Area-based interventions to ameliorate deprived Dutch neighborhoods in practice: Does the Dutch District Approach address the social determinants of health to such an extent that future health impacts may be expected?

The impact of intervening in green space in Dutch deprived neighbourhoods on physical activity and general health: results from the quasi-experimental URBAN40 study

“…It is possible that the health impact of the improvements in green space may have been outweighed by the impact of other interventions that discouraged physical activity and led to a detrimental health impact. Information on the amount, duration and scale of 17 other types of interventions that were part of the District Approach was summarised in one measure that reflected the intensity of the District Approach 23. Adjustment of the results presented here for this summary measure did not alter any of the results (results not shown).…”

“…We used standardised questionnaires and face-to-face interviews with local managers 23. This procedure yielded complete information on the implementation of the District Approach in 36 neighbourhoods.…”

“…All analyses were adjusted for age (continuous), sex, household composition (four categories), ethnicity (Dutch, western non-Dutch, non-western ethnic background and unknown), education (five ordinal groups), and standardised disposable household income (quintiles) at the individual level. Additionally, we adjusted for the overall intensity of the District Approach, based on the number of interventions across all 18 different types of activities (for detailed description, see Droomers et al ),23 in an attempt to adjust for the impact of the other interventions that were carried out within the context of the District Approach. The intensity of the District Approach, however, did not change our findings; results of these analyses are, therefore, not reported.…”

The impact of greenery on physical activity and mental health of adolescent and adult residents of deprived neighborhoods: A longitudinal study

“…Seventh and finally, although interviews and audits may have many advantages over the use of Geographical Information Systems, the basis for the objective changes in greenery was information given by the district managers. As noted by Droomers and colleagues (Droomers et al, 2014), not all activities might have been reported which may have led to an underestimation of intervention activities actually conducted. Moreover, the consequence of this approach was that objective measures were only available for 10 out of 20 districts, as interventions were only conducted in the districts from the Dutch District Approach.…”

“…The questionnaire focused on 18 different types of activities, among which investments to improve green space in a specific district. For each district, we listed all activities implemented in this field of action for longer than 1 year (see Droomers et al (2014) for more information). We distinguished between districts that improved their green character (e.g.…”