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
Stewart, Orion Theodore; Moudon, Anne Vernez; Littman, Alyson; Seto, Edmund; Saelens, Brian E. (2018). The Association between Park Facilities and the Occurrence of Physical Activity during Park Visits. Journal Of Leisure Research, 49(3-5), 217 – 235.
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Abstract
Prior research has found a positive relationship between the variety of park facilities and park-based physical activity (PA) but has not provided an estimate of the effect that additional different PA facilities have on whether an individual is active during a park visit. Using objective measures of park visits and PA from an urban sample of 225 adults in King County, Washington, we compared the variety of PA facilities in parks visited where an individual was active to PA facilities in parks where the same individual was sedentary. Each additional different PA facility at a park was associated with a 6% increased probability of being active during a visit. Adding different PA facilities to a park appears to have a moderate effect on whether an individual is active during a park visit, which could translate into large community health impacts when scaled up to multiple park visitors.
Keywords
Accelerometer Data; Built Environment; Walking; Density; Health; Adults; Size; Gps; Attractiveness; Improvements; Measurement; Parks; Physical Activity; Quantitative Research; Urban Planning
Muni, Kennedy; Kobusingye, Olive; Mock, Charles; Hughes, James P.; Hurvitz, Philip M.; Guthrie, Brandon. (2020). Motorcycle Taxi Programme Increases Safe Riding Behaviours Among Its Drivers In Kampala, Uganda. Injury Prevention, 26(1), 5 – 11.
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Abstract
Background SafeBoda is a motorcycle taxi company that provides road safety training and helmets to its drivers in Kampala, Uganda. We sought to determine whether SafeBoda drivers are more likely to engage in safe riding behaviours than regular drivers (motorcycle taxi drivers not part of SafeBoda). Methods We measured riding behaviours in SafeBoda and regular drivers through: (1) computer-assisted personal interview (CAPI), where 400 drivers were asked about their riding behaviours (eg, helmet and mobile phone use) and (2) roadside observation, where riding behaviours were observed in 3000 boda-boda drivers and their passengers along major roads in Kampala. Results Across the two cross-sectional studies, a higher proportion of SafeBoda drivers than regular drivers engaged in safe riding behaviours. For instance, helmet use among SafeBoda compared with regular drivers was 21% points higher (95% CI 0.15 to 0.27; p<0.001) based on the CAPI and 45% points higher (95% CI 0.43 to 0.47; p<0.001) based on roadside observation. Furthermore, compared with regular drivers, SafeBoda drivers were more likely to report having a driver's license (66.3% vs 33.5 %; p<0.001) and a reflective jacket (99.5% vs 50.5 %; p<0.001) and were less likely to report driving towards oncoming traffic (4% vs 45.7 %; p<0.001) in the past 30 days. Conclusion The SafeBoda programme is associated with increased safe riding behaviours among motorcycle taxi drivers in Kampala. Therefore, the promotion and expansion of such programmes may lead to a reduction in morbidity and mortality due to road injuries.
Keywords
Multiple-imputation; Helmet Use; Knowledge; Injuries; Riders
Stewart, Orion; Moudon, Anne Vernez; Claybrooke, Charlotte. (2012). Common Ground: Eight Factors that Influence Walking and Biking to School. Transport Policy, 24, 240 – 248.
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Abstract
The primary goals of Safe Routes to School (SRTS) programs are to increase the number and safety of children walking, biking or using other forms of active travel to school (ATS). This study reviewed quantitative and qualitative research and identified eight common factors that influenced the choice of ATS: distance to school, parental fear of traffic and crime, family schedule constraints and values, neighborhood and family resources and culture, weather, and school characteristics. Suggestions were made as to how these barriers and facilitators of ATS could be integrated into the decision to fund local SRTS programs and to improve their effectiveness. Published by Elsevier Ltd.
