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• Measuring the impact of green space interventions in deprived neighbourhoods on physical activity and health
  Karine Bernard
  Published on: 24 May 2016

• Published on: 24 May 2016

  Measuring the impact of green space interventions in deprived neighbourhoods on physical activity and health

  • Karine Bernard, Master's Candidate

  Droomers et al. examined the association between green space interventions in Dutch deprived neighborhoods and short-term impacts on physical activity (PA) and perceived general health (PGH) among adults. The authors reported an absence of short-term positive effects on PA and health from improvements in green space in deprived neighbourhoods.[1]

  The authors made significant efforts to control for the clusterin...

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  Droomers et al. examined the association between green space interventions in Dutch deprived neighborhoods and short-term impacts on physical activity (PA) and perceived general health (PGH) among adults. The authors reported an absence of short-term positive effects on PA and health from improvements in green space in deprived neighbourhoods.[1]

  The authors made significant efforts to control for the clustering of individuals within neighbourhoods and to adjust analyses at both individual and neighbourhood levels.[1] They acknowledged several shortcomings in the research design including the wide range of socioeconomic interventions undertaken by the Dutch District Approach, in addition to the varied mix of locally tailored green space interventions.[1, 2] However, effect modifiers and information bias were possibly introduced in the study design leading to inaccurate conclusions.

  Social neighbourhood environments are considered to be effect modifiers.[3, 4] However, the overall intensity of the Dutch District Approach method used to adjust for the impact of interventions not related to green space was based on the number of interventions;[1] not on the type of interventions. Therefore, a fully justified sample size allowing stratified analysis was needed.

  Furthermore, I argue that exposure and outcome measures possibly introduced information bias limiting opportunities to capture positive impacts of green space interventions on PA and health. Information about respondents' use of green space is vital to examine their impacts on PA and health.[2, 4] However, green space exposure was not measured in terms of use, access or proximity to green space interventions, but in terms of their implementation. This information bias might have pulled the results toward the null hypothesis, as the assumption was that all respondents were "exposed" to green space interventions, but this was not necessarily true. Differential misclassification of outcomes was also potentially introduced. Given the variety of green space interventions (e.g. community gardens), PA domains specifically related to these green space interventions might have shed light on the impact of the neighbourhood green space attributes.[4] In addition to PGH, the study would have been more robust if physical, mental, and social health constructs had been operationalized.[5]

  Doomers et al. reported that green space interventions do not impact PA and health. Given the wide variety of interventions: 1) a fully justified sample size allowing stratified analysis and 2) measures, which accurately classify exposure to green space and capture PA and health domains specifically related to green space interventions are needed to limit potential type II error.

  References

  1 Droomers M, Jongeneel-Grimen B, Kramer D, et al. The impact of intervening in green space in Dutch deprived neighbourhoods on physical activity and general health: results from the quasi-experimental URBAN40 study. J Epidemiol Community Health 2016;70:147-154. doi:10.1136/jech-2014 -205210

  2 Droomer M, Harting J, Jongeneel-Grimen B, et al. Area-based interventions to ameliorate deprived Dutch neighborhoods in practice: Does the Dutch District Approach address the social determinants of health to such an extent that future health impacts may be expected? Prev Med 2014;61:122-127. http://dx.doi.org.qe2a- proxy.mun.ca/10.1016/j.ypmed.2014.01.009

  3 Diez Roux AV, Mair C. Neighborhoods and health. Ann NY Acad Sci 2010;1186:125-145. doi: 10.1111/j.1749-6632.2009.05333.x

  4 Hunter RF, Christian H, Veitch J, et al. The impact of interventions to promote physical activity in urban green space: A systematic review and recommendations for future research. Soc Sci & Med 2015;124:246-256. http://dx.doi.org.qe2a- proxy.mun.ca/10.1016/j.soscimed.2014.11.051

  5 van den Berg AE, Maas J, Verheij RA, et al. Green space as a buffer between stressful life events and health. Soc Sci & Med 2010;70:1203- 1210. doi:10.1016/j.socscimed.2010.01.002

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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