Abstract
Citation
Wong F, Stevens D, O'Connor-Duffany K, Siegel K, Gao Y, Community Interventions for Health (CIH) collaboration. Community Health Environment Scan Survey (CHESS): a novel tool that captures the impact of the built environment on lifestyle factors. Glob Health Action 2011 Mar 7;4:5276.
Abstract
BACKGROUND: Novel efforts and accompanying tools are needed to tackle the global burden of chronic disease. This paper presents an approach to describe the environments in which people live, work, and play. Community Health Environment Scan Survey (CHESS) is an empirical assessment tool that measures the availability and accessibility, of healthy lifestyle options lifestyle options. CHESS reveals existing community assets as well as opportunities for change, shaping community intervention planning efforts by focusing on community-relevant opportunities to address the three key risk factors for chronic disease (i.e. unhealthy diet, physical inactivity, and tobacco use). METHODS: The CHESS tool was developed following a review of existing auditing tools and in consultation with experts. It is based on the social-ecological model and is adaptable to diverse settings in developed and developing countries throughout the world. RESULTS: For illustrative purposes, baseline results from the Community Interventions for Health (CIH) Mexico site are used, where the CHESS tool assessed 583 food stores and 168 restaurants. Comparisons between individual-level survey data from schools and community-level CHESS data are made to demonstrate the utility of the tool in strategically guiding intervention activities. CONCLUSION: The environments where people live, work, and play are key factors in determining their diet, levels of physical activity, and tobacco use. CHESS is the first tool of its kind that systematically and simultaneously examines how built environments encourage/discourage healthy eating, physical activity, and tobacco use. CHESS can help to design community interventions to prevent chronic disease and guide healthy urban planning.
Full Text
The full text is available at https://dx.doi.org/10.3402/gha.v4i0.5276
At A Glance
Food Environment Variables
# | Type of Environment/Institution |
---|---|
168 | Full Service Restaurant |
583 | Grocery Store |
- | Limited Service/Fast Food Restaurant |
- | Recreational Facility |
16 | School (K-12) |
Measure | objective | perceived |
---|---|---|
Availability/Access | ✔ | ✘ |
Marketing/Advertising/Promotion | ✔ | ✘ |
Food Group/Type of Food |
---|
Low-fat foods other than dairy |
Fruits and vegetables |
Foods of minimal nutritional value |
Sweetened beverages |
Physical Activity Environment Variables
# | Type of Environment/Location |
---|---|
15 | Community/Neighborhood as a Whole |
- | Recreational Facility/Area |
- | School |
# | Scale |
---|---|
15 | Neighborhood |
Measure | objective | perceived |
---|---|---|
Facility Access/Availablity/Proximity | ✔ | ✘ |
Domain(s)
Food Environment
Physical Activity Environment
Measure Type
Questionnaire
GIS protocol/detailed description
Measure Availability
Measure included in article
Number of Items
46 Reported
Study location
Not Reported
Mexico
Community Interventions for Health (CIH) pilot study site
Languages
Spanish
Information about Development of Measure
A literature search of available tools that assess community environments related to diet, physical activity, and tobacco use was performed. International experts in the fields of diet, physical activity, and tobacco use were consulted in order to develop a framework for assessing each risk factor. Prior to the Community Health Environment Scan Survey (CHESS), there were no tools addressing all three risk factors simultaneously. Some aspects of accessibility are measured using GIS mapping as well as other key attributes, such as hours of operation. The final version of CHESS includes eight brief assessment tools that inventory streets, stores, restaurants, street vendors, recreational facilities, parks/gardens, vending machines, and the information environment.
Study Design
Study Participants
Age
12 - 18 Years
Sex
Female
Male
Race/Ethnicity
Hispanic
Predominantly Low-income/Low-SES
Not reported
Sample Size
4608
Study Design
Design Type
Instrument/Method Development Without Validation/Reliability
Health Outcomes Assessed
None
Obesity Measures
Not reported
BMI Measured or Self-reported
Not reported
Covariates
Other health-related behaviors (e.g., tobacco use, substance use)
GIS protocol/detailed description
Data Reported on Race/Ethnicity
Quantitative data for community or area
Data Reported on SES
Not applicable
SES-related Variables
Not applicable
How To Use
Administration
Who Administered
Self-administered
Researcher-administered
How Administered
In-person
Direct observation, PC/PDA/GPS unit
Time Required
14 to 21 days
Training Required
Yes, time reported: 3 days
Instructions on Use
Instructions on instrument use included in article
Data Analysis
Data Collection/Analysis Costs
Not available
Data Collection/Protocol
A community assessment using CHESS was conducted via neighborhood walks, which initiated from selected schools within each community and extends in a 400 m radii. Maps of the areas to be scanned were created using Google Earth Pro, and the 400 m radii surrounding schools were created using a circular ruler program. CHESS data were collected using a personal digital device (PDA) with integrated GPS and camera (Magellan Mobile Mapper 6). Community Health Environment Scan Survey (CHESS) was programmed using electronic survey software (Snap version 9). Approximately 2,000 children between 12 and 14 years of age from selected schools were administered surveys.
Instructions on Data Analysis
Instructions on analysis included in article
Validity (0)
There are no validity tests reported for this measure.
Reliability (0)
There are no reliability tests reported for this measure.