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Background: Environmental improvement is a priority for urban sustainability and health and achieving it requires transformative change in cities. An approach to achieving such change is to bring together researchers, decision-makers, and public groups in the creation of research and use of scientific evidence. Methods: This article describes the development of a programme theory for Complex Urban Systems for Sustainability and Health (CUSSH), a four-year Wellcome-funded research collaboration which aims to improve capacity to guide transformational health and environmental changes in cities. Results: Drawing on ideas about complex systems, programme evaluation, and transdisciplinary learning, we describe how the programme is understood to “work” in terms of its anticipated processes and resulting changes. The programme theory describes a chain of outputs that ultimately leads to improvement in city sustainability and health (described in an ‘action model’), and the kinds of changes that we expect CUSSH should lead to in people, processes, policies, practices, and research (described in a ‘change model’). Conclusions: Our paper adds to a growing body of research on the process of developing a comprehensive understanding of a transdisciplinary, multiagency, multi-context programme. The programme theory was developed collaboratively over two years. It involved a participatory process to ensure that a broad range of perspectives were included, to contribute to shared understanding across a multidisciplinary team. Examining our approach allowed an appreciation of the benefits and challenges of developing a programme theory for a complex, transdisciplinary research collaboration. Benefits included the development of teamworking and shared understanding and the use of programme theory in guiding evaluation. Challenges included changing membership within a large group, reaching agreement on what the theory would be ‘about’, and the inherent unpredictability of complex initiatives.
Gemma Moore; Susan Michie; Jamie Anderson; Kristine Belesova; Melanie Crane; Clément Deloly; Sani Dimitroulopoulou; Hellen Gitau; Joanna Hale; Simon J. Lloyd; Blessing Mberu; Kanyiva Muindi; Yanlin Niu; Helen Pineo; Irene Pluchinotta; Aarathi Prasad; Anne Roue-Le Gall; Clive Shrubsole; Catalina Turcu; Ioanna Tsoulou; Paul Wilkinson; Ke Zhou; Nici Zimmermann; Michael Davies; David Osrin. Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health. Wellcome Open Research 2021, 6, 35 .
AMA StyleGemma Moore, Susan Michie, Jamie Anderson, Kristine Belesova, Melanie Crane, Clément Deloly, Sani Dimitroulopoulou, Hellen Gitau, Joanna Hale, Simon J. Lloyd, Blessing Mberu, Kanyiva Muindi, Yanlin Niu, Helen Pineo, Irene Pluchinotta, Aarathi Prasad, Anne Roue-Le Gall, Clive Shrubsole, Catalina Turcu, Ioanna Tsoulou, Paul Wilkinson, Ke Zhou, Nici Zimmermann, Michael Davies, David Osrin. Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health. Wellcome Open Research. 2021; 6 ():35.
Chicago/Turabian StyleGemma Moore; Susan Michie; Jamie Anderson; Kristine Belesova; Melanie Crane; Clément Deloly; Sani Dimitroulopoulou; Hellen Gitau; Joanna Hale; Simon J. Lloyd; Blessing Mberu; Kanyiva Muindi; Yanlin Niu; Helen Pineo; Irene Pluchinotta; Aarathi Prasad; Anne Roue-Le Gall; Clive Shrubsole; Catalina Turcu; Ioanna Tsoulou; Paul Wilkinson; Ke Zhou; Nici Zimmermann; Michael Davies; David Osrin. 2021. "Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health." Wellcome Open Research 6, no. : 35.
Helen Pineo; Ke Zhou; Yanlin Niu; Joanna Hale; Catherine Willan; Melanie Crane; Nici Zimmermann; Susan Michie; Qiyong Liu; Michael Davies. Evidence-informed urban health and sustainability governance in two Chinese cities. Buildings and Cities 2021, 2, 550 -567.
AMA StyleHelen Pineo, Ke Zhou, Yanlin Niu, Joanna Hale, Catherine Willan, Melanie Crane, Nici Zimmermann, Susan Michie, Qiyong Liu, Michael Davies. Evidence-informed urban health and sustainability governance in two Chinese cities. Buildings and Cities. 2021; 2 (1):550-567.
Chicago/Turabian StyleHelen Pineo; Ke Zhou; Yanlin Niu; Joanna Hale; Catherine Willan; Melanie Crane; Nici Zimmermann; Susan Michie; Qiyong Liu; Michael Davies. 2021. "Evidence-informed urban health and sustainability governance in two Chinese cities." Buildings and Cities 2, no. 1: 550-567.