Keywords
Commuting; Transportation Of School Children; Transportation Safety Measures; Qualitative Research; Cycling; Walking; Bike; Child; Pedestrian; Safe Routes To School; Safety; Walk; Active Transportation; Physical-activity; Urban Form; Elementary-schools; Safe Routes; Travel Mode; Children; Prevalence; Trip; Environment
Berrigan, David; Hipp, J. Aaron; Hurvitz, Philip M.; James, Peter; Jankowska, Marta M.; Kerr, Jacqueline; Laden, Francine; Leonard, Tammy; Mckinnon, Robin A.; Powell-wiley, Tiffany M.; Tarlov, Elizabeth; Zenk, Shannon N.; The Trec Spatial And Contextual Measures And Modeling Work Group. (2015). Geospatial and Contextual Approaches to Energy Balance and Health. Annals Of Gis, 21(2), 157 – 168.
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Abstract
In the past 15 years, a major research enterprise has emerged that is aimed at understanding associations between geographic and contextual features of the environment (especially the built environment) and elements of human energy balance, including diet, weight and physical activity. Here we highlight aspects of this research area with a particular focus on research and opportunities in the United States as an example. We address four main areas: (1) the importance of valid and comparable data concerning behaviour across geographies; (2) the ongoing need to identify and explore new environmental variables; (3) the challenge of identifying the causally relevant context; and (4) the pressing need for stronger study designs and analytical methods. Additionally, we discuss existing sources of geo-referenced health data which might be exploited by interdisciplinary research teams, personnel challenges and some aspects of funding for geospatial research by the US National Institutes of Health in the past decade, including funding for international collaboration and training opportunities. [ABSTRACT FROM AUTHOR]; Copyright of Annals of GIS is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Keywords
Bioenergetics; Geospatial Data; Contextual Analysis; Physical Activity; Obesity; Contextual; Energy Balance; Geospatial; Spatial
Tang, W.; Aggarwal, A.; Liu, Z.; Acheson, M.; Rehm, C. D.; Moudon, A. V.; Drewnowski, A. (2016). Validating Self-Reported Food Expenditures against Food Store and Eating-Out Receipts. European Journal Of Clinical Nutrition, 70(3), 352 – 357.
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Abstract
BACKGROUND/OBJECTIVES: To compare objective food store and eating-out receipts with self-reported household food expenditures. SUBJECTS/METHODS: The Seattle Obesity Study II was based on a representative sample of King County adults, Washington, USA. Self-reported household food expenditures were modeled on the Flexible Consumer Behavior Survey (FCBS) Module from 2007 to 2009 National Health and Nutrition Examination Survey (NHANES). Objective food expenditure data were collected using receipts. Self-reported food expenditures for 447 participants were compared with receipts using paired t-tests, Bland-Altman plots and.-statistics. Bias by sociodemographics was also examined. RESULTS: Self-reported expenditures closely matched with objective receipt data. Paired t-tests showed no significant differences between receipts and self-reported data on total food expenditures, expenditures at food stores or eating out. However, the highest-income strata showed weaker agreement. Bland-Altman plots confirmed no significant bias across both methods-mean difference: 6.4; agreement limits: -123.5 to 143.4 for total food expenditures, mean difference 5.7 for food stores and mean difference 1.7 for eating out. The kappa-statistics showed good agreement for each (kappa 0.51, 0.41 and 0.49 respectively. Households with higher education and income had significantly more number of receipts and higher food expenditures. CONCLUSIONS: Self-reported food expenditures using NHANES questions, both for food stores and eating out, serve as a decent proxy for objective household food expenditures from receipts. This method should be used with caution among high-income populations, or with high food expenditures. This is the first validation of the FCBS food expenditures question using food store and eating-out receipts.
