Chrisinger Benjamin W, King Abby C, Hua Jenna, Saelens Brian E, Frank Lawrence D, Conway Terry L, Cain Kelli L, Sallis James F
Stanford Prevention Research Center, Stanford University School of Medicine, 1070 Arastradero Road, Suite 300, Palo Alto, CA 94304, USA.
Department of Health Research & Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA 94305, USA.
Geriatrics (Basel). 2019 Jan 10;4(1):11. doi: 10.3390/geriatrics4010011.
(1) Background: Findings from observational studies of relations between neighborhood environments and health outcomes underscore the importance of both objective and perceived experiences of those environments. A clearer understanding of the factors associated with discrepancies between these two assessment approaches is needed to tailor public health interventions to specific populations. This study examined how individual and neighborhood characteristics affect perceptions of supermarket distance, particularly when perceptions do not match objective measures. (2) Methods: Participants were older adults ( = 880) participating in the Senior Neighborhood Quality of Life Study in the Seattle/King County, WA or Baltimore/Washington, DC regions. Two main analyses were conducted. The primary outcome for Analysis I was participants' geographic information systems (GIS)-based objective network distance to the closest supermarket. Generalized linear mixed models with block group-level random effects were used to assess associations between objective supermarket distance and individual/neighborhood characteristics. The primary outcome for Analysis II was a categorical "accuracy" variable, based on participants' perceived distance to the nearest supermarket/grocery store relative to the objective distance, assuming a walking speed of 1.0 m/s. Multivariate log-linear models fit neural networks were used to assess influential covariates. (3) Results: Several significant associations with objective distance to the nearest supermarket were observed, including a negative relationship with body mass index (BMI) (95% CI = -45.56, -0.23), having walked to the supermarket in the last 30 days (-174.86, -59.42), living in a high-walkability neighborhood, and residing in Seattle/King County (-707.69, -353.22). In terms of participants' distance accuracy, 29% were classified as accurate, 33.9% were "Underestimators", 24.0% "Overestimators", and 13.2% responded "Don't Know". Compared to Accurate participants, Overestimators were significantly less likely to have walked to the supermarket in the last 30 days, and lived objectively closer to a supermarket; Underestimators perceived significantly higher pedestrian safety and lived objectively further from a supermarket; and Don't Know were more likely to be women, older, not living independently, and not having recently walked to the supermarket. (4) Conclusions: Both modifiable and nonmodifiable factors influence the accuracy of older adults' perceptions of their proximity to the nearest supermarket. Recent experience in walking to the closest supermarket, along with personal safety, represent potentially modifiable perceived environmental factors that were related to older adults' accuracy of perceptions of their neighborhood food environment.
(1) 背景：关于邻里环境与健康结果之间关系的观察性研究结果强调了这些环境的客观体验和主观感受的重要性。为了针对特定人群量身定制公共卫生干预措施，需要更清楚地了解与这两种评估方法之间差异相关的因素。本研究考察了个体和邻里特征如何影响对超市距离的感知，特别是当感知与客观测量不匹配时。(2) 方法：参与者为880名老年人，他们参与了华盛顿州西雅图/金县或华盛顿特区巴尔的摩/华盛顿地区的老年邻里生活质量研究。进行了两项主要分析。分析I的主要结果是参与者基于地理信息系统（GIS）的到最近超市的客观网络距离。使用具有街区组水平随机效应的广义线性混合模型来评估客观超市距离与个体/邻里特征之间的关联。分析II的主要结果是一个分类的“准确性”变量，该变量基于参与者相对于客观距离感知到的到最近超市/杂货店的距离，并假设步行速度为1.0米/秒。使用拟合神经网络的多元对数线性模型来评估有影响的协变量。(3) 结果：观察到与到最近超市的客观距离有几个显著关联，包括与体重指数（BMI）呈负相关（95%置信区间 = -45.56，-0.23），在过去30天内步行去过超市（-174.86，-59.42），生活在步行便利性高的邻里，以及居住在西雅图/金县（-707.69，-353.22）。就参与者的距离准确性而言，29%被归类为准确，33.9%为“低估者”，24.0%为“高估者”，13.2%回答“不知道”。与准确的参与者相比，高估者在过去30天内步行去超市的可能性显著更低，并且客观上住得离超市更近；低估者感知到的行人安全性显著更高，并且客观上住得离超市更远；而回答“不知道”的人更可能是女性且年龄较大，不独立生活，并且最近没有步行去超市。(4) 结论：可改变和不可改变的因素都影响老年人对其与最近超市距离感知的准确性。最近步行去最近超市的经历以及个人安全，代表了可能与老年人对邻里食物环境感知准确性相关的可改变的感知环境因素。
