Commuting and health in Cambridge: a study of a 'natural experiment' in the provision of new transport infrastructure

BackgroundModifying transport infrastructure to support active travel (walking and cycling) could help to increase population levels of physical activity. However, there is limited evidence for the effects of interventions in this field, and to the best of our knowledge no study has convincingly demonstrated an increase in physical activity directly attributable to this type of intervention. We have therefore taken the opportunity presented by a 'natural experiment' in Cambridgeshire, UK to establish a quasi-experimental study of the effects of a major transport infrastructural intervention on travel behaviour, physical activity and related wider health impacts.Design and methodsThe Commuting and Health in Cambridge study comprises three main elements: a cohort study of adults who travel to work in Cambridge, using repeated postal questionnaires and basic objective measurement of physical activity using accelerometers; in-depth quantitative studies of physical activity energy expenditure, travel and movement patterns and estimated carbon emissions using household travel diaries, combined heart rate and movement sensors and global positioning system (GPS) receivers; and a longitudinal qualitative interview study to elucidate participants' attitudes, experiences and practices and to understand how environmental and social factors interact to influence travel behaviour, for whom and in what circumstances. The impacts of a specific intervention - the opening of the Cambridgeshire Guided Busway - and of other changes in the physical environment will be examined using a controlled quasi-experimental design within the overall cohort dataset.DiscussionAddressing the unresolved research and policy questions in this area is not straightforward. The challenges include those of effectively combining different disciplinary perspectives on the research problems, developing common methodological ground in measurement and evaluation, implementing robust quantitative measurement of travel and physical activity behaviour in an unpredictable 'natural experiment' setting, defining exposure to the intervention, defining controls, and conceptualising an appropriate longitudinal analytical strategy.

[1]  Lilah M. Besser,et al.  Walking to public transit: steps to help meet physical activity recommendations. , 2005, American journal of preventive medicine.

[2]  N. Wareham,et al.  A translational framework for public health research , 2009, BMC public health.

[3]  U. Ekelund,et al.  Physical activity and dietary behaviour in a population-based sample of British 10-year old children: the SPEEDY study (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people) , 2008, BMC public health.

[4]  Peter Schantz,et al.  The active commuting route environment scale (ACRES): development and evaluation , 2010, The international journal of behavioral nutrition and physical activity.

[5]  K McPherson,et al.  FORESIGHT TACKLING OBESITIES: FUTURE CHOICES , 2011 .

[6]  N. Mutrie,et al.  Interventions to promote walking: systematic review , 2007, BMJ : British Medical Journal.

[7]  Aaron Kofner,et al.  The effect of light rail transit on body mass index and physical activity. , 2010, American journal of preventive medicine.

[8]  Susan Michie,et al.  Developing and Evaluating Complex Interventions , 2015 .

[9]  D. Ogilvie,et al.  Interventions to promote cycling: systematic review , 2010, BMJ : British Medical Journal.

[10]  J. Bottorff,et al.  Further Than the Eye Can See? Photo Elicitation and Research With Men , 2007, Qualitative health research.

[11]  Karsten Froberg,et al.  Hierarchy of individual calibration levels for heart rate and accelerometry to measure physical activity. , 2007, Journal of applied physiology.

[12]  M. Thorogood,et al.  Interventions for promoting physical activity. , 2005, The Cochrane database of systematic reviews.

[13]  M. Petticrew,et al.  Promoting walking and cycling as an alternative to using cars: systematic review , 2004, BMJ : British Medical Journal.

[14]  T. Baranowski,et al.  Mediating variable framework in physical activity interventions. How are we doing? How might we do better? , 1998, American journal of preventive medicine.

[15]  M. Petticrew,et al.  Personal and environmental correlates of active travel and physical activity in a deprived urban population , 2008, The international journal of behavioral nutrition and physical activity.

[16]  K. Powell,et al.  The Effectiveness of Urban Design and Land Use and Transport Policies and Practices to Increase Physical Activity: A Systematic Review. , 2006, Journal of physical activity & health.

[17]  Rosalind Hurworth,et al.  The Use of Photo-interviewing: Three Examples from Health Evaluation and Research , 2005 .

[18]  A. Bauman,et al.  Understanding environmental influences on walking; Review and research agenda. , 2004, American journal of preventive medicine.

[19]  F. Bull,et al.  Evaluation of the implementation of a state government community design policy aimed at increasing local walking: design issues and baseline results from RESIDE, Perth Western Australia. , 2008, Preventive medicine.

[20]  Lawrence D. Frank,et al.  Active transportation and physical activity: opportunities for collaboration on transportation and public health research , 2004 .

[21]  B. Verplanken,et al.  Reflections on past behavior: A self-report index of habit strength , 2003 .

[22]  Lin Yang,et al.  Methods for Researching the Physical Activity Impacts of 'Natural Experiments' in Modifying the Built Environment , 2010 .

[23]  J. Ware,et al.  How to score and interpret single-item health status measures: a manual for users of the SF-8™ Health Survey. , 2001 .

