The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results

被引:17
作者
Phillips, Gemma [1 ]
Renton, Adrian [1 ]
Moore, Derek G. [3 ]
Bottomley, Christian [2 ]
Schmidt, Elena [1 ]
Lais, Shahana [1 ]
Yu, Ge [1 ]
Wall, Martin [4 ]
Tobi, Patrick [1 ]
Frostick, Caroline [3 ]
Clow, Angela [5 ]
Lock, Karen [6 ]
Petticrew, Mark [7 ]
Hayes, Richard [2 ]
机构
[1] Univ E London, Inst Hlth & Human Dev, London E15 4LZ, England
[2] Univ London London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, Dept Infect Dis Epidemiol, Trop Epidemiol Grp, London WC1E 7HT, England
[3] Univ E London, Inst Res Child Dev, London E15 4LZ, England
[4] Ctr Social & Hlth Outcomes Res & Evaluat, Auckland, New Zealand
[5] Univ Westminster, Dept Psychol, London W1B 2UW, England
[6] London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London WC1H 9SH, England
[7] London Sch Hyg & Trop Med, Dept Social & Environm Hlth Res, London WC1H 9SH, England
基金
英国医学研究理事会; 英国惠康基金;
关键词
Cluster randomized trial; Community engagement; Health promotion; Physical activity; Healthy eating; Mental wellbeing; Social determinants; EVALUATING-COMPLEX-INTERVENTIONS; PHYSICAL-ACTIVITY QUESTIONNAIRE; START LOCAL-PROGRAMS; AREA DEPRIVATION; MULTIPLE IMPUTATION; ILL HEALTH; IMPROVEMENT PROGRAMS; CONSTRUCT-VALIDITY; FOOD ENVIRONMENT; SCALE WEMWBS;
D O I
10.1186/1745-6215-13-105
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT). The baseline survey data are reported here. Methods: The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs); ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. Results: There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of physical activity were higher in the Well London adult population but this is likely to be due to the different measurement tools used in the two surveys. Conclusions: Randomization of social interventions such as Well London is acceptable and feasible and in this study the intervention and control arms are well-balanced with respect to the primary outcomes and key sociodemographic characteristics. The matched design has improved the statistical efficiency of the study amongst adults but less so amongst adolescents. Follow-up data collection will be completed 2012.
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页数:15
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