Background Household overcrowding is associated with increased risk of infectious diseases across contexts and countries. Limited data exist linking household overcrowding and risk of COVID-19. We used data collected from the Virus Watch cohort to examine the association between overcrowded households and SARS-CoV-2. Methods The Virus Watch study is a household community cohort of acute respiratory infections in England & Wales that began recruitment in June 2020. We calculated the persons per room for each household and classified accommodation as overcrowded when the number of rooms□was fewer than the number of people. We considered two primary outcomes - PCR-confirmed positive SARS-CoV-2 antigen tests and laboratory confirmed SARS-CoV-2 antibodies (Roche Elecsys anti-N total immunoglobulin assay). We used mixed effects logistic regression models that accounted for household structure to estimate the association between household overcrowding and SARS-CoV-2 infection. Results The proportion of participants with a positive SARS-CoV-2 PCR result was highest in the overcrowded group (6.6%; 73/1,102) and lowest in the under-occupied group (2.9%; 682/23,219). In a mixed effects logistic regression model that included age, sex, ethnicity, household income and geographical region, we found strong evidence of an increased odds of having a positive PCR SARS-CoV-2 antigen result (Odds Ratio 3.72; 95% CI: 1.92, 7.13; p-value < 0.001) and increased odds of having a positive SARS-CoV-2 antibody result in individuals living in overcrowded houses (2.96; 95% CI: 1.13, 7.74; p-value =0.027) compared to people living in under-occupied houses. The proportion of variation at the household level was 75.1% and 74.0% in the PCR and antibody models respectively. Discussion Public health interventions to prevent and stop the spread of SARS-CoV-2 should consider the much greater risk of infection for people living in overcrowded households and pay greater attention to reducing household transmission. There is an urgent need to better recognise housing as a leading determinant of health in the context of a pandemic and beyond.
Robert W Aldridge; Helen Pineo; Ellen Fragaszy; Max Eyre; Jana Kovar; Vincent Nguyen; Sarah Beale; Thomas Byrne; Anna Aryee; Colette Smith; Delanjathan Devakumar; Jonathon Taylor; Srinivasa Vittal Katikireddi; Wing Lam Erica Fong; Cyril Geismar; Parth Patel; Madhumita Shrotri; Isobel Braithwaite; Annalan M D Navaratnam; Anne M Johnson; Andrew Hayward. Household overcrowding and risk of SARS-CoV-2: analysis of the Virus Watch prospective community cohort study in England and Wales. 2021, 1 .
AMA StyleRobert W Aldridge, Helen Pineo, Ellen Fragaszy, Max Eyre, Jana Kovar, Vincent Nguyen, Sarah Beale, Thomas Byrne, Anna Aryee, Colette Smith, Delanjathan Devakumar, Jonathon Taylor, Srinivasa Vittal Katikireddi, Wing Lam Erica Fong, Cyril Geismar, Parth Patel, Madhumita Shrotri, Isobel Braithwaite, Annalan M D Navaratnam, Anne M Johnson, Andrew Hayward. Household overcrowding and risk of SARS-CoV-2: analysis of the Virus Watch prospective community cohort study in England and Wales. . 2021; ():1.
Chicago/Turabian StyleRobert W Aldridge; Helen Pineo; Ellen Fragaszy; Max Eyre; Jana Kovar; Vincent Nguyen; Sarah Beale; Thomas Byrne; Anna Aryee; Colette Smith; Delanjathan Devakumar; Jonathon Taylor; Srinivasa Vittal Katikireddi; Wing Lam Erica Fong; Cyril Geismar; Parth Patel; Madhumita Shrotri; Isobel Braithwaite; Annalan M D Navaratnam; Anne M Johnson; Andrew Hayward. 2021. "Household overcrowding and risk of SARS-CoV-2: analysis of the Virus Watch prospective community cohort study in England and Wales." , no. : 1.
Background: Environmental improvement is a priority for urban sustainability and health and achieving it requires transformative change in cities. An approach to achieving such change is to bring together researchers, decision-makers, and public groups in the creation of research and use of scientific evidence. Methods: This article describes the development of a programme theory for Complex Urban Systems for Sustainability and Health (CUSSH), a four-year Wellcome-funded research collaboration which aims to improve capacity to guide transformational health and environmental changes in cities. Results: Drawing on ideas about complex systems, programme evaluation, and transdisciplinary learning, we describe how the programme is understood to “work” in terms of its anticipated processes and resulting changes. The programme theory describes a chain of outputs that ultimately leads to improvement in city sustainability and health (described in an ‘action model’), and the kinds of changes that we expect CUSSH should lead to in people, processes, policies, practices, and research (described in a ‘change model’). Conclusions: Our paper adds to a growing body of research on the process of developing a comprehensive understanding of a transdisciplinary, multiagency, multi-context programme. The programme theory was developed collaboratively over two years. It involved a participatory process to ensure that a broad range of perspectives were included, to contribute to shared understanding across a multidisciplinary team. Examining our approach allowed an appreciation of the benefits and challenges of developing a programme theory for a complex, transdisciplinary research collaboration. Benefits included the development of teamworking and shared understanding and the use of programme theory in guiding evaluation. Challenges included changing membership within a large group, reaching agreement on what the theory would be ‘about’, and the inherent unpredictability of complex initiatives.
Gemma Moore; Susan Michie; Jamie Anderson; Kristine Belesova; Melanie Crane; Clément Deloly; Sani Dimitroulopoulou; Hellen Gitau; Joanna Hale; Simon J. Lloyd; Blessing Mberu; Kanyiva Muindi; Yanlin Niu; Helen Pineo; Irene Pluchinotta; Aarathi Prasad; Anne Roue-Le Gall; Clive Shrubsole; Catalina Turcu; Ioanna Tsoulou; Paul Wilkinson; Ke Zhou; Nici Zimmermann; Michael Davies; David Osrin. Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health. Wellcome Open Research 2021, 6, 35 .
