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Towards a more active society? Searching for evidence in the living laboratory
- 1. David Ogilvie Towards a more active society? Searching for evidence in the living laboratory openclipart.org
- 2. This is a slightly modified version of the slideset that accompanied a keynote lecture given at the International Congress on Physical Activity and Public Health in Rio de Janeiro on 9 April 2014 (www.icpaph2014.com). The slides were designed to illustrate the lecture, not to stand as a document in their own right.To follow the story you will need to play detective, following the clues in the slides that will lead you to the papers where the ideas are developed further. A fully hyperlinked reference list is available at www.tinyurl.com/living-laboratory.
- 3. •Setting the scene •Defining the problem •Mapping the terrain •Entering the arena •The road ahead
- 5. For too long the focus has been on advising individuals to take an active approach to life. Das and Horton, Lancet 2012
- 6. The greatest potential to increase population-level physical activity might be through creation of supportive policies in other sectors. Pratt et al., Lancet 2012
- 8. www.mrc-epid.cam.ac.uk www.cedar.iph.cam.ac.uk www.davidogilvie.net www.tinyurl.com/living-laboratory MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR) University of Cambridge
- 9. pixabay.com
- 13. Past a certain threshold of energy consumption, the transportation industry dictates the configuration of social space. Illich, 1974
- 16. •Setting the scene •Defining the problem •Mapping the terrain •Entering the arena •The road ahead
- 17. 0 10 20 30 Switzerland Canada Australia Ireland United States United Kingdom New Zealand Germany Sweden Netherlands China Denmark Adapted from Hallal et al., Lancet 2012b Cycling to work Prevalence (%)
- 18. 2. Transport policies and systems that prioritise walking, cycling and public transport. www.globalpa.org.uk
- 19. Tell us something we don't already know or do! Allender et al., J Public Health Policy 2009
- 20. Most studies fall far short of the ideal research design for evaluating interventions… As a result, these studies do not adequately address the direction of causality. Pucher et al., Prev Med 2010
- 21. WikimediaCommons
- 22. In general, there is a degree of doubt, caution and modesty, which, in all kinds of scrutiny and decision, ought forever to accompany a just reasoner. Hume, 1748
- 23. Good intentions and received wisdom are not enough. Macintyre and Petticrew, J Epidemiol Community Health 2000 Sally Macintyre Mark Petticrew
- 24. Ogilvie et al., BMC Public Health 2009
- 25. Ogilvie et al., BMC Public Health 2009
- 26. Ogilvie et al., BMC Public Health 2009
- 27. Ogilvie et al., BMC Public Health 2009
- 28. Ogilvie et al., BMC Public Health 2009
- 29. Ogilvie et al., BMC Public Health 2009
- 30. There has been far too little consideration of the social and physical environments that enable such activity to be taken. Das and Horton, Lancet 2012
- 31. Bauman et al., Lancet 2012
- 32. WikimediaCommons
- 33. •Setting the scene •Defining the problem •Mapping the terrain •Entering the arena •The road ahead
- 34. The idea of a systematic review is a nonsense, and the sooner those advocates of it are tried at the International Court of Human Rights at the Hague (or worse still, sent for counseling), the better. Rees, AmJ Dermatol 2002
- 36. Ogilvie et al. BMJ 2004
- 37. Ogilvie et al. BMJ 2004 Ogilvie et al. BMJ 2007
- 38. Ogilvie et al. BMJ 2004 Ogilvie et al. BMJ 2007 Yang et al. BMJ 2010
- 41. WikimediaCommons
- 42. Petticrew and Roberts, 2005
- 43. Ogilvie et al., BMJ 2007 Walking
- 44. Ogilvie et al., BMJ 2007 Walking + 30-60 min·wk-1
- 45. Walking for transport Ogilvie et al., BMJ 2007
- 46. Walking for transport Ogilvie et al., BMJ 2007 + 15-30 min·wk-1
- 47. Walking for transport Ogilvie et al., BMJ 2007
- 48. WikimediaCommons We’re living an experiment. Enrique Peñalosa quoted in Montgomery, 2013
- 49. More of the same (in terms of research and practice) will not be enough. Hallal et al., Lancet 2012a
- 50. Craig et al., MRC 2011; Craig et al., J Epidemiol Community Health 2012
