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Examining the effectiveness of place-based interventions to improve public health and reduce health inequalities: an umbrella review.

BMC public health
January 1, 1970
V J McGowan et al. (7 authors)
Journal ArticleResearch Support, Non-U.S. Gov'tSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to synthesize evidence on the effectiveness of place-based interventions, including walking routes, on health outcomes and health inequalities.

Results Summary

The study found tentative evidence that walking routes and other physical environment interventions can positively impact health outcomes, particularly physical activity, but effects on health inequalities remain unclear due to lack of equity data.

Population

High-income countries (general population, no specific demographic details provided).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (20)
InterventionDirectionEndpointPopulationDosageImpactClaim #
provision of housing/home modifications
increase
health outcomes
-
-
can have positive impacts
#1
improving the public realm
increase
health outcomes
-
-
can have positive impacts
#2
parks and playgrounds
increase
health outcomes
-
-
can have positive impacts
#3
supermarkets
increase
health outcomes
-
-
can have positive impacts
#4
transport
increase
health outcomes
-
-
can have positive impacts
#5
cycle lanes
increase
health outcomes
-
-
can have positive impacts
#6
walking routes
increase
health outcomes
-
-
can have positive impacts
#7
outdoor gyms
increase
health outcomes
-
-
can have positive impacts
#8
provision of housing/home modifications
increase
physical activity
-
-
can have positive impacts
#9
improving the public realm
increase
physical activity
-
-
can have positive impacts
#10
parks and playgrounds
increase
physical activity
-
-
can have positive impacts
#11
supermarkets
increase
physical activity
-
-
can have positive impacts
#12
transport
increase
physical activity
-
-
can have positive impacts
#13
cycle lanes
increase
physical activity
-
-
can have positive impacts
#14
walking routes
increase
physical activity
-
-
can have positive impacts
#15
outdoor gyms
increase
physical activity
-
-
can have positive impacts
#16
place-based interventions
increase
physical health
-
-
can be effective at improving
#17
place-based interventions
increase
health behaviours
-
-
can be effective at improving
#18
place-based interventions
increase
social determinants of health outcomes
-
-
can be effective at improving
#19
high agentic interventions
increase
health outcomes
those living in greater proximity to the intervention
-
indicate greater improvements
#20
Abstract

BACKGROUND: Locally delivered, place-based public health interventions are receiving increasing attention as a way of improving health and reducing inequalities. However, there is limited evidence on their effectiveness. This umbrella review synthesises systematic review evidence of the health and health inequalities impacts of locally delivered place-based interventions across three elements of place and health: the physical, social, and economic environments. METHODS: Systematic review methodology was used to identify recent published systematic reviews of the effectiveness of place-based interventions on health and health inequalities (PROGRESS+) in high-income countries. Nine databases were searched from 1st January 2008 to 1st March 2020. The quality of the included articles was determined using the Revised Assessment of Multiple Systematic Reviews tool (R-AMSTAR). RESULTS: Thirteen systematic reviews were identified - reporting 51 unique primary studies. Fifty of these studies reported on interventions that changed the physical environment and one reported on changes to the economic environment. Only one primary study reported cost-effectiveness data. No reviews were identified that assessed the impact of social interventions. Given heterogeneity and quality issues, we found tentative evidence that the provision of housing/home modifications, improving the public realm, parks and playgrounds, supermarkets, transport, cycle lanes, walking routes, and outdoor gyms - can all have positive impacts on health outcomes - particularly physical activity. However, as no studies reported an assessment of variation in PROGRESS+ factors, the effect of these interventions on health inequalities remains unclear. CONCLUSIONS: Place-based interventions can be effective at improving physical health, health behaviours and social determinants of health outcomes. High agentic interventions indicate greater improvements for those living in greater proximity to the intervention, which may suggest that in order for interventions to reduce inequalities, they should be implemented at a scale commensurate with the level of disadvantage. Future research needs to ensure equity data is collected, as this is severely lacking and impeding progress on identifying interventions that are effective in reducing health inequalities. TRIAL REGISTRATION: PROSPERO CRD42019158309.

Medical Subject Headings (MeSH)
Cost-Benefit AnalysisExerciseHealth Status DisparitiesHousingHumansPublic HealthSystematic Reviews as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations53
Citations/Year13.3
Relative Citation Ratio6.19
NIH Percentile95.1%
Research Impact Scores
APT Score0.75
Weight Score1.87
Normalized Score0.66
Related Supplements
Examining the effectiveness of place-based interventions to ... | Panacea Index