Virtual audits of streetscapes by crowdworkers

Audits have been used to provide objective ratings of neighborhood environments. Physical audits, however, are time- and resource-intensive. This study examines the efficiency and reliability of virtual auditing using Google Street View and crowdsourcing to conduct walkability audits of streets in Japan. Overall, 830 street segments were physically and virtually audited by two trained auditors; 300 untrained crowdworkers also virtually audited 3 street segments. Statistical analysis found good inter-source and inter-rater reliability. This study helps establish crowdsourced virtual auditing as a valuable method of measuring neighborhood walkability, reducing audit costs as well as enabling large-scale auditor recruitment while maintaining reliability.     

Can Virtual Streetscape Audits Reliably Replace Physical Streetscape Audits?

There is increasing recognition that the neighborhood-built environment influences health outcomes, such as physical activity behaviors, and technological advancements now provide opportunities to examine the neighborhood streetscape remotely. Accordingly, the aims of this methodological study are to: (1) compare the efficiencies of physically and virtually conducting a streetscape audit within the neighborhood context, and (2) assess the level of agreement between the physical (criterion) and virtual (test) audits. Built environment attributes associated with walking and cycling were audited using the New Zealand Systematic Pedestrian and Cycling Environment Scan (NZ-SPACES) in 48 street segments drawn from four neighborhoods in Auckland, New Zealand. Audits were conducted physically (on-site) and remotely (using Google Street View) in January and February 2010. Time taken to complete the audits, travel mileage, and Internet bandwidth used were also measured. It was quicker to conduct the virtual audits when compared with the physical audits (χ = 115.3 min (virtual), χ = 148.5 min (physical)). In the majority of cases, the physical and virtual audits were within the acceptable levels of agreement (ICC ≥ 0.70) for the variables being assessed. The methodological implication of this study is that Google Street View is a potentially valuable data source for measuring the contextual features of neighborhood streets that likely impact on health outcomes. Overall, Google Street View provided a resource-efficient and reliable alternative to physically auditing the attributes of neighborhood streetscapes associated with walking and cycling. Supplementary data derived from other sources (e.g., Geographical Information Systems) could be used to assess the less reliable streetscape variables.     

Reliability and One-Year Stability of the PIN3 Neighborhood Environmental Audit in Urban and Rural Neighborhoods

Reliable and stable environmental audit instruments are needed to successfully identify the physical and social attributes that may influence physical activity. This study described the reliability and stability of the PIN3 environmental audit instrument in both urban and rural neighborhoods. Four randomly sampled road segments in and around a one-quarter mile buffer of participants’ residences from the Pregnancy, Infection, and Nutrition (PIN3) study were rated twice, approximately 2 weeks apart. One year later, 253 of the year 1 sampled roads were re-audited. The instrument included 43 measures that resulted in 73 item scores for calculation of percent overall agreement, kappa statistics, and log-linear models. For same-day reliability, 81% of items had moderate to outstanding kappa statistics (kappas ≥?0.4). Two-week reliability was slightly lower, with 77% of items having moderate to outstanding agreement using kappa statistics. One-year stability had 68% of items showing moderate to outstanding agreement using kappa statistics. The reliability of the audit measures was largely consistent when comparing urban to rural locations, with only 8% of items exhibiting significant differences (α <?0.05) by urbanicity. The PIN3 instrument is a reliable and stable audit tool for studies assessing neighborhood attributes in urban and rural environments.     

Development and validation of automated microscale walkability audit method

Measuring microscale factors of walkability has been labor-intensive and expensive. To reduce the cost, various efforts have been made including virtual audits (i.e., manual audits using street view images) and the introduction of computer vision techniques. Although studies have shown that virtual audits (i.e., manual audits using street view images) can reliably replicate in-person audits, they are still prohibitively expensive to be applied to a large geographic area. Past studies used computer vision techniques to help automate the audit process, but off-the-shelf models cannot detect some of the important microscale walkability characteristics, falling short of fully capturing the multi-facetted concept of walkability. This study is one of the earliest attempts to use the combination of custom-trained computer vision models, geographic information systems, and street view images to automatically audit a complete set of items of a validated microscale walkability audit tool. This study validates the reliability of the automated audit with virtual audit results. The automated audit results show high reliability, indicating automated audit can be a highly scalable and reliable replacement of virtual audit.     

