Neighborhood violent crime exposure is associated with PrEP non-use among black sexually minoritized men and transgender women: A GPS Study.

OBJECTIVE: The objective of this study is to use GPS technology to determine if violent and property crime exposure to participants activity spaces affect outcomes of the HIV prevention and care continuum (PCC) among Young Black sexually minoritized men (YBSMM) and Transgender women (TW), a subgroup at high vulnerability for new HIV diagnoses. Exposure to violent and property crime adversely affects a variety of acute and chronic medical conditions; however the relationship between exposure to violent and property crime and HIV risk (e.g., PrEP non use) is unknown. Spatial analytic analysis using dynamic Global Position Systems (GPS) technology can accurately detect geospatial associations between the crime exposure and objective HIV related outcomes. METHODS: With the Neighborhoods and Networks (N2) Cohort Study, GPS technology to identify the activity space of 286 (123 PLWH and 163 PWoH) YBSMM & TW living in Chicago, IL, to identified spatial associations between violent and property crime exposures with HIV PCC outcomes. RESULTS: We found that YBSMM & TGW with higher exposure areas with higher levels of violent crime were less likely to use HIV preexposure prophylaxis (PrEP) therapy (aOR 0.76, 95% CI 0.63-0.91, p = 0.03). CONCLUSION: This study demonstrates the importance of clinical providers to consider violent crime as a potential sociostructural barrier that may impact medication adherence and health care outcomes among vulnerable populations. Additionally, GPS technology offers an alternative data analytic process that may be used to future studies to assist in identifying barriers to ending the HIV epidemic.

Geospatially clustered low COVID-19 vaccine rates among adolescents in socially vulnerable US counties.

COVID-19 vaccinations are widely available across the United States (U.S.), yet little is known about the spatial clustering of COVID-19 vaccinations. This study aimed to test for geospatial clustering of COVID-19 vaccine rates among adolescents aged 12-17 across the U.S. counties and to compare these clustering patterns by sociodemographic characteristics. County-level data on COVID-19 vaccinations and sociodemographic characteristics were obtained from the COVID-19 Community Profile Report up to April 14, 2022. A total of 3,108 counties were included in the analysis. Global Moran's I statistic and Anselin Local Moran's analysis were used, and clustering patterns were compared to sociodemographic variables using t-tests. Counties with low COVID-19 vaccinated clusters were more likely, when compared to unclustered counties, to have higher numbers of individuals in poverty and uninsured individuals, and higher values of Social Vulnerability Index (SVI) and COVID-19 Community Vulnerability Index (CCVI). While high COVID-19 vaccinated clusters, compared to neighboring counties, had lower numbers of Black population, individuals in poverty, and uninsured individuals, and lower values of SVI and CCVI, but a higher number of Hispanic population. This study emphasizes the importance of addressing systemic barriers, such as poverty and lack of health insurance, which were found to be associated with low COVID-19 vaccination coverage.

Structural racism and homophobia evaluated through social media sentiment combined with activity spaces and associations with mental health among young sexual minority men.

BACKGROUND: Research suggests that structural racism and homophobia are associated with mental well-being. However, structural discrimination measures which are relevant to lived experiences and that evade self-report biases are needed. Social media and global-positioning systems (GPS) offer opportunity to measure place-based negative racial sentiment linked to relevant locations via precise geo-coding of activity spaces. This is vital for young sexual minority men (YSMM) of color who may experience both racial and sexual minority discrimination and subsequently poorer mental well-being. METHODS: P18 Neighborhood Study (n = 147) data were used. Measures of place-based negative racial and sexual-orientation sentiment were created using geo-located social media as a proxy for racial climate via socially-meaningfully-defined places. Exposure to place-based negative sentiment was computed as an average of discrimination by places frequented using activity space measures per person. Outcomes were number of days of reported poor mental health in last 30 days. Zero-inflated Poisson regression analyses were used to assess influence of and type of relationship between place-based negative racial or sexual-orientation sentiment exposure and mental well-being, including the moderating effect of race/ethnicity. RESULTS: We found evidence for a non-linear relationship between place-based negative racial sentiment and mental well-being among our racially and ethnically diverse sample of YSMM (p < .05), and significant differences in the relationship for different race/ethnicity groups (p < .05). The most pronounced differences were detected between Black and White non-Hispanic vs. Hispanic sexual minority men. At two standard deviations above the overall mean of negative racial sentiment exposure based on activity spaces, Black and White YSMM reported significantly more poor mental health days in comparison to Hispanic YSMM. CONCLUSIONS: Effects of discrimination can vary by race/ethnicity and discrimination type. Experiencing place-based negative racial sentiment may have implications for mental well-being among YSMM regardless of race/ethnicity, which should be explored in future research including with larger samples sizes.

