Communities

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The way communities are designed has a great influence on how active we are. When communities are safe, well-maintained and have appealing scenery, children and families are more likely to be active. Unfortunately, many people—especially those at high risk for obesity—live in communities that lack parks and have high crime rates, dangerous traffic patterns and unsafe sidewalks.  Such communities discourage residents from walking, bicycling and playing outside. Increasingly, local governments are considering how community design will impact residents’ physical activity. Our research documents effective strategies for creating communities that support active living and promote health.

View The Role of Communities in Promoting Physical Activity infographic.

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Physical Activity and Food Environment Assessments: Implications for Practice

Date: 
05/01/2015
Description: 

Eyler, A. A., Blanck, H. M., Gittelsohn, J., Karpyn, A., McKenzie, T. L., Partington, S., et al. (2015). Physical Activity and Food Environment Assessments: Implications for Practice. American Journal of Preventive Medicine, 48(5), 639-645.

Abstract: 

There is growing interest in the use of physical activity and nutrition environmental measures by both researchers and practitioners. Built environment assessment methods and tools range from simple to complex and encompass perceived, observed, and geographic data collection. Even though challenges in tool selection and use may exist for non-researchers, there are opportunities to incorporate these measures into practice. The aims of this paper are to (1) describe examples of built environment assessment methods and tools in the practice context; (2) present case studies that outline successful approaches for the use of built environment assessment tools and data among practitioners; and (3) make recommendations for both research and practice. As part of the Built Environment Assessment Training Think Tank meeting in July 2013, experts who work with community partners gathered to provide input on conceptualizing recommendations for collecting and analyzing built environment data in practice and research. The methods were summarized in terms of perceived environment measures, observational measures, and geographic measures for physical activity and food environment assessment. Challenges are outlined and case study examples of successful use of assessments in practice are described. Built environment assessment tools and measures are important outside the research setting. There is a need for improved collaboration between research and practice in forming partnerships for developing tools, collecting and analyzing data, and using the results to work toward positive environmental changes.

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Technologies to Measure and Modify Physical Activity and Eating Environments

Date: 
05/01/2015
Description: 

King, A. C., Glanz, K., & Patrick, K. (2015). Technologies to Measure and Modify Physical Activity and Eating Environments. American Journal of Preventive Medicine, 48(5), 630-638.

This paper is part of a special themed section in AJPM, funded by Active Living Research, Healthy Eating Research, and the University of Pennsylvania, highlighting outcomes from a Built Environment and Assessment Training (BEAT) Institute Think Tank meeting on the state of science and practice in environmental assessment.

Abstract: 

CONTEXT: The explosion of technologic advances in information capture and delivery offers unparalleled opportunities to assess and modify built and social environments in ways that can positively impact health behaviors. This paper highlights some potentially transformative current and emerging trends in the technology arena applicable to environmental context-based assessment and intervention relevant to physical activity and dietary behaviors. EVIDENCE ACQUISITION: A team of experts convened in 2013 to discuss the main issues related to technology use in assessing and changing built environments for health behaviors particularly relevant to obesity prevention. Each expert was assigned a specific domain to describe, commensurate with their research and expertise in the field, along with examples of specific applications. This activity was accompanied by selective examination of published literature to cover the main issues and elucidate relevant applications of technologic tools and innovations in this field. EVIDENCE SYNTHESIS: Decisions concerning which technology examples to highlight were reached through discussion and consensus-building among the team of experts. Two levels of impact are highlighted: the “me” domain, which primarily targets measurement and intervention activities aimed at individual-level behaviors and their surrounding environments; and the “we” domain, which generally focuses on aggregated data aimed at groups and larger population segments and locales. CONCLUSIONS: The paper ends with a set of challenges and opportunities for significantly advancing the field. Key areas for progress include data collection and expansion, managing technologic considerations, and working across sectors to maximize the population potential of behavioral health technologies.

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Food and Physical Activity Environments: An Energy Balance Approach for Research and Practice

Date: 
05/01/2015
Description: 

Economos, C. D., Hatfield, D. P., King, A. C., Ayala, G. X., & Pentz, M. A. (2015). Food and Physical Activity Environments: An Energy Balance Approach for Research and Practice. American Journal of Preventive Medicine, 48(5), 620-629.

This paper is part of a special themed section in AJPM, funded by Active Living Research, Healthy Eating Research, and the University of Pennsylvania, highlighting outcomes from a Built Environment and Assessment Training (BEAT) Institute Think Tank meeting on the state of science and practice in environmental assessment.

