Progress 07/01/07 to 06/30/11
Outputs
OUTPUTS: Project information was disseminated at the local, state and national level.Six oral presentations were conducted. These include 1)Zhang, W. Spears, K. E. Lee, W., Yang, W. Oral Presentation at 2008 Nevada Public Health Association Annual Meeting, Academic, "Attributes of built environment to physical activity: a new approach to utilize both GIS and complex design population survey", Nevada Public Health Association, Las Vegas, NV. (October 2, 2008), 2)Spears, K. E., Washoe County Childhood Obesity Forum, Academic, "Environmental Influences on Childhood obesity", Invited, get healthy Washoe, Reno NV. (September 10, 2009), 3)Spears, K. E., Powell, P. J., Churchill County meeting, Non-Academic, "Creating an Active Living and Healthy Eating Community", Fallon, NV. (July 6, 2009), 4)Yang, W., Spears, K.E., Zhang, F., Lee, W., and Himler H.L. oral presentation at 2010 27th Annual BRFSS Conference, "Behavioral Risk Factor Surveillance System (BRFSS) as a Data Source in Data Linkage between Overweight Outcome and Built Environment Variables". 27th Annual BRFSS Conference in San Diego, CA, (March 23, 2010), 5)Spears, K. E., Nevada Nutrition Consortium Annual Meeting, Non-Academic, "Use of Geographic Information Systems in Nevada Nutrition Services", Invited, Division of Welfare and Supportive Services. (November 3, 2011), and 6)Spears, K. E. Yang W. oral presentation at 138th American Public Health Association Annual Meeting, "Evaluating the relationship between community food environment and obesity: What assessment method should we use" Denver, CO (November 9, 2010). A poster was displayed for the public at the Nevada Agricultural Experiment Station Field Day, title "Designing healthy communities: Evaluating the Obesogenic Built Environment in Nevada", (September 10, 2011). A workshop was given at the Society for Nutrition Education 43rd annual Conference, title "Introduction to Geographic Information System for Health and Childhood Obesity Evaluation ", Reno, NV (July 28, 2010). This project allowed training for eleven undergraduate students and one graduate student on conducting research and collecting and validating Geographic Information System data. Stemming from this project, a web-based Geographic Information System (GIS)resource for the Nevada Nutrition Assistance Consortium is under development that includes information such as location of nutrition assistance programs, food outlets and physical activity opportunities, transportation routes, and socioeconomic characteristics of neighborhoods throughout Nevada.This information will allow agencies and coalitions to collaborate on health services delivery and identify any areas lacking service. The important aspect is coordinating services. PARTICIPANTS: Individuals that worked on the project: Spears, K.E. (PI), Wei Yang (Co-I), Zhang, F. (biostatistician), Lee, W. (research assistant), Himler H.L. (research assistant), Rezaeiarya S (graduate student). Undergraduate students include Musgrove D. Frances Arnold, Carol Stack, Nicole Rivas, Masako Horino, Jacqueline Houts, Eileen Luna. Six other undergraduates assisted in various aspects of conducting the project. Partners and collaborators include members and staff from Washoe County Health District, University of Nevada, Reno Cooperative Extension, State Women, Infant and Children Program, State Health Division, Washoe County Food Service, Food Bank of Northern Nevada, Nevada Office of Rural Health, Nevada Department of Education, and Churchill County Planning Committee. TARGET AUDIENCES: Local and state policy makers to incorporate legislation and department guidelines that create healthier communities. Agencies and coalitions that provide nutrition and health services to people living in Nevada. Currently, the project collaborates with members and staff from Washoe County Health District, University of Nevada, Reno Cooperative Extension, State Women, Infant and Children Program, State Health Division, Washoe County Food Service, Food Bank of Northern Nevada, Nevada Office of Rural Health, Nevada Department of Education, and Churchill County Planning Committee. PROJECT MODIFICATIONS: none
Impacts
