Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocol

Introduction Urban green and blue space (UGBS) interventions, such as the development of an urban greenway, have the potential to provide public health benefits and multiple co-benefits in the realms of the environment, economy and society. This paper presents the protocol for a 5-year follow-up eva...

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Main Authors: Frank Kee, Ruoyu Wang, Ruth F Hunter, Mike Clarke, Sophie Jones, John Barry, Ciaran O’Neill, Leandro Garcia, Christopher R Cardwell, Hüseyin Küçükali, Claire Cleland, Aideen Maguire, Niamh O’Kane, Selin Akaraci, Christopher Tate, Shay Mullineaux, Geraint Ellis, Brendan Murtagh, Anna Jurek-Loughrey, Dominic Bryan, Jeremy Hilton, Mehdi Hafezi, Natalie Clewley
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e097530.full
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author Frank Kee
Ruoyu Wang
Ruth F Hunter
Mike Clarke
Sophie Jones
John Barry
Ciaran O’Neill
Leandro Garcia
Christopher R Cardwell
Hüseyin Küçükali
Claire Cleland
Aideen Maguire
Niamh O’Kane
Selin Akaraci
Christopher Tate
Shay Mullineaux
Geraint Ellis
Brendan Murtagh
Anna Jurek-Loughrey
Dominic Bryan
Jeremy Hilton
Mehdi Hafezi
Natalie Clewley
author_facet Frank Kee
Ruoyu Wang
Ruth F Hunter
Mike Clarke
Sophie Jones
John Barry
Ciaran O’Neill
Leandro Garcia
Christopher R Cardwell
Hüseyin Küçükali
Claire Cleland
Aideen Maguire
Niamh O’Kane
Selin Akaraci
Christopher Tate
Shay Mullineaux
Geraint Ellis
Brendan Murtagh
Anna Jurek-Loughrey
Dominic Bryan
Jeremy Hilton
Mehdi Hafezi
Natalie Clewley
author_sort Frank Kee
collection DOAJ
description Introduction Urban green and blue space (UGBS) interventions, such as the development of an urban greenway, have the potential to provide public health benefits and multiple co-benefits in the realms of the environment, economy and society. This paper presents the protocol for a 5-year follow-up evaluation of the public health benefits and co-benefits of an urban greenway in Belfast, UK.Methods and analysis The natural experiment evaluation uses a range of systems-oriented and mixed-method approaches. First, using group model building methods, we codeveloped a causal loop diagram with stakeholders to inform the evaluation framework. We will use other systems methods including viable systems modelling and soft systems methodology to understand the context of the system (ie, the intervention) and the stakeholders involved in the development, implementation and maintenance phases. The effectiveness evaluation includes a repeat cross-sectional household survey with a random sample of 1200 local residents (adults aged ≥16 years old) who live within 1 mile of the greenway. The survey is complemented with administrative data from the National Health Service. For the household survey, outcomes include physical activity, mental well-being, quality of life, social capital, perceptions of environment and biodiversity. From the administrative data, outcomes include prescription medications for a range of non-communicable diseases such as cardiovascular disease, type II diabetes mellitus, chronic respiratory and mental health conditions. We also investigate changes in infectious disease rates, including COVID-19, and maternal and child health outcomes such as birth weight and gestational diabetes. A range of economic evaluation methods, including a cost-effectiveness analysis and social return on investment (SROI), will be employed. Findings from the household survey and administrative data analysis will be further explored in focus groups with a subsample of those who complete the household survey and the local community to explore possible mechanistic pathways and other impacts beyond those measured. Process evaluation methods include intercept surveys and direct observation of the number and type of greenway visitors using the Systems for Observing Play and Recreation in Communities tool. Finally, we will use methods such as weight of evidence, simulation and group model building, each embedding participatory engagement with stakeholders to help us interpret, triangulate and synthesise the findings.Ethics and dissemination To our knowledge, this is one of the first natural experiments with a 5-year follow-up evaluation of an UGBS intervention. The findings will help inform future policy and practice on UGBS interventions intended to bring a range of public health benefits and co-benefits. Ethics approval was obtained from the Medicine, Health and Life Sciences Research Ethics Committee prior to the commencement of the study. All participants in the household survey and focus group workshops will provide written informed consent before taking part in the study. Findings will be reported to (1) participants and stakeholders; (2) funding bodies supporting the research; (3) local, regional and national governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.
