The role of the contextual food environment and community programs and policies on diet and dietary disparities in the national Healthy Communities Study

背景食物环境和社区计划以及饮食政策和饮食差异在国家健康社区研究中的作用

• 批准号: 10730780
• 负责人: NATALIE COLABIANCHI
• 金额: $ 12.52万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10730780
• 关键词: Address; Affect; African American; Ancillary Study; Area; Behavior; Behavioral; Beverages; Black race; Body mass index; Buffers; Businesses; Characteristics; Child; Communities; Community Developments; Consumption; Data; Data Analyses; Data Set; Diet; Dietary Fiber; Dietary intake; Disparity; Effectiveness; Energy Intake; Ethnic Origin; Ethnic Population; Familiarity; Food; Future; Geography; Grant; Health; Health Benefit; Healthy Eating; Heart Diseases; Hematological Disease; Hispanic; Home; Household; Individual; Inequity; Intake; Intercept; Intervention; Interview; Investments; Knowledge; Latino; Life; Link; Literature; Local Government; Lung diseases; Measures; Modeling; National Heart, Lung, and Blood Institute; Neighborhoods; Nutrition Policy; Nutritional; Outcome; Participant; Physical activity; Policies; Race; Reduce health disparities; Research; Restaurants; Role; Sampling; Schools; Shapes; Sleep Disorders; Socioeconomic Status; Subgroup; Supermarket; Unhealthy Diet; United States; Weight; community intervention; community organizations; community setting; community-level factor; contextual factors; cost effective; data integration; density; dietary; dietary guidelines; fast food; food consumption; food environment; fruits and vegetables; good diet; health disparity; health inequalities; improved; informant; low socioeconomic status; novel; nutrition; programs; racial difference; racial diversity; racial population; response; secondary analysis; sugar; sweetened beverage

ABSTRACT Unhealthy diets are associated with numerous deleterious health outcomes. Yet, most children do not consume a healthy diet, in particular Black/African American and Hispanic children, and children of low socio-economic status (SES). Previous studies have found that community characteristics influence diet but the effectiveness of community programs and policies (CPPs) to influence diet is not consistent across communities by racial/ethnic composition and community SES. The contextual food environment is an important consideration in understanding the effectiveness of CPPs on diet and may explain, in part, the differential effect of CPPs across subgroups. However, very few studies have examined what interventions are most effective for improving diet within community settings and there are even fewer national studies of how contextual factors influence food environment intervention outcomes. The proposed study will leverage existing NHLBI datasets with information on CPPs, contextual food environments, and child, household, neighborhood, school, and community characteristics that can affect child diet. The study includes over 4,500 children in grades K – 8 from diverse racial/ethnic and SES backgrounds in 130 communities in the United States. Nearly 10,000 CPPs were documented from over 1,400 key informant interviews within communities. Contextual food environment measures (e.g., density of supermarkets) in 1, 3, 5, and 8 km buffers around the home, and in a school-centric buffer, were derived from over 58 million business listings. The specific aims in this study are to 1) determine the effect of CPPs and the contextual food environment on diet including intake of energy-dense foods of minimal nutritional value; total added sugar intake; sugar intake from SSBs; fruit and vegetable intake; whole grain consumption; and fast food consumption, and 2) determine whether differences persist by race, ethnicity, and SES in the relationship between CPPs and diet once contextual food environment data are considered. To assess our aims, a generalized linear mixed model with random intercepts and slopes will be estimated controlling for clustering at the community level. The proposed study is cost-effective in that it entails secondary data analyses using linked data from two previous studies. The study is unique in its use of CPPs and contextual food environment measures at multiple geographic scales in a large, diverse national sample of children along with control variables at the child, household, neighborhood, school, and community levels. The findings are expected to help shape how future community investments in programs, interventions, and policies are tailored and implemented to improve children’s diets and to address diet-related health disparities early in life.

抽象的 不健康的饮食与许多已删除的健康结果有关。但是，大多数孩子没有 食用健康的饮食，尤其是黑人/非裔美国人和西班牙裔儿童，以及低矮的孩子 社会经济地位（SES）。先前的研究发现社区特征会影响 饮食但社区计划和政策（CPP）影响饮食的有效性不一致 种族/族裔组成和社区SES在整个社区之间。上下文食物 环境是理解CPP对饮食有效性的重要考虑因素，可能 在某种程度上解释了CPP跨亚组的差异效应。但是，很少有研究 检查了哪些干预措施最有效地改善社区环境中的饮食 关于上下文因素如何影响食物环境干预的国家研究更少 结果。拟议的研究将利用现有的NHLBI数据集以及有关CPP的信息， 上下文美食环境以及儿童，家庭，邻里，学校和社区 可能影响儿童饮食的特征。该研究包括来自4,500多名K级的儿童。 美国130个社区的种族/种族和SES背景。将近10,000 从社区内的1,400多名主要线人访谈中记录了CPP。上下文食物 在房屋周围的1、3、5和8公里缓冲区中的环境措施（例如超市的密度）， 在以学校为中心的缓冲区中，源自超过5800万个业务清单。具体目的 这项研究是1）确定CPP和上下文食物环境对饮食的影响 摄入最小营养价值的能量密集食品；总添加了糖摄入量；糖的摄入量 SSB；水果和蔬菜摄入；全谷物消耗；和快餐消费，以及2） 确定CPP之间关系中种族，种族和SE的差异是否持续 饮食一旦考虑了上下文的食物环境数据。为了评估我们的目标，一个广义的 将估计具有随机截距和插槽的线性混合模型，以控制聚类 社区层面。拟议的研究具有成本效益，因为IT官员使用二级数据分析 从前两项研究中链接了数据。该研究在使用CPP和上下文食物方面是独一无二的 在大型，潜水国家的儿童样本中，在多个地理尺度上进行环境测量 以及儿童，家庭，社区，学校和社区层面的控制变量。 期望发现有助于塑造未来社区对计划，干预措施和 政策是针对改善儿童饮食的量身定制和实施的，并解决与饮食有关的健康 生命早期的差异。