MICA: Developing system-oriented interventions to reduce car dependency for improved population health in Belfast

In Northern Ireland, an average person does over 80% of their journeys by car. This is very high compared to other parts of the UK, where 63% of journeys are made by car, and in Ireland, where the figure is just over 50%. Belfast is also one of the most congested cities in the UK. These problems are because too many people are driving too often. Being too reliant on our cars to get around leads to many detrimental impacts. For example, we walk and cycle less, our air quality worsens, and the number of road traffic collisions increases. It is, therefore, a growing issue in public health with more and more cities looking for solutions to help reduce our reliance on cars. However, solutions to such a problem are not simple as there are many different groups involved in or affected by the transport system. If we are to find policies and programmes that help reduce car reliance long term, then these groups must work together to solve the problem.

Our project aims to co-develop sustainable and scalable policies and programmes that reduce the reliance on cars in Belfast. Our project is organised into 3 workstreams: 1) understanding the multiple layers of the system that influence the reliance on cars in Belfast; 2) exploring the current evidence and knowledge of what has worked in other cities; 3) developing possible policies and programmes with key organisations to reduce car use.
Our policies and programmes are aimed at citizens who use their car for work, school drop-off, leisure and other activities in Belfast. But other road users will also directly benefit from less cars on the road, through less air pollution and fewer road traffic collisions. The general population will also benefit from cleaner air, less noise, and potential positive impacts on climate change.

Our research includes the following steps:
1. We will undertake a survey using a technique known as Network Analysis to help us understand the network of stakeholders involved in the development, implementation and evaluation of programmes and policies to reduce car dependency and how they might best work together.
2. We will undertake a survey with road users in Belfast to evaluate and rank the importance of influences on car dependency and on alternative travel modes, using a technique known as Discrete Choice Experiments.
3. To develop agreement among stakeholders about the nature, ordering and relationships between programmes and policies of different organisations to reduce car dependency, we will develop visual diagrams of the 'system' of the various aspects that affect car dependency, using a technique known as causal loop diagrams.
4. We will host workshops with local citizens to 'sense-check' promising intervention approaches and policies to explore and ensure the acceptability, utility, affordability, feasibility and sustainability of new initiatives.
Possible policies and programmes may include, for example: improved public transport, with the introduction of a new rapid transit system; investment in urban greenways to increase walking and cycling journeys; expanding the car-free areas of the city centre; extension of 'park and ride' and 'park and stride' facilities at the edge of the city.

Our work will have the following outputs:
1. Identification of stakeholders influencing car dependency in Belfast and their relationships.
2. A review of the evidence for actions to reduce car dependency, leading to identification of possible new interventions and policies to be considered by stakeholders.
3. A map identifying ongoing and planned policies and interventions and their potential interplay.
4. A suite of potential co-ordinated policies and interventions 'tested' (in terms of acceptability and feasibility) with road users and local citizens.
5. A consensual understanding of the evidence provided and implications for reducing car dependency in Belfast.
6. A roadmap for multi-sectoral action to reduce car dependency in Belfast.

Our aim is to engage with stakeholders from various sectors to co-design sustainable systems-oriented interventions and policies to reduce reliance on cars in Belfast. Our project is organised upon 3 pillars: 1) understanding the multiple layers that shape car dependency in Belfast; 2) synthesizing evidence and knowledge of what has worked in other cities; 3) developing a shared vision and co-ordinate innovative actions with stakeholders to reduce car use in Belfast. Firstly, we will map stakeholders and partnerships influencing car dependency in Belfast, using stakeholder network analysis. In parallel, we will undertake a rapid literature review to synthetize the evidence and lessons from actions across the globe designed to reduce car dependency. Next, we will map ongoing and planned policies and interventions that will likely affect car dependency in Belfast and the complex interplay between them, via analysis of policy documents and semi-structured interviews with policymakers. A participatory group model building workshop will be conducted with stakeholders, in which a shared understanding of the complex system perpetuating car dependency and a transition vision for the city will be co-produced. Then, using Discrete Choice Experiments, we will undertake a survey primarily with road users in Belfast to evaluate the importance of various transport infrastructure attributes on car dependency and on alternative travel modes, and the willingness of users to accept policies and interventions identified in the previous activity. A series of citizen juries will 'sense-check' the acceptability, utility, applicability, affordability and feasibility of possible actions. Lastly, stakeholders will be gathered again for collectively interpreting the findings of the previous activities, planning for an orchestrated multi-sectoral action (the 'intervention'), and agreeing on ways to sustain collaborations towards the common vision of reducing car dependency in Belfast.

Our partners have identified a range of beneficial impacts. We have designed our communication strategy (see Communication Plan) to maximise these benefits both for our partners and for our wider stakeholder community. The main benefits are a clear roadmap to guide the implementation of intervention approaches (i.e., coordinated multi-sectoral interventions and policies) and deeper understanding of how these actions may be better able to generate meaningful changes in the urban fabric and consequent population health risk factors.
Promoting transdisciplinarity and ensuring stakeholder engagement will help us to deliver high-impact research, with multiple beneficiaries in Belfast, the UK and beyond, including: the general public; public health practitioners; transport practitioners; urban designers and planners; and policymakers. A number of academic beneficiaries are detailed elsewhere (see Academic Beneficiaries).
Considerable time and resources have been included in the grant to ensure that key stakeholders, including local citizens, are involved throughout the study in order to maximise benefits and that the proposed collaborations are ongoing; indeed, such collaborations have been instrumental in developing the current proposal. Long term, we envisage such benefits to include the development of collaborative interventions and policies that reduce car dependency for improved population health, but also social, economic and environmental co-benefits. Our partners will ensure that study findings are disseminated in a meaningful and appropriate manner. Ongoing development of the research series will provide benchmarks and a methodological platform for future researchers to launch additional research efforts.
The general public will benefit through the practical application of this research and embodiment into policy and practice regimes. The general public will be involved via the citizen juries which will explore in-depth issues such as acceptability, affordability, utility, and accessibility. We hypothesise that interventions to purposefully reduce car dependency will not only have health benefits, but also co-benefits from the social, economic and environment realms.
Urban design and planning practitioners will benefit from a deeper understanding of the complex system which governs car dependency, and identification of 'leverage points' within the system in which to intervene.
Public health practitioners will benefit from knowledge gained through the workshops hosted in partnership with our multi-disciplinary stakeholders, and delivered as part of the implementation of the Public Health Agency's Knowledge Management Strategy and the work of the Northern Ireland Public Health Research Forum (of which Kee was the inaugural Director). These workshops will particularly focus on how best we can incorporate and elicit mechanisms of urban design and planning to inform policies and practices to reduce car dependency.
Policymakers and funders of research will find the research of value in assessing the public health priorities and novel approaches to the reduction of car dependency. We have engaged with multiple stakeholders from the outset, to ensure that this work will have long term policy relevance and impact. While the timelines for research and policy may not always be aligned, we will maintain our strong relationships with key decision makers to ensure that they have access to updates on new research and emerging results.
All beneficiaries will come together in a Strategic Innovation Lab in Belfast to build consensus and think about how changes might be effected within complex urban systems.