AMA StyleGemma Moore, Susan Michie, Jamie Anderson, Kristine Belesova, Melanie Crane, Clément Deloly, Sani Dimitroulopoulou, Hellen Gitau, Joanna Hale, Simon J. Lloyd, Blessing Mberu, Kanyiva Muindi, Yanlin Niu, Helen Pineo, Irene Pluchinotta, Aarathi Prasad, Anne Roue-Le Gall, Clive Shrubsole, Catalina Turcu, Ioanna Tsoulou, Paul Wilkinson, Ke Zhou, Nici Zimmermann, Michael Davies, David Osrin. Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health. Wellcome Open Research. 2021; 6 ():35.
Chicago/Turabian StyleGemma Moore; Susan Michie; Jamie Anderson; Kristine Belesova; Melanie Crane; Clément Deloly; Sani Dimitroulopoulou; Hellen Gitau; Joanna Hale; Simon J. Lloyd; Blessing Mberu; Kanyiva Muindi; Yanlin Niu; Helen Pineo; Irene Pluchinotta; Aarathi Prasad; Anne Roue-Le Gall; Clive Shrubsole; Catalina Turcu; Ioanna Tsoulou; Paul Wilkinson; Ke Zhou; Nici Zimmermann; Michael Davies; David Osrin. 2021. "Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health." Wellcome Open Research 6, no. : 35.
Healthy urban development, in the form of buildings and infrastructure, is necessary to reduce disease and injury internationally. The urban development process is complex, characterised by a plurality of actors, decisions, delays, and competing priorities that affect the integration of health and wellbeing. Despite clear shifts in the built environment sector towards considering health, there is a lack of research about how the principles of healthy design are put into practice in development projects. We explored this topic via semi-structured interviews with 31 built environment and public health professionals involved in such projects in Australia, China, England, the Netherlands, Sweden and the United States. We used thematic analysis and three themes emerged from our hybrid deductive and inductive approach, encompassing challenges and potential solutions for integrating health in development. Managing risk, responsibility and economic constraints were paramount to persuade developers to adopt healthy design measures. Participants could push business-as-usual practices towards healthy urbanism by showing economic benefits or piloting new approaches. Finally, participants had contrasting views on whether increasing professional knowledge is required, with several arguing that financial barriers are more problematic than knowledge gaps. This exploratory study contributes insights into an under-research topic and outlines priorities for further investigation.
Helen Pineo; Gemma Moore. Built environment stakeholders’ experiences of implementing healthy urban development: an exploratory study. Cities & Health 2021, 1 -15.
AMA StyleHelen Pineo, Gemma Moore. Built environment stakeholders’ experiences of implementing healthy urban development: an exploratory study. Cities & Health. 2021; ():1-15.
Chicago/Turabian StyleHelen Pineo; Gemma Moore. 2021. "Built environment stakeholders’ experiences of implementing healthy urban development: an exploratory study." Cities & Health , no. : 1-15.
Summary Transdisciplinary research approaches are being applied to today’s complex health problems, including the climate crisis and widening inequalities. Diverse forms of disciplinary and experiential knowledge are required to understand these challenges and develop workable solutions. We aimed to create an updated model reflective of the strengths and challenges of current transdisciplinary health research that can be a guide for future studies. We searched Medline using terms related to transdisciplinary, health and research. We coded data deductively and inductively using thematic analysis to develop a preliminary model of transdisciplinary research. The model was tested and improved through: (i) a workshop with 27 participants at an international conference in Xiamen, China and (ii) online questionnaire feedback from included study authors. Our revised model recommends the following approach: (i) co-learning, an ongoing phase that recognizes the distributed nature of knowledge generation and learning across partners; (ii) (pre-)development, activities that occur before and during project initiation to establish a shared mission and ways of working; (iii) reflection and refinement to evaluate and improve processes and results, responding to emergent information and priorities as an ongoing phase; (iv) conceptualization to develop goals and the study approach by combining diverse knowledge; (v) investigation to conduct the research; (vi) implementation to use new knowledge to solve societal problems. The model includes linear and cyclical processes that may cycle back to project development. Our new model will support transdisciplinary research teams and their partners by detailing the necessary ingredients to conduct such research and achieve health impact.
Helen Pineo; Eleanor R Turnbull; Michael Davies; Mike Rowson; Andrew C Hayward; Graham Hart; Anne M Johnson; Robert W Aldridge. A new transdisciplinary research model to investigate and improve the health of the public. Health Promotion International 2021, 36, 481 -492.
AMA StyleHelen Pineo, Eleanor R Turnbull, Michael Davies, Mike Rowson, Andrew C Hayward, Graham Hart, Anne M Johnson, Robert W Aldridge. A new transdisciplinary research model to investigate and improve the health of the public. Health Promotion International. 2021; 36 (2):481-492.
