Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial.

Journal article


Wall, M, Hayes, R, Moore, D, Petticrew, M, Clow, A, Schmidt, E, Draper, A, Lock, K, Lynch, R and Renton, A (2009). Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial. BMC Public Health. 9 (1), p. 207. https://doi.org/10.1186/1471-2458-9-207
AuthorsWall, M, Hayes, R, Moore, D, Petticrew, M, Clow, A, Schmidt, E, Draper, A, Lock, K, Lynch, R and Renton, A
Abstract

BACKGROUND: In London and the rest of the UK, diseases associated with poor diet, inadequate physical activity and mental illness account for a large proportion of area based health inequality. There is a lack of evidence on interventions promoting healthier behaviours especially in marginalised populations, at a structural or ecological level and utilising a community development approach.The Well London project financed by the Big Lottery 'Wellbeing' Fund and implemented by a consortium of London based agencies led by the Greater London Authority and the London Health Commission is implementing a set of complex interventions across 20 deprived areas of London. The interventions focus on healthy eating, healthy physical activity and mental health and wellbeing and are designed and executed with community participation complementing existing facilities and services. METHODS/DESIGN: The programme will be evaluated through a cluster randomised controlled trial. Forty areas across London were chosen based on deprivation scores. Areas were characterised by high proportion of Black and Minority Ethnic residents, worklessness, ill-health and poor physical environments. Twenty areas were randomly assigned to the intervention arm of Well London project and twenty 'matched' areas assigned as controls. Measures of physical activity, diet and mental health are collected at start and end of the project and compared to assess impact.The quantitative element will be complemented by a longitudinal qualitative study elucidating pathways of influence between intervention activities and health outcomes. A related element of the study investigates the health-related aspects of the structural and ecological characteristics of the project areas. The project 'process' will also be evaluated. DISCUSSION: The size of the project and the fact that the interventions are 'complex' in the sense that firstly, there are a number of interacting components with a wide range of groups and organisational levels targeted by the intervention, and secondly, a degree of flexibility or tailoring of the intervention, makes this trial potentially very useful in providing evidence of the types of activities that can be used to address chronic health problems in communities suffering from multiple deprivation. TRIAL REGISTRATION: Current Controlled Trials ISRCTN68175121.

KeywordsHumans; Health Surveys; Health Status Indicators; Cluster Analysis; Data Interpretation, Statistical; Longitudinal Studies; Attitude to Health; Socioeconomic Factors; Adolescent; Adult; Ethnic Groups; Health Promotion; Community Health Services; Health Services Research; London; Adolescent; Adult; Attitude to Health; Cluster Analysis; Community Health Services; Data Interpretation, Statistical; Ethnic Groups; Health Promotion; Health Services Research; Health Status Indicators; Health Surveys; Humans; London; Longitudinal Studies; Socioeconomic Factors; 1117 Public Health And Health Services; Public Health
Year2009
JournalBMC Public Health
Journal citation9 (1), p. 207
PublisherBMC
ISSN1471-2458
Digital Object Identifier (DOI)https://doi.org/10.1186/1471-2458-9-207
Publication dates
Print28 Jun 2009
Publication process dates
Deposited26 Feb 2018
Accepted28 Jun 2009
Accepted author manuscript
License
File Access Level
Open
Permalink -

https://openresearch.lsbu.ac.uk/item/87q4z

  • 67
    total views
  • 139
    total downloads
  • 1
    views this month
  • 1
    downloads this month

