Uncertainties in the geographic context of health behaviors: a study of substance users’ exposure to psychosocial stress using GPS data

Mei Po Kwan, Jue Wang, Matthew Tyburski, David H. Epstein, William J. Kowalczyk, Kenzie L. Preston

Research output: Contribution to journalArticlepeer-review

Abstract

This study examined how contextual areas defined and operationalized differently may lead to different exposure estimates. Substance users’ exposures to environmental stress (in terms of two variables: community social economic status and crime) were assessed from global positioning systems (GPS) data. Participants were 47 outpatients with substance use disorders admitted for methadone maintenance at a research clinic in Baltimore, Maryland. From 35.2 million GPS tracking points, we compared 7 different methods for defining activity space. The different methods yielded different exposure estimates, which would lead to different conclusions in studies using only one method. These results have important implications for future research on the effect of contextual influences on health behaviors and outcomes: whether a study observes any significant influence of an environmental factor on health may depend on what contextual units are used to assess individual exposure.

Original languageEnglish (US)
Pages (from-to)1176-1195
Number of pages20
JournalInternational Journal of Geographical Information Science
Volume33
Issue number6
DOIs
StatePublished - Jun 3 2019

Keywords

  • GPS data
  • Geographic context
  • contextual uncertainties
  • substance use
  • the uncertain geographic context problem

ASJC Scopus subject areas

  • Information Systems
  • Geography, Planning and Development
  • Library and Information Sciences

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