Food Environment - Heart Healthy Hoods

Transcripción

Tobacco Social Environment
Ecological Momentary Assessment using
smartphone applications
–  Tobacco Social Environment
–  Tobacco Control Implementation: •  In playgrounds
•  In health care and education centers
•  In restaurants, bars, pubs and clubs
•  Sales of single sticks (Loosies)
http://hhhproject.eu
Presenter’s Name
Date
Presenter’s Name
Date
Synthetic Index walkability
And healthy food availability
INDICE
SINTETICO
HFAI + WALKABILITY
HFAI
WALKABILITY
BARRIO
PILOTO
Presenter’s Name
Date
Presenter’s Name
Date
Food Environment
Madrid Bal/more Circle radius is propor/onal to HFAI Map Scale is the same for both maps http://hhhproject.eu
Food Environment
Public food markets
Las Ventas Madrid http://hhhproject.eu
Food Environment
Public food markets
Waverly (Bal3more) http://hhhproject.eu
HHH Pilot Study
Qualitative Study
Objective: Gain better understanding of residents and
stakeholders perceptions and norms regarding neighborhood
environment and cardiovascular health
Stratified purposeful sampling to include “key
neighbourhood informants”. 15 conducted and transcribed
semi-structured interviews:
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6 long term residents (Females and Males)
2 recent immigrants
3 health practitioners
2 primary school teachers
1 food market leader, local butcher
1 neighborhood association / community leader
1 local politician
HHH Pilot Study
Qualitative Study
Food Environment: “Voy al mercado de La Elipa que ya
conozco a la gente….De toda la vida, claro, yo al carnicero ya
le compro hace 30 años”
Physical Activity Environment: “Y cuando somos mayores,
pues yo voy en una silla de ruedas por la calle, si hubiera
bancos en la calle yo no necesitaba la silla porque andar pues
20 metros ando muy bien, pero yo a lo mejor los 25 no”
Alcohol and Tobacco Environment: (Not perceived as
socially influenced. More an individual decisions) “Por el
nivel cultural yo creo que sí que hay una mayor tendencia al
consumo elevado de alcohol, no exageradamente”
Pilot Qualitative Study
Emergent categories
The role of immigration in shaping behavior patterns related
to the use of open spaces “…mi hijo no va al parque porque
está lleno de inmigrantes.” “Los inmigrantes, que cogen las canchas
como espacios propios, y ahí han tenido problemas”
The current economic crisis shaping the neighborhood´s
shopping environment “Yo tengo hamburguesa porque tengo a mi
nieto a comer y entonces tengo no sé cuánto… 3 o 4 euros…,
entonces o comemos hamburguesa o no comemos”
The role of social networks shaping health behavior patterns
in residents “se han perdido muchos hábitos de consumo, el
hábito de antes se salía a tomar el vermut el domingo y te juntabas
con tu vecino, con tus amigos y tal.”
Best Practices for Mixed Methods
Research in the Health Sciences
Commissioned by the
A priority exists in health science research to develop Office of
and Social Sciences Research
(OBSSR)
new mBehavioral
ethodologies to improve the quality and scien/ﬁc Helen I. Meissner, Ph.D., Office of Behavioral and Social Sciences Research
power of data leading to methodological diversity. By
John W.
Creswell, Ph.D.,a
University
Nebraska-Lincoln
The diversity lso sofignals a growing acceptance of Ann Carroll Klassen, Ph.D., Drexel University
Vicki L. Plano Clark,a
Ph.D.,
of Nebraska-Lincoln
qualita/ve nd University
social science research, the forma/on of Katherine Clegg Smith, Ph.D., Johns Hopkins University
interdisciplinary research teams, and use of mul/-‐level With the Assistance of a Specially Appointed Working Group
