2004 Progress Report: Growing Up Healthy in East Harlem (Community-Based Participatory Research)

EPA Grant Number: R831711C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R831711
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Mount Sinai Center for Children’s Health and the Environment
Center Director: Wolff, Mary S.
Title: Growing Up Healthy in East Harlem (Community-Based Participatory Research)
Investigators: Brenner, Barbara , Galvez, Maida
Current Investigators: Brenner, Barbara , Galvez, Maida , Teitelbaum, Susan , Wolff, Mary S.
Institution: Mount Sinai School of Medicine
EPA Project Officer: Callan, Richard
Project Period: November 1, 2003 through October 31, 2008 (Extended to October 31, 2010)
Project Period Covered by this Report: May 7, 2004 through October 31,2004
RFA: Centers for Children's Environmental Health and Disease Prevention Research (2003) RFA Text |  Recipients Lists
Research Category: Children's Health , Health Effects , Health

Objective:

The overall goal of this Community-Based Research Project is to work in partnership with community leaders in East Harlem to assess urban environmental exposures, structural as well as chemical, that may influence somatic growth and risk of obesity in inner city children. The specific aims, which have not changed, are:

  1. To geocode information on locations of food stores, fast-food outlets, playgrounds, and parks in order to characterize the urban-built environment of East Harlem.
  2. To characterize diets and accessibility to healthy foods.
  3. To characterize children’s levels of physical activity and access to resources.
  4. To characterize children’s exposures to endocrine disruptors (EDs) using urinary biomarkers and a product-use data collection instrument that will be developed in this Project and will then be used in both this study and Project 2 (R831711C002).
  5. To examine relationships between obesity in the children of East Harlem and (1) diet; (2) physical activity; (3) structural factors in the urban built environment; and (4) ED exposures.

New Investigator, Dr. Maida P. Galvez is committed to conducting community-based research in inner city, underserved areas in partnership with the community in keeping with community-based participatory research principles. Dr. Galvez has identified factors in the urban built environment and how they influence diet and physical activity levels as her principle interest. Her specific aims, which remain unchanged since the previous grant, are:

  1. To characterize the urban built environment of East Harlem using geocoded information on locations of food stores, fast-food outlets, playgrounds, and parks.
  2. To characterize diets in a population of East Harlem children who will be ages 4 to 5 years old at the time of entry and follow them as they grow through ages 7 to 8 years old, and specifically assess their consumption of fast foods, “junk” foods from vending machines, and phytoestrogens from fresh foods through standardized dietary recall instruments.
  3. To characterize these children’s levels of physical activity, their use of parks and playgrounds, and their participation in sports and other organized youth activities through a structured recall questionnaire.
  4. To characterize these children’s exposures to EDs using: (1) urinary biomarkers to assess exposures to phthalates and bisphenol A; (2) dietary recall to estimate phytoestrogen consumption; and (3) recall history to identify use of personal care products; and (4) a household inventory to assess products in the home environment that may contain EDs. Through tasks 3 and 4 in this objective, a questionnaire will be created to assess children’s exposures to ED-containing products. The same data collection instrument will then be used in both this study and Project 2 (R831711C002).
  5. To examine relationships between obesity in the children of East Harlem and (1) diet; (2) physical activity; (3) structural factors in the urban built environment; and (4) ED exposures.

Progress Summary:

While implementation of the study was later than planned due to a delay in receiving the award letter, study methods were developed and piloted with children, ages 6-8, and their parents, using an anonymous consent process. A pilot study on reliability and validity of urinary biomarkers of EDs was begun, to consist of six consecutive urine specimen collections over 6 months among 30 children, along with the newly developed product use questionnaire. A similar pilot study on pedometer use in children to assess physical activity was initiated. The following were piloted:

41 questionnaire interviews were completed with parents/caregivers of 24 girls, 14 boys, and 3 unknowns. Of these 24 were black, 16 were white, and 1 was of unknown race. Nineteen were Hispanic, including six who reported as Black Hispanics.

The following summarizes pilot data for urine sampling:

# of Baseline urines to measure exposure to endocrine disrupters - 10
# of Boys - 6
# of Girls - 4
# Hispanic - 6, including 1 Black Hispanic
# Black - 4

# of 2-Week Follow- Up urines - 7
# of 4-Week Follow- Up urines - 7
# of 6-Week Follow- Up urines - 1
# of 8-Week Follow- Up urines - 2W (see editor’s note in view markup)

These urines were sent to the Centers for Disease Control and Prevention (CDC) for analysis and reliability testing of the method.

The following summarizes pilot data collected for pedometer testing:

# of Pedometers, with physical activity log, distributed - 10
# of Pedometers and physical activity logs returned - 8

The protocol, consents, and final questionnaires for the study have been reviewed and approved by the Mount Sinai Institutional Review Board (IRB). Study recruitment and enrollment is expected to begin in September 2004.

A Community Advisory Board to work with investigators on Children’s Environmental Health studies has been reorganized and convened. Membership consists of community residents and service providers who had worked with the principal investigator and study staff to implement our prior community intervention study on Integrated Pest Management, as well as new members – East Harlem residents/ parents and service providers committed to addressing the epidemic of overweight and obesity in children. The Board held its first full meeting in June 2004.