Abstract: 

Increases in the prevalence of overweight and obesity are a function of chronic, population-level energy imbalance, whereby energy intakes exceed energy expenditures. Although sometimes viewed in isolation, energy intakes and expenditures in fact exist in a dynamic interplay: energy intakes may influence energy expenditures and vice versa. Obesogenic environments that promote positive energy balance play a central role in the obesity epidemic, and reducing obesity prevalence will require re-engineering environments to promote both healthy eating and physical activity. There may be untapped synergies in addressing both sides of the energy balance equation in environmentally focused obesity interventions, yet food/beverage and physical activity environments are often addressed separately. The field needs design, evaluation, and analytic methods that support this approach. This paper provides a rationale for an energy balance approach and reviews and describes research and practitioner work that has taken this approach to obesity prevention at the environmental and policy levels. Future directions in research, practice, and policy include moving obesity prevention toward a systems approach that brings both nutrition and physical activity into interdisciplinary training, funding mechanisms, and clinical and policy recommendations/guidelines.

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Advances in Physical Activity and Nutrition Environment Assessment Tools and Applications: Recommendations

Date: 
05/01/2015
Description: 

Glanz, K., Sallis, J. F., & Saelens, B. E. (2015). Advances in Physical Activity and Nutrition Environment Assessment Tools and Applications: Recommendations. American Journal of Preventive Medicine, 48(5), 615-619.

This paper is part of a special themed section in AJPM, funded by Active Living Research, Healthy Eating Research, and the University of Pennsylvania, highlighting outcomes from a Built Environment and Assessment Training (BEAT) Institute Think Tank meeting on the state of science and practice in environmental assessment.

Abstract: 

INTRODUCTION: In the past 15 years, researchers, practitioners, and community residents and leaders have become increasingly interested in associations among built environments and physical activity, diet, and obesity. Numerous tools to measure activity and food environments have been developed but vary in quality and usability. Future progress depends on aligning these tools with new communication technology and increasing their utility for planning and policy. METHODS: The Built Environment Assessment Training Institute Think Thank was held in July 2013. Expert participants discussed priorities, gaps, and promising opportunities to advance the science and practice of measuring obesity-related built environments. Participants proposed and voted on recommended future directions in two categories: “big ideas” and additional recommendations. RESULTS: Recommendations for the first “big idea” involve developing new, simplified built environment assessment tools and deploying them through online trainings and easily accessible web-based apps. Future iterations of the tools would link to databases of key locations (e.g., parks, food stores); have built-in scoring and analysis; and provide clear, simple feedback to users. A second “big idea” addresses dissemination of results from built environment assessments and translation into policies including land use and food access planning. Additional recommendations include (1) improving multidisciplinary collaborations; (2) engaging stakeholders across sectors; (3) centralized data resource centers; (4) increased use of emerging technologies to communicate findings; and (5) advocating for expanded funding for measurement development, training, and dissemination. CONCLUSIONS: Implementing these recommendations is likely to improve the quality of built environment measures and expand their use in research and practice.

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Built Environment Assessment and Interventions for Obesity Prevention: Moving the Field Forward

Date: 
05/01/2015
Description: 

Glanz, K., & Davis, E. L. (2015). Built Environment Assessment and Interventions for Obesity Prevention: Moving the Field Forward. American Journal of Preventive Medicine, 48(5), 613-614.

This paper is part of a special themed section in AJPM, funded by Active Living Research, Healthy Eating Research, and the University of Pennsylvania, highlighting outcomes from a Built Environment and Assessment Training (BEAT) Institute Think Tank meeting on the state of science and practice in environmental assessment.

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A Community-based Intervention Increases Physical Activity and Reduces Obesity in School-age Children in North Carolina

Date: 
06/01/2015
Description: 

Benjamin Neelon, S. E., Namenek Brouwer, R. J., Østbye, T., Evenson, K. R., Neelon, B., Martinie, A., & Bennett, G. G. (2015). A Community-based Intervention Increases Physical Activity and Reduces Obesity in School-age Children in North Carolina. Childhood Obesity, 11(3), 297-303.

