Evaluating the Relationship Between Physical Activity, Diet, Weight, and the Neighborhood Environment for Adolescents

Obesity is an increasingly important health problem in the United States, particularly among
adolescents. Previous studies among adults have shown that people who live in neighborhoods
with good "walkability" and recreational environments have increased physical activity
levels, and some studies have suggested that there is a relationship between the
neighborhood food environment and eating patterns. While these concepts have been studied in
adults, more research is needed on the effect of the neighborhood environment on
adolescents. In this study, adolescents who live in select neighborhoods in Seattle-King
County, WA and Baltimore-Washington, DC will be enrolled. Forty-eight neighborhoods in these
areas will be studied, with researchers taking into account the neighborhoods' walkability
levels (e.g., combination of street connectivity, residential density, land use mix, retail
floor area ratio) and median income levels. Study researchers will examine and create
formulas to measure walkability, pedestrian infrastructure, public recreation space, and
nutrition environment quality. Researchers will also examine crime and weather patterns;
psychosocial variables; parent support; and perceived neighborhood, school, and home
environments. Overall, this study will evaluate the ability of a research model to explain
the variation in physical activity levels, sedentary behavior, dietary patterns, and weight
among adolescents, with an emphasis on neighborhood environment.

There will be no study visits for this study: participation will take place entirely through
the mail, phone, or internet. Participants will include adolescents between the ages of 12
and 16 years old and their parents, all of whom live in the identified study neighborhoods.
At the time of study entry, adolescents will complete a questionnaire on neighborhood and
safety issues, diet, physical activity habits and places where activity occurs, grades,
school policies and parental rules that affect physical activity and eating, and the support
they get from people regarding healthy eating and physical activity. One parent of each
adolescent will also complete a neighborhood information questionnaire. Adolescents will
measure their height, weight, and waist circumference and send the measurements to study
staff along with the questionnaire. Next, a 4-week period, study staff will call adolescents
on three random days and collect information on their diet in the previous 24 hours. During
this period, adolescents will wear an activity meter and a GPS monitor for 7 consecutive
days and will mail the devices to study staff for analysis.

Inclusion Criteria:

- Child is between 12 and 16 years old

- Child and parent live in identified block group

- Child and parent speak English

- Child attends middle school or high school

Exclusion Criteria:

- Child must not have a diagnosed thought disorder, suicidality, substance abuse
disorder, or other psychological or medical condition that would prevent full
participation in the study

- Child must not have a disability or illness that would prevent moderate intensity
physical activity

- Child must not have an eating disturbance indicative of significant eating disorder
pathology