Exploring expectations and lived experiences of Low Traffic Neighbourhoods in Birmingham, UK

In the UK, urban environments suffer disproportionately from pollution and community severance due to private vehicle use and related infrastructure. During the COVID-19 pandemic, local authorities implemented Low Traffic Neighbourhoods (LTN) to encourage active travel and improve urban residential environments. This research explored people’s expectations and lived experience of two LTNs in Birmingham, a large city, providing insights for future schemes. Birmingham City Council held pre-LTN (July-November 2020) and post-LTN consultations (February-April 2021). A qualitative thematic analysis of respondents’ responses explored thoughts on local transport issues, expectations, and lived experiences of LTNs. There were 3751 and 791 responses to pre- and post-LTN consultations. Most respondents were female local residents; with 45-54 years olds the most frequent responders. Overarching categories: (i) Pre-LTN transport concerns and proposed solutions; (ii) Anticipated and reported benefits from the LTN and (ii) Anticipated and reported disadvantages from the LTN. Cited benefits included reduced traffic and safety concerns, increased active transport and an improved sense of community. Disadvantages included frustration, inconvenience and great resentment between residents of roads with and without filters. Both support and opposition to LTNs was found. LTNs addressed some, but not all local traffic concerns. Feelings of discrimination were noted by residents of streets without filters; high street residents encountering displaced traffic and disabled car users. Piecemeal LTN implementation may undermine community cohesion. Networks of modal filters across neighbouring residential areas with measures addressing the interplay between residential, business, school and faith environments and additional measures supporting boundary roads may maximise LTN benefits

Feasibility of collecting oral fluid samples in the home setting to determine seroprevalence of infections in a large-scale cohort of preschool-aged children

Oral fluid is a non-invasive biological sample, which can be returned by post, making it suitable for large-scale epidemiological studies in children. We report our experience of oral fluid collection from 14 373 preschool-aged children in the UK Millennium Cohort Study. Samples were collected by mothers in the home setting following the guidance of trained interviewers, and posted to the laboratory. Samples were received from 11698 children (81.4 %). Children whose mothers were of Black Caribbean ethnicity and who lived in non-English-speaking households were less likely to provide a sample, and those with a maternal history of asthma more likely to provide a sample [adjusted risk ratio (95 % CI) 0.85 (0.73-0.98), 0.87 (0.77-0.98) and 1.03 (1.00-1.05) respectively]. Collection of oral fluid samples is feasible and acceptable in large-scale child cohort studies. Formal interpreter support may be required to increase participation rates in surveys that collect biological samples from ethnic minorities

Remote delivery of alcohol and/or substance misuse interventions for adults: A systematic review protocol

© 2021 Howlett et al. This is an open access article distributed under the terms of the Creative Commons Attribution License. https://creativecommons.org/licenses/by/4.0/Introduction: Alcohol and substance misuse are a public health priority. The World Health Organisation (WHO) estimates that harmful alcohol use accounts for 5.1% of the global burden of disease and that 35.6 million people worldwide are affected by substance misuse. The Coronavirus Disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has disrupted delivery of face-to-face alcohol and substance misuse interventions and has forced the development of alternative remote interventions or adaptation to existing ones. Although existing research on remote interventions suggests they might be as effective as face-to-face delivery, there has been a lack of systematic exploration of their content, the experience of service users, and their effectiveness for behavioural outcomes. This review will provide a narrative synthesis of the behaviour change techniques (BCT) contained in interventions for alcohol and/or substance misuse and their association with effectiveness. Methods and analysis: Systematic searches will be conducted in MEDLINE, Scopus, PsycINFO (ProQuest), and the Cochrane Library. Included studies will be those reporting remote interventions focusing on alcohol and/or substance misuse among adults living in the community and which have a primary behaviour change outcome (i.e., alcohol levels consumed). Data extraction will be conducted by one author and moderated by a second, and risk of bias and behaviour change technique (BCT) coding will be conducted by two authors independently. A narrative synthesis will be undertaken focussing upon the association of BCTs with intervention effectiveness using promise ratios. Patient and Public Involvement (PPI): The Public Involvement in Research Group (PIRG), part of the NIHR-funded PHIRST, will be involved in refining the review questions, eligibility criteria, data synthesis and dissemination. Dissemination: Dissemination will be through an academic peer reviewed publication, alongside other outputs to be shared with non-academic policy, professional, and public audiences, including local authorities, service users and community organisations.Peer reviewedFinal Published versio

