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.

Beckton Sustainable Living Initiative, Working Paper 4.

This working paper reflects the authors’ involvement with a civic engagement project funded by the University of East London’s (UEL) Institute for Civic Engagement. It was a collaborative initiative between the Centre for Social Justice and Change, School of Social Sciences, and UEL’s Sustainability Research Institute. The initiative commenced in November 2015 and was completed in July 2016. The civic engagement project is part of an ongoing sustainable living project in Beckton. Situated in the hinterland of UEL’s Docklands campus in the London Borough of Newham this initiative provided an opportunity to work with communities local to UEL. Our involvement in a civic engagement initiative raised issues about what our role as students representing a University might involve, how we may contribute rather than replicate or duplicate ongoing local activities, and what additional skills we could bring to make a positive contribution. Our project was about taking practical actions; by completing a communal garden in a local park and distributing water-saving devices to enable households to reduce their expenditure and contribute towards sustainable living. Research findings informed these practical actions and we were able to use our knowledge concerning environmental sustainability and research in discussions with residents and local agencies. Our experience also raised issues about how best to do research that can be used to inform and facilitate social action. This is particularly challenging in local communities which are ethnically diverse and culturally fragmented. This working paper describes our experiences and reflections.