David Ogilvie

London School of Hygiene and Tropical Medicine, London, ENG, United Kingdom

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Publications (83)290.94 Total impact

  • Cochrane database of systematic reviews (Online) 04/2014; · 5.70 Impact Factor
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    ABSTRACT: The idea that behaviour can be influenced at population level by altering the environments within which people make choices (choice architecture) has gained traction in policy circles. However, empirical evidence to support this idea is limited, especially its application to changing health behaviour. We propose an evidence-based definition and typology of choice architecture interventions that have been implemented within small-scale micro-environments and evaluated for their effects on four key sets of health behaviours: diet, physical activity, alcohol and tobacco use. We argue that the limitations of the evidence base are due not simply to an absence of evidence, but also to a prior lack of definitional and conceptual clarity concerning applications of choice architecture to public health intervention. This has hampered the potential for systematic assessment of existing evidence. By seeking to address this issue, we demonstrate how our definition and typology have enabled systematic identification and preliminary mapping of a large body of available evidence for the effects of choice architecture interventions. We discuss key implications for further primary research, evidence synthesis and conceptual development to support the design and evaluation of such interventions. This conceptual groundwork provides a foundation for future research to investigate the effectiveness of choice architecture interventions within micro-environments for changing health behaviour. The approach we used may also serve as a template for mapping other under-explored fields of enquiry.
    BMC Public Health 12/2013; 13(1):1218. · 2.08 Impact Factor
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    Inka Barnett, Cornelia Guell, David Ogilvie
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    ABSTRACT: Physical activity patterns have been shown to change significantly across the transition to retirement. As most older adults approach retirement as part of a couple, a better understanding of how spousal pairs influence each other's physical activity behaviour in retirement may help inform more effective interventions to promote physical activity in older age. This qualitative study aimed to explore and describe how couples influence each other's physical activity behaviour in retirement. A qualitative descriptive study that used purposive sampling to recruit seven spousal pairs with at least one partner of each pair recruited from the existing EPIC-Norfolk study cohort in the east of England, aged between 63 and 70 years and recently retired (within 2-6 years). Semi-structured interviews with couples were performed, audio-recorded, transcribed verbatim and analysed using data-driven content analysis. Three themes emerged: spousal attitude towards physical activity, spouses' physical activity behaviour and spousal support. While spouses' attitudes towards an active retirement were concordant, attitudes towards regular exercise diverged, were acquired across the life course and were not altered in the transition to retirement. Shared participation in physical activity was rare and regular exercise was largely an individual and independent habit. Spousal support was perceived as important for initiation and maintenance of regular exercise. Interventions should aim to create supportive spousal environments for physical activity in which spouses encourage each other to pursue their preferred forms of physical activity; should address gender-specific needs and preferences, such as chances for socialising and relaxation for women and opportunities for personal challenges for men; and rather than solely focusing on promoting structured exercise, should also encourage everyday physical activity such as walking for transport.
    BMC Public Health 12/2013; 13(1):1197. · 2.08 Impact Factor
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    ABSTRACT: Retirement is associated with an increase in recreational physical activity but its impact on other domains of activity (at home, for transport) and sedentary behaviour, such as time spent watching television (TV) is unknown. We examined the association between retirement and changes in domain-specific and overall activity and TV viewing. Data were derived from the population-based EPIC (European Prospective Investigation into Cancer)-Norfolk cohort. Physical activity and TV viewing time were self-reported at baseline (1997-2000) and follow-up 2 (2006-2007) by 3334 participants employed at baseline, of whom 785 (24%) were retired at follow-up 1 (2002-2006). Multivariable regression models were fitted to estimate the association between retirement and changes in physical activity and weekly TV viewing time. Compared with continued employment, retirement was associated with a decline in overall activity (men: non-manual, -40.9 MET h/wk; manual, -49.6 MET h/wk; women: non-manual, -26.9 MET h/wk; manual, -31.6 MET h/wk; all p<0.001 (MET, metabolic equivalent of task)). Domain-specific activity declined for transport and occupational (p<0.001) and increased for recreational (p<0.02) and household (p≤0.002) activity. We observed significant interaction between retirement and social class in respect of overall and domain-specific activity apart from household activity. Retirement was associated with a mean increase in TV viewing time, with the largest increase among manual social classes (men: +3.9 h/wk; women: +2.8 h/wk; both p<0.001). Interventions should aim to promote household and transport as well as recreational activity. Further research on the impact of retirement on sedentary behaviour is needed.
