Norms and Built Environment: Use of Shade in U.S. and Australian City Parks

描述(申请人提供)：这项研究旨在了解遮阳发展在皮肤癌预防中的价值，并测试来自社会生态模型的预测，即健康行为是建筑环境、社会环境、个人因素、环境特征和感知环境之间相互作用的结果。全世界的卫生当局都建议使用遮阳物；然而，提供遮阳物需要改变昂贵的物理环境，只有在健康教育创造了鼓励使用遮阳物的社会环境(例如，规范)和个人因素(例如，习惯)时，才可能有效。一个跨国研究团队将探索在公园内的被动娱乐区(PRA；社交、准备/就餐、观看或指导体育运动、观看音乐会、上课或等待时坐/站的区域，或人们散步观光、观看户外展示或购物的区域)中使用建筑阴影的情况，并比较美国和澳大利亚的使用情况，以前瞻性地测试社会环境对建筑环境的缓和影响。初步研究证实，澳大利亚维多利亚州墨尔本的成年人比美国科罗拉多州丹佛市的成年人有更强的防晒习惯和规范。项目的具体目标是：a)在丹佛和墨尔本的公园中引入已建遮荫结构(即遮阳帆)；b)比较有遮荫和未遮荫的PRA的使用情况；c)比较引入遮荫后丹佛和墨尔本的PRA使用的变化；d)检查社会环境、个人因素、其他环境小气候物理特征(即环境)、感知环境和PRA使用者后测试中构建的遮荫之间的关系。在这个为期60个月的项目中，研究小组将在公园的PRA建造遮阳帆，并在随机的前测-后测对照设计中比较使用PRA和未遮挡的PRA。PRA将按地点分层(丹佛80个，墨尔本80个)，并在3年内随机分配到3个样本波中的一个。在每一波中，将在第一个夏天对区域进行预先测试，根据基线使用情况进一步分层，并在秋季、冬季和春季随机建造遮阳帆。公园审计将描述公园、PRA和社区环境。开机自检将在明年夏天进行。总共有40个PRA将被随机分成遮阳帆建造组(每个城市20个)和120个没有遮阳帆的PRA对照组(每个城市60个)。主要的结果指标将是观察使用PRA的个体数量和他们的平均紫外线暴露(以最小红斑剂量[MED])。观察者将记录其他PRA的使用情况、公园使用者的数量、社会群体、防晒、性别和年龄。与PRA用户进行的拦截调查将收集有关社会环境、个人因素和感知环境的数据。紫外线测量仪将测量紫外线水平。数据收集将在夏季的4个工作日和4个周末进行，为期16周。初步分析将对每日PRAs和MED的加权平均使用情况进行分析；将对调节因素和中介因素进行分析，以检验从理论上得出的假设。

DESCRIPTION (provided by applicant): This study is designed to understand the value of shade development in skin cancer prevention and test predictions from social ecologic models that health behavior results from the interplay among the built environment, social environment, individual factors, setting features, and perceived environment. Use of shade is recommended by health authorities worldwide; however, shade provision requires expensive physical environment changes and may be effective only when health education has created a social environment (e.g., norms) and individual factors (e.g., habits) that motivates its use. A multi-national research team will explore the use of built shade in passive recreation areas (PRAs; areas for sitting/ standing while socializing, preparing/eating a meal, watching or coaching sports, watching a concert, taking a class, or waiting, or areas where people stroll for sightseeing, while observing outdoor displays, or shopping) within public parks and compare use between the United States and Australia to prospectively test the moderating influence of social environment on the built environment. Pilot studies confirmed that adults in Melbourne, Victoria, Australia had stronger sun protection habits and norms than adults in Denver, Colorado, USA. The specific aims of the project are to: a) introduce built shade structures (i.e., shade sails) in public parks in Denver and Melbourne; b) compare the use of PRAs with and without built shade; c) compare the change in use of the PRAs in Denver and Melbourne after introduction of built shade, and d) examine the relationship among social environment, individual factors, other physical features of the environment micro-climate (i.e., setting), and perceived environment and built shade in posttest with PRA users. In this 60-month project, the research team will build shade sails at PRAs in public parks and compare use of PRAs to unshaded PRAs in a randomized pretest- posttest controlled design. PRAs will be stratified by location (80 in Denver and 80 in Melbourne) and randomized to one of 3 sample waves over 3 years. In each wave, areas will be pretested in a first summer, further stratified based on baseline use, and randomized to construction of a shade sail during the fall, winter, and spring. A park audit will describe the park, PRA and neighborhood setting. Post testing will occur the following summer. In total, 40 PRAs will be randomized to shade sail construction (20 per city) and 120 PRAs to control with no shade sails (60 per city). The primary outcome measures will be observation of the number of individuals using the PRAs and their average UV exposure (in minimal erythemal doses [MEDs]). Observers will record use of other PRAs, number of park users, social group, sun protection, gender, and age. Intercept surveys with PRA users will collect data on social environment, individual factors, and perceived environment. UV meters will measure UV levels. Data collection will occur on 4 weekdays and 4 weekend days over 16-weeks in the summer. Primary analyses will be performed on the weighted average use of PRAs and MEDs per day; analyses will be conducted on moderating and mediating factors to test theoretically-derived hypotheses.