Catlin Tegan K, Simoes Eduardo J, Brownson Ross C
Department of Community Health, St Louis University School of Public Health, 3545 Lafayette Avenue, Salus Center 469, St Louis, MO 63104-1314, USA.
Am J Health Promot. 2003 Mar-Apr;17(4):249-58. doi: 10.4278/0890-1171-17.4.249.
To measure the association between environmental and policy factors (i.e., community perceptions, community infrastructure, and worksite infrastructure) and being overweight.
Cross-sectional data from the Missouri Cardiovascular Disease Survey, a one-time random-digit-dialed telephone interview of noninstitutionalized adults.
Missouri, 1999 to 2000.
The response rate was 69.6%. A total of 2821 adults completed the interview. The sample was weighted to represent the population of Missouri: 52% female, 71% white, and 59% overweight.
The survey comprised 92 closed-ended multiple-choice items. Overweight was defined as a body mass index greater than or equal to 25 kg/m2 on the basis of self-reported height and weight.
After adjustment for demographic and behavioral factors, environmental variables associated with being overweight included negative (i.e., unsafe and unpleasant) community perceptions (adjusted odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.1, 2.3) and the absence of outdoor exercise facilities (OR = 1.2; CI = 1.0, 1.5). Worksite policy variables were not related to the outcome; however, negative community perceptions (OR = 2.8; CI = 1.5, 5.2) and the absence of sidewalks and shoulders (OR = 1.7; CI = 1.3, 2.4) were associated with overweight among employed persons.
An ecological perspective, focusing on the physical and social environment, was adopted to address the subject of overweight and obesity. Results of this study show that negative perceptions of the physical environment and the absence of enabling infrastructure are modestly associated with overweight, in comparison with other known risk factors. Environmental and policy interventions that promote healthier lifestyles by encouraging physical activity and healthy eating may have an effect on reducing the prevalence of overweight and obesity.
测量环境与政策因素（即社区认知、社区基础设施和工作场所基础设施）与超重之间的关联。
来自密苏里心血管疾病调查的横断面数据，这是一项对非机构化成年人进行的一次性随机数字拨号电话访谈。
密苏里州，1999年至2000年。
应答率为69.6%。共有2821名成年人完成了访谈。该样本经过加权以代表密苏里州的人口：52%为女性，71%为白人，59%超重。
该调查包括92个封闭式多项选择题。根据自我报告的身高和体重，超重被定义为体重指数大于或等于25kg/m²。
在对人口统计学和行为因素进行调整后，与超重相关的环境变量包括负面（即不安全和不愉快）的社区认知（调整后的优势比[OR]=1.6；95%置信区间[CI]=1.1，2.3）以及缺乏户外锻炼设施（OR=1.2；CI=1.0，1.5）。工作场所政策变量与结果无关；然而，负面的社区认知（OR=2.8；CI=1.5，5.2）以及缺乏人行道和路肩（OR=1.7；CI=1.3，2.4）与就业人员超重有关。
采用了关注物理和社会环境的生态视角来探讨超重和肥胖问题。本研究结果表明，与其他已知风险因素相比，对物理环境的负面认知和缺乏有利基础设施与超重有一定关联。通过鼓励体育活动和健康饮食来促进更健康生活方式的环境和政策干预措施可能对降低超重和肥胖的患病率有效果。
