Effects of The Built Environment, Crime & Food Prices on BMI, Activity & Eating
The Moving to Opportunity for Fair Housing Demonstration (MTO) provided an excellent setting to examine the role of neighborhood characteristics on obesity, physical activity and fruit/vegetable intake. The goal of MTO was to determine whether persons who moved to "better" neighborhoods would experience improvements in a variety of outcomes such as education, economic and health compared to similar persons who did not move. To ensure that comparisons were made between similar persons, families were randomly assigned to one of three groups: the experimental group (who were required to move to census tracts where less than 10% of persons lived in poverty), the Section 8 group and the control group. The key advantage of the MTO data is participants were randomized to treatment and control groups, which would likely eliminate any baseline differences among these groups. Since many weight loss interventions fail, an important finding of the MTO study was that adult participants (N=3526) in the experimental group had a significantly lower BMI 4 to 7 years after randomization compared to controls. Additionally, those in the experimental group had a higher frequency of fruit and vegetable consumption and those in the Section 8 experimental group had a greater frequency of physical activity relative to controls. Thus the purpose of our research was to examine whether the differences in these outcomes seen across study groups were mediated by attributes of the participant's environment. This study linked MTO Interim Evaluation data with environmental characteristics of participant's neighborhoods. The MTO Interim Evaluation included information on health outcomes including BMI, physical activity levels and consumption of fruit and vegetables along with demographic information. Environmental characteristics that were collected and linked with the Interim Evaluation include: food availability, food prices, commercially and publicly available physical activity resources, city-sponsored recreation centers, connectivity of streets, land use, residential density, crime statistics and census data.
Defining The Built Environment
Most built environment research relies on prescribed geographic boundaries such as census tracts, though many researchers have noted that these boundaries are unlikely to match an individual's perception of his/her neighborhood. A definition of neighborhood boundaries that matches resident perceptions and accurate descriptions of neighborhood resource use patterns could assist with identifying the environmental factors that contribute to the development of obesity and ultimately lead to more targeted environmental interventions to decrease the prevalence of obesity. Many studies of the built environment and obesity have concentrated on urban areas, but few have examined adolescent residents of subsidized housing complexes. Ecological models of health outcomes have not guided public housing policymakers' decision-making about estate construction and placement. There are important and practical policy implications if research can demonstrate that estate location and design affect obesity prevalence. This study employed a combination of quantitative and qualitative methods to explore the effects of the self-defined built environment on the consumption and physical activity behaviors of 140 adolescent residents of public housing estates.
Measuring the Features and Amenities of Physical Activity Resources and the Variety and Pricing of Food Around Public Housing
The Foundation's Active Living Research program was designed to support investigator-initiated research to identify and assess structural, environmental, and policy changes with the potential to increase population levels of physical activity. This grant provides supplemental funds for a study originally funded by the National Cancer Institute (NCI) focusing on obesity and the built environment that examines the feasibility of obtaining adolescent self-defined neighborhood boundaries via a mapping exercise, tests the practicability of having adolescents complete travel diaries to document their travel and utilization behavior, and elicits factors that are important to adolescents in determining utilization, route preference and neighborhood boundaries. The supplemental grant increased the use of objective data from a built environment assessment tool, the Physical Activity Resource Assessment instrument, and a nutrition environment assessment tool, the Nutrition Environment Measurement Study, to answer the question, "how does quality (objectively measured) and availability of specific amenities or food variety affect physical activity and eating behavior in adolescents?"
Utilization and Physical Activity Levels at Renovated and Unrenovated School Playgrounds
This study examines whether renovated and unrenovated playgrounds have different levels of use and activity. 10 renovated and 10 unrenovated playgrounds in Cleveland, Ohio were examined to track levels of attendance and physical activity at each playground. The researchers conducted paired t-tests, Wilcoxon Signed Rank tests, and regression analyses to identify differences between the sets of playgrounds. We found more adults and children spent time at the renovated playgrounds than at the unrenovated playgrounds; vigorous play, especially among boys, was more common at renovated playgrounds. However, moderate to vigorous play levels were not different between playgrounds; and absolute levels of use of playgrounds were low at all playgrounds, regardless of renovation status. This study demonstrates that renovated playgrounds may help increase the level and intensity of physical activity among children.
Using A Mobile Phone Application to Assess Time Use, Physical Activity and Obesity
Time use (i.e., how people spend their time) can play an important role in both physical and psychological health. Surprisingly few studies, however, have examined adolescent time use and its association with physical activity and obesity. Usual methods for gathering information about time use, including paper-and-pencil self-administered diaries, can be time-consuming and are often prone to the errors associated with retrospective recall. The goal of this pilot study was to test the feasibility and acceptability of a new method of collecting real-time time use data among adolescents—specifically, via a mobile phone application. We will use the data from this pilot study to generate preliminary estimates of key relationships of interest (e.g., the association between time spent watching TV and obesity) and to inform power calculations for a future larger-scale study.