Evaluating the Impact of Improvements in Urban Green Space on Older Adults' Physical Activity and Wellbeing: a Natural Experimental Study

Study Overview
=================
Brief Summary
-----------------
Background: Creating or improving urban green space has the potential to be an effective and sustainable way to increase physical activity and improve other aspects of wellbeing in older adults. However, the size and quality of the existing evidence base is weak. There is particularly a lack of studies on older adults and in the United Kingdom. This study aims to evaluate the effect of four small local street greening intervention projects on older adults' physical activity and wellbeing over a one-year period. The street greening includes tree and flower planting, and artificial tree decorations. These projects are based in a deprived urban neighbourhood in Greater Manchester, United Kingdom. Methods: Eight unimproved comparison sites were selected to compare with the intervention sites. The researchers will measure physical activity and two other behavioural indicators of wellbeing (Connect: connecting with other people; and Take Notice: taking notice of the environment) using a newly developed observation tool. It is thought that the largest effect of the interventions will be on Take Notice behaviour due to improvements in the aesthetic quality of green space at the intervention sites. Baseline data collection occurred in September 2017 before the interventions were installed in November 2017. Follow-up data collection will be repeated in February/ March 2018 (6 months) and September 2018 (12 months). Discussion: The present study offers a rare opportunity to evaluate the before-and-after effects of small-scale changes in urban green space, in an understudied population (older adults) and setting (United Kingdom). Although the interventions are expected to have small effects on peoples' behaviour, this study will address key weaknesses in previous studies.

Official Title
-----------------
Evaluating the Impact of Improvements in Urban Green Space on Older Adults' Physical Activity and Wellbeing: a Natural Experimental Study

Conditions
-----------------
Physical Activity and Wellbeing

Intervention / Treatment
-----------------
* Behavioral: Urban street greening


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: ° All individuals (infants, children, teens, adults, older adults) entering the target area during observation periods Exclusion Criteria: ° Any individuals that request their data to be removed from the study
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intervention site 1<br>2 planted trees; bulb planting | Behavioral: Urban street greening<br>* The interventions are located on four publicly accessible sites; the total size of the floor area of green space in each of the intervention sites is small, ranging from 0.09 to 0.35 acres. Components of the interventions include tree and flower planting (expected to bloom by March 2018) and artificial tree decorations such as strings of small electric lights and tree socks (the interventions are hereafter collectively referred to as urban street greening). The total cost for all components across all four intervention sites is approximately £6,000, although this excludes artist fees connected to the project. All components of the interventions were implemented within a one week period in November 2017 by two arborists, two local artists, staff members at Southway Housing Trust, and local community members from Old Moat and a local school.<br>|
| Comparison site 1A<br> | |
| Comparison site 1B<br> | |
| Intervention site 2<br>12 planted trees; bulb planting; artificial tree decorations (string lights) | Behavioral: Urban street greening<br>* The interventions are located on four publicly accessible sites; the total size of the floor area of green space in each of the intervention sites is small, ranging from 0.09 to 0.35 acres. Components of the interventions include tree and flower planting (expected to bloom by March 2018) and artificial tree decorations such as strings of small electric lights and tree socks (the interventions are hereafter collectively referred to as urban street greening). The total cost for all components across all four intervention sites is approximately £6,000, although this excludes artist fees connected to the project. All components of the interventions were implemented within a one week period in November 2017 by two arborists, two local artists, staff members at Southway Housing Trust, and local community members from Old Moat and a local school.<br>|
| Comparison site 2A<br> | |
| Comparison site 2B<br> | |
| Intervention site 3<br>3 planted trees; artificial tree decorations (string lights, tree socks) | Behavioral: Urban street greening<br>* The interventions are located on four publicly accessible sites; the total size of the floor area of green space in each of the intervention sites is small, ranging from 0.09 to 0.35 acres. Components of the interventions include tree and flower planting (expected to bloom by March 2018) and artificial tree decorations such as strings of small electric lights and tree socks (the interventions are hereafter collectively referred to as urban street greening). The total cost for all components across all four intervention sites is approximately £6,000, although this excludes artist fees connected to the project. All components of the interventions were implemented within a one week period in November 2017 by two arborists, two local artists, staff members at Southway Housing Trust, and local community members from Old Moat and a local school.<br>|
| Comparison site 3A<br> | |
| Comparison site 3B<br> | |
| Intervention site 4<br>8 planted trees; bulb planting; artificial tree decorations (string lights, tree socks) | Behavioral: Urban street greening<br>* The interventions are located on four publicly accessible sites; the total size of the floor area of green space in each of the intervention sites is small, ranging from 0.09 to 0.35 acres. Components of the interventions include tree and flower planting (expected to bloom by March 2018) and artificial tree decorations such as strings of small electric lights and tree socks (the interventions are hereafter collectively referred to as urban street greening). The total cost for all components across all four intervention sites is approximately £6,000, although this excludes artist fees connected to the project. All components of the interventions were implemented within a one week period in November 2017 by two arborists, two local artists, staff members at Southway Housing Trust, and local community members from Old Moat and a local school.<br>|
| Comparison site 4A<br> | |
| Comparison site 4B<br> | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Take Notice behaviour | The primary outcome will be a count per observation period of Take Notice behaviour at 12 months. Take Notice behaviour is the primary outcome because the interventions are expected to improve the aesthetic quality of green space by providing visual information of value to users, thus causing more overt appreciation in the intervention sites. | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Take Notice behaviour | The investigators will also assess a count per observation period of Take Notice behaviour at 6 months. | 6 months | 
| Overall count of older adults | The secondary outcome will be the overall count of older adults per observation period. | 6 months | 
| Overall count of older adults | The secondary outcome will be the overall count of older adults per observation period. | 12 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Natural experiment, Protocol, GHIA, Physical activity, Wellbeing, Urban green space, Older adults