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The Olympic Healthcare Legacy: A Study to Investigate the Perceptions of Relevant Stakeholders to See How the 2012 Olympics Have Affected the Health and Wellbeing of Children in East London by Use of Semi-structured Interviews

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American Journal of Sports Science and Medicine, 2018, Vol. 6, No. 2, 60-66
Available online at http://pubs.sciepub.com/ajssm/6/2/4
©Science and Education Publishing
DOI:10.12691/ajssm-6-2-4
The Olympic Healthcare Legacy: A Study to Investigate
the Perceptions of Relevant Stakeholders to See
How the 2012 Olympics Have Affected the Health
and Wellbeing of Children in East London
by Use of Semi-structured Interviews
Robin Chatterjee1,2,*, Stephanie Hemmings1
1Sports & Exercise Medicine Department, Queen Mary University of London, London, E1 4NS, UK
2Department of Sports & Exercise Medicine, Homerton University Hospital, London, E9 6SR, UK
*Corresponding author: robinchatterjee1@yahoo.co.uk
Abstract The six London Boroughs hosting the Games published plans for legacy in the Strategic Regeneration
Framework (SRF), where their determination to have parity with the rest of London in various aspects of life
including healthcare in children were outlined. There is a paucity of evidence to support the notion that hosting an
Olympic games leads to an increase in participation in physical or sporting activities for host countries with also
little evidence to suggest other health benefits. To date no research has been conducted to see what the perceptions
of stakeholders involved in the healthcare of younger children in East London are, in terms of what healthcare
legacy has been left from the 2012 Games. The key objectives were to determine what relevant stakeholders in the
care of primary school aged children in the London Borough of Tower Hamlets understood by the term ‘healthcare
legacy’, and to assess their views on the impact of the Olympics on the children and to provide recommendations on
how the health and well being of the children may be improved. A qualitative semi-structured interview study design
was used. The Framework Method was used to analyse results. 14 stakeholders (GPs, teachers, paediatric
community nurses, councillors, youth centre worker) were interviewed and 10 themes were identified: general
awareness of healthcare legacy, pre-Olympic status, funding, education, diet, non-tangible effects of the Olympics,
Exercise, Social support, local regeneration and further recommendations. The investigation suggested that the
Games did emanate a healthcare legacy of sorts. However the effects were largely transient. The multicultural and
low socioeconomic nature of Tower Hamlets has made it difficult to establish a legacy. Future recommendations
include education of both parents and children on the benefits of a healthy lifestyle.
Keywords: Olympic, healthcare, legacy, diet, exercise, East London
Cite This Article: Robin Chatterjee, and Stephanie Hemmings, The Olympic Healthcare Legacy: A Study to
Investigate the Perceptions of Relevant Stakeholders to See How the 2012 Olympics Have Affected the Health
and Wellbeing of Children in East London by Use of Semi-structured Interviews.” American Journal of Sports
Science and Medicine, vol. 6, no. 2 (2018): 60-66. doi: 10.12691/ajssm-6-2-4.
1. Introduction
One of the key factors in London being awarded the
Olympics was it’s potential to leave a ‘lasting legacy’. [1]
It was thought that the hype that accompanies the Games
would herald a renaissance in grass root participation in
sports and a positive shift in attitude. [1]
A number of ‘lasting legacies’ were formalised by the
government of the time to ensure that the Games did
actually leave a long-term beneficial effect on the local
community. [2,3,4]
Amongst the different legacies that the Government and
the British Olympic Association (BOA) promised were a
healthcare legacy and a regeneration of the East End of
London. [2] It was hoped that the sporting achievements
in today’s athletes would lead to an improvement in the
health and fitness of tomorrow’s children. Indeed the six
London Boroughs hosting the Games published plans for
legacy in the Strategic Regeneration Framework (SRF),
where their determination to have parity with the rest of
London in various aspects of life including healthcare in
children were outlined [5].
