Abstract
The majority of studies examining the relation between neighborhood environments and health have used census-based indicators to characterize neighborhoods. These studies have shown that neighborhood socieconomic characteristics are associated with a range of health outcomes. Establishing if these associations reflect causal relations requires testing hypotheses regarding how specific features of neighborhoods are related to specific health outcomes. However, there is little information on the reliability of neighborhood measures. The purpose of this study was to estimate the reliability of a questionnaire measuring various self-reported measures of the neighborhood environment of possible relevance to cardiovascular disease. The study consisted of a faceto-face and telephone interview administered twice to 48 participants over a 2-week period. The face-to-face and telephone portions of the interview lasted an average of 5 and 11 minutes, respectively. The questionnaire was piloted among a largely Latino and African American study sample recruited from a public hospital setting in New York City. Scales were used to assess six neighborhood domains: aesthetic quality, walking/ exercise environment, safety from crime, violence, access to healthy foods, and social cohesion. Cronbach’s α’s ranged from. 77 to. 94 for the scales corresponding to these domains, with test-retest correlations ranging from 0.78 to 0.91. In addition neighborhood indices for presence of recreational facilities, quality of recreational facilities, neighborhood participation, and neighborhood problems were examined. Test-retest reliability measures for these indices ranged from 0.73 to 0.91. The results from this study suggested that self-reported neighborhood characteristics can be reliably measured.
Keywords: Cardiovascular disease, Neighborhoods, Pathways, Reliability, Self-report
Full Text
The Full Text of this article is available as a PDF (138.0 KB).
Footnotes
Dr. Ana Diez-Roux and Sandra Echeverria were in part supported by the Columbia Center for the Health of Urban Minorities (CHUM). Additional support was provided to Sandre Echeverria by the Kellogg Foundation, Health Policy Doctoral Fellowship Program. Dr. Bruce. G. Link was supported by a Robert Wood Johnson Health Policy Investigator Award.
References
- 1.Oakes M. The (mis)estimation of neighborhood effects: causal inference for a practicable social epidemiology. Soc. Sci Med. 2004;58:1929–1952. doi: 10.1016/j.socscimed.2003.08.004. [DOI] [PubMed] [Google Scholar]
- 2.Diez Roux AV. Investigating neighborhood and area effects on health. Am. J Public Health. 2001;91:1783–1789. doi: 10.2105/ajph.91.11.1783. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Macintyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc. Sci Med. 2002;55:125–139. doi: 10.1016/S0277-9536(01)00214-3. [DOI] [PubMed] [Google Scholar]
- 4.Sampson R, Raudenbush S. Systematic social observation of public spaces: a new look at disorder in urban neighborhoods. Am J Sociol. 1999;105:603–651. doi: 10.1086/210356. [DOI] [Google Scholar]
- 5.Giles-Corti B, Donovan RJ. Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment. Prev Med. 2002;35:601–611. doi: 10.1006/pmed.2002.1115. [DOI] [PubMed] [Google Scholar]
- 6.Giles-Corti B, Donovan RJ. The relative influence of individual, social and physical environment determinants of physical activity. Soc Sci Med. 2002;54:1793–1812. doi: 10.1016/S0277-9536(01)00150-2. [DOI] [PubMed] [Google Scholar]
- 7.Pikora TJ, Bull FC, Jamrozik K, Knuiman M, Giles-Corti B, Donovan RJ. Developing a reliable audit instrument to measure the physical environment for physical activity. Am J Prev Med. 2002;23:187–194. doi: 10.1016/S0749-3797(02)00498-1. [DOI] [PubMed] [Google Scholar]
- 8.Balfour JL, Kaplan GA. Neighborhood environment and loss of physical function in older adults: evidence from the Alameda County Study. Am J Epidemiol. 2002;155:507–515. doi: 10.1093/aje/155.6.507. [DOI] [PubMed] [Google Scholar]
- 9.Humpel N, Owen N, Leslie E. Environmental factors associated with adults’ participation in physical activity: a review. Am J Prev Med. 2002;22:188–199. doi: 10.1016/S0749-3797(01)00426-3. [DOI] [PubMed] [Google Scholar]
- 10.Raudenbush SW. Quantitative assessment of neighborhood social environments. In: Kawachi I, Berkman LF, editors. Neighborhoods and Health. Oxford, England: Oxford University Press; 2003. pp. 112–131. [Google Scholar]
- 11.Sampson RJ, Raudenbush SW, Earls F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997;277:918–924. doi: 10.1126/science.277.5328.918. [DOI] [PubMed] [Google Scholar]
- 12.Davey Smith G, Hart C, Watt G, Hole D, Hawthorne V. Individual social class, areabased deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study. J Epidemiol Community Health. 1998;52:399–405. doi: 10.1136/jech.52.6.399. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Hart C, Ecob R, Smith GD. People, places and coronary heart disease risk factors: a multilevel analysis of the Scottish Heart’ Health Study archive. Soc Sci Med. 1997;45:893–902. doi: 10.1016/S0277-9536(96)00431-5. [DOI] [PubMed] [Google Scholar]
- 14.Diez Roux AV, Merkin SS, Arnett D, et al. Neighborhood of residence and incidence of coronary heart, disease. N Engl J Med. 2001;345:99–106. doi: 10.1056/NEJM200107123450205. [DOI] [PubMed] [Google Scholar]
- 15.Diez-Roux AV, Nieto FJ, Muntaner C, et al. Neighborhood environments and coronary heart disease: a multilevel analysis. Am J Epidemiol. 1997;146:48–63. doi: 10.1093/oxfordjournals.aje.a009191. [DOI] [PubMed] [Google Scholar]
- 16.Bureau US Census. Census 2000 Summary File 3 (SF3), Sample Data, Detailed Tables. Vol. 9 June 2004. Accessed June 11, 2004. Available at: http://www.census.gov/servlet.