[24]  P. Atkinson,et al.  Contours of Culture: Complex Ethnography and the Ethnography of Complexity , 2007 .

[25]  J. Pucher,et al.  Infrastructure, programs, and policies to increase bicycling: an international review. , 2010, Preventive medicine.

[26]  J. Welshman,et al.  Using different physical activity measurements in eight European countries. Results of the European Physical Activity Surveillance System (EUPASS) time series survey , 2003, Public Health Nutrition.

[27]  Jeremy N. Morris,et al.  Exercise in the prevention of coronary heart disease: today's best buy in public health. , 1994, Medicine and science in sports and exercise.

[28]  R. Shephard Interventions to promote walking: systematic review , 2008 .

[29]  F. Bull,et al.  An applied ecological framework for evaluating infrastructure to promote walking and cycling: the iConnect study. , 2011, American journal of public health.

[30]  Laura S. Lorenz,et al.  Involving the public through participatory visual research methods , 2009, Health expectations : an international journal of public participation in health care and health policy.

[31]  Adrian Bauman,et al.  The physical environment and physical activity: moving from ecological associations to intervention evidence , 2005, Journal of Epidemiology and Community Health.

[32]  A Cope,et al.  Analysis and synthesis of evidence on the effects of investment in six Cycling Demonstration Towns , 2009 .

[33]  P. Corso,et al.  The effectiveness of interventions to increase physical activity. A systematic review. , 2002, American journal of preventive medicine.

[34]  A. Dhar,et al.  National Institute for Health and Clinical Excellence , 2005 .

[35]  C. Dora,et al.  A different route to health: implications of transport policies , 1999, BMJ.

[36]  U. Ekelund,et al.  Temporal trends in physical activity in England: the Health Survey for England 1991 to 2004. , 2007, Preventive medicine.

[37]  S. Jebb,et al.  Foresight. Tackling obesities: future choices. Project report. , 2007 .

[38]  I. Ajzen,et al.  Choice of Travel Mode in the Theory of Planned Behavior: The Roles of Past Behavior, Habit, and Reasoned Action , 2003 .

[39]  S. Titze,et al.  Environmental, social, and personal correlates of cycling for transportation in a student population. , 2007, Journal of physical activity & health.

[40]  M. Petticrew,et al.  Perceived characteristics of the environment associated with active travel: development and testing of a new scale , 2008, The international journal of behavioral nutrition and physical activity.

[41]  Caroline C. Wang,et al.  Photovoice Ethics: Perspectives from Flint Photovoice , 2001, Health education & behavior : the official publication of the Society for Public Health Education.

[42]  S. Griffin,et al.  Neighborhood, route, and school environments and children's active commuting. , 2010, American journal of preventive medicine.

[43]  Ulf Ekelund,et al.  Estimating physical activity energy expenditure, sedentary time, and physical activity intensity by self-report in adults. , 2010, The American journal of clinical nutrition.

[44]  U. Ekelund,et al.  Reliability and validity of the combined heart rate and movement sensor Actiheart , 2005, European Journal of Clinical Nutrition.

[45]  Karen Villanueva,et al.  Achieving 10,000 steps: a comparison of public transport users and drivers in a university setting. , 2008, Preventive medicine.

[46]  S. Griffin,et al.  Environmental supportiveness for physical activity in English schoolchildren: a study using Global Positioning Systems , 2009, The international journal of behavioral nutrition and physical activity.

[47]  M. Petticrew,et al.  Natural experiments: an underused tool for public health? , 2005, Public health.

[48]  M. Petticrew,et al.  Developing and evaluating complex interventions: the new Medical Research Council guidance , 2008, BMJ : British Medical Journal.

[49]  M. Petticrew,et al.  Shoe leather epidemiology: active travel and transport infrastructure in the urban landscape , 2010, The international journal of behavioral nutrition and physical activity.

[50]  Godfrey Fowler,et al.  THE STRATEGY OF PREVENTIVE MEDICINE , 1992 .

[51]  Charles E Matthews,et al.  Prediction of activity mode with global positioning system and accelerometer data. , 2008, Medicine and science in sports and exercise.

[52]  R. Wener,et al.  A Morning Stroll , 2007 .

[53]  J Head,et al.  A comparison of self-reported sickness absence with absences recorded in employers’ registers: evidence from the Whitehall II study , 2005, Occupational and Environmental Medicine.

[54]  H. Frith,et al.  Using Photographs to Capture Women's Experiences of Chemotherapy: Reflecting on the Method , 2007, Qualitative health research.

[55]  N. Day,et al.  Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire. , 2002, International journal of epidemiology.

[56]  Publications Tackling Obesities: Future Choices , 2007 .

[57]  Max Bulsara,et al.  Active commuting in a university setting: Assessing commuting habits and potential for modal change , 2006 .

[58]  D. Corson The Research Studies , 1995 .

[59]  U. Ekelund,et al.  Criterion-related validity of the last 7-day, short form of the International Physical Activity Questionnaire in Swedish adults , 2006, Public Health Nutrition.