Evaluation of the implementation of an intervention to improve the street environment and promote walking for transport in deprived neighbourhoods

Adams, Emma J.; Cavill, Nick; Sherar, Lauren B.

Abstract

Background:
Levels of physical activity remain low, particularly in deprived areas. Improving the street environment to promote walking for transport using a community engagement approach is a potential strategy to increase physical activity. An understanding of the implementation of this intervention approach is needed to facilitate further research, replication and scale-up. The aim of this study was to evaluate the implementation of the Fitter for Walking (FFW) intervention in deprived neighbourhoods.

Methods:
FFW was delivered in five regions of England between August 2008 and March 2012 and aimed to use a community engagement approach to improve the street environment to promote walking for transport. Implementation was assessed in relation to reach; dosage; implementation processes and adaptation; and factors influencing implementation. Three data sources were used: focus groups and face-to-face interviews with coordinators; implementation logs; and participation records.

Results:
Reach: 155 community groups participated in FFW engaging 30,230 local residents. Dosage: A wide variety of environmental improvements were implemented by local authorities (LAs) (42 projects) and by communities (46 projects). Examples of LA-led improvements included removal of encroaching vegetation, new/improved pedestrian signage, new dropped kerbs/kerb improvements and new, repaired or improved footpaths. Examples of community-led improvements included planting bulbs, shrubs or bedding plants, clean-up days and litter pick-ups. In 32 projects, no environmental improvements were implemented. Promotional and awareness-raising activities were undertaken in 81 projects. Examples included led walks, themed walks, development of maps/resources to promote improved routes and community events. Processes and adaptation: The need for a planning phase, a preparatory phase, and a delivery phase with a four step process were identified. Adaptability to local context was important. Factors influencing implementation: Five key themes were identified in relation to the barriers and facilitators of implementing FFW: local knowledge and contacts; intervention delivery; coordinator role; working with LAs and other partners; and working with communities.

Conclusions
FFW is one of few reported interventions which have used a community engagement approach to change the street environment to promote walking for transport in deprived neighbourhoods. Delivering these types of interventions is complex and requires considerable resource and time. A set of recommendations and an implementation framework are proposed for future delivery of this and similar types of programme.

Citation

Adams, E. J., Cavill, N., & Sherar, L. B. (2017). Evaluation of the implementation of an intervention to improve the street environment and promote walking for transport in deprived neighbourhoods. BMC Public Health, 17, Article 655. https://doi.org/10.1186/s12889-017-4637-5

• Journal Article Type: Article
• Acceptance Date: Jul 26, 2017
• Online Publication Date: Aug 14, 2017
• Publication Date: 2017-12
• Deposit Date: Jan 31, 2022
• Publicly Available Date: Jan 31, 2022
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 17
• Article Number: 655
• DOI: https://doi.org/10.1186/s12889-017-4637-5
• Keywords: Public Health, Environmental and Occupational Health
• Public URL: https://nottingham-repository.worktribe.com/output/7357834
• Publisher URL: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4637-5