- 52. It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. RooseveltT, Paris 1910 (slightly edited)
- 53. The credit belongs to the man who is actually in the arena; who errs, who comes short again and again; but who does actually strive to do the deeds. RooseveltT, Paris 1910 (slightly edited)
- 54. WikimediaCommons
- 55. •Setting the scene •Defining the problem •Mapping the terrain •Entering the arena •The road ahead
- 58. Evaluating the impact of large- scale public health programs is difficult. Victora et al., AmJ Public Health 2004
- 59. Studies with plausibility designs are often the only feasible option and may provide valid evidence of impact. Victora et al., AmJ Public Health 2004
- 62. Cycling to workPrevalence(%,95%CI) 02468 1981 1991 2001 Intervention towns Intervention period Goodman et al., SocSci Med 2013 2011
- 63. Cycling to workPrevalence(%,95%CI) 02468 1981 1991 2001 Matched comparison Intervention towns National comparison Unfunded comparison Intervention period Goodman et al., SocSci Med 2013 2011
- 64. Cycling to work Difference-in-differences 0.69 (0.60, 0.77) Ratio-of-ratios 1.09 (1.06, 1.11) Prevalence(%,95%CI) 02468 1981 1991 2001 Matched comparison Intervention towns National comparison Unfunded comparison Intervention period Goodman et al., SocSci Med 2013 2011
- 65. 0-4 -2 2 4 I2 = 98% 0.23 (-0.31, 0.81) Town by town Goodman et al., SocSci Med 2013 Percentage point increase
- 66. openclipart.org “Data! Data! Data!” he cried impatiently. “I can’t make bricks without clay.” Sherlock Holmes inConan Doyle, 1892
- 67. Impact of COnstructing Non-motorised Networks and Evaluating Changes in Travel FUNDED BY PARTNERS Brand et al., Appl Energy 2013 Bird et al., Health Psychol 2013 Adams et al., Int J Behav Nutr Phys Act 2013 Goodman et al., Prev Med 2013 Song et al., Environ Plann A 2013 Goodman et al., Am J Public Health in press Ogilvie et al., Am J Public Health 2011 Sahlqvist et al., BMC Med Res Methodol 2011 Powell et al., Built Environ 2011 Ogilvie et al., BMJ Open 2012 Sahlqvist et al., Prev Med 2012 Goodman et al., Environ Health 2012 Sahlqvist et al., Int J Behav Nutr Phys Act 2013
- 68. Video of a Connect2 intervention study site www.iconnect.ac.uk/NAI8PW757431 Credit: Andre Neves, University of Oxford
- 69. Ogilvie et al., BMJ Open 2012 Connect2 case study sites
- 72. 0 100 200 300 400 Walkingandcyclingatbaseline (min·wk-1,95%CI) ≥4 3-3.99 2-2.99 1-1.99 <1 Balanced exposure groups Proximity (km) Goodman et al., Prev Med 2013
- 73. -10 0 10 20 30 Effects of Connect2 Change(min·wk-1,95%CI) One year Two years Walking and cycling Overall PA Walking and cycling Overall PA 4.6 4.3 15.3 12.5 Adjusted linear regression coefficients per kilometre of proximity N=1796
- 74. -200 -100 0 100 200 Active travel and physical activity Sahlqvist et al., IntJ Behav Nutr Phys Act 2013 Active travel increased Active travel decreased Recreational PA Overall PA Recreational PA Overall PA Change(min·wk-1,95%CI) Adjusted linear regression coefficients. N=1628
- 75. -200 -100 0 100 200 Change(min·wk-1) Active travel increased Active travel decreased Recreational Total Recreational Total WikimediaCommons
- 76. Health impacts of the Cambridgeshire Guided Busway: the Commuting and Health in Cambridge study Ogilvie et al, BMC Public Health 2010 Panter et al., Int J Behav Nutr Phys Act 2011 Goodman et al., Soc Sci Med 2012 Guell et al., Soc Sci Med 2012 Jones & Ogilvie, Int J Behav Nutr Phys Act 2012 Panter et al., PLoS ONE 2012 Yang et al., Prev Med 2012 Yang et al., BMC Public Health 2012 Carse et al., J Transport Geogr 2013 Panter et al., Prev Med 2013a Guell et al., BMC Public Health 2013 Dalton et al., PLoS ONE 2013 Humphreys et al., Prev Med 2013 Jones et al., PLoS ONE 2013 Panter et al., Prev Med 2013b Guell & Ogilvie, Qual Res 2013
- 78. Commuting is always the car. Wouldn’t be anything else in reality, purely because of convenience and time… One female commuter quoted in Guell et al., SocSci Med 2012 flickr.com/PaulWhiltehouse
- 79. Same female commuter quoted in Guell et al., SocSci Med 2012 flickr.com/LutleyPrimarySchool … It’s usually the bike, the bike’s quicker.
