A review of effectiveness, including cost effectiveness wherever possible, of commissioned healthy weight-related projects in City and Hackney: final report

Combatting rising levels of overweight and obesity and their subsequent negative impact on health and well-being is an international, national and local priority. Strategies for promoting healthy weight need to encompass efforts to tackle the obesogenic environment as well as individual lifestyles. Before launching new strategies and projects there is a need to take stock of what is already happening. What is required is a clear picture of the kinds of healthy weight related projects that are currently in operation and an assessment of whether these projects demonstrate the characteristics known to associated with effectiveness, acceptability, accessibility and good practice. The research project described in this report aimed to: identify and map healthy weight-related projects at a local level in the London boroughs of City and Hackney, review project strengths and weaknesses, and develop a set of assessment metrics (including cost where possible) to review and monitor projects in the future. The project was part of a larger programme of work commissioned by NHS City and Hackney, Hackney Council, the Corporation of London and their partners who are seeking to effect a step change in their strategy to tackle obesity and promote healthy weight

A multilevel analysis of the association between social networks and support on leisure time physical activity: evidence from 40 disadvantaged areas in London

There has been extensive conceptual and empirical work on the associations between social relations and health in recent years. However, the specific pathways through which social interactions impact on health have not been fully elucidated. The aim of this paper is to estimate associations between leisure time physical activity (LTPA) and social networks and support. Using data from a cross-sectional household survey in 40 disadvantaged Lower Super Output Areas in London, we applied a multilevel model to investigate psychosocial and environmental determinants of physical activity in these populations. Our findings present a strong case for the influence of individual-level social networks on the level of LTPA, although the associations between the types of social support and LTPA were insignificant. We also found that crime rate was an important area-level correlates of LTPA

Types of Social Capital and Mental Disorder in Deprived Urban Areas: A Multilevel Study of 40 Disadvantaged London Neighbourhoods

Objectives To examine the extent to which individual and ecological-level cognitive and structural social capital are associated with common mental disorder (CMD), the role played by physical characteristics of the neighbourhood in moderating this association, and the longitudinal change of the association between ecological level cognitive and structural social capital and CMD. Design Cross-sectional and longitudinal study of 40 disadvantaged London neighbourhoods. We used a contextual measure of the physical characteristics of each neighbourhood to examine how the neighbourhood moderates the association between types of social capital and mental disorder. We analysed the association between ecological-level measures of social capital and CMD longitudinally. Participants 4,214 adults aged 16-97 (44.4% men) were randomly selected from 40 disadvantaged London neighbourhoods. Main Outcome Measures General Health Questionnaire (GHQ-12). Results Structural rather than cognitive social capital was significantly associated with CMD after controlling for socio-demographic variables. However, the two measures of structural social capital used, social networks and civic participation, were negatively and positively associated with CMD respectively. ‘Social networks’ was negatively associated with CMD at both the individual and ecological levels. This result was maintained when contextual aspects of the physical environment (neighbourhood incivilities) were introduced into the model, suggesting that ‘social networks’ was independent from characteristics of the physical environment. When ecological-level longitudinal analysis was conducted, ‘social networks’ was not statistically significant after controlling for individual-level social capital at follow up. Conclusions If we conceptually distinguish between cognitive and structural components as the quality and quantity of social capital respectively, the conclusion of this study is that the quantity rather than quality of social capital is important in relation to CMD at both the individual and ecological levels in disadvantaged urban areas. Thus, policy should support interventions that create and sustain social networks. One of these is explored in this article

Creating and Maintaining a Healthy Stratford City: Principles and Practices for Success

Health and other professionals in London Borough of Newham recognise that there are many challenges and opportunities for the promotion of health and the provision of health services with the construction of the Olympic park and new homes, retail outlets and business adjacent to the site. In particular, incorporating new residents into existing communities and existing health services with an expanded provision requires foresight and careful planning. This report aims to contribute to their thinking, planning and decision-making. Research findings from a range of sources including reviews of academic literature and case studies are used to propose some principles and practices to inform decision-making by health and other professions. Our proposals recommend a focus on developing and sustaining a healthy place rather than on ill-health and illness. We outline the reasons why we think that this perspective is preferable and how it may be achieved