Childhood obesity and inactivity are major issues in our
society today, which can lead to long-term adverse health
consequences [6,7]. In the United Kingdom (UK), 23% of
children aged 4-5 and 34% of those aged 10-11 are
overweight or obese [8].
Physical inactivity is a greater cause of mortality
than smoking [9,10]. Physical activity levels are however
the most prevalent modifiable risk factor for chronic
American Journal of Sports Science and Medicine 61
disease [11]. Studies have shown that although there are
many factors responsible for inactivity and obesity, even a
modest school effect has the potential to have a substantial
impact on children’s weight status at a population level.
[12,13] Schools and physical education teachers in
particular are in a unique position to promote health and
fitness and the Olympics provided an opportunity to
reaffirm their importance [14].
The original tender document for the London bid
(which the SRF was based on) included chapters on
improvement of healthy living and reduction of
inequalities in the local population; this would be as a
result of actual legislative and fiscal policies as well as
more indirect effects such as the ‘demonstration effect’
and the ‘festival effect’ [15]. The demonstration effect
was the term used to describe the process by which people
are inspired by elite sport, sports people and sports events
to participate themselves [16]. The festival effect
described the desire to participate in physical activity as a
result of celebration and camaraderie contributing to the
feeling that an event is bigger than and beyond the
sporting occasion itself [17].
However a recent overview of systematic reviews
reported that there was a paucity of evidence to support
the notion that hosting an Olympic games leads to an
increase in participation in physical or sporting activities
for host countries with also little evidence to suggest other
health benefits [18]. The study reported that there were
only two systematic reviews of note: (1) McCartney et al
(2010), which was a review of literature published
between 1978 and 2008, found insufficient evidence to
support or refute any health or socioeconomic impacts
from major multisport events [19]; (2) Weed et al (2009)
concluded that communities that were not engaged with
the 2012 games were likely to be beyond the reach of any
legacy and that the key to providing a physical activity
legacy was to promote the festival effect and to promote
exercise through community events or programmes [20].
In addition a recent qualitative study postulated that the
London Olympics have not inspired any change in the
physical activity of individuals [21].
Various different legacies have been investigated since
the end of the London Olympics. The ORiEL study has
investigated the thoughts of adolescents and parents on
how the Olympics have affected them [22]. A study
looking into the effects of the Vancouver Winter
Olympics on local children found that the games had no
measurable impact on objectively measured physical
activity or increased sports participation [23]. To date no
research has been conducted to see what the perceptions
of stakeholders involved in the healthcare of younger
children in East London are, in terms of what healthcare
legacy has been left from the 2012 Games.
The objectives of this study were:
1. To determine what relevant stakeholders in the care
of primary school aged children in the London
Borough of Tower Hamlets (one of the six
boroughs that contributed to the SRF) understood
by the term ‘healthcare legacy’ [5].
2. To assess the views of the stakeholders on what
tangible and non-tangible impact the 2012 Olympic
games have had on the healthcare of the children
that they care for.
3. To provide recommendations on how the health and
well being of primary school children in the London
Borough of Tower Hamlets could be improved.
2. Materials and Methods
2.1. Design
Given the aims of this study, a qualitative study using
semi-structured interviews was used to harvest data. This
approach is commonly used when the data needed is based
upon complex behaviours, needs, systems and cultures
[24]. This method allowed a range of views to be taken
using a flexible approach with an evolving nature of
questioning based on interviewee response [24].
2.2. Participants
Relevant stakeholders in the healthcare of children aged
between 5-11 years old in the London Borough were
selected for interview. A sampling frame was used to
purposefully recruit participants in order to optimise
external validity and appropriately represent the population
being studied (see Table 1).
2.3. Ethics Approval
Ethical approval was obtained from Queen Mary
University of London (QMUL) Research Committee in
February 2015. Research Ethics Committee (REC)
approval was granted by North Central London Research
Consortium (NoCLoR) in April 2015. NHS Research and
development (R&D) approval was obtained from Barts
Health NHS Trust in June 2015.