Development and deployment of the Computer Assisted Neighborhood Visual Assessment System (CANVAS) to measure health-related neighborhood conditions

Public health research has shown that neighborhood conditions are associated with health behaviors and outcomes. Systematic neighborhood audits have helped researchers measure neighborhood conditions that they deem theoretically relevant but not available in existing administrative data. Systematic audits, however, are expensive to conduct and rarely comparable across geographic regions. We describe the development of an online application, the Computer Assisted Neighborhood Visual Assessment System (CANVAS), that uses Google Street View to conduct virtual audits of neighborhood environments. We use this system to assess the inter-rater reliability of 187 items related to walkability and physical disorder on a national sample of 150 street segments in the United States. We find that many items are reliably measured across auditors using CANVAS and that agreement between auditors appears to be uncorrelated with neighborhood demographic characteristics. Based on our results we conclude that Google Street View and CANVAS offer opportunities to develop greater comparability across neighborhood audit studies.     

Effects of 12-week supplementation of marine Omega-3 PUFA-based formulation Omega3Q10 in older adults with prehypertension and/or elevated blood cholesterol

Backgrounds

To study the effects of supplementation of a marine omega-3 poly-unsaturated fatty acids (n3-PUFA) formulation (Omega3Q10) in older adults with hypertension and/or hypercholesterolemia.

Methods

A total of 97 people were enrolled to receive 12-week supplementation of either Omega3Q10 (n?=?48) or soybean oil (n?=?49). Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and hypertension-related symptoms were determined before and after the supplementation.

Results

There were no baseline differences between the two groups. Omega3Q10 supplementation significantly reduced diastolic blood pressure (DBP) (from 81.6?±?5.3 mmHg to 79.3?±?5.2 mmHg, P?<?0.05). Blood concentrations of TC and LDL-C decreased significantly and blood HDL-C level increased significantly after 12 weeks of Omega3Q10 (5.5?±?0.7 vs. 5.3?±?0.5, P?<?0.05; 3.7?±?0.8 vs. 3.3?±?0.6, P?<?0.05; 1.2?±?0.6 vs. 1.3?±?0.5, P?<?0.05, respectively) and soybean oil supplementation (5.7?±?0.8 vs. 5.6?±?0.7, P?<?0.05; 3.6?±?0.7 vs. 3.4?±?0.8, P?<?0.05; 1.0?±?0.8 vs. 1.2?±?0.7, P?<?0.05, respectively) but no group differences were found. A significantly greater proportion of the people in the Omega3Q10 group became free from headache and palpitations & chest tightness symptoms after the 12-week supplementation compared to that of the soybean oil group (95.5% vs. 71.4%, P?<?0.01; 95.8 vs. 75.5%, P?<?0.01, respectively).

Conclusion

12-week supplementation of Fish oil-based PUFA appear to be more effective in improving DBP and hypertension-related symptoms than soybean oil in old adults with hypertension and hypercholesterolemia although both supplementation improved TC, LDL-C and HDL-C concentrations.

     

Validation of a Google Street View-Based Neighborhood Disorder Observational Scale

Recently, there has been a growing interest in developing new tools to measure neighborhood features using the benefits of emerging technologies. This study aimed to assess the psychometric properties of a neighborhood disorder observational scale using Google Street View (GSV). Two groups of raters conducted virtual audits of neighborhood disorder on all census block groups (N?=?92) in a district of the city of Valencia (Spain). Four different analyses were conducted to validate the instrument. First, inter-rater reliability was assessed through intraclass correlation coefficients, indicating moderated levels of agreement among raters. Second, confirmatory factor analyses were performed to test the latent structure of the scale. A bifactor solution was proposed, comprising a general factor (general neighborhood disorder) and two specific factors (physical disorder and physical decay). Third, the virtual audit scores were assessed with the physical audit scores, showing a positive relationship between both audit methods. In addition, correlations between the factor scores and socioeconomic and criminality indicators were assessed. Finally, we analyzed the spatial autocorrelation of the scale factors, and two fully Bayesian spatial regression models were run to study the influence of these factors on drug-related police interventions and interventions with young offenders. All these indicators showed an association with the general neighborhood disorder. Taking together, results suggest that the GSV-based neighborhood disorder scale is a reliable, concise, and valid instrument to assess neighborhood disorder using new technologies.     