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spelling doaj-art-9d7cd2a3a3a94123b1d8538f0b1de7752025-08-20T03:33:11ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-097530Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocolFrank Kee0Ruoyu Wang1Ruth F Hunter2Mike Clarke3Sophie Jones4John Barry5Ciaran O’Neill6Leandro Garcia7Christopher R Cardwell8Hüseyin Küçükali9Claire Cleland10Aideen Maguire11Niamh O’Kane12Selin Akaraci13Christopher Tate14Shay Mullineaux15Geraint Ellis16Brendan Murtagh17Anna Jurek-Loughrey18Dominic Bryan19Jeremy Hilton20Mehdi Hafezi21Natalie Clewley22Centre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKSchool of History, Anthropology, Philosophy and Politics, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKCentre for Public Health, Queen’s University Belfast, Belfast, UKSchool of Natural and Built Environment, Queen’s University Belfast, Belfast, UKSchool of Natural and Built Environment, Queen’s University Belfast, Belfast, UKSchool of Electronics, Electrical Engineering and Computer Science, Queen’s University Belfast, Belfast, UKSchool of History, Anthropology, Philosophy and Politics, Queen’s University Belfast, Belfast, UKComplex Systems Governance Group, Faculty of Engineering and Applied Science, Cranfield University, Cranfield, UKComplex Systems Governance Group, Faculty of Engineering and Applied Science, Cranfield University, Cranfield, UKComplex Systems Governance Group, Faculty of Engineering and Applied Science, Cranfield University, Cranfield, UKIntroduction Urban green and blue space (UGBS) interventions, such as the development of an urban greenway, have the potential to provide public health benefits and multiple co-benefits in the realms of the environment, economy and society. This paper presents the protocol for a 5-year follow-up evaluation of the public health benefits and co-benefits of an urban greenway in Belfast, UK.Methods and analysis The natural experiment evaluation uses a range of systems-oriented and mixed-method approaches. First, using group model building methods, we codeveloped a causal loop diagram with stakeholders to inform the evaluation framework. We will use other systems methods including viable systems modelling and soft systems methodology to understand the context of the system (ie, the intervention) and the stakeholders involved in the development, implementation and maintenance phases. The effectiveness evaluation includes a repeat cross-sectional household survey with a random sample of 1200 local residents (adults aged ≥16 years old) who live within 1 mile of the greenway. The survey is complemented with administrative data from the National Health Service. For the household survey, outcomes include physical activity, mental well-being, quality of life, social capital, perceptions of environment and biodiversity. From the administrative data, outcomes include prescription medications for a range of non-communicable diseases such as cardiovascular disease, type II diabetes mellitus, chronic respiratory and mental health conditions. We also investigate changes in infectious disease rates, including COVID-19, and maternal and child health outcomes such as birth weight and gestational diabetes. A range of economic evaluation methods, including a cost-effectiveness analysis and social return on investment (SROI), will be employed. Findings from the household survey and administrative data analysis will be further explored in focus groups with a subsample of those who complete the household survey and the local community to explore possible mechanistic pathways and other impacts beyond those measured. Process evaluation methods include intercept surveys and direct observation of the number and type of greenway visitors using the Systems for Observing Play and Recreation in Communities tool. Finally, we will use methods such as weight of evidence, simulation and group model building, each embedding participatory engagement with stakeholders to help us interpret, triangulate and synthesise the findings.Ethics and dissemination To our knowledge, this is one of the first natural experiments with a 5-year follow-up evaluation of an UGBS intervention. The findings will help inform future policy and practice on UGBS interventions intended to bring a range of public health benefits and co-benefits. Ethics approval was obtained from the Medicine, Health and Life Sciences Research Ethics Committee prior to the commencement of the study. All participants in the household survey and focus group workshops will provide written informed consent before taking part in the study. Findings will be reported to (1) participants and stakeholders; (2) funding bodies supporting the research; (3) local, regional and national governments to inform policy; (4) presented at local, national and international conferences and (5) disseminated by peer-review publications.https://bmjopen.bmj.com/content/15/7/e097530.full
spellingShingle Frank Kee
Ruoyu Wang
Ruth F Hunter
Mike Clarke
Sophie Jones
John Barry
Ciaran O’Neill
Leandro Garcia
Christopher R Cardwell
Hüseyin Küçükali
Claire Cleland
Aideen Maguire
Niamh O’Kane
Selin Akaraci
Christopher Tate
Shay Mullineaux
Geraint Ellis
Brendan Murtagh
Anna Jurek-Loughrey
Dominic Bryan
Jeremy Hilton
Mehdi Hafezi
Natalie Clewley
Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocol
BMJ Open
title Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocol
title_full Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocol
title_fullStr Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocol
title_full_unstemmed Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocol
title_short Investigating the long-term public health and co-benefit impacts of an urban greenway intervention in the UK: a natural experiment evaluation – study protocol
title_sort investigating the long term public health and co benefit impacts of an urban greenway intervention in the uk a natural experiment evaluation study protocol
url https://bmjopen.bmj.com/content/15/7/e097530.full
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