    Journal of epidemiology and community health 12/2013; · 3.04 Impact Factor
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    ABSTRACT: Carbon dioxide (CO2) emissions from motorised travel are hypothesised to be associated with individual, household, spatial and other environmental factors. Little robust evidence exists on who contributes most (and least) to travel CO2 and, in particular, the factors influencing commuting, business, shopping and social travel CO2. This paper examines whether and how demographic, socio-economic and other personal and environmental characteristics are associated with land-based passenger transport and associated CO2 emissions. Primary data were collected from 3474 adults using a newly developed survey instrument in the iConnect study in the UK. The participants reported their past-week travel activity and vehicle characteristics from which CO2 emissions were derived using an adapted travel emissions profiling method. Multivariable linear and logistic regression analyses were used to examine what characteristics predicted higher CO2 emissions. CO2 emissions from motorised travel were distributed highly unequally, with the top fifth of participants producing more than two fifth of emissions. Car travel dominated overall CO2 emissions, making up 90% of the total. The strongest independent predictors of CO2 emissions were owning at least one car, being in full-time employment and having a home-work distance of more than 10 km. Income, education and tenure were also strong univariable predictors of CO2 emissions, but seemed to be further back on the causal pathway than having a car. Male gender, late-middle age, living in a rural area and having access to a bicycle also showed significant but weaker associations with emissions production. The findings may help inform the development of climate change mitigation policies for the transport sector. Targeting individuals and households with high car ownership, focussing on providing viable alternatives to commuting by car, and supporting planning and other policies that reduce commuting distances may provide an equitable and efficient approach to meeting carbon mitigation targets.
    Applied Energy. 10/2013; 104:158–169.
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    ABSTRACT: Cycling confers health and environmental benefits, but few robust studies have evaluated large-scale programmes to promote cycling. In England, recent years have seen substantial, town-wide cycling initiatives in six Cycling Demonstration Towns (funded 2005-2011) and 12 Cycling Cities and Towns (funded 2008-2011). The initiatives involved mixtures of capital investment (e.g. cycle lanes) and revenue investment (e.g. cycle training), tailored to each town. This controlled before-after natural experimental study used English census data to examine impacts on the prevalence of travelling to work by bicycle and other modes, comparing changes in the intervention towns with changes in three comparison groups (matched towns, unfunded towns and a national comparison group). We also compared effects between more and less deprived areas, and used random-effects meta-analysis to compare intervention effects between towns. Among 1.3 million commuters in 18 intervention towns, we found that the prevalence of cycling to work rose from 5.8% in 2001 to 6.8% in 2011. This represented a significant increase relative to all three comparison groups (e.g. +0.69 (95% CI 0.60,0.77) percentage points for intervention vs. matched towns). Walking to work also increased significantly compared with comparison towns, while driving to work decreased and public transport use was unchanged. These effects were observed across all fifths of area deprivation, with larger relative changes in deprived areas. There was substantial variation in effect sizes between towns, however, and the average town-level effect on cycling was non-significant (+0.29 (-0.26,0.84) percentage points for intervention vs. matched towns). We conclude that to date, cycling to work has increased (and driving to work decreased) in the intervention towns, in a relatively equitable manner. The variation in effects between towns indicates uncertainty regarding the likely impact of comparable investment in future towns. Nevertheless these results support the case for implementing and evaluating further town-wide cycling initiatives.
