Abstract
BackgroundGrowing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed. The Wisconsin Assessment of the Social and Built Environment (WASABE) is an objective audit tool designed as an addition to a statewide household-based health examination survey, the Survey of the Health of Wisconsin (SHOW), to objectively measure participant’s neighborhoods.MethodsThis paper describes the development and implementation of the WASABE and examines the instrument’s ability to capture a range of social and built environment features in urban and rural communities. A systematic literature review and formative research were used to create the tool. Inter-rater reliability parameters across items were calculated. Prevalence and density of features were estimated for strata formed according to several sociodemographic and urbanicity factors.ResultsThe tool is highly reliable with over 81% of 115 derived items having percent agreement above 95%. It captured variance in neighborhood features in for a diverse sample of SHOW participants. Sidewalk density in neighborhoods surrounding households of participants living at less than 100% of the poverty level was 67% (95% confidence interval, 55-80%) compared to 34% (25-44%) for those living at greater than 400% of the poverty level. Walking and biking trails were present in 29% (19-39%) of participant buffer in urban areas compared to only 7% (2-12%) in rural communities. Significant environmental differences were also observed for white versus non-white, high versus low income, and college graduates versus individuals with lower level of education.ConclusionsThe WASABE has strong inter-rater reliability and validity properties. It builds on previous work to provide a rigorous and standardized method for systematically gathering objective built and social environmental data in a number of geographic settings. Findings illustrate the complex milieu of built environment features found in participants neighborhoods and have relevance for future research, policy, and community engagement purposes.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1165) contains supplementary material, which is available to authorized users.
Highlights
Growing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed
Descriptive analyses - prevalence of selected built and social environmental features In order to assess construct validity of WASABE, we examined the ability of the instrument to capture variation in exposure to built and social environment features within the Survey of the Health of Wisconsin (SHOW) sample
The results of our literature review (Table 1) demonstrate a growing body of evidence supporting the notion that many aspects of the built and social environment can impact health behaviors and outcomes
Summary
Growing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed. There is growing recognition and interest in understanding how social and built environment features affect a broader set of health determinants including sleep quality, overall wellness, and mental health outcomes [2,4,5,6,7,8]. Despite this growing body of research, there is a paucity of information regarding the mechanisms by which such environmental features promote health, in part due to a lack of systematic methods and standardized tools for measuring neighborhood environments and features across diverse geographies including urban and rural areas [9,10]. The majority of prior studies using audit tools were designed for active living research or have focused on narrowly-defined study populations (e.g., urban, elderly) [9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
