Longacre Meghan R, Primack Brian A, Owens Peter M, Gibson Lucinda, Beauregard Sandy, Mackenzie Todd A, Dalton Madeline A
Department of Pediatrics, Dartmouth Medical School, Lebanon, NH 03756-0001, USA.
J Am Diet Assoc. 2011 Apr;111(4):577-82. doi: 10.1016/j.jada.2011.01.008.
Communities are being encouraged to develop locally based interventions to address environmental risk factors for obesity. Online public directories represent an affordable and easily accessible mechanism for mapping community food environments, but may have limited utility in rural areas. The primary aim of this study was to evaluate the efficacy of public directories vs rigorous onsite field verification to characterize the community food environment in 32 geographically dispersed towns from two rural states covering 1,237.6 square miles. Eight types of food outlets were assessed in 2007, including food markets and eating establishments, first using two publically available online directories followed by onsite field verification by trained coders. χ(2) and univariate binomial regression were used to determine whether the proportion of outlets accurately listed varied by food outlet type or town population. Among 1,340 identified outlets, only 36.9% were accurately listed through public directories; 29.6% were not listed but were located during field observation. Accuracy varied by outlet type, being most accurate for big box stores and least accurate for farm/produce stands. Overall, public directories accurately identified fewer than half of the food outlets. Accuracy was significantly lower for rural and small towns compared to mid-size and urban towns (P<0.001). In this geographic sample, public directories seriously misrepresented the actual distribution of food outlets, particularly for rural and small towns. To inform local obesity-prevention efforts, communities should strongly consider using field verification to characterize the food environment in low-population areas.
社区正被鼓励制定基于当地的干预措施，以应对导致肥胖的环境风险因素。在线公共目录是绘制社区食物环境的一种经济实惠且易于获取的机制，但在农村地区的效用可能有限。本研究的主要目的是评估公共目录与严格的现场实地核查在描述来自两个农村州、地理分布分散的32个城镇（覆盖面积1237.6平方英里）的社区食物环境方面的效果。2007年对八种类型的食品销售点进行了评估，包括食品市场和餐饮场所，首先使用两个公开可用的在线目录，然后由经过培训的编码员进行现场实地核查。使用卡方检验和单变量二项式回归来确定准确列出的销售点比例是否因食品销售点类型或城镇人口而异。在1340个已识别的销售点中，通过公共目录准确列出的仅占36.9%；29.6%未被列出，但在实地观察中被找到。准确性因销售点类型而异，对大型商店最准确，对农场/农产品摊位最不准确。总体而言，公共目录准确识别的食品销售点不到一半。与中型和城市城镇相比，农村和小城镇的准确性显著更低（P<0.001）。在这个地理样本中，公共目录严重歪曲了食品销售点的实际分布，尤其是在农村和小城镇。为了为当地的肥胖预防工作提供信息，社区应强烈考虑使用实地核查来描述低人口地区的食物环境。
