Search

Background: Increasing active travel (primarily walking and cycling) has been widely advocated for reducing obesity levels and achieving other population health benefits. However, the strength of evidence underpinning this strategy is unclear. This study aimed to assess the evidence that active travel has significant health benefits., Methods: The study design was a systematic review of (i) non-randomised and randomised controlled trials, and (ii) prospective observational studies examining either (a) the effects of interventions to promote active travel or (b) the association between active travel and health outcomes. Reports of studies were identified by searching 11 electronic databases, websites, reference lists and papers identified by experts in the field. Prospective observational and intervention studies measuring any health outcome of active travel in the general population were included. Studies of patient groups were excluded., Results: Twenty-four studies from 12 countries were included, of which six were studies conducted with children. Five studies evaluated active travel interventions. Nineteen were prospective cohort studies which did not evaluate the impact of a specific intervention. No studies were identified with obesity as an outcome in adults; one of five prospective cohort studies in children found an association between obesity and active travel. Small positive effects on other health outcomes were found in five intervention studies, but these were all at risk of selection bias. Modest benefits for other health outcomes were identified in five prospective studies. There is suggestive evidence that active travel may have a positive effect on diabetes prevention, which may be an important area for future research., Conclusions: Active travel may have positive effects on health outcomes, but there is little robust evidence to date of the effectiveness of active transport interventions for reducing obesity. Future evaluations of such interventions should include an assessment of their impacts on obesity and other health outcomes.

There is now an established body of evidence that the alcohol industry seeks to obstruct public health policies that could affect the availability, affordability or marketing of alcohol. In parallel, the alcohol industry is active in funding corporate social responsibility initiatives, with a particular focus on 'responsible drinking' campaigns, often facilitated by national-level charities established and/or funded by the alcohol industry and associated organizations. While evidence continues to grow regarding biases in the content produced by such health information organizations, they remain active in partnerships with government health departments on national health promotion campaigns and provide a range of health-related information to the public, community organizations and schools. To understand the implications of such access for policymakers, researchers and the public, there is a need to consider the wider, system-level influences of such organizations and their place in wider alcohol industry strategies. In this article, we describe evolving evidence of the direct and indirect strategic effects of such organizations and demonstrate how they serve key roles in the alcohol industry through their existence, content, partnerships and public profiles. We end by considering the implications for how we conceptualize charities established or funded (entirely or partly) by harmful commodity industries, and to what extent current conflicts of interest guidelines are sufficiently effective. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is often characterised as a 'crisis', requiring action by public, private, and third-sector stakeholders to achieve strategic change. Crisis narratives are powerful and may be co-opted to privilege solutions promoted by influential groups. In relation to AMR, this applies particularly to the pharmaceutical and medical diagnostics industries. Given the associated risk of inefficient use of public funds, critical attention must be paid to how the promoted 'solutions' to the AMR crisis are constructed, and their symbolic and material effects on health policy. We conducted a critical discourse analysis (CDA) of the seventy-one written submissions to the UK House of Commons Health and Social Care Committee's 2018 inquiry into AMR. Two researchers collaboratively coded the findings and categorised the submissions. We applied the Policy Dystopia Model to further analyse the proposed solutions and ascertain the discursive and instrumental arguments in the industry submissions to the Committee. We found that industry submissions deployed economic and governance discursive strategies, articulating three main 'market paradoxical' arguments: (i) interference but non-interference; (ii) power but powerlessness; and (iii) for-profit but not-for-profit. The industry submissions also drew upon instrumental strategies including: coalition management, information management, and direct involvement and influence in policymaking. Our analysis suggests that commercial interests deploy crisis narratives to advocate for solutions involving market deregulation and industry subsidies. Thus, the solutions presented to the Committee were heavily shaped by a technocratic-industrial complex. This contributes to influencing what is seen as possible and acceptable in the global AMR policy landscape. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2009.11.027 Byline: Shona Hilton, Kate Hunt, Mairi Langan, Helen Bedford, Mark Petticrew Abstract: In September 2008, the human papillomavirus (HPV) immunisation programme was introduced in the UK for schoolgirls aged between 12 and 18 years of age. The vaccine shows high efficacy in preventing infection against HPV types 16 and 18 responsible for 70% of cervical cancer. However, to be most effective, the vaccine needs to be administered before exposure to the viruses and therefore, ideally, before young people become sexually active. The introduction of any new vaccine, and perhaps particularly one given to young teenage girls to prevent a sexually transmitted cancer-causing virus, has the potential to attract a great deal of media attention. This paper reports on content analysis of 344 articles published between January 2005 and December 2008 in 15 UK newspapers. It includes both manifest and latent analysis to examine newsprint media coverage of the introduction of the HPV vaccination programme and its role in HPV advocacy. We concluded that the newspapers were generally positive towards the new HPV vaccination and that over the 4 years period the newsworthiness of the HPV vaccination programme increased. In 2008 two events dominated coverage, firstly, the introduction of the HPV programme in September 2008 and secondly, in August 2008 the diagnosis on camera of cervical cancer given to Jade Goody, a 27 year old mother of two, who gained fame and notoriety in the UK through her participation in several reality television shows. There are two conclusions from this study. Firstly, the positive media coverage surrounding the introduction of the HPV vaccination programme is to be welcomed as it is likely to contribute towards influencing public perceptions about the acceptability and need for HPV vaccination. Secondly, the focus on prevalence rates of HPV infection among women and on women's sexual behaviours, in relation to HPV vaccination 'encouraging' promiscuity, is an unhelpful aspect of media coverage. Author Affiliation: Medical Research Council, Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, United Kingdom

