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Grant Details

Grant Number: 1R01CA172726-01A1 Interpret this number
Primary Investigator: Zenk, Shannon
Organization: University Of Illinois At Chicago
Project Title: Environmental Attributes and Weight Control: Study of Over 1.3 Million Veterans
Fiscal Year: 2013


DESCRIPTION (provided by applicant): Obesity contributes to the development of debilitating chronic health conditions in millions of Americans, underlies nearly 10 percent of all U.S. medical spending, and conservatively accounts for 30% of the gap in life expectancy between Americans and their counterparts in 13 other high-income countries. Despite tremendous investment in obesity treatment, little headway has been made. Of those who try, less than half succeed in losing a clinically significant amount of weight; few maintain weight loss; and adult obesity rates, currently 35.7% overall, have not declined. These disappointing outcomes challenge researchers and policymakers to consider how the residential environment can facilitate healthful eating and physical activity. Despite promising early research, there is no consensus about environmental contributors to body weight. To address this gap, the objective of the proposed study is to estimate the contributions of residential environment attributes (walkability, aesthetics, recreational places, healthy and unhealthy food availability, and prices for healthy and less healthy foods) to BMI and other diet-sensitive and physical activity-sensitive measures of metabolic risk (blood pressure, serum glucose, and lipids) among adults. Specific aims are: (1) Through a retrospective 10- year longitudinal nationwide study of over 1.3 million veterans, determine specific attributes of the residential environment that help individuals to maintain healthier BMI, BMI trajectory, and metabolic risk status; and (2) In over 200,000 veterans who participated in the MOVE! weight management program and a similar number of matched controls, determine the extent to which specific attributes of the residential environment help individuals lose weight at six months, maintain weight loss at 18 months, and achieve healthier BMI trajectory longer term (5 years). To achieve these aims, we will link data on veterans' health to public and proprietary data characterizing attributes of their residential environments and employ panel data statistical models that are robust to a broad class of potential sources of bias and reverse causality. We will use similar models with a matched control group derived through propensity score analysis to determine the moderating impact of environmental attributes on MOVE! program effectiveness. The proposed study is highly innovative because it draws on the largest sample and the broadest geographic coverage of any study to date. We will use unique electronic health data stores, information on precise residential location, and detailed and repeated measures of environmental attributes, allowing us to capture changes in the environment and residential location over time to examine effects on individuals' BMI and metabolic risk over periods up to 10 years, including determining whether environmental attributes moderate the effectiveness of a weight management intervention. This research is significant because it will provide the most robust evidence to date that is needed to formulate effective public health policies to eradicate obesity and because it has the potential to fundamentally transform weight management intervention approaches.