Table 1. Sampling Frame with Inclusion and Exclusion Criteria
Stakeholder Inclusion Criteria Exclusion Criteria Number contacted
Number
Interviewed
General
Practitioners
The subject must work in the London Borough of
Tower Hamlets
They must be actively working with, treating or
involved in the healthcare management of primary
school aged (5-11 year old) children in the borough
They must have worked with the population being
studied for at least 2 years prior to the advent of the
Olympics (from 2010)
They must work for the public sector only
If a GP then must be a partner or salaried doctor.
If a teacher then must be either a head teacher or PE
teacher.
The interviewee must have
no direct affiliation with
the BOA, government or
Olympic Games
They must not gain
financially from any
intervention that may have
benefitted the healthcare of
the children
36 practices (110
GPs)
4
Teachers
60 schools (60 head
teachers and 48 PE
teachers)
6
(2 PE teachers and
4 head teachers)
Local
Councillors
12 1
Youth Centre
Worker
8 1
Paediatric
Nurse
Practitioners
10 2
62 American Journal of Sports Science and Medicine
2.4. Data Collection
Using the sampling frame prospective patients were
contacted by e-mail. 60 primary schools in the London
Borough of Tower Hamlets, were identified from the
website of the Local Authority. [25] Local councillors
involved in child health and welfare and council accredited
charity workers for young children were also obtained
from the same site. 36 general practices were identified
from the Tower Hamlets Clinical Commissioning Group
(CCG) website. [26] 10 community paediatric nurses were
identified from the same website. Prospective participants
who were identified according to the inclusion and
exclusion criteria were forwarded an opening email, participant
information sheet and consent form. Recruitment was
without coercion. The consent form was required to be
signed prior to interview.
Each interview was semi-structured in nature, face-to-face,
conducted in a location suitable for the participant.
Internal validation was conducted in a number of ways. (i)
Use of a topic guide to fully explore the views of each
participant and ensure a certain uniformity of questions
(see Table 2); (ii) the study author was always the
interviewer; (iii) Interviews were continued until data
saturation occurred; (iv) They were all conducted within a
two-week period and recorded in order to improve recall
and accuracy during analysis. All interviewees were
guaranteed anonymity, in order to allow individuals to
speak freely, especially if they wished to express negative
views.
Table 2. Interview topic guide
General Awareness of the Healthcare Legacy
Pre-Olympic Status
Funding
Legislation and direction from the Local Education & Health
Authorities
Education
Diet
Exercise
Non-tangible Impact of the Olympics
Further Recommendations
2.5. Analysis
All interviews were fully transcribed before a thematic
analysis was performed using the Framework Method
[27,28]. This method involved five stages:
I. Familiarisation of the transcription
II. Development of a theoretical framework: Important
recurrent themes were identified and then subdivided
into subthemes and microthemes. This took place
through an internal process of reflection and
compulsory written reflection. Internal validation
took place at this stage by re-reading all transcripts
to identify all possible themes.
III. Indexing and charting: Themes were coded based
on similarities and differences between initial themes
which allowed refinement of the initial themes to
more accurately reflect the data. These themes
and subthemes were then charted to allow clear
identification of emerging concepts.
IV. Summarisation of data: this was done to make the
data simple and easy to interpret.
V. Mapping and interpreting: Themes and subthemes
were compared and contrasted to allow the initial
objectives of the study to be answered. A completed
framework was then tabulated. Respondent validation
was then conducted by presenting the framework to
a GP and a teacher who had taken part in the study.
They provided feedback and any new suggestions
were further included in the final results.
Respondent validation was performed by allowing two
of the participants (a teacher and a GP) to read through
their own transcriptions to ensure that the nuances of their
interviews had been captured.
