Elena Sautkina

Mixed Messages about Mixed Tenure: Do Reviews Tell the Real Story?

Mixed tenure is the predominant development and regeneration strategy and is a key component of UK housing and urban policy. It is purported to provide wide-ranging social, environmental and economic benefits to residents. While there is a large literature on mixed tenure, policy makers are likely to rely on reviews and summaries of the evidence rather than primary studies. But can they rely on such reviews? Using systematic review methods this paper critically appraises recent reviews for the evidence that mixed tenure policies and strategies have achieved any of these expected benefits. Of the six UK reviews of primary studies, most drew on less than half the available primary studies, none provided a critical appraisal of individual studies and made no comment on conflicting evidence between and within studies. While the reviews gave indications of the deficiencies of the evidence base, rather than focus on the implications of these deficiencies, four of the six reviews emphasised the positive effects of tenure mix.

Mixed Evidence on Mixed Tenure Effects: Findings from a Systematic Review of UK Studies, 1995–2009

Mixed tenure is a key feature of UK housing and regeneration policy. Following an earlier review-of-reviews pertaining to mixed tenure effects (Bond et al., 2011), this paper presents a systematic review of the UK evidence published between 1999 and 2005. The majority of the available evidence is cross-sectional, mostly derived from modest-quality case-study research across nearly 100 sites, supplemented by a very few secondary studies using national data. Six broad domains of outcomes have been investigated across 27 studies. Some positive impacts of mixed tenure were found in the social and residential domains, though notably without impacts on social capital. The evidence for mixed tenure effects in the environmental, safety and economic domains is very mixed. In the human capital domain of health and education, the evidence is sparse. A stronger theoretical base (including the assessment of causal mechanisms) is required to guide future research on mixed tenure effects, which should be longer term and longitudinal in nature, using comparison case studies and secondary data.

The role and status of evidence and innovation in the healthy towns programme in England: a qualitative stakeholder interview study

Background In 2008, the Healthy Community Challenge Fund commissioned nine ‘healthy towns’ in England to implement and evaluate community-based environmental interventions to prevent obesity. This paper examines the role of evidence in informing intervention development, innovation and the potential for programmes to contribute to the evidence base on the effectiveness of interventions that tackle population obesity. Method Twenty qualitative interviews with local programme stakeholders and national policy actors were conducted. Interview transcripts were coded and thematically analysed. Initial analyses were guided by research questions regarding the nature and role of evidence in the development and implementation of the healthy towns programme and the capacity for evidence generation to inform future intervention design, policy and practice. Findings Stakeholders relied on local anecdotal and observational evidence to guide programme development. While the programme was considered an opportunity to trial new and innovative approaches, the requirement to predict likely health impacts and adopt evidence-based practice was viewed contradictory to this aim. Stakeholders believed there were missed opportunities to add to the existing empirical evidence base due to a lack of clarity and planning, particularly around timing, in local and national evaluations. Conclusions A strong emphasis on relying on existing evidence-based practice and producing positive impacts and outcomes may have impeded the opportunity to implement truly innovative programmes because of fear of failure. Building more time for development, implementation and evaluation into future initiatives would maximise the use and generation of robust and relevant evidence for public health policy and practice.

OP64 More than Obesity Prevention? Defining Outcomes in the Healthy Towns Programme in England

Background In 2008, £30 million was invested by UK Government in the Healthy Towns (HT) Programme in England. Nine urban areas were selected to develop and implement interventions to tackle the obesogenic environment. These involved multi-sector approaches to promoting physical activity and improve diet through the use of environmental interventions. In this paper, we explore how stakeholders conceptualised and defined programme outcomes in relation to national and local priorities, and across multiple policy sectors. Methods We undertook semi-structured, face-to-face interviews with 65 HT staff (programme leads, intervention managers and staff) in 2010–2011. Interviews lasted 50 to 110 minutes and were digitally recorded, anonymised and transcribed verbatim. Participants were asked about: the main outcomes and benefits of the HT programme, and links and synergies with other policy areas. Thematic analysis was undertaken; three authors developed and discussed the coding framework, coding outputs and agreed the resultant main themes. Results Programme staff conceptualised outcomes as extending beyond obesity-related behaviours and identified multiple, complementary policy areas that they were attempting to address through the initiative. Four broad categories of outcomes were articulated: [1] direct obesity-related outcomes (healthy diet, physical activity); [2] indirect obesity-related outcomes (obesity awareness, infrastructure provision); [3] wider health-related outcomes (air quality, social capital); [4] non-health outcomes (environmental sustainability, monetary savings). Stakeholders emphasised the interrelatedness of these four categories of outcomes. For example, tackling obesity, improving transport planning and air quality could all be addressed using active travel interventions; tackling obesity, enhancing social capital and promoting environmental sustainability could be addressed using ‘growing food’ interventions. Furthermore, obesity and non-obesity agendas were seen as complementary in terms of delivery of their respective outcomes. Discussion The range and number of outcomes identified may have been both a consequence of the multi-sector, holistic approach taken by HT programme and the ‘on the ground’ reality of implementing complex interventions, whose components touch a wide variety of policy sectors. When planning programmes and their evaluation, consideration of the impact on outcomes that extend beyond the focus of a particular programme could also be beneficial. In the HT programme, policy makers and practitioners believed that delivered interventions could address a range of complementary policy areas, which were all equally important. Taking such a ‘joined-up’ perspective could help increase the efficiency and acceptability of social, environmental, and health policies and interventions.