived measures of the environment such as crime, heavy traffic, and proximity to bars, liquor stores, and fast food were all associated with lower property values. By contrast, living in neighborhoods that were perceived as safe, quiet, clean, and attractive was associated with higher property values. Higher property values were associated, in turn, with lower BMIs among women. The observed associations between perceived environment measures and BMI were largely attenuated after accounting for residential property values. Conclusions: Environments perceived as obesogenic are associated with lower property values. Studies in additional locations need to explore to what extent other perceived environment measures can be reflected in residential property values. (C) 2014 American Journal of Preventive Medicine
Keywords
Body-mass Index; Physical-activity; Objective Measures; Childhood Obesity; Food Stores; Neighborhood Disorder; Atherosclerosis Risk; Collective Efficacy; Racial Composition; Built Environment
Drewnowski, Adam; Aggarwal, Anju; Cook, Andrea; Stewart, Orion; Moudon, Anne Vernez. (2016). Geographic Disparities in Healthy Eating Index Scores (HEI-2005 and 2010) by Residential Property Values: Findings from Seattle Obesity Study (SOS). Preventive Medicine, 83, 46 – 55.
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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. (C) 2015 Elsevier Inc. All rights reserved.
Keywords
Obesity Treatment; Prevention Of Obesity; Disease Mapping; Socioeconomics; Multivariate Analysis; Population Geography; Census; Diet; Housing; Nutrition Policy; Questionnaires; Research Funding; Socioeconomic Factors; Body Mass Index; Health Equity; Cross-sectional Method; Economics; Seattle (wash.); Washington (state); Diet Quality; Geographic Information Systems; Healthy Eating Index; Residential Property Values; Socio-economic Status; Local Food Environment; Vitamin-e Consumption; Socioeconomic Position; United-states; Social-class; Energy-density; Association; Indicators; Trends
Drewnowski, A.; Buszkiewicz, J.; Aggarwal, A.; Cook, A.; Moudon, A. V. (2018). A New Method to Visualize Obesity Prevalence in Seattle-King County at the Census Block Level. Obesity Science & Practice, 4(1), 14 – 19.
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Abstract
Objective The aim of this study is to map obesity prevalence in Seattle King County at the census block level. Methods Data for 1,632 adult men and women came from the Seattle Obesity Study I. Demographic, socioeconomic and anthropometric data were collected via telephone survey. Home addresses were geocoded, and tax parcel residential property values were obtained from the King County tax assessor. Multiple logistic regression tested associations between house prices and obesity rates. House prices aggregated to census blocks and split into deciles were used to generate obesity heat maps. Results Deciles of property values for Seattle Obesity Study participants corresponded to county-wide deciles. Low residential property values were associated with high obesity rates (odds ratio, OR: 0.36; 95% confidence interval, CI [0.25, 0.51] in tertile 3 vs. tertile 1), adjusting for age, gender, race, home ownership, education, and incomes. Heat maps of obesity by census block captured differences by geographic area. Conclusion Residential property values, an objective measure of individual and area socioeconomic status, are a useful tool for visualizing socioeconomic disparities in diet quality and health.
Keywords
Residential Property-values; Socioeconomic-status; Health; Environment; Adults; Census Block; Geographic Information Systems; Mapping Obesity; Ses Measures
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
Lin, Lin; Chen, Xueming (Jimmy); Moudon, Anne Vernez. (2021). Measuring the Urban Forms of Shanghai’s City Center and Its New Districts: A Neighborhood-Level Comparative Analysis. Sustainability, 13(15).
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Abstract
Rapid urban expansion has radically transformed the city centers and the new districts of Chinese cities. Both areas have undergone unique redevelopment and development over the past decades, generating unique urban forms worthy of study. To date, few studies have investigated development patterns and land use intensities at the neighborhood level. The present study aims to fill the gap and compare the densities of different types of developments and the spatial compositions of different commercial uses at the neighborhood level. We captured the attributes of their built environment that support instrumental activities of daily living of 710 neighborhoods centered on the public elementary schools of the entire Shanghai municipality using application programming interfaces provided in Baidu Map services. The 200 m neighborhood provided the best fit to capture the variations of the built environment. Overall, city center neighborhoods had significantly higher residential densities and housed more daily routine destinations than their counterparts in the new districts. Unexpectedly, however, the total length of streets was considerably smaller in city-center neighborhoods, likely reflecting the prominence of the wide multilane vehicular roads surrounding large center city redevelopment projects. The findings point to convergence between the city center's urban forms and that of the new districts.
Keywords
Quantifying Spatiotemporal Patterns; Fast-food Restaurants; Instrumental Activities; Physical-activity; Chinese Cities; Land; Schools; Redevelopment; Expansion; Transformation; Built Environment; Planning; Neighborhood; Urban Form; Shanghai
Drewnowski, Adam; Rehm, Colin D.; Moudon, Anne V.; Arterburn, David. (2014). The Geography of Diabetes by Census Tract in a Large Sample of Insured Adults in King County, Washington, 2005-2006. Preventing Chronic Disease, 11.
