BackgroundThe built and natural environment and health are inextricably linked. However, there is considerable debate surrounding the strength and quality of the evidence base underpinning principles of good practice for built and natural environment design in promoting health. This umbrella review aimed to assess relationships between the built and natural environment and health, concentrating on five topic areas: neighbourhood design, housing, food environment, natural and sustainable environment, and transport.MethodsA structured search was conducted for quantitative systematic reviews and stakeholder reviews published between January 2005 and April 2016. Seven databases and the websites of 15 relevant and respected stakeholder organisations known to publish review-level documentation were searched. Searches were limited to English-language publications and duplicate references were removed. Evidence quality and strength was appraised using validated techniques. Findings were used to develop a diagram for each topic area, illustrating relationships between built and natural environment planning principles and health-related outcomes.ResultsA total of 117 systematic reviews and review-level documents were eligible for inclusion. The quality of evidence was mixed; much of the evidence examined relied on findings from cross-sectional studies, making it difficult to draw clear causal links between built environment exposures and health-related impacts and outcomes. Fourteen actionable planning principles associated with positive health-related outcomes were identified across the five topic areas. For example, neighbourhoods that enhanced walkability, were complete and compact in design, and those which enhanced connectivity through safe and efficient infrastructure were associated with better health-related outcomes relating to physical activity, social engagement, mental health, perceptions of crime, and road traffic collisions. Evidence for the effectiveness of planning principles across different topic areas and on reducing health inequalities was sparse and inconclusive.ConclusionsFindings provide an up-to-date overview of relationships between the built and natural environment and health and present logical, evidence-based messages to aid communication between public health and planning professionals.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5870-2) contains supplementary material, which is available to authorized users.
Context In a health service environment where timescales for patient participation in service design are short and resources scarce, a balance needs to be achieved between research rigour and the timeliness and utility of the findings of patient participation processes.Objective To develop a pragmatic mind mapping approach to managing the qualitative data from patient participation processes.Design While this article draws on experience of using mind maps in a variety of participation processes, a single example is used to illustrate the approach. In this example mind maps were created during the course of patient participation focus groups. Two group discussions were also transcribed verbatim to allow comparison of the rapid mind mapping approach with traditional thematic analysis of qualitative data.Setting and participants The illustrative example formed part of a local alcohol service review which included consultation with local alcohol service users, their families and staff groups.Findings The mind mapping approach provided a pleasing graphical format for representing the key themes raised during the focus groups. It helped stimulate and galvanize discussion and keep it on track, enhanced transparency and group ownership of the data analysis process, allowed a rapid dynamic between data collection and feedback, and was considerably faster than traditional methods for the analysis of focus groups, while resulting in similar broad themes.Conclusion This study suggests that the use of a mind mapping approach to managing qualitative data can provide a pragmatic resolution of the tension between limited resources and quality in patient participation processes.
The ex‐prisoner population is an under‐researched, socially excluded group, whose broad health needs are seldom assessed and often unmet. This qualitative study aims to identify the broad health needs of ex‐prisoners living in an urban borough in the NorthWest of England. We interviewed 27 exprisoners and 14 of the service providers who work with them, from all the resettlement pathways. We asked them about the resettlement experience and how it impacts on ex‐prisoners’ health, what broad health concerns ex‐prisoners have, and how these could be rectified or improved. This study contributes detail from the perspective of ex‐prisoners themselves, and the workers who know their needs best. We have been able to demonstrate that the transition from prison to community is often a health depleting experience, particularly when accommodation has not been adequately arranged. We have found that whilst ex‐prisoners doubtless suffer very poor health they do not often prioritise their own health. However, the majority of ex‐prisoners clearly suffer particularly from mental health and substance misuse problems. Much can be done to tackle these issues by improving communication and partnership working between key stakeholders.
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