Natural experimental studies point the way for healthy transport policies
A shift towards more active lifestyles could be a ‘best buy’ for improving public health, and CEDAR has been leading the way in developing and applying innovative methods to learn more about how changes to our physical environment might affect our travel choices, physical activity and health.
The opening in 2011 of the Cambridgeshire Guided Busway (a new bus network with a high-quality off-road path for walking and cycling) provided the opportunity for a natural experimental study of the effect on residents’ travel patterns.
The study showed that how people travelled to work depended on many different factors, ranging from childcare to parking. Nevertheless, over time, people living closer to the busway were more likely to increase their cycling, and less likely to use their car, for commuting than those living further away. This demonstrated how changing transport systems has the potential to improve people’s health through physical activity.
Among other work in this area, CEDAR also led the evaluation work package of iConnect (Impact of COnstructing Non-motorised Networks and Evaluating Changes in Travel). This multidisciplinary study integrated various perspectives from public health and transport research. It evaluated the travel, physical activity and carbon impacts of Sustrans’ Connect programme, a UK-wide project to create new traffic-free crossings and bridges to enable access to schools, shops, parks and countryside.
Results showed that these new routes have encouraged more people to get about by foot and by bike, and it was one of the first studies to show that changing the environment to support walking and cycling in the UK can have measurable benefits for public health. The study also highlighted the importance of multi-sectoral and cross-disciplinary collaboration across research, policy and practice in encouraging healthy transport policies.
SPEEDY to GoActive, from observation to interventions with Centre support
Prior to establishing CEDAR, the Behavioural Epidemiology Programme at the MRC Epidemiology Unit was developing a world-leading body of work on correlates and determinants of physical activity behaviour in young people, with the aim of informing future intervention development.
The UKCRC investment in CEDAR enabled the team to accelerate the learning from this observational research and to initiate the translation of this evidence into the development of interventions targeting physical activity in young people.
Observational work demonstrated the importance of the periods outside of school lesson times for changes in young people’s physical activity, and that the factors influencing this change are time- and context-specific.
This led to an investigation of how and where adolescents would like to change behaviour, showing the importance of choice and flexibility in the types and locations of activity and who to engage with.
CEDAR investment into further work to develop interventions for adolescents led to the initiation of GoActive – www.goactive-uk.com – an intervention targeting the whole of Year 9 and offering flexibility, competition, mentorship, rewards, novelty, and choice.
Following successful preliminary feasibility and pilot testing, the team were awarded an NIHR Public Health Research grant to evaluate the effectiveness of GoActive in 16 secondary schools in over 2500 students, a study which is ongoing3. An embedded mixed-methods process evaluation is included to help understand how and why the GoActive intervention works.