Objective and Subjective Neighborhood Crime Associated with Poor Sleep among Young Sexual Minority Men: a GPS Study.

Sleep disparities in sexual minority male (SMM) populations have received relatively little attention but they may be critical to explaining other health disparities seen among SMM, via neural or hormonal pathways. Recent research suggests that crime may be a psychosocial stressor that contributes to sleep disparities but that finding has been based on subjective measures of crime. We conducted the P18 Neighborhood Study of 250 SMM in New York City, including 211 with adequate GPS tracking data. We used the GPS tracking data to define daily path area activity spaces and tested the associations of violent crime in those activity spaces and in the subject's residential neighborhood, perceived neighborhood safety, and witnessing crime with a subjective measure of sleep. Using quasi-Poisson regression, adjusted for individual and neighborhood socio-demographics, we found that SMM who witnessed more types of crime experienced significantly more nights of poor sleep over the course of a month (RR: 1.16, 95%CI: 1.05-1.27, p-value: < 0.01). We did not find any associations between violent crime rates in either the activity area or residential area and sleep. Our findings support the conclusion that personal exposure to crime is associated with sleep problems and provide further evidence for the pathway between stress and sleep. The lack of association between neighborhood crime levels and sleep suggests that there must be personal experience with crime and ambient presence is insufficient to produce an effect.

Combining Global Positioning System (GPS) with saliva collection among sexual minority adults: A feasibility study.

BACKGROUND: This is the first study, of which we are aware, to evaluate the feasibility and accessibility of simultaneous use of Global Positioning System (GPS) and saliva collection for biomarker assessment as an objective measure of stress physiology among sexual minority (lesbian, gay, bisexual, queer, and other non-heterosexual identities) individuals. The principal motivation for pairing GPS and saliva collection was to investigate how characteristics of the built and social environments along with participants' daily activity paths affect stress. This can contribute to a better understanding of health and health behaviors in the sexual minority community. METHODS: A convenience sample of enrolled participants (N = 124) from Houston, Texas was asked to complete questionnaires, carry with them a GPS unit daily, and collect and store 6 samples of saliva at specific times across the span of a day prior to a second visit around one week later. RESULTS: Of 124 participants, 16 participants (12.90%) provided no useable GPS data and 98 (79.03%) provided at least 4 days of data. More than three-fourths (n = 98, 79.03%) also provided complete saliva samples. CONCLUSIONS: Our results show that the simultaneous use of GPS and saliva collection to assess sexual minority individuals' activity paths and stress level is feasible.

Geographic Density and Uptake of Pre-exposure Prophylaxis (PrEP) Among Young Gay, Bisexual and Other Sexual Minority Men: A Global Positioning System (GPS) Study.