Background The Alcohol Industry (AI), and the Social Aspects/Public Relations Organisations (SAPRO) it funds, has been shown to mis-represent the risk of alcohol with respect to cancer and pregnancy. It is theorized that the AI would position alcohol as 'heart healthy' to further undermine public perceptions of risks from drinking. Methods A comparative analysis (including content, thematic and context analyses) of cardiovascular health information published on the websites of AI-funded (n  = 18, such as 'Drinkaware' and the 'Distilled Spirits Council of the US') and non-AI-funded (n  = 18, such as 'NHS.uk') organizations based in multiple high-income jurisdictions. Results Websites of non-industry-funded health organizations were more likely than AI/SAPRO websites to label alcohol as a risk factor for a range of important cardiovascular diseases (such as myocardial infarction, congestive cardiac failure, hypertension and stroke). Conversely, AI/SAPRO websites were more likely to suggest alcohol was protective in the development of some heart conditions. AI/SAPRO websites frequently referenced the J-shaped curve as proof of benefit from moderate alcohol consumption; suggested a balance between the benefits and harms from drinking; positioned alcohol as consistent with a 'healthy lifestyle'; and framed drinking as a social norm. Conclusions AI-funded health organizations mis-represent the evidence on cardiovascular effects of moderate alcohol consumption. Healthcare professionals should appreciate the role of funding source in biasing content, and exercise caution when directing patients to content funded by the AI. Tighter regulation of messaging that AI/SAPRO's provide to the public is required, to avoid the dissemination of harmful misinformation. [ABSTRACT FROM AUTHOR]

Three hundred and eighty-eight men undergoing transurethral resection of the prostate of benign prostatic hypertrophy completed a presurgical questionnaire and three follow-up questionnaires 3, 6 and 12 months after surgery. The questionnaires covered details of prostatic symptoms, general health, and expectations and results of surgery. At each follow-up point 40 randomly selected patients were interviewed by two female research assistants. The response rate to the questionnaires was over 90% at each follow-up point while that for the interviews was lower at around 80%. We examine the reliability of the postal questionnaires in assessing health status by comparing questionnaire and interview responses, with a view to the wider employment of such a method in the follow-up of surgical patients. In general, and as reported elsewhere, responses to questions on easily defined topics are highly comparable between questionnaire and interview. Responses to more subjective questions are moderately reliable, but with a tendency for postal questionnaires to underestimate a patient's health problems. It is difficult to assess the reliability of the questionnaires with regard to questions of an intimate nature since such questions caused embarrassment during interview with consequent incomplete responses. Key words--postal questionnaire, interview, surgical outcomes, prostatectomy