Chicago/Turabian StyleHelen Pineo; Eleanor R Turnbull; Michael Davies; Mike Rowson; Andrew C Hayward; Graham Hart; Anne M Johnson; Robert W Aldridge. 2021. "A new transdisciplinary research model to investigate and improve the health of the public." Health Promotion International 36, no. 2: 481-492.
A growing number of international standards promote Healthy Built Environment (HBE) principles which aim to enhance occupant and user health and wellbeing. Few studies examine the implementation of these standards; whether and how they affect health through changes to built-environment design, construction, and operations. This study reviews a set of sustainability and HBE standards, based on a qualitative analysis of standard documents, standard and socio-technical literature on normalization and negotiation, and interviews with 31 practitioners from four geographical regions. The analysis indicates that standards can impact individual, organizational, and market-scale definitions of an HBE. Some changes to practice are identified, such as procurement and internal layout decisions. There is more limited evidence of changes to dominant, short-term decision-making practices related to cost control and user engagement in operational decisions. HBE standards risk establishing narrow definitions of health and wellbeing focused on building occupants rather than promoting broader, contextually situated, principles of equity, inclusion, and ecosystem functioning crucial for health. There is a need to improve sustainability and HBE standards to take better account of local contexts and promote systems thinking. Further examination of dominant collective negotiation processes is required to identify opportunities to better embed standards within organizational practice.
Rosalie Callway; Helen Pineo; Gemma Moore. Understanding the Role of Standards in the Negotiation of a Healthy Built Environment. Sustainability 2020, 12, 9884 .
AMA StyleRosalie Callway, Helen Pineo, Gemma Moore. Understanding the Role of Standards in the Negotiation of a Healthy Built Environment. Sustainability. 2020; 12 (23):9884.
Chicago/Turabian StyleRosalie Callway; Helen Pineo; Gemma Moore. 2020. "Understanding the Role of Standards in the Negotiation of a Healthy Built Environment." Sustainability 12, no. 23: 9884.
The globally distributed health impacts of environmental degradation and widening population inequalities require a fundamental shift in understandings of healthy urbanism – including policies and decisions that shape neighbourhood and building design. The built environment tends to disadvantage or exclude women, children, the elderly, disabled, poor and other groups, starting from design and planning stages through to occupation, and this results in avoidable health impacts. Although these concepts are not new, they are rapidly emerging as built environment research and practice priorities without clear understanding of the interconnected aims of healthy environments that are sustainable, equitable and inclusive. This article promotes a new framework – Towards Healthy uRbanism: InclusiVe Equitable Sustainable (THRIVES) – that extends previous conceptualisations and reorients focus towards the existential threat of environmental breakdown and the social injustice created through inequitable and exclusive urban governance and design processes and outcomes. The Framework was developed through synthesising knowledge from research and practice, and by testing this new conceptualisation in a participatory workshop. Ongoing research is exploring implementation of the Framework in practice. If widely adopted, this Framework may contribute towards achieving the goals of sustainable development through a focus on increasing human health and wellbeing in urban development.
Helen Pineo. Towards healthy urbanism: inclusive, equitable and sustainable (THRIVES) – an urban design and planning framework from theory to praxis. Cities & Health 2020, 1 -19.
AMA StyleHelen Pineo. Towards healthy urbanism: inclusive, equitable and sustainable (THRIVES) – an urban design and planning framework from theory to praxis. Cities & Health. 2020; ():1-19.
Chicago/Turabian StyleHelen Pineo. 2020. "Towards healthy urbanism: inclusive, equitable and sustainable (THRIVES) – an urban design and planning framework from theory to praxis." Cities & Health , no. : 1-19.
Anthropogenic environmental change will heavily impact cities, yet associated health risks will depend significantly on decisions made by urban leaders across a wide range of non-health sectors, including transport, energy, housing, basic urban services, and others. A subset of planetary health researchers focus on understanding the urban health impacts of global environmental change, and how these vary globally and within cities. Such researchers increasingly adopt collaborative transdisciplinary approaches to engage policy-makers, private citizens, and other actors in identifying and evaluating potential policy solutions that will reduce environmental impacts in ways that simultaneously promote health, equity, and/or local economies—in other words, maximising ‘co-benefits’. This report presents observations from a participatory workshop focused on challenges and opportunities for urban planetary health research. The workshop, held at the 16th International Conference on Urban Health (ICUH) in Xiamen, China, in November 2019, brought together 49 participants and covered topics related to collaboration, data, and research impact. It featured research projects funded by the Wellcome Trust’s Our Planet Our Health (OPOH) programme. This report aims to concisely summarise and disseminate participants’ collective contributions to current methodological practice in urban planetary health research.
Helen Pineo; Camilla Audia; Daniel Black; Matthew French; Emily Gemmell; Gina Lovasi; James Milner; Felipe Montes; Yanlin Niu; Carolina Pérez-Ferrer; José Siri; Ruzka R. Taruc. Building a Methodological Foundation for Impactful Urban Planetary Health Science. Journal of Urban Health 2020, 98, 442 -452.
