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
168Full Service Restaurant
583Grocery Store
-Limited Service/Fast Food Restaurant
-Recreational Facility
16School (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
15Community/Neighborhood as a Whole
-Recreational Facility/Area
-School
# Scale
15Neighborhood
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.