Environments, Preferences and Childhood Obesity: Evidence From a Natural Experiment

环境、偏好和儿童肥胖：来自自然实验的证据

• 批准号: 9903282
• 负责人: ASHLESHA DATAR
• 金额: $ 88.48万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9903282
• 关键词: 13 year old; Address; Adolescent; Adolescent obesity; Aging; Attention; Behavior; Body Composition; Body Weight; Characteristics; Child; Data; Data Collection; Diet; Environment; Ethnic Origin; Exercise; Family; Funding; Future; Gender; Goals; Health; Health behavior; Heterogeneity; Home environment; Individual; Intervention; Joints; Link; Literature; Location; Measures; Methods; Military Personnel; Natural experiment; Neighborhoods; Obesity; Outcome; Parents; Persons; Phase; Play; Policies; Population; Public Health; Race; Research Design; Risk; Role; Self-control as a personality trait; Source; Subgroup; Surveys; Teenagers; Time; United States National Institutes of Health; Variant; Work; base; behavioral outcome; cohort; diet and exercise; experience; experimental study; high school; innovation; intergenerational; longitudinal analysis; novel; nutrition; obesity in children; obesogenic; policy implication; preference; socioeconomics

PROJECT SUMMARY Child and adolescent obesity continue to be serious public health challenges of the 21st century. Recently, the role of the built- and policy (B&P) environments in contributing to diet, activity and BMI has received significant attention. But, evaluating these relationships is challenging due to concerns about selection and heterogeneity. Individuals select neighborhoods based on preferences towards health and other factors, which may bias estimates. Because random assignment is infeasible, experts have called for natural- and quasi- experimental methods that leverage exogenous variation. Moreover, environments may not affect all individuals equally and can average out to small or null effects, yielding misleading conclusions. Such heterogeneity has thus far only been examined by demographic characteristics. However, evidence on environments’ effects is mixed even within these subgroups, suggesting that other factors may be at work. An emerging literature suggests that time-and risk (T&R) preferences (e.g. future-orientation and risk-aversion) may play such a role. T&R preferences vary considerably and have been linked with health behaviors. Therefore, it is possible that individuals who vary in their future-orientation and risk-aversion are differentially impacted by the B&P environment. However, to our knowledge, this has not been examined empirically. Adolescents represent a key subpopulation in which to study these issues; their obesity rates have quadrupled during the past thirty years, and their T&R preferences, health behaviors, and interactions with the B&P environment are evolving towards independence, making this a critical time for interventions. Our goal is to exploit a rare opportunity to estimate the effects of B&P environments on obesogenic behaviors and outcomes among adolescents while addressing selection and heterogeneity. We propose to expand our NIH-funded Military Teenagers’ Environment, Exercise, and Nutrition Study (M- TEENS), which leveraged a natural experiment due to the compulsory (re)location of Army families. M-TEENS collected up to 3 waves of data on diet, activity and BMI from 1519 12-13 year old children in Army families. Our proposed extension will collect 2 additional waves of data (2017 & 2018), yielding a 5-year longitudinal panel with rarely-available exogenous within-child changes in the B&P environment. A novel contribution of the proposed study is the examination of whether the environment’s effects vary by adolescents’ and their parents’ T&R preferences. This is a time-sensitive application; our cohort will complete high-school at the end of the proposed data collection, making their relocations and, therefore environments, less exogenous thereafter. This study is likely to have a high impact because it addresses a highly significant health issue, combines a natural experiment study design with longitudinal data, and is highly innovative in its focus on the role of adolescents’ and parents’ preferences in understanding environments’ effects.

项目总结 儿童和青少年肥胖仍然是21世纪严重的公共卫生挑战。最近， 建筑和政策(B&P)环境在促进饮食、活动和BMI方面的作用已经得到 重要的关注。但是，评估这些关系是具有挑战性的，因为对选择和 异质性。个人根据对健康和其他因素的偏好来选择社区，这 可能会对估计产生偏差。因为随机分配是不可行的，专家们呼吁自然-和准- 利用外源变异的实验方法。此外，环境可能不会影响所有人 每个人都是平等的，可以平均得出小的或零的影响，从而产生误导性的结论。是这样的 到目前为止，异质性只能通过人口统计特征来检验。然而，有证据表明 即使在这些亚群中，环境的影响也是复杂的，这表明其他因素可能在起作用。一个 新出现的文献表明，时间和风险(T&R)偏好(例如，面向未来和规避风险) 可能起到这样的作用。T&R偏好差异很大，并与健康行为有关。 因此，未来取向和风险厌恶程度不同的人有可能是不同的 受B&P环境的影响。然而，据我们所知，这还没有得到实证检验。 青少年是研究这些问题的关键人群；他们的肥胖率翻了两番。 以及他们的T&R偏好、健康行为以及与B&P的互动 环境正在朝着独立的方向发展，这使得现在是干预的关键时刻。我们的目标是 利用难得的机会评估B&P环境对肥胖的影响 在解决选择和异质性的同时，研究青少年的行为和结果。我们 建议扩大我们国家卫生研究院资助的军事青少年环境、锻炼和营养研究(M- 青少年)，这利用了一个自然的实验，因为强制(重新)安置军队家庭。M-青少年 从1519名12-13岁的军人家庭儿童中收集了多达3波关于饮食、活动和BMI的数据。 我们提议的延期将额外收集两波数据(2017和2018)，产生5年的纵向数据 在B&P环境中具有罕见的外源性儿童内部变化的小组。一项新的贡献 这项拟议的研究旨在检查环境对青少年的影响是否因青少年和青少年的不同而有所不同 父母的T&R偏好。这是一个时间敏感的申请；我们的同龄人将在 结束拟议的数据收集，使它们的位置重新定位，从而减少环境的外部影响 之后。这项研究可能会产生很大的影响，因为它解决了一个非常重要的健康问题， 将自然的实验研究设计与纵向数据相结合，在关注 青少年和父母的喜好在理解环境影响方面的作用。