The project increased our knowledge regarding the relationship between built environment factors and an individual's health behavior and health outcome. The relationship between multiple built environmental factors and individual characteristics on leisure-time physical activity was evaluated. The number (density) and distance to recreational facilities were determined at a 0.5 mile, 1 mile, or 3 miles radius from subjects' residence. Among individual factors, no engagement in leisure-time physical activity was significantly associated with older age (AOR 1.84), less education (AOR 1.80), and lower income (AOR 1.92). Subjects who are neither overweight nor obese (AOR 1.57), or overweight (AOR 1.41) have significantly higher odds of engaging in LTPA than subjects who are obese. Built environment factors significantly associated with LTPA included less commute time (AOR 1.28), lower violent crime (AOR 1.43), lower property crime (AOR 1.58), living in rural (vs. urban) (AOR 1.29), and living in less population dense areas (AOR 1.31). Factors not significantly associated with LTPA were residential distance to a park or recreation facility, air quality, nor land mix. Reporting good health and life satisfaction were the two most "powerful" correlates to engaging in LTPA with adjusted odds ratios 2.37 and 1.95, respectively. The relationship between density, proximity, and diversity of food outlets and adult overweight/obesity in Nevada was evaluated. Half, 1 mile, and 3 mile buffer zones were created around subjects' residence with density and distance to the closest food outlets determined within each buffer zone. The adjusted odds of being overweight or obesity were not significant for the distance to the closest food outlets, density of supermarket/grocery stores within half and 1 mile, and the density of fast-food restaurants and convenience stores within half-mile, 1 mile, and 3 miles buffer zones. Those who had 3 vs. 1-2 or supermarket/grocery stores within their 3 mile buffer zone had higher adjusted odds of being overweight/obese (AOR=1.87). The study evaluated the relationship of perceived vs. actual built environment and physical activity and fruit and vegetable consumption. Physical activity was related to individual's perception of built environment factors, including being able to access a park (AOR= 1.34, P=0.03), open space (AOR=2.04), walking or biking trail (AOR=1.41), a recreational center, gym, or fitness facility (AOR =1.29), and having a pleasant atmosphere neighborhood for walk (1.79). Access to a basketball court, tennis court or a swimming pool was not significantly related to physical activity. Incorporating multiple data systems and Geographical Information Systems (GIS) spatial analysis is a valuable tools in analyzing a complex population survey. The project served as a catalyst for a Nevada county to pursue a community built environment self-assessment to create a healthy community. Four grants have been submitted to conduct a community participatory research with the University of Nevada, Reno Cooperative Extension.
Publications
- Powell, P., Spears, K., Rebori, M. What is Obesogenic Environment University of Nevada Cooperative Extension 2010 Factsheet-10-11. Rezaeiarya S. Thesis "Relationship between proximity, density, and diversity of food outlets and obesity". Nutrition department, University of Nevada, Reno. January 2010 - May 2011.
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Progress 01/01/10 to 12/31/10
Outputs
OUTPUTS: This study evaluates the association between physical activity and food environment to health outcomes; especially obesity. To accomplish this, there are 3 phases: 1) Exploratory Phase: Explore interrelationships between Behavioral Risk factor surveillance System (BRFSS) respondent's health behaviors and health status to respondent's built environment, 2) Statistical Modeling: Develop and apply a community obeseogenic built environment rating system for Nevada and 3) Subject Perception: Evaluate the relationship between subject's perceived and actual built environment and their health behaviors. In 2010, the dataset was expanded to include 2008 Nevada BRFSS respondents; the full dataset now comprises 2006, 2007, and 2008 respondents. The additional six additional questions in the 2008 Nevada BRFSS regarding nutrition intake and physical activity were incorporated into the database. These supplemental questions included aspects such as: rating their access to fruit and vegetable from stores within their community, selecting why access maybe fair/poor, identifying access to physical activity facilities within their community and rating the atmosphere for walking in their neighborhood. Few studies have explored perceived vs. actual access to food and physical activity outlets and an individual's health behavior. This data will provide a unique and more comprehensive generated statistical model. We obtained a supplemental list of food outlets within Nevada. We continue to collaborate with Churchill County Planning Commission and Cooperative Extension to conduct a countywide built environment needs assessment. A new grant was submitted for objective 3. Spears, K. Powell, P. J, Granner, M. L, Rebori, M. K., Benedict, J. A, Yang, W., and Heaton, J. S. "Rural Community Strategic Plan to Increase Physical Activity using Geographic Information System and Community Survey", Sponsored by National Institute of Food and Agriculture, (submitted 6/1/2010, not awarded). PARTICIPANTS: Spears, K.E. (PI) -oversee all aspects of the study, data collection and validation Wei Yang (Co-I). -oversee data storage and analysis Zhang, F. (research assistant) - biostatistician Lee, W. (research assistant) -Geographic Information System and BRFSS data Himler H.L. (research assistant) - program management, preparation of manuscripts Whittmann C.