Export as

Related outputs

Disability inclusive elections in Africa: a systematic review of published and unpublished literature
Virendrakumar, B, Jolley, E, Badu, E and Schmidt, E (2018). Disability inclusive elections in Africa: a systematic review of published and unpublished literature. Disability and Society. 33 (4), pp. 1-30. https://doi.org/10.1080/09687599.2018.1431108
‘Maybe I will give some help…. maybe not to help the eyes but different help’: an analysis of care and support of children with visual impairment in community settings in Malawi
Gladstone, M, McLinden, M, Douglas, G, Jolley, E, Schmidt, E, Chimoyo, J, Magombo, H and Lynch, P (2017). ‘Maybe I will give some help…. maybe not to help the eyes but different help’: an analysis of care and support of children with visual impairment in community settings in Malawi. Child: Care, Health and Development. 43 (4), pp. 608-620. https://doi.org/10.1111/cch.12462
Cohort differences in exercise adherence among primary care patients referred for mental health versus physical health conditions.
Tobi, P, Kemp, P and Schmidt, E (2017). Cohort differences in exercise adherence among primary care patients referred for mental health versus physical health conditions. Primary Health Care Research and Development. 18 (5), pp. 463-471. https://doi.org/10.1017/S1463423617000214
Education and social inclusion of people with disabilities in five countries in West Africa: a literature review
Jolley, E, Lynch, P, Virendrakumar, B, Rowe, S and Schmidt, E (2017). Education and social inclusion of people with disabilities in five countries in West Africa: a literature review. Disability and Rehabilitation. 40 (22), pp. 2704-2712. https://doi.org/10.1080/09638288.2017.1353649
Employment Supports for Adults With Disabilities in Low- and Middle-Income Countries
Tripney, J, Hogrebe, N, Schmidt, E, Vigurs, C and Stewart, R (2017). Employment Supports for Adults With Disabilities in Low- and Middle-Income Countries. Research on Social Work Practice. 29 (3), pp. 243-255. https://doi.org/10.1177/1049731517715316
The cost of mapping trachoma: data from the Global Trachoma Mapping Project
Trotignon, G, Jones, E, Engels, T, Schmidt, E, McFarland, DA, Macleod, CK, Amer, K, Bio, AA, Bakhtiar, A, Bovill, S, Doherty, AH, Khan, AA, Mbofana, M, McCullagh, S, Millar, T, Mwale, C, Rotondo, LA, Weaver, A, Willis, R and Solomon, AW (2017). The cost of mapping trachoma: data from the Global Trachoma Mapping Project. PLoS Neglected Tropical Diseases. 11 (10), pp. 1-19. https://doi.org/10.1371/journal.pntd.0006023
Integration of Eye Health into Primary Care Services in Tanzania: A Qualitative Investigation of Experiences in Two Districts.
Jolley, E, Mafwiri, M, Hunter, J and Schmidt, E (2017). Integration of Eye Health into Primary Care Services in Tanzania: A Qualitative Investigation of Experiences in Two Districts. BMC Health Services Research. 17 (823), pp. 1-12. https://doi.org/10.1186/s12913-017-2787-x
The impact of climate on the abundance of Musca sorbens, the vector of trachoma
Ramesh, A, Bristow, J, Kovats, S, Lindsay, SW, Haslam, D, Schmidt, E and Gilbert, C (2016). The impact of climate on the abundance of Musca sorbens, the vector of trachoma. Parasites & Vectors. 9 (1). https://doi.org/10.1186/s13071-016-1330-y
Mixed methods evaluation of a primary eye care training programme for primary health workers in Morogoro Tanzania
Mafwiri, M, Jolley, E, Hunter, J, Gilbert, CE and Schmidt, E (2016). Mixed methods evaluation of a primary eye care training programme for primary health workers in Morogoro Tanzania. BMC Nursing. 15 (1). https://doi.org/10.1186/s12912-016-0163-5
Factors Associated with Ivermectin Non-Compliance and Its Potential Role in Sustaining Onchocerca volvulus Transmission in the West Region of Cameroon
Senyonjo, L, Oye, J, Bakajika, D, Biholong, B, Tekle, A, Boakye, D, Schmidt, E and Elhassan, E (2016). Factors Associated with Ivermectin Non-Compliance and Its Potential Role in Sustaining Onchocerca volvulus Transmission in the West Region of Cameroon. PLoS Neglected Tropical Diseases. 10 (8), pp. e0004905-e0004905. https://doi.org/10.1371/journal.pntd.0004905
Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals.
Bozzani, FM, Griffiths, UK, Blanchet, K and Schmidt, E (2014). Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals. BMC Health Services Research. 14 (1), p. 94. https://doi.org/10.1186/1472-6963-14-94
Ocular morbidity and health seeking behaviour in Kwara state, Nigeria: implications for delivery of eye care services.
Senyonjo, L, Lindfield, R, Mahmoud, A, Kimani, K, Sanda, S and Schmidt, E (2014). Ocular morbidity and health seeking behaviour in Kwara state, Nigeria: implications for delivery of eye care services. PLoS ONE. 9 (8), p. e104128. https://doi.org/10.1371/journal.pone.0104128
Physical activity in deprived communities in London: examining individual and neighbourhood-level factors.
Watts, P, Phillips, G, Petticrew, M, Hayes, R, Bottomley, C, Yu, G, Schmidt, E, Tobi, P, Moore, D, Frostick, C, Lock, K and Renton, A (2013). Physical activity in deprived communities in London: examining individual and neighbourhood-level factors. PLoS ONE. 8 (7), p. e69472. https://doi.org/10.1371/journal.pone.0069472
Prevalence and causes of ocular morbidity in Mbeere District, Kenya. Results of a population-based survey.
Kimani, K, Lindfield, R, Senyonjo, L, Mwaniki, A and Schmidt, E (2013). Prevalence and causes of ocular morbidity in Mbeere District, Kenya. Results of a population-based survey. PLoS ONE. 8 (8), p. e70009. https://doi.org/10.1371/journal.pone.0070009
The impact of climatic risk factors on the prevalence, distribution, and severity of acute and chronic trachoma.
Ramesh, A, Kovats, S, Haslam, D, Schmidt, E and Gilbert, CE (2013). The impact of climatic risk factors on the prevalence, distribution, and severity of acute and chronic trachoma. PLoS Neglected Tropical Diseases. 7 (11), p. e2513. https://doi.org/10.1371/journal.pntd.0002513
Types of social capital and mental disorder in deprived urban areas: a multilevel study of 40 disadvantaged London neighbourhoods.
Bertotti, M, Watts, P, Netuveli, G, Yu, G, Schmidt, E, Tobi, P, Lais, S and Renton, A (2013). Types of social capital and mental disorder in deprived urban areas: a multilevel study of 40 disadvantaged London neighbourhoods. PLoS ONE. 8 (12), p. e80127. https://doi.org/10.1371/journal.pone.0080127
The Well London program--a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results.
Phillips, G, Renton, A, Moore, DG, Bottomley, C, Schmidt, E, Lais, S, Yu, G, Wall, M, Tobi, P, Frostick, C, Clow, A, Lock, K, Petticrew, M and Hayes, R (2012). The Well London program--a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results. Trials. 13 (1), p. 105. https://doi.org/10.1186/1745-6215-13-105