The promotion of health equity, the absence of avoidable and unfair differences in health outcomes, is a global imperative. Systematic reviews are an important source of evidence for health decision-makers, but have been found to lack assessments of the intervention effects on health equity. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) is a 27-item checklist intended to improve the transparency and reporting of systematic reviews. We developed an equity extension for PRISMA (PRISMA-E 2012) to help systematic reviewers identify, extract, and synthesise evidence on equity in systematic reviews. In this explanation and elaboration paper we provide the rationale for each extension item. These items are additions or modifications to the existing PRISMA Statement items, in order to incorporate a focus on equity. An example of good reporting is provided for each item as well as the original PRISMA item. This explanation and elaboration document is intended to accompany the PRISMA-E 2012 Statement and the PRISMA Statement to improve understanding of the reporting guideline for users. The PRISMA-E 2012 reporting guideline is intended to improve the transparency and completeness of the reporting of equity-focused systematic reviews. Improved reporting can lead to better judgement of applicability by policymakers, which may result in more appropriate policies and programmes and may contribute to reductions in health inequities. To encourage wide dissemination of this article it is accessible on the International Journal for Equity in Health, Journal of Clinical Epidemiology, and Journal of Development Effectiveness websites. [ABSTRACT FROM PUBLISHER]

Aims In the United Kingdom, alcohol warning labels are the subject of a voluntary agreement between industry and government. In 2011, as part of the Public Health Responsibility Deal in England, the industry pledged to ensure that 80% of products would have clear, legible health warning labelling, although an analysis commissioned by Portman found that only 57.1% met best practice. We assessed what proportion of alcohol products now contain the required health warning information, and its clarity and placement. Design Survey of alcohol labelling data. Setting United Kingdom. Participants Analysis of the United Kingdom's 100 top-selling alcohol brands ( n = 156 individual products). Measurements We assessed the product labels in relation to the presence of five labelling elements: information on alcohol units, government consumption guidelines, pregnancy warnings, reference to the Drinkaware website and a responsibility statement. We also assessed the size, colour and placement of text, and the size and colouring of the pregnancy warning logo. Findings The first three (required) elements were present on 77.6% of products examined. The mean font size of the Chief Medical Officer's (CMO) unit guidelines (usually on the back of the product) was 8.17-point. The mean size of pregnancy logos was 5.95 mm. The pregnancy logo was on average smaller on wine containers. Conclusions The UK Public Health Responsibility Deal alcohol labelling pledge has not been fully met. Labelling information frequently falls short of best practice, with font and logos smaller than would be accepted on other products with health effects. [ABSTRACT FROM AUTHOR]

The article discusses the importance of improving better evidence on health and social outcomes. Better evidence refers to those that explore the effects of interventions within different sections of society and that can be used to tackle health inequalities. Reviewers are advised to consider how study contexts affect the delivery, uptake and effectiveness of interventions. According to the authors, the task of collecting evidence on inequalities is difficult and has been described as a wicked issue.

