Assessing the health impact of local amenities: a qualitative study of contrasting experiences of local swimming pool and leisure provision in two areas of Glasgow

Pooling the evidence: A review of swimming and atopic dermatitis

Swimming is an excellent form of aerobic exercise and is an essential life skill. Many children with atopic dermatitis (AD) are advised not to swim because of concerns about negative impacts on their skin disease, and some children with AD do not swim because they are self-conscious about the appearance of their skin. We aimed to perform a narrative review of the available literature on swimming and AD and scientifically analyze the potential impact of all components of swimming in AD-water, skin barrier, swimming gear, and exercise. Studies examined the impact of swimming on the skin barrier and the relative contraindications to swimming. Constituents of water which may affect AD include hardness, pH, temperature, antiseptics, and other chemicals. Potential interventions to reduce damage included emollient application, special swim gear, and showering post-submersion. The benefits of swimming as a form of exercise in AD included reduced sweating, cardiorespiratory fitness, and maintenance of healthy weight. Drawbacks of swimming as a form of exercise in AD included the limited benefit on bone mineral density. Future research should examine the impact of swimming on flares of AD using noninvasive biomarkers as well as clinical severity assessment and assess the role for different types of emollient as an intervention for optimal eczema control. This review highlights gaps in the scientific literature on swimming and AD and provides evidence-based guidance on interventions to minimize deleterious effects on skincare and maximize opportunities for children with AD to swim.

Older People's Usage Pattern, Satisfaction with Community Facility and Well-Being in Urban Old Districts

Community facilities are an important element that supports older people's daily life and promotes their well-being. However, there is a dearth of comprehensive studies on the effect of planning and design of different types of community facilities on older people's usage patterns and satisfaction. This study aims to provide a framework to explore the relationship among the planning of community facilities, older people's usage and satisfaction level and well-being for different types of community facilities. Both spatial analysis and questionnaire survey (n = 497) methods are employed in this study. This study finds that commercial (89.34%), municipal (83.10%) and leisure (88.13%) facilities are most commonly used by older people. This study suggests that older people's frequency of visiting community facilities is mainly affected by the purpose of visiting a community facility. Planning and design quality of the community facility are found to be significantly associated with older people's satisfaction level with using a community facility. In addition, older people's higher satisfaction level and usage level of community facilities could increase their physical and psychological well-being. The findings of this study not only contribute to the knowledge gap of older people's usage and satisfaction with using community facilities but also suggest that planners should aim toward a better distribution of community facilities to improve older adults' well-being.

Beliefs about using an outdoor pool: Understanding perceptions of place in the context of a recreational environment to improve health

Following the Reasoned Action Approach, an online survey of 74 outdoor pool users illustrates how a theory-based behavioral analysis can be used to identify people's perceptions of a place in their environment. Regression analysis of close-ended data demonstrated that intention "to use the outdoor pool next summer season" was predicted (R(2)=.636, p<.0001) from the weighted combination of attitude (β=.663, p<.0001) and perceived control (β=.197, p<.05). The importance of attitude suggests that use can be encouraged by addressing advantages. The content analysis of open-ended elicitation data revealed that users believed that pool use provides physical, social, and emotional advantages and could be made easier by modifying facility parameters. Implications for promoting and designing public health spaces to attract users to aquatic environments and to improve health are discussed.

[Health impact assessment of regeneration projects in Pasaia Bay (Spain): perceptions of the affected population]

AIM

To determine the health impact perceived by residents and social players involved in two urban regeneration interventions (a new fish market and the redevelopment of North/West Herrera) in Pasaia Bay (Gipuzkoa, Spain) that have been the subject of a health impact assessment (HIA).

METHOD

Qualitative methodology was used with theoretical and intentional sampling. Information was obtained through 18 personal interviews and five discussion groups and was analyzed in accordance with the sociological analysis model of discourse. The preliminary results were triangulated and contrasted among the team members and those taking part in the study.

RESULTS

Four interrelated areas of health impact were identified: urban quality, connectivity, social cohesion, and-to a lesser extent-employment. Specific aspects for improvement were indicated for each field, as well as the influence of the sociopolitical context and conceptions of health. Other significant findings were the impact of the process of carrying out the building work and the distinct perspectives due to the differing roles and social profiles of participants.

CONCLUSIONS

Knowledge of the perceptions and expectations of affected individuals through qualitative methods provides novel elements and interrelations that are needed to apply HIA as a tool for improving health and for citizen participation.

Community-based dietary and physical activity interventions in low socioeconomic groups in the UK: a mixed methods systematic review

OBJECTIVE

Low socioeconomic status (SES) is a risk factor for type 2 diabetes and changes in diet and physical activity can prevent diabetes. We assessed the effectiveness and acceptability of community-based dietary and physical activity interventions among low-SES groups in the UK.

METHOD

We searched relevant databases and web resources from 1990 to November 2009 to identify relevant published and grey literature using an iterative approach, focusing on UK studies.

RESULTS

Thirty-five relevant papers (nine quantitative, 23 qualitative and three mixed methods studies) were data extracted, quality assessed and synthesised using narrative synthesis and thematic analysis. The relationship between interventions and barriers and facilitators was also examined. Dietary/nutritional, food retail, physical activity and multi-component interventions demonstrated mixed effectiveness. Qualitative studies indicated a range of barriers and facilitators, which spanned pragmatic, social and psychological issues. The more effective interventions used a range of techniques to address some surface-level psychological and pragmatic concerns, however many deeper-level social, psychological and pragmatic concerns were not addressed.