(research assistant) - computer database programmer Musgrove D. (undergraduate student) - validation of food outlet classification system Other students that assisted in validation of GIS data: Frances Arnold, Carol Stack, Nicole Rivas, Masako Horino, Jacqueline Houts, Eileen Luna. Contacts for obtaining variables include: Market group, Nevada Health Department, U.S. Census Bureau, the U.S. Environmental Protection Agency (EPA), the Environmental Systems Research Institute (ESRI), the Federal Highway Administration, and the Federal Bureau of Investigation or local law enforcement agencies, Nevada state GIS databases, Division of State Parks, North American Industry Classification System. Training for Donald Musgrove, Frances Arnold, Carol Stack, Nicole Rivas, Masako Horino, Jacqueline Houts, Eileen Luna -undergraduate students. Eleanor Lockwood, Churchill County Planning commissioner. TARGET AUDIENCES: State and local government policymakers to assist in developing sustainable healthier communities. Ultimately, all residents of the state of Nevada will benefit from study built environment rating system. This will identify target areas within Nevada that modifications in built environment may reduce the prevalence of obesity. PROJECT MODIFICATIONS: Initially the study was designed with two objectives. 1) Exploratory Phase: Explore interrelationships between Behavioral Risk factor surveillance System (BRFSS) respondent's health behaviors and health status to respondent's built environment, 2) Statistical Modeling: Develop and apply a community obeseogenic built environment rating system for Nevada. However, the importance a subject's perceived built environment was being identified in the literature as potentially a stronger determinant of health outcomes than the actual environment. Therefore, a third study objective as added to evaluate the relationship of respondent's perceived built environment and their decision making process for health behaviors related to physical activity and fruit and vegetable consumption compared to actual obeseogenic built environment and reported heath behaviors. To accomplish this, six questions were integrated into the 2008 BRFSS telephone survey and the sample population was expanded to include 2008 BRFSS respondents. The study sample, hence statistical power, was also increased by incorporating 2006 respondents. Instead of obtaining information from a single year, the study now includes data for 2006, 2007 and 2008 BRFSS respondents.
Impacts
We continue to increase knowledge and skills in the use of Geographic Information System for Health in public health. Information was provided through workshops and national conventions. Spears K.E. "Introduction to Geographic Information System for Health and Childhood Obesity Evaluation", Post-Conference Workshop Society of Nutrition Education Annual conference, Reno, NV (July 28, 2010). Spears K.E., and Yang W. Oral Presentation. "Evaluating the relationship between community food environment and obesity: What assessment method should we use". American Public Health Association Annual Conference. Denver, CO (November 9, 2010). Yang, W., Spears, K. E., 27th Annual BRFSS Conference, Academic, "BRFSS as a Data Source in Data Linkage between Overweight Outcome and Built Environment Variables", San Diego, CA. (March 23, 2010).Study results are dependent upon which variables selected in the model. For example, the literature has identified land mix, urban vs. rural residency and population density as important aspect influencing physical activity. These parameters were incorporated into a new statistical model. Some variables were no longer statistically associated with leisure time physical activity level (e.g. being diabetic). This emphasizes the interaction and complexity between individual characteristics, built environment and health behavior.
Publications
- Powell P., Spears K. Rebori M. What is Obesogenic Environment Special Publication. University of Nevada Cooperative Extension. (submitted Aug 30, 2010).
- Rezaeiarya S., Spears K., and Yang, W. 2011Relationship between food environment (distance, density, and diversity of food outlet) to obesity. Public Health Nutrition (pending).
