Showcase continued: GoWell

There is a large body of evidence showing that living in a deprived neighbourhood is associated with poor health and life chances and there is an expectation that improvement to housing and neighbourhood conditions will improve health, however there is a lack of robust evidence to inform what matters most. In 2005, and in collaboration with colleagues in the Department of Urban Studies at the University of Glasgow and the Glasgow Centre for Population Health, researchers in the Unit designed and implemented a multi-method evaluation (GoWell) to assess the effects of regeneration of a £1.2 billion programme of housing (70,000 homes) and area regeneration (15 neighbourhoods) across Glasgow at the individual, community and city-wide level including the development of an economic evaluation of this complex intervention. This longitudinal study is the largest of its kind in the world in examining how national policy goals related to communities, regeneration and health are achieved at the local level

Are perceived neighbourhood problems associated with the likelihood of smoking?

<p><b>Objective:</b></p> <p>To explore associations between residents’ perceptions of the local residential environment and the likelihood of their smoking.</p> <p><b>Design:</b></p> <p>Using data (n = 2615) from the West of Scotland Twenty-07 Study, separately by gender, cross-sectional associations between respondents’ perceptions of neighbourhood (perceived absence of goods, incivilities and physical environmental problems) and the likelihood of being a current smoker and the amount smoked were examined.</p> <p><b>Results:</b></p> <p>Perceived neighbourhood problems are associated with the likelihood of smoking but mainly among those with the most negative view of the local neighbourhood. Perceptions of the provision of neighbourhood amenities seems to be more strongly associated with women’s than men’s smoking status, whereas the perceived quality of the local neighbourhood appears to be a better predictor of men’s smoking.</p> <p><b>Conclusions:</b></p> <p>Efforts to reduce smoking levels among more deprived groups may need to pay more attention to the role of local environmental conditions in influencing smoking behaviour.</p&gt

Graffiti, greenery, and obesity in adults: secondary analysis of European cross sectional survey

Obesity levels are high and increasing worldwide. Being overweight is linked with increased death rates and contributes to a wide range of conditions, including ischaemic heart disease, hypertension, stroke, diabetes, certain cancers, and diseases of the gall bladder.1 The principal cause of obesity is an imbalance between energy intake and energy expenditure. And there is growing recognition that, independently of individual characteristics, place of residence may be associated with health outcomes, including body size2 and health related behaviours, such as level of physical exercise.3 Few studies have explored which features of the local neighbourhood might be related to these outcomes or behaviours, although perceived attractiveness has been found to be related to levels of physical activity.4 Levels of incivilities, such as litter and graffiti, are associated with poorer health outcomes such as general wellbeing but not, to our knowledge, with levels of physical activity. Few studies use objectively measured indicators of the residential environment or similar research instruments across different settings. Based on our previous work, we hypothesised that areas which are pleasant with lots of greenery and few incivilities might encourage people to take exercise and thereby influence levels of obesity

Lack of agreement between measured and self-reported distance from public green parks in Glasgow, Scotland

<p><b>Background:</b></p> <p>Reviews have reported mixed findings for associations between physical activity and proximity to a range of environmental resources. Initially most studies used self reported proximity, but more are now using GIS techniques to measure proximity objectively. We know little about the extent of agreement between self reported and directly measured proximity of the same resource.</p> <p><b>Methods:</b></p> <p>We used previously collected data in a community survey in Glasgow in which 658 respondents aged around 40 and 60 were asked whether they lived within half a mile of a public park. We compared their answers with GIS measures of whether there was a park within a half mile service area of their home (and whether their home was within a half mile crow fly buffer of a park).</p> <p><b>Results:</b></p> <p>Agreement was poor; percentage agreement between measured network distance and reported residence within 0.5 miles of a park was 62.0%, and the kappa value was 0.095. Agreement was no higher than poor in any socio-demographic subgroup, or when using crow fly buffers instead of service areas.</p> <p><b>Conclusion:</b></p> <p>One should be cautious about assuming that respondents' self reports of proximity to a resource are a valid proxy for actual distance, or vice versa. Further research is needed to establish whether actual or self-reported proximity predict physical activity or other behaviours, and if so which is the strongest predictor. Further, qualitative study, also needs to examine the basis of people's judgements about the location of resources, and the possibility that these are shaped by their social and personal significance.</p&gt

