Int J Health Geogr - Does the choice of neighbourhood supermarket access measure influence associations with individual-level fruit and vegetable consumption? A case study from Glasgow.

Tópicos

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Resumo

CKGROUND: Previous studies have provided mixed evidence with regards to associations between food store access and dietary outcomes. This study examines the most commonly applied measures of locational access to assess whether associations between supermarket access and fruit and vegetable consumption are affected by the choice of access measure and scale.METHOD: Supermarket location data from Glasgow, UK (n=119), and fruit and vegetable intake data from the 'Health and Well-Being' Survey (n=1041) were used to compare various measures of locational access. These exposure variables included proximity estimates (with different points-of-origin used to vary levels of aggregation) and density measures using three approaches (Euclidean and road network buffers and Kernel density estimation) at distances ranging from 0.4km to 5km. Further analysis was conducted to assess the impact of using smaller buffer sizes for individuals who did not own a car. Associations between these multiple access measures and fruit and vegetable consumption were estimated using linear regression models.RESULTS: Levels of spatial aggregation did not impact on the proximity estimates. Counts of supermarkets within Euclidean buffers were associated with fruit and vegetable consumption at 1km, 2km and 3km, and for our road network buffers at 2km, 3km, and 4km. Kernel density estimates provided the strongest associations and were significant at a distance of 2km, 3km, 4km and 5km. Presence of a supermarket within 0.4km of road network distance from where people lived was positively associated with fruit consumption amongst those without a car (coef. 0.657; s.e. 0.247; p0.008).CONCLUSIONS: The associations between locational access to supermarkets and individual-level dietary behaviour are sensitive to the method by which the food environment variable is captured. Care needs to be taken to ensure robust and conceptually appropriate measures of access are used and these should be grounded in a clear a priori reasoning.

Resumo Limpo

ckground previous studi provid mix evid regard associ food store access dietari outcom studi examin common appli measur locat access assess whether associ supermarket access fruit veget consumpt affect choic access measur scalemethod supermarket locat data glasgow uk n fruit veget intak data health wellb survey n use compar various measur locat access exposur variabl includ proxim estim differ pointsoforigin use vari level aggreg densiti measur use three approach euclidean road network buffer kernel densiti estim distanc rang km km analysi conduct assess impact use smaller buffer size individu car associ multipl access measur fruit veget consumpt estim use linear regress modelsresult level spatial aggreg impact proxim estim count supermarket within euclidean buffer associ fruit veget consumpt km km km road network buffer km km km kernel densiti estim provid strongest associ signific distanc km km km km presenc supermarket within km road network distanc peopl live posit associ fruit consumpt amongst without car coef se pconclus associ locat access supermarket individuallevel dietari behaviour sensit method food environ variabl captur care need taken ensur robust conceptu appropri measur access use ground clear priori reason

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