Keywords
Household Food; Supermarket; Obesity; Energy; Purchases; Patterns; Women; Fat
Drewnowski, A.; Arterburn, D.; Zane, J.; Aggarwal, A.; Gupta, S.; Hurvitz, P. M.; Moudon, A., V; Bobb, J.; Cook, A.; Lozano, P.; Rosenberg, D. (2019). The Moving to Health (M2H) Approach to Natural Experiment Research: A Paradigm Shift for Studies on Built Environment and Health. Ssm-population Health, 7.
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Abstract
Improving the built environment (BE) is viewed as one strategy to improve community diets and health. The present goal is to review the literature on the effects of BE on health, highlight its limitations, and explore the growing use of natural experiments in BE research, such as the advent of new supermarkets, revitalized parks, or new transportation systems. Based on recent studies on movers, a paradigm shift in built-environment health research may be imminent. Following the classic Moving to Opportunity study in the US, the present Moving to Health (M2H) strategy takes advantage of the fact that changing residential location can entail overnight changes in multiple BE variables. The necessary conditions for applying the M2H strategy to Geographic Information Systems (GIS) databases and to large longitudinal cohorts are outlined below. Also outlined are significant limitations of this approach, including the use of electronic medical records in lieu of survey data. The key research question is whether documented changes in BE exposure can be linked to changes in health outcomes in a causal manner. The use of geo-localized clinical information from regional health care systems should permit new insights into the social and environmental determinants of health.
Keywords
Body-mass Index; Neighborhood Food Environment; Residential Property-values; Cardiometabolic Risk-factors; New-york-city; Physical-activity; Obesity Rates; King County; Weight-gain; Land-use; Built Environment (be); Geographic Information Systems (gis); Electronic Medical Records; Natural Experiments; Obesity; Diabetes; Residential Mobility
Rhew, Isaac C.; Duckworth, Jennifer C.; Hurvitz, Philip M.; Lee, Christine M. (2020). Within- and Between-Person Associations of Neighborhood Poverty with Alcohol Use and Consequences: A Monthly Study of Young Adults. Drug & Alcohol Dependence, 212.
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Abstract
Background: Studies have shown associations between neighborhood disadvantage and alcohol misuse among adults. Less is known about the role of neighborhood context in young adults (YAs), who engage in more disordered forms of alcohol use compared to other age groups. Using data collected monthly, this study examined whether YAs reported more alcohol use and consequences when they were living in neighborhoods with greater concentration of poverty. Method: This study used data from 746 participants aged 18-23 years living in the Seattle, WA, region. Surveys were administered each month for 24 consecutive months. Measures included typical number of drinks per week and past month count of alcohol-related consequences. Residential addresses at each month were geocoded and linked to census-tract level percentage of households living at or below poverty threshold. Multilevel over-dispersed Poisson models were used to estimate associations between standardized monthly deviations in tract-level poverty from one's average and alcohol outcomes. Results: Across 14,247 monthly observations, the mean number of typical drinks per week was 4.8 (SD = 7.4) and the mean number of alcohol consequences was 2.1 (SD = 3.5). On months when they were living in neighborhoods with higher levels of poverty than their average, participants reported significantly higher levels of alcohol consequences (Count Ratio = 1.05; p = .045). Conclusion: YAs may engage in more problematic forms of drinking when they reside in neighborhoods with higher levels of disadvantage. During a time of frequent residential changes, YAs moving to more disadvantaged neighborhoods may benefit from additional supports.
Keywords
Alcohol Drinking; Young Adults; Neighborhoods; Age Groups; Poverty; Western Australia; Seattle (wash.); Alcohol; Neighborhood Context; Young Adulthood; Emergency-department Visits; Heavy Episodic Drinking; College-students; United-states; Substance Use; Use Disorders; Models; Health; Disorganization; Availability
Kang, Bumjoon; Moudon, Anne V.; Hurvitz, Philip M.; Reichley, Lucas; Saelens, Brian E. (2013). Walking Objectively Measured: Classifying Accelerometer Data with GPS and Travel Diaries. Medicine & Science In Sports & Exercise, 45(7), 1419 – 1428.