Using remote sensing to define environmental characteristics related to physical activity and dietary behaviours: A systematic review (the SPOTLIGHT project)

We performed a systematic literature review on the use of free geospatial services as potential tools to assess built environmental characteristics related to dietary behaviour and physical activity. We included 13 studies, all published since 2010 and conducted in urban contexts, with Google Earth and Google Street View as the two main free geospatial services used. The agreement between virtual and field audit was higher for items related to objectively verifiable measures (e.g. presence of infrastructure and equipment) and lower for subjectively assessed items (e.g. aesthetics, street atmosphere, etc.). Free geospatial services appear as promising alternatives to field audit for assessment of objective dimensions of the built environment.     

African-American women’s Upward Economic Mobility and Small for Gestational Age Births: A Population-Based Study

Background The relationship between African-American women’s upward economic mobility and small for gestational age (weight for gestational?<?10th percentile, SGA) rates is incompletely understood. Objective To ascertain the extent to which African-American women’s upward economic mobility from early-life impoverishment is coupled with reduced SGA rates. Methods Stratified and multilevel logistic regression analyses were completed on the Illinois transgenerational dataset of African-American infants (1989–1991) and their Chicago-born mothers (1956–1976) with linked U.S. census income information. Results Impoverished-born (defined as lowest quartile of neighborhood income distribution) African-American women (n?=?4891) who remained impoverished by the time of delivery had a SGA rate of 19.7%. Individuals who achieved low (n?=?5827), modest (n?=?2254), or high (n?=?732) upward economic mobility by adulthood had lower SGA rates of 17.2, 14.8, and 13.7%, respectively; RR?=?0.9 (0.8–0.9), 0.8 (0.7–0.8), and 0.7 (0.6–0.8), respectively. In adjusted (controlling for traditional individual-level risk factors) multilevel regression models, there was a decreasing linear trend in SGA rates with increasing levels of upward economic mobility; the adjusted RR of SGA birth for impoverished-born African-American women who experienced low, modest, of high (compared to no) upward mobility equaled 0.95 (0.91, 0.99), 0.90 (0.83, 0.98), and 0.86 (0.75, 0.98), respectively, p?<?0.05. Conclusions African-American women’s upward economic mobility from early-life residence in poor urban communities is associated with lower SGA rates independent of adulthood risk status.     

Examining the Prevalence Rates of Preexisting Maternal Medical Conditions and Pregnancy Complications by Source: Evidence to Inform Maternal and Child Research

Objectives We sought to examine whether there are systematic differences in ascertainment of preexisting maternal medical conditions and pregnancy complications from three common data sources used in epidemiologic research. Methods Diabetes mellitus, chronic hypertension, gestational diabetes mellitus (GDM), gestational hypertensive disorders (GHD), placental abruption and premature rupture of membranes (PROM) among 4821 pregnancies were identified via birth certificates, maternal self-report at approximately 4 months postpartum and by discharge codes from the Statewide Planning and Research Cooperative System (SPARCS), a mandatory New York State hospital reporting system. The kappa statistic (k) was estimated to ascertain beyond chance agreement of outcomes between birth certificates with either maternal self-report or SPARCS. Results GHD was under-ascertained on birth certificates (5.7?%) and more frequently indicated by maternal report (11?%) and discharge data (8.2?%). PROM was indicated more on birth certificates (7.4?%) than maternal report (4.5?%) or discharge data (5.7?%). Confirmation across data sources for some outcomes varied by maternal age, race/ethnicity, prenatal care utilization, preterm delivery, parity, mode of delivery, infant sex, use of infertility treatment and for multiple births. Agreement between maternal report and discharge data with birth certificates was generally poor (kappa?<?0.4) to moderate (0.4?≤?kappa?<?0.75) but was excellent between discharge data and birth certificates for GDM among women who underwent infertility treatment (kappa?=?0.79, 95?% CI 0.74, 0.85). Conclusions for Practice Prevalence and agreement of conditions varied across sources. Condition-specific variations in reporting should be considered when designing studies that investigate associations between preexisting maternal medical and pregnancy-related conditions with health outcomes over the life-course.     

