Athens Jessica K, Duncan Dustin T, Elbel Brian
J Acad Nutr Diet. 2016 Aug;116(8):1266-75. doi: 10.1016/j.jand.2015.12.022. Epub 2016 Feb 28.
This study used cross-sectional data to test the independent relationship of proximity to chain fast-food outlets and proximity to full-service supermarkets on the frequency of mealtime dining at fast-food outlets in two major urban areas, using three approaches to define access. Interactions between presence of a supermarket and presence of fast-food outlets as predictors of fast-food dining were also tested.
Residential intersections for respondents in point-of-purchase and random-digit-dial telephone surveys of adults in Philadelphia, PA, and Baltimore, MD, were geocoded. The count of fast-food outlets and supermarkets within quarter-mile, half-mile, and 1-mile street network buffers around each respondent's intersection was calculated, as well as distance to the nearest fast-food outlet and supermarket. These variables were regressed on weekly fast-food dining frequency to determine whether proximity to fast food and supermarkets had independent and joint effects on fast-food dining.
The effect of access to supermarkets and chain fast-food outlets varied by study population. Among telephone survey respondents, supermarket access was the only significant predictor of fast-food dining frequency. Point-of-purchase respondents were generally unaffected by proximity to either supermarkets or fast-food outlets. However, ≥1 fast-food outlet within a 1-mile buffer was an independent predictor of consuming more fast-food meals among point-of-purchase respondents. At the quarter-mile distance, ≥1 supermarket was predictive of fewer fast-food meals.
Supermarket access was associated with less fast-food dining among telephone respondents, whereas access to fast-food outlets were associated with more fast-food visits among survey respondents identified at point-of-purchase. This study adds to the existing literature on geographic determinants of fast-food dining behavior among urban adults in the general population and those who regularly consume fast food.
本研究使用横断面数据，采用三种定义可达性的方法，来检验在两个主要城区中，靠近连锁快餐店的程度和靠近提供全方位服务超市的程度与在快餐店用餐频率之间的独立关系。还检验了超市的存在与快餐店的存在之间的交互作用，以此作为快餐用餐的预测因素。
对宾夕法尼亚州费城和马里兰州巴尔的摩的成年人进行的购买点调查和随机数字拨号电话调查中，受访者的居住交叉点进行了地理编码。计算了每个受访者交叉点周围四分之一英里、半英里和1英里街道网络缓冲区内的快餐店和超市数量，以及到最近的快餐店和超市的距离。将这些变量对每周快餐用餐频率进行回归，以确定靠近快餐和超市是否对快餐用餐有独立和联合影响。
超市和连锁快餐店可达性的影响因研究人群而异。在电话调查受访者中，超市可达性是快餐用餐频率的唯一显著预测因素。购买点调查的受访者通常不受靠近超市或快餐店的影响。然而，在1英里缓冲区内有≥1家快餐店是购买点调查受访者中食用更多快餐的独立预测因素。在四分之一英里的距离内，≥1家超市预示着快餐用餐次数减少。
超市可达性与电话受访者中较少的快餐用餐相关，而靠近快餐店则与在购买点识别出的调查受访者中更多的快餐光顾相关。本研究为关于普通人群和经常食用快餐的城市成年人快餐用餐行为的地理决定因素的现有文献增添了内容。
