Summary
There exists a large body of literature examining the association between built environment factors and dietary intake, physical activity, and weight status; however, synthesis of this literature has been limited. To address this gap, we conducted a scoping review of reviews and identified 74 reviews and meta‐analyses that investigated the association between built environment factors and dietary intake, physical activity, and/or weight status. Results across reviews were mixed, with heterogeneous effects demonstrated in terms of strength and statistical significance; however, preliminary support was identified for several built environment factors. For example, quality of dietary intake appeared to be associated with the availability of grocery stores, higher levels of physical activity appeared to be most consistently associated with greater walkability, and lower weight status was associated with greater diversity in land‐use mix. Overall, reviews reported substantial concern regarding methodological limitations and poor quality of existing studies. Future research should focus on improving study quality (e.g., using longitudinal methods, including natural experiments, and newer mobile sensing technologies) and consensus should be drawn regarding how to define and measure both built environment factors and weight‐related outcomes.
New approaches, such as partnerships with existing community organizations and expanded use of telehealth interventions, are needed to provide rural communities with greater access to effective weight-management programs such as the National Diabetes Prevention Program. Policy: Funding for the National Diabetes Prevention Program should earmark support for rural communities and other populations disproportionately affected by obesity-related health conditions. Research: Ongoing dissemination and implementation research is needed to evaluate the effectiveness and cost efficiency of telehealth interventions for weight management and diabetes prevention in rural communities.
Several communities are implementing trauma‐informed, community‐level approaches focused on addressing/preventing adverse childhood experiences (ACEs), yet most community resilience definitions from published articles are based on acute traumas. This scoping review aims to determine how community resilience is defined and operationalized within the context of chronic/complex traumas. Methods: We performed a rigorous, comprehensive literature search using multiple databases. Results: The 38 included articles addressed multiple types of chronic traumas, including historical trauma, poverty, minority stress, mass incarceration, and ACEs. A variety of definitions of community resilience were cited, several of which stressed the ability to thrive despite risk factors and the safety and wellbeing of residents. Few articles operationalized community resilience within the context of ACEs, suggesting significant gaps in the literature. Conclusion: This review can serve as an important building block to develop expanded definitions of community resilience for chronic traumas and assist communities in promoting community‐wide responses to ACEs.
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