The geographic availability of pre-exposure prophylaxis (PrEP) providers is one important factor that significantly affects PrEP uptake. While most previous studies have employed spatial accessibility in static residential neighborhood definitions or self-reported healthcare accessibility, we examined the associations of the objectively measured geographic density of PrEP services with current PrEP use, using global positioning system (GPS) among sexual minority men (SMM) in New York City. 250 HIV-negative SMM participated in a 2-week GPS monitoring (January 2017-January 2018). Geographic PrEP density was measured as total numbers of PrEP providers in (1) individual activity space defined as daily path area of GPS points, (2) residential street network buffers and (3) census tract and ZIP code of residential locations. Geographic PrEP density within GPS-based activity space was positively associated with current PrEP use (prevalence ratio for 50-m activity space = 1.10, 95% confidence interval: [1.02, 1.18]). PrEP provider counts in residential buffer areas and administrative neighborhoods were not associated with PrEP use. Although it is not generalizable beyond New York City, our finding suggests the importance of daily mobility pattern in HIV prevention and PrEP implementation strategies.

Assessment of spatial mobility among young men who have sex with men within and across high HIV prevalence neighborhoods in New York city: The P18 neighborhood study.

The purpose of this study was to examine and quantify spatial mobility among HIV-negative young men who have sex with men (YMSM) within and across high prevalence HIV neighborhoods in New York City (NYC). We completed an analysis with global positioning system (GPS) and survey data to quantify spatial mobility for participants enrolled in the P18 Neighborhood Study (analytic n = 211; 83.4%). Spatial mobility was documented with self-reported survey data and objective GPS data, which was uncorrelated. Nearly one-quarter of participants (26.1%) said that they consider the neighborhood in which they currently live to differ from the neighborhood in which they had sex most frequently. In addition, 62.9% of participants' GPS points were recorded in NYC ZIP Code Tabulation Areas within the highest quartile of HIV prevalence. Future studies of YMSM populations should be conducted to examine how environments beyond the residential neighborhood can influence sexual health, which may guide HIV prevention services.

Associations of spatial mobility with sexual risk behaviors among young men who have sex with men in New York City: A global positioning system (GPS) study.

Spatial contexts and spatial mobility are important factors of the HIV epidemic and sexually transmitted infections. Using global positioning system (GPS) devices, we examined the associations of objectively measured spatial mobility with sexual risk behaviors among gay, bisexual and other men who have sex with men (MSM) in New York City. This observational study included a subgroup of 253 HIV-negative MSM from the Project 18 Cohort Study, who participated in the GPS monitoring sub-study. Spatial mobility was measured as (1) distance traveled and (2) activity space size defined as daily path area during 2-week of GPS tracking. We examined the associations of these measures with numbers of male sexual partners and condomless anal intercourse (CAI) acts during last six months using quasi-Poisson models, adjusting for socio-demographics. Results demonstrated that spatial mobility was positively associated with sexual risk behaviors, for example, with CAI (incidence rate ratio [IRR] = 1.01 for a 10 km increase in distance traveled and IRR = 1.04 for a 1 km2 increase in 50 m-buffer activity space size). Our findings may enhance the understanding of spatial contexts of HIV risk. Future studies should be conducted to examine the mechanisms for the associations between spatial mobility behaviors with sexual risk behaviors as well as the influence of neighborhood characteristics in various neighborhood contexts, which may guide the place-based HIV prevention services.

Longitudinal cohort of HIV-negative transgender women of colour in New York City: protocol for the TURNNT ('Trying to Understand Relationships, Networks and Neighbourhoods among Transgender women of colour') study.

