Physical Activity Impacts of a Planned Activity-Friendly Community: The What, Where, When and Why of Environmental Approaches to Obesity Prevention

 描述（由申请人提供）：身体活动（PA）有助于预防肥胖和减少慢性疾病，如癌症，糖尿病和心脏病，并可以通过环境/政策干预在人口水平上推广。然而，现有的经验知识环境PA的关系主要是基于横截面的研究，这提供了调查因果关系的外部因素的控制不足。此外，本发明还 关于环境因素如何影响PA的空间（在哪里）和时间（何时）模式以及这种影响的潜在机制（为什么），包括心理社会因素的潜在中介作用，知之甚少。本纵向个案比较研究的目的是探讨居民搬到活动友好型社区（AFC）后PA的短期和长期变化。它利用了一个独特而短暂的机会，在未来3年内，在一个大型的计划AFC中将建造约3000套新住宅。重点是那些目前久坐不动或活动不足，生活在缺乏PA支持的环境中的人。病例参与者（n~350）是从非AFC转移到该AFC且在转移前基线时不符合CDC PA指南的成年人。将根据性别和年龄（±5岁）将每例病例参与者与居住在其搬迁前非AFC中的对照参与者进行匹配，该对照参与者也是久坐不动或活动不足，并且至少两年（本项目的随访测量期）不计划搬迁。这项拟议研究的具体目的是：（1）检查总PA水平（每周分钟数）和PA的空间和时间模式（PA在社区内发生的比例，总PA的步行比例以及PA融入日常生活的水平）的短期和长期变化， 在久坐不动或活动不足的个人从非AFC移动到AFC之后;以及（2）确定哪些建筑和自然环境因素（例如密度、土地使用、人行道、小径/路径、公园、水景）直接或间接地通过影响与PA相关的心理社会因素导致这些人群中PA的变化。利用这一及时的机会，以获得纵向评估这一自然实验是至关重要的，以推进知识的健康和地方的交叉点，因为它涉及到促进PA的状态。跨学科研究团队在这个主题上有丰富的经验，并通过试点工作在这个研究社区。在本研究结束时，我们将确定更有力的证据支持AFC对人口水平行为变化的影响，这些行为变化朝着更积极的身体活动生活方式（短期目标）和减轻全国肥胖负担（长期目标）。

 DESCRIPTION (provided by applicant): Physical activity (PA) helps prevent obesity and reduce chronic conditions such as cancer, diabetes, and heart disease, and can be promoted through environmental/policy interventions at the population level. However, existing empirical knowledge on environment-PA relationships is primarily based on cross-sectional studies, which provide insufficient control of extraneous factors for investigating causal relationships. Further, little is known about how environmental factors affect spatial (where) and temporal (when) patterns of PA and the underlying mechanisms (why) of such impacts, including potential mediating effects of the psychosocial factors. The objective of this longitudinal, case-comparison study is to examine both short-term and long-term changes in PA after residents move to an activity-friendly community (AFC). It utilizes a unique and fleeting opportunity with ~3000 new homes being built in a large planned AFC over the next ~3 years. The focus is on those who are currently sedentary or insufficiently active and living in an environment lacking support for PA. Case participants (n~350) are those adults moving from non-AFCs to this AFC and not meeting the CDC guidelines for PA at pre-move baseline. Each case participant will be matched based on gender and age (±5 years) with a comparison participant who lives in his/her pre-move non-AFC, is also sedentary or insufficiently active, and is not planning to move for at least two years (this project's follow-up measurement period). The specific aims of this proposed study are to (1) examine the short-term and long-term changes in total PA levels (weekly minutes) and in spatial and temporal patterns of PA (proportion of PA taking place within the community, proportion of walking out of total PA, and level of PA integration into daily routines), after sedentary or insufficiently active individuals move from non-AFCs to an AFC; and (2) determine what built and natural environmental factors (e.g. density, land uses, sidewalks, trails/paths, parks, water features) lead to changes in PA among these populations, either directly or indirectly by affecting psychosocial factors related to PA. Using this timely opportuniy to gain longitudinal assessments for this natural experiment is of critical importance to advancing the status of knowledge on the intersection of health and place as it relates to promoting PA. The interdisciplinary research team has extensive experiences on this topic and in this study community through pilot work. At the conclusion of this study, we will have identified stronger evidence supporting the impact of an AFC on population-level behavior changes toward more physically active lifestyles (short-term goal) and toward lessening the burden of obesity throughout the nation (long-term goal).