The influence of environmental factors on the generalisability of public health research evidence: physical activity as a worked example

Article

Watts, P., Phillips, Gemma, Harden, A. and Renton, A. 2011. The influence of environmental factors on the generalisability of public health research evidence: physical activity as a worked example. International Journal of Behavioural Nutrition and Physical Activity. 8 (1), pp. 1479-5868.
AuthorsWatts, P., Phillips, Gemma, Harden, A. and Renton, A.
Abstract

Background: It is rare that decisions about investing in public health interventions in a city, town or other location
can be informed by research generated in that specific place. It is therefore necessary to base decisions on
evidence generated elsewhere and to make inferences about the extent to which this evidence is generalisable to
the place of interest. In this paper we discuss the issues involved in making such inferences, using physical activity
as an example. We discuss the ways in which elements of the structural, physical, social and/or cultural
environment (environmental factors [EFs]) can shape physical activity (PA) and also how EFs may influence the
effectiveness of interventions that aim to promote PA. We then highlight the ways in which EFs may impact on
the generalisability of different types of evidence.
Discussion: We present a framework for thinking about the influence of EFs when assessing the generalisability of
evidence from the location in which the evidence was generated (place A) to the location to which the evidence
is to be applied (place B). The framework relates to similarities and differences between place A and place B with
respect to: a) the distributions of EFs; b) the causal pathways through which EFs or interventions are thought to
exert their effect on PA and c) the ways in which EFs interact with each other. We suggest, using examples, how
this scheme can be used by public health professionals who are designing, executing, reporting and synthesising
research on PA; or designing/implementing interventions.
Summary: Our analysis and scheme, although developed for physical activity, may potentially be adapted and
applied to other evidence and interventions which are likely to be sensitive to influence by elements of the
structural, physical, social and/or cultural environment such as the epidemiology of obesity and healthy weight
promotion.

Keywordsphysical activity; environment; public health; external validity
JournalInternational Journal of Behavioural Nutrition and Physical Activity
Journal citation8 (1), pp. 1479-5868
ISSN1479-5868
Year2011
Publisher's version
License
CC BY-ND
Web address (URL)http://hdl.handle.net/10552/1590
Publication dates
Print16 Nov 2011
Publication process dates
Deposited09 May 2012
Additional information

Citation:
Watts, P., Phillips, G., Petticrew, M., Harden, A. and Renton, A. (2011) 'The influence of environmental factors on the generalisability of public health research evidence: physical activity as a worked example', International Journal of Behavioural Nutrition and Physical Activity, 2011, 8(1), p.128, doi:10.1186/1479-5868-8-128.

