Optimizing investments in the built environment to reduce youth obesity

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Principal Investigators: Lyons, Renée F. and Grant, Jill L. (Dalhousie University)

Co-Investigators: Arthur, Michael H. (Nova Scotia Health Promotion and Protection); Blanchard, Chris (Dalhousie University); Chircop, Andrea M. (Dalhousie University); Dummer, Trevor J. B. (IWK Health Centre); Kirk, Sara F. L. (Dalhousie University); Manuel, Patricia M. (Dalhousie University); Parker, Louise (Dalhousie University); Pitter, Robert (Acadia University); Rainham, Daniel G. C. (University of Ottawa); Rehman, Laurene A. (Dalhousie University); Shields, Christopher A. (Acadia University).
This project is funded by the Heart and Stroke Foundation of Canada (HSFC) and the Canadian Institutes of Health Research (CIHR).

1. The research question 

Obesity is a problem of national and global significance. Nova Scotia has one of the highest rates of youth obesity in Canada (Tjepkema, 2006, Willms et al., 2003). Recent statistics revealed that only a small percentage of students in grade 7 and grade 11 in Nova Scotia met the recommended physical activity levels needed to achieve health benefits (Campagna et al., 2005). Furthermore, their diets did not meet the guidelines in Canada’s Food Guide. Changes in physical activity during adolescence are often carried into adulthood. Therefore, adolescence is an important time to make changes in physical activity and eating behaviour in order to reduce rates of obesity. 
Governments and developers spend billions of dollars each year modifying the built environment based on policies related to zoning and building, land use, neighbourhood form, transportation, and capital funding. Yet, these policies rarely take into consideration the growing problem of youth obesity. 

2. The objectives

1) Understand the role of the built environment (e.g., land mix, walkability, recreation facilities), and the policies that affect its use, in contributing to youth obesity;
2) Determine what modifications to policies and practices can help government optimize investments in the built environment to modify obesity-related risk factors (i.e., physical activity, nutrition).

3. The approach

1) Examine the role of the built environment in contributing to youth obesity in a series of qualitative and quantitative studies;
2) Scan existing policies in Nova Scotia, in Canada, and in the world; review literature on the link between the built environment and youth obesity;
3) Present findings to local, national, and international stakeholders including provincial and national policy forums;
4) Develop a training module for planners, developers, and other decision makers to orient their thinking toward planning for built environments that support physical activity and healthy eating for youth.

4. The unique factors

1) Participants wearing accelerometers and GPS devices.
With the participants wearing these devices, we learn if they are physically active, where they go to be active, and how they use the built environment in their routine. By engaging young Nova Scotians in the project, we help them become active participants in supporting healthy communities.
2) The multiple aspects of the built environment.
We look at the multiple aspects as part of the social ecological model. This model acknowledges that an individudal's behaviour (e.g., physical activity and nutritional choices) has multiple influences including interpersonal (e.g., family), institutional (e.g., school) and environmental (e.g., availability of recreation facilities). We also consider policies that surround each level of influence. 
3) Training module for decision makers.
4) Presenting results to provincial and national policy forums.

5. How the project is relevant to the objectives of the initiative

1) Explain how the built environment and land use in Nova Scotia affect physical activity, food choices, and obesity in adolescents;
2) Shed light on the link between the built environment and physical activity, food choices, attitude, and health outcome;
3) Identify if physical activity, eating behaviour, and obesity differ among youth living in urban, suburban, or rural areas;
4) Understand how policies on the built environment impact youth;
5) Allow youth and their families to share perceptions of barriers and facilitators to physical activity and healthy eating in the neighbourhood where they live.