Will moving into social and affordable housing in the Athletes' Village increase family physical activity levels? Evaluation of a natural experiment

Lead Research Organisation: St George's University of London
Department Name: Inst of Medical & Biomedical Education

Abstract

It is assumed that where you live has an impact on your health; this is often given as a reason for poor health amongst those living in less privileged surroundings. There have been a number of large-scale housing regeneration projects over the years, which aim to improve the living conditions and lifestyles of those living in low cost housing. However, these projects are long-term (often taking a decade or so to complete), making it difficult to demonstrate effects on lifestyle above those taking place over time. Effects of the built environment on physical activity levels are of particular interest as higher physical activity levels have a beneficial impact on a wide range of health outcomes. The specific provision of social and affordable housing provided by the Athletes' Village after the London 2012 Olympic Games (available from 2013) offers a unique opportunity to examine whether and how the 'built environment' affects physical activity patterns and body size in adults and children moving into the area. We will recruit a cohort of families before the Village accommodation becomes available, and follow up those that move into the Village, and compare physical activity patterns with those in families that do not move to the Village over a 2 year period. We will measure how the built environment is used in terms of walkability, ease of access, convenience of use etc., and how perceptions of the local environment influence its use, e.g. perceived levels of safety, social interactions and cohesion etc. Physical activity patterns will be assessed using accurate movement sensors, body size will be measured objectively using bio-electrical impedance. Geographical positioning systems will be employed to trace patterns of use of the local environment. While the short time scale of the intervention is unique, the findings will be generalisable, informing future design of residential developments that are destined to take place elsewhere. The key to public value of the proposal is that: (i) evidence based policy requires evidence on whether environmental changes thought to benefit residents actually do; (ii) the cost of evaluations such as that proposed is small compared to the costs of building and compared to the potential health benefit; (iii) small changes distributed widely in the population have the potential to deliver major health benefits; (iv) such benefits can only be identified by carefully designed evaluations of natural experiments. Finally we recognize the importance of disseminating our findings; we believe our proposed pathway to dissemination, including a stake holder forum including individuals identified by our extensive network of contacts, will provide this.

Technical Summary

We propose to examine whether people moving into the Athletes' Village increase their physical activity levels to a greater extent than people who do not. To observe the impact of this natural experiment, a two-year longitudinal (cohort) study will be carried out, examining changes in physical activity levels in 600 families which move into the Village (intervention) with 600 families which do not. Participants (who apply to live in social and affordable homes in the Village) will be studied initially in their current place of residence and then either in the Villlage (intervention) or the same place of residence (controls). Changes in physical activity (measured objectively using Actigraph monitors) and body build (including bio-electrical impedance) occurring in families living in the Village will be compared with changes occurring in those living in surrounding boroughs. Research objectives will examine:-
(i) whether families living in social and affordable housing in the Village show a sustained change in their physical activity levels, compared to their levels before moving into the Village, and by comparison with physical activity changes in families outside the Village.
(ii) whether any increase in physical activity in children and adults living in the Village is directly attributable to use of their local built environment, and if so, which facilities.
(iii) whether changes in physical activity patterns in families living in the Village are modified by other factors including age, gender, ethnicity, proximity to facilities, perceived social cohesion and safety, social class / employment status.
(iv) we will examine (i) in relation to adiposity as well as physical activity levels.
The study will provide proof of principle that the built environment can increase physical activity levels. Results will inform evidence-based urban planning that will happen in the future, and the way in which environmental changes impact on health inequalities.

Planned Impact

The social rented sector (including accommodation rented from local authorities and housing associations) accounts for 3.6 million properties in England. Trends in the supply of social and affordable housing have increased over the last decade. The biggest increase has been in the affordable sector, with 58,000 additional affordable home being supplied in England from 2009 to 2010. In London, as elsewhere, there is a shortage of affordable housing and Strategic Housing Market Assessment (SHMA) estimates that at least 33,000 new homes, including 18,000 affordable homes, are needed every year. A target has been set by the London Mayor of delivering 50,000 affordable homes, of which 30,000 will be socially rented, by March 2012 (25,000 have been provided in the last 2 years). A number of housing activities are ongoing in London; these include the Kidbroke estate Greewich which will provide 1500 new affordable homes, Woodberry down in Hackney 2300, Clapham Park in Lambeth will provide 85 new affordable homes but will see a major regeneration of existing housing stock. The Athletes Village will also contribute to this housing stock, with 1400 new homes, but will be unique in providing these in a short space of time (within a year). While other initiatives are ongoing and future projects are needed to address the demand for new housing, it is important to appreciate the effect of these new built environments on health and health behaviour (physical activity levels) in both the young and old, privileged and less privileged. The findings from this study will identify features of new housing that result in higher physical activity levels, providing evidence-based recommendations for future builds which are needed to keep up with current demand. As such, there are many housing providers outside the academic community who will benefit from these findings. A major drive of this initiative will be to disseminate these findings to these individuals, using the network of contacts and stakeholders that we are currently involved with. It is important to recognise that these findings are generalisable to the wider provision of housing in major conurbations, both at a national and international level, in order to provide built environments which encourage healthy living.

Publications

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Procter D (2017) Identification of Travel Behaviour from Objective Physical Activity Data in Journal of Transport & Health

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Procter DS (2018) An open-source tool to identify active travel from hip-worn accelerometer, GPS and GIS data. in The international journal of behavioral nutrition and physical activity

 
Description NIHR Public Health Programme Call - Walking and Cycling
Amount £607,327 (GBP)
Funding ID 12/211/69 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 06/2014 
End 03/2017
 
Description ENABLE London engagement activities 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Although the East Village development is unique in some respects, the specific features of the East Village development which could influence physical activity, walking, cycling levels in residents are (or could be) features of many built environment developments. The findings of this study will therefore have substantial potential for wider application. Opportunities for dissemination are actively being sought both in academic and non-academic forums. Attendance at the UK Prevention Research Partnership launch event in May 2017 provided the opportunity to re-establish links with the Town and Country Planning Association (Michael Chang, Head of Policy), and potentially forge future links related to examining the influence of the built environment on physical activity. In addition to the ENABLE London cohort profile paper published in BMJ Open, and our paper in Health and Place, we have 3 papers under review and in preparation. We are currently drafting papers outlining longitudinal change in physical activity and adiposity levels in the ENABLE London cohort, and a paper outlining change in mental health and well-being outcomes. We have submitted abstracts to the 7th International Society for Physical Activity and Health Congress being held in London 2018, and the Society for Social Medicine Annual Scientific Meeting in Glasgow 2018. We will seek other opportunities to disseminate findings, especially as we approach the point where we will be able to use longitudinal data to examine whether there has been any change in physical activity and other health related behaviours associated with moving to East Village, compared to change observed amongst those who do not. Publications emanating from the ENABLE London study, including the baseline cohort paper, have been posted on our website (see - http://www.enable.sgul.ac.uk/publications). We will seek other opportunities to disseminate findings, especially as we approach the point where we will be able to use longitudinal data to examine whether there has been any change in physical activity and other health related behaviours associated with moving to East Village, compared to change observed amongst those who do not. Publications emanating from the ENABLE London study, including the baseline cohort paper, have been posted on our website (see - http://www.enable.sgul.ac.uk/publications). A yearly newsletter will continue to keep participants informed of study findings.
Year(s) Of Engagement Activity 2015,2017
URL https://www.mrc.ac.uk/research/initiatives/population-health-sciences/ukprp-initiative-launch/