2.6. Ethics Approval
Ethical approval was obtained from Queen Mary
University of London (QMUL) Research Committee in
February 2015. REC approval was granted by NoCLoR in
April 2015. NHS R&D approval was obtained from Barts
Health NHS Trust in June 2015.
3. Results
A total of 248 individuals were contacted with only 14
(5%) recruited and interviewed; this included 2 PE
teachers, 4 head teachers, 4 GPs, 1 local councillor, 1
youth centre worker and 2 community paediatric nurses
(see Table 1). Interviews ranged in length between 10
minutes and 58 minutes with a mean time of 27 minutes.
31 subthemes were identified which were grouped into 10
themes (see Table 3).
3.1. General Awareness of Healthcare Legacy
Most of the participants had heard of the term
‘healthcare legacy’ though not in an official capacity.
They were aware of it through mass media rather than any
direction from local government. Their ideas on what it
meant varied from meaning an increase in funding due to
the Olympics, promotion of health and well being to an
improvement in infrastructure.
In terms of knowledge of any specific commitment
made by the London Borough of Tower Hamlets towards
the health and well being of the local population, most
were unaware of such a thing. Nobody had heard of the
Strategic Regeneration Framework and there was no
knowledge of any formal documentation detailing what
plans the six involved boroughs had to implement a
healthcare legacy. Those who thought that they were
aware of a commitment, in fact did not offer much detail,
but instead offered speculative conjecture.
3.2. Pre-Olympic Status
Diet and exercise were an afterthought for both the
children and their parents prior to the Olympics. With a
high percentage of children originating from a South East
Asian background, academia was deemed more important
by the parents than sporting achievement. Some interviewees
stated that being larger in size was actually desirable trait
American Journal of Sports Science and Medicine 63
in some children and their families as it was considered a
sign of prosperity in their culture.
Although most stakeholders felt that facilities and
funding prior to the Olympics was poor, some did observe
that schools were still afforded a reasonable budget for PE
and that finances were available but maybe not spent in
the correct areas.
3.3. Funding
The majority of stakeholders felt that funding
post-Olympics had remained poor. Some thought that
there was a temporary increase immediately after the
Games but with the commencement of the Government’s
commitment to austerity measures that any increase had
been reduced in recent times. Those who had felt the
impact of an increase in funding because of the Olympics
generally thought that the healthcare of the children was
being addressed with the commencement of free fruit and
milk and breakfast at school. Obesity clinics for all ages
had also been introduced as a result of an increase in post-
games funding. One PE teacher felt that since the
Olympics, his departmental budget had significantly
increased and as he was given the responsibility of
distributing the funds he felt that it had been allocated
adequately. Suggestions for where funds could be
distributed to further help child healthcare included after-
school schemes, language classes for parents and obesity
prevention (as opposed to treatment) services.
3.4. Education
Some schools had home economic classes for primary
school children and all schools in the area had at least one
compulsory PE lesson per week. However it was felt that
more was needed to overcome cultural beliefs and
traditions such as the consumption of high fat foods and
discouragement of girls to exercise. Stakeholders believed
that this could be achieved through education of parents
more than the children. They felt that a multi-organisational
approach (i.e. both health and education services) was
needed to accomplish this. Most felt that there was no
leadership or guidance from their respective local
authorities with regards to this.
Table 3. Abbreviated Framework to Show Themes, Subthemes and Illustrative Quotes Established From Semi-Structured Interviews Together
with Findings
Themes Subthemes Illustrative Quotes
General
awareness of
healthcare legacy
Understanding of the term healthcare legacy
Knowledge of specific commitments made to London
Borough of Tower Hamlets in terms of health and well-being
as a result of Olympics
‘….to promote health and fitness in anyone…..’