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Cooper, Keith, Shepherd, Jonathan, Picot, Jo, Jones, Jeremy, Kavanagh, Josephine, Harden, A., Barnett-Page, Elaine, Clegg, Andrew, Hartwell, Debbie, Frampton, Geoff and Price, Alison 2012. An economic model of school-based behavioral interventions to prevent sexually transmitted infections. International Journal of Technology Assessment in Health Care. 28 (04), pp. 407-414.
The school environment and student health: a systematic review and meta-ethnography of qualitative research
Jamal, F., Fletcher, Adam, Harden, A., Wells, Helene, Thomas, James and Bonell, Chris 2013. The school environment and student health: a systematic review and meta-ethnography of qualitative research. BMC Public Health. 13 (1), p. 798.
Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK
Cresswell, Jenny A, Yu, Ge, Hatherall, B., Morris, Joanne, Jamal, Farah, Harden, A. and Renton, A. 2013. Predictors of the timing of initiation of antenatal care in an ethnically diverse urban cohort in the UK. BMC Pregnancy and Childbirth. 13 (1), p. 103.
Physical activity in deprived communities in London: examining individual and neighbourhood-level factors
Watts, Paul, Phillips, G., Petticrew, Mark, Hayes, Richard, Bottomley, Christian, Yu, Ge, Schmidt, Elena, Tobi, P., Moore, D., Frostick, C., Lock, Karen and Renton, A. 2013. Physical activity in deprived communities in London: examining individual and neighbourhood-level factors. PLoS ONE. 8 (7), p. e69472. https://doi.org/10.1371/journal.pone.0069472
Energy, Development and Health Futures in Poorer Countries
Renton, A. 2013. Energy, Development and Health Futures in Poorer Countries. UEL Research and Knowledge Exchange Conference 2013. University of East London, London 26 Jun 2013 London University of East London.
Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis
Bonell, C., Farah, Jamal, Harden, A., Wells, H., Parry, W., Fletcher, A., Petticrew, M., Thomas, J., Whitehead, M., Campbell, R., Murphy, S. and Moore, L. 2013. Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis. Public Health Research. 1 (1).
Consulting with young people to inform systematic reviews: an example from a review on the effects of schools on health
Jamal, F. and Harden, A. 2013. Consulting with young people to inform systematic reviews: an example from a review on the effects of schools on health. UEL Research and Knowledge Exchange Conference 2013. University of East London, London 26 Jun 2013 London University of East London.
Environmental interventions to reduce fear of crime: systematic review of effectiveness
Lorenc, Theo, Petticrew, Mark, Whitehead, Margaret, Neary, David, Clayton, Stephen, Wright, Kath, Thomson, Hilary, Cummins, Steven, Sowden, Amanda and Renton, A. 2013. Environmental interventions to reduce fear of crime: systematic review of effectiveness. Systematic Reviews. 2 (1), p. 30.
Fear of crime and the environment: systematic review of UK qualitative evidence
Lorenc, Theo, Petticrew, Mark, Whitehead, Margaret, Neary, David, Clayton, Stephen, Wright, Kath, Thomson, Hilary, Cummins, Steven, Sowden, Amanda and Renton, A. 2013. Fear of crime and the environment: systematic review of UK qualitative evidence. BMC Public Health. 13 (1), p. 496.
Absence of direct association between variables does not always mean no evidence of association: Indirect pathways between neighbourhood characteristics and physical activity
Watts, Paul, Phillips, Gemma and Renton, A. 2013. Absence of direct association between variables does not always mean no evidence of association: Indirect pathways between neighbourhood characteristics and physical activity. UEL Research and Knowledge Exchange Conference 2013. University of East London, London 26 Jun 2013 London University of East London.
Getting older and living longer with HIV: Findings from a pilot study conducted in Newham
Foster, Nena, Freeman, Emily, Harden, A., Tobi, Patrick and Fakoya, Ade 2012. Getting older and living longer with HIV: Findings from a pilot study conducted in Newham. UEL Research and Knowledge Exchange Conference 2012. University of East London, London 03 May 2012 London University of East London.
The Olympic Regeneration in East London (ORiEL) study: protocol for a prospective controlled quasi-experiment to evaluate the impact of urban regeneration on young people and their families
Smith, N. R., Clark, C., Fahy, A. E., Tharmaratnam, V., Lewis, D. J., Thompson, C., Renton, A., Moore, D., Bhui, K. S., Taylor, S. J. C., Eldridge, S., Petticrew, M., Greenhalgh, T., Stansfeld, S. A. and Cummins, S. 2012. The Olympic Regeneration in East London (ORiEL) study: protocol for a prospective controlled quasi-experiment to evaluate the impact of urban regeneration on young people and their families. BMJ Open. 2 (4), p. e001840.
The school environment and student health: a systematic review and meta-ethnography of qualitative research
Jamal, Farah, Fletcher, Adam, Harden, A., Wells, Helene, Thomas, James and Bonell, Chris 2013. The school environment and student health: a systematic review and meta-ethnography of qualitative research. BMC Public Health. 13 (1), p. 798.
Key barriers to community cohesion: views from residents of 20 London deprived neighbourhoods
Bertotti, M., Adams-Eaton, F., Sheridan, K. and Renton, A. 2011. Key barriers to community cohesion: views from residents of 20 London deprived neighbourhoods. GeoJournal. 47 (2), pp. 168-183.
The contribution of a social enterprise to the building of social capital in a disadvantaged urban area of London
Bertotti, M., Harden, A., Renton, A. and Sheridan, K. 2012. The contribution of a social enterprise to the building of social capital in a disadvantaged urban area of London. Community Development Journal. 47 (2), pp. 168-183.
Think of your art-eries: Arts participation, behavioural cardiovascular risk factors and mental well-being in deprived communities in London
Renton, A., Phillips, Gemma, Daykin, N, Yu, Ge, Taylor, K and Petticrew, Mark 2012. Think of your art-eries: Arts participation, behavioural cardiovascular risk factors and mental well-being in deprived communities in London. Public Health. 126 (Supp 1), pp. S57-S64.
A multilevel analysis of the association between social networks and support on leisure time physical activity: evidence from 40 disadvantaged areas in London
