Characterizing health impacts of built environment features using complex data

项目总结 背景和意义：已建成环境的特点和特定社区的可用性 资源限制了个人的选择，因此可能有助于采用和维护健康- 促进健康饮食和体力活动等行为，这反过来可能会影响 下游生物学指标(如体重指数)和临床结果(如心血管疾病)。新技术已经 迅速提高了将数据库与环境特征的地理参考信息相链接的能力 个人层面的健康数据，从而指数级地推动研究，检查 建筑环境与健康。这种关联的信息与临床实践高度相关，使其具有可行性 量身定做干预和治疗；以及使用大型数据库的新颖研究设计，如电子 健康记录，以调查建成环境因素和个人易感性对 健康和保健成果的范围。这些关联数据对于构建证据也很重要 支持寻求创造促进健康的环境的新兴城市设计战略。然而， 方法学上的挑战，包括暴露评估和选择偏差，使得很难确定 建筑环境对个人行为的真正影响，以及随之而来的基于场所的设计能力 改善健康的干预措施。目标、创新：该项目使用最先进的数据 解决住宅自选问题的纵向研究和方法，并开发和应用创新 应对测量挑战的方法。该项目将：(1)估计地理和时间 与社区资源的时变可用性和构建的影响相关的规模 关于重复测量健康行为、生物学和临床结果的环境特征，以及(1b) 量化不同个体和具体机制在地理和时间尺度上的差异； 开发和应用新的方法来确定和量化暴露在多种复杂环境中的情况 特征，并评估其对健康指标的同时影响；(3)量化测量的影响 估计关联的现有大型建成环境数据库中存在错误。建议的分析 将通过R软件包免费提供工具，并将结果传播给多个 观众，包括城市规划者。影响：该项目的结果将(A)提高 建筑环境过去、现在和未来研究的翻译、解释和证据合成 对健康的影响；(B)为科学家提供具体指导，说明如何使建筑的措施标准化 环境，并将其纳入大规模的个人健康数据库(例如，电子健康 记录)；以及(C)为下一代关于建筑的影响的研究提供最佳做法 环境对人口健康的影响。该项目将导致采取更准确和更 综合衡量多种环境因素对健康的影响。

PROJECT SUMMARY Background and significance: Features of the built environment and the availability of specific community resources constrain individuals’ choices and thus may contribute to the adoption and maintenance of health- promoting behaviors, such as eating healthy diets and engaging in physical activity, that in turn may affect downstream biological (e.g., BMI) and clinical outcomes (e.g., cardiovascular disease). New technologies have rapidly increased the ability to link databases with geo-referenced information on environmental features to individual-level health data, thereby exponentially propelling research that examines associations between the built environment and health. This linked information is highly relevant to clinical practice, making it feasible to tailor interventions and treatments; and to novel study designs that use large databases, such as electronic health records, to investigate the joint effects of built environment factors and individual susceptibility on a range of health and health care outcomes. These linked data are also important for building evidence to support emerging urban design strategies that seek to create environments that promote health. However, methodological challenges, including exposure assessment and selection biases, make it difficult to identify the true impact of the built environment on individual behaviors, and the consequent ability to design place-based interventions to improve health. Objectives, innovation: This project uses data from a state of the art longitudinal study and methods that address residential self-selection, and develops and applies innovative approaches to address measurement challenges. The project will: (1a) estimate the geographic and temporal scales that are relevant for the effects of time-varying availability of community resources and built environment features on repeated measures of health behaviors, biological and clinical outcomes, and (1b) quantify differences in geographic and temporal scales across individuals and specific mechanisms; (2) develop and apply novel methods to ascertain and quantify exposures to multiple, complex environmental features, and assess their simultaneous impact on health indicators; (3) quantify the impact of measurement error in existing large scale built environment databases on estimated associations. The proposed analytical tools will be made freely available through R software packages, and results will be disseminated to multiple audiences, including urban planners. Impact: Results from this project will (a) increase precision in the translation, interpretation and evidence synthesis of past, current, and future studies of built environment health effects; (b) provide scientists with specific guidance on how to standardize measures of the built environment, and incorporate them into large scale individual-level health databases (e.g., electronic health records); and (c) inform best practices for the next generation of research on the impact of the built environment on population health. The project will result in approaches to more accurately and comprehensively measure the impact of multiple environmental factors on health.