INTRODUCTION: In the USA, transgender women are among the most vulnerable to HIV. In particular, transgender women of colour face high rates of infection and low uptake of important HIV prevention tools, including pre-exposure prophylaxis (PrEP). This paper describes the design, sampling methods, data collection and analyses of the TURNNT ('Trying to Understand Relationships, Networks and Neighbourhoods among Transgender women of colour') study. In collaboration with communities of transgender women of colour, TURNNT aims to explore the complex social and environmental (ie, neighbourhood) structures that affect HIV prevention and other aspects of health in order to identify avenues for intervention. METHODS AND ANALYSES: TURNNT is a prospective cohort study, which will recruit 300 transgender women of colour (150 Black/African American, 100 Latina and 50 Asian/Pacific Islander participants) in New York City. There will be three waves of data collection separated by 6 months. At each wave, participants will provide information on their relationships, social and sexual networks, and neighbourhoods. Global position system technology will be used to generate individual daily path areas in order to estimate neighbourhood-level exposures. Multivariate analyses will be conducted to assess cross-sectional and longitudinal, independent and synergistic associations of personal relationships (notably individual social capital), social and sexual networks, and neighbourhood factors (notably neighbourhood-level social cohesion) with PrEP uptake and discontinuation. ETHICS AND DISSEMINATION: The TURNNT protocol was approved by the Columbia University Institutional Review Board (reference no. AAAS8164). This study will provide novel insights into the relationship, network and neighbourhood factors that influence HIV prevention behaviours among transgender women of colour and facilitate exploration of this population's health and well-being more broadly. Through community-based dissemination events and consultation with policy makers, this foundational work will be used to guide the development and implementation of future interventions with and for transgender women of colour.

Using global positioning system methods to explore mobility patterns and exposure to high HIV prevalence neighbourhoods among transgender women in New York.

The aim of this study was to assess mobility patterns among a sample of transgender women (n=14) in New York City via survey and Global Positioning System (GPS) monitoring. We found varying levels of concordance between the residential neighbourhood and each of the non-residential contexts: 64.3% considered the neighbourhood that they socialised in most often to be different from their residential neighbourhood. While participants' residences represented 10 zone improvement plan code tabulation areas (ZCTAs), GPS data were recorded in 124 of 263 ZCTAs (47.1%). Overall, 58.2% (n=373,262) were recorded in ZCTAs in the highest quartile of human immunodeficiency virus (HIV) prevalence. The association between place, community HIV prevalence, mobility, and factors that increase the vulnerability of transgender women to HIV infection are worthy of future investigation in reducing the burden of the HIV epidemic in these communities.

The Social Context of HIV Prevention and Care among Black Men Who Have Sex with Men in Three U.S. Cities: The Neighborhoods and Networks (N2) Cohort Study.

Background: In many parts of the world, stark racial disparities in human immunodeficiency virus (HIV) prevalence, incidence, prevention, and care outcomes persist among gay, bisexual, and other men who have sex with men (MSM), with Black MSM significantly impacted in the United States (U.S.). Individual-level characteristics, including sexual behaviors and socioeconomic status, do not fully account for racial/ethnic disparities in HIV among MSM. We hypothesize that neighborhood contexts and network characteristics influence risk for HIV infection as well as HIV-related prevention and care behaviors. As such, the study design includes the use of real-time geospatial methods and in-depth assessments of multiple network typologies to investigate the impact of neighborhood and network-level factors on HIV prevention and treatment among Black MSM residing in longstanding priority HIV elimination areas in the U.S., namely Chicago, Illinois and in the Deep South (Jackson, Mississippi and New Orleans, Louisiana) (n = 450, n = 50, and n = 100, respectively). We describe the design, sampling methods, data collection, data management methods, and preliminary findings of the ongoing 'Neighborhoods and Networks (N2) Cohort Study'. Methods/Design: N2 employs a prospective longitudinal design. The sample includes Black MSM participants in Chicago recruited via respondent-driven sampling and assessed every six months over two years of follow-up. Participants enrolled in Jackson and New Orleans are being recruited through existing health and community services and assessed every six months over one year of follow-up. Mobility within and between neighborhoods is being assessed using global positioning system (GPS) technology. Social and sexual networks among Black MSM are being studied through egocentric network inventories as well as newer methods of creating meso-level networks that involve social media (Facebook) and mobile phone contacts. Key HIV prevention outcomes such as pre-exposure prophylaxis (PrEP) care engagement, and HIV/STI (sexually transmitted infections) biomarkers will be examined at baseline and follow-up. Results: As of 31 December 2018, a total of 361 men were enrolled across all study sites: 259 in Chicago and 102 in the Deep South (75 in New Orleans and 27 in Jackson). At baseline, participants ranged in age from 17 to 65 years old (mean = 34.3, standard deviation = 5.1) with 123 men (34.1%) self-reported as HIV positive. While HIV treatment levels were similar between sites, men in the Deep South reported higher rates of adherence than men in Chicago (63.3% versus 49.4%, p = 0.03). Sexual risk profiles were mainly the same between men from different study sites, with 22.9% of men in Chicago and 28.9% in the Deep South reporting consistent condom use during vaginal and anal sex (p = 0.26). Regarding their home neighborhoods, men in the Deep South were more likely than those in Chicago to characterize theirs as having a good reputation (43.1% versus 24.7%, p < 0.001) and as being safe (37.3% versus 21.2%, p = 0.002). Conclusions: The focus on Black MSM in the N2 Study will allow for a nuanced exploration of the attitudes, beliefs, behaviors, and practices of a diverse group of Black MSM. The study is also positioned to provide novel insight about neighborhood and network characteristics that influence HIV-related behaviors. A health equity framework ensures that Black MSM are not explicitly or implicitly deemed as deviant, disordered, or the non-reference group. Findings from N2 will provide guidance for the implementation of more impactful HIV prevention interventions that engage a diverse population of Black MSM as we work toward HIV elimination in the U.S.

