This K01 will allow the PI to establish an independent career in public health and to help her achieve her career goal to conduct research that explains a variety of health outcomes and disparities in outcomes, in terms of the role of modifiable factors in the local environmental context. The candidate is applying for the award to gain extensive training and experience in social and spatial epidemiology, including multilevel modeling, Geographic Information Systems (GIS) and the built environment, analysis of complex survey design data, and adolescent health. The knowledge and experience obtained will be used to investigate the role of the physical and social macro-environments on adolescent behavior substance use, physical activity, and dietary habits. Despite the growth in empirical research on neighborhood environmental characteristics and their influence on adolescent health behaviors, much remains to be learned. Many researchers have not gone beyond the two-level conceptualizations of a multilevel model, yet it is reasonable to assume that adolescent health is influenced by numerous levels. Adolescents will be nested not only within their neighborhoods but also within their family or household unit providing a unique and rare opportunity to examine multiple levels of influence. Although there have been calls to modify environments to reduce negative health outcomes, most work has focused on the micro-environment (e.g., home, school influences). This study will use the unique opportunity of georeferenced national survey data on a racially diverse sample of adolescents included in the National Health and Nutrition Examination Survey (NHANES). Primary Aims are:1) to develop neighborhood-level measures that characterize physical and social neighborhood factors thought to influence adolescent health behavior; 2) to evaluate whether characteristics of the physical and social environment explain a substantial proportion of the variance in adolescent health behaviors; 3) to determine moderators of the association between the physical and social environment and adolescent health behavior; and 4) to identify racial and ethnic disparities in health behavior and to examine whether physical and characteristics of the neighborhood where an adolescent resides explains disparities. The skills gained during the proposed training will provide the candidate with the requisite training to become a strong independent investigator in neighborhood influences on health and specifically, adolescent health. ? ? ?
| Ruiz, Rachael L; Shah, Monisha K; Lewis, Marva L et al. (2014) Perceived access to health services and provider information and adverse birth outcomes: findings from LaPRAMS, 2007-2008. South Med J 107:137-43 |
| Theall, Katherine P; Brett, Zoe H; Shirtcliff, Elizabeth A et al. (2013) Neighborhood disorder and telomeres: connecting children's exposure to community level stress and cellular response. Soc Sci Med 85:50-8 |
| Theall, Katherine P; Dunaway, Lauren F; Mabile, Emily (2013) Food security and C-reactive protein in adolescents. Am J Public Health 103:e5 |
| Theall, Katherine P; Drury, Stacy S; Shirtcliff, Elizabeth A (2012) Cumulative neighborhood risk of psychosocial stress and allostatic load in adolescents. Am J Epidemiol 176 Suppl 7:S164-74 |
| Theall, Katherine P; Scribner, Richard; Broyles, Stephanie et al. (2011) Impact of small group size on neighbourhood influences in multilevel models. J Epidemiol Community Health 65:688-95 |
| Broyles, Stephanie T; Mowen, Andrew J; Theall, Katherine P et al. (2011) Integrating social capital into a park-use and active-living framework. Am J Prev Med 40:522-9 |
| Scribner, Richard; Theall, Kathrine P; Simonsen, Neal et al. (2010) HIV risk and the alcohol environment: advancing an ecological epidemiology for HIV/AIDS. Alcohol Res Health 33:179-83 |
| Theall, Katherine P; Sterk, Claire E; Elifson, Kirk W (2009) Perceived neighborhood fear and drug use among young adults. Am J Health Behav 33:353-65 |
| Theall, Katherine P; DeJong, William; Scribner, Richard et al. (2009) Social capital in the college setting: the impact of participation in campus activities on drinking and alcohol-related harms. J Am Coll Health 58:15-23 |