Adopting a Whole Systems Approach to Transport Decarbonisation, Air Quality and Health: An Online Participatory Systems Mapping Case Study in the UK

In a drive to achieve net zero emissions, U.K. transport decarbonisation policies are predominantly focussed on measures to promote the uptake and use of electric vehicles (EVs). This is reflected in the COP26 Transport Declaration signed by 38 national governments, alongside city region governments, vehicle manufacturers and investors. However, emerging evidence suggests that EVs present multiple challenges for air quality, mobility and health, including risks from non-exhaust emissions (NEEs) and increasing reliance on vehicles for short trips. Understanding the interconnected links between electric mobility, human health and the environment, including synergies and trade-offs, requires a whole systems approach to transport policymaking. In the present paper, we describe the use of Participatory Systems Mapping (PSM) in which a diverse group of stakeholders collaboratively constructed a causal model of the U.K. surface transport system through a series of interactive online workshops. We present the map and its analysis, with our findings illustrating how unintended consequences of EV-focussed transport policies may have an impact on air quality, human health and important social functions of the transport system. We conclude by considering how online participatory causal modelling techniques could be effectively integrated with empirical metrics to facilitate effective policy design and appraisal in the transport sector

The middle-out perspective:an approach to formalise 'normal practice' in public health advocacy

AIMS: The middle-out perspective (MOP) provides a lens to examine how actors positioned between government (top) and individuals (bottom) act to promote broader societal changes from the middle-out (rather than the top-down or bottom-up). The MOP has been used in recent years in the fields of energy, climate change, and development studies. We argue that public health practitioners involved with advocacy activities and creating alliances to amplify health promotion actions will be familiar with the general MOP concept if not the formal name. The article aims to demonstrate this argument. METHODS: This article introduces the MOP conceptual framework and customises it for a public health audience by positioning it among existing concepts and theories for actions within public health. Using two UK case studies (increasing signalised crossing times for pedestrians and the campaign for smoke-free legislation), we illustrate who middle actors are and what they can do to result in better public health outcomes. RESULTS: These case studies show that involving a wider range of middle actors, including those not traditionally involved in improving the public's health, can broaden the range and reach of organisations and individuals involving in advocating for public health measures. They also demonstrate that middle actors are not neutral. They can be recruited to improve public health outcomes, but they may also be exploited by commercial interests to block healthy policies or even promote a health-diminishing agenda. CONCLUSION: Using the MOP as a formal approach can help public health organisations and practitioners consider potential 'allies' from outside traditional health-related bodies or professions. Formal mapping can expand the range of who are considered potential middle actors for a particular public health issue. By applying the MOP, public health organisations and staff can enlist the additional leverage that is brought to bear by involving additional middle actors in improving the public's health

Environmental and Health Impacts of E-cycling - Policy Briefing Note produced by the TRANSITION Clean Air Network

Electrically assisted bicycles (e-bikes) can have an important role in enabling UK transport to achieve net zero, improve air quality, increase levels of physical activity and improve mental and physical health. This briefing note examines the current evidence on the environmental and health impacts of e-cycling, highlighting why the promotion of e-cycling should be a key component to address UK health, climate and clean air challenges. The TRANSITION Clean Air Network is a UK-wide network, led by the University of Birmingham in collaboration with nine universities and over 20 cross-sector partners, aiming to optimise the air quality and health outcomes of transport decarbonisation; it is funded by UKRI via the UK Clean Air Strategic Priorities Fund, administered by NERC [NE/V002449/1]