Acceptability of smartphone applications for global positioning system (GPS) and ecological momentary assessment (EMA) research among sexual minority men.

BACKGROUND: Emerging research is using global positioning system (GPS) and ecological momentary assessment (EMA) methods among sexual minority men (SMM), a population that experiences multiple health disparities. However, we are not aware of any research that has combined these approaches among SMM, highlighting the need for acceptability and feasibility research. The purpose of this study was to examine the acceptability of implementing GPS and EMA research protocols using smartphone applications among SMM as well as related socio-demographic correlates. METHODS: Data come from a sample of SMM on a popular geosocial-networking app in Paris, France (n = 580). We assessed the acceptability of implementing GPS and EMA research protocols on smartphone apps as well as socio-demographic characteristics (i.e., age, sexual orientation, country of origin, employment status, and relationship status). We examined the anticipated acceptability of GPS and EMA data collection methods as well as socio-demographic correlates of acceptability of GPS and EMA methods. RESULTS: We found that over half (54.1%) of the sample was willing to download a smartphone app for GPS-based research and we found that almost 60% of the participants were willing to download a smartphone app for EMA-based research. In total, 44.0% reported that they were willing to download both GPS and EMA apps. In addition, we found that older participants were less willing to download a smartphone app for EMA research than younger participants aged 18-24 (40-49 years: aPR = 0.40; 95% CI = 0.20, 0.78) and students were more willing to download smartphone apps for both GPS and EMA research (aPR = 1.41; 95% CI = 1.02, 1.95). CONCLUSION: Results from this study suggest that using smartphone apps to implement GPS and EMA methods among some SMM are acceptable. However, care should be taken as segments of SMM are less likely to be willing to engage in this type of research.

Assessments of residential and global positioning system activity space for food environments, body mass index and blood pressure among low-income housing residents in New York City.