Background: In London and the rest of the UK, diseases associated with poor diet, inadequate physical activity and mental illness account for a large proportion of area based health inequality. There is a lack of evidence on interventions promoting healthier behaviours especially in marginalised populations, at a structural or ecological level and utilising a community development approach. The Well London project financed by the Big Lottery "Wellbeing" Fund and implemented by a consortium of London based agencies led by the Greater London Authority and the London Health Commission is implementing a set of complex interventions across 20 deprived areas of London. The interventions focus on healthy eating, healthy physical activity and mental health and wellbeing and are designed and executed with community participation complementing existing facilities and services. Methods/Design: The programme will be evaluated through a cluster randomised controlled trial. Forty areas across London were chosen based on deprivation scores. Areas were characterised by high proportion of Black and Minority Ethnic residents, worklessness, ill-health and poor physical environments. Twenty areas were randomly assigned to the intervention arm of Well London project and twenty "matched" areas assigned as controls. Measures of physical activity, diet and mental health are collected at start and end of the project and compared to assess impact. The quantitative element will be complemented by a longitudinal qualitative study elucidating pathways of influence between intervention activities and health outcomes. A related element of the study investigates the health-related aspects of the structural and ecological characteristics of the project areas. The project "process" will also be evaluated. Discussion: The size of the project and the fact that the interventions are "complex" in the sense that firstly, there are a number of interacting components with a wide range of groups and organisational levels targeted by the intervention, and secondly, a degree of flexibility or tailoring of the intervention, makes this trial potentially very useful in providing evidence of the types of activities that can be used to address chronic health problems in communities suffering from multiple deprivation. Trial Registration: Current Controlled Trials ISRCTN68175121 [ABSTRACT FROM AUTHOR]

Health impact assessment (HIA) has been recommended as a means of estimating how policies, programmes and projects may impact on public health and on health inequalities. This paper considers the difference between predicting health impacts and measuring those impacts. It draws upon a case study of the building of a new hypermarket in a deprived area of Glasgow, which offered an opportunity to reflect on the issue of the predictive validity of HIA, and to consider the difference between potential and actual impacts. We found that the actual impacts of the new hypermarket on diet differed from that which would have been predicted based on previous studies. Furthermore, they challenge current received wisdom about the impact of food retail outlets in poorer areas. These results are relevant to the validity of HIA as a process and emphasise the importance of further research on the predictive validity of HIA, which should help improve its value to decision-makers. [Copyright &y& Elsevier]

Copyright of Policy & Politics is the property of Policy Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study objective: To assess the secondary health impacts of a traffic calming scheme on a community. Methods: Prospective cohort study of a randomly selected sample of the local community using postal questionnaires and pedestrian counts on the affected road six months before and six months after the implementation of the scheme. The selling was a community in which a traffic calming scheme was built in the main road (2587 households). The Short Form 36 version 2 was included in the questionnaire and summary measures of physical health (physical component summary) and mental health (mental component summary) calculated. A random sample of 750 households was initially posted the pre-intervention questionnaire. Main results: There were increases in observed pedestrian activity in the area after the introduction of the traffic calming scheme. Physical health improved significantly but mental health did not change. Traffic related problems improved, while other local nuisances were reported to be worse. Conclusions: The introduction of a traffic calming scheme is associated with improvements in health and health related behaviours. It is feasible to prospectively evaluate broader health impacts of similar transport interventions although poor response rates may limit the validity of results. [ABSTRACT FROM AUTHOR]

We sought to synthesize evidence of the health effects of construction of new roads by systematically reviewing observational studies of such effects. We included and critically appraised 32 studies. The review suggested that out-of-town bypasses decrease injuries on main roads through or around towns, although more robust evidence is needed on effects on secondary roads. New major urban roads have statistically insignificant effects on injury incidence. New major roads between towns decrease injuries. Out-of-town bypasses reduce disturbance and community severance in towns but increase them elsewhere. Major urban roads increase disturbance and severance. More robust research is needed in this area, particularly regarding effects of new roads on respiratory health, mental health, access to health services, and physical activity. (Am J Public Health. 2003;93: 1463-1471) [ABSTRACT FROM AUTHOR]

The article discusses key issues concerning the proposed new Cochrane Public Health Collaborative Review Group (PHCRG) in the area of public-health decision making in Europe. The PHCRG aims to provide editorial direction and leadership in the synthesis of evidence on public-health interventions that address health inequalities and upstream, population-level determinants of health. The scope of the PHCRG includes systematic reviews of public-health programs and interventions aimed at reducing health inequalities and improving health equity. Also cited are the issues' implications for public health.