    Social Science [?] Medicine 09/2013; · 2.73 Impact Factor
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    ABSTRACT: To assess the predictors of uptake and maintenance of walking and cycling, and of switching to or from the car as the usual mode of travel, for commuting. 655 commuters in Cambridge, UK reported all commuting trips using a seven-day recall instrument in 2009 and 2010. Individual and household characteristics, psychological measures relating to car use and environmental conditions on the route to work were self-reported in 2009. Objective environmental characteristics were assessed using Geographical Information Systems. Associations between uptake and maintenance of commuting behaviours and potential predictors were modelled using multivariable logistic regression. Mean within-participant changes in commuting were relatively small (walking: +3.0minutes/week, s.d. 66.7; cycling: -5.3minutes/week, s.d. 74.7). Self-reported and objectively-assessed convenience of public transport predicted uptake of walking and cycling respectively, while convenient cycle routes predicted uptake of cycling and a pleasant route predicted maintenance of walking. A lack of free workplace parking predicted uptake of walking and alternatives to the car. Less favourable attitudes towards car use predicted continued use of alternatives to the car. Improving the convenience of walking, cycling and public transport and limiting the availability of workplace car parking may promote uptake and maintenance of active commuting.
    Preventive Medicine 08/2013; · 3.50 Impact Factor
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    Dataset: bmjsupp
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    ABSTRACT: Emerging evidence suggests that walking and cycling for different purposes such as transport or recreation may be associated with different attributes of the physical environment. Few studies to date have examined these behaviour-specific associations, particularly in the UK. This paper reports on the development, factor structure and test-retest reliability of a new scale assessing perceptions of the environment in the neighbourhood (PENS) and the associations between perceptions of the environment and walking and cycling for transport and recreation. A new 13-item scale was developed for assessing adults' perceptions of the environment in the neighbourhood (PENS). Three sets of analyses were conducted using data from two sources. Exploratory and confirmatory factor analyses were used to identify a set of summary environmental variables using data from the iConnect baseline survey (n = 3494); test-retest reliability of the individual and summary environmental items was established using data collected in a separate reliability study (n = 166); and multivariable logistic regression was used to determine the associations of the environmental variables with walking for transport, walking for recreation, cycling for transport and cycling for recreation, using iConnect baseline survey data (n = 2937). Four summary environmental variables (traffic safety, supportive infrastructure, availability of local amenities and social order), one individual environmental item (street connectivity) and a variable encapsulating general environment quality were identified for use in further analyses. Intraclass correlations of these environmental variables ranged from 0.44 to 0.77 and were comparable to those seen in other similar scales. After adjustment for demographic and other environmental factors, walking for transport was associated with supportive infrastructure, availability of local amenities and general environment quality; walking for recreation was associated with supportive infrastructure; and cycling for transport was associated only with street connectivity. There was limited evidence of any associations between environmental attributes and cycling for recreation. PENS is acceptable as a short instrument for assessing perceptions of the urban environment. Previous findings that different attributes of the environment may be associated with different behaviours are confirmed. Policy action to create supportive environments may require a combination of environmental improvements to promote walking and cycling for different purposes.
    International Journal of Behavioral Nutrition and Physical Activity 07/2013; 10(1):87. · 3.58 Impact Factor
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    ABSTRACT: INTRODUCTION: Process evaluations of environmental public health interventions tend not to consider issues of spatial equity in programme delivery. However, an intervention is unlikely to be effective if it is not accessible to those in need. Methods are required to enable these considerations to be integrated into evaluations. Using the Healthy Towns programme in England, we demonstrate the potential of spatial equity analysis in the evaluation of environmental interventions for diet and physical activity, examining whether the programme was delivered to those in greatest need. METHODS: Locations of new physical infrastructure, such as cycle lanes, gyms and allotments, were mapped using a geographic information system. A targeting ratio was computed to indicate how well-located the infrastructure was in relation to those at whom it was specifically aimed, as detailed in the relevant project documentation, as well as to generally disadvantaged populations defined in terms of UK Census data on deprivation, age and ethnicity. Differences in targeting were examined using Kruskal-Wallis and t-tests. RESULTS: The 183 separate intervention components identified were generally well located, with estimated targeting ratios above unity for all population groups of need, except for black and ethnic minorities and children aged 5--19 years. There was no evidence that clustering of population groups influenced targeting, or that trade-offs existed when components were specifically targeted at more than one group. CONCLUSIONS: The analysis of spatial equity is a valuable initial stage in assessing the provision of environmental interventions. The Healthy Towns programme can be described as well targeted in that interventions were for the most part located near populations of need.
