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.

University of East London: the 2015 biodiversity update

In May 2012 the Rio+20 summit confirmed a 30% global decline in wildlife since 1970. Following on from the United Nations (UN) International Year of Biodiversity in 2010, global declines in biodiversity have never had such high profile. Rio+20 has been billed as a chance for world leaders to put global society on a sustainable path and an opportunity for the world to get serious about the need for development to be sustainable (Black 2012). For development to be truly sustainable this must include conserving, on a landscape scale, the valuable ecosystem services that biodiversity provides (TEEB 2010). Not only does this mean protecting and enhancing natural and semi-natural landscapes, but also restoring green and blue infrastructure of high biodiversity value in urban areas. As such, rather than merely targeting conservation efforts across the broader countryside, biodiversity also must be returned to our cities, towns and suburbs by breaking up expanses of hard impermeable surfaces and creating niches within which nature can take a hold.