Neighborhood Built and Social Environment and Physical Activity and Weight Status

描述(申请人提供)：超重和肥胖是一系列健康问题的危险因素。超重和肥胖的患病率在美国人口的各个阶层中一直在稳步上升。在寻找肥胖流行的驱动因素时，超重/肥胖的研究现在集中在饮食和体力活动(PA)之间的平衡。为了应对肥胖症的流行，研究人员已经开始探索与肥胖相关的结果的更广泛的背景决定因素，希望找到新的方法来促进PA和遏制不断上升的肥胖潮。这项研究试图通过考察社区建筑环境和社会人口背景对美国个人PA和体重状况的影响程度来为文献做出贡献。为了指导本次调查，我们使用了社会认知理论和生态模型，并使用了多种数据来源，包括2000年人口普查数据、各种来源的基于地理信息系统的数据、其他基于地点的聚集数据和1999年至2008年连续的国民健康保险数据。我们问：1)背景构建环境和社会人口因素如何影响客观和主观测量的PA和权重状况，而不是个体特征？2)背景构建环境和社会人口因素在影响PA和体重状况时，有什么交互和中介作用？这些观察到的背景效应是否部分地由个体心理社会途径来调节？3)邻里因素如何与个体因素相互作用影响PA和体重状况？4)上述关系对当地邻里的地理聚集方式如何敏感？5)当地邻里之间的空间依赖如何影响上述分析产生的观察到的模式？这个项目在五个方面超越了当前的研究。首先，它考察了地区和县两级更广泛的基于地点的上下文特征。第二，这是一项覆盖整个美国的全国性研究。第三，它检查了对PA和体重状况的自我报告和客观评估。第四，它提供了一个独特的机会来检查多个级别的互动(例如，个人-邻里、邻里-县)。第五，它检验了文献中研究不足的假设，如可修改的面积单位问题和空间依赖问题。这个项目结合了社会学、城市规划、地理学和空间流行病学的观点；它将这些学科联系起来，形成研究，解决对PA的环境决定因素和体重状况研究至关重要的一系列问题。 公共卫生相关性：这项研究考察了人口普查地区和县一级的地理和背景因素与全国样本中个人水平的体力活动和体重之间的关系。建成环境和社会人口背景都将被考虑。鉴于美国肥胖症流行的上升趋势，近十年来，保持体重和减肥的研究、战略和计划已成为公共卫生的高度优先事项。

DESCRIPTION (provided by applicant): Overweight and obesity are risk factors for a range of health problems. The prevalence of overweight and obesity has been steadily rising among every segment of the U.S. population. In searching for factors driving the obesity epidemic, the overweight/obesity research is now focused on the balance between diet and physical activity (PA). To address the obesity epidemic, researchers have begun to explore the wider contextual determinants of obesity-related outcomes in hope of identifying new approaches to promoting PA and curbing the rising tide of obesity. This study attempts to contribute to the literature by examining the extent to which neighborhood built environments and socio-demographic contexts influence individual PA and weight status in the United States. To guide this investigation, we employ the social cognitive theory and ecological models and use multiple data sources including the 2000 Census data, GIS-based data from various sources, other place-based aggregate data, and continuous NHANES from 1999 to 2008. We ask: 1) How do contextual built environmental and socio-demographic factors affect objectively and subjectively measured PA and weight status over and above individual characteristics? 2) What are the interacting and mediating effects among contextual built environmental and socio-demographic factors in their impacts on PA and weight status? Are these observed contextual effects partly mediated by individual psychosocial pathways? 3) How do neighborhood factors interact with individual factors to impact PA and weight status? 4) How are the above relationships sensitive to geographic aggregation methods of local neighborhoods? 5) How does spatial dependency among local neighborhoods affect the observed patterns produced from the above analysis? This project goes beyond current research in five ways. First, it examines a wider range of place-based contextual features at both tract- and county-levels. Second, it is a national study covering the entire U.S. Third, it examines both self-reports and objective assessments of PA and weight status. Fourth, it provides a unique opportunity to examine interactions across a number of levels (e.g., individual- neighborhood, neighborhood-county). Fifth, it tests under-studied hypotheses in this literature such as the Modifiable Areal Unit Problem and the spatial dependency issues. This project combines perspectives from sociology, urban planning, geography, and spatial epidemiology; it bridges these disciplines to formulate research that addresses a set of questions vital to research on environmental determinants of PA and weight status. PUBLIC HEALTH RELEVANCE: This study examines how geographic and contextual factors at census tract level and county level are associated with individual-level physical activity and body weight in a national sample. Both the built environments and socio-demographic contexts will be considered. Given the rising tide of the obesity epidemic in the United States, research, strategies and programs for weight maintenance and weight reduction have become a high public health priority in the recent decade.