title: Proximity to Fast-Food Outlets and Supermarkets as Predictors of Fast-Food Dining Frequency.
abstract: This study used cross-sectional data to test the independent relationship of proximity to chain fast-food outlets and proximity to full-service supermarkets on the frequency of mealtime dining at fast-food outlets in two major urban areas, using three approaches to define access. Interactions between presence of a supermarket and presence of fast-food outlets as predictors of fast-food dining were also tested.
  
  
  
  Residential intersections for respondents in point-of-purchase and random-digit-dial telephone surveys of adults in Philadelphia, PA, and Baltimore, MD, were geocoded. The count of fast-food outlets and supermarkets within quarter-mile, half-mile, and 1-mile street network buffers around each respondent's intersection was calculated, as well as distance to the nearest fast-food outlet and supermarket. These variables were regressed on weekly fast-food dining frequency to determine whether proximity to fast food and supermarkets had independent and joint effects on fast-food dining.
  
  
  
  The effect of access to supermarkets and chain fast-food outlets varied by study population. Among telephone survey respondents, supermarket access was the only significant predictor of fast-food dining frequency. Point-of-purchase respondents were generally unaffected by proximity to either supermarkets or fast-food outlets. However, ≥1 fast-food outlet within a 1-mile buffer was an independent predictor of consuming more fast-food meals among point-of-purchase respondents. At the quarter-mile distance, ≥1 supermarket was predictive of fewer fast-food meals.
  
  
  
  Supermarket access was associated with less fast-food dining among telephone respondents, whereas access to fast-food outlets were associated with more fast-food visits among survey respondents identified at point-of-purchase. This study adds to the existing literature on geographic determinants of fast-food dining behavior among urban adults in the general population and those who regularly consume fast food.
authors.forename: Jessica K
authors.initials: JK
authors.lastname: Athens
authors.forename: Dustin T
authors.initials: DT
authors.lastname: Duncan
authors.forename: Brian
authors.initials: B
authors.lastname: Elbel
mesh_terms: D000328:Adult; D015142:Baltimore; D003132:Commerce; D003430:Cross-Sectional Studies; D057140:Fast Foods / Q000600:supply & distribution*; D005247:Feeding Behavior; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D015143:Philadelphia; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012147:Restaurants / Q000600:supply & distribution*; D013997:Time Factors; D014505:Urban Population
keywords: Fast-food dining; Meal patterns; Proximity to food retail