Research has examined how the food environment affects the risk of cardiovascular disease (CVD). Many studies have focused on residential neighbourhoods, neglecting the activity spaces of individuals. The objective of this study was to investigate whether food environments in both residential and global positioning system (GPS)-defined activity space buffers are associated with body mass index (BMI) and blood pressure (BP) among low-income adults. Data came from the New York City Low Income Housing, Neighborhoods and Health Study, including BMI and BP data (n=102, age=39.3±14.1 years), and one week of GPS data. Five food environment variables around residential and GPS buffers included: fast-food restaurants, wait-service restaurants, corner stores, grocery stores, and supermarkets. We examined associations between food environments and BMI, systolic and diastolic BP, controlling for individual- and neighbourhood-level sociodemographics and population density. Within residential buffers, a higher grocery store density was associated with lower BMI (ß=- 0.20 kg/m2, P<0.05), and systolic and diastolic BP (ß =-1.16 mm Hg; and ß=-1.02 mm Hg, P<0.01, respectively). In contrast, a higher supermarket density was associated with higher systolic and diastolic BP (ß=1.74 mm Hg, P<0.05; and ß=1.68, P<0.01, respectively) within residential buffers. In GPS neighbourhoods, no associations were documented. Examining how food environments are associated with CVD risk and how differences in relationships vary by buffer types have the potential to shed light on determinants of CVD risk. Further research is needed to investigate these relationships, including refined measures of spatial accessibility/exposure, considering individual's mobility.

Characterizing Geosocial-Networking App Use Among Young Black Men Who Have Sex With Men: A Multi-City Cross-Sectional Survey in the Southern United States.

BACKGROUND: Understanding where and how young black men who have sex with men (YBMSM) in the southern United States meet their sexual partners is germane to understanding the underlying factors contributing to the ongoing HIV transmission in this community. Men who have sex with men (MSM) commonly use geosocial networking apps to meet sexual partners. However, there is a lack of literature exploring geosocial networking app use in this particular population. OBJECTIVE: Our aim was to examine the characteristics, preferences, and behaviors of a geographically diverse sample of geosocial networking app-using YBMSM in the southern United States. METHODS: Data were collected from a sample of 75 YBMSM across three cities (Gulfport, Mississippi; Jackson, Mississippi; and New Orleans, Louisiana). Multiple aspects of geosocial networking app use were assessed, including overall app use, age of participant at first app use, specific apps used, reasons for app use, photos presented on apps, logon times and duration, number of messages sent and received, and characteristics of and behaviors with partners met on apps. Survey measures of app-met partner and sexual behavior characteristics assessed at midpoint (Day 7) and completion visits (Day 14) were compared using McNemar's test or Wilcoxon signed-rank test. In addition, we assessed activity spaces derived from GPS devices that participants wore for 2 weeks. RESULTS: Of the 70 participants who responded to the overall app-use item, almost three-quarters (53/70, 76%) had ever used geosocial networking apps. Jack'd was the most commonly used geosocial networking app (37/53, 70%), followed by Adam4Adam (22/53, 42%), and Grindr (19/53, 36%). The mean and median number of apps used were 4.3 (SD 2.7) and 4.0 (range 0-13), respectively. Most app-using participants displayed their face on the profile picture (35/52, 67%), whereas fewer displayed their bare legs (2/52, 4%) or bare buttocks (or ass; 2/52, 4%). The mean age at the initiation of app use was 20.1 years (SD 2.78) ranging from 13-26 years. Two-thirds (35/53, 66%) of the sample reported using the apps to "kill time" when bored. A minority (9/53, 17%) reported using the apps to meet people to have sex/hook up with. The vast majority of participants reported meeting black partners for sex. Over two-thirds (36/53, 68%) reported that the HIV status of their app-met partners was negative, and 26% (14/53) reported that they did not know their partner's HIV status. There was a significant difference in GPS activity spaces between app using YBMSM compared to nonapp using YBMSM (2719.54 km2 vs 1855.68 km2, P=.011). CONCLUSIONS: Use of geosocial networking apps to meet sexual partners among our sample of YBMSM in the southern United States was common, with a diverse range of app use behaviors being reported. Further research should characterize the association between geosocial networking app use and engagement in sexual behaviors that increase risk for HIV acquisition and transmission. In addition, geosocial networking apps present a promising platform for HIV prevention interventions targeting YBMSM who use these apps.

Collecting Mobility Data with GPS Methods to Understand the HIV Environmental Riskscape Among Young Black Men Who Have Sex with Men: A Multi-city Feasibility Study in the Deep South.

