title: The Stanford Healthy Neighborhood Discovery Tool: a computerized tool to assess active living environments.
abstract: BACKGROUND
  The built environment can influence physical activity, particularly among older populations with impaired mobility. Existing tools to assess environmental features associated with walkability are often cumbersome, require extensive training, and are not readily available for use by community residents.
  
  
  OBJECTIVE
  This project aimed to develop and evaluate the utility of a computerized, tablet-based participatory tool designed to engage older residents in identifying neighborhood elements that affect active living opportunities.
  
  
  METHODS
  Following formative testing, the tool was used by older adults (aged ≥65 years, in 2011) to record common walking routes (tracked using built-in GPS) and geocoded audio narratives and photographs of the local neighborhood environment. Residents (N=27; 73% women; 77% with some college education; 42% used assistive devices) from three low-income communal senior housing sites used the tool while navigating their usual walking route in their neighborhood. Data were analyzed in 2012.
  
  
  RESULTS
  Elements (from 464 audio narratives and photographs) identified as affecting active living were commensurate with the existing literature (e.g., sidewalk features, aesthetics, parks/playgrounds, crosswalks). However, within each housing site, the profile of environmental elements identified was distinct, reflecting the importance of granular-level information collected by the tool. Additionally, consensus among residents was reached regarding which elements affected active living opportunities.
  
  
  CONCLUSIONS
  This tool serves to complement other assessments and assist decision makers in consensus-building processes for environmental change.
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California; School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona. Electronic address: mbuman@asu.edu.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Buman
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Winter
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Jylana L
authors.initials: JL
authors.lastname: Sheats
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California; School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Hekler
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Otten
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Grieco
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California; Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055812:Community-Based Participatory Research; D034201:Computers, Handheld; D004779:Environment Design; D005260:Female; D040362:Geographic Information Systems; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009043:Motor Activity; D011203:Poverty; D012111:Residence Characteristics; D016138:Walking