Measures of exposure to the Well London Phase-1 intervention and their association with health well-being and social outcomes

In this paper, we describe the measures of intervention exposure used in the cluster randomised trial of the Well London programme, a public health intervention using community engagement and community-based projects to increase physical activity, healthy eating and mental health and well-being in 20 of the most deprived neighbourhoods in London.10 No earmarked resources to support the development of these measures and associated data collection were provided to either the research team or to those delivering the interventions on the ground. Instead, these were derived from contractually specified performance management information reported quarterly by partners and by inclusion of questions seeking information about participation in the follow-up questionnaires used to measure the main trial outcomes. The exposure measures are consequently considerably less sophisticated than those used in the US studies, where earmarked funding was available

Measures of exposure to the Well London Phase-1 intervention and their association with health well-being and social outcomes

In this paper, we describe the measures of intervention exposure used in the cluster randomised trial of the Well London programme, a public health intervention using community engagement and community-based projects to increase physical activity, healthy eating and mental health and well-being in 20 of the most deprived neighbourhoods in London.10 No earmarked resources to support the development of these measures and associated data collection were provided to either the research team or to those delivering the interventions on the ground. Instead, these were derived from contractually specified performance management information reported quarterly by partners and by inclusion of questions seeking information about participation in the follow-up questionnaires used to measure the main trial outcomes. The exposure measures are consequently considerably less sophisticated than those used in the US studies, where earmarked funding was available

Types of Social Capital and Mental Disorder in Deprived Urban Areas: A Multilevel Study of 40 Disadvantaged London Neighbourhoods

<div><p>Objectives</p><p>To examine the extent to which individual and ecological-level cognitive and structural social capital are associated with common mental disorder (CMD), the role played by physical characteristics of the neighbourhood in moderating this association, and the longitudinal change of the association between ecological level cognitive and structural social capital and CMD.</p> <p>Design</p><p>Cross-sectional and longitudinal study of 40 disadvantaged London neighbourhoods. We used a contextual measure of the physical characteristics of each neighbourhood to examine how the neighbourhood moderates the association between types of social capital and mental disorder. We analysed the association between ecological-level measures of social capital and CMD longitudinally.</p> <p>Participants</p><p>4,214 adults aged 16-97 (44.4% men) were randomly selected from 40 disadvantaged London neighbourhoods.</p> <p>Main Outcome Measures</p><p>General Health Questionnaire (GHQ-12).</p> <p>Results</p><p>Structural rather than cognitive social capital was significantly associated with CMD after controlling for socio-demographic variables. However, the two measures of structural social capital used, social networks and civic participation, were negatively and positively associated with CMD respectively. ‘Social networks’ was negatively associated with CMD at both the individual and ecological levels. This result was maintained when contextual aspects of the physical environment (neighbourhood incivilities) were introduced into the model, suggesting that ‘social networks’ was independent from characteristics of the physical environment. When ecological-level longitudinal analysis was conducted, ‘social networks’ was not statistically significant after controlling for individual-level social capital at follow up.</p> <p>Conclusions</p><p>If we conceptually distinguish between cognitive and structural components as the quality and quantity of social capital respectively, the conclusion of this study is that the quantity rather than quality of social capital is important in relation to CMD at both the individual and ecological levels in disadvantaged urban areas. Thus, policy should support interventions that create and sustain social networks. One of these is explored in this article.</p> <p>Trial Registration</p><p><a href="http://controlled-trials.com" target="_blank">Controlled-Trials.com</a> ISRCTN68175121 <a href="http://www.controlled-trials.com/isrctn68175121" target="_blank">http://www.controlled-trials.com/ISRCTN68175121</a></p> </div