approaches to inves/gate complicated health problems, such as cultural and social models of illness and health. Creswell JW, Klassen AC, Plano Clark VL, Smith KC for the Oﬃce of Behavioral and Social Sciences Research. August 2011. Na/onal Ins/tutes of Health hOp://obssr.od.nih.gov/mixed_methods_research http://hhhproject.eu
Mixed methods in the HHH
The need
Ø  Through qualitative and quantitative methods we gain a
deeper understanding of local context, norms, meanings,
beliefs, barriers and opportunities related to the urban
environment in Madrid.
Ø  Food, Alcohol, Physical Activity and Tobacco environments
would be assessed using a mixed methods approach
The aim
Ø  To characterize the urban environment in 6 areas of the
HHH in the city of Madrid and understand how the
residents perceive it, using a mixed methods approach
Characterizing the Food Environment using
Mixed methods in the HHH study Madrid
HHH Formative research for intervention
PHOTOVOICE Seminar Oct 8 2014
Pilot Study Sociodemographic Profile
Primary Health Care Records
•  Total Pilot Area Population: 15,751
•  Population in the Primary Care Health System Geocoded to
census section level: 14,857 (95%)
–  Possibility of obtaining data for 2 million people
•  Median Age: 44 (Range: 0 to 106)
–  49% Above 45 years (CVD Health Target Group)
•  Sex: 55% Women (65% in >75 years)
•  Primary Care Health Centers: 98% in 3 centers
•  Education: 50% > primary education
•  Immigration: 19% foreign-born
Pilot Study Cardiovascular Profile
Primary Health Care Records
Population > 45 ys
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Population: 7,252
Age: 45-106
Sex: 59% Women
Diabetes Prevalence: 12%
Diabetes Control (HbA1c<7): 63%
Hypertension Prevalence: 34%
Obesity (BMI >30): 20%
Dyslipidemia (all): 32%
CVD Morbidity and Mortality
Linkable to Primary Care Health Records
•  Morbidity (CVD Incidence and Hospital Admissions)
–  Individual level data
•  All-Cause Mortality
–  Individual level data
•  Cause-Specific Mortality
–  Aggregated at the census block level
HHH Pilot Study: Results/Manuscript Drafts
AHA EPI NPAM 2014 San Francisco
1.  Measuring the Food, Tobacco, Alcohol and Physical Activity
Urban Environments in Relation to Cardiovascular Health:
The Heart Healthy Hoods Pilot Study in Madrid, Spain
2.
Validation of a Walking and Cycling Audit Tool in the
Streets of Madrid using On-Field and Google Street
View Audits
3.
Food Stores, Food Markets and Healthy Food
Availability in Comparable Neighborhoods in Madrid and
Baltimore
HHH and media
HHH and media
HHH and media
Madrid Regional Gobernment
October 23 2013
Entorno urbano y salud en Madrid
Impacto Social del Estudio ERC
Resultados sobre los cuatro factores de riesgo de las
Enfermedades Crónicas No Transmisibles:
Tabaquismo
Consumo elevado de Alcohol
Sedentarismo
Mala alimentación
Los resultados ofrecen evidencias políticas relacionadas
con la primera causa de muerte en Europa
Acknowledgements
Social and Cardiovascular Epi Group UAH
Trainees: Usama Bilal, Julia Diez, Silvia Alfayate,
Pedro Gullón, Carlos Martinez, Alba Cerbecos
Faculty: Patxi Escobar, María Sandin, Angel Asunsolo,
Jesús Rivera, Marta Gutierrez, Paco Bolumar
Admin: Sandra Fernandez, Maria Luisa Alegre
Photography: Victor Carreño
Graphic Design: Cesar García
Acknowledgements
International collaborations
Ana Diez-Roux, Drexel University, Philadelphia
Richard Cooper, Loyola University Chicago
Javier Nieto, University of Wisconsin-Madison
Mariana Lazo, Ben Caballero, Tom Glass, Joel
Gittelsohn, Hopkins School of Public Health
Hannah Badland, University of Melbourne
CUNY ?
Acknowledgements
European Research Council
Starting Grant 2013
The “2 Million Dollar
Baby(s)”
Presenter’s Name
Date

Food Environment - Heart Healthy Hoods

Transcripción

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