Cheadle A, Wagner E, Koepsell T, Kristal A, Patrick D
Department of Health Services, University of Washington, Seattle 98195.
Am J Prev Med. 1992 Nov-Dec;8(6):345-50.
We propose using a class of community-level measures--environmental indicators--as part of the evaluation of community-based health-promotion programs. Community-level measures of health-related behavior can be divided into three conceptual categories. The first two categories comprise statistical aggregates (e.g., means, sums, percentages) of measurements made on individuals, distinguished by whether individual-level covariates are also available. Individual-disaggregated measures include covariates, such as a comprehensive survey of health-risk behavior, including demographic information; individual-aggregated measures, such as sales data, do not. Our main focus is on the third category, environmental indicators, derived from observations of the community environment. Environmental indicators measures aspects of the physical, legal, social, and economic environment in a community that reflect, and likely influence, the attitudes and behavior of individual community members. They also measure an important intermediate step in community-based health-promotion interventions, namely environmental factors that programs target to modify individual attitudes and behavior. We present examples of environmental indicators for tobacco use and diet.
我们建议使用一类社区层面的指标——环境指标——作为基于社区的健康促进项目评估的一部分。与健康相关行为的社区层面指标可分为三个概念类别。前两个类别包括对个体进行测量的统计汇总（如均值、总和、百分比），其区别在于个体层面的协变量是否也可用。个体分解指标包括协变量，如对健康风险行为的全面调查，包括人口统计信息；个体汇总指标，如销售数据，则不包括。我们主要关注的是第三类，即从社区环境观察中得出的环境指标。环境指标衡量社区中物理、法律、社会和经济环境的各个方面，这些方面反映并可能影响社区个体成员的态度和行为。它们还衡量基于社区的健康促进干预措施中的一个重要中间步骤，即项目旨在改变个体态度和行为所针对的环境因素。我们给出了烟草使用和饮食方面的环境指标示例。