- 17.Local Area Survey. Social and Public Health Sciences Unit, University of Glasgow, Scotland.
- 18.Ball K, Bauman A, Leslie E, Own N. Perceived environmental aesthetics and convenience and company are associated with walking for exercise among Australian adults. Prev Med. 2001;33:434–440. doi: 10.1006/pmed.2001.0912. [DOI] [PubMed] [Google Scholar]
- 19.Sallis JF, Johnson MF, Calfas KJ, Caparosa S, Nichols JF. Assessing perceived physical environmental variables that may influence physical activity. Res Q Exerc Sport. 1997;68:345–351. doi: 10.1080/02701367.1997.10608015. [DOI] [PubMed] [Google Scholar]
- 20.King AC, Castro C, Wilcox S, Eyler AA, Sallis JF, Brownson RC. Personal and environmental factors associated with physical inactivity among different racial-ethnic groups of U.S. middle-aged and older-aged women. Health Psychol. 2000;19:354–364. doi: 10.1037/0278-6133.19.4.354. [DOI] [PubMed] [Google Scholar]
- 21.Stahl T, Rutten A, Nutbeam D, et al. The importance of the social environment for physically active lifestyle—results from an international study. Soc Sci Med. 2001;52:1–10. doi: 10.1016/S0277-9536(00)00116-7. [DOI] [PubMed] [Google Scholar]
- 22.Handy SL, Boarnet MG, Ewing R, Killingsworth RE. How the built environment affects physical activity: views from urban planning. Am J Prev Med. 2002;23(2 suppl):64–73. doi: 10.1016/S0749-3797(02)00475-0. [DOI] [PubMed] [Google Scholar]
- 23.Booth ML, Owen N, Bauman A, Clavisi O, Leslie E. Social-cognitive and perceived environment influences associated with physical activity in older Australians. Prev Med. 2000;31:15–22. doi: 10.1006/pmed.2000.0661. [DOI] [PubMed] [Google Scholar]
- 24.Neighborhood safety and the prevalence of physical inactivity-selected states, 1996. JAMA. 1999;281:1373. [PubMed]
- 25.The Social Capital Benchmark Survey (Data Codebook) Storrs, CT: The Roper Center for Public Opinion Research; 2002. [Google Scholar]
- 26.Sooman A, Macintyre S. Health and perceptions of the local environment in socially contrasting neighborhoods in Glasgow. Health Place. 1995;1:15–26. doi: 10.1016/1353-8292(95)00003-5. [DOI] [Google Scholar]
- 27.Steptoe A, Feldman PJ. Neighborhood problems as sources of chronic stress: development of a measure of neighborhood problems, and associations with socioeconomic status and health. Ann Behav Med. 2001;23:177–185. doi: 10.1207/S15324796ABM2303_5. [DOI] [PubMed] [Google Scholar]
- 28.Perkins DD, Taylor RB. Ecological assessments of community disorder: their relationship to fear of crime and theoretical implications. Am J Community Psychol. 1996;24:63–107. doi: 10.1007/BF02511883. [DOI] [PubMed] [Google Scholar]
- 29.Troutt D. The thin red line: how the poor still pay more. San Francisco, CA: Consumers Union, West Coast Regional Office; 1993. [Google Scholar]
- 30.Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol. Bull. 1979;2:420–428. doi: 10.1037//0033-2909.86.2.420. [DOI] [PubMed] [Google Scholar]
- 31.Cicchetti DV, Allison T. A new procedure for assessing the reliability of scoring EEG sleep recordings. Am J EEG Technol. 1971;11:101–109. [Google Scholar]
- 32.Saelens BE, Sallis JF, Black JB, Chen D. Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health. 2003;93:1552–1558. doi: 10.2105/ajph.93.9.1552. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Brownson RC, Chang JJ, Eyler AA, et al. Measuring the environment for friendliness toward physical activity: a comparison of the reliability of three questionnaires. Am J Public Health. 2004;94:473–483. doi: 10.2105/ajph.94.3.473. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34.Addy CL, Wilson DK, Kirtland KA, Ainsworth BE, Sharpe P, Kimsey D. Associations of perceived social and physical environmental supports with physical activity and walking behavior. Am J Public Health. 2004;94:440–443. doi: 10.2105/AJPH.94.3.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.Suttles GD. The Social Construction of Communities. Chicago, IL: University of Chicago Press; 1972. [Google Scholar]
- 36.Kawachi I, Berkman LF. Introduction. In: Kawachi I, Berkman LF, editors. Neighborhoods and Health. Oxford, England: Oxford Publishing Press; 2003. pp. 1–19. [Google Scholar]