Active living-oriented zoning codes and cardiometabolic conditions across the lifespan.
Authors: Zenk S.N. , Pugach O. , Chriqui J.F. , Wing C. , Raymond D. , Tarlov E. , Sheridan B. , Jones K.K. , Slater S.J. .
Source: Translational behavioral medicine, 2022-05-25; 12(4), p. 595-600.
PMID: 35192715
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Development of a Predictive Algorithm to Identify Adults With Mobility Limitations Using VA Health Care Administrative Data.
Authors: Eisenberg Y. , Powell L.M. , Zenk S.N. , Tarlov E. .
Source: Medical care research and review : MCRR, 2021 Oct; 78(5), p. 572-584.
EPub date: 2020-08-26.
PMID: 32842872
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Racial/ethnic and educational differences in perceptions and use of a new urban trail.
Authors: Kraft A.N. , Nunez J. , Tarlov E. , Slater S. , Zenk S.N. .
Source: Ethnicity & health, 2021 May; 26(4), p. 614-629.
EPub date: 2018-10-29.
PMID: 30372629
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Neighborhood Food Outlet Access and Dietary Intake among Adults with Chronic Kidney Disease: Results from the Chronic Renal Insufficiency Cohort Study.
Authors: Madrigal J.M. , Cedillo-Couvert E. , Ricardo A.C. , Appel L.J. , Anderson C.A.M. , Deo R. , Hamm L.L. , Cornish-Zirker D. , Tan T.C. , Sha D. , et al. .
Source: Journal of the Academy of Nutrition and Dietetics, 2020 Jul; 120(7), p. 1151-1162.e3.
EPub date: 2020-03-04.
PMID: 32146126
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Neighborhood Food Environment and Health Outcomes in U.S. Low-Socioeconomic Status, Racial/Ethnic Minority, and Rural Populations: A Systematic Review.
Authors: Kraft A.N. , Thatcher E.J. , Zenk S.N. .
Source: Journal of health care for the poor and underserved, 2020; 31(3), p. 1078-1114.
PMID: 33416683
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Neighborhood Walkability and BMI Change: A National Study of Veterans in Large Urban Areas.
Authors: Tarlov E. , Silva A. , Wing C. , Slater S. , Matthews S.A. , Jones K.K. , Zenk S.N. .
Source: Obesity (Silver Spring, Md.), 2020 Jan; 28(1), p. 46-54.
EPub date: 2019-12-05.
PMID: 31804004
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Does the built environment influence the effectiveness of behavioral weight management interventions?
Authors: Zenk S.N. , Tarlov E. , Wing C. , Slater S. , Jones K.K. , Fitzgibbon M. , Powell L.M. .
Source: Preventive medicine, 2019 Sep; 126, p. 105776.
EPub date: 2019-07-19.
PMID: 31330154
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The price of ultra-processed foods and beverages and adult body weight: Evidence from U.S. veterans.
Authors: Powell L.M. , Jones K. , Duran A.C. , Tarlov E. , Zenk S.N. .
Source: Economics and human biology, 2019 Aug; 34, p. 39-48.
EPub date: 2019-05-29.
PMID: 31204255
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Would increasing access to recreational places promote healthier weights and a healthier nation?
Authors: Slater S.J. , Tarlov E. , Jones K. , Matthews S.A. , Wing C. , Zenk S.N. .
Source: Health & place, 2019 Mar; 56, p. 127-134.
EPub date: 2019-02-06.
PMID: 30738347
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Contextual correlates of energy-dense snack food and sweetened beverage intake across the day in African American women: An application of ecological momentary assessment.
Authors: Ghosh Roy P. , Jones K.K. , Martyn-Nemeth P. , Zenk S.N. .
Source: Appetite, 2019-01-01; 132, p. 73-81.
EPub date: 2018-09-24.
PMID: 30261234
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Foreclosures and weight gain: Differential associations by longer neighborhood exposure.
Authors: Duran A.C. , Zenk S.N. , Tarlov E. , Duda S. , Smith G. , Lee J.M. , Berbaum M.L. .
Source: Preventive medicine, 2019 Jan; 118, p. 23-29.
EPub date: 2018-07-17.
PMID: 30026119
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Does Effectiveness of Weight Management Programs Depend on the Food Environment?
Authors: Tarlov E. , Wing C. , Gordon H.S. , Matthews S.A. , Jones K.K. , Powell L.M. , Zenk S.N. .
Source: Health services research, 2018 Dec; 53(6), p. 4268-4290.
EPub date: 2018-09-23.
PMID: 30246454
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How many days of global positioning system (GPS) monitoring do you need to measure activity space environments in health research?
Authors: Zenk S.N. , Matthews S.A. , Kraft A.N. , Jones K.K. .
Source: Health & place, 2018 May; 51, p. 52-60.
PMID: 29549754
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Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics.
Authors: Zenk S.N. , Tarlov E. , Powell L.M. , Wing C. , Matthews S.A. , Slater S. , Gordon H.S. , Berbaum M. , Fitzgibbon M.L. .
Source: American journal of health promotion : AJHP, 2018 Mar; 32(3), p. 779-794.
EPub date: 2017-03-02.
PMID: 29214851
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Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter?
Authors: Zenk S.N. , Tarlov E. , Wing C.M. , Matthews S.A. , Tong H. , Jones K.K. , Powell L. .
Source: International journal of environmental research and public health, 2018-01-26; 15(2), .
EPub date: 2018-01-26.
PMID: 29373556
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Neighborhood Resources to Support Healthy Diets and Physical Activity Among US Military Veterans.
Authors: Tarlov E. , Zenk S.N. , Matthews S.A. , Powell L.M. , Jones K.K. , Slater S. , Wing C. .
Source: Preventing chronic disease, 2017-11-09; 14, p. E111.
EPub date: 2017-11-09.
PMID: 29120701
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Geographic Accessibility Of Food Outlets Not Associated With Body Mass Index Change Among Veterans, 2009-14.
Authors: Zenk S.N. , Tarlov E. , Wing C. , Matthews S.A. , Jones K. , Tong H. , Powell L.M. .
Source: Health affairs (Project Hope), 2017-08-01; 36(8), p. 1433-1442.
PMID: 28784736
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A step-by-step approach to improve data quality when using commercial business lists to characterize retail food environments.
Authors: Jones K.K. , Zenk S.N. , Tarlov E. , Powell L.M. , Matthews S.A. , Horoi I. .
Source: BMC research notes, 2017-01-07; 10(1), p. 35.
EPub date: 2017-01-07.
PMID: 28061798
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