    International Journal for Equity in Health 06/2013; 12(1):43. · 1.71 Impact Factor
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    David K Humphreys, David Ogilvie
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    ABSTRACT: BACKGROUND: This study applied an equity lens to existing research to investigate what is known about the impact of population-level physical activity interventions on social inequalities. METHODS: We performed a pilot systematic review to assess the availability of information on the social distribution of intervention effects, the targeting or allocation of interventions, and the baseline characteristics of participants. This comprised (i) a rapid review of systematic reviews and (ii) a review and synthesis of a sample of primary studies included in the eligible systematic reviews. RESULTS: We found 19 systematic reviews of environmental and policy interventions. Relatively few of these (26%, n=5) were prospectively designed to examine effects on inequalities, and none were able to fully synthesise evidence of distributional effects. Over 40% of primary studies reported subgroup intervention effects; 18% reported socio-demographic interaction effects. Studies most often compared effectiveness by gender, followed by age, ethnicity, and socio-economic status. For gender, effects appeared to be evenly distributed overall, although heterogeneity in gradients between studies suggested that some interventions affect males and females differently. CONCLUSIONS: Our findings suggest that it is feasible to generate better evidence about how public health interventions may affect health inequalities using existing data and innovative methods of research synthesis.
    International Journal of Behavioral Nutrition and Physical Activity 06/2013; 10(1):76. · 3.58 Impact Factor
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    Cornelia Guell, Jenna Panter, David Ogilvie
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    ABSTRACT: BACKGROUND: Perceptions of the environment appear to be associated with walking and cycling. We investigated the reasons for walking and cycling to or from work despite reporting an unsupportive route environment in a sample of commuters. METHODS: This mixed-method analysis used data collected as part of the Commuting and Health in Cambridge study. 1164 participants completed questionnaires which assessed the travel modes used and time spent on the commute and the perceived environmental conditions on the route to work. A subset of 50 also completed qualitative interviews in which they discussed their experiences of commuting. Participants were included in this analysis if they reported unsupportive conditions for walking or cycling on their route (e.g. heavy traffic) in questionnaires, walked or cycled all or part of the journey to work, and completed qualitative interviews. Using content analysis of these interviews, we investigated their reasons for walking or cycling. RESULTS: 340 participants reported walking or cycling on the journey to work despite unsupportive conditions, of whom 15 also completed qualitative interviews. From these, three potential explanations emerged. First, some commuters found strategies for coping with unsupportive conditions. Participants described knowledge of the locality and opportunities for alternative routes more conducive to active commuting, as well as their cycling experience and acquired confidence to cycle in heavy traffic. Second, some commuters had other reasons for being reliant on or preferring active commuting despite adverse environments, such as childcare arrangements, enjoyment, having more control over their journey time, employers' restrictions on car parking, or the cost of petrol or parking. Finally, some survey respondents appeared to have reported not their own environmental perceptions but those of others such as family members or 'the public', partly to make a political statement regarding the adversity of active commuting in their setting. CONCLUSIONS: Participants report walking and cycling to work despite adverse environmental conditions. Understanding this resilience might be just as important as investigating 'barriers' to cycling. These findings suggest that developing knowledge of safe walking and cycling routes, improving cycling confidence and restricting workplace parking may help to encourage walking and cycling to and from work.
    BMC Public Health 05/2013; 13(1):497. · 2.08 Impact Factor
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    ABSTRACT: OBJECTIVE: To examine whether a relationship exists between active commuting and physical and mental wellbeing. METHOD: In 2009, cross-sectional postal questionnaire data were collected from a sample of working adults (aged 16 and over) in the Commuting and Health in Cambridge study. Travel behaviour and physical activity were ascertained using the Recent Physical Activity Questionnaire (RPAQ) and a seven-day travel-to-work recall instrument from which weekly time spent in active commuting (walking and cycling) was derived. Physical and mental wellbeing were assessed using the Medical Outcomes Study Short Form survey (SF-8). Associations were tested using multivariable linear regression. RESULTS: An association was observed between physical wellbeing (PCS-8) score and time spent in active commuting after adjustment for other physical activity (adjusted regression coefficients 0.48, 0.79 and 1.21 for 30-149 min/week, 150-224 min/week and ≥225 min/week respectively versus <30 min/week, p=0.01 for trend; n=989). No such relationship was found for mental wellbeing (MCS-8) (p=0.52). CONCLUSION: Greater time spent actively commuting is associated with higher levels of physical wellbeing. Longitudinal studies should examine the contribution of changing levels of active commuting and other forms of physical activity to overall health and wellbeing.
