People with mobility impairments (PMI) are disproportionately affected by weight-related health compromising conditions such as hypertension, diabetes, and some cancers compared to those without mobility impairments. PMI are severely underserved by national efforts targeting the surveillance, treatment, and prevention of dietary habits and obesity. This study will aim to address this gap by using a comprehensive, theoretically and consumer-guided, ecological and dynamic approach to identifying ecologic factors that contribute to dietary habits and weight-related health disparities in PMI. Healthy dietary habits are important for controlling and preventing obesity in all populations, and may be particularly challenging to achieve for PMI, who are often dependent upon their immediate environment. PMI anecdotally report numerous barriers in the physical and social environment that lead to poor dietary habits; however, currently there is no clear guiding model or specific instrument to operationalize barriers and environmental factors that impact dietary habits in PMI. This study is theoretically guided by the Ecologic Model of Obesity (EMO), which posits that enduring physical and social environmental factors, processes, and linkages directly and indirectly impact behavior change and maintenance. The EMO provides a framework for examining ecologic factors, such as the macro-level regional design (urban vs. rural) that can foster access and equity to nutritious foods; micro-level availability and accessibility of goods and services in the neighborhood and home; and meso- and exo-level linkages, which include dynamic, social processes, such as access to support (e.g., transportation, personal assistance). The EMO also accounts for individual sense of personal control, psychosocial factors, severity and complexity of disability, knowledge of healthy dietary habits, and socioeconomic status. With the guidance of a Community Advisory Board, this project will use Nominal Group Technique (NGT) focus groups to translate constructs from the EMO for PMI to identify multi-level factors that facilitate or inhibit healthy dietary habits. Information learned through NGT groups will be used to develop items for self-report measures of EMO constructs to investigate multi-level factors that facilitate or inhibit dietary habits in PMI. The instrument will be tested and refined via cognitive interviews with community representatives. Last, this study will use state of the science techniques to examine psychometric properties and will assess the usefulness and feasibility of complementing measures of healthy dietary habits with the new instrument.
|Effective start/end date||5/23/16 → 12/30/16|
- DOD-NAVY: Office of Naval Research (ONR): $78,000.00