The role of the contextual food environment and community programs and policies on diet and dietary disparities in the national Healthy Communities Study

背景食物环境和社区计划以及饮食政策和饮食差异在国家健康社区研究中的作用

• 批准号: 10730780
• 负责人: NATALIE COLABIANCHI
• 金额: $ 12.52万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730780
• 关键词: Address; Affect; African American; Ancillary Study; Area; Behavior; Behavioral; Beverages; Black race; Body mass index; Buffers; Businesses; Characteristics; Child; Communities; Community Developments; Consumption; Data; Data Analyses; Data Set; Diet; Dietary Fiber; Dietary intake; Disparity; Effectiveness; Energy Intake; Ethnic Origin; Ethnic Population; Familiarity; Food; Future; Geography; Grant; Health; Health Benefit; Healthy Eating; Heart Diseases; Hematological Disease; Hispanic; Home; Household; Individual; Inequity; Intake; Intercept; Intervention; Interview; Investments; Knowledge; Latino; Life; Link; Literature; Local Government; Lung diseases; Measures; Modeling; National Heart, Lung, and Blood Institute; Neighborhoods; Nutrition Policy; Nutritional; Outcome; Participant; Physical activity; Policies; Race; Reduce health disparities; Research; Restaurants; Role; Sampling; Schools; Shapes; Sleep Disorders; Socioeconomic Status; Subgroup; Supermarket; Unhealthy Diet; United States; Weight; community intervention; community organizations; community setting; community-level factor; contextual factors; cost effective; data integration; density; dietary; dietary guidelines; fast food; food consumption; food environment; fruits and vegetables; good diet; health disparity; health inequalities; improved; informant; low socioeconomic status; novel; nutrition; programs; racial difference; racial diversity; racial population; response; secondary analysis; sugar; sweetened beverage

ABSTRACT Unhealthy diets are associated with numerous deleterious health outcomes. Yet, most children do not consume a healthy diet, in particular Black/African American and Hispanic children, and children of low socio-economic status (SES). Previous studies have found that community characteristics influence diet but the effectiveness of community programs and policies (CPPs) to influence diet is not consistent across communities by racial/ethnic composition and community SES. The contextual food environment is an important consideration in understanding the effectiveness of CPPs on diet and may explain, in part, the differential effect of CPPs across subgroups. However, very few studies have examined what interventions are most effective for improving diet within community settings and there are even fewer national studies of how contextual factors influence food environment intervention outcomes. The proposed study will leverage existing NHLBI datasets with information on CPPs, contextual food environments, and child, household, neighborhood, school, and community characteristics that can affect child diet. The study includes over 4,500 children in grades K – 8 from diverse racial/ethnic and SES backgrounds in 130 communities in the United States. Nearly 10,000 CPPs were documented from over 1,400 key informant interviews within communities. Contextual food environment measures (e.g., density of supermarkets) in 1, 3, 5, and 8 km buffers around the home, and in a school-centric buffer, were derived from over 58 million business listings. The specific aims in this study are to 1) determine the effect of CPPs and the contextual food environment on diet including intake of energy-dense foods of minimal nutritional value; total added sugar intake; sugar intake from SSBs; fruit and vegetable intake; whole grain consumption; and fast food consumption, and 2) determine whether differences persist by race, ethnicity, and SES in the relationship between CPPs and diet once contextual food environment data are considered. To assess our aims, a generalized linear mixed model with random intercepts and slopes will be estimated controlling for clustering at the community level. The proposed study is cost-effective in that it entails secondary data analyses using linked data from two previous studies. The study is unique in its use of CPPs and contextual food environment measures at multiple geographic scales in a large, diverse national sample of children along with control variables at the child, household, neighborhood, school, and community levels. The findings are expected to help shape how future community investments in programs, interventions, and policies are tailored and implemented to improve children’s diets and to address diet-related health disparities early in life.

摘要