Developing Measures of the Built Nutritional Environment

描述（由申请人提供）：包括肥胖在内的饮食和营养相关因素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多地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。现在有几项研究提供了证据，表明一个社区中存在的食品销售点的类型与饮食行为有关，比如吃推荐量的水果和蔬菜，满足膳食脂肪推荐量。离超市的距离也可能影响饮食摄入的质量。地理信息系统（GIS）技术的出现使得对营养环境等空间属性的探索成为流行病学研究的一个新的、有前景的领域。为了促进这种研究，必须通过严格和全面的过程来发展表征和量化营养环境的方法。本研究的主要目的是：1)利用实地调查验证的现有数据来源，构建一个时空准确且经过验证的1个城市县和7个农村县的营养环境GIS数据库。2)开发并应用有意义的空间营养环境数据库可达性测度。这些将包括累积指数、累积机会指数和复杂的重力测量。3)评价营养可及性指标在基础数据库中用于研究和公共卫生目的的统计特性。4)评价基于人口普查的人口和社会经济特征与营养环境可及性措施之间的关系。这项拟议中的研究将在几个方面具有开创性。这将是第一个使用GIS技术严格评估营养可及性测量的统计特性，从而导致营养流行病学中这一新维度的测量和评估的改进。此外，它将对农村和城市营养环境进行研究，这一点很重要，因为农村地区迄今在很大程度上被忽视，在基础地理和数据质量方面提出了额外的方法挑战。拟议研究中制定的方法有可能对研究和公共卫生实践作出高度创新的贡献。在研究设计阶段，多层次观察研究和干预计划将能够建立在这些社区层面对个人饮食行为影响的测量之上。此外，我们的研究将使公共卫生规划者能够确定和瞄准营养环境不足的社区。提出的营养环境可及性措施研究可作为流行病学研究和公共卫生实践的基础。在研究设计阶段，多层次观察研究和干预计划将能够建立在这些社区层面对个人饮食行为影响的测量之上。此外，我们的研究将使公共卫生规划者能够确定和瞄准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.