- 80. geograph.org.uk/DerekHarper Jones andOgilvie, IntJ Behav Nutr Phys Act 2012
- 81. geograph.org.uk/HughVenables Panter et al., Prev Med 2013a
- 82. Panter et al., Prev Med 2013b 1 10 100 Oddsratio(95%CI) Convenient cycle routes No free parking at work 4.7 22.6 Adjusted odds ratios Predictors of switching from the car
- 83. Targeting evidence-based mediators in interventions is a crucial step in improvement of the effectiveness of physical activity interventions. Bauman et al., Lancet 2012
- 84. Sahlqvist et al., ISBNPA 2013 Connect2 case study sites
- 85. Effects of Connect2 Panter andOgilvie, ICPAPH 2014 Increase in time spent walking and cycling Increase in perceived supportiveness of environment Use of C2 Proximity to C2
- 86. Effects of Connect2 Increase in time spent walking and cycling Increase in perceived supportiveness of environment Use of C2 Proximity to C2 Panter andOgilvie, ICPAPH 2014
- 88. Use of Connect2 Goodman et al., Prev Med 2013Percentage of users who reported each type of use at two-year follow-up Transport Recreation 0 100 Cycling Walking 18 32 39 85 Walking Transport Cycling Recreation
- 90. -10 0 10 20 30 Effects of Connect2 One year Two years Walking and cycling Overall PA Walking and cycling Overall PA 4.6 4.3 15.3 12.5 Adjusted linear regression coefficients per kilometre of proximity Change(min·wk-1,95%CI) N=1796
- 91. -10 0 10 20 30 Effects of Connect2 One year Two years Walking and cycling Overall PA Walking and cycling Overall PA 4.6 4.3 15.3 12.5 Adjusted linear regression coefficients per kilometre of proximity Change(min·wk-1,95%CI) N=1796 Two years N=1465 Goodman et al., AmJ Public Health in press
- 92. PercentusingConnect2(95%CI) 0204060 0 1-149 150-299 300-449 ≥ 450 Walking and cycling at baseline (min·wk-1) Effects of Connect2 Goodman et al., Prev Med 2013
- 93. -100 0 100 Change(min·wk-1,95%CI) ≥3 2-2.99 1-1.99 <1 Proximity (km) Car No car Effects of Connect2 Goodman et al., AmJ Public Health in pressp=0.007 for interaction
- 94. Panter andOgilvie, ICPAPH 2014 0.1 1 10 Oddsratio(95%CI) More than 2km from Connect2 Up to 2km from Connect2 2.6 Adjusted odds ratio Uptake of walking
- 95. Alice Dalton Amy Nimegeer Andrew Carse Andrew Dymond Andy Jones Anna Goodman Ashley Cooper Calum Mattocks Caroline Jones Cheryl Chapman Christian Brand Cornelia Guell David Humphreys Emma Adams Emma Bird Eva Heinen Fiona Bull Fiona Crawford Fiona Whittle Harry Rutter Hilary Thomson Jane Powell Jenna Panter Joanna Kesten John Preston Karen Ghali Lee Smith Lin Yang Louise Foley Oliver Mytton Richard Mitchell Richard Prins Roger Mackett Shannon Sahlqvist Shona Hilton Silvia Costa Tim Jones Wing Wong Yena Song … and many more And with particular credit to the lead authors of the analyses featured in this presentation… With thanks to…
- 96. Jenna Panter Shannon Sahlqvist Anna Goodman Cornelia Guell
- 97. •Setting the scene •Defining the problem •Mapping the terrain •Entering the arena •The road ahead
- 98. JennaPanter
- 99. WikimediaCommons
- 101. WikimediaCommons
- 103. — Health impacts of a new urban motorway: the M74 study Ogilvie et al., Am J Prev Med 2006 Ogilvie et al., Int J Behav Nutr Phys Act 2008a Ogilvie et al., Int J Behav Nutr Phys Act 2008b Ogilvie et al., Int J Behav Nutr Phys Act 2010
- 104. I just wouldn't like to think that I would walk up there and this big motorway thundering over my head [...] With the thunder of that traffic, it's a bit scary. All this traffic going on top of you [...] it's just big, cold, stark, concrete... it's just only built for cars.You know? Local female residents quoted in Ogilvie et al., IntJ Behav Nutr Phys Act 2010
- 105. AmyNimegeer
- 106. Past a certain threshold of energy consumption, the transportation industry dictates the configuration of social space. Illich, 1974
- 107. 2006
- 108. 2012
- 109. 2012
- 114. For physical activity, a strong case can be made that the science of how to change individual behaviours has overshadowed efforts to understand true population-level change. Kohl et al., Lancet 2012
- 115. Enrique Peñalosa quoted in Montgomery, 2013 We need to walk, just as birds need to fly.. WikimediaCommons
- 116. The PhysicalActivity and Public Health research programme is supported by the Medical Research Council, and the research described in this talk was carried out as part of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence funded by the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research (NIHR) and WellcomeTrust under the auspices of the UK Clinical Research Collaboration. www.mrc-epid.cam.ac.uk/research/research-areas/physical-activity-and-public-health The iConnect study was funded by the Engineering and Physical Sciences Research Council.The Commuting and Health in Cambridge and M74 studies are funded by the NIHR Public Health Research programme. Anna Goodman and Jenna Panter are supported by NIHR Postdoctoral Fellowships.The Department forTransport provided information on the Cycling DemonstrationTowns and CyclingCities andTowns programmes. The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health.