Point-of-Sale E-cigarette Advertising Among Tobacco Stores

The marketing expenditure and sale of e-cigarettes increased sharply in the United States in recent years. However, little is known about neighborhood characteristics of point-of-sale (POS) e-cigarette advertising among tobacco stores. The purpose of this study was to examine socio-demographic characteristics of POS e-cigarette advertising among tobacco stores in the Omaha metropolitan area of Nebraska, USA. Between April and June 2014, trained fieldworkers completed marketing audits of all stores that sell tobacco (n?=?463) in the Omaha metropolitan area and collected comprehensive e-cigarette advertising data of these stores. Based on the auditing information, we categorized tobacco stores based on e-cigarette advertising status. Logistic regression was used to examine the association between neighborhood socio-demographic factors and e-cigarette advertising among tobacco stores. 251 (54.2%) of the 463 tobacco stores had e-cigarette advertisements. We found that neighborhoods of stores with POS e-cigarette advertising had higher per capita income (p?<?0.05), higher percentage of non-hispanic whites (p?<?0.005), and higher percentage of individuals with high school education (p?<?0.005) than neighborhoods of stores without POS e-cigarette advertising. There were negative associations between e-cigarette advertising and number of adolescents or number of middle/high school students. After adjusting for covariates, only percentage of non-Hispanic Whites remained a significant factor for e-cigarette advertising. POS e-cigarette advertising among tobacco stores is related with neighborhood socioeconomic and demographic characteristics. Future studies are needed to understand how these characteristics are related with e-cigarette purchasing and e-cigarette prevalence among social groups.     

Active neighborhood checklist: a user-friendly and reliable tool for assessing activity friendliness

PURPOSE: To test the reliability of the Active Neighborhood Checklist (the Checklist), a user-friendly audit tool for assessing neighborhood environmental supports for physical activity. METHODS: Sixty-four street segments in St. Louis and southeastern Missouri were selected among diverse areas that varied with respect to socioeconomic levels, urbanization, and land use. Fifteen public health researchers and seven community stakeholders conducted audits in April 2005 following a two-hour training session. Interrater reliability was measured for the items in each section of the Checklist (land use characteristics, sidewalks, shoulders and bike lanes, street characteristics, and quality of the environment for a pedestrian) using observed agreement and the kappa statistic. RESULTS: The mean observed agreement for 57 evaluated items was 0.87 (range, 0.61-1.00). The mean kappa statistic was 0.68 (range, 0.21-1.00). DISCUSSION: With minimal training of the auditors, the Checklist demonstrated strong reliability. Future studies are needed to provide information about its usability for various stakeholders and across different settings.     

Measurement Properties of the Modified Spinal Function Sort (M-SFS): Is It Reliable and Valid in Workers with Chronic Musculoskeletal Pain?

Purpose To analyze the reliability and validity of a picture-based questionnaire, the Modified Spinal Function Sort (M-SFS). Methods Sixty-two injured workers with chronic musculoskeletal disorders (MSD) were recruited from two work rehabilitation centers. Internal consistency was assessed by Cronbach’s alpha. Construct validity was tested based on four a priori hypotheses. Structural validity was measured with principal component analysis (PCA). Test–retest reliability and agreement was evaluated using intraclass correlation coefficient (ICC) and measurement error with the limits of agreement (LoA). Results Total score of the M-SFS was 54.4 (SD 16.4) and 56.1 (16.4) for test and retest, respectively. Item distribution showed no ceiling effects. Cronbach’s alpha was 0.94 and 0.95 for test and retest, respectively. PCA showed the presence of four components explaining a total of 74% of the variance. Item communalities were >0.6 in 17 out of 20 items. ICC was 0.90, LoA was ±12.6/16.2 points. The correlations between the M-SFS were 0.89 with the original SFS, 0.49 with the Pain Disability Index, ?0.37 and ?0.33 with the Numeric Rating Scale for actual pain, ?0.52 for selfreported disability due to chronic low back pain, and 0.50, 0.56–0.59 with three distinct lifting tests. No a priori defined hypothesis for construct validity was rejected. Conclusions The M-SFS allows reliable and valid assessment of perceived self-efficacy for work-related tasks and can be recommended for use in patients with chronic MSD. Further research should investigate the proposed M-SFS score of <56 for its predictive validity for non-return to work.     

