Population Health Research Institute, Hamilton Health Sciences & McMaster University, Hamilton, Canada.
PLoS One. 2010 Dec 10;5(12):e14294. doi: 10.1371/journal.pone.0014294.
The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors.
METHOD/PRINCIPAL FINDINGS: THE ENVIRONMENTAL PROFILE OF COMMUNITY HEALTH (EPOCH) INSTRUMENT COMPRISES TWO PARTS: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents' perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient--ICC>0.75) for 24 of 38 items and fair to good (ICC 0.4-0.75) for 14 of 38 items.
This report shows data collection with the EPOCH instrument is feasible and direct observation of community measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings.
人们生活的环境对于影响心血管疾病的饮食、身体活动、吸烟、心理社会和其他风险因素是很重要的。然而，目前还没有一种工具可以评估这些多种环境因素，并且适合在不同的社区、地区和国家使用。本报告介绍了一种用于测量心血管危险因素环境决定因素的工具的设计和可靠性。
方法/主要发现：社区健康环境概况（EPOCH）工具包括两部分：（一）对物理环境的评估，（二）通过访谈者对居民对其社区的看法进行问卷调查。我们检验了该仪器直接观察部分（EPOCH I）的 3 名观察者在 5 个国家（加拿大、哥伦比亚、巴西、中国和印度）的 93 个农村和城市社区中的观察者之间的评分者间可靠性。在所有社区中，EPOCH 仪器的数据收集都是可行的。该仪器的可靠性对于 38 个项目中的 24 个项目为优秀（组内相关系数 ICC>0.75），对于 38 个项目中的 14 个项目为良好至优秀（ICC 0.4-0.75）。
本报告表明，EPOCH 仪器的数据收集是可行的，社区测量的直接观察是可靠的。EPOCH 仪器将使来自广泛背景的人群研究能够进一步研究健康的环境决定因素。
