Improving safety and access for physical activity supplement

描述（由申请人提供）：本项目的总体目标是扩大正在进行的NIH赠款“改善安全和获得身体活动”（积极行动为今天的健康（PATH）：R01 DK 067615）的评估。具体来说，这个补充项目将增加跟踪观察和空间分析，以提高我们对PATH干预措施如何工作的理解。PATH试验中的两个社区被随机分配接受社会营销加警察巡逻步行计划或警察巡逻步行干预。我们已经制定了进行系统的跟踪使用观察和审计的物理路径相关的环境协议，并制定了相关的社会环境因素（社区连通性，集体效能，社交网络，社会支持）的额外的个人水平的措施，这个补充项目。南卡罗来纳州营养研究联合会提供了内部过渡资金，使我们能够在开始PATH干预之前对这些措施进行基线评估。这 拟议的补充项目将支持12个月、18个月和24个月的试验观察，这将为PATH提供第二个主要结局，并加深我们对社会营销干预如何与24个月干预期间社会因素、适度体力活动（MPA）和试验使用的改善相关的理解。共有260名参与者（每个社区130人）将成为这项补充赠款的重点（迄今已招募219人）。补充项目的主要目的将是研究1）社会营销中的步道使用加上警察巡逻步行与警察巡逻步行的社区，2）家庭接近步行道和步道使用的住宅集群如何与个人水平的社会环境变量相关联，以及3）从基线到12个月、18个月和24个月，社会营销干预参与者个体水平社会因素的改善如何介导MPA和试验使用的变化。公共卫生相关性：拟议的研究的好处将包括增加我们对社会营销的理解，接近步行道，以及在某些住宅区较高的步道使用集群与低收入，高暴力社区的体育活动和步道使用的社会和物理环境决定因素的变化有关。了解在服务不足的社区促进体育活动的社会和物理环境机制将最终降低美国的肥胖率，慢性病和医疗保健费用。

DESCRIPTION (provided by applicant): The overall goal of this project is to expand on the evaluation of an ongoing NIH grant "Improving Safety and Access for Physical Activity" (Positive Action for Today's Health (PATH): R01 DK067615). Specifically this supplemental project will add trail observations and spatial analyses to enhance our understanding of how the PATH interventions may work. Two communities in the PATH trial have been randomized to receive a social marketing plus police patrolled-walking program or a police patrolled walking only intervention. We have developed protocols for conducting systematic trail use observations and audits of the physical trail-related environment and have developed additional individual level measures of related social environmental factors (community connectedness, collective efficacy, social networks, social support) for this supplemental project. Internal bridge funds have been provided by the South Carolina Research Nutrition Consortium to allow us to conduct baseline assessments of these measures prior to beginning the PATH interventions. This proposed supplement project would support the 12-month, 18-month and 24-month trail observations which will provide a second primary outcome for PATH as well as enhance our understanding of how the social marketing intervention is related to improvements in social factors, moderate physical activity (MPA) and trail use over the 24-month intervention. A total of 260 (130 per community) participants will be the focus of this supplement grant (219 recruited to date). The primary aims of the supplemental project will be to examine 1) trail use in the social marketing plus police patrolled walking vs. police patrolled-walking only communities, 2) how, household proximity to the walking trails and residential clustering of trail use are associated with individual level social environmental variables, and 3) how changes in MPA and trail use are mediated by improvements in individual level social factors in social marketing intervention participants from baseline to 12-months, 18-months and 24-months. PUBLIC HEALTH RELEVANCE: The benefits of the proposed research will include increasing our understanding about how social marketing, proximity to the walking trails, and clustering of higher trail use in certain residential areas relates to changes in the social and physical environmental eterminants of physical activity and trail use in low-income, high violent communities. Understanding the social and physical environmental mechanisms in promoting physical activity in underserved communities will ultimately reduce the rate of obesity, chronic disease, and health care costs in the United States.