Norms and Built Environment: Use of Shade in U.S. and Australian City Parks

描述（由申请人提供）：本研究旨在了解阴影发展在皮肤癌预防中的价值，并测试社会生态模型的预测，即健康行为源于建筑环境，社会环境，个人因素，设置特征和感知环境之间的相互作用。全世界的卫生当局都建议使用树荫;然而，提供树荫需要昂贵的物理环境改变，只有当健康教育创造了一个社会环境（例如，规范）和个体因素（例如，习惯（habits），这是它的使用动机。一个多国研究小组将探索在被动休闲区使用建筑遮阳（PRA;用于在社交、准备/吃饭、观看或指导运动、观看音乐会、上课或等待时坐/站的区域，或者人们在观看户外显示器时漫步观光的区域，或购物），并比较美国和澳大利亚之间的使用，以前瞻性地测试社会环境对建筑环境的调节影响。试点研究证实，澳大利亚维多利亚墨尔本的成年人比美国科罗拉多丹佛的成年人有更强的防晒习惯和规范。该项目的具体目标是：a）引入建造的遮阳结构（即，遮阳帆）在丹佛和墨尔本的公共公园中; B）比较有和没有建筑遮阳的PRA的使用; c）比较在引入建筑遮阳后丹佛和墨尔本的PRA的使用的变化，以及d）检查社会环境、个体因素、环境微气候的其他物理特征（即，设置），并与PRA用户的后测感知环境和建筑阴影。在这个为期60个月的项目中，研究小组将在公园的PRA上建造遮阳帆，并在随机的前后测控制设计中比较PRA和未遮阳PRA的使用。PRA将按位置分层（丹佛80例，墨尔本80例），并在3年内随机分配至3个样本波之一。在每一波中，区域将在第一个夏天进行预测试，根据基线使用情况进一步分层，并在秋季、冬季和春季随机建造遮阳帆。公园审计将描述公园，PRA和社区设置。测试将在明年夏天进行。总共将40个PRA随机分配至遮阳帆结构（每个城市20个），120个PRA随机分配至无遮阳帆的对照组（每个城市60个）。主要结局指标将是观察使用PRA的个体数量及其平均紫外线暴露量（最小暴露剂量[MED]）。观察员将记录其他PRA的使用情况、公园使用者人数、社会群体、防晒、性别和年龄。拦截PRA用户的调查将收集有关社会环境，个人因素和感知环境的数据。紫外线测量仪将测量紫外线水平。数据收集将在夏季的16周内的4个工作日和4个周末进行。将对PRA和MED每日的加权平均使用进行主要分析;将对调节和中介因素进行分析，以检验理论推导的假设。

DESCRIPTION (provided by applicant): This study is designed to understand the value of shade development in skin cancer prevention and test predictions from social ecologic models that health behavior results from the interplay among the built environment, social environment, individual factors, setting features, and perceived environment. Use of shade is recommended by health authorities worldwide; however, shade provision requires expensive physical environment changes and may be effective only when health education has created a social environment (e.g., norms) and individual factors (e.g., habits) that motivates its use. A multi-national research team will explore the use of built shade in passive recreation areas (PRAs; areas for sitting/ standing while socializing, preparing/eating a meal, watching or coaching sports, watching a concert, taking a class, or waiting, or areas where people stroll for sightseeing, while observing outdoor displays, or shopping) within public parks and compare use between the United States and Australia to prospectively test the moderating influence of social environment on the built environment. Pilot studies confirmed that adults in Melbourne, Victoria, Australia had stronger sun protection habits and norms than adults in Denver, Colorado, USA. The specific aims of the project are to: a) introduce built shade structures (i.e., shade sails) in public parks in Denver and Melbourne; b) compare the use of PRAs with and without built shade; c) compare the change in use of the PRAs in Denver and Melbourne after introduction of built shade, and d) examine the relationship among social environment, individual factors, other physical features of the environment micro-climate (i.e., setting), and perceived environment and built shade in posttest with PRA users. In this 60-month project, the research team will build shade sails at PRAs in public parks and compare use of PRAs to unshaded PRAs in a randomized pretest- posttest controlled design. PRAs will be stratified by location (80 in Denver and 80 in Melbourne) and randomized to one of 3 sample waves over 3 years. In each wave, areas will be pretested in a first summer, further stratified based on baseline use, and randomized to construction of a shade sail during the fall, winter, and spring. A park audit will describe the park, PRA and neighborhood setting. Post testing will occur the following summer. In total, 40 PRAs will be randomized to shade sail construction (20 per city) and 120 PRAs to control with no shade sails (60 per city). The primary outcome measures will be observation of the number of individuals using the PRAs and their average UV exposure (in minimal erythemal doses [MEDs]). Observers will record use of other PRAs, number of park users, social group, sun protection, gender, and age. Intercept surveys with PRA users will collect data on social environment, individual factors, and perceived environment. UV meters will measure UV levels. Data collection will occur on 4 weekdays and 4 weekend days over 16-weeks in the summer. Primary analyses will be performed on the weighted average use of PRAs and MEDs per day; analyses will be conducted on moderating and mediating factors to test theoretically-derived hypotheses.