Neighborhood Food Environment, Diet and Health: Quasi-experimental Study

描述(由申请人提供) 降低人口肥胖率是当前的一项主要公共卫生目标。降低肥胖率的干预措施通常侧重于个人行为和生活方式，但收效甚微。注重建筑环境作用的战略一直被忽视。这项创新的试点研究的目的是，使用准实验设计，评估州政府资助的一个为期三年、耗资4000万美元的计划-宾夕法尼亚州生鲜食品融资计划-对饮食和心理健康的影响，该计划旨在改善费城当地建成的食品零售环境。该项目有四个具体目标。1)描述和比较干预社区和对照社区的水果和蔬菜消费模式和心理健康指标。2)评估在干预社区的新食品超市(干预)开业后，与匹配的对照地点相比，这些模式是否发生了变化。3)探讨基于收入、教育和基线消费状况对确定的居民亚群的影响。4)调查干预社区零售经济的变化，并与对照社区进行比较。将对费城两个社区的居民进行电话调查(一项干预和一项比较)，每个社区18岁以上的男性和女性在随访时的样本量达到466人。在基线阶段，将向答复者发出一封预先通知函，随后将进行一次电话通话，旨在促使人们对有关饮食、心理健康、对食物获取的看法、食物购买行为、交通和一系列社会人口数据等问题作出答复。然后，受访者将在8个月后接受随访，以评估干预的效果。此外，还将利用地理信息系统评估当地食品零售经济的积极和消极变化，并将这些变化与获得食物的实际机会的变化联系起来。该项目的结果将被用来准备一份向NIH提交的提案，在美国各地的一系列社区环境(城市、小城镇、农村)进行更大规模的混合方法、多地点实验研究。

DESCRIPTION (provided by applicant) Reducing the population prevalence of obesity is a current major public health goal. Interventions to reduce the prevalence of obesity have generally focused on individual behavior and lifestyle but have met with limited success. Strategies that focus on the role of the built environment have been neglected. The purpose of this innovative pilot study is to evaluate, using a quasi-experimental design, the impact on diet and psychological health of a three-year $40 million state-government funded program - The Pennsylvania Fresh Food Financing Initiative - that aims to improve the local built food retail environment in Philadelphia. The project has four specific aims. 1) To describe and compare fruit and vegetable consumption patterns and measures of psychological health in an intervention neighborhood against a matched comparison neighborhood. 2) To evaluate whether these patterns change after the opening of a new food supermarket (the intervention) in the intervention neighborhood compared to a matched comparison site. 3) To explore impacts on defined subgroups of residents based on income, education and baseline consumption status. 4) To investigate changes in the retail economy in the intervention neighborhood and compare these with the comparison neighborhood. A telephone survey of residents of two Philadelphia neighborhoods (one intervention and one comparison) with an achieved sample size of four hundred and sixty-six men and women aged 18+ in each neighborhood at follow-up will be undertaken. At baseline, respondents will be contacted with a pre-notification letter which will then be followed by a telephone call designed to elicit responses to questions relating to diet, mental health, perceptions of food access, food shopping behavior, transport and a range of socio-demographic data. Respondents will then be followed-up at eight months in order to assess the effect of the intervention. In addition geographical information systems will be used to assess positive and negative changes in the local food retail economy and relate them to changes in physical access to food. Findings from the project will be used to prepare a proposal to NIH for a larger mixed-method, multi-site experimental study in a range of community settings (urban, small town, rural) throughout the USA.