Table 4 Conclusions of the Heart Healthy Hoods exploratory study: challenges and opportunities for measuring urban environments and cardiovascular health

Electronic Health Records

Validation of EHR diagnosis (beyond diabetes and hypertension).

Not available. Can be performed in a selected subset.

GIS allows for data integration of location and attributes of features of each domain, administrative boundaries, public transportation network, parks and street segments.

With this data integration, geospatial analysis of various kinds can be performed.

Future data should include accessibility, other distance-based indicators, the use of more detailed geostatistics (dispersion, centrality, etc.) and other tools (such as map algebra).

Availability of sufficient quality data.

Design and validation of a cartographic model, based on a combination of the above analyses, to produce meaningful composite indices.

Use of EHR for continuous surveillance of chronic diseases.

Food environment

More emphasis should be placed on the measurement of affordability.

A more in-depth approach to dietary patterns is needed.

A further culturally adapted NEMS-S survey is needed.

Better insights to the effects of family composition on dietary patterns.

Public markets are a unique feature in Spain.

Alcohol environment

Use of implementation science tools to measure compliance.

Further exploration of spaces of consumption and social norms associated to these.

Physical activity environment

Validation of virtual audit methods (Google Street View)

More in-depth insights on barriers to physical activity (including physical and social barriers)

Tobacco environment

Measurement of exposure to second-hand tobacco.

Perceptions regarding smoking need to be stratified by smoking status.

Use of implementation science tools to measure compliance with tobacco regulations

More research is needed on social norms that influence smoking and the implementation of smoking regulations