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 然而，不健康的饮食与许多有害的健康结果有关。 保持健康饮食，特别是黑人/非裔美国人和西班牙裔儿童以及低收入儿童 先前的研究发现社区特征会影响社会经济地位（SES）。 但社区计划和政策 (CPP) 影响饮食的有效性并不一致 按种族/族裔构成和社区社会经济地位划分的跨社区。 环境是了解 CPP 对饮食的有效性的一个重要考虑因素，并且可能 部分解释了 CPP 跨亚组的差异效应，但很少有研究对此进行解释。 研究了哪些干预措施对于改善社区环境中的饮食最有效 关于背景因素如何影响食品环境干预的国家研究更少 拟议的研究将利用现有的 NHLBI 数据集以及 CPP 信息， 情境食物环境以及儿童、家庭、邻里、学校和社区 该研究涵盖了 4,500 多名 K 至 8 年级的儿童。 美国 130 个社区中近 10,000 个具有不同种族/民族和 SES 背景的人。 CPP 是通过对社区内 1,400 多次关键知情人的采访记录的。 家庭周围 1、3、5 和 8 公里缓冲区的环境措施（例如超市的密度）， 以及以学校为中心的缓冲中，来自超过 5800 万个企业列表的具体目标。 本研究的目的是 1) 确定 CPP 和背景食物环境对饮食的影响，包括 摄入营养价值最低的能量密集食品； SSB；水果和蔬菜摄入量；和快餐摄入量；2) 确定 CPP 之间的关系中是否存在因种族、族裔和社会经济地位而存在的差异 为了评估我们的目标，我们需要考虑到相关的食物环境数据。 将估计具有随机截距和斜率的线性混合模型，以控制聚类 拟议的研究具有成本效益，因为它需要使用二次数据进行分析。 该研究的独特之处在于它使用了 CPP 和情境食品。 在多个地理范围内针对大量不同国家儿童样本采取的环境措施 以及儿童、家庭、邻里、学校和社区层面的控制变量。 研究结果预计将有助于确定未来社区如何投资于项目、干预措施和 制定并实施政策以改善儿童饮食并解决与饮食相关的健康问题 生命早期的差异。