Exploratory Study of Environmental Effects on Activity/Overweight in Older Women

描述（由申请人提供）：缺乏身体活动和超重/肥胖是许多癌症的重要风险因素，包括乳腺癌和结肠癌。美国成年人的体育活动水平低于最佳水平，肥胖症的流行日益严重。越来越多的证据表明，社区建筑环境的某些方面会影响身体活动，而城市扩张等因素与超重有关。迄今为止的研究有重要的局限性，包括很少使用较小规模的客观环境措施，缺乏研究使用客观和感知的环境措施，以及老年人的证据有限。在这项为期两年的探索性R21研究中，我们组建了一个经验丰富的跨学科研究团队，来自公共卫生，城市规划和地理学，以制定护士健康研究（NHS）中老年女性建筑环境的合理措施，并评估这些因素对身体活动，BMI，超重和肥胖的影响。我们的具体目标是：1）为三个州的约30，000名NHS参与者制定建筑环境的家庭级客观措施，并检查与身体活动和体重相关结果的横截面关联; 2）在3800名妇女的子样本中测量对邻里环境和身体活动的感知，并评估感知和客观环境措施与关键结果之间的关联;以及3）试验性地使用高分辨率正射摄影仪来开发若干微观尺度的建筑环境测量。我们将获得公开和商业上可用的地理信息系统（GIS）数据，以创建住宅密度，土地利用组合和街道连通性的家庭水平的措施，在MA，PA和CA的NHS参与者与地理编码的家庭地址。本研究将使用邻里环境步行能力量表（NEWS）和老年人体力活动量表（PASE）对女性进行调查。在MA的一个小样本中，我们将使用正射摄影来创建建筑环境的几个微观尺度测量（例如，步行的便利设施）。为了检验相关性，我们将使用多变量建模技术来控制潜在的个体和环境混杂因素。本研究的一个关键目标是开发可用于未来前瞻性研究的方法，这些方法可能有助于阐明建筑环境与体力活动和肥胖之间的因果关系。此外，我们预计使用这项研究的结果，为老年妇女设计更有效的身体活动干预措施，包括环境战略。相关性：这项研究可能会对社区环境的特征如何影响老年女性参与定期体育活动产生新的见解，并提供有关这些特征如何与超重和肥胖风险相关的信息。我们计划利用这项研究的结果，制定更有效的举措，以促进老年妇女的身体活动，考虑到邻里的特点和资源。最终，这项研究的发现可能有助于降低与缺乏体力活动有关的几种癌症的风险-无论是老年人还是年轻人。

DESCRIPTION (provided by applicant): Physical inactivity and overweight/obesity are important risk factors for a number of cancers, including breast and colon. Physical activity levels among U.S. adults are less than optimal and there is a growing epidemic of obesity. There is increasing evidence that certain aspects of the neighborhood built environment influence physical activity and that factors such as greater urban sprawl are related to overweight. Studies to-date have important limitations, including infrequent use of smaller scale objective environmental measures, scant research using both objective and perceived environmental measures, and limited evidence for older adults. For this two-year exploratory R21 study, we have assembled an experienced transdisciplinary team of researchers from public health, urban planning and geography to develop sound measures of the built environment for older women in the Nurses Health Study (NHS) and to assess the effects of these factors on physical activity, BMI, overweight, and obesity. Our specific aims are: 1) develop household-level objective measures of the built environment for approximately 30,000 NHS participants in three states and examine cross-sectional associations with physical activity and weight-related outcomes; 2) measure perceptions of neighborhood environment and physical activity in a sub-sample of 3800 women and assess associations between perceived and objective environmental measures and key outcomes; and 3) pilot test the use of high-resolution orthophotographs to develop several micro-scale measures of the built environment. We will obtain publicly and commercially available geographic information systems (GIS) data in order to create household-level measures of residential density, land use mix, and street connectivity for NHS participants in MA, PA, and CA with geocoded home addresses. We will survey women with the Neighborhood Environment Walkability Scale (NEWS) and the Physical Activity Scale for the Elderly (PASE). In a small sample in MA, we will use orthophotographs to create several micro-scale measures of the built environment (e.g., amenities for walking). To test for associations we will use multivariable modeling techniques that control for potential individual and environmental confounders. A key goal of this study is the development of methods that can be used in future prospective studies that may help elucidate causal pathways between the built environment and physical activity and obesity. Also, we anticipate using the findings from this study to design more effective physical activity interventions for older women that incorporate environmental strategies. Relevance: This study may yield new insights into how characteristics of neighborhood environments influence older women's participation in regular physical activity and information as to how these characteristics may be related to the risk of overweight and obesity. We plan to use this study's results to develop more effective initiatives to promote physical activity among older women that take into consideration neighborhood characteristics and resources. Ultimately, this study's findings may help to decrease the risk of several cancers related to lack of physical activity -- both among older adults and younger populations.