International evaluation of the Microscale Audit of Pedestrian Streetscapes (MAPS) Global instrument: comparative assessment between local and remote online observers.

OBJECTIVES: The use of online imagery by non-local observers to conduct remote, centralized collection of streetscape audit data in international studies has the potential to enhance efficiency of collection and comparability of such data for research on built environments and health. The objectives of the study were to measure (1) the consistency in responses between local in-field observers and non-local remote online observers and (2) the reliability between in-country online observers and non-local remote online observers using the Microscale Audit of Pedestrian Streetscapes Global tool to characterize pedestrian-related features along streets in five countries. METHODS: Consistency and inter-rater reliability were analyzed between local and non-local observers on a pooled database of 200 routes in five study regions (Melbourne, Australia; Ghent, Belgium; Curitiba, Brazil; Hong Kong, China; and Valencia, Spain) for microscale environmental feature subscales and item-level variables using the intraclass correlation coefficient (ICC). RESULTS: A local in-field versus remote online comparison had an ICC of 0.75 (95 % CI: 0.68-0.80) for the grand total score. An ICC of 0.91 (95 % CI: 0.88-0.93) was found for the local online versus remote online comparison. Positive subscales yielded stronger results in comparison to negative subscales, except for the similarly poor-performing positive aesthetics/social characteristics. CONCLUSIONS: This study demonstrated remote audits of microscale built environments using online imagery had good reliability with local in-field audits and excellent reliability with local online audits. Results generally supported remote online environmental audits as comparable to local online audits. This identification of low-cost and efficient data acquisition methods is important for expanding research on microscale built environments and physical activity globally.

Framing Federal School Nutrition Policy: The Healthy, Hunger-Free Kids Act in the Nation's News.

The 2010 Healthy, Hunger-Free Kids Act (HHFKA) represented a major and controversial overhaul of national nutrition standards for foods served in the United States' nearly 100,000 public schools. To unpack how debate over this far-reaching policy was presented to the public, we examined 152 national print; network, network affiliate, and cable television; and public radio news stories about the policy, all appearing during the window surrounding its scheduled reauthorization (9/1/14-1/31/16). We found that HHFKA opponents were more likely to argue from a smaller set of frames that comprised a concise, clear narrative they frequently repeated, while proponents drew from a broader range of frames, each used less frequently, to present their position. In addition, key voices expected to be prominent in a debate over child health-children and parents-were relatively deemphasized. Overall, the primary frames on either side of this debate argued past one another, leaving largely unanswered critical charges about the role of government in assuring the public's health. This debate reflects deeper arguments at the root of many public health policy decisions, and as such, is an illustrative case example for those planning how to enter and help shape national debate over public health policy.

State-Issued Identification Cards Reveal Patterns in Adult Weight Status.

BACKGROUND: State-issued identification cards are a promising data source for neighborhood-level obesity estimates. METHODS: We used information from three million Oregon state-issued identification cards to compute age-adjusted estimates of average adult body mass index (BMI) for each census tract in the state. We used multivariate linear regression to identify associations between weight status and population characteristics, food access, commuting behavior, and geography. RESULTS: Together, home values, education, race, ethnicity, car commuting, and rural-urban commuting area (RUCA) explained 86% of the variation in BMI among tracts. BMI was lower in areas with higher home values and greater educational attainment, and higher in areas with more workers commuting by car. DISCUSSION: Our findings are consistent with other research on socioeconomic disparities in obesity. This demonstrates state-issued identification cards are a promising data source for BMI surveillance and may offer new insight into the association between weight status and economic and environmental factors. Public health agencies should explore options for developing their own obesity estimates from identification card data.