Evidence map›Paper›PMID 35096526›Full record

ArticleJournal of transport & health2022

Causal evaluation of the health effects of light rail line: A Natural Experiment.

Behram Wali, Lawrence D Frank, Deborah R Young, Richard T Meenan, Brian E Saelens, John F Dickerson, Stephen P Fortmann

Abstract read
In one paragraph

Article in Journal of transport & health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Behram WaliUrban Design 4 Health, Inc., 24 Jackie Circle East, Rochester, NY 14612.
Lawrence D FrankUrban Design 4 Health, Inc., 24 Jackie Circle East, Rochester, NY 14612.
Deborah R YoungDivision of Behavioral Research, Department of Research & Evaluation Southern California, Kaiser Permanente Research, Pasadena, CA 91101, USA.
Richard T MeenanCenter for Health Research, Kaiser Permanente Northwest, Oregon, Portland, USA.
Brian E SaelensSeattle Children's Research Institute & The University of Washington, Seattle, WA, USA.
John F DickersonCenter for Health Research, Kaiser Permanente Northwest, Oregon, Portland, USA.
Stephen P FortmannScience Programs, Center for Health Research, Kaiser Permanente Northwest, Oregon, Portland, USA.

Funding

Health and Economic Effects of Light Rail Lines: A Natural ExperimentR01DK103385 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI FORTMANN, STEPHEN PAUL · 2014 to 2018
$3.3M
NIDDK NIH HHS R01 DK103385
6 · The paper itself

Abstract

BACKGROUND AND

objectiveNo research to date has causally linked built environment data with health care costs derived from clinically assessed health outcomes within the framework of longitudinal intervention design. This study examined the impact of light rail transit (LRT) line intervention on health care costs after controlling for mode-specific objectively assessed moderateto-vigorous physical activity (MVPA), participant-level neighborhood environmental measures, demographics, attitudinal predispositions, and residential choices. DATA AND

methodsBased on a natural experiment related to a new LRT line in Portland - 282 individuals divided into treatment and control groups were prospectively followed during the pre- and post-intervention periods. For each individual, we harness high-resolution data on Electronic Medical Record (EMR) based health care costs, mode-specific MVPA, survey-based travel behavior, attitudinal/perception information, and objectively assessed built environment measures. Simulation-assisted longitudinal grouped random parameter models are developed to gain more accurate insights into the effects of LRT line intervention.

resultsRegarding the "average effect" of the LRT line intervention, no statistically significant reductions in health care costs were observed for the treated individuals over time. However, substantial heterogeneity was observed not only in the magnitude of effects but its direction as well after controlling for the within- and between-individual variations. For a subgroup of treated individuals, the LRT line opening decreased health care costs over time relative to the control group. Further comparative analysis based on the findings of heterogeneity-based models revealed that the effect of LRT intervention for the treated individuals differed by individual characteristics, attitudes/perceptions, and neighborhood level environmental features.

conclusionsThe study revealed the presence of significant effect modifiers and distinct subgroup structures in the data related to the effects of LRT line intervention on health care costs. Severe implications of ignoring unobserved heterogeneity are highlighted. Limitations and potential avenues for future research are discussed.

Indexed as

Built environment & active travelHealth care costsLight rail transitLongitudinal AnalysisSimulation-assisted Random Parameter ModelsTransportation

Identifiers

PMID35096526
PMCPMC8797061

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.