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Progress 01/01/09 to 12/31/09
Outputs
OUTPUTS: This study evaluates the association between physical activity and food environment to health outcomes; especially obesity. To accomplish this, there are 3 phases: 1) Exploratory Phase: Explore interrelationships between Behavioral Risk factor surveillance System (BRFSS) respondent's health behaviors and health status to respondent's built environment, 2) Statistical Modeling: Develop and apply a community obeseogenic built environment rating system for Nevada and 3) Subject Perception: Evaluate the relationship between subject's perceived and actual built environment and their health behaviors. We received the 2008 BRFSS data over the course of 2009. It was tabulated and 2008 BRFSS respondents geocoded. Total study sample size is 7,724; a 1,908 increase from last year. This information allowed exploration regarding the relationship of food environment, built environment (physical activity and food environments) and individual characteristics to the obesity health outcome; culminating in a manuscript. In addition, further environment information was obtained to expand our database on Nevada's built environment; requiring data re-formatting for integration into the database. Previous research studies have not used a standardized coding system for classifying food outlets. During 2009, we established study working definitions and a coding system to clearly distinguish various commercial food establishments in reference to their availability of fruits and vegetables. Furthermore, we confirmed the coding system through direct observations in a subsample of food establishments. This process advanced the knowledge of GIS and the fundamental components of research for an undergraduate nutrition student in the College of Agriculture, biotechnology and Natural Resources. To avoid collinearity, several statistical analysis using GIS were generated that incorporated a single food environment measurement. For example, only one of the variables listed: type of food outlets, distance to food outlet, density of food outlets were added to model. Combinations of type of food outlet and either distance or density added further dimensions to the model. Food outlet were included in the analytical models and newly obtained food outlets from health department has been formatted and cross-matched with existing dataset where geo information available Collaboration with the Churchill County and cooperative Extension continued in 2009. They have committed to testing, project objective 2, the statistical model develop from our research finding. The residents will engage in collecting perceived and actual built environment information. This information will be entered into the developed model to validate the rating system for Nevada. A grant proposal was prepared to obtain funding for this aspect. It required additional collaborators and will be submitted in 2010. Prepared Grant Proposal: Spears, K.E. (PI) and Powell, P.J.(Co-I), Wei Yang (Co-I). "Churchill County Physical Environment Evaluation: What Promotes or Hinders Healthful Behaviors", Sponsored by CSREES: Cooperative State Research, Education, and Extension Service AFRI grant, Federal.(Not Yet Submitted) PARTICIPANTS: Spears, K.E. (PI) -oversee all aspects of the study, data collection and validation Wei Yang (Co-I). -oversee data storage and analysis Zhang, F. (research assistant) - biostatistician Lee, W. (research assistant) -Geographic Information System and BRFSS data Himler H.L. (research assistant) - program management, preparation of manuscripts Whittmann C.(research assistant) - computer database programmer Musgrove D. (undergraduate student) - validation of food outlet classification system Other students that assisted in validation of GIS data: Frances Arnold, Carol Stack, Nicole Rivas, Masako Horino, Jacqueline Houts, Eileen Luna. Contacts for obtaining variables include: Market group, Nevada Health Department, U.S. Census Bureau, the U.S. Environmental Protection Agency (EPA), the Environmental Systems Research Institute (ESRI), the Federal Highway Administration, and the Federal Bureau of Investigation or local law enforcement agencies, Nevada state GIS databases, Division of State Parks, North American Industry Classification System. Training for Donald Musgrove, Frances Arnold, Carol Stack, Nicole Rivas, Masako Horino, Jacqueline Houts, Eileen Luna -undergraduate students TARGET AUDIENCES: State and local government policymakers to assist in developing sustainable healthier communities. Ultimately, all residents of the state of Nevada will benefit from study built environment rating system. This will identify target areas within Nevada that modifications in built environment may reduce the prevalence of obesity. PROJECT MODIFICATIONS: Initially the study was designed with two objectives. 1) Exploratory Phase: Explore interrelationships between Behavioral Risk factor surveillance System (BRFSS) respondent's health behaviors and health status to respondent's built environment, 2) Statistical Modeling: Develop and apply a community obeseogenic built environment rating system for Nevada. However, the importance a subject's perceived built environment was being identified in the literature as potentially a stronger determinant of health outcomes than the actual environment. Therefore, a third study objective as added to evaluate the relationship of respondent's perceived built environment and their decision making process for health behaviors related to physical activity and fruit and vegetable consumption compared to actual obeseogenic built environment and reported heath behaviors. To accomplish this, five questions were integrated into the 2008 BRFSS telephone survey and the sample population was expanded to include 2008 BRFSS respondents. The study sample, hence statistical power, was also increased by incorporating 2006 respondents. Instead of obtaining information from a single year, the study now includes data for 2006, 2007 and 2008 BRFSS respondents.
