244472 Neighborhood and 1-Year Weight-Related Factors in the Look AHEAD Study

Wednesday, November 2, 2011: 1:09 PM

Tiffany Gary-Webb, PhD , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Alejandro Castro III, MPH , Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Kesha Baptiste-Roberts, PhD, MPH , School of Nursing, Penn State University, Hershey, PA
Jacqueline Wesche-Thobaben , Division of Internal Medicine, University of Pittsburgh, Pittsburgh, PA
Jennifer Patricio , New York Obesity Research Center, St. Luke's/Roosevelt Hospital, New York, NY
Xavier Pi-Sunyer, MD , New York Obesity Research Center, St. Luke's/Roosevelt Hospital, New York, NY
LaShonda Jones, PhD , School of Medicine, University of Pennsylvania, Philadelphia, PA
James Hill, PhD , Anschultz Health and Wellness Center-Pediatrics, University of Colorado, Aurora, CO
Monika Safford, MD , Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Mara Vitolins, DrPH , Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC
Frederick Brancati, MD, MHS , Department of Medicine & Epidemiology, Johns Hopkins University, Baltimore, MD
Previous studies have shown that neighborhood factors are associated with obesity, but few studies have examined their association with weight-related health behaviors. Therefore, we conducted a multi-level analysis examining neighborhood socioeconomic status (SES) and weight-related health behaviors at 1 year in Look AHEAD, a randomized trial of intensive lifestyle intervention (ILI) vs. diabetes support and education (DSE) in persons with type 2 diabetes. Individual-level data on 958 participants were linked to neighborhood-level data (2000 US Census tracts). Neighborhood variables included SES (% living below the federal poverty level) and the availability of food stores, convenience stores, and restaurants. Outcomes at 1 year included individual-level weight and eating patterns collected on participants in the Look AHEAD study. Multi-level models were used to adjust for individual-level SES and potential confounders. Results were stratified to determine if the associations with neighborhood characteristics differed by intervention group. Although neighborhood variables were not significantly associated with weight loss in either intervention group, the availability of restaurants in neighborhoods was related to several eating patterns. Participants in neighborhoods with more restaurants reported that they were less likely to eat breakfast at a fast food restaurant (prevalence Ratio [PR] 0.55 95% CI: 0.30-1.00) in the ILI and more likely to have lunch at non –fast food restaurants (PR=1.72, 1.21-2.45) in the DSE. In this selected group of weight-loss trial participants, restaurant availability in neighborhoods was associated with some individual-level eating patterns after one year of intervention, but had no significant effects on the success of the ILI intervention.

Learning Areas:
Chronic disease management and prevention
Public health or related research
Social and behavioral sciences

Learning Objectives:
To understand how neighborhood socioeconomic status and food availability is associated with weight and weight-related behaviors one year after a weight loss intervention

Keywords: Environment, Weight Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I coordinated the research conducted and being presented in the paper. Obesity-related expertise/interests: epidemiology of diabetes and it complications, clinical trial design and conduct, and medical claims data analysis; socioeconomic and cultural influences on diabetes management.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.