Reducing CVD risk/health disparities--active living

描述(申请人提供)：心血管疾病(CVD)、癌症和糖尿病是美国发病率和死亡率的主要原因，但我们在预防这些昂贵且令人衰弱的慢性病方面效果不佳。尽管需要改善行为筛查和咨询的方案和战略，但仅靠卫生保健干预不足以预防心血管疾病和其他慢性病。与指出多层次影响健康重要性的社会生态学模型一致，关于建筑环境对心血管危险行为的影响的研究提供了一个令人信服的案例，将“积极生活”作为一种有效的基于社区的心血管疾病预防策略。斯台普顿开发项目是美国目前正在进行的最大的城市重建项目。斯台普顿位于丹佛空置的斯台普顿机场，2001年由森林城市企业公司开始重新开发，该公司受雇领导这项数十年的努力。它占地4700英亩(其中三分之一以上用于绿地)，被设计为混合用途社区，以增强人们的积极生活，拥有袖珍公园、步行和自行车道、宽阔的人行道和社区娱乐设施。目前斯台普顿有近1500户家庭，10年后将有超过30,000名居民。重要的是，它毗邻种族和民族多元化、社会经济条件较差的邻近社区，为之前经历了40多年机场噪音、交通和污染的居民提供了积极的生活便利设施。这种具有已建立环境的新城市飞地的开发是一种不同寻常的情况，为了解社区发展及其对新社区和周围现有社区的健康和健康差距的影响提供了绝佳的机会。我们提议的项目符合最近的建议，即增加对以人群为基础的方法预防心血管疾病的影响的了解。我们将使用与社区和文化相关的数据收集方法，了解如何增加对斯台普顿活跃生活环境的利用，以提高斯台普顿及其邻近社区居民的体力活动水平和心血管风险。这项研究的一个重要资源将是一个基于社区的参与性研究(CBPR)过程，让斯台普顿及其周围社区(以下称为大斯台普顿社区)的不同居民参与解决这些复杂的问题。尽管斯台普顿在其规划过程中很早就纳入了社区意见，但该项目建立了一个正式的CBPR过程，创造了一种更广泛的社区范围的方法，以建立一个多样化和“可渗透的”活跃的生活社区。

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD), cancer and diabetes are the leading causes of morbidity and mortality in the United States, yet we are ineffective in preventing these costly and debilitating chronic conditions. Although programs and strategies to improve behavioral screening and counseling are needed, health care interventions alone are inadequate for preventing CVD and other chronic diseases. Consistent with social ecological models, which point to the importance of multi-level influences on health, research on the impact of the built environment on CVD risk behaviors offers a compelling case for building "active living" into neighborhoods as an effective community-based CVD prevention strategy. The Stapleton development is the largest urban renewal project currently ongoing in the United States. Located on the vacated Stapleton Airport grounds in Denver, Stapleton's redevelopment began in 2001 by Forest City Enterprises, the developer hired to lead this multi-decade effort. Its 4,700 acres (of which more than one third is dedicated to green space) are designed as mixed-use neighborhoods to enhance active living with pocket parks, walking and bicycle trails and wide sidewalks and its community recreation facilities. Currently Stapleton has almost 1,500 families, and in 10 years will be home to over 30,000 residents. Importantly, its close proximity to adjacent neighborhoods that are racially and ethnically diverse and socio-economically disadvantaged, offers access to active living amenities to residents who previously experienced over 40 years of airport noise, traffic and pollution. This development of a new urban enclave with an established built environment is an unusual circumstance that presents exceptional opportunities for learning about community development and its impact on health and health disparities both in the new community and in the established communities surrounding it. Our proposed project fits with recent recommendations to increase knowledge of the impacts of population-based approaches for preventing cardiovascular disease. We will use community- and culturally-relevant data collection methods to understand how to increase use of Stapleton's active living environment to improve levels of physical activity and cardiovascular risk by residents of Stapleton and the diverse communities adjacent to it. An important resource for this research will be a community-based participatory research (CBPR) process that involves diverse residents of Stapleton and surrounding neighborhoods (hereinafter called the Greater Stapleton Community) in addressing these complex issues. Although Stapleton included community input early in its planning process, this project's establishment of a formalized CBPR process creates a more community-wide approach for building a diverse and "permeable" active living community.