The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results

Background The Well London programme used community engagement, complemented by changes to the physical and social neighbourhood environment, to improve physical activity levels, healthy eating and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomised trial (CRT). The baseline survey data are reported here. Methods The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas; ranked in the 11% most deprived LSOAs in London by Index of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighbourhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating and mental wellbeing were assessed using standardised, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. Results There were 4107 adults and 1214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighbourhoods were broadly similar. There was greater between cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking and self-reported anxiety/depression were similar in the Well London population and the national Health Survey for England. Levels of physical activity were higher in the Well London population but this is likely to be due to the different measurement tools used in the two surveys. Conclusions Randomisation of social interventions such as Well London is acceptable and feasible and in this study the intervention and control arms are well balanced with respect to the primary outcomes and key sociodemographic characteristics. The matched design has improved the statistical efficiency of the study amongst adults but less so amongst adolescents. Follow-up data collection will be completed 2012.

A Race to the bottom – Prison Education and the English and Welsh Policy Context

This article examines prison education in England and Wales arguing that a disjuncture exists between the policy rhetoric of entitlement to education in prison at the European level and the playing out of that entitlement in English and Welsh prisons. Caught between conflicting discourses around a need to combat recidivism and a need for incarceration, prison education in England exists within a policy context informed, in part, by an international human rights agenda on the one hand and global recession, financial cutbacks, and a moral panic about crime on the other. The European Commission has highlighted a number of challenges facing prison education in Europe including over‐crowded institutions, increasing diversity in prison populations, the need to keep pace with pedagogical changes in mainstream education and the adoption of new technologies for learning (Hawley et al., 2013). These are challenges confronting all policy makers involved in prison education in England and Wales in a policy context that is messy, contradictory and fiercely contested. The article argues that this policy context, exacerbated by socio‐economic discourses around neo‐liberalism, is leading to a race‐to‐the‐bottom in the standards of educational provision for prisoners in England and Wales.