AMA StyleHelen Pineo, Camilla Audia, Daniel Black, Matthew French, Emily Gemmell, Gina Lovasi, James Milner, Felipe Montes, Yanlin Niu, Carolina Pérez-Ferrer, José Siri, Ruzka R. Taruc. Building a Methodological Foundation for Impactful Urban Planetary Health Science. Journal of Urban Health. 2020; 98 (3):442-452.
Chicago/Turabian StyleHelen Pineo; Camilla Audia; Daniel Black; Matthew French; Emily Gemmell; Gina Lovasi; James Milner; Felipe Montes; Yanlin Niu; Carolina Pérez-Ferrer; José Siri; Ruzka R. Taruc. 2020. "Building a Methodological Foundation for Impactful Urban Planetary Health Science." Journal of Urban Health 98, no. 3: 442-452.
There are increasing arguments for bridging diverse knowledges and co-producing new knowledge between researchers, professional communities and citizens to create health-promoting built environments. The new THRIVES Framework (Towards Healthy uRbanism: InclusiVe, Equitable, Sustainable) echoes the call that healthy urbanism processes should be participatory and this principle informed the development of the Framework itself, which involved several stages of informal and formal testing with stakeholders, through a process of action research and ‘extended peer review’. Formal feedback about the design of the preliminary Framework and its implementation in built environment practice was gathered through a participatory workshop with 26 built environment and public health professionals in January 2020. Participants were encouraged to share their knowledge, ask questions, critique and provide recommendations. Overall, participants were supportive of the conceptual messages of the THRIVES Framework and more critical of the visual design of the preliminary version. They also questioned whether further resources would be required to implement the Framework. This research created a forum for stakeholders, who may typically be outside the research process, to shape the development of a conceptual framework for healthy urbanism. Further research and collaboration will create resources to bridge the gap between this new conceptualisation and practice.
Helen Pineo; Gemma Moore; Isobel Braithwaite. Incorporating practitioner knowledge to test and improve a new conceptual framework for healthy urban design and planning. Cities & Health 2020, 1 -16.
AMA StyleHelen Pineo, Gemma Moore, Isobel Braithwaite. Incorporating practitioner knowledge to test and improve a new conceptual framework for healthy urban design and planning. Cities & Health. 2020; ():1-16.
Chicago/Turabian StyleHelen Pineo; Gemma Moore; Isobel Braithwaite. 2020. "Incorporating practitioner knowledge to test and improve a new conceptual framework for healthy urban design and planning." Cities & Health , no. : 1-16.
Public health practitioners produce urban health indicator (UHI) tools to inform built environment policy and decision-making, among other objectives. Indicator producers perceive UHI tools as an easily understandable form of evidence about the urban environment impact on health for policy-makers’ consumption. However, indicator producers often conceptualise policy-making as a rational and linear process, therefore underestimating the complex and contested nature of developing and implementing policy. This study investigates the health-promotion value of UHI tools in the complex urban planning policy and decision-making context. A thematic analysis was conducted following semi-structured interviews with 22 indicator producers and users in San Francisco, Melbourne and Sydney. The analysis was informed by collaborative rationality and systems theories and the results were used to develop causal loop diagrams (CLDs) of producers and users’ mental models. The preliminary CLDs were tested and improved through a participatory modelling workshop (six participants). A high-level CLD depicts users and producers’ shared mental model in which indicator development and use are embedded in policy development and application processes. In the cases analysed, creating and using UHI tools increased inter-sectoral relationships, which supported actors to better understand each other’s opportunities and constraints. These relationships spurred new advocates for health in diverse organisations, supporting health-in-all-policies and whole-of-society approaches. Constraints to health-promoting policy and implementation (such as those which are legal, political and economic in nature), were overcome through community involvement in UHI tools and advocacy effectiveness. A number of factors reduced the perceived relevance and authority of UHI tools, including: a high number of available indicators, lack of neighbourhood scale data and poor-quality data. In summary, UHI tools were a form of evidence that influenced local urban planning policy and decision-making when they were embedded in policy processes, networks and institutions. In contrast to the dominant policy impact model in the indicator literature, such evidence did not typically influence policy as an exogenous entity. Indicators had impact when they were embedded in local institutions and well-resourced over time, resulting in trusted relationships and collaborations among indicator producers and users. Further research is needed to explore other governance contexts and how UHI tools affect the power of different actors, particularly for under-represented communities.
Helen Pineo; Nici Zimmermann; Michael Davies. Integrating health into the complex urban planning policy and decision-making context: a systems thinking analysis. Palgrave Communications 2020, 6, 1 -14.
AMA StyleHelen Pineo, Nici Zimmermann, Michael Davies. Integrating health into the complex urban planning policy and decision-making context: a systems thinking analysis. Palgrave Communications. 2020; 6 (1):1-14.
Chicago/Turabian StyleHelen Pineo; Nici Zimmermann; Michael Davies. 2020. "Integrating health into the complex urban planning policy and decision-making context: a systems thinking analysis." Palgrave Communications 6, no. 1: 1-14.
Helen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. Correction to: Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis. Journal of Urban Health 2019, 97, 436 -437.
