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，该模型认为健康行为是由建筑环境、社会环境、个体因素、环境特征和感知环境相互作用产生的。世界各地的卫生当局都建议使用遮阳处；然而，提供荫蔽需要昂贵的物理环境变化，并且只有在健康教育创造了促使其使用的社会环境（例如规范）和个人因素（例如习惯）时才可能有效。一个多国研究小组将探索在被动娱乐区使用人造树荫(pra；在公共公园内的社交、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，或人们散步观光、观看户外展览或购物时的区域，并比较美国和澳大利亚的使用情况，以前瞻性地测试社会环境对建筑环境的调节影响。初步研究证实，澳大利亚维多利亚州墨尔本的成年人比美国科罗拉多州丹佛市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)在丹佛和墨尔本的公共公园引入人造遮阳结构（即遮阳帆）；b)比较有和没有内置遮荫的PRAs的使用情况；c)比较丹佛和墨尔本引入人造树荫后的PRA使用变化，d)对PRA用户进行后测，考察社会环境、个人因素、环境小气候的其他物理特征（即设置）以及感知环境和人造树荫之间的关系。在这个为期60个月的项目中，研究团队将在公共公园的PRAs中建造遮荫帆，并在随机测试前-测试后对照设计中比较使用PRAs和未遮荫PRAs的情况。pra将按地点分层（丹佛80个，墨尔本80个），并在3年内随机分为3个样本波。在每个波浪中，将在第一个夏天对区域进行预测试，根据基线使用情况进一步分层，并在秋季，冬季和春季随机构建遮阳帆。公园审计将描述公园、PRA和社区环境。后测试将在次年夏天进行。总共有40个地方将被随机分配到建造遮阳帆的地方（每个城市20个），120个地方将被随机分配到没有遮阳帆的地方（每个城市60个）。主要结果测量将是观察使用PRAs的个体数量和他们的平均紫外线暴露（最小红斑剂量[MEDs]）。观察员将记录其他公园的使用情况、公园使用者人数、社会群体、防晒、性别和年龄。对PRA用户的拦截调查将收集有关社会环境、个人因素和感知环境的数据。紫外线计将测量紫外线水平。数据收集将在夏季16周内的4个工作日和4个周末进行。将对每天的pra和med的加权平均使用量进行初步分析；分析将进行调节和中介因素，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.