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Abstract
Purpose: This study developed and tested an algorithm to classify accelerometer data as walking or nonwalking using either GPS or travel diary data within a large sample of adults under free-living conditions. Methods: Participants wore an accelerometer and a GPS unit and concurrently completed a travel diary for seven consecutive days. Physical activity (PA) bouts were identified using accelerometry count sequences. PA bouts were then classified as walking or nonwalking based on a decision-tree algorithm consisting of seven classification scenarios. Algorithm reliability was examined relative to two independent analysts' classification of a 100-bout verification sample. The algorithm was then applied to the entire set of PA bouts. Results: The 706 participants' (mean age = 51 yr, 62% female, 80% non-Hispanic white, 70% college graduate or higher) yielded 4702 person-days of data and had a total of 13,971 PA bouts. The algorithm showed a mean agreement of 95% with the independent analysts. It classified PA into 8170 walking bouts (58.5 %) and 5337 nonwalking bouts (38.2%); 464 bouts (3.3%) were not classified for lack of GPS and diary data. Nearly 70% of the walking bouts and 68% of the nonwalking bouts were classified using only the objective accelerometer and GPS data. Travel diary data helped classify 30% of all bouts with no GPS data. The mean + SD duration of PA bouts classified as walking was 15.2 + 12.9 min. On average, participants had 1.7 walking bouts and 25.4 total walking minutes per day. Conclusions: GPS and travel diary information can be helpful in classifying most accelerometer-derived PA bouts into walking or nonwalking behavior.
Keywords
Walking; Algorithms; Decision Trees; Geographic Information Systems; Research Funding; Travel; Accelerometry; Diary (literary Form); Descriptive Statistics; Algorithm; Classification; Physical Activity; Walk Trip; Global Positioning Systems; Physical-activity; Environment; Behaviors; Validity; Location
Cohen-Cline, Hannah; Lau, Richard; Moudon, Anne V.; Turkheimer, Eric; Duncan, Glen E. (2015). Associations between Fast-Food Consumption and Body Mass Index: A Cross-sectional Study in Adult Twins. Twin Research & Human Genetics, 18(4), 375 – 382.
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Abstract
Obesity is a substantial health problem in the United States, and is associated with many chronic diseases. Previous studies have linked poor dietary habits to obesity. This cross-sectional study aimed to identify the association between body mass index (BMI) and fast-food consumption among 669 same-sex adult twin pairs residing in the Puget Sound region around Seattle, Washington. We calculated twin-pair correlations for BMI and fast-food consumption. We next regressed BMI on fast-food consumption using generalized estimating equations (GEE), and finally estimated the within-pair difference in BMI associated with a difference in fast-food consumption, which controls for all potential genetic and environment characteristics shared between twins within a pair. Twin-pair correlations for fast-food consumption were similar for identical (monozygotic; MZ) and fraternal (dizygotic; DZ) twins, but were substantially higher in MZ than DZ twins for BMI. In the unadjusted GEE model, greater fast-food consumption was associated with larger BMI. For twin pairs overall, and for MZ twins, there was no association between within-pair differences in fast-food consumption and BMI in any model. In contrast, there was a significant association between within-pair differences in fast-food consumption and BMI among DZ twins, suggesting that genetic factors play a role in the observed association. Thus, although variance in fast-food consumption itself is largely driven by environmental factors, the overall association between this specific eating behavior and BMI is largely due to genetic factors.
Keywords
Diseases In Twins; Obesity; Adults; Diseases; Food Habits; Food Consumption; Body Mass Index; Cross-sectional Method; United States; Fast-food Consumption; Generalized Estimating Equations; Twin Studies; Fto Gene Variants; Physical-activity; Dietary-intake; Weight Status; Environment Interaction; Human Obesity; Young-adults; Zygosity; Patterns; Exercise