Date of Award

Summer 8-14-2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Health Promotion and Disease Prevention Research

First Advisor

Terry T-K Huang, PhD, MPH, CPH

Abstract

Increasing children’s physical activity (PA) at school is a national focus to address childhood obesity. Research has demonstrated associations between school built environments and students’ PA, but has lacked a comprehensive synthesis of evidence. Chapter 1 presents new evidence-, theory-, and practice-informed school design guidelines, including evidence substantiality ratings, to promote PA in school communities. These guidelines delineate strategies for school designers, planners, and educators to create K-12 school environments conducive to PA. They also engage public health scientists in needed transdisciplinary perspectives.

There have been few longitudinal studies to verify causal relationships between the school built environment and PA. Chapter 2 presents results from a natural experiment with objective PA-related measures before and after a move to a new K-5 school designed based on the Chapter 1 guidelines. The study hypothesized that the school would have desirable impacts on students’ sedentary behaviors and PA. The intervention school group was compared longitudinally with a demographically-similar group at 2 control schools. School-time analyses showed that the intervention school design had positive impact on accumulation of sedentary time, and time in light PA, likely due to movement-promoting classroom design.

Studies of built environment impacts on human behaviors and health have presented challenges in control of confounding effects. Chapter 3 presents results from experiments using an agent based model (ABM) to simulate population samples of children and to quantify the impact of a single design intervention, dynamic furniture in school, on obesity and overweight prevalence over time. Results of computational experiments showed that there could be some desirable population impact among girls with low PA profiles.

Chapter 4 places the work presented in Chapters 1-3 in a larger context. Via exploration of theories of space as a social phenomenon, of design as a discipline with human purpose, and of limitations of current public health built environment studies, the investigator proposes key strategies toward achieving substantial unrealized potential to design our built environments to achieve health.

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