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

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 Objectives: In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection.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

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

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

Combining GPS, GIS, and accelerometry to explore the physical activity and environment relationship in children and young people – a review

The environment has long been associated with physical activity engagement, and recent developments in technology have resulted in the ability to objectively quantify activity behaviours and activity context. This paper reviews studies that have combined Global Positioning Systems (GPS), Geographic Information Systems (GIS) and accelerometry to investigate the PA-environment relationship in children and young people (5–18 years old). Literature searches of the following bibliographic databases were undertaken: Sportdiscus, Medline, Embase, CINAHL, Psychinfo and Applied Social Sciences Index and Abstracts (ASSIA). Fourteen studies met the inclusion criteria, and covered topics including greenspace use, general land use, active travel, and the built environment. Studies were largely cross-sectional and took place across developed countries (UK, USA, Canada, New Zealand, and Australia). Findings suggest that roads and streets, school grounds, and the home location are important locations for total PA, and moderate to vigorous PA (MVPA). The relationship between greenspace was positive, however, multiple definitions and outcome measures add complexity to the results. MVPA was more likely in those exposed to higher levels of greenspace compared to sedentary individuals. Total MVPA time in greenspace is low, but when framed as a proportion of the total can be quite high. Domestic gardens may be an important area for higher intensity activity.<p></p> Researchers are encouraged to show transparency in their methods. As a relatively new area of research, with ever-evolving technology, future work is best placed in developing novel, but robust, methods to investigate the PA and environment relationship. Further descriptive work is encouraged to build on a small but increasing knowledge base; however, longitudinal studies incorporating seasonal/weather variation would also be extremely beneficial to elicit some of the nuances associated with land use. A greater understanding of geographic variation (i.e. within and between countries), as well as urban/suburban and rural dwelling is welcomed, and future work should also include the investigation of psycho-social health as an outcome, as well as differences in socio-economic status, sex and adiposity

Are changes in neighbourhood perceptions associated with changes in self-rated mental health in adults? A 13 year repeat cross-sectional study, UK

The aim of this study was to examine changes in neighbourhood perceptions on self-rated mental health problems over time, and to explore demographic, geographic and socio-economic factors as determinants of increased or decreased anxiety and depression symptoms. We conducted a repeat cross-sectional study of individuals (N: 4480) living in the same areas of west central Scotland in 1997 and 2010. Individuals were asked to complete a questionnaire at both time-points, containing 14 questions relating to neighbourhood perceptions and the Hospital Anxiety and Depression Scale (HADS). A three-level linear regression model was fitted to HADS scores and changes in neighbourhood perceptions over time; controlling for a number of individual and area-level variables. Overall, area-level mean HADS scores decreased from 1997 to 2010. When adjusted for individual and area-level variables, this decrease did not remain for HADS anxiety. Applying an overall 14-scale neighbourhood perception measure, worsening neighbourhood perceptions were associated with small increases in depression (0.04, 95% confidence interval (CI) 0.01 to 0.07) and anxiety (0.04, 95% CI 0.00 to 0.08) scores over time. This highlights a need for local and national policy to target areas where neighbourhood characteristics are substantially deteriorating in order to ensure the mental health of individuals does not worsen

The validity of the Youth Physical Activity Questionnaire in 12-13 year old Scottish adolescents

Background: The development of accurate methods to measure health-behaviours forms an integral component in behavioural epidemiology. Population surveillance of physical activity often relies on self/proxy reported questionnaires due to cost and relative ease of administration. The aim of this study was to examine the criterion validity and measurement agreement between the Youth Physical Activity Questionnaire (YPAQ) and accelerometry before being included in a Scotland-wide study. Methods: Forty four participants (12–13 years old; 61% girls) completed the YPAQ following 7 days wearing the Actigraph GT3X+. Mean moderate-to-vigorous physical activity (MVPA) per day was derived from YPAQ and accelerometer and validity was assessed using Spearman's correlation; Bland-Altman plots examined absolute agreement between methods. Results: Pearson's and Spearman’s correlations between YPAQ and accelerometer were r = 0.47 and rs = 0.39 (p<0.01) respectively. The YPAQ over reported mean MVPA by 25.6 ± 50.2 minutes (95% CI 10.4-40.9 minutes; p <0.001), with 95% limits of agreement of −72.69 minutes and + 123.99 minutes. Evidence of underreporting at lower levels of activity and over reporting at higher levels of activity was evident (Pearson's r=0.81), in addition to heteroscedasticity, where variances increased as MVPA increased. Conclusions: Although a moderate correlation between the two methods was apparent, the YPAQ should not be used interchangeably with accelerometry. The YPAQ does demonstrate a reasonable ability to rank MVPA, although it tends to under-report lower levels and over-report higher levels. This, and other administering factors, should be taken into consideration if being used for group or individual level analyses

Walkability around primary schools and area deprivation across Scotland

Background: A number of studies based in the US, Canada, and Australia, have found evidence of associations between the built environment (BE) and mode of transport to school, and links between active travel and deprivation. Limited research in the UK compares potential BE supports for walking to school by area deprivation. Within this study, we gathered data on BE attributes previously linked to active travel, i.e., street/path connectivity, and dwelling density, created a composite ‘walkability score’ (WS) for areas around primary schools across urban Scotland, and explored whether poorer areas exhibit lower scores than more affluent areas, or vice versa. We consider this to be a novel approach as few studies have compared BE features by deprivation across a whole country. Methods: Address and road/path maps were obtained and primary schools (N = 937) across mainland Scotland were mapped. Schools were attributed income deprivation scores (scores divided into quintiles (Q1: least deprived, Q5: most deprived)). Catchment area (CA) boundaries, i.e., the geographic area representing eligibility for local school attendance, were drawn around schools, and WS calculated for each CA. We compared mean WS by income quintile (ANOVA), for all local authorities (LAs) combined (N = 29), and separately for the four LAs with the greatest number of schools included in the analysis. Results: For all LAs combined, the least deprived quintile (Q1) showed a significantly lower WS (−0.61), than quintiles 3, 4 and 5 (Q2: −0.04 (non-sig), Q3: 0.38, Q4: 0.09, Q5: 0.18); while for Glasgow the second least deprived quintile (Q2) showed significantly higher WS (Q1: 1.35, Q2: 1.73), than middling (Q3: 0.18) and most deprived quintiles (Q4: 0.06, Q5: −0.10). Conclusion: WS differ by deprivation with patterns varying depending on the spatial scale of the analysis. It is essential that less walkable areas are provided with the resources to improve opportunities to engage in active travel

Objectively Measured Physical Activity Levels of Scottish Children: Analysis from A Sub-Sample of 10-11 Year Olds in the Growing Up in Scotland Study

Report using data from the Growing Up in Scotland (GUS) study to explore physical activity levels in Scottish 10 and 11-year-olds

Physical Activity in Secondary School Pupils: Headline Indicators 2014

In 2013, GoWell East commenced a cohort study of physical activity among secondary school pupils in Glasgow. The study will run from 2013 to 2017, following a group of pupils in six Glasgow secondary schools throughout their school careers from S1 to S5. The study tracks pupils’ participation in physical activity, including sports, as well as other types of activity (including travel to and from school), during their school time and leisure time, during the week and at the weekend. The research is done by asking pupils to complete the Youth Physical Activity Questionnaire (YPAQ)1 .   A group of S5 pupils were also asked to complete the survey in 2013 in order to provide a benchmark with which to compare the S1 study cohort when they reach S5 in 2017