Protocol for a mixed methods study investigating the impact of investment in housing, regeneration and neighbourhood renewal on the health and wellbeing of residents: the GoWell programme

Abstract

BackgroundThere is little robust evidence to test the policy assumption that housing-led area regeneration strategies will contribute to health improvement and reduce social inequalities in health. The GoWell Programme has been designed to measure effects on health and wellbeing of multi-faceted regeneration interventions on residents of disadvantaged neighbourhoods in the city of Glasgow, Scotland.Methods/DesignThis mixed methods study focused (initially) on 14 disadvantaged neighbourhoods experiencing regeneration. These were grouped by intervention into 5 categories for comparison. GoWell includes a pre-intervention householder survey (n = 6008) and three follow-up repeat-cross sectional surveys held at two or three year intervals (the main focus of this protocol) conducted alongside a nested longitudinal study of residents from 6 of those areas. Self-reported responses from face-to-face questionnaires are analysed along with various routinely produced ecological data and documentary sources to build a picture of the changes taking place, their cost and impacts on residents and communities. Qualitative methods include interviews and focus groups of residents, housing managers and other stakeholders exploring issues such as the neighbourhood context, potential pathways from regeneration to health, community engagement and empowerment.DiscussionUrban regeneration programmes are 'natural experiments.' They are complex interventions that may impact upon social determinants of population health and wellbeing. Measuring the effects of such interventions is notoriously challenging. GoWell compares the health and wellbeing effects of different approaches to regeneration, generates theory on pathways from regeneration to health and explores the attitudes and responses of residents and other stakeholders to neighbourhood change.

Is empowerment a route to improving mental health and wellbeing in an urban regeneration (UR) context?

“…Similarly, research with residents in areas of demolition, including with those who had been involved in consultation processes around master-planning exercises, revealed that, despite a number of engagement events and processes organised by the regeneration partners, people still felt a lack of empowerment, sometimes because they had no understanding of who was making the final decisions about their areas' futures -the decision-making process had not been explained to them, or because they did not know how agreed plans were to be funded and progressed, nor who they could ask about progress -the implementation process had not been explained to them either (Lawson andKearns 2010 and. Others have argued that housing providers should put in place feedback mechanisms that allow residents to understand the impact of their views and the rationale for the final decisions that were taken (Stubbs et al, 2005).…”

“…These study areas, comprising 32 sub-areas, are among the most deprived neighbourhoods nationally, all with levels of income deprivation falling within the bottom 15% of areas in the Scottish Index of Multiple Deprivation (Egan et al, 2010).…”

“…4270 adult householders aged 16 years or over (one householder per household) from these areas were interviewed about their personal circumstances, perceptions of their communities and neighbourhoods, and the state of their health (Egan et al, 2010). Full details of the study design have been published elsewhere (Egan et al, 2010).…”

“…Empowerment data from the 2011 GoWell Community Health and Wellbeing Survey of 15 Glasgow communities undergoing regeneration was used (Egan et al, 2010). These study areas, comprising 32 sub-areas, are among the most deprived neighbourhoods nationally, all with levels of income deprivation falling within the bottom 15% of areas in the Scottish Index of Multiple Deprivation (Egan et al, 2010).…”

Using Routinely Collected Administrative Data in Public Health Research: Geocoding Alcohol Outlet Data

“…Natural experiments can be the best source of available evidence where the randomised controlled trial is not feasible and the intervention(s) have a natural non-random variability in geographical location and time. Many public health interventions, such as urban regeneration schemes, (Egan et al 2010;Petticrew et al 2009) are based in small geographical areas and so the spatial scale of measurement of exposures and outcomes that change over time becomes an important consideration.…”