Within-person fluctuations in wellbeing and task-specific work ability

Purpose

To research within-person fluctuations in occupational health, work ability and wellbeing, we need new measurement strategies. We studied absolute agreement for weekly measurements of task-specific work ability and relationships between wellbeing, work demands and personal factors and task-specific work ability over time.

Methods

Forty-eight Dutch academic researchers answered questions during 12 consecutive weeks. Physical and mental work demands, indicators of wellbeing and task-specific work ability in each week were measured. Intra-class correlation coefficients (ICC) for absolute agreement between task-specific work ability measures were calculated. For application in individual workers, an ICC?>?0.90 was regarded as suitable. Multilevel models were used to relate both time-invariant and time-varying predictors to task-specific work ability.

Results

Multiple measurements increased the reliability. Absolute agreement, however, did not reach the optimal level, except for the task ‘ability to conduct data analyses’ which had an ICC value of 0.95 (95% CI 0.91–0.98). Individuals’ leisure time physical activity (p?=?0.03) and relational (p?=?0.02) and social (p?=?0.02) wellbeing were related to their average task-specific work ability. Weekly physical demands (p?=?0.01) and personal (p?=?0.04) and general wellbeing (p?=?0.03) were related to weekly fluctuations in work ability.

Conclusions

We demonstrated intra-individual variability in repeated assessments of task-specific work ability, pointing to the need for multiple measurements when characterizing work ability. The finding that some time-invariant and time-varying predictors can be related to the estimate of aspects of task-specific work ability and its fluctuations is helpful in understanding the dynamics of this concept.

     

城市体力活动相关建成环境客观评价工具的信度和效度研究

目的 在杭州市6个社区中研究城市体力活动相关建成环境评价工具的信度和效度.方法 在杭州市按公共建筑开发功能区选取6个社区共205个路段,2名调查员同时独立进行调查评价调查者间信度,间隔7d重复调查约一半路段(104个)评价调查者内信度.采用因子分析方法检验结构效度.结果 问卷调查者间信度Kappa值大部分在0.8以上;调查者内信度低于调查者间信度,Kappa值大部分在0.4以上.问卷表面效度良好.结构效度研究提取了6个因子,符合问卷的初始题目设计,因子负荷矩阵显示问卷结构效度良好.结论 此建成环境评价量表的信度、效度较好,适合在杭州使用.     

<Emphasis Type="Italic">True Love</Emphasis>: Effectiveness of a School-Based Program to Reduce Dating Violence Among Adolescents in Mexico City

Dating violence is a significant problem in Mexico. National survey data estimated 76 % of Mexican youth have been victims of psychological aggression in their relationships; 15.5 % have experienced physical violence; and 16.5 % of women have been the victims of sexual violence. Female adolescents perpetrate physical violence more frequently than males, while perpetration between genders of other types of violence is unclear. Furthermore, poor, marginalized youth are at a higher risk for experiencing dating violence. “Amor… pero del Bueno” (True Love) was piloted in two urban, low-income high schools in Mexico City to prevent dating violence. The intervention consisted of school-level and individual-level components delivered over 16 weeks covering topics on gender roles, dating violence, sexual rights, and strategies for coping with dating violence. The short-term impact was assessed quasi-experimentally, using matching techniques and fixed-effects models. A sample of 885 students (381 students exposed to the classroom-based curriculum of the individual-level component (SCC, IL-1) and 540 exposed only to the school climate component (SCC)) was evaluated for the following: changes in dating violence behaviors (psychological, physical and sexual), beliefs related to gender norms, knowledge, and skills for preventing dating violence. We found a 58 % (p?<?0.05) and 55 % (p?<?0.05) reduction in the prevalence of perpetrated and experienced psychological violence, respectively, among SCC, IL-1 males compared to males exposed only to the SCC component. We also found a significant reduction in beliefs and attitudes justifying sexism and violence in dating relationships among SCC, IL-1 females (6 %; p?<?0.05) and males (7 %; p?<?0.05).     

