Reducing CVD risk/health disparities--active living

描述（由申请人提供）：心血管疾病（CVD）、癌症和糖尿病是美国发病率和死亡率的主要原因，但我们在预防这些昂贵且使人衰弱的慢性疾病方面无效。虽然需要改善行为筛查和咨询的计划和策略，但单靠医疗干预不足以预防心血管疾病和其他慢性病。与社会生态模型相一致，它指出了多层次影响健康的重要性，对建筑环境对CVD风险行为的影响的研究提供了一个令人信服的案例，将“积极生活”作为一种有效的社区CVD预防策略。斯台普顿开发项目是美国目前正在进行的最大的城市更新项目。斯台普顿位于丹佛空置的斯台普顿机场地面上，2001年开始由森林城市企业，开发商聘请领导这几十年的努力。它的4,700英亩（其中超过三分之一是专门为绿色空间）被设计为混合用途的社区，以提高积极的生活与口袋公园，步行和自行车道和宽阔的人行道和社区娱乐设施。目前，斯台普顿有近1,500个家庭，10年后将有3万多名居民。重要的是，它靠近邻近的种族和民族多元化和社会经济弱势社区，为以前经历过40多年机场噪音，交通和污染的居民提供了积极的生活设施。这种具有既定建筑环境的新城市飞地的发展是一种不寻常的情况，为了解社区发展及其对新社区和周围现有社区的健康和健康差异的影响提供了难得的机会。我们提出的项目符合最近的建议，以增加对预防心血管疾病的人群为基础的方法的影响的认识。我们将使用社区和文化相关的数据收集方法，以了解如何增加使用斯台普顿的积极的生活环境，以提高身体活动水平和心血管疾病的风险由斯台普顿和它附近的不同社区的居民。这项研究的一个重要资源将是一个基于社区的参与式研究（CBPR）过程，涉及斯台普顿和周围社区的不同居民（以下称为大斯台普顿社区）在解决这些复杂的问题。虽然斯台普顿在规划过程的早期就纳入了社区的投入，但该项目建立了一个正式的CBPR过程，为建立一个多样化和“渗透性”的积极生活社区创造了一个更广泛的社区方法。

DESCRIPTION (provided by applicant): Cardiovascular disease (CVD), cancer and diabetes are the leading causes of morbidity and mortality in the United States, yet we are ineffective in preventing these costly and debilitating chronic conditions. Although programs and strategies to improve behavioral screening and counseling are needed, health care interventions alone are inadequate for preventing CVD and other chronic diseases. Consistent with social ecological models, which point to the importance of multi-level influences on health, research on the impact of the built environment on CVD risk behaviors offers a compelling case for building "active living" into neighborhoods as an effective community-based CVD prevention strategy. The Stapleton development is the largest urban renewal project currently ongoing in the United States. Located on the vacated Stapleton Airport grounds in Denver, Stapleton's redevelopment began in 2001 by Forest City Enterprises, the developer hired to lead this multi-decade effort. Its 4,700 acres (of which more than one third is dedicated to green space) are designed as mixed-use neighborhoods to enhance active living with pocket parks, walking and bicycle trails and wide sidewalks and its community recreation facilities. Currently Stapleton has almost 1,500 families, and in 10 years will be home to over 30,000 residents. Importantly, its close proximity to adjacent neighborhoods that are racially and ethnically diverse and socio-economically disadvantaged, offers access to active living amenities to residents who previously experienced over 40 years of airport noise, traffic and pollution. This development of a new urban enclave with an established built environment is an unusual circumstance that presents exceptional opportunities for learning about community development and its impact on health and health disparities both in the new community and in the established communities surrounding it. Our proposed project fits with recent recommendations to increase knowledge of the impacts of population-based approaches for preventing cardiovascular disease. We will use community- and culturally-relevant data collection methods to understand how to increase use of Stapleton's active living environment to improve levels of physical activity and cardiovascular risk by residents of Stapleton and the diverse communities adjacent to it. An important resource for this research will be a community-based participatory research (CBPR) process that involves diverse residents of Stapleton and surrounding neighborhoods (hereinafter called the Greater Stapleton Community) in addressing these complex issues. Although Stapleton included community input early in its planning process, this project's establishment of a formalized CBPR process creates a more community-wide approach for building a diverse and "permeable" active living community.