Yu, Ge, Renton, A., Schmidt, Elena, Tobi, Patrick, Bertotti, M., Watts, P. and Lais, Shahana 2011. A multilevel analysis of the association between social networks and support on leisure time physical activity: evidence from 40 disadvantaged areas in London. Health & Place. 17 (5), pp. 1023-1029.
A scoping review of the evidence relevant to life checks for young people aged 9 to 14 years
Harden, A. 2007. A scoping review of the evidence relevant to life checks for young people aged 9 to 14 years. London EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
Thematic synthesis
Harden, A. and Thomas, James 2008. Thematic synthesis. ESRC Research Methods Festival. St Catherine’s College, Oxford 30 Jun - 03 Jul 2008 Southampton ESRC National Centre for Research Methods.
Testing and building theories: mixed methods synthesis
Harden, A. 2008. Testing and building theories: mixed methods synthesis. ESRC Research Methods Festival. St Catherine’s College, Oxford 30 Jun - 03 Jul 2008 Southampton ESRC National Centre for Research Methods.
Critical appraisal and qualitative research: exploring sensitivity analysis
Harden, A. 2008. Critical appraisal and qualitative research: exploring sensitivity analysis. ESRC Research Methods Festival. St Catherine’s College, Oxford 30 Jun - 03 Jul 2008
Social and environmental interventions to reduce childhood obesity: a systematic map of reviews
Harden, A. 2008. Social and environmental interventions to reduce childhood obesity: a systematic map of reviews. London EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
Including diverse groups of children and young people in health promotion and public health research: a review of methodology and practice
Harden, A. 2008. Including diverse groups of children and young people in health promotion and public health research: a review of methodology and practice. London EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
Health promotion, inequalities and young people’s health: a systematic review of research
Harden, A. 2008. Health promotion, inequalities and young people’s health: a systematic review of research. London EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
A review of effectiveness, including cost effectiveness wherever possible, of commissioned healthy weight-related projects in City and Hackney: final report
Harden, A., Estacio, Emee Vida, Tobi, Patrick, Adams-Eaton, Faye, Bertotti, Marcello and Lais, Shahana 2009. A review of effectiveness, including cost effectiveness wherever possible, of commissioned healthy weight-related projects in City and Hackney: final report. London Institute of Health and Human Development, University of East London.
A project to assist Family Actions's Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement: final report
Harden, A., Lloyd-Reichling, E., Mcdermott, M., Potter, Sylvia and Sayeed, Zahirun 2009. A project to assist Family Actions's Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement: final report. London University of East London.
The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results
Phillips, G., Renton, A., Moore, D., Bottomley, Christian, Schmidt, Elena, Lais, Shahana, Yu, Ge, Wall, Martin, Tobi, P., Frostick, C., Clow, Angela, Lock, Karen, Petticrew, Mark and Hayes, Richard 2012. The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results. Trials. 13 (105).
Methods for the thematic synthesis of qualitative research in systematic reviews
Thomas, James and Harden, A. 2008. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology. 8 (45), pp. 1471-2288.
Creating and Maintaining a Healthy Stratford City: Principles and Practices for Success
Sampson, Alice, Harden, A., Brimicombe, A., Bertotti, Marcello, Lais, Shahana, Barrow-Guevera, Gail, Boniwell, Ilona, Joseph, Hipolina, Sheridan, Kevin, Adams-Eaton, Faye, Tobi, Patrick and Li, Yang 2010. Creating and Maintaining a Healthy Stratford City: Principles and Practices for Success. University of East London, Centre for Institutional Studies.
Protocol for a systematic review of the effects of schools and school-environment interventions on health: evidence mapping and syntheses
Harden, A. and Jamal, Farah 2011. Protocol for a systematic review of the effects of schools and school-environment interventions on health: evidence mapping and syntheses. BMC Public Health. 11 (453).
Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up?
Tobi, Patrick, George, Gavin, Schmidt, Elena and Renton, A. 2008. Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up? Tropical Medicine and International Health. 13 (12), pp. 1452-1458.
Integrating qualitative research with trials in systematic reviews
Thomas, James, Harden, A., Oakley, Ann, Oliver, Sandy, Sutcliffe, Katy, Rees, Rebecca, Brunton, Ginny and Kavanagh, Josephine 2004. Integrating qualitative research with trials in systematic reviews. British Medical Journal. 328 (7446), pp. 1010-1012.
Applying systematic review methods to studies of people’s views: an example from public health research
Harden, A., Garcia, Jo, Oliver, Sandy, Rees, Rebecca, Shepherd, Jonathan, Brunton, Ginny and Oakley, Ann 2004. Applying systematic review methods to studies of people’s views: an example from public health research. Journal of Epidemiology and Community Health. 58 (9), pp. 794-800.
A project to assist Family Action’s Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement (Final Report).
Harden, A., Lloyd-Reichling, E., Mcdermott, M., Potter, Sylvia and Sayeed, Zahirun 2009. A project to assist Family Action’s Building Bridges practitioners with the use of the Index of Family Relations as an outcome measurement (Final Report). Family Action, Institute of Health and Human Development and CASS School of Education, University of East London.
Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies
Harden, A., Brunton, Ginny, Fletcher, Adam and Oakley, Ann 2009. Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies. British Medical Journal. 339 (121).
Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial
Wall, Martin, Hayes, Richard, Moore, D., Petticrew, Mark, Clow, Angela, Schmidt, Elena, Draper, Alizon, Lock, Karen, Lynch, Rebecca and Renton, A. 2009. Evaluation of community level interventions to address social and structural determinants of health: a cluster randomised controlled trial. BMC Public Health. 9 (207).
Methods for the thematic synthesis of qualitative research in systematic reviews
Thomas, James and Harden, A. 2008. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology. 8 (45).