Department of Preventive and Social Medicine, University of Otago, 18 Frederick St, Dunedin, 9054, New Zealand.
Mackie Research, Ltd, Auckland, New Zealand.
BMC Public Health. 2018 Jul 9;18(1):850. doi: 10.1186/s12889-018-5758-1.
Achieving a shift from car use to walking, cycling and public transport in cities is a crucial part of healthier, more environmentally sustainable human habitats. Creating supportive active travel environments is an important precursor to this shift. The longevity of urban infrastructure necessitates retrofitting existing suburban neighbourhoods. Previous studies of the effects of street changes have generally relied on natural experiments, have included few outcomes, and have seldom attempted to understand the equity impacts of such interventions.
In this paper we describe the design of Te Ara Mua - Future Streets, a mixed-methods, controlled before-after intervention study to assess the effect of retrofitting street changes at the suburb scale on multiple health, social and environmental outcomes. The study has a particular focus on identifying factors that improve walking and cycling to local destinations in low-income neighbourhoods and on reducing social and health inequities experienced by Māori (Indigenous New Zealanders) and Pacific people. Qualitative system dynamics modelling was used to develop a causal theory for the relationships between active travel, and walking and cycling infrastructure. On this basis we selected outcomes of interest. Together with the transport funder, we triangulated best evidence from the literature, transport policy makers, urban design professionals and community knowledge to develop interventions that were contextually and culturally appropriate. Using a combination of direct observation and random sample face to face surveys, we are measuring outcomes in these domains of wellbeing: road-user behaviour, changes to travel mode for short trips, physical activity, air quality, road traffic injuries, greenhouse gas emissions, and perceptions of neighbourhood social connection, safety, and walking and cycling infrastructure .
While building on previous natural experiments, Te Ara Mua - Future Streets is unique in testing an intervention designed by the research team, community and transport investors together; including a wide range of objective outcome measures; and having an equity focus. When undertaking integrated intervention studies of this kind, a careful balance is needed between epidemiological imperatives, the constraints of transport funding and implementation and community priorities, while retaining the ability to contribute new evidence for healthy, equitable transport policy. The study was retrospectively registered as a clinical trial on 21 June 2018 in the ISCRTN registry: ISRCTN89845334 http://www.isrctn.com/ISRCTN89845334.
在城市中实现从汽车出行向步行、骑行和公共交通的转变，是建设更健康、更具环境可持续性的人类栖息地的关键一环。营造支持性的出行环境，是实现这一转变的重要前提。城市基础设施的使用寿命要求对现有郊区社区进行改造。以往关于街道变化影响的研究通常依赖于自然实验，纳入的结果较少，并且很少试图了解此类干预措施的公平影响。
在本文中，我们介绍了 Te Ara Mua-未来街道（Te Ara Mua - Future Streets）的设计，这是一项混合方法、对照前后干预研究，旨在评估在郊区层面改造街道以对多种健康、社会和环境结果产生影响。该研究特别关注确定在低收入社区改善本地出行的步行和骑行的因素，以及减少毛利人（新西兰原住民）和太平洋岛民的社会和健康不平等。定性系统动力学建模用于为积极出行与步行和骑行基础设施之间的关系建立因果理论。在此基础上，我们选择了感兴趣的结果。我们与交通资助者一起，从文献、交通政策制定者、城市设计专业人员和社区知识中综合最佳证据，制定了具有上下文和文化适宜性的干预措施。我们使用直接观察和随机抽样面对面调查的组合，正在衡量这些福祉领域的结果：道路使用者行为、短途出行方式的变化、身体活动、空气质量、道路交通伤害、温室气体排放以及对邻里社会联系、安全和步行和骑行基础设施的看法。
虽然 Te Ara Mua-未来街道（Te Ara Mua - Future Streets）是基于以往的自然实验，但它具有独特之处，即测试了由研究团队、社区和交通投资者共同设计的干预措施；包括广泛的客观结果衡量标准；并关注公平问题。在进行此类综合干预研究时，需要在流行病学要求、交通资金和实施的限制以及社区的优先事项之间取得平衡，同时保持为健康、公平的交通政策提供新证据的能力。该研究于 2018 年 6 月 21 日在 ISCRTN 登记处作为临床试验进行了回顾性登记：ISRCTN89845334 http://www.isrctn.com/ISRCTN89845334。
