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.

The ‘peaks and troughs’ of societal violence: Revisiting the actions of Turkish and Kurdish shopkeepers during the 2011 London riots

This article examines an instance of contained violence during the 2011 riots in London, when Turkish and Kurdish ‘shopkeepers’ in Dalston, East London prevented rioters from entering the area. Introducing a ‘peaks’ and ‘troughs’ approach to the sociological study of violence, the article argues that we need to look at the troughs of non-violence in order to understand the peaks of violence and vice-versa. Based on a small-scale empirical study, this article also shows that contrary to the dominant representation of social actors playing fixed roles during social unrest, we found shifting positions and blurred boundaries in the drama of the 2011 riots. The paper demonstrates that the instance of contained violence in Dalston was informed by three types of reverberations. Firstly, we identified anticipatory reverberations, as the shopkeepers were aware of concurrent events elsewhere in London and, as a result, anticipated rioting in Dalston. Secondly, we saw experiential reverberations, as they used their own experience of unrest in Turkey to inform their behaviour. Finally, the representation of the action of the shopkeepers in traditional and social media may have contributed to the containment of violence elsewhere in England, suggesting representational reverberations.