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

 描述(由申请者提供)：体力活动(PA)有助于预防肥胖和减少癌症、糖尿病和心脏病等慢性疾病，并可通过人口层面的环境/政策干预来促进。然而，现有的关于环境-PA关系的经验知识主要是基于横断面研究，这些研究不足以控制外部因素来调查因果关系。此外， 关于环境因素如何影响PA的空间(地点)和时间(时间)模式以及这种影响的潜在机制(原因)，包括心理社会因素的潜在中介效应，人们知之甚少。这项纵向病例对照研究的目的是考察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，一个大型规划的亚足联将建造约3000套新住房。重点是那些目前久坐不动或活动不足的人，他们生活在缺乏PA支持的环境中。病例参与者(n~350)是那些从非AFC迁移到本AFC且在迁移前基线不符合疾病预防控制中心关于PA的指南的成年人。每个病例参与者将根据性别和年龄(±5岁)与一名对照参与者配对，该参与者居住在搬家前的非AFC，也是久坐不动或活动不足，并且至少两年内(本项目的后续测量期)不打算搬家。这项研究的具体目的是(1)考察PA总水平(每周分钟)以及PA的时空模式(PA发生在社区内的比例，走出总PA的比例，以及PA融入日常生活的程度)的短期和长期变化， 在不活动或不够活跃的个体从非AFC搬到AFC后，研究人员将：(1)确定哪些建筑和自然环境因素(如密度、土地利用、人行道、步道/小径、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，导致这些人群的PA发生变化。利用这一及时的机会获得对这一自然实验的纵向评估，对于提高健康和地点交叉知识的地位至关重要，因为这与促进PA有关。跨学科研究团队在这一主题上以及通过试点工作在这个研究领域拥有丰富的经验。在这项研究的结论中，我们将确定更有力的证据，支持AFC对人群水平的行为变化的影响，转向更多体育活动的生活方式(短期目标)和减轻全国范围内的肥胖负担(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).