TitleThe Wisconsin Assessment of the Social and Built Environment (WASABE): a multi-dimensional objective audit instrument for examining neighborhood effects on health.
Publication TypeJournal Article
Year of Publication2014
AuthorsMalecki, KC, Engelman, CD, Peppard, PE, F. Nieto, J, Grabow, ML, Bernardinello, M, Bailey, E, Bersch, AJ, Walsh, MC, Lo, JY, Martinez-Donate, A
JournalBMC Public Health
Volume14
Pagination1165
Date Published2014 Nov 13
ISSN1471-2458
KeywordsAdult, Aged, Environment Design, Female, Health Status Disparities, Health Status Indicators, Humans, Male, Middle Aged, Reproducibility of Results, Residence Characteristics, Rural Population, Socioeconomic Factors, Wisconsin
Abstract
 

BACKGROUND: Growing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed. The Wisconsin Assessment of the Social and Built Environment (WASABE) is an objective audit tool designed as an addition to a statewide household-based health examination survey, the Survey of the Health of Wisconsin (SHOW), to objectively measure participant's neighborhoods.

METHODS: This paper describes the development and implementation of the WASABE and examines the instrument's ability to capture a range of social and built environment features in urban and rural communities. A systematic literature review and formative research were used to create the tool. Inter-rater reliability parameters across items were calculated. Prevalence and density of features were estimated for strata formed according to several sociodemographic and urbanicity factors.

RESULTS: The tool is highly reliable with over 81% of 115 derived items having percent agreement above 95%. It captured variance in neighborhood features in for a diverse sample of SHOW participants. Sidewalk density in neighborhoods surrounding households of participants living at less than 100% of the poverty level was 67% (95% confidence interval, 55-80%) compared to 34% (25-44%) for those living at greater than 400% of the poverty level. Walking and biking trails were present in 29% (19-39%) of participant buffer in urban areas compared to only 7% (2-12%) in rural communities. Significant environmental differences were also observed for white versus non-white, high versus low income, and college graduates versus individuals with lower level of education.

CONCLUSIONS: The WASABE has strong inter-rater reliability and validity properties. It builds on previous work to provide a rigorous and standardized method for systematically gathering objective built and social environmental data in a number of geographic settings. Findings illustrate the complex milieu of built environment features found in participants neighborhoods and have relevance for future research, policy, and community engagement purposes.

DOI10.1186/1471-2458-14-1165
Alternate JournalBMC Public Health
PubMed ID25391283
PubMed Central IDPMC4289353
Grant ListUL1 TR000427 / TR / NCATS NIH HHS / United States
5UL 1RR025011 / RR / NCRR NIH HHS / United States
RC2 HL101468 / HL / NHLBI NIH HHS / United States
UL1 RR025011 / RR / NCRR NIH HHS / United States
1 RC2 HL101468 / HL / NHLBI NIH HHS / United States
P2C HD047873 / HD / NICHD NIH HHS / United States