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Outcomes of behavioral lifestyle interventions for promoting weight loss vary widely across participants. The effectiveness of a weight management intervention may depend on a person's environmental context. This study compared short- and longer-term effects of a structured nationwide weight management program for people living in neighborhoods with different levels of walkability and different access to recreational places (parks, fitness facilities). Drawing on the health production model, we tested competing hypotheses for whether treatment effects of the program complement environmental supports or substitute for environmental constraints. We studied the US Department of Veterans Affairs (VA) MOVE! weight management program using VA electronic heath record data (2009-2014) and a difference-in-differences design with an inverse propensity score matched comparison group. A total of 114,256 program participants and 498,494 non-participants comprised the sample. Built environment features were measured within one-mile of each person's home. We estimated program effects on body mass index (BMI) for subgroups with different built environments at 6-, 12-, 18-, and 24-month follow-up using linear regressions with person and year fixed effects. At 6 months, the program reduced BMI by 0.4-0.6 kg/m 2 among men and 0.3-0.5 kg/m 2 among women. The effect diminished at 12, 18, and 24 months. The program effect did not vary significantly across subgroups with different walkability, park access, or fitness facility access. The MOVE! program was not sensitive to environmental context. Results did not lend support to either hypothesis that the MOVE! program complements or substitutes for a person's built environment to affect weight management outcomes., (Copyright © 2019 Elsevier Inc. All rights reserved.)

This study examined relationships between contextual factors and within-person variations in snack food and sweetened beverage intake in African American women (n = 79), aged 25-65 years living in metropolitan Chicago. For seven days, participants wore a global positioning system (GPS) logger and were signaled five times per day to complete an ecological momentary assessment (EMA) survey assessing behaviors and environmental, social, and other contextual factors via smartphones. Within-person associations between snack food and beverage intake and contextual factors were analyzed using three-level logistic regressions. Participants reported consuming a snack food at 38.4% of signals and a sweetened beverage at 17.9% of signals. Fast food restaurant and convenience store density within the daily activity space was not associated with either snack food or sweetened beverage intake. However, perceptions of close proximity to fast food restaurants and convenience stores making it easier to eat/drink, while accounting for one's usual proximity, were associated with increased odds of snack intake (O.R. 2.1; 95% C.I. 1.4, 3.0) but not sweetened beverage. We also found engaging in activities such as watching television (O.R. 1.8; 95% C.I. 1.2, 2.7) and talking (O.R. 1.7; 95% C.I. 1.1, 2.6) while eating were associated with higher snack intake. These factors were not related to sweetened beverage intake. Public health interventions addressing fast food restaurant and convenience store accessibility and food offerings and marketing within these outlets may help reduce snack food intake. Additionally, to reduce concurrent activities while eating, real-time interventions using smart technology could be used to enhance attentive eating in this population., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

We describe a process for evaluating proposed ecosystem restoration projects intended to improve survival of juvenile salmon in the Columbia River estuary (CRE). Changes in the Columbia River basin (northwestern USA), including hydropower development, have contributed to the listing of 13 salmon stocks as endangered or threatened under the U.S. Endangered Species Act. Habitat restoration in the CRE, from Bonneville Dam to the ocean, is part of a basin-wide, legally mandated effort to mitigate federal hydropower impacts on salmon survival. An Expert Regional Technical Group (ERTG) was established in 2009 to improve and implement a process for assessing and assigning "survival benefit units" (SBUs) to restoration actions. The SBU concept assumes site-specific restoration projects will increase juvenile salmon survival during migration through the 234 km CRE. Assigned SBUs are used to inform selection of restoration projects and gauge mitigation progress. The ERTG standardized the SBU assessment process to improve its scientific integrity, repeatability, and transparency. In lieu of experimental data to quantify the survival benefits of individual restoration actions, the ERTG adopted a conceptual model composed of three assessment criteria-certainty of success, fish opportunity improvements, and habitat capacity improvements-to evaluate restoration projects. Based on these criteria, an algorithm assigned SBUs by integrating potential fish density as an indicator of salmon performance. Between 2009 and 2014, the ERTG assessed SBUs for 55 proposed projects involving a total of 181 restoration actions located across 8 of 9 reaches of the CRE, largely relying on information provided in a project template based on the conceptual model, presentations, discussions with project sponsors, and site visits. Most projects restored tidal inundation to emergent wetlands, improved riparian function, and removed invasive vegetation. The scientific relationship of geomorphic and salmonid responses to restoration actions remains the foremost concern. Although not designed to establish a broad strategy for estuary restoration, the scoring process has adaptively influenced the types, designs, and locations of restoration proposals. The ERTG process may be a useful model for others who have unique ecosystem restoration goals and share some of our common challenges., (Copyright © 2016 Elsevier Ltd. All rights reserved.)