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Abstract
Introduction Identifying areas of high diabetes prevalence can have an impact on public health prevention and intervention programs. Local health practitioners and public health agencies lack small-area data on obesity and diabetes. Methods Clinical data from the Group Health Cooperative health care system were used to estimate diabetes prevalence among 59,767 adults by census tract. Area-based measures of socioeconomic status and the Modified Retail Food Environment Index were obtained at the census-tract level in King County, Washington. Spatial analyses and regression models were used to assess the relationship between census tract level diabetes and area-based socioeconomic status and food environment variables. The mediating effect of obesity on the geographic distribution of diabetes was also examined. Results In this population of insured adults, diabetes was concentrated in south and southeast King County, with smoothed diabetes prevalence ranging from 6.9% to 21.2%. In spatial regression models, home value and college education were more strongly associated with diabetes than was household income. For each 50% increase in median home value, diabetes prevalence was 1.2 percentage points lower. The Modified Retail Food Environment Index was not related to diabetes at the census-tract level. The observed associations between area-based socioeconomic status and diabetes were largely mediated by obesity (home value, 58%; education, 47%). Conclusion The observed geographic disparities in diabetes among insured adults by census tract point to the importance of area socioeconomic status. Small-area studies can help health professionals design community-based programs for diabetes prevention and control.
Keywords
Prevalence; Obesity; Us; Disease
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
Goh, Charlene E.; Mooney, Stephen J.; Siscovick, David S.; Lemaitre, Rozenn N.; Hurvitz, Philip; Sotoodehnia, Nona; Kaufman, Tanya K.; Zulaika, Garazi; Lovasi, Gina S. (2018). Medical Facilities in the Neighborhood and Incidence of Sudden Cardiac Arrest. Resuscitation, 130, 118 – 123.
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Abstract
Background: Medical establishments in the neighborhood, such as pharmacies and primary care clinics, may play a role in improving access to preventive care and treatment and could explain previously reported neighborhood variations in sudden cardiac arrest (SCA) incidence and survival. Methods: The Cardiac Arrest Blood Study Repository is a population-based repository of data from adult cardiac arrest patients and population-based controls residing in King County, Washington. We examined the association between the availability of medical facilities near home with SCA risk, using adult (age 18-80) Seattle residents experiencing cardiac arrest (n = 446) and matched controls (n = 208) without a history of heart disease. We also analyzed the association of major medical centers near the event location with emergency medical service (EMS) response time and survival among adult cases (age 18+) presenting with ventricular fibrillation from throughout King County (n = 1537). The number of medical facilities per census tract was determined by geocoding business locations from the National Establishment Time-Series longitudinal database 1990-2010. Results: More pharmacies in the home census tract was unexpectedly associated with higher odds of SCA (OR: 1.28, 95% CI: 1.03, 1.59), and similar associations were observed for other medical facility types. The presence of a major medical center in the event census tract was associated with a faster EMS response time (-53 s, 95% CI: -84, -22), but not with short-term survival. Conclusions: We did not observe a protective association between medical facilities in the home census tract and SCA risk, orbetween major medical centers in the event census tract and survival.
Keywords
Cardiac Arrest; Medical Care; Emergency Medical Services; Ventricular Fibrillation; Heart Diseases; Patients; Medical Facilities; Neighborhood; Observational Study; Sudden Cardiac Arrest; Survival; Ambulance Response-times; Socioeconomic-status; Association; Care; Resuscitation; Disparities; Population; Provision; Disease
Muni, Kennedy; Kobusingye, Olive; Mock, Charlie; Hughes, James P.; Hurvitz, Philip M.; Guthrie, Brandon. (2019). Motorcycle Taxi Programme is Associated with Reduced Risk of Road Traffic Crash among Motorcycle Taxi Drivers in Kampala, Uganda. International Journal Of Injury Control & Safety Promotion, 26(3), 294 – 301.
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Abstract
SafeBoda is a transportation company that provides road safety training and helmets to its motorcycle taxi drivers in Kampala. We sought to determine whether risk of road traffic crash (RTC) was lower in SafeBoda compared to regular (non-SafeBoda) motorcycle taxi drivers during a 6-month follow-up period. We collected participant demographic and behavioural data at baseline using computer-assisted personal interview, and occurrence of RTC every 2 months using text messaging and telephone interview from a cohort of 342 drivers. There were 85 crashes (31 in SafeBoda and 54 in regular drivers) during follow-up. Over the 6-month follow-up period, SafeBoda drivers were 39% less likely to be involved in a RTC than regular drivers after adjusting for age, possession of a driver's license, and education (RR: 0.61, 95% CI: 0.39-0.97, p = .04). These findings suggest that the SafeBoda programme results in safer driving and fewer RTCs among motorcycle taxi drivers in Kampala.
Keywords
Motorcyclists; Motorcycle Helmets; Text Messages; Telephone Interviewing; Motorcycles; Kampala (uganda); Uganda; Boda-boda; Crash; Injury; Road Safety; Injuries; Burden; Riders; Kenya; Traffic Accidents; Transportation; Risk Management; Crashes; Demographics; Transportation Safety; Short Message Service; Traffic; Traffic Accidents & Safety; Roads; Risk Reduction; Taxicabs; Protective Equipment; Drivers Licenses; Kampala Uganda