Controlled before-after intervention study of suburb-wide street changes to increase walking and cycling: Te Ara Mua-Future Streets study design

Abstract

BackgroundAchieving a shift from car use to walking, cycling and public transport in cities is a crucial part of healthier, more environmentally sustainable human habitats. Creating supportive active travel environments is an important precursor to this shift. The longevity of urban infrastructure necessitates retrofitting existing suburban neighbourhoods. Previous studies of the effects of street changes have generally relied on natural experiments, have included few outcomes, and have seldom attempted to understand the equity impacts of such interventions.MethodsIn this paper we describe the design of Te Ara Mua – Future Streets, a mixed-methods, controlled before-after intervention study to assess the effect of retrofitting street changes at the suburb scale on multiple health, social and environmental outcomes. The study has a particular focus on identifying factors that improve walking and cycling to local destinations in low-income neighbourhoods and on reducing social and health inequities experienced by Māori (Indigenous New Zealanders) and Pacific people. Qualitative system dynamics modelling was used to develop a causal theory for the relationships between active travel, and walking and cycling infrastructure. On this basis we selected outcomes of interest. Together with the transport funder, we triangulated best evidence from the literature, transport policy makers, urban design professionals and community knowledge to develop interventions that were contextually and culturally appropriate. Using a combination of direct observation and random sample face to face surveys, we are measuring outcomes in these domains of wellbeing: road-user behaviour, changes to travel mode for short trips, physical activity, air quality, road traffic injuries, greenhouse gas emissions, and perceptions of neighbourhood social connection, safety, and walking and cycling infrastructure .DiscussionWhile building on previous natural experiments, Te Ara Mua - Future Streets is unique in testing an intervention designed by the research team, community and transport investors together; including a wide range of objective outcome measures; and having an equity focus. When undertaking integrated intervention studies of this kind, a careful balance is needed between epidemiological imperatives, the constraints of transport funding and implementation and community priorities, while retaining the ability to contribute new evidence for healthy, equitable transport policy.The study was retrospectively registered as a clinical trial on 21 June 2018 in the ISCRTN registry: ISRCTN89845334 http://www.isrctn.com/ISRCTN89845334

System Dynamics Applications to Injury and Violence Prevention: a Systematic Review

“…After excluding articles that did not involve an actual SDrelated application and were not injury-related, 62 articles remained. Two members of the research team conducted a thorough text review of these 62 and determined that 18 [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] had a direct and specific link to an injury outcome and utilized a SD-related method or tool (e.g., CLD, SD simulation model). These 18 studies were included in the review (Table 1).…”

“…Since 2009, one to three applications have been published each year. Topic areas included youth violence [50], domestic violence [55,56], community violence [51]; suicide [63]; drug overdose [54,[64][65][66][67]; occupational injury [53]; road traffic injury [52,[58][59][60][61][62]; and traumatic brain injury [57]. Studies were conducted within a variety of geographic contexts and scales.…”

“…Studies were conducted within a variety of geographic contexts and scales. Half of the studies (n=9) [50,51,55,56,[58][59][60][61][62] were framed within the context of one or more specific communities or cities, and one-third (n=6) [54,[63][64][65][66][67] involved a national context. The remaining three occurred within a specific organization [53], a region of a country [52], or the context was not specified [57].…”

Built environment changes and active transport to school among adolescents: BEATS Natural Experiment Study protocol

“…An ecological approach that examines the multiple levels of influence on ATS is essential for developing and identifying effective interventions to promote ATS. Since the randomised controlled trial (RCT) design is rarely feasible due to prohibitive costs associated with changes to the BE 26 and probable opposition presented by town councils and communities to RCTs affecting road infrastructure, natural experiments are considered a priority for examining causal associations between the BE and PA. 27 28 Few natural experiments [29][30][31][32][33] to date have examined the effects of walking and cycling infrastructure changes on PA and active transport in adults, and none have examined the effects of such changes on PA and ATS among adolescents. The practice-based evidence pathway to improving population health, exemplified in natural experiments, is an essential complement to the more established evidence-based practice pathway, typified in the RCT, and is often the only way to generate meaningful evidence to address critical questions about population health interventions.…”

Technology and value network evolution in telehealth

“…In this case, a qualitative system dynamics model can provide insights without the danger of producing wrong numerical outputs (Coyle, 2000). Recent examples of using qualitative system dynamics can be found, for example, in public health (Macmillan et al, 2018) and electric power fields (Riva et al, 2018).…”