Table 2.
Residential Environmental and MOVE! Weight Management Program Exposure Measures.
| Construct | Conceptual Definition | Operational Definition | Source |
|---|---|---|---|
| Residential Environmental Attributes | |||
|
| |||
| Healthier food outlet accessibilitya | Availabilityb of food outlets offering a large selection of healthier food products | Chain and non-chain supermarkets Grocery stores Supercenters and other general merchandise storesc |
InfoUSA |
| Less healthy food outlet accessibilitya | Availabilityb of food outlets primarily selling energy-dense, nutrient-poor food products | Convenience stores | InfoUSA |
| Chain and non-chain fast food restaurants | Dun & Bradstreet | ||
| Healthier food product pricesd | Prices of healthier foods and beverages | Fruit and vegetable prices: summary measure of raw potatoes (10 lb bag), bananas (per lb), lettuce (head), peas (15–15.25 oz can), tomatoes, frozen corn (16 oz), peaches (29 oz can) | C2ER Cost of Living Index |
| Food at home prices: summary measure including items such as eggs, milk, chicken, coffee, cereal, and bread | C2ER Cost of Living Index | ||
| Less healthy food product pricesd | Prices of and sales taxes on energy-dense, nutrient-poor foods and beverages | Fast food prices: summary measure of pizza (11–12 inch thin cheese), hamburger (1/4 lb), 2 piece chicken (thigh plus drumstick) | C2ER Cost of Living Index |
| Soda prices: Coke (12 oz) | |||
| Soda taxes (i.e., state-level sales taxes on soda) | http://www.bridgingthegapresearch.org/research/sodasnack_taxes/ | ||
| Walkabilitye | Availability of non- residential destinations and directness of walking routes | Street connectivity (e.g., density of street intersections, ratio of 4- way to all street) | NAVTEQ |
| Population and housing unit densities | ACS | ||
| Density of commercial destinations | InfoUSA and Dun & Bradstreet | ||
| Accessibility of recreational settingsa | Availabilityb of indoor and outdoor settings to be physically active | Parks – count and land area | NAVTEQ and TeleAtlas |
| Fitness facilities | InfoUSA | ||
| Aestheticse | Attractiveness or appeal | Vacant housing unit density | ACS |
| Traffic safetye | Road features that slow or calm traffic | Presence of (a) median/dividers, (b) roundabouts, and (c) “low mobility” features (e.g., low speeds and traffic volumes) | NAVTEQ |
| Socioeconomic and demographic characteristics | Deprivation and affluence | % below poverty Median household income % college educated |
ACS |
| VA healthcare accessibility | Proximity of VA healthcare facility | Distance from patient’s home to (a) nearest VA inpatient facility, (b) nearest VA outpatient facility, and (c) patient’s most frequently used VA facility | |
| Urbanicityf | Degree of urbanization | Urban-Rural Classification Scheme: metropolitan area (large central metro, large fringe metro, medium metro, small metro) and non-metropolitan area (micropolitan, non-core) | NCHS |
|
| |||
| MOVE! Program Characteristicsg | |||
|
| |||
| MOVE! program elements | Nutrition supports | Total nutrition specialist FTE Specific provider specialty FTE (Registered Dietician vs. Dietetic Technician) Multidisciplinary approach: Involvement of dietetic/nutrition specialist and behavioral health specialist (yes/no; FTE ratio) Includes a highly structured low-calorie diet (yes/no) |
MOVE! Annual Reporth |
| Physical activity supports | Total physical activity specialist FTE Specific provider specialty FTE (Recreational Therapist vs. Physical, Occupational, or Kinesiotherapist) Multidisciplinary approach: Involvement of physical activity specialist and behavioral health specialist (yes/no; FTE ratio) Physical activity incorporated into MOVE! group sessions (yes/no) Dedicated indoor physical activity space (yes/no) Outdoor environment for physical activity (yes/no) |
MOVE! Annual Report | |
| Behavioral health supports | Total behavioral health specialist FTE Specific provider specialty FTE (Psychologist or Social Worker vs. Mental Health Technician) “Sufficient” behavioral/mental health specialist involvement to meet needs (yes/no) Self-management support skill development:
Use of incentives/rewards (yes/no) |
MOVE! Annual Report | |
| Distance supports | Telehealth utilization (available yes/no; % of all MOVE! encounters):
|
MOVE! Annual Report | |
Abbreviations: FTE: Full time equivalent; NPCD: National Patient Care Database
Constructed for approximately 0.25, 1, 3, and 5-mile buffers from home location.
Count, count per capita, and count per land area, as well as distance to the nearest
Supercenters and other mass merchandisers may be considered a less healthy food outlet due to marketing of unhealthy food products
Food price data are available nationwide for core-based statistical areas (CBSAs). Therefore, price data are assigned according to the CBSA in which the home is located or the nearest CBSA. Food sales tax data are available nationwide at the state level. Therefore, tax data are assigned according to the state in which home is located.
Constructed for 0.25 and 1-mile buffers from home address
Constructed based on county in which home is located
All measures to be derived from data contained in MOVE! Annual Reports, FY2008–2013 (excluding 2012 when data were not collected)
Data recollected via electronic survey from each medical center with a MOVE! Program; no survey conducted in 2012 or 2014