Exploratory Study of Environmental Effects on Activity/Overweight in Older Women

描述（由申请人提供）：缺乏运动和超重/肥胖是许多癌症的重要危险因素，包括乳腺癌和结肠癌。美国成年人的体育活动水平低于理想水平，肥胖也越来越普遍。越来越多的证据表明，社区建筑环境的某些方面会影响身体活动，而城市扩张等因素与超重有关。迄今为止的研究有重要的局限性，包括很少使用较小规模的客观环境测量，同时使用客观和感知环境测量的研究很少，以及对老年人的证据有限。在这项为期两年的探索性R21研究中，我们召集了一个由公共卫生、城市规划和地理领域经验丰富的跨学科研究人员组成的团队，在护士健康研究（NHS）中为老年妇女制定健全的建筑环境措施，并评估这些因素对身体活动、BMI、超重和肥胖的影响。我们的具体目标是：1)为三个州约30,000名NHS参与者开发家庭层面的建筑环境客观测量，并检查与身体活动和体重相关结果的横断面关联；2)测量3800名妇女对社区环境和体育活动的感知，评估感知和客观环境措施与关键结果之间的关联；3)试点测试使用高分辨率正射影像来开发几种微观尺度的建筑环境测量。我们将获得公开和商业上可用的地理信息系统（GIS）数据，以便为马萨诸塞州、宾夕法尼亚州和加利福尼亚州的国民保健服务参与者创建住宅密度、土地使用组合和街道连通性的家庭水平测量，并提供地理编码的家庭地址。我们将使用社区环境步行能力量表（NEWS）和老年人身体活动量表（PASE）对妇女进行调查。在马萨诸塞州的一个小样本中，我们将使用正射影像来创建几个微观尺度的建筑环境测量（例如，步行设施）。为了检验关联，我们将使用多变量建模技术来控制潜在的个人和环境混杂因素。本研究的一个关键目标是开发可用于未来前瞻性研究的方法，这可能有助于阐明建筑环境与体育活动和肥胖之间的因果关系。此外，我们期望利用这项研究的结果为老年妇女设计更有效的体育活动干预措施，其中包括环境策略。相关性：这项研究可能会对社区环境特征如何影响老年妇女参加定期体育活动以及这些特征如何与超重和肥胖风险相关的信息提供新的见解。我们计划利用这项研究的结果来制定更有效的举措，以促进老年妇女的体育活动，同时考虑到社区的特点和资源。最终，这项研究的发现可能有助于降低与缺乏体育锻炼有关的几种癌症的风险——无论是在老年人还是年轻人中。

DESCRIPTION (provided by applicant): Physical inactivity and overweight/obesity are important risk factors for a number of cancers, including breast and colon. Physical activity levels among U.S. adults are less than optimal and there is a growing epidemic of obesity. There is increasing evidence that certain aspects of the neighborhood built environment influence physical activity and that factors such as greater urban sprawl are related to overweight. Studies to-date have important limitations, including infrequent use of smaller scale objective environmental measures, scant research using both objective and perceived environmental measures, and limited evidence for older adults. For this two-year exploratory R21 study, we have assembled an experienced transdisciplinary team of researchers from public health, urban planning and geography to develop sound measures of the built environment for older women in the Nurses Health Study (NHS) and to assess the effects of these factors on physical activity, BMI, overweight, and obesity. Our specific aims are: 1) develop household-level objective measures of the built environment for approximately 30,000 NHS participants in three states and examine cross-sectional associations with physical activity and weight-related outcomes; 2) measure perceptions of neighborhood environment and physical activity in a sub-sample of 3800 women and assess associations between perceived and objective environmental measures and key outcomes; and 3) pilot test the use of high-resolution orthophotographs to develop several micro-scale measures of the built environment. We will obtain publicly and commercially available geographic information systems (GIS) data in order to create household-level measures of residential density, land use mix, and street connectivity for NHS participants in MA, PA, and CA with geocoded home addresses. We will survey women with the Neighborhood Environment Walkability Scale (NEWS) and the Physical Activity Scale for the Elderly (PASE). In a small sample in MA, we will use orthophotographs to create several micro-scale measures of the built environment (e.g., amenities for walking). To test for associations we will use multivariable modeling techniques that control for potential individual and environmental confounders. A key goal of this study is the development of methods that can be used in future prospective studies that may help elucidate causal pathways between the built environment and physical activity and obesity. Also, we anticipate using the findings from this study to design more effective physical activity interventions for older women that incorporate environmental strategies. Relevance: This study may yield new insights into how characteristics of neighborhood environments influence older women's participation in regular physical activity and information as to how these characteristics may be related to the risk of overweight and obesity. We plan to use this study's results to develop more effective initiatives to promote physical activity among older women that take into consideration neighborhood characteristics and resources. Ultimately, this study's findings may help to decrease the risk of several cancers related to lack of physical activity -- both among older adults and younger populations.