    Preventive Medicine 04/2013; · 3.50 Impact Factor
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    ABSTRACT: Objective: Evidence on the effectiveness of walking and cycling interventions is mixed. This may be partly attributable to differences in intervention content, such as the cognitive and behavioral techniques (BCTs) used. Adopting a taxonomy of BCTs, this systematic review addressed two questions: (a) What are the behavior change techniques used in walking and cycling interventions targeted at adults? (b) What characterizes interventions that appear to be associated with changes in walking and cycling in adults? Method: Previous systematic reviews and updated database searches were used to identify controlled studies of individual-level walking and cycling interventions involving adults. Characteristics of intervention design, context, and methods were extracted in addition to outcomes. Intervention content was independently coded according to a 26-item taxonomy of BCTs. Results: Studies of 46 interventions met the inclusion criteria. Twenty-one reported a statistically significant effect on walking and cycling outcomes. Analysis revealed substantial heterogeneity in the vocabulary used to describe intervention content and the number of BCTs coded. "Prompt self-monitoring of behavior" and "prompt intention formation" were the most frequently coded BCTs. Conclusion: Future walking and cycling intervention studies should ensure that all aspects of the intervention are reported in detail. The findings lend support to the inclusion of self-monitoring and intention formation techniques in future walking and cycling intervention design, although further exploration of these and other BCTs is required. Further investigation of the interaction between BCTs and study design characteristics would also be desirable. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Health Psychology 03/2013; · 3.83 Impact Factor
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    ABSTRACT: BACKGROUND: To better understand the health benefits of promoting active travel, it is important to understand the relationship between a change in active travel and changes in recreational and total physical activity. METHODS: These analyses, carried out in April 2012, use longitudinal data from 1628 adult respondents (mean age 54 years; 47% male) in the UK-based iConnect study. Travel and recreational physical activity were measured using detailed seven-day recall instruments. Adjusted linear regression models were fitted with change in active travel defined as 'decreased' (<-15 min/week), 'maintained' (+/-15 min/week) or 'increased' (>15 min/week) as the primary exposure variable and changes in (a) recreational and (b) total physical activity (min/week) as the primary outcome variables. RESULTS: Active travel increased in 32% (n=529), was maintained in 33% (n=534) and decreased in 35% (n=565) of respondents. Recreational physical activity decreased in all groups but this decrease was not greater in those whose active travel increased. Conversely, changes in active travel were associated with commensurate changes in total physical activity. Compared with those whose active travel remained unchanged, total physical activity decreased by 176.9 min/week in those whose active travel had decreased (adjusted regression coefficient -154.9, 95% CI -195.3 to -114.5) and was 112.2 min/week greater among those whose active travel had increased (adjusted regression coefficient 135.1, 95% CI 94.3 to 175.9). CONCLUSION: An increase in active travel was associated with a commensurate increase in total physical activity and not a decrease in recreational physical activity.