The Influence of Home and School Environments on Children’s Diet and Physical Activity,and Body Mass Index: A Structural Equation Modelling Approach

Introduction The home and school environments play important roles in influencing children’s health behaviours. However, their simultaneous influence on childhood obesity has not yet been examined. We explore the relationship of the home and school environments with childhood obesity, to determine whether this relationship is mediated by children’s fruit and vegetable intake and physical behaviours. Methods This study uses baseline data from 9 to 11 year old children, their parents and school principals (matched data n?=?2466) from the Obesity Prevention and Lifestyle Project. Child-reported behaviours, parent-reported home environment and principal-reported school environment data were collected via questionnaires. Trained researchers measured children’s height and weight, and Body Mass Index (BMI, kg/m²) was calculated. Structural equation modelling was used to assess the relationship of the home and school environments with children’s fruit and vegetable intake, physical activity behaviours, and children’s BMI. Result The home diet environment was positively associated with child diet (β?=?0.18, p?<?0.001). The home physical activity environment had the largest inverse association with BMI (β?=???0.11, p?<?0.001), indirectly through child physical activity (β?=?0.28 ,p?<?0.001). Schools’ healthy eating policy implementation was significantly associated with child diet (β?=?0.52, p?<?0.05), but physical activity policy was not associated with child activity (β?=???0.007, p?>?0.05). The school environment was not associated with child BMI. Discussion The home environment had a stronger association with healthier child behaviours, compared to the school environment. These findings suggest that future childhood obesity interventions targeting healthier home environments and supporting parents can promote healthier child eating and physical activity behaviours.     

Contributions of Neighborhood Parks to Physical Activity in High-Poverty Urban Neighborhoods

Neighborhood parks are important venues for the urban population to do moderate-to-vigorous physical activity in leisure time. Parks can be particularly important for low-income neighborhoods, whose residents suffer from high rates of chronic diseases and may have less access to fee-based fitness exercise facilities. This study assessed the contribution of parks to local populations’ physical activity in 48 high-poverty neighborhoods in the city of Los Angeles, using systematic observation of park use and surveys of park users and residents conducted between 2013 and 2015. We found that parks accounted for approximately 2.1% (between-park SD?=?1.4%) of moderate physical activity time and 3.1% (between-park SD?=?2.1%) of vigorous physical activity time of the local population, both of which were notably lower than the city-level average previously reported. Parks’ contribution to physical activity was positively associated with park size (β?=?0.13, p?<?0.0001) and negatively associated with poverty (β?=???0.10, p?<?0.0001) and local population density (β?=???0.25, p?=?0.005). Parks in high-poverty neighborhoods in Los Angeles are underutilized, and more efforts are needed to fully realize their potential for population health.     

The association of sidewalk walkability and physical disorder with area-level race and poverty

INTRODUCTION: There are significant differences in physical inactivity in various geographical areas and among demographic groups. Previous research suggests that walking is the most common form of physical activity; however, not all built environments support walking for recreational or transportation purposes. OBJECTIVE: The purpose of this study was to assess the extent to which area-level factors, poverty rate and racial distribution, are associated with aspects of the street-scale environment (i.e. sidewalk walkability and physical disorder) using community audits. METHODS: Street segments were randomly selected from 210 block groups. Pairs of trained auditors walked each street segment using an audit tool designed to capture aspects of the street environment. Multilevel logistic regression was used to assess the degree of neighborhood (i.e. block group) variation in sidewalk unevenness, sidewalk obstruction and the presence of physical disorder and the association with area-level characteristics. RESULTS: 1780 street segments were audited. Block groups that were predominantly African-American were 38 times more likely to have a lot of unevenness, 15 times more likely to have many obstructions, and 12 times more likely to have physical disorder. Poverty rate was not independently associated with sidewalk walkability; however, block groups with the highest poverty rates were 21 times more likely to have physical disorder. CONCLUSION: The results indicate that aspects of the built environment vary by characteristics of the neighborhood. This suggests that there is a differential investment in community infrastructures and resources in neighborhoods that are mostly African-American. This differential investment is likely to influence disparities in rates of physical activity.