Department of Architecture, Texas A&M University, College Station, TX, United States.
Center for Health Systems & Design, Texas A&M University, College Station, TX, United States.
Front Public Health. 2022 Jun 15;10:929331. doi: 10.3389/fpubh.2022.929331. eCollection 2022.
Stakeholders from multiple sectors are increasingly aware of the critical need for identifying sustainable interventions that promote healthy lifestyle behaviors. Activity-friendly communities (AFCs) have been known to provide opportunities for engaging in physical activity (PA) across the life course, which is a key to healthy living and healthy aging.
Our purpose is to describe the study protocol developed for a research project that examines: (a) the short- and long-term changes in total levels and spatial and temporal patterns of PA after individuals move from non-AFCs to an AFC; and (b) what built and natural environmental factors lead to changes in PA resulting from such a move, either directly or indirectly (e.g., by affecting psychosocial factors related to PA).
This protocol is for a longitudinal, case-comparison study utilizing a unique natural experiment opportunity in Austin, Texas, USA. Case participants were those adults who moved from non-AFCs to an AFC. Matching comparison participants were residents from similar non-AFCs who did not move during the study period. Recruitment venues included local businesses, social and print media, community events, and individual referrals. Objectively measured moderate-to-vigorous PA and associated spatial and temporal patterns served as the key outcomes of interest. Independent (e.g., physical environments), confounding (e.g., demographic factors), and mediating variables (e.g., psychosocial factors) were captured using a combination of objective (e.g., GIS, GPS, Tanita scale) and subjective measures (e.g., survey, travel diary). Statistical analyses will be conducted using multiple methods, including difference-in-differences models, repeated-measures linear mixed models, hierarchical marked space-time Poisson point pattern analysis, and hierarchical linear mixed models.
Natural experiment studies help investigate causal relationships between health and place. However, multiple challenges associated with participant recruitment, extensive and extended data collection activities, and unpredictable intervention schedules have discouraged many researchers from implementing such studies in community-based populations. This detailed study protocol will inform the execution of future studies to explore how AFCs impact population health across the life course.
越来越多的来自多个领域的利益相关者意识到，迫切需要确定可持续的干预措施，以促进健康的生活方式行为。适宜活动社区（AFC）被认为提供了贯穿整个生命周期进行身体活动（PA）的机会，这是健康生活和健康老龄化的关键。
我们的目的是描述为一个研究项目制定的研究方案，该项目旨在研究：（a）个人从非 AFC 转移到 AFC 后，PA 的总水平以及时空模式的短期和长期变化；（b）哪些建筑和自然环境因素直接或间接导致 PA 的变化（例如，通过影响与 PA 相关的心理社会因素）。
本方案是一项针对美国德克萨斯州奥斯汀市的一项纵向病例对照研究，利用独特的自然实验机会。病例参与者是那些从非 AFC 转移到 AFC 的成年人。匹配的对照组参与者是在研究期间没有搬家的来自类似非 AFC 的居民。招募地点包括当地企业、社交和印刷媒体、社区活动和个人推荐。作为主要关注的关键结果，测量了客观的中等到剧烈的 PA 及其相关的时空模式。使用客观（例如，GIS、GPS、Tanita 秤）和主观测量（例如，调查、旅行日记）来捕获独立（例如，物理环境）、混杂（例如，人口统计学因素）和中介变量（例如，心理社会因素）。将使用多种方法进行统计分析，包括差异中的差异模型、重复测量线性混合模型、分层标记时空泊松点模式分析和分层线性混合模型。
自然实验研究有助于调查健康与地点之间的因果关系。然而，与参与者招募、广泛和扩展的数据收集活动以及不可预测的干预计划相关的多个挑战，使许多研究人员不愿在基于社区的人群中实施此类研究。本详细的研究方案将为未来研究提供信息，以探讨 AFC 如何影响整个生命周期的人群健康。