‘….rejuvenating a deprived area and getting pupils more
involved in sports. I don’t necessarily think that happened’
Pre-Olympic
status
Attitudes
Facilities/Amenities/Funding
‘… it’s a multi-ethnic society and they all have different diets
which can
be very unhealthy… emphasis isn’t on health
promotion…’
Funding
Current levels acceptable
Suggestions of where funds should be allocated
Current levels unacceptable
Awareness of any increase in funding aimed at improving the
health and well-being of the children since the Olympics
‘following the Olympics… a burst of increased funding but I
think the funding isn’t there any more’
‘…there was increased funding for these schools..that’s been
reduced again since the austerity started..’
Education
Educating Children
Educating Parents
Direction from local education or health authorities
‘Allocate some funding to educating parents in the local
borough, making them aware of the benefits of eating
healthy… encouraging their children to partake in sports, not
just boys but both girls’
Diet
School
Cultural Influences
Environmental Influences
Socioeconomic Influences
‘…at home parents feed their children..food that’s high in
cholesterol, high in fats, ghee for instance…a lot of these
parents they just don’t have the education…it’s more about
just cooking what they are used to cooking’
Non tangible
effects of
Olympics
Demonstration Effect
Festival Effect
No effect
‘…not many local children actually did go to see the
Olympics’
‘…they
felt less British and they weren’t really that interested
in the Olympics’
Exercise
Type of sport preferred
Exercise at school
Exercise outside school
Socioeconomic influences
‘They’d just do football because it was a lot more accessible
to these kids’
‘So, the PE time has been cut in the last decade. So, children
are spending less time active in class’
Local
Regeneration
Encourage out-of-school hours exercise
No effect
‘…cycle lanes… it’s a lot safer to cycle and there’s parks and
green
areas where they can go and play and do things after
school’
Social support as
a result of the
Olympics
Out of school help
‘there needs to be…after-hours facility for the kids so that
they can…participate in…sports so that if the parents are
working late then they have something that’s positive and fun
to do’
Further
Recommendations
Education
Funding
Diet
Addressing deprivation
Exercise
School
‘…you need to try and educate them on the importance of
fresh fruit and veg
and a balanced diet…I would try to explain
about parents who really don’t understand about the
importance of health and education…..Lots of leaflets…health
promotion, adverts…’
64 American Journal of Sports Science and Medicine
3.5. Diet
The large South East Asian diaspora in the region
together with higher levels of deprivation meant that most
diets consisted of high fat, high cholesterol curries at
home with fried chicken and chips considered the take
away of choice. These foods were considered tastier and
cheaper than fruit or vegetables or other alternate diets.
Although free fruit, milk and breakfasts were being
offered at school since the Olympics, stakeholders felt that
long standing beliefs held on diet still existed.
3.6. Non-tangible Effects of the Olympic
Games
Most stakeholders felt that that the Olympics provided
both a demonstration and a festival effect on the local
children. This effect was thought to be mainly transient
with declining influence as time lapsed since the games.
However, it was felt that some children of Bangladeshi
origin did not experience either of these effects as they
were less likely to feel ‘British’ and so were not overly
influenced by the success experienced by Team GB. In
addition many children and their families were priced out
of going to any of the Olympics, which contributed to an
overall greater feeling of disenfranchisement from British
society. Longer lasting effects included the introduction of
new sports to schools such as table tennis, which occurred
due to interest being raised from the Games.
3.7. Exercise
Those children who were interested in sport prior to the
Games were more likely to be influenced by the Olympics
and thus the healthcare legacy had a greater impact on
them. Cricket and football appeared to be the sports of
choice for the children despite introduction to new sports
via the Olympics. Only one compulsory session of PE
occurred per week and this was not increased after the
Olympics. In fact PE time was cut in some schools
because of a cut in funding.
3.8. Local Regeneration
Though more parklands and cycle lanes were created, it
was felt that these were more likely to benefit older
children and adults rather than the primary school aged
children. The actual Olympic Park and its associated sites
were also deemed too expensive for the local children to
use.