The food retail environment and area deprivation in Glasgow City

It has previously been suggested that deprived neighbourhoods within modern cities have poor access to general amenities, for example, fewer food retail outlets. Here we examine the distribution of food retailers by deprivation in the City of Glasgow, UK.We obtained a list of 934 food retailers in Glasgow, UK, in 2007, and mapped these at address level. We categorised small areas (data zones) into quintiles of area deprivation using the 2006 Scottish Index of Multiple Deprivation Income sub-domain score. We computed mean number of retailers per 1000 residents per data zone, and mean network distance to nearest outlet from data zone centroid, for all retailers combined and for each of seven categories of retailer separately (i.e. bakers, butchers, fruit and vegetable sellers, fishmongers, convenience stores, supermarkets and delicatessens).The most deprived quintile (of areas) had the greatest mean number of total food retailers per 1000 residents while quintile 1 (least deprived) had the least, and this difference was statistically significant (Chi-square p < 0.01). The closest mean distance to the nearest food retailer was within quintile 3 while the furthest distance was within quintile 1, and this was also statistically significant (Chi-square p < 0.01). There was variation in the distribution of the seven different types of food retailers, and access to amenities depended upon the type of food retailer studied and whether proximity or density was measured. Overall the findings suggested that deprived neighbourhoods within the City of Glasgow did not necessarily have fewer food retail outlets

Evaluating a virtual learning environment in the context of its community of practice

The evaluation of virtual learning environments (VLEs) and similar applications has, to date, largely consisted of checklists of system features, phenomenological studies or measures of specific forms of educational efficacy. Although these approaches offer some value, they are unable to capture the complex and holistic nature of a group of individuals using a common system to support the wide range of activities that make up a course or programme of study over time. This paper employs Wenger's theories of 'communities of practice' to provide a formal structure for looking at how a VLE supports a pre-existing course community. Wenger proposes a Learning Architecture Framework for a learning community of practice, which the authors have taken to provide an evaluation framework. This approach is complementary to both the holistic and complex natures of course environments, in that particular VLE affordances are less important than the activities of the course community in respect of the system. Thus, the VLE's efficacy in its context of use is the prime area of investigation rather than a reductionist analysis of its tools and components. An example of this approach in use is presented, evaluating the VLE that supports the undergraduate medical course at the University of Edinburgh. The paper provides a theoretical grounding, derives an evaluation instrument, analyses the efficacy and validity of the instrument in practice and draws conclusions as to how and where it may best be used

The unanticipated challenges associated with implementing an observational study protocol in a large scale physical activity and GPS data collection

Background: Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. Objectives: In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. Methods: The SPACES (Studying Physical Activity in Children’s Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. Results: Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of fieldworkers to increase recruitment and the return of consent forms. Finally, we encountered data issues when processing physical activity and GPS data that had been initiated across daylight saving time. Conclusions: We present learning points and recommendations that may benefit future studies of similar methodology in their early stages of development

Are housing tenure and car access still associated with health? A repeat cross-sectional study of UK adults over a 13-year period