Impacts
change in knowledge fundamental or applied knowledge significant enough to be included in a publication During 2009, GIS spatial analysis and weighted multiple logistic regression were conducted. Based on 2007-2008 Nevada BRFSS respondents, Adjusted odds for individual being overweight/obesity was significantly associated with being older, male, non-smoker, and having diabetes. An individual's reported leisure time physical activity, quantity of fruits/vegetables intake, and the distance and density of different food outlet types were non-significant. However, when testing density, being overweight/obese was significantly more likely when no or <3 groceries/supermarkets were present compared to ≥3 stores within 3 miles. Our findings also indicated that although some built environment factors were significantly related to physical activity, more individual factors were related. Multiple data systems including complex population survey and GIS spatial analysis are valuable tools in analyzing population level health behaviors studies. The relationship between physical activity and additional built environment factors needs to be examined. In conclusion, this study found incorporation of multiple data systems and GIS spatial analysis were valuable tools in analyzing a complex population survey. In addition, physiological and physiological that affect overall health and life satisfaction should not be overlooked. Findings also suggest that policy makers should consider design based strategies to reduce violent and property crime rates. It is unknown why this study observed a significant association between an individual's characteristics and leisure physical activity. Future studies aimed to determine if good health and life satisfaction promotes physical activity or if physical activity promotes good health and life satisfaction promote physical activity is needed. change in knowledge of scientist: Karen Spears attended the International conference on diet and activity Methods in Washington DC, June 5-7, 2009. Multiple sessions focused on GIS such as: New methods and analysis of using geographic positioning system for measuring physical activity, tools to measure the physical activity and food environments: an introduction to GIS, a review of physical activity of environment measures; Reliability and validity of measure of environmental barrier to active transport to school; Measuring the neighborhood crime environment: a comparison of perceived and objective measures; and Targeting intervention in the built environment by GIS.
Publications
- Yang, W., Spears, K.E.,Zhang, F., Lee, W., and Himler H.L. Behavioral Risk Factor Surveillance System (BRFSS) as a Data Source in Data Linkage between Overweight Outcome and Built Environment Variables. oral presentation at 2010 27th Annual BRFSS Conference in San Diego, CA.(accepted)
- Yang, W., Spears, K.,Zhang, F., Lee, W., and Himler H.L. Association of Personal and Built Environment Attributes to Physical Activity Am J Prev Med (pending 2009)
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Progress 01/01/08 to 12/31/08
Outputs
OUTPUTS: We have built upon the outcomes achieved from last year's funding. The 2006 and 2007 BRFSS participants (n=2575) that could be geocoded is completed. We exhaustively sought community-based attributes at no cost. Then, we purchased a database from ESRI to augment our list of community-based attributes. The majorities of community-based variables have been located, format, standardized, geocoded, and inputted to the database. The Field Adapted Survey Toolkit (FAST) software was utilized for validation of the georeference data. A customized data collection form was developed and transferred to handheld Personal digital Assistant (PDAs. Over the summer, field research assistants were hired, trained, and conducted data collection on community built environment using the PDAs and FAST. Statistical analysis and modeling of the data was initiated. Preliminary spatial layers were creates that included both BRFSS data and community-based attributes. Several complex statistical analysis models were generated and compared. Physical activity outcome reported by individual respondents to the 2006-2007 BRFSS were weighted to reflect responses for the whole state of Nevada. Findings regarding physical activity and built environment were presented at the Nevada Public Health Association Annual Meeting. from Two meetings were conducted with Fallon. The community of Fallon is eager to apply our findings to improve the healthfulness of their built environment. The results for the five new questions added to 2008 BRFSS are beginning compiled. PARTICIPANTS: Dr. Spears oversaw built environment attribute collection. She meet monthly (occasionally the meeting was cancelled)with Fan Zhang to provide direction in this endeavor. She also developed the customized FAST interface for built environment data collection used by field research assistance. Dr. Spears hired, trained field research assistants. She conducted data quality assurance obtained by the field research assistants. She co-authored and was a presenter of the study findings. She is continuing to develop the relationship with Fallon. Dr. Yang oversees data analysis. Working with William Lee and Fan Zhang, geocoding for 2006-2007 BRFSS was completed. Spatial analysis initiated and preliminary maps created. He provided guidance in weighing data and development of statistical models.He co-authored and was a presenter of the abstract for presentation. Partnership is being cultivated with representatives from Fallon. TARGET AUDIENCES: Communities within Nevada to provide information in assisting planning to improve their built environment to promote healthful lifestyles. Policymakers to guide legislation that promote healthful lifestyles. Researchers to stimulate addition questions in this area of reserach and increase understanding of the interaction of built environment and health behaviors. PROJECT MODIFICATIONS: Last year added 2008 BRFSS respondants and added 5 questions to the BRFSS questionnaire.Change in investigators.
