Developing Measures of the Built Nutritional Environment

描述（由申请人提供）：饮食和营养相关因素（包括肥胖）是仅次于烟草的癌症风险决定因素。研究人员和卫生专业人员越来越认识到建筑环境对健康结果和行为（如饮食和体育活动）的影响。一些研究现在提供的证据表明，社区中存在的食品店类型与饮食行为有关，例如食用推荐量的水果和蔬菜以及满足膳食脂肪建议。距离超市也可能影响饮食摄入质量。地理信息系统（GIS）技术的出现，使探索空间属性，如营养环境的流行病学研究的一个新的和有前途的领域。为了促进这种研究，必须通过严格和全面的过程来开发表征和量化营养环境的方法。本研究的主要目的是：1）利用经地面实况调查验证的数据源，建立一个时空上准确的、经过验证的关于一个城市和七个农村县营养环境的GIS数据库。2)制定和应用有意义的无障碍措施的空间营养环境数据库。这些指标将包括累积指数、累积机会指数和复杂的重力测量。3)为了评估营养可及性措施的统计特性，将其应用于研究和公共卫生目的的基础数据库。4)评估基于普查的人口和社会经济特征与营养环境可及性衡量标准之间的关联。拟议的研究将在几个方面具有开创性。这将是第一个严格评估的统计特性的营养可及性措施，利用地理信息系统技术，从而导致改善的测量和评估这一新的层面在营养流行病学。此外，还将对农村和城市的营养环境进行评估，这一点很重要，因为迄今为止在很大程度上被忽视的农村地区在基本地理和数据质量方面提出了额外的方法挑战。在拟议的研究中开发的方法有可能为研究和公共卫生实践做出高度创新的贡献。多层次的观察性研究和干预计划将能够在研究设计阶段建立这些社区水平对个人饮食行为影响的措施。此外，我们的研究将使公共卫生规划人员能够确定和针对营养环境不足的社区。 项目叙述拟议的营养环境可及性措施的研究可以作为流行病学研究和公共卫生实践的基础。多层次的观察性研究和干预计划将能够在研究设计阶段建立这些社区水平对个人饮食行为影响的措施。此外，我们的研究将使公共卫生规划人员能够确定和针对营养环境不足的社区。

DESCRIPTION (provided by applicant): Diet and nutrition-related factors including obesity are second only to tobacco as determinants of cancer risk. Researchers and health professionals increasingly are recognizing the influence of the built environment on health outcomes and behaviors such as diet and physical activity. Several studies now provide evidence that the types of food outlets present in a community are related to diet behaviors such as eating the recommended amounts of fruit and vegetables and meeting the dietary fat recommendations. Distance to a supermarket also may influence dietary intake quality. The advent of geographic information systems (GIS) technology has made the exploration of spatial attributes like the nutritional environment a novel and promising domain for epidemiologic research. To facilitate such research, methodology to characterize and quantify the nutritional environment must be developed through a rigorous and comprehensive process. The proposed study has the following aims: 1) To construct a spatially and temporally accurate and verified GIS database on the nutritional environment of one urban and seven rural counties utilizing available data sources verified by ground-truthing field work. 2) To develop and apply meaningful accessibility measures to the spatial nutritional environment database. These will include the cumulative index, the cumulative opportunity index and sophisticated gravity measures. 3) To evaluate the statistical properties of the nutritional accessibility measures in their applications to the underlying database for both research and public health purposes. 4) To evaluate the association of Census-based demographic and socio-economic characteristics with the accessibility measures of the nutritional environment. The proposed study will be groundbreaking in several ways. It will be the first to rigorously evaluate the statistical properties of the nutritional accessibility measures using GIS technology, thereby leading to improvements in the measurement and assessment of this novel dimension in nutritional epidemiology. Furthermore, it will be conducted on both rural and urban nutritional environments, which is important because rural areas, largely overlooked to date, present additional methodological challenges embedded in the underlying geography and data quality. The methodology developed in the proposed study has the potential to make a highly innovative contribution to both research and public health practice. Multi-level observational studies and intervention programs will be able to build upon these measures of community-level influences on individual dietary behaviors in their study design phase. Furthermore, our research will allow public health planners to identify and target communities with inadequate nutrition environments. Project Narrative The proposed study on accessibility measures of the nutritional environment can serve as the foundation for both epidemiologic research and public health practice. Multi-level observational studies and intervention programs will be able to build upon these measures of community-level influences on individual dietary behaviors in their study design phase. Furthermore, our research will allow public health planners to identify and target communities with inadequate nutrition environments.