This article discusses an agreement between the Campbell Collaboration Equity Methods Group and the Cochrane Collaboration Equity Field to conduct research assessing the effect of interventions on health disparities and health equity. The two groups will attempt to fill a void in a comprehensive database on interventions to reduce health disparities. Many interventions benefit affluent and middle-class populations more than poor communities. Cost-effectiveness approaches will need to be modified because they currently favor the richest populations where it costs less to achieve the same results in a disadvantaged neighborhood.

The article presents a letter to the editor in response to the article "Respiratory symptoms, pulmonary function and markers of inflammation among bar workers before and after a legislative ban on smoking in public places," by D. Menzies, A. Nair, and P. A. Williamson in a previous issue.

Background: Over the last few years an increasing number of studies investigating the association between the physical environment and physical activity have been published. Many reviews have also summarized this emerging body of research, and such review papers are frequently used by public health policymakers and researchers themselves to inform decision making.Methods: This paper systematically appraises methodologic aspects of literature reviews examining the relationship between physical activity and the physical environment published in peer-reviewed journals between 2000 and 2005. Eleven reviews and their antecedent source papers were examined.Results: The majority of these reviews omitted between one third and two thirds of the studies that could have been eligible for inclusion at the time they conducted the review. Methodologic information on how the review was conducted was not always provided. Furthermore, in some cases results of a study were reported incorrectly, or physical environmental aspects were conflated with social environmental or cognitive factors. Moreover, when results were reported incorrectly, physical environmental variables were almost always reported as significantly associated with physical activity, when these associations were nonsignificant, or were not assessed as part of the primary study.Conclusions: Users of reviews in this field should be aware that there are significant methodologic variations among them, and that some reviews may include only a sample of the relevant primary studies. However, this is difficult to determine given the frequent incompleteness of review method reporting. Greater standardization in the reporting of review methods may assist with future efforts to summarize studies of the relationship between physical environments and physical activity. [ABSTRACT FROM AUTHOR]

Background: Approximately one fifth of workers are engaged in some kind of shift work. The harmful effects of shift work on the health and work–life balance of employees are well known. A range of organizational interventions has been suggested to address these negative effects. Methods: This study undertook the systematic review (following Quality Of Reporting Of Meta [QUORUM] analyses guidelines) of experimental and quasi-experimental studies, from any country (in any language) that evaluated the effects on health and work–life balance of organizational-level interventions that redesign shift work schedules. Twenty-seven electronic databases (medical, social science, economic) were searched. Data extraction and quality appraisal were carried out by two independent reviewers. Narrative synthesis was performed. The review was conducted between October 2005 and November 2006. Results: Twenty-six studies were found relating to a variety of organizational interventions. No one type of intervention was found to be consistently harmful to workers. However, three types were found to have beneficial effects on health and work–life balance: (1) switching from slow to fast rotation, (2) changing from backward to forward rotation, and (3) self-scheduling of shifts. Improvements were usually at little or no direct organizational cost. However, there were concerns about the generalizability of the evidence, and no studies reported on impacts on health inequalities. Conclusions: This review reinforces the findings of epidemiologic and laboratory-based research by suggesting that certain organizational-level interventions can improve the health of shift workers, their work–life balance, or both. This evidence could be useful when designing interventions to improve the experience of shift work. [Copyright &y& Elsevier]

Abstract: The Healthy Living Centre (HLC) programme was designed to address the wider determinants of health, in particular social exclusion and socio-economic disadvantage, through targeting services at the most deprived local communities. This paper draws on data collected during an in-depth process evaluation of six Scottish HLC case study sites. Food-related services, which were found to cross-cut all the sites, were used to address social exclusion and to promote health. Three types of service, each linked to a social model of health, were found to be in operation: those which enhance skills; those which promote social inclusion; and those which influence food accessibility. The paper illustrates how food-related services have developed in the case study HLCs to take account of the differing needs of the communities and neighbourhoods that have been targeted. Consideration is then given to how HLCs adapt to meet the practicalities of improving health while addressing social exclusion through targeting health inequalities. [Copyright &y& Elsevier]