    International Journal of Behavioral Nutrition and Physical Activity 02/2013; 10(1):28. · 3.58 Impact Factor
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    Jenna Panter, Carol Desousa, David Ogilvie
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    ABSTRACT: OBJECTIVE: Small increases in walking or cycling for transport could contribute to population health improvement. We explore the individual, workplace and environmental characteristics associated with the incorporation of walking and cycling into car journeys. METHODS: In 2009, participants from the Commuting and Health in Cambridge study (UK) reported transport modes used on the commute in the last week as well as individual, workplace and environmental characteristics. Logistic regression was used to assess the explanatory variables associated with incorporating walking or cycling into car commuting journeys. RESULTS: 31% of car commuters (n=419, mean age 43.3 years, SD 0.3) regularly incorporated walking or cycling into their commute. Those without access to car parking at work (OR:26.0, 95% CI:11.8 to 57.2) and who reported most supportive environments for walking and cycling en route to work (highest versus lowest tertile, OR: 2.7, 95% CI 1.4 to 5.5) were more likely to incorporate walking or cycling into their car journeys. CONCLUSIONS: Interventions that provide pleasant and convenient routes, limit or charge for workplace car parking and provide free off-site car parking may encourage car commuters to incorporate walking and cycling into car journeys. The effects of such interventions remain to be evaluated.
    Preventive Medicine 01/2013; · 3.50 Impact Factor
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    ABSTRACT: Commuting provides opportunities for regular physical activity which can reduce the risk of chronic disease. Commuters' mode of travel may be shaped by their environment, but understanding of which specific environmental characteristics are most important and might form targets for intervention is limited. This study investigated associations between mode choice and a range of objectively assessed environmental characteristics. Participants in the Commuting and Health in Cambridge study reported where they lived and worked, their usual mode of travel to work and a variety of socio-demographic characteristics. Using geographic information system (GIS) software, 30 exposure variables were produced capturing characteristics of areas around participants' homes and workplaces and their shortest modelled routes to work. Associations between usual mode of travel to work and personal and environmental characteristics were investigated using multinomial logistic regression. Of the 1124 respondents, 50% reported cycling or walking as their usual mode of travel to work. In adjusted analyses, home-work distance was strongly associated with mode choice, particularly for walking. Lower odds of walking or cycling rather than driving were associated with a less frequent bus service (highest versus lowest tertile: walking OR 0.61 [95% CI 0.20-1.85]; cycling OR 0.43 [95% CI 0.23-0.83]), low street connectivity (OR 0.22, [0.07-0.67]; OR 0.48 [0.26-0.90]) and free car parking at work (OR 0.24 [0.10-0.59]; OR 0.55 [0.32-0.95]). Participants were less likely to cycle if they had access to fewer destinations (leisure facilities, shops and schools) close to work (OR 0.36 [0.21-0.62]) and a railway station further from home (OR 0.53 [0.30-0.93]). Covariates strongly predicted travel mode (pseudo r-squared 0.74). Potentially modifiable environmental characteristics, including workplace car parking, street connectivity and access to public transport, are associated with travel mode choice, and could be addressed as part of transport policy and infrastructural interventions to promote active commuting.
    PLoS ONE 01/2013; 8(6):e67575. · 3.73 Impact Factor
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    Caroline H D Jones, Simon Cohn, David Ogilvie
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    ABSTRACT: An increase in public transport use has the potential to contribute to improving population health, and there is growing interest in innovative public transport systems. Yet how new public transport infrastructure is experienced and integrated (or not) into daily practice is little understood. We investigated how the Cambridgeshire Guided Busway, UK, was used and experienced in the weeks following its opening, using the method of participant observation (travelling on the busway and observing and talking to passengers) and drawing on Normalization Process Theory to interpret our data. Using excerpts of field notes to support our interpretations, we describe how the ease with which the new transport system could be integrated into existing daily routines was important in determining whether individuals would continue to use it. It emerged that there were two groups of passengers with different experiences and attitudes. Passengers who had previously travelled frequently on regular bus services did not perceive the new system to be an improvement; consequently, they were frustrated that it was differentiated from and not coherent with the regular system. In contrast, passengers who had previously travelled almost exclusively by car appraised the busway positively and perceived it to be a novel and superior form of travel. Our rich qualitative account highlights the varied and creative ways in which people learn to use new public transport and integrate it into their everyday lives. This has consequences for the introduction and promotion of future transport innovations. It is important to emphasise the novelty of new public transport, but also the ways in which its use can become ordinary and routine. Addressing these issues could help to promote uptake of other public transport interventions, which may contribute to increasing physical activity and improving population health.
