Patient Access, Utilization, and Perceptions of Neighborhood and Built Environment Resources

Keeley J Pratt; Jamie Blalock; Lindsay Breslin; Haley Kiser; Andrew Hanks; Brian C Focht; Michael Outrich; Sabrena Noria; Bradley Needleman

doi:10.1007/s11695-021-05788-x

Patient Access, Utilization, and Perceptions of Neighborhood and Built Environment Resources

Obes Surg. 2022 Feb;32(2):416-427. doi: 10.1007/s11695-021-05788-x. Epub 2021 Nov 16.

Authors

Keeley J Pratt^{1

2}, Jamie Blalock³, Lindsay Breslin⁴, Haley Kiser³, Andrew Hanks³, Brian C Focht³, Michael Outrich⁵, Sabrena Noria⁶, Bradley Needleman⁶

Affiliations

¹ Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 129 Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA. Pratt.192@osu.edu.
² Department of Surgery, The Ohio State University Medical Wexner Center, Columbus, OH, USA. Pratt.192@osu.edu.
³ Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 129 Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA.
⁴ Information Technology Department, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁵ The Kirwan Institute for the Study of Race and Ethnicity, The Ohio State University, Columbus, OH, USA.
⁶ Department of Surgery, The Ohio State University Medical Wexner Center, Columbus, OH, USA.

Abstract

Purpose: There is a critical need to explore bariatric patients' perceptions of existing neighborhood and built environment resources and supports to assist with postoperative behavior change and weight loss maintenance. The objective of this study was to survey postoperative patients to determine neighborhood food retail, fitness facility, and options for outdoor activity access, utilization, satisfaction, and perceptions of resources.

Materials and methods: A convenience sample of postoperative patients from a single academic surgical center in the USA (N = 44) completed an online survey about access, utilization, satisfaction, and safety for food retail, fitness facility, and outdoor activity options in their neighborhoods. Analysis included descriptives (frequency, percent, Chi-square), and independent samples t tests and ANOVA determined differences based on race, insurance status, geographic location, and receipt of governmental assistance programs. Open-ended questions were analyzed using summative content analysis.

Results: Patients reported the highest access to lower-cost national food retailers and fitness facilities. The most prevalent challenge in finding food products to meet patients' goals was financial (39%). Patients' top suggestions for fitness facilities included training staff/facilities (59%) and trainers (35%) in postoperative patient care and exercise. The highest access for outdoor activity options was for walking/running trails, city/metro parks, and sidewalks. Significant differences in access, utilization, and safety were found based on geographic location, receipt of at least one assistant program, and race.

Conclusion: The development of targeted resources may benefit patients in non-suburban areas and who receive governmental assistant programs to increase safety of outdoor options and access to lower-cost food retailers and to increase utilization of lower-cost fitness facilities.

Keywords: Bariatric surgery; Build environment; Neighborhood; Resources; Social determinants of health; Support.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Built Environment
Environment Design*
Humans
Obesity, Morbid* / surgery
Residence Characteristics
Walking