During the past year, Dr. Galvez has been one of the principal contributors in the development of study protocols for Project 1 (R831711C001). The pilot project for Project 1 is underway, which includes developing and piloting the main questionnaire. Dr. Galvez has a specific focus on developing a built environment questionnaire that addresses the influence of the urban built environment on children’s behaviors. This Neighborhood Survey will further our understanding of (1) the knowledge of resources in the East Harlem community; (2) which resources children are using; and (3) what factors influence their use. Areas to be covered include time spent playing outdoors; questions about parks, playgrounds, and other recreational areas; and whether safety plays a role in use of these play areas. In addition, we will be asking about food shopping (both the child’s purchase and the guardian’s purchases) in the neighborhood and about the availability and quality of healthy foods such as a fruits and vegetables, whole grain foods, and low fat dairy products.

Since we will characterize these children’s levels of physical activity, their use of parks and playgrounds, and their participation in sports and other organized youth activities through a structured recall questionnaire, we can then see if the built environment influences a child’s behavior, specifically their level of physical activity. We can also determine if the food stores available in the community influence quality of the diet and subsequent risk of childhood obesity.

Data obtained from the neighborhood survey will be compared to mapping of the community. We plan to characterize the urban built environment of East Harlem using geocoded information on locations of food stores, fast food outlets, playgrounds, and parks. The maps will be used as a reference when conducting the neighborhood survey. A survey of East Harlem ZIP codes 10029 and 10035 was performed through (1) direct observation via walking tours of the neighborhoods and (2) compiling information from city and state agencies. A series of maps depicting physical activity resources available to East Harlem children in addition to the food environment of East Harlem has been developed using the geographic information systems software package, ArcGIS. These maps illustrate food sources (fast food stores, restaurants, bodegas, supermarkets, and specialty stores) and their proximity to schools and neighborhood housing. They also provide location information on resources such as public parks, playgrounds, pools, recreation centers, after school activities, dance lessons, and sports instruction and teams.

Analysis of the maps will provide information on distribution of resources throughout the community. For example, these data highlight the limited availability of high quality fresh fruits and produce and the abundance of food stores with unhealthy foods located in this community. Further analysis will examine baseline demographics of the East Harlem community and how availability, proximity, and density of resources impact diets and physical activity levels of East Harlem children.

The maps will thus be used to examine the effect of access and utilization of physical activity resources on levels of overweight and obesity in East Harlem children. The implications of this study include the need to address factors at both the individual level when recommending dietary changes and at the community level when addressing deficiencies in the local food environment.

In addition, Dr. Galvez has participated in development of the anthropometry, pedometer, and biospecimen protocols. The first round of samples will be sent to CDC for analysis before the end of this fiscal year.

Significance. The pilot study is underway and will provide important information on how both macro- (built environment) and micro environmental factors (environmental exposure to endocrine disruptors) influence’s children’s growth and development.

Future Activities:

We plan to continue to pilot/finalize our surveys and protocols. The pilot study will provide us with information regarding the inter/intrapersonal variability of urinary biomarkers for EDs. We also plan to continue to strengthen and refine our community advisory board, which has provided feedback on the surveys and on the direction of the project and lastly on the use of the GIS maps as a community resource.


Journal Articles on this Report : 1 Displayed | Download in RIS Format

Other subproject views: All 91 publications 56 publications in selected types All 51 journal articles
Other center views: All 253 publications 140 publications in selected types All 118 journal articles
Type Citation Sub Project Document Sources
Journal Article Brenner BL, Markowitz S, Rivera M, Romero H, Weeks M, Sanchez E, Deych E, Garg A, Godbold J, Wolff MS, Landrigan PJ, Berkowitz G. Integrated pest management in an urban community: a successful partnership for prevention. Environmental Health Perspectives 2003;111(13):1649-1653. R831711 (2004)
R831711 (2005)
R831711 (2006)
R831711 (2007)
R831711 (Final)
R831711C001 (2004)
R831711C001 (2006)
R831711C002 (2006)
R831711C003 (2006)
  • Full-text from PubMed
  • Abstract from PubMed
  • Supplemental Keywords:

    lipase, paraoxonase, fast food, obesity, endocrine disruptors, neurodevelopment,, RFA, Health, Scientific Discipline, ENVIRONMENTAL MANAGEMENT, POLLUTANTS/TOXICS, Environmental Chemistry, Health Risk Assessment, Chemicals, Endocrine Disruptors - Environmental Exposure & Risk, endocrine disruptors, Biochemistry, Children's Health, Endocrine Disruptors - Human Health, Risk Assessment, environmental health, childhood development, community-based intervention, endocrine disrupting chemicals, exposure studies, phtalates, Human Health Risk Assessment, childhood obesity, children's vulnerablity, neurodevelopmental toxicity, exposure pathways, children's environmental health

    Relevant Websites:

    http://www.childenvironment.org/ Exit

    Progress and Final Reports:

    Original Abstract
  • 2005 Progress Report
  • 2006 Progress Report
  • 2007 Progress Report
  • 2008
  • 2009
  • Final Report

  • Main Center Abstract and Reports:

    R831711    Mount Sinai Center for Children’s Health and the Environment

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R831711C001 Growing Up Healthy in East Harlem (Community-Based Participatory Research)
    R831711C002 Pesticides, Endocrine Disruptors, Childhood Growth and Development (Birth Cohort)
    R831711C003 Genetics of Phthalate and Bisphenol A Risk in Minority Populations (Individual Susceptibility)