Fighting Obesity by Reinventing Public Transportation: A Natural Experiment

项目总结 使用公共交通与增加体力活动有关，并被认为是一种很有前途的方法 降低肥胖和其他与年龄相关的慢性疾病，如癌症、糖尿病和心脏病的风险。然而， 人们对日益流行的快速公交(BRT)对身体活动的影响知之甚少 轨道交通的能力、速度和可靠性，以及传统公交系统的灵活性和成本优势。 此外，缺乏关于交通导向的多层次干预(TOMI)的影响的研究，这些干预同时 考虑采用多种协同策略来促进体力活动。 这项及时的自然-实验研究使用了Pre-Post(2018年秋季德克萨斯州埃尔帕索新BRT走廊的开放)，案例- 快速公交与其他支持TOMI策略对居民身体影响的比较设计 活动。这项研究涉及750名接触过紫外线的人(居住在距离新BRT车站0.5英里的范围内)和500名未接触过空气的人(居住在 距离任何BRT站超过1英里)居住在城市中且每周不进行体育活动的成年参与者 建议(150分钟的中等到剧烈的PA)。这项拟议研究的具体目的是 (1)确定BRT对体力活动的影响；(2)检查其他TOMI策略对体力活动的影响， 包括教育(通过提供智能手机应用程序和培训来帮助过境旅行来消除知识障碍 计划并增强有关使用BRT和BRT可及体力活动资源的知识)和成本(提升 通过执行介绍性免费票价战略来解决交通使用的财务障碍)；以及(3)探讨 快速公交的实施，以及快速公交使用的障碍和促进者。2018年春季将有三波数据采集， 2019年春季和2021年春季。 多学科小组(来自城市规划、交通、公共卫生、统计学和差异研究的专家) 提出了许多创新的政策、理论和方法上的进展，以了解 面向服务的环境干预。其中包括：a)将影响和 改进过境使用的战略，b)纳入多个案例比较，c)应用相关方法 在其他研究查询中更常用的方法，以及d)公民科学方法，以获得更多背景信息 对PA-过境关系的理解。它与当地社区和利益攸关方的紧密联系以及 大量的研究合作记录确保了拟议研究的有效执行。在结束时， 提出的研究，研究人员希望确定BRT和其他TOMI策略对体力活动的影响，检查 BRT实施的好处和成本，并揭示BRT使用的障碍和促进者。

PROJECT SUMMARY Use of public transit has been associated with increased physical activity, and considered a promising approach to reducing the risk of obesity and other age-related chronic conditions such as cancer, diabetes, and heart disease. However, little is known about the physical activity impacts of the increasingly popular Bus Rapid Transit (BRT) which combines the capacity, speed, and reliability of rail transit with the flexibility and cost advantage of a conventional bus system. Further, research is lacking about impacts of transit-oriented multilevel interventions (TOMI) that simultaneously consider multiple synergetic strategies to promote physical activity. This timely natural-experimental study uses a pre-post (opening of new BRT corridors in El Paso, Texas, fall 2018), case- comparison design to examine the causal impact of BRT and other supporting TOMI strategies on residents’ physical activity. The study involves 750 exposed (living within 0.5 miles from a new BRT station) and 500 non-exposed (living beyond 1 mile from any BRT stations) adult participants who live in the city and do not meet weekly physical activity recommendations (150+ minutes of moderate-to-vigorous PA) at baseline. The specific aims of this proposed study are to (1) determine physical activity impacts of BRT; (2) examine physical activity impacts of additional TOMI strategies, including education (lifting the knowledge barrier by offering a smartphone app and training to assist transit trip scheduling and to enhance knowledge about using BRT and BRT-reachable physical activity resources) and cost (lifting the financial barrier to transit use by executing an introductory free-fare strategy); and (3) explore benefits and costs of BRT implementation, and barriers and facilitators of BRT use. There will be three waves of data collection in spring 2018, spring 2019, and spring 2021, respectively. The multidisciplinary team (experts from urban planning, transportation, public health, statistics and disparities research) proposes many innovative policy, theoretical and methodological advances to understand the obesity reduction roles of service-oriented environmental interventions. These include a) conceptualization of multi-level factors influencing and strategies for modifying transit use, b) inclusion of multiple case-comparisons, c) application of relevant methodological approaches more commonly used in other research queries, and d) a citizen science approach for more contextual understanding of the PA-transit relationship. Its strong connection with the local communities and stakeholders and substantial record of research collaboration ensure an effective execution of the proposed research. At the end of the proposed study, the researchers expect to identify the physical activity impact of BRT and other TOMI strategies, examine the benefits and costs of BRT implementation, and reveal barriers and facilitators of BRT use.