Mobley Lee R, Finkelstein Eric A, Khavjou Olga A, Will Julie C
RTI International, Health, Social and Economics Research, Research Triangle Park, NC 27709, USA.
J Womens Health (Larchmt). 2004 Jun;13(5):519-28. doi: 10.1089/1540999041281034.
The WISEWOMAN program focuses on reducing cardiovascular disease (CVD) risk factors by providing screening and lifestyle interventions for many low-income and uninsured women. To provide the most effective interventions possible, it is important to understand the characteristics of WISEWOMAN participants and their communities.
We used baseline data collected for WISEWOMAN participants from five states (Connecticut, Michigan, Nebraska, North Carolina, and South Dakota) who had enrolled in WISEWOMAN between January 2001 and December 2002 in order to examine body mass index (BMI) and smoking behavior for evidence of spatial clustering. We then examined whether neighborhood characteristics in clusters of high-risk factors differed from neighborhood characteristics in other locations.
Six percent of the WISEWOMAN participants lived in ZIP codes with high-BMI clusters, and 4% lived in ZIP codes with high-smoking clusters. High-BMI and high-smoking clusters occurred, however, in different locations from each other. The high-BMI-clustered ZIP codes were, on average, located in more disadvantaged areas. Most of the differences between the high-smoking-clustered ZIP codes and the remaining ZIP codes were not statistically significant.
Our analysis revealed spatial clustering in CVD risk factors among WISE-WOMAN participants. We also found evidence of a correlation between high-BMI clusters and low socioeconomic status of the surrounding community. A more in-depth analysis of the relationship between risk factors (e.g., BMI) and community characteristics in clustered locations will provide further information concerning the role of the community in affecting individual behavior and should allow for tailoring interventions to reduce these risk factors more effectively.
明智女性计划致力于通过为众多低收入且未参保的女性提供筛查和生活方式干预措施，来降低心血管疾病（CVD）风险因素。为了尽可能提供最有效的干预措施，了解明智女性计划参与者及其社区的特征非常重要。
我们使用了从2001年1月至2002年12月期间参加明智女性计划的来自五个州（康涅狄格州、密歇根州、内布拉斯加州、北卡罗来纳州和南达科他州）的参与者的基线数据，以检查体重指数（BMI）和吸烟行为，寻找空间聚集的证据。然后，我们研究了高风险因素聚集区的社区特征与其他地区的社区特征是否存在差异。
6%的明智女性计划参与者居住在BMI高聚集的邮政编码区域，4%居住在吸烟率高聚集的邮政编码区域。然而，高BMI聚集区和高吸烟聚集区位于不同的地方。平均而言，BMI高聚集的邮政编码区域位于更贫困的地区。吸烟率高聚集的邮政编码区域与其余邮政编码区域之间的大多数差异无统计学意义。
我们的分析揭示了明智女性计划参与者中CVD风险因素的空间聚集现象。我们还发现了高BMI聚集区与周边社区低社会经济地位之间存在关联的证据。对聚集地区的风险因素（如BMI）与社区特征之间的关系进行更深入的分析，将提供有关社区在影响个人行为方面作用的更多信息，并应有助于更有效地量身定制干预措施以降低这些风险因素。
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