AMA StyleHelen Pineo, Ketevan Glonti, Harry Rutter, Nici Zimmermann, Paul Wilkinson, Michael Davies. Correction to: Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis. Journal of Urban Health. 2019; 97 (3):436-437.
Chicago/Turabian StyleHelen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. 2019. "Correction to: Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis." Journal of Urban Health 97, no. 3: 436-437.
Helen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. Correction to: Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis. 2019, 1 .
AMA StyleHelen Pineo, Ketevan Glonti, Harry Rutter, Nici Zimmermann, Paul Wilkinson, Michael Davies. Correction to: Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis. . 2019; ():1.
Chicago/Turabian StyleHelen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. 2019. "Correction to: Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis." , no. : 1.
BackgroundAt least 145 urban health indicator (UHI) tools exist internationally. Previous studies have shown that public health researchers and practitioners produce them to inform built environment policy and decision making. Little research exists on their use and how it affects policy. This study used qualitative system dynamics to investigate the benefit and use of UHI tools to promote health in the complex context of urban planning policy and decision making.MethodsThis qualitative system dynamics study involved semistructured interviews with indicator producers (typically public health professionals) and indicator users (typically urban planners) in case study settings of San Francisco (CA, USA), Melbourne (VIC, Australia), and Sydney (NSW, Australia) to ascertain experts' understandings (or mental models) of the use (ie, direct reporting of) and value (ie, knowledge gained leading to policy changes) of UHI tools in urban planning policy and decision making. Exemplifying cases of UHI tools (ie, those designed with characteristics to support policy makers) were selected from the literature and we used purposive sampling to approach potential interview participants through departmental websites and the professional network of HP. We did a thematic analysis using collaborative rationality and systems theories. We constructed causal loop diagrams (CLDs) using system dynamics methods (CLDs represented participants' mental models). We tested whether our preliminary CLDs corresponded to experts' views through a participatory workshop.FindingsInterviews took place on April 5–7, 2016, with six participants in the USA, and March 13–22, 2018, with 16 participants in Australia, and the workshop was on Jan 16, 2019, with six participants in the USA. Indicator users and producers had overlapping mental models of the value and use of UHI tools, and workshop participants broadly agreed with the CLDs. The thematic analysis produced five themes that were represented in CLDs, summarised as follows. Developing and applying UHI tools increases knowledge of the social determinants of health and intersectoral relationships. This supports actors to better understand each other's perspectives and helps create new advocates for health in diverse organisations, supporting health-in-all-policies or whole-of-society approaches. Community involvement in UHI tools and having effective advocates for health reduces obstacles to health-promoting policy. However, the high number of available indicators can create confusion and reduce indicator use.InterpretationUHI tools influence local urban planning when they are embedded in policy processes, networks, and institutions, which often requires long-term funding. Indicator producers should consider such resource requirements and the potential for co-producing indicators to create intersectoral relationships and better respond to users' information needs. Further research is needed to explore how UHI tools affect the power of different actors in governance processes, particularly of under-represented communities.FundingThe Building Research Establishment (BRE) and BRE Trust.
Helen Pineo; Nici Zimmermann; Paul Wilkinson; Michael Davies. Impact of urban health indicators in urban planning policy and decision making: a qualitative system dynamics study. The Lancet 2019, 394, S12 .
AMA StyleHelen Pineo, Nici Zimmermann, Paul Wilkinson, Michael Davies. Impact of urban health indicators in urban planning policy and decision making: a qualitative system dynamics study. The Lancet. 2019; 394 ():S12.
Chicago/Turabian StyleHelen Pineo; Nici Zimmermann; Paul Wilkinson; Michael Davies. 2019. "Impact of urban health indicators in urban planning policy and decision making: a qualitative system dynamics study." The Lancet 394, no. : S12.
Global initiatives have raised awareness of the need for cross-departmental and cross-sectoral activities to support urban health, sustainability, and equity, with respective indicators routinely used as a way to catalyze and monitor action toward pre-defined goals. Despite the existence of at least 145 urban health indicator (UHI) tools globally, there has been very little research on the use of indicators by policy- and decision-makers; more attention has been devoted to their development and validation. This paper describes the second part of a two-part systematic review of the characteristics (part A) and use (part B, this part) of UHI tools by municipal built environment policy- and decision-makers. Part B is a narrative synthesis of studies on the use of UHI tools. This PRISMA-P compliant review follows a mixed methods sequential explanatory design. The search was conducted using seven bibliographic databases, grey literature searches, and key journal hand searches. Ten studies describing the use of ten UHI tools in seven countries were included in the narrative synthesis, resulting in development of a theory of change (ToC). We found that both expert-led and participatory indicator projects can be underpinned by research evidence and residents’ knowledge. Our findings contradict the dominant view of indicator use in policy-making as a linear process, highlighting a number of technical, organizational, political, knowledge, and contextual factors that affect their use. Participatory UHI tools with community involvement were generally more effective at supporting “health in all policies” and “whole-of-society” approaches to governing healthy cities than expert-led processes. UHI tool producers proposed a range of techniques to address urban health complexity characteristics. Finally, in combining data from both parts of the review, we found that potentially important UHI tool features, such as neighbourhood-scale data, were influential in the use of indicators by built environment policy- and decision-makers.