Background: It is usually assumed that housing tenure and car access are associated with health simply because they are acting as markers for social class or income and wealth. However, previous studies conducted in the late 1990s found that these household assets were associated with health independently of social class and income. Here, we set out to examine if this is still the case. Methods: We use data from our 2010 postal survey of a random sample of adults (n=2092) in 8 local authority areas in the West of Scotland. Self-reported health measures included limiting longstanding illness (LLSI), general health over the last year and the Hospital Anxiety and Depression Scale. Results: We found a statistically significant relationship between housing tenure and all 4 health measures, regardless of the inclusion of social class or income as controls. Compared with owner occupiers, social renters were more likely to report ill-health (controlling for social class—LLSI OR: 3.24, general health OR: 2.82, anxiety η2: 0.031, depression η2: 0.048, controlling for income—LLSI OR: 3.28, general health OR: 2.82, anxiety η2: 0.033, depression η2: 0.057) (p<0.001 for all models). Car ownership was independently associated with depression and anxiety, with non-owners at higher risk of both (controlling for income—anxiety η2: 0.010, depression η2: 0.023, controlling for social class—anxiety η2: 0.013, depression η2: 0.033) (p<0.001 for all models). Conclusions: Our results show that housing tenure and car ownership are still associated with health, after taking known correlates (age, sex, social class, income) into account. Further research is required to unpack some of the features of these household assets such as the quality of the dwelling and access to and use of different forms of transport to determine what health benefits or disbenefits they may be associated with in different contexts

Reuse as heuristic : from transmission to nurture in learning activity design

In recent years a combination of ever more flexible and sophisticated Web technologies and an explosion in the quantity of online content has sparked learning technologists around the world to pursue the promise of the 'reusable learning object' or RLO with the idea that RLOs could be reused in different educational contexts, thereby providing greater overall flexibility and return on investment. In 2002 the ACETS Project undertook a three-year study in the UK to investigate whether RLOs worked in practice and how the pursuit of reuse affected the teacher and their teaching. Teachers working in healthcare-related subjects in Higher and Further Education were asked to create an original learning design or activity from third-party digital resources and to reflect both on the process and its outcomes. The expectation was that teachers would be the ones selecting and reusing third-party materials. This paper describes how one of the ACETS exemplifiers reinterpreted this remit, challenged the anticipated transmissive model of learning, and instead, gave their students an opportunity to create their own original learning designs and learning activities from third-party digital resources. By describing the educational enhancements, the resulting heightened levels of critical thinking, and sensitivity to patient needs, 'reuse' will be shown to be an effective heuristic for student self-direction and professional development

Changes over time in population level transport satisfaction and mode of travel: a 13 year repeat cross-sectional study, UK

Aim: The aim of the study was to examine changes over time in satisfaction with usual transport mode, explore individual and area level characteristics as mediators in the likelihood of transport satisfaction, and whether any changes in transport satisfaction varied by these factors over time. Methods: Adults from West Central Scotland, United Kingdom, who participated at both waves of the repeat cross-sectional ‘Transport, Health and Well-being Study’ conducted in 1997 (n=2735) and 2010 (n=2024) were assessed. Individuals completed a detailed postal questionnaire at both time points including self-rated satisfaction with usual transport mode (using a seven point scale subsequently dichotomised to a binary outcome of satisfied (1–2) and other (3–7)). Participants reported usual transport mode for travel to various destinations. A multilevel logistic regression model was used and individuals were nested within areas (c. 4000 population). Results: At the 2010 sweep, two thirds (n=1345) of individuals were satisfied with their transport choice. Those with fair/poor health were less satisfied with their usual transport compared to those in better health (Odds Ratio (OR) 0.49, p<0.001). Access to a car was associated with overall transport satisfaction (OR 2.63, p<0.001) and the effect of deprivation on transport satisfaction was mitigated when adjusted by household car access. Transport satisfaction increased more from 1997 to 2010 for retired individuals compared to those in employment (OR 1.40, p=0.032), and for those who travelled by public transport (OR 2.39, p=0.005) and using multiple modes (OR 2.19, p<0.001) compared to those who travelled by car. Conclusions: The proportion of those who travelled using public transport, active modes or by multiple mode increased journey satisfaction over time at a greater rate than those who travelled by car, highlighting that continued efforts should be made to promote these more active transport modes which have potential to impact on health