3.9. Social Support as a Result of the
Olympics
Only two stakeholders were aware of any additional
social services that were available post-Olympics. These
services were pre and post school clubs and new youth
centres for younger children. Most of the participants felt
that more social support was needed for both parents and
children to allow them to have greater finances to buy
healthier foodstuffs or join gyms and clubs and also
to have more time to spend as a family; hopefully
participating in exercise.
3.10. Further Recommendations
The participants identified a diverse range of
recommendations. This included increased education for
the parents as well as their children. Education involved
improved language skills, the challenge of cultural beliefs
such as notions that girls should not exercise or that being
overweight is a desirable quality. It should be impressed
upon the parents that physical activity is as important as
academic and that the two actually go hand in hand.
4. Discussion
This study explored the perceptions of relevant
stakeholders to see how the 2012 Olympics affected the
health and wellbeing of primary school aged children
(aged 5-11 years) in the London Borough of Tower
Hamlets by use of semi-structured interviews. The
participants consisted of GPs, PE teachers, head teachers,
paediatric community nurses, 1 youth centre worker and 1
local councillor. The investigation was conducted because
Tower Hamlets was one of six London boroughs, which
contributed towards a document called the Strategic
Regeneration Framework. This document stated that
amongst other things, the children in the locality would
have a healthcare legacy bestowed upon them as a result
of the Olympics. A topic guide was used to highlight key
themes to indicate if a healthcare legacy was perceived to
have occurred successfully.
The main findings of the study were that stakeholders
thought that the Olympics had a minimal transient effect
on the children. The main factors identified as reasons
why the Olympics did not have more of an effect were the
large local Bangladeshi population, the high level of
deprivation and poor education.
32% of the local population was of Bangladeshi descent.
[29] Stakeholders reported that this population somewhat
felt disenfranchised from mainstream British society and
so the Olympics had less of a festival effect than on other
communities. Culturally parents from this community
tended to encourage their children to focus more on
academic success rather than sporting, as it was
considered a more realistic route for future prosperity, and
this negated a demonstration effect. High fat and high
cholesterol diets were also a norm in this community and
this contributed to high obesity levels in children. Poor
spoken English and deprivation contributed to a
diminished festival effect. A lack of exercise was found to
be a greater problem in the young girls rather than boys, as
they were likely told by their parents that they should not
expose skin (i.e. t-shirt, shorts, swimming costumes) for
reasons of modesty or merely that it was not acceptable
for a girl to exercise.
Table 4. Ethnic diversity in London Borough of Tower Hamlets [29]
Race Tower Hamlets % London % England %
White 45.2 59.8 85.4
Mixed 4.1 5.0 2.3
Asian or Asian British 41.1 18.5 7.8
Black or Black British
13.3
3.5
Other Ethnic Group
3.4
1.0
American Journal of Sports Science and Medicine 65
Tower Hamlets has the highest rate of income poverty
across all local authorities in England and Wales and
double the national average (22%). [30] This level of
deprivation contributed towards the dietary choices of the
local children and their families. Dining in one of the
many fried chicken and chip shops was considered a
cheaper option to eating fresh fruit and vegetables. Local
children were unable to actually see any of the Olympic
events even though they were occurring on their doorstep,
as tickets were unaffordable. Minority sports that captured
the public imagination during the games, such as cycling
or rowing did not have much of an impact in this community,
as they again were considered financially inaccessible.
The Cricket World Cup had more of a demonstration
effect than the Olympics. Premier League Football also
had a greater impact on the children than the Olympics
due to the constant media coverage and affordability and
simplicity of playing football at school or parks.
Positive effects of the Olympics included free fruit,
milk and breakfast at school, to ensure at least some
nutrients were being consumed on a daily basis. At least 1
session of PE was compulsory in schools, though this
appears to have also occurred pre-Olympics. Anti-obesity
clinics and MEND (mind, exercise, nutrition, do-it)
childhood obesity programmes have also been afforded
increased relevance and funding since the Olympics. [31]
Local regeneration was found to have increased parklands
and cycling lanes but the impact of this on younger
children was disputed.