Helen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis. Journal of Heredity 2019, 97, 418 -435.
AMA StyleHelen Pineo, Ketevan Glonti, Harry Rutter, Nici Zimmermann, Paul Wilkinson, Michael Davies. Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis. Journal of Heredity. 2019; 97 (3):418-435.
Chicago/Turabian StyleHelen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. 2019. "Use of Urban Health Indicator Tools by Built Environment Policy- and Decision-Makers: a Systematic Review and Narrative Synthesis." Journal of Heredity 97, no. 3: 418-435.
Helen Pineo. Increasing physical activity and equity in urban regeneration. The Lancet Public Health 2019, 4, e367 -e368.
AMA StyleHelen Pineo. Increasing physical activity and equity in urban regeneration. The Lancet Public Health. 2019; 4 (8):e367-e368.
Chicago/Turabian StyleHelen Pineo. 2019. "Increasing physical activity and equity in urban regeneration." The Lancet Public Health 4, no. 8: e367-e368.
Urban health indicator (UHI) tools provide evidence about the health impacts of the physical urban environment which can be used in built environment policy and decision-making. Where UHI tools provide data at the neighborhood (and lower) scale they can provide valuable information about health inequalities and environmental deprivation. This review performs a census of UHI tools and explores their nature and characteristics (including how they represent, simplify or address complex systems) to increase understanding of their potential use by municipal built environment policy and decision-makers. We searched seven bibliographic databases, four key journals and six practitioner websites and conducted Google searches between January 27, 2016 and February 24, 2016 for UHI tools. We extracted data from primary studies and online indicator systems. We included 198 documents which identified 145 UHI tools comprising 8006 indicators, from which we developed a taxonomy. Our taxonomy classifies the significant diversity of UHI tools with respect to topic, spatial scale, format, scope and purpose. The proportions of UHI tools which measure data at the neighborhood and lower scale, and present data via interactive maps, have both increased over time. This is particularly relevant to built environment policy and decision-makers, reflects growing analytical capability and offers the potential for improved understanding of the complexity of influences on urban health (an aspect noted as a particular challenge by some indicator producers). The relation between urban health indicators and health impacts attributable to modifiable environmental characteristics is often indirect. Furthermore, the use of UHI tools in policy and decision-making appears to be limited, thus raising questions about the continued development of such tools by multiple organisations duplicating scarce resources. Further research is needed to understand the requirements of built environment policy and decision-makers, public health professionals and local communities regarding the form and presentation of indicators which support their varied objectives.
Helen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. Urban Health Indicator Tools of the Physical Environment: a Systematic Review. Journal of Urban Health 2018, 95, 613 -646.
AMA StyleHelen Pineo, Ketevan Glonti, Harry Rutter, Nici Zimmermann, Paul Wilkinson, Michael Davies. Urban Health Indicator Tools of the Physical Environment: a Systematic Review. Journal of Urban Health. 2018; 95 (5):613-646.
Chicago/Turabian StyleHelen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. 2018. "Urban Health Indicator Tools of the Physical Environment: a Systematic Review." Journal of Urban Health 95, no. 5: 613-646.
There is a growing awareness among city leaders and policy-makers of the impact of the urban environment on health outcomes and inequalities. Increasingly, practitioners in built environment city departments, such as housing, planning, transport and regeneration, seek new tools and guidance to understand how their respective policies and decisions can support the creation of healthier cities. This paper presents the development of a global index to help city leaders and practitioners understand their role in delivering health outcomes through urban environment policies and programmes. The Building Research Establishment’s international Healthy Cities Index (BRE HCI) contains 10 environment categories and 58 indicators, supported by a causal pathways framework. This was achieved through an iterative process including: stakeholder engagement, evaluating research evidence, selecting indicators and identifying data sources. We tested the index and causal pathways approach on two case study cities: Dubai and London. We found that they contributed to: raising awareness of the links between the environment and health; identifying shared responsibilities and the need to work across departmental silos; and uncovering the competing demands faced by some departments (and private sector stakeholders) as they seek to deliver health promoting environments alongside other objectives.
Helen Pineo; Nici Zimmermann; Ellie Cosgrave; Robert W. Aldridge; Michele Acuto; Harry Rutter. Promoting a healthy cities agenda through indicators: development of a global urban environment and health index. Cities & Health 2018, 2, 27 -45.
AMA StyleHelen Pineo, Nici Zimmermann, Ellie Cosgrave, Robert W. Aldridge, Michele Acuto, Harry Rutter. Promoting a healthy cities agenda through indicators: development of a global urban environment and health index. Cities & Health. 2018; 2 (1):27-45.
Chicago/Turabian StyleHelen Pineo; Nici Zimmermann; Ellie Cosgrave; Robert W. Aldridge; Michele Acuto; Harry Rutter. 2018. "Promoting a healthy cities agenda through indicators: development of a global urban environment and health index." Cities & Health 2, no. 1: 27-45.