Impacts
Zhang, W. (Presenter & Author), Spears, K. E. (Presenter & Author), Lee, W. (Author Only), Yang, F. (Author Only), 2008 Nevada Public Health Association Annual Meeting, Academic, "Attributes of built environment to physical activity: a new approach to utilize both GIS and complex design population survey", Accepted, Nevada Public Health Association, Las Vegas, NV. (October 2, 2008). Prior studies found a modest association between exercise facilities accessibility and physical activity. Very few have studied the large population level. This study aims to identify built environment al attributes that encourage or discourage physical activity through newly developed methodology. Data were aggregated from data sources of geology, social economics, and health behaviors including EPA, ESRI, and BRFSS. GIS spatial analysis and weighted multiple logistic regression were utilized to account for complex survey design. All analyses were conducted using ArcMap v.9.2. and SAS v.9.1. 6352 respondents who completed 2006-07 Nevada BRFSS survey from a zip-code more than 30 respondents were included in the final model. 75.3% respondents reported they attended physical activities during the past 30 days. Results indicate that physical activity were significantly associated to air quality, population density and weather comfort index but none significant to distance to a park and recreation facility, criminal rate or commute times. Other significant risk factors to non-physical activity include being obese, not satisfied life, self reported poor health status, Hispanic group, lower income, lower education. Physical activity has related to some community environmental factors. GIS spatial analysis has shown as a powerful tool to analyze complex designed population survey. Further built environmental factors which might attributes to health behaviors to be conducted in the next phase of the study.
Publications
- Zhang, W. (Presenter & Author), Spears, K. E. (Presenter & Author), Lee, W. (Author Only), Yang, F. (Author Only), 2008 Nevada Public Health Association Annual Meeting, Academic, "Attributes of built environment to physical activity: a new approach to utilize both GIS and complex design population survey", Accepted, Nevada Public Health Association, Las Vegas, NV. (October 2, 2008).
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Progress 07/01/07 to 01/28/08
Outputs
OUTPUTS: We have been very productive towards achieving our goals and objectives. We obtained Institutional Review Board Approval and hired two research assistants. We have almost completed geocoding all of the 2007 Behavior risk Factor Surveillance System (BRFSS) respondents (10 months completed). This allows us to places their residence as a X,Y coordinate on a map. We have started to create a database for the obeseogenic built environment such as number and distance to parks and bike and walking trails. This prepares us to meet one of our objectives: increasing our understanding between a respondent's body mass index and related health behaviors to their built environment. We have created and added five new questions to the 2008 BRFSS to further explore actual vs. perceived relationship between respondent's health behaviors and their obeseogenic built environment.
PARTICIPANTS: Wai Lee, research biostatistician. Lee attended courses at the University of Nevada to increase his understanding of the Geographic Information System (GIS). Fan Zhang, research biostatistician. Zhang is attending a advance mathamatics class at the University of Nevada to increase her understanding for data analysis. She has also conducted several on line GIS educational courses.
PROJECT MODIFICATIONS: The project has been extended from 3 years to 4 years.
Impacts
The full outcome/impact is not available since we are in the exploratory phase of the study. One product we developed was five new questions to be added to the 2008 BRFSS in order to further explore the actual vs. perceived relationship between respondent's health behaviors and their obeseogenic built environment.
Publications
- No publications reported this period
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