    PLoS ONE 01/2013; 8(7):e69254. · 3.73 Impact Factor
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    ABSTRACT: In scoping reviews, boundaries of relevant evidence may be initially fuzzy, with refined conceptual under-standing of interventions and their proposed mechanisms of action an intended output of the scoping process rather than its starting point. Electronic searches are therefore sensitive, often retrieving very large record sets that are impractical to screen in their entirety. This paper describes methods for applying and evaluating the use of text mining (TM) technologies to reduce impractical screening workload in reviews, using examples of two extremely large-scale scoping reviews of public health evidence (choice architecture (CA) and economic environment (EE)). Electronic searches retrieved >800,000 (CA) and >1 million (EE) records. TM technologies were used to prioritise records for manual screening. TM performance was measured prospectively. TM reduced manual screening workload by 90% (CA) and 88% (EE) compared with conventional screening (absolute reductions of ≈430 000 (CA) and ≈378 000 (EE) records). This study expands an emerging corpus of empirical evidence for the use of TM to expedite study selection in reviews. By reducing screening workload to manageable levels, TM made it possible to assemble and configure large, complex evidence bases that crossed research discipline boundaries. These methods are transferable to other scoping and systematic reviews incorporating conceptual development or explanatory dimensions.
    Research Synthesis Methods. 01/2013;
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    ABSTRACT: Unhealthy diet and low levels of physical activity are common behavioural factors in the aetiology of many non-communicable diseases. Recent years have witnessed an upsurge of policy and research interest in the use of taxes and other economic instruments to improve population health. To assemble, configure and analyse empirical research studies available to inform the public health case for using economic instruments to promote dietary and physical activity behaviour change. We conducted a systematic scoping review of evidence for the effects of specific interventions to change, or general exposure to variations in, prices or income on dietary and physical activity behaviours and corollary outcomes. Systematic electronic searches and parallel snowball searches retrieved >1 million study records. Text mining technologies were used to prioritise title-abstract records for screening. Eligible studies were selected, classified and analysed in terms of key characteristics and principal findings, using a narrative, configuring synthesis focused on implications for policy and further research. We identified 880 eligible studies, including 192 intervention studies and 768 studies that incorporated evidence for prices or income as correlates or determinants of target outcomes. Current evidence for the effects of economic instruments and exposures on diet and physical activity is limited in quality and equivocal in terms of its policy implications. Direct evidence for the effects of economic instruments is heavily skewed towards impacts on diet, with a relative lack of evidence for impacts on physical activity. The evidence-based case for using economic instruments to promote dietary and physical activity behaviour change may be less compelling than some proponents have claimed. Future research should include measurement of people's actual behavioural responses using study designs capable of generating reliable causal inferences regarding intervention effects. Policy implementation needs to be carefully aligned with evaluation planning and design.
    PLoS ONE 01/2013; 8(9):e75070. · 3.73 Impact Factor

Publication Stats

1k Citations
748 Downloads
290.94 Total Impact Points

Institutions

  • 2012–2013
    • London School of Hygiene and Tropical Medicine
      • Faculty of Epidemiology and Population Health
      London, ENG, United Kingdom
    • University of East Anglia
      • • School of Environmental Sciences
      • • Norwich Medical School
      Norwich, ENG, United Kingdom
    • Deakin University
      Geelong, Victoria, Australia
    • Centre hospitalier de l'Université de Montréal (CHUM)
      Montréal, Quebec, Canada
  • 2008–2013
    • Medical Research Council (UK)
      Londinium, England, United Kingdom
    • University of Cambridge
      • Cambridge Institute of Public Health
      Cambridge, England, United Kingdom
    • University of Strathclyde
      • • Department of Civil and Environmental Engineering
      • • Department of Sport, Culture and the Arts
      Glasgow, SCT, United Kingdom
  • 2011
    • Karl-Franzens-Universität Graz
      • Institute of Earth Sciences
      Graz, Styria, Austria
  • 2010
    • The Medical Research Council
      United Kingdom
  • 2004–2006
    • University of Glasgow
      • MRC/CSO Social and Public Health Sciences Unit
      Glasgow, Scotland, United Kingdom