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Guell C, Ogilvie D, Green J. Changing mobility practices. Can meta-ethnography inform transferable and policy-relevant theory? Soc Sci Med 2023; 337:116253. [PMID: 37857239 DOI: 10.1016/j.socscimed.2023.116253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/24/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023]
Abstract
Social practice theories have attracted attention for their potential insights into how to change transport systems towards "healthier" states. However, most evidence is from small-scale qualitative case studies. We explored whether a synthesis of qualitative evidence on mobility practices in one country, informed by meta-ethnography and a Bourdieusian approach to practice, could produce theory that is of sufficient abstraction to be transferable, yet also capable of informing intervention planning. The synthesis identified three third order constructs: mobility practices result from habitus plus capital in fields; specific configurations of local mobility practices are shaped, but not determined, by material infrastructures and social structures; and changes in practice happen across a number of scales and temporalities. This body of evidence as a whole was then interpreted as an integrative "storyline": Mobility systems are complex, in that outcomes from interventions are neither unilinear nor necessarily predictable from aggregations of individual practice changes. Infrastructure changes may be a necessary, but not sufficient, condition for change. Moving systems towards "healthier" states requires changing habitus such that "healthier" practices align with fields, and that interventions take sufficient account of the power relations that materially and symbolically constrain or enable attachments to and changes in mobility practices. Meta-ethnography is a useful approach for integrating qualitative evidence for informing policy.
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Affiliation(s)
- Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter Medical School, Penryn, UK; Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK.
| | - David Ogilvie
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Judith Green
- Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK
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Milton K, Kelly MP, Baker G, Cleland C, Cope A, Craig N, Foster C, Hunter R, Kee F, Kelly P, Nightingale G, Turner K, Williams AJ, Woodcock J, Jepson R. Use of natural experimental studies to evaluate 20mph speed limits in two major UK cities. JOURNAL OF TRANSPORT & HEALTH 2021; 22:101141. [PMID: 34603959 PMCID: PMC8463832 DOI: 10.1016/j.jth.2021.101141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/18/2021] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Reductions in traffic speed can potentially offer multiple health and public health benefits. In 2016, implementation of 20mph (30kph) speed limit interventions began in Edinburgh (city-wide) and Belfast (city centre). The aims of this paper are to describe 1) the broad theoretical approach and design of two natural experimental studies to evaluate the 20mph speed limits in Edinburgh and Belfast and 2) how these studies allowed us to test and explore theoretical mechanisms of 20mph speed limit interventions. METHODS The evaluation consisted of several work packages, each with different research foci, including the political decision-making processes that led to the schemes, their implementation processes, outcomes (including traffic speed, perceptions of safety, and casualties) and cost effectiveness. We used a combination of routinely and locally collected quantitative data and primary quantitative and qualitative data. RESULTS The evaluation identified many contextual factors influencing the likelihood of 20mph speed limits reaching the political agenda. There were substantial differences between the two sites in several aspects related to implementation. Reductions in speed resulted in significant reductions in collisions and casualties, particularly in Edinburgh, which had higher average speed at baseline. The monetary value of collisions and casualties prevented are likely to exceed the costs of the intervention and thus the overall balance of costs and benefits is likely to be favourable. CONCLUSIONS Innovative study designs, including natural experiments, are important for assessing the impact of 'real world' public health interventions. Using multiple methods, this project enabled a deeper understanding of not only the effects of the intervention but the factors that explain how and why the intervention and the effects did or did not occur. Importantly it has shown that 20mph speed limits can lead to reductions in speed, collisions and casualties, and are therefore an effective public health intervention.
