Knapp Emily A, Nau Claudia, Brandau Sy, DeWalle Joseph, Hirsch Annemarie G, Bailey-Davis Lisa, Schwartz Brian S, Glass Thomas A
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Am J Prev Med. 2017 Apr;52(4):530-540. doi: 10.1016/j.amepre.2016.11.013. Epub 2017 Feb 13.
There are currently no direct observation environmental audit tools that measure diverse aspects of the obesity-related environment efficiently and reliably in a variety of geographic settings. The goal was to develop a new instrument to reliably characterize the overall properties and features of rural, suburban, and urban settings along multiple dimensions. The Community Audit of Social, Civil, and Activity Domains in Diverse Environments (CASCADDE) is an iPad-based instrument that incorporates GPS coordinates and photography and comprises 214 items yielding seven summary indices. A comprehensive spatial sampling strategy, training manual, and supporting data analysis code were also developed. Random geospatial sampling using GIS was used to capture features of the community as a whole. A single auditor collected 510 observation points in 30 communities (2013-2015). This analysis was done in 2015-2016. Correlation coefficients were used to compare items and indices to each other and to standard measures. Multilevel unconditional means models were used to calculate intraclass correlation coefficients to determine if there was significant variation between communities. Results suggest that CASCADDE measures aspects of communities not previously captured by secondary data sources. Additionally, seven summary indices capture meaningful differences between communities based on 15 observations per community. Community audit tools such as CASCADDE complement secondary data sources and have the potential to offer new insights about the mechanisms through which communities affect obesity and other health outcomes.
目前还没有直接观察环境的审计工具能够在各种地理环境中高效且可靠地衡量与肥胖相关环境的多个方面。目标是开发一种新工具，以便在多个维度上可靠地描述农村、郊区和城市环境的整体属性和特征。《不同环境下社会、公民和活动领域社区审计》（CASCADDE）是一种基于iPad的工具，它结合了GPS坐标和摄影功能，包含214个项目，产生七个汇总指标。还制定了全面的空间抽样策略、培训手册和支持性数据分析代码。利用地理信息系统（GIS）进行随机地理空间抽样，以捕捉整个社区的特征。一名审计员在30个社区收集了510个观察点（2013 - 2015年）。该分析于2015 - 2016年进行。使用相关系数将各个项目和指标相互比较，并与标准测量进行比较。使用多水平无条件均值模型计算组内相关系数，以确定社区之间是否存在显著差异。结果表明，CASCADDE能够衡量社区中先前未被二手数据源捕捉到的方面。此外，七个汇总指标基于每个社区15次观察捕捉到了社区之间有意义的差异。像CASCADDE这样的社区审计工具补充了二手数据源，并有可能为社区影响肥胖及其他健康结果的机制提供新的见解。
