Exploratory Study of Environmental Effects on Activity/Overweight in Older Women

描述(申请人提供)：缺乏运动和超重/肥胖是一些癌症的重要风险因素，包括乳腺癌和结肠癌。美国成年人的体力活动水平并不理想，肥胖症的流行也在不断加剧。越来越多的证据表明，社区建筑环境的某些方面会影响身体活动，城市扩张等因素与超重有关。到目前为止，研究具有重要的局限性，包括很少使用较小规模的客观环境措施，使用客观和可感知的环境措施的研究很少，以及针对老年人的证据有限。在这项为期两年的探索性R21研究中，我们召集了一支来自公共卫生、城市规划和地理学的经验丰富的跨学科研究团队，为护士健康研究(NHS)中的老年女性制定合理的建筑环境衡量标准，并评估这些因素对体力活动、BMI、超重和肥胖的影响。我们的具体目标是：1)为三个州的大约30,000名NHS参与者制定家庭层面的建筑环境客观测量，并检查与体力活动和体重相关结果的横截面关联；2)测量3800名妇女对社区环境和体力活动的感知，并评估感知和客观环境测量与关键结果之间的关联；以及3)试点测试使用高分辨率正射摄影技术来制定几种建筑环境的微尺度测量。我们将获取公共和商业可用的地理信息系统(GIS)数据，以便为马萨诸塞州、宾夕法尼亚州和加利福尼亚州的NHS参与者创建住宅密度、土地利用组合和街道连通性的家庭水平测量，并使用地理编码的家庭地址。我们将使用社区环境步行量表(NEWS)和老年人体力活动量表(PASE)对女性进行调查。在马萨诸塞州的一个小样本中，我们将使用正射摄影来创建建筑环境的几个微观尺度的测量(例如，步行的便利设施)。为了测试关联性，我们将使用多变量建模技术来控制潜在的个人和环境混杂因素。这项研究的一个关键目标是开发可用于未来前瞻性研究的方法，这些方法可能有助于阐明建筑环境与体力活动和肥胖之间的因果关系。此外，我们预计将利用这项研究的发现，为老年妇女设计更有效的体力活动干预措施，纳入环境战略。相关性：这项研究可能会对社区环境特征如何影响老年女性参与定期体育活动提供新的见解，并提供关于这些特征如何与超重和肥胖风险相关的信息。我们计划利用这项研究的结果，制定更有效的倡议，在考虑到社区特征和资源的情况下，在老年妇女中促进体育活动。最终，这项研究的发现可能有助于降低与缺乏体力活动有关的几种癌症的风险--无论是在老年人还是年轻人中。

DESCRIPTION (provided by applicant): Physical inactivity and overweight/obesity are important risk factors for a number of cancers, including breast and colon. Physical activity levels among U.S. adults are less than optimal and there is a growing epidemic of obesity. There is increasing evidence that certain aspects of the neighborhood built environment influence physical activity and that factors such as greater urban sprawl are related to overweight. Studies to-date have important limitations, including infrequent use of smaller scale objective environmental measures, scant research using both objective and perceived environmental measures, and limited evidence for older adults. For this two-year exploratory R21 study, we have assembled an experienced transdisciplinary team of researchers from public health, urban planning and geography to develop sound measures of the built environment for older women in the Nurses Health Study (NHS) and to assess the effects of these factors on physical activity, BMI, overweight, and obesity. Our specific aims are: 1) develop household-level objective measures of the built environment for approximately 30,000 NHS participants in three states and examine cross-sectional associations with physical activity and weight-related outcomes; 2) measure perceptions of neighborhood environment and physical activity in a sub-sample of 3800 women and assess associations between perceived and objective environmental measures and key outcomes; and 3) pilot test the use of high-resolution orthophotographs to develop several micro-scale measures of the built environment. We will obtain publicly and commercially available geographic information systems (GIS) data in order to create household-level measures of residential density, land use mix, and street connectivity for NHS participants in MA, PA, and CA with geocoded home addresses. We will survey women with the Neighborhood Environment Walkability Scale (NEWS) and the Physical Activity Scale for the Elderly (PASE). In a small sample in MA, we will use orthophotographs to create several micro-scale measures of the built environment (e.g., amenities for walking). To test for associations we will use multivariable modeling techniques that control for potential individual and environmental confounders. A key goal of this study is the development of methods that can be used in future prospective studies that may help elucidate causal pathways between the built environment and physical activity and obesity. Also, we anticipate using the findings from this study to design more effective physical activity interventions for older women that incorporate environmental strategies. Relevance: This study may yield new insights into how characteristics of neighborhood environments influence older women's participation in regular physical activity and information as to how these characteristics may be related to the risk of overweight and obesity. We plan to use this study's results to develop more effective initiatives to promote physical activity among older women that take into consideration neighborhood characteristics and resources. Ultimately, this study's findings may help to decrease the risk of several cancers related to lack of physical activity -- both among older adults and younger populations.