While research increasingly studies how neighborhood contexts influence HIV among gay, bisexual and other men who have sex with men (MSM) populations, to date, no research has used global positioning system (GPS) devices, an innovative method to study spatial mobility through neighborhood contexts, i.e., the environmental riskscape, among a sample of Black MSM. The purpose of this study was to examine the feasibility of collecting two-week GPS data (as measured by a pre- and post-surveys as well as objectively measured adherence to GPS protocol) among a geographically-diverse sample of Black MSM in the Deep South: Gulfport, MS, Jackson, MS, and New Orleans LA (n = 75). GPS feasibility was demonstrated including from survey items, e.g. Black MSM reported high ratings of pre-protocol acceptability, ease of use, and low levels of wear-related concerns. Findings from this study demonstrate that using GPS methods is acceptable and feasible among Black MSM in the Deep South.

Acceptability and Feasibility of Using a Novel Geospatial Method to Measure Neighborhood Contexts and Mobility Among Transgender Women in New York City.

Purpose: To date, no studies utilizing global positioning system (GPS) technologies to measure mobility and environmental exposures have been conducted among a sample of transgender women despite the potential salient role neighborhood contexts may play in the health of this population. As such, the purpose of this study was to assess the acceptability and feasibility of a weeklong GPS protocol among a sample of transgender women in New York City. Methods: A sample of 14 transgender women residing in the New York City metropolitan area were recruited through community based methods to wear and charge a GPS device for 7 days to measure daily mobility. The acceptability of these methods was assessed using a pre- and postprotocol survey and their feasibility was measured using objective data derived from the GPS device. Pre- and postprotocol survey measures were compared using McNemar's test. Results: Participants reported high ratings of preprotocol acceptability, as well as few concerns regarding safety, appearance, and losing the device, all of which were maintained after completing the protocol. All 14 devices that were distributed were returned. In addition, all 14 participants had GPS data for at least 1 h on 1 day, and nine participants (64.3%) had at least 8 h of GPS data on all days. Conclusion: The findings of this pilot study demonstrate that the GPS methods are both acceptable and feasible among this sample of transgender women. GPS devices may be used in research among transgender women to understand neighborhood determinants of HIV and other STIs.

Residential and GPS-Defined Activity Space Neighborhood Noise Complaints, Body Mass Index and Blood Pressure Among Low-Income Housing Residents in New York City.

Little is known about how neighborhood noise influences cardiovascular disease (CVD) risk among low-income populations. The aim of this study was to investigate associations between neighborhood noise complaints and body mass index (BMI) and blood pressure (BP) among low-income housing residents in New York City (NYC), including the use of global positioning system (GPS) data. Data came from the NYC Low-Income Housing, Neighborhoods and Health Study in 2014, including objectively measured BMI and BP data (N = 102, Black = 69%), and 1 week of GPS data. Noise reports from "NYC 311" were used to create a noise complaints density (unit: 1000 reports/km2) around participants' home and GPS-defined activity space neighborhoods. In fully-adjusted models, we examined associations of noise complaints density with BMI (kg/m2), and systolic and diastolic BP (mmHg), controlling for individual- and neighborhood-level socio-demographics. We found inverse relationships between home noise density and BMI (B = -2.7 [kg/m2], p = 0.009), and systolic BP (B = -5.3 mmHg, p = 0.008) in the fully-adjusted models, and diastolic BP (B = -3.9 mmHg, p = 0.013) in age-adjusted models. Using GPS-defined activity space neighborhoods, we observed inverse associations between noise density and systolic BP (B = -10.3 mmHg, p = 0.019) in fully-adjusted models and diastolic BP (B = -7.5 mmHg, p = 0.016) in age-adjusted model, but not with BMI. The inverse associations between neighborhood noise and CVD risk factors were unexpected. Further investigation is needed to determine if these results are affected by unobserved confounding (e.g., variations in walkability). Examining how noise could be related to CVD risk could inform effective neighborhood intervention programs for CVD risk reduction.