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Affiliation(s)
- Karen Milton
- Norwich Medical School, University of East Anglia, UK
| | - Michael P. Kelly
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Graham Baker
- Physical Activity for Health Research Centre (PAHRC), Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, UK
| | - Claire Cleland
- School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, UK
| | | | | | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, UK
| | - Ruth Hunter
- Centre for Public Health, Queen's University Belfast, UK
| | - Frank Kee
- School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre (PAHRC), Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, UK
| | - Glenna Nightingale
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, UK
| | - Kieran Turner
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, UK
| | - Andrew J. Williams
- Division of Population and Behavioural Science, School of Medicine, University of St Andrews, UK
| | - James Woodcock
- Centre for Diet and Activity Research, University of Cambridge, UK
| | - Ruth Jepson
- Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, UK
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Ogilvie D, Bauman A, Foley L, Guell C, Humphreys D, Panter J. Making sense of the evidence in population health intervention research: building a dry stone wall. BMJ Glob Health 2021; 5:bmjgh-2020-004017. [PMID: 33298470 PMCID: PMC7733100 DOI: 10.1136/bmjgh-2020-004017] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
To effectively tackle population health challenges, we must address the fundamental determinants of behaviour and health. Among other things, this will entail devoting more attention to the evaluation of upstream intervention strategies. However, merely increasing the supply of such studies is not enough. The pivotal link between research and policy or practice should be the cumulation of insight from multiple studies. If conventional evidence synthesis can be thought of as analogous to building a wall, then we can increase the supply of bricks (the number of studies), their similarity (statistical commensurability) or the strength of the mortar (the statistical methods for holding them together). However, many contemporary public health challenges seem akin to herding sheep in mountainous terrain, where ordinary walls are of limited use and a more flexible way of combining dissimilar stones (pieces of evidence) may be required. This would entail shifting towards generalising the functions of interventions, rather than their effects; towards inference to the best explanation, rather than relying on binary hypothesis-testing; and towards embracing divergent findings, to be resolved by testing theories across a cumulated body of work. In this way we might channel a spirit of pragmatic pluralism into making sense of complex sets of evidence, robust enough to support more plausible causal inference to guide action, while accepting and adapting to the reality of the public health landscape rather than wishing it were otherwise. The traditional art of dry stone walling can serve as a metaphor for the more ‘holistic sense-making’ we propose.
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Affiliation(s)
- David Ogilvie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Adrian Bauman
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter, Truro, UK
| | - David Humphreys
- Department of Social Policy and Innovation, University of Oxford, Oxford, UK
| | - Jenna Panter
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Local walking and cycling by residents living near urban motorways: cross-sectional analysis. BMC Public Health 2019; 19:1434. [PMID: 31675933 PMCID: PMC6824089 DOI: 10.1186/s12889-019-7621-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 09/13/2019] [Indexed: 11/18/2022] Open
Abstract
Background Everyday activities, such as walking or cycling, may be a feasible and practical way to integrate physical activity into everyday life. Walking and cycling for transport or recreation in the area local to a person’s home may have additional benefits. However, urban planning tends to prioritise car use over active modes. We explored the cross-sectional association between living near an urban motorway and local walking and cycling. Methods In 2013, residents living in an area (a) near a new urban motorway (M74), (b) near a longstanding urban motorway (M8), or (c) without a motorway, in Glasgow, Scotland, were invited to complete postal surveys assessing local walking and cycling journeys and socio-demographic characteristics. Using adjusted regression models, we assessed the association between motorway proximity and self-reported local walking and cycling, as well as the count of types of destination accessed. We stratified our analyses according to study area. Results One thousand three hundred forty-three residents (57% female; mean age: 54 years; SD: 16 years) returned questionnaires. There was no overall association between living near an urban motorway and the likelihood of local walking or cycling, or the number of types of local destination accessed by foot or bicycle. In stratified analyses, for those living in the area around the new M74 motorway, increasing residential proximity to the motorway was associated with lower likelihood of local recreational walking and cycling (OR 0.63, 95% CI: 0.39 to 1.00) a pattern not found in the area with the longstanding M8 motorway. In the area near the M8 motorway residential proximity was statistically significantly (p = 0.014) associated with a 12% decrease in the number of types of destination accessed, a pattern not found in the M74 study area. Conclusions Our findings suggest that associations between living near a motorway and local walking and cycling behaviour may vary by the characteristics of the motorway, and by whether the behaviour is for travel or recreation. The lack of associations seen in the study area with no motorway suggests a threshold effect whereby beyond a certain distance from a motorway, additional distance makes no difference.
