Protocol for a naturalistic study of residents living in an agriculturally-integrated ("agrihood") neighborhood.

Background: Poor nutrition and inadequate physical activity are key contributors to rising chronic disease rates across the United States. It is well-documented that neighborhood built environments play an important role in shaping these modifiable health behaviors. Agriculturally-integrated neighborhoods ("agrihoods") offer a relatively new and promising approach to health-promoting residential design and development. Centered around a working farm, agrihoods are designed to connect residents with fresh foods and outdoor spaces that encourage physical activity. However, no rigorous or longitudinal evaluations of their impact on resident health have been conducted to date. We detail the protocol for a naturalistic study that aims to (1) assess short-term changes in dietary intake, physical activity, cardiometabolic health indicators, and social connectedness among agrihood and matched comparison residents; (2) document time use with and preferences for agrihood design features; and (3) examine agrihood economic benefits. Methods: This mixed-methods, quasi-experimental study will last approximately 6 months including assessment at three timepoints (baseline, 3 months, 6 months). Agrihood participants will be new adult residents in an agrihood residential development (Richmond, TX), while comparison participants will be adults currently residing in a nearby residential development (Katy, TX). All participants will complete three 30-min online surveys, including items to produce geospatial data; agrihood participants will complete two additional 30-min in-person health assessments and three timepoints of accelerometer wear on 7 consecutive days, with a subsample completing three 30-min online dietary recalls. Data will be collected by trained staff, and Difference-in-Differences (DiD) generalized linear mixed-effects models will examine longitudinal change and its interaction with participant groups. The economic analysis will account for break-even time, farmer compensation, maintenance costs, and public incentive programs. Discussion: This will be the first study to examine a longitudinal cohort of new agrihood residents compared to a master planned residential development to understand the use and health impacts of agrihood living. Our data-driven design, including biological data collection, device-captured physical activity, and validated self-report measures, can pave the way for future research, policy and philanthropic initiatives to adapt and scale models for developments that promote environmental and economic growth, and improve human health and wellbeing. Clinical trial registration: https://clinicaltrials.gov/study/NCT06950775, Identifier NCT06950775.