Swansea University Medical School, Swansea University, Swansea, UK.
European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Cornwall, UK.
BMJ Open. 2019 Apr 20;9(4):e027289. doi: 10.1136/bmjopen-2018-027289.
Studies suggest that access and exposure to green-blue spaces (GBS) have beneficial impacts on mental health. However, the evidence base is limited with respect to longitudinal studies. The main aim of this longitudinal, population-wide, record-linked natural experiment, is to model the daily lived experience by linking GBS accessibility indices, residential GBS exposure and health data; to enable quantification of the impact of GBS on well-being and common mental health disorders, for a national population.
This research will estimate the impact of neighbourhood GBS access, GBS exposure and visits to GBS on the risk of common mental health conditions and the opportunity for promoting subjective well-being (SWB); both key priorities for public health. We will use a Geographic Information System (GIS) to create quarterly household GBS accessibility indices and GBS exposure using digital map and satellite data for 1.4 million homes in Wales, UK (2008-2018). We will link the GBS accessibility indices and GBS exposures to individual-level mental health outcomes for 1.7 million people with general practitioner (GP) data and data from the National Survey for Wales (n=~12 000) on well-being in the Secure Anonymised Information Linkage (SAIL) Databank. We will examine if these associations are modified by multiple sociophysical variables, migration and socioeconomic disadvantage. Subgroup analyses will examine associations by different types of GBS. This longitudinal study will be augmented by cross-sectional research using survey data on self-reported visits to GBS and SWB.
All data will be anonymised and linked within the privacy protecting SAIL Databank. We will be using anonymised data and therefore we are exempt from National Research Ethics Committee (NREC). An Information Governance Review Panel (IGRP) application (Project ID: 0562) to link these data has been approved.The research programme will be undertaken in close collaboration with public/patient involvement groups. A multistrategy programme of dissemination is planned with the academic community, policy-makers, practitioners and the public.
研究表明，接触和暴露于绿色蓝色空间（GBS）对心理健康有有益的影响。然而，就纵向研究而言，证据基础有限。本纵向、全人群、记录关联自然实验的主要目的是通过将 GBS 可达性指数、居住 GBS 暴露和健康数据进行关联，来模拟日常居住体验，从而量化 GBS 对幸福感和常见心理健康障碍的影响，为全国人口服务。
本研究将估计社区 GBS 可达性、GBS 暴露和访问 GBS 对常见心理健康状况风险和促进主观幸福感（SWB）的机会的影响；这两个都是公共卫生的重点优先事项。我们将使用地理信息系统（GIS）利用数字地图和卫星数据为英国威尔士的 140 万套住房（2008-2018 年）创建每季度家庭 GBS 可达性指数和 GBS 暴露。我们将把 GBS 可达性指数和 GBS 暴露与全科医生（GP）数据和来自威尔士全国调查（n=~12000）的幸福感数据（在安全匿名信息链接（SAIL）数据库中）联系起来，研究 170 万人的个体心理健康结果。我们将检查这些关联是否会受到多种社会物理变量、移民和社会经济劣势的影响。亚组分析将按不同类型的 GBS 检查关联。本纵向研究将通过使用关于自我报告访问 GBS 和 SWB 的调查数据的横断面研究进行补充。
所有数据将在隐私保护的 SAIL 数据库中匿名化和链接。我们将使用匿名数据，因此我们不需要获得国家研究伦理委员会（NREC）的批准。链接这些数据的信息治理审查小组（IGRP）申请（项目 ID：0562）已获得批准。该研究计划将与公众/患者参与团体密切合作进行。计划开展多策略传播计划，涵盖学术界、政策制定者、从业者和公众。