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Foley L, Coombes E, Hayman D, Humphreys D, Jones A, Mitchell R, Ogilvie D. Longitudinal association between change in the neighbourhood built environment and the wellbeing of local residents in deprived areas: an observational study. BMC Public Health 2018; 18:545. [PMID: 29699544 PMCID: PMC5921539 DOI: 10.1186/s12889-018-5459-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 04/12/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Features of the urban neighbourhood influence the physical, social and mental wellbeing of residents and communities. We explored the longitudinal association between change to the neighbourhood built environment and the wellbeing of local residents in deprived areas of Glasgow, Scotland. METHODS A cohort of residents (n = 365; mean age 50 years; 44% male; 4.1% of the 9000 mailed surveys at baseline) responded to a postal survey in 2005 and 2013. Wellbeing was assessed with the mental (MCS-8) and physical (PCS-8) components of the SF-8 scale. We developed software to aid identification of visible changes in satellite imagery occurring over time. We then used a Geographical Information System to calculate the percentage change in the built environment occurring within an 800 m buffer of each participant's home. RESULTS The median change in the neighbourhood built environment was 3% (interquartile range 6%). In the whole sample, physical wellbeing declined by 1.5 units on average, and mental wellbeing increased by 0.9 units, over time. In multivariable linear regression analyses, participants living in neighbourhoods with a greater amount of change in the built environment (unit change = 1%) experienced significantly reduced physical (PCS-8: -0.13, 95% CI -0.26 to 0.00) and mental (MCS-8: -0.16, 95% CI -0.31 to - 0.02) wellbeing over time compared to those living in neighbourhoods with less change. For mental wellbeing, a significant interaction by baseline perception of financial strain indicated a larger reduction in those experiencing greater financial strain (MCS-8: -0.22, 95% CI -0.39 to - 0.06). However, this relationship was reversed in those experiencing lower financial strain, whereby living in neighbourhoods with a greater amount of change was associated with significantly improved mental wellbeing over time (MCS-8: 0.38, 95% CI 0.04 to 0.72). CONCLUSIONS Overall, we found some evidence that living in neighbourhoods experiencing higher levels of physical change worsened wellbeing in local residents. However, we found a stronger negative relationship in those with lower financial security and a positive relationship in those with higher financial security. This is one of few studies exploring the longitudinal relationship between the environment and health.
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Affiliation(s)
- Louise Foley
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
| | - Emma Coombes
- Norwich Medical School and CEDAR, University of East Anglia, Norwich, NR4 7TJ UK
| | | | - David Humphreys
- Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER UK
| | - Andrew Jones
- Norwich Medical School and CEDAR, University of East Anglia, Norwich, NR4 7TJ UK
| | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences Unit and Centre for Research on Environment, Society and Health, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB UK
| | - David Ogilvie
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ UK
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Nimegeer A, Thomson H, Foley L, Hilton S, Crawford F, Ogilvie D. Experiences of connectivity and severance in the wake of a new motorway: Implications for health and well-being. Soc Sci Med 2018; 197:78-86. [PMID: 29222998 PMCID: PMC5777829 DOI: 10.1016/j.socscimed.2017.11.049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 10/16/2017] [Accepted: 11/27/2017] [Indexed: 11/17/2022]
Abstract
The construction of new urban roads may cause severance, or the separation of residents from local amenities or social networks. Using qualitative data from a natural experimental study, we examined severance related to a new section of urban motorway constructed through largely deprived residential neighbourhoods in Glasgow, Scotland. Semi-structured and photo-elicitation interviews were used to better understand severance and connectivity related to the new motorway, and specifically implications for individual and community-level health and well-being through active travel and social connections. Rather than a clear severance impact attributable to the motorway, a complex system of connection and severance was spoken about by participants, with the motorway being described by turns as a force for both connection and severance. We conclude that new transport infrastructure is complex, embedded, and plausibly causally related to connectedness and health. Our findings suggest the potential for a novel mechanism through which severance is enacted: the disruptive impacts that a new road may have on third places of social connection locally, even when it does not physically sever them. This supports social theories that urge a move away from conceptualising social connectedness in terms of the local neighbourhood only, towards an understanding of how we live and engage dynamically with services and people in a much wider geographical area, and may have implications for local active travel and health through changes in social connectedness.
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Affiliation(s)
- Amy Nimegeer
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, United Kingdom.
| | - Hilary Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, United Kingdom
| | - Louise Foley
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, United Kingdom
| | - Fiona Crawford
- Glasgow Centre for Population Health, Third Floor, Olympia Building, Bridgeton Cross, Glasgow, G40 2QH, United Kingdom
| | - David Ogilvie
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom
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