In terms of fulfilling the objectives of the study, the
investigation concluded that:
I. Most stakeholders had heard of the term ‘healthcare
legacy’ but not on a formal basis. They had wildly
varying interpretations as to what this encompassed
but generally everyone agreed that it had an element
of aspiration to improve the well-being of the local
children.
II. The games did indeed have a tangible and non-
tangible impact on the local children (as detailed
above), though this effect was short-lived. Funding
appeared to have decreased with the Government’s
agenda of austerity thus hastening the speed with
which the impact dwindled.
III. In evaluating the findings from the study, a
summary of the recommendations made to improve
the health and well-being of the children include:
4.1. Limitations
Despite attempting to recruit a large number of subjects
the sample was small. Thematic saturation may have been
achieved because of a lack of diversity among the sample.
Given the high rates of refusal to participate, recruitment
bias may have been a factor, as only the more opinionated
individuals were likely to participate. More teachers and
GPs were interviewed than other professions, thus
skewing the themes formed as the same topics would be
likely to arise. The study only took place in one of the six
boroughs involved in the SRF and so results from this
study may not be applicable to the others. There were no
other interviewers or analysts apart from the main author.
This may have limited the internal validity of the study as
no other researcher could check participant’s understanding
of the questions or re-read transcripts to optimise
familiarisation. Triangulation using different interviewers
and analysts would have been preferable. As no similar
study has been performed, it was difficult to compare
results with previous research thus limiting ability to
confirm trends identified.
5. Conclusion
This was the first study to look at the perceptions of
grass-root workers on what healthcare legacy the Olympics
had bestowed on young children in one of the boroughs
that hosted the games. 10 themes were identified: general
awareness of healthcare legacy, pre-Olympic status, funding,
education, diet, non-tangible effects of the Olympics,
Exercise, Social support, local regeneration and further
recommendations. The investigation suggested that the
Games did emanate a healthcare legacy of sorts. However
the effects were largely transient. The specific healthcare
needs of the local population appear not to have been
considered prior to the conception of the idea of the
healthcare legacy and this has most likely contributed to
the perceived lack of full success of the healthcare legacy.
Further studies that can be conducted include a
qualitative study in the other boroughs to see if trends are
similar in each. An audit of how the finances in the
borough were distributed post-Olympics could also be
done to see if there is any correlation between the
perceptions of stakeholders and distribution of funds.
Acknowledgements
The author would like to thank all participants of this
study and also research facilitators at North Central
London Research Consortium (NoCLoR) research support
service for their assistance in obtaining Research Ethics
Committee (REC) and Research and development (R&D)
approval.
Statement of Competing Interests
The authors declare that they have no financial or non-
financial competing interests.
List of Abbreviations
BOA: British Olympic Association
GP: General Practitioner
NHS: National Health Service
NoCLoR: North Central London Research Consortium
ORiEL: Olympic Regeneration in East London
PE: Physical education
QMUL: Queen Mary University of London
R&D: Research and development
REC: Research Ethics Committee
SRF: Strategic Regeneration Framework
UK: United Kingdom
66 American Journal of Sports Science and Medicine
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... 227 In terms of a health legacy, studies have failed to find sustained health improvements in the area. 217,230,231 Although several studies have examined the effect of the Games on residents of the Olympics boroughs, there has been relatively little research examining the views of residents of the new East Village. The Speaking Out of Place project 232 interviewed tenants from the social, intermediate and market-rent groups in East Village, in addition to individuals with a community role in East Village and residents from neighbouring areas. ...
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Background Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited. Objectives The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined. Design The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment. Setting East Village, London, UK. Participants A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years. Intervention The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport. Main outcome measure Change in objectively measured daily steps from baseline to follow-up. Methods Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village. Results A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity. Conclusions Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research ; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).
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