CITY KNOW-HOW Human health and planetary health are both influenced by city lifestyles, city leadership, and city development. For both, worrying trends are leading to increasing concern. It is imperative that both become core foci in urban policy. Changing the trajectory will require concerted action. The journal Cities & Health journal is dedicated to supporting the flow of knowledge, in all directions to help make this happen. We want to support communication between researchers, practitioners, policy-makers, communities and decision-makers in cities. This is the purpose of this City Know-how section of the journal. ‘Research for city practice’ disseminates lessons from research, explaining the key messages for city leaders, communities and the professions involved in city policy and practice. ‘City shorts’ provide glimpses of what is being attempted or achieved. ’Case studies’ are where you will find evaluations of interventions and ‘Commentary and debate’ helps extend the conversations we are having and develop much needed new thinking. Join in these conversations. In service to strengthening the community of interest, we would like to include many and varied voices, including those from younger practitioners and researchers, connected with supporting health and health equity in everyday urban lives.
Marcus Grant; Caroline Brown; Michele Acuto; Rob Aldridge; Hannah Badland; Ellie Cosgrave; Billie Giles-Corti; Luis F. Gomez; William Hatton; Helen Jordan; Bruno Marques; Jacqueline McIntosh; Christopher Millett; Victoria Morckel; Maureen Murphy; Diana C. Parra; Helen Pineo; Jose D. Pinzon; Harry Rutter; Greg Rybarczyk; Nici Zimmermann. City Know-how. Cities & Health 2018, 2, 1 -10.
AMA StyleMarcus Grant, Caroline Brown, Michele Acuto, Rob Aldridge, Hannah Badland, Ellie Cosgrave, Billie Giles-Corti, Luis F. Gomez, William Hatton, Helen Jordan, Bruno Marques, Jacqueline McIntosh, Christopher Millett, Victoria Morckel, Maureen Murphy, Diana C. Parra, Helen Pineo, Jose D. Pinzon, Harry Rutter, Greg Rybarczyk, Nici Zimmermann. City Know-how. Cities & Health. 2018; 2 (1):1-10.
Chicago/Turabian StyleMarcus Grant; Caroline Brown; Michele Acuto; Rob Aldridge; Hannah Badland; Ellie Cosgrave; Billie Giles-Corti; Luis F. Gomez; William Hatton; Helen Jordan; Bruno Marques; Jacqueline McIntosh; Christopher Millett; Victoria Morckel; Maureen Murphy; Diana C. Parra; Helen Pineo; Jose D. Pinzon; Harry Rutter; Greg Rybarczyk; Nici Zimmermann. 2018. "City Know-how." Cities & Health 2, no. 1: 1-10.
BackgroundUrban health indicator (UHI) tools offer one form of evidence about the urban environment's impact on health to inform built environment policy and decision making, particularly in relation to health and spatial inequalities. Many UHI tools have been developed, potentially duplicating scarce resources, with little knowledge of their subsequent impact on policy. This study aimed to examine the nature and characteristics of UHI tools to increase understanding of their potential use by municipal built environment policy and decision-makers.MethodsThe methods of this systematic review are detailed in our published protocol, including a PRISMA-P checklist. We defined UHI tools as compilations of UHIs that needed to measure at least two physical urban environment characteristics. We searched seven bibliographic databases, four key journals, and six practitioner websites, and conducted Google searches between Jan 27, 2016, and Feb 24, 2016, for UHI tools. We extracted data from primary studies and online indicator systems.FindingsWe included 198 documents, which identified 145 UHI tools comprising 8006 indicators, from which we developed a taxonomy of indicators (using a hybrid inductive and deductive approach). The diversity in UHI tools was extensive with respect to topic, spatial scale, format, scope, and purpose, which we identified as key taxonomic classifiers. Over time, the proportion of UHI tools that measured data at the neighbourhood and lower scale increased, as did the proportion of tools that presented data via interactive maps. This increase reflected growing analytical capability, and offered the potential for improved understanding of the complexity of influences on urban health (an aspect noted as being especially challenging by some indicator producers).InterpretationUHI tools of increasing sophistication provide insights into multiple dimensions of the urban environment and their impacts on health, but they are not always used in the policy and decision-making process. In addition, many indicators have only an indirect association with health impacts attributable to modifiable urban environment characteristics. Further research is needed to understand the form and presentation of indicators that are of greatest utility to built environment policy development, and that reflect community input and health and development priorities.FundingHP is fully funded by the Building Research Establishment Ltd. HR was supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North Thames at Barts Health NHS Trust.
Helen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. Census, characteristics, and taxonomy of urban health indicator tools: a systematic review. The Lancet 2017, 390, S70 .
AMA StyleHelen Pineo, Ketevan Glonti, Harry Rutter, Nici Zimmermann, Paul Wilkinson, Michael Davies. Census, characteristics, and taxonomy of urban health indicator tools: a systematic review. The Lancet. 2017; 390 ():S70.
Chicago/Turabian StyleHelen Pineo; Ketevan Glonti; Harry Rutter; Nici Zimmermann; Paul Wilkinson; Michael Davies. 2017. "Census, characteristics, and taxonomy of urban health indicator tools: a systematic review." The Lancet 390, no. : S70.