Quantifying spatial misclassification in exposure to noise complaints among low-income housing residents across New York City neighborhoods: a Global Positioning System (GPS) study.

PURPOSE: To examine if there was spatial misclassification in exposure to neighborhood noise complaints among a sample of low-income housing residents in New York City, comparing home-based spatial buffers and Global Positioning System (GPS) daily path buffers. METHODS: Data came from the community-based NYC Low-Income Housing, Neighborhoods and Health Study, where GPS tracking of the sample was conducted for a week (analytic n = 102). We created a GPS daily path buffer (a buffering zone drawn around GPS tracks) of 200 m and 400 m. We also used home-based buffers of 200 m and 400 m. Using these "neighborhoods" (or exposure areas), we calculated neighborhood exposure to noisy events from 311 complaints data (analytic n = 143,967). Friedman tests (to compare overall differences in neighborhood definitions) were applied. RESULTS: There were differences in neighborhood noise complaints according to the selected neighborhood definitions (P < .05). For example, the mean neighborhood noise complaint count was 1196 per square kilometer for the 400-m home-based and 812 per square kilometer for the 400-m activity space buffer, illustrating how neighborhood definition influences the estimates of exposure to neighborhood noise complaints. CONCLUSIONS: These analyses suggest that, whenever appropriate, GPS neighborhood definitions can be used in spatial epidemiology research in spatially mobile populations to understand people's lived experience.

Mapping Multi-Day GPS Data: A Cartographic Study in NYC.

Multi-day GPS data is increasingly being used in research-including in the field of spatial epidemiology. We present several maps as ways to present multi-day GPS data. Data come from the NYC Low-Income Housing, Neighborhoods and Health Study (n=120). Participants wore a QStarz BT-Q1000XT GPS device for about a week (mean: 7.44, SD= 2.15). Our maps show various ways to visualize multi-day GPS data; these data are presented by overall GPS data, by weekday/weekend and by day of the week. We discuss implications for each of the maps.

Perceived spatial stigma, body mass index and blood pressure: a global positioning system study among low-income housing residents in New York City.

Previous research has highlighted the salience of spatial stigma on the lives of low-income residents, but has been theoretical in nature and/or has predominantly utilised qualitative methods with limited generalisability and ability to draw associations between spatial stigma and measured cardiovascular health outcomes. The primary objective of this study was to evaluate relationships between perceived spatial stigma, body mass index (BMI), and blood pressure among a sample of low-income housing residents in New York City (NYC). Data come from the community-based NYC Low-income Housing, Neighborhoods and Health Study. We completed a crosssectional analysis with survey data, which included the four items on spatial stigma, as well objectively measured BMI and blood pressure data (analytic n=116; 96.7% of the total sample). Global positioning systems (GPS) tracking of the sample was conducted for a week. In multivariable models (controlling for individual-level age, gender, race/ethnicity, education level, employment status, total household income, neighborhood percent non-Hispanic Black and neighborhood median household income) we found that participants who reported living in an area with a bad neighborhood reputation had higher BMI (B=4.2, 95%CI: -0.01, 8.3, P=0.051), as well as higher systolic blood pressure (B=13.2, 95%CI: 3.2, 23.1, P=0.01) and diastolic blood pressure (B=8.5, 95%CI: 2.8, 14.3, P=0.004). In addition, participants who reported living in an area with a bad neighborhood reputation had increased risk of obesity/overweight [relative risk (RR)=1.32, 95%CI: 1.1, 1.4, P=0.02) and hypertension/pre-hypertension (RR=1.66, 95%CI: 1.2, 2.4, P=0.007). However, we found no differences in spatial mobility (based GPS data) among participants who reported living in neighborhoods with and without spatial stigma (P>0.05). Further research is needed to investigate how placebased stigma may be associated with impaired cardiovascular health among individuals in stigmatised neighborhoods to inform effective cardiovascular risk reduction interventions.