Urban Transportation Infrastructure and Weight

项目摘要/摘要 每三个美国成年人中就有一个以上患有肥胖症，非洲人中肥胖的比例更高 美国人和拉美人。虽然行为体重管理干预的范围往往有限，而且 只与暂时的小幅减肥有关，环境干预，如提供 支持体育活动的基础设施，有可能惠及大部分人口并促进 持久的体重控制。主动交通基础设施(ATI)由支持安全的物理结构组成 步行和骑自行车，包括人行道、自行车道和小路，以及与彩绘行人的十字路口 人行横道或行人信号灯。到目前为止，人们对邻居ATI和ATI之间的关系知之甚少 个人体重指数(BMI)。利用来自多个来源的次要数据，拟议的观测 研究将确定：(A)生活在ATI较高社区的成年人是否有更健康的BMI和(B) 生活在ATI更高社区的成年人在体重管理计划中减掉的体重比 那些住在ATI较少的社区的人。它还将检查这些关系是否有以下不同 种族/民族。样本将由城市体重和退伍军人的子样本(n=232,000成年人)组成 环境研究(WAVE)I，这是一项全国性的回溯性纵向研究，涉及320多万人 2009至2015年间从美国退伍军人事务部获得医疗保健的退伍军人 (R01CA172726)。使用OpenStreetMap数据，将构建创新的邻里ATI测量， 包括人行道和自行车道或小路的可用性和密度以及行人交叉路口的安全。 多变量回归将估计ATI和BMI之间的关联。这项研究将提供重要的 有证据表明，通过政策和环境修改来加强ATI是否可能有所帮助 人们达到或保持更健康的体重。除了支持完成拟议的 在这项研究中，这项研究金将为首席调查员提供额外的研究培训，包括统计方面的培训 分析(例如，二级、纵向和空间数据分析)。这些经验和技能将提供 为专注于改善城市环境的独立研究事业奠定坚实的基础 人口和个人健康结果。

Project Summary/Abstract Obesity affects more than one out of every three U.S. adults and even higher proportions of African Americans and Latinos. While behavioral weight management interventions tend to have limited scope and are associated with only temporary small weight loss, environmental interventions, such as the provision of infrastructure to support physical activity, have the potential to reach large portions of the population and foster lasting weight control. Active transportation infrastructure (ATI) consists of physical structures that support safe walking and bicycling and include sidewalks, bicycle lanes and paths, and intersections with painted pedestrian crosswalks or pedestrian signals. To date, little is known about the relationship between neighborhood ATI and individual body mass index (BMI). Using secondary data from multiple sources, the proposed observational study will determine whether (a) adults who live in a neighborhood with greater ATI have healthier BMI and (b) adults who live in a neighborhood with greater ATI lose more weight in a weight management program than those living in a neighborhood with less ATI. It will also examine whether these relationships differ by race/ethnicity. The sample will consist of an urban subsample (n=232,000 adults) of the Weight And Veterans Environments Study (WAVES) I, which is a nationwide, retrospective longitudinal study of over 3.2 million veterans receiving healthcare from the U.S. Department of Veterans Affairs between 2009 and 2015 (R01CA172726). Using OpenStreetMap data, innovative neighborhood ATI measures will be constructed, including availability and density of sidewalks and bicycle lanes or paths and pedestrian intersection safety. Multivariable regression will estimate associations between ATI and BMI. This study will provide important evidence about whether enhancing ATI through policies and environmental modifications is likely to help people achieve or maintain a healthier body weight. In addition to supporting the completion of the proposed study, this fellowship will support additional research training for the principal investigator including in statistical analysis (e.g., secondary, longitudinal, and spatial data analysis). These experiences and skills will provide a strong foundation for an independent research career focused on enhancing urban environments to improve population and individual health outcomes.