Adams Emma J, Cavill Nick, Sherar Lauren B
National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
Cavill Associates Ltd, 185A Moss Lane, Bramhall, Stockport, Cheshire, SK7 1BA, UK.
BMC Public Health. 2017 Aug 14;17(1):655. doi: 10.1186/s12889-017-4637-5.
Levels of physical activity remain low, particularly in deprived areas. Improving the street environment to promote walking for transport using a community engagement approach is a potential strategy to increase physical activity. An understanding of the implementation of this intervention approach is needed to facilitate further research, replication and scale-up. The aim of this study was to evaluate the implementation of the Fitter for Walking (FFW) intervention in deprived neighbourhoods.
FFW was delivered in five regions of England between August 2008 and March 2012 and aimed to use a community engagement approach to improve the street environment to promote walking for transport. Implementation was assessed in relation to reach; dosage; implementation processes and adaptation; and factors influencing implementation. Three data sources were used: focus groups and face-to-face interviews with coordinators; implementation logs; and participation records.
Reach: 155 community groups participated in FFW engaging 30,230 local residents. Dosage: A wide variety of environmental improvements were implemented by local authorities (LAs) (42 projects) and by communities (46 projects). Examples of LA-led improvements included removal of encroaching vegetation, new/improved pedestrian signage, new dropped kerbs/kerb improvements and new, repaired or improved footpaths. Examples of community-led improvements included planting bulbs, shrubs or bedding plants, clean-up days and litter pick-ups. In 32 projects, no environmental improvements were implemented. Promotional and awareness-raising activities were undertaken in 81 projects. Examples included led walks, themed walks, development of maps/resources to promote improved routes and community events. Processes and adaptation: The need for a planning phase, a preparatory phase, and a delivery phase with a four step process were identified. Adaptability to local context was important. Factors influencing implementation: Five key themes were identified in relation to the barriers and facilitators of implementing FFW: local knowledge and contacts; intervention delivery; coordinator role; working with LAs and other partners; and working with communities.
FFW is one of few reported interventions which have used a community engagement approach to change the street environment to promote walking for transport in deprived neighbourhoods. Delivering these types of interventions is complex and requires considerable resource and time. A set of recommendations and an implementation framework are proposed for future delivery of this and similar types of programme.
身体活动水平仍然较低，尤其是在贫困地区。采用社区参与的方法改善街道环境以促进出行步行是增加身体活动的一项潜在策略。需要了解这种干预方法的实施情况，以促进进一步的研究、推广和扩大规模。本研究的目的是评估“更适合步行”（FFW）干预措施在贫困社区的实施情况。
2008年8月至2012年3月期间，FFW在英格兰的五个地区实施，旨在采用社区参与的方法改善街道环境，以促进出行步行。从覆盖范围、剂量、实施过程与调整以及影响实施的因素等方面对实施情况进行了评估。使用了三个数据源：与协调员进行的焦点小组讨论和面对面访谈；实施日志；以及参与记录。
覆盖范围：155个社区团体参与了FFW，涉及30230名当地居民。剂量：地方当局（LA）实施了42个项目，社区实施了46个项目，进行了各种各样的环境改善。LA主导的改善措施包括清除侵占的植被、新设/改善行人标识、新设/改善下车道路缘石/路缘石以及新建、修复或改善人行道。社区主导的改善措施包括种植球茎植物、灌木或花坛植物、清洁日和垃圾清理活动。在32个项目中，未实施任何环境改善措施。在81个项目中开展了宣传和提高认识活动。例如包括引导步行、主题步行、绘制地图/开发资源以推广更好的路线以及社区活动。过程与调整：确定了需要一个规划阶段、一个筹备阶段以及一个包含四个步骤的实施阶段。适应当地情况很重要。影响实施的因素：确定了与实施FFW的障碍和促进因素相关的五个关键主题：当地知识和联系；干预措施的实施；协调员角色；与地方当局及其他合作伙伴合作；以及与社区合作。
FFW是少数几个报告的采用社区参与方法来改变街道环境以促进贫困社区出行步行的干预措施之一。实施这类干预措施很复杂，需要大量资源和时间。针对未来实施此类及类似项目提出了一系列建议和一个实施框架。
