Obesity and Neighborhood Characteristics

描述（由申请人提供） 美国目前的肥胖流行病主要归因于行为和社会生态因素。 个人层面的预防方法效果有限，突出表明需要改变政治、社会经济和物质环境，以促进个人行为的改变。 这一研究领域的一个优先事项是开发适用于地方一级的测量技术，并根据国家和州的数据收集系统，帮助评估邻里环境变化可能对健康产生的影响。 这个R21项目将开发邻里环境因素（NEF）的措施，并量化它们与个人肥胖状况的关系。 邻里的运作概念是康涅狄格州、马萨诸塞州和罗得岛的乡镇--公务员、卫生机构和土地使用规划委员会运作的最低级别的市政府。 具体而言，该项目将： 1)制定城镇一级的5个关键NEFs的措施，并评估其可靠性。 五个环境要素包括餐厅可达性、超市可达性、运动设施可达性、安全性和土地利用组合模式; 2)在调整个人和城镇社会经济地位后，评估NEF与个人肥胖状况、体育活动水平和水果蔬菜消费量的相关性; 3)在预防肥胖的背景下，使用NEF的简约子集和城镇级社会经济地位指标，制定城镇级邻里质量指数（或指数）。 邻里环境变量将使用来自Info USA商业登记处、美国人口普查局和州地理信息系统中心的数据库。 使用行为风险因素监测系统（BRFSS）的数据，他们的关系，个人肥胖状况，体力活动和水果和蔬菜的消费将检查分层线性或广义线性混合模型，同时考虑抽样概率和测量误差。 将评估将研究扩展到更大地理区域的可行性，并准备R 01赠款申请。

DESCRIPTION (provided by applicant) The current obesity epidemic in the US is largely attributed to behavioral and social ecological factors. Limited efficacies of individual-level approaches to prevention highlight the need for modifications in the political, socioeconomic and physical environment to facilitate individual behavior change. A priority in this area of research is to develop measurement techniques that are applicable at the local level and would help evaluate the likely health effects of neighborhood environmental changes based on national and state data collection systems. This R21 project will develop measures of neighborhood environmental factors (NEFs) and quantify their relationship to individuals' obesity status. The operating concept of neighborhood is the township in Connecticut, Massachusetts and Rhode Island - the lowest level of municipal government at which civil services, health agencies and land use planning boards operate. Specifically, this project will: 1) Develop town-level measures of 5 key NEFs and assess their reliability. The five NEFs include restaurant accessibility, supermarket accessibility, exercise facility accessibility, safety and land use mix pattern; 2) Assess the association of the NEFs with individual's obesity status, level of physical activity and amount of fruit and vegetable consumption, after adjusting for individual- and town-level socioeconomic status; 3) Develop a town-level Neighborhood Quality Index (or indices) in the context of prevention of obesity using a parsimonious subset of the NEFs, and town-level socioeconomic status indicators. The neighborhood environmental variables will be derived using databases compiled from Info USA business registry, US Census, and state Geographic Information Systems centers. Using the Behavioral Risk Factors Surveillance System (BRFSS) data, their relations to individual obesity status, physical activity and fruit and vegetable consumption will be examined with hierarchical linear or generalized linear mixed models while accounting for sampling probability and measurement error. The feasibility of extending the research into a larger geographic region will be assessed, and a R01 grant application will be prepared.