Abstract: 

BACKGROUND: Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment-a community intervention designed to promote active living and decrease obesity within a small southern town. METHODS: In 2011, community leaders implemented the Mebane on the Move intervention-a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to post-intervention change in minutes of PA and BMI z-score, adjusting for confounders. RESULTS: At follow-up, children in Mebane modestly increased their moderate-to-vigorous PA (1.3 minutes per hour; 95% confidence interval (CI): 0.2, 2.3; p=0.03) and vigorous activity (0.8 minutes per hour; 95% CI: 0.1, 1.5; p=0.04) more than comparison children. In intervention children, BMI z-scores decreased 0.5 units (kg/m(2); 95% CI: -0.9, -0.02; p=0.045), compared to children in the comparison community. CONCLUSIONS: We observed positive effects on PA level and weight status of children in Mebane, despite high rates of attrition, suggesting that the community-based intervention may have been successful.

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SaludABLEOmaha: Improving Readiness to Address Obesity Through Healthy Lifestyle in a Midwestern Latino Community, 2011-2013

Date: 
02/01/2015
Description: 

Frerichs, L., Brittin, J., Robbins, R., Steenson, S., Stewart, C., Fisher, C., et al. (2015). SaludABLEOmaha: Improving Readiness to Address Obesity Through Healthy Lifestyle in a Midwestern Latino Community, 2011-2013. Preventing Chronic Disease, 12(E20).

Abstract: 

BACKGROUND: A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. COMMUNITY CONTEXT:  This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. METHODS: SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. OUTCOME: The community increased in readiness from stage 3 of the Community Readiness Model, “vague awareness,” at baseline to stage 5, “preparation,” at follow-up. INTERPRETATION: SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities.

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Built Environment Associations with Adiposity Parameters Among Overweight and Obese Hispanic Youth

Date: 
07/01/2015
Description: 

Hsieh, S., Klassen, A. C., Curriero, F. C., Caulfield, L. E., Cheskin, L. J., Davis, J. N., et al. (2015). Built Environment Associations with Adiposity Parameters Among Overweight and Obese Hispanic Youth. Preventive Medicine Reports, 2, 406-412.

Abstract: 

OBJECTIVE: The purpose of this cross-sectional study was to establish neighborhood built environment correlates of adiposity as measured by dual X-ray absorptiometry. The utility and methodological gains of using this measure for built environment research were further investigated by comparing model fit across parallel models on body mass index z-scores and waist circumference. METHODS: Pre-existing data collected from 2001 to 2011 on 576 overweight and obese Hispanic youth were compiled with built environment data, and 2000 census data for analyses conducted in 2012. Walking-distance buffers were built around participants' residential locations. Variables for park space, food access, walkability, and neighborhood socio-cultural aspects were entered into a multivariate regression model predicting percent body fat. Parallel models were built for body mass index z-score, and waist circumference. RESULTS: Significant associations were found between percent body fat and supermarket access for boys, and percent body fat and increased park space and decreased neighborhood linguistic isolation for girls. Neighborhood socio-cultural characteristics accounted for more variance in obesity compared to body mass index z-score or waist circumference. CONCLUSION: Park access, food environment, and neighborhood socio-cultural characteristics are independent contributors to body fat in children, and the contribution of these risks differs by gender. There are incremental gains to using a more accurate measure of body fat in built environment obesity studies.

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Microscale Audit of Pedestrian Streetscapes (MAPS)

Date: 
05/01/2015
Description: 

The Microscale Audit of Pedestrian Streetscapes (MAPS) was developed to collect audit data on the pedestrian environment and walkability in neighborhoods.

Abstract: 

“Microscale” factors of the built environment differ from macro-level design elements such as street connectivity and residential density and include details about streets, sidewalks, intersections, and design characteristics (e.g., road crossing features, presence of trees, bicycle lanes, curbs), as well as characteristics of the social environment (e.g., stray dogs, graffiti, trash). Microscale factors may also influence physical activity but have not been studied as extensively as macro-level factors. Studying microscale factors allows for a more fine-grained examination of the environmental features that enable or inhibit physical activity and may be more cost effectively and easily modified than macro characteristics. Microscale data are typically collected using in-person environmental audits.

There are three versions of the MAPS tool, each with varying degrees of complexity and intended users:

  • MAPS-Full: 120-item audit survey, intended for researcher use
  • MAPS-Abbreviated: 60-item audit survey, intended for researcher and advanced practitioner use
  • MAPS-Mini: 15-item audit survey, intended for practitioner, advocacy, and community member use

 

The MAPS tool and protocols can be found here.

Information specifically on the MAPS-Mini can be found here.

Authors: 
Kelli L. Cain, Rachel A. Millstein, James F. Sallis, Terry L. Conway, Kavita A. Gavand, Lawrence D. Frank, Brian E. Saelens, Carrie M. Geremia, James Chapman, Marc A. Adams, Karen Glanz, Abby C. King
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