CONCLUSION

Evidence on the effectiveness of community-based dietary and physical activity interventions is inconclusive. A range of barriers and facilitators exist, some of which were addressed by interventions but some of which require consideration in future research.

Swimming pools and health-related behaviours: results of an Italian multicentre study on showering habits among pool users

OBJECTIVES

Showering before entering a swimming pool is highly recommended to reduce the risk of biological and chemical contamination. This study evaluated the behaviour of indoor swimming pool users; analysed the variables associated with lack of showering; and assessed awareness of the importance of showering.

STUDY DESIGN

Cross-sectional study.

METHODS

A self-administered questionnaire was used to collect data about users of swimming pools located in five different Italian cities. The association between specific variables and the lack of showering was assessed. P < 0.05 was considered to indicate statistical significance.

RESULTS

In total, 4356 questionnaires were analysed. Sixty-five percent of interviewees always showered before entering the pool. The main reason given for pre-swim showering was 'to wash oneself' (50.5%); or 'to get used to the temperature of the water' (44.3%); and 5.2% answered 'for both reasons'. Risk factors significantly associated with lack of showering were: female sex (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.2-1.59), age 14-17 years (OR 5.09, 95% CI 3.40-7.64); not reading the swimming pool rules (OR 1.24, 95% CI 1.10-1.41); living in Central Italy (OR 3.3, 95% CI 2.65-4.1) or Southern Italy (OR 1.35, 95% CI 1.18-1.55); and previous/current attendance of a swimming course (OR 1.7, 95% CI 1.48-1.97).

CONCLUSIONS

The results revealed low compliance with the rule of showering before entering a swimming pool, and little awareness of the preventive role of showering in the hygienic management of swimming pools. There is a need for targeted educational interventions to inform swimming pool users of the reasons for the importance of showering before entering a pool.

Body mass index, safety hazards, and neighborhood attractiveness

BACKGROUND

Neighborhood attractiveness and safety may encourage physical activity and help individuals maintain a healthy weight. However, these neighborhood characteristics may not be equally relevant to health across all settings and population subgroups.

PURPOSE

To evaluate whether potentially attractive neighborhood features are associated with lower BMI, whether safety hazards are associated with higher BMI, and whether environment-environment interactions are present such that associations for a particular characteristic are stronger in an otherwise supportive environment.

METHODS

Survey data and measured height and weight were collected from a convenience sample of 13,102 adult New York City (NYC) residents in 2000-2002; data analyses were completed 2008-2012. Built-environment measures based on municipal GIS data sources were constructed within 1-km network buffers to assess walkable urban form (density, land-use mix, transit access); attractiveness (sidewalk cafés, landmark buildings, street trees, street cleanliness); and safety (homicide rate, pedestrian-auto collision and fatality rate). Generalized linear models with cluster-robust SEs controlled for individual and area-based sociodemographic characteristics.

RESULTS

The presence of sidewalk cafés, density of landmark buildings, and density of street trees were associated with lower BMI, whereas the proportion of streets rated as clean was associated with higher BMI. Interactions were observed for sidewalk cafés with neighborhood poverty, for street-tree density with walkability, and for street cleanliness with safety. Safety hazard indicators were not independently associated with BMI.

CONCLUSIONS

Potentially attractive community and natural features were associated with lower BMI among adults in NYC, and there was some evidence of effect modification.

Mental health and quality of residential environment

BACKGROUND

There is increasing interest in the proposition that residential environment can affect mental health.

AIMS

To study the degree to which common mental disorder clusters according to postcode units and households. To investigate whether contextual measures of residential environment quality and geographical accessibility are associated with symptoms of common mental disorder.

METHOD

A total of 1058 individuals aged 16-75 years (response rate 66%) participated in a cross-sectional survey. The 12-item General Health Questionnaire measured symptoms of common mental disorder.

RESULTS

Only 2% (95% CI 0-6) of the unexplained variation in symptoms existed at postcode unit level, whereas 37% (95% CI 27-49) existed at household-level, but the postcode unit variation was reduced to zero after adjustments. There was little evidence to suggest that residential quality or accessibility were associated with symptoms.

CONCLUSIONS

There was substantial unexplained variation at the household level but we could find no evidence of postcode unit variation and no association with residential environmental quality or geographical accessibility. It is likely that the psychosocial environment is more important than the physical environment in relation to common mental disorder.

Depressive symptoms in mothers of pre-school children--effects of deprivation, social support, stress and neighbourhood social capital

BACKGROUND

Depressive symptoms in mothers of young children can have serious consequences for the health of the child. In particular, children whose mothers are experiencing depressive symptoms are at significantly greater risk of poisoning and accidental injury. A mother's risk of developing depressive symptoms has been shown to be related to socio-economic disadvantage, high levels of stress and a perceived lack of social support. Residents who perceive their neighbourhoods to be of low social capital are more likely to report poor mental health. The aim of this study was to investigate the relationship between maternal depressive symptoms, deprivation, social support, stress and neighbourhood social capital in a group of mothers living in deprived areas of Nottingham, United Kingdom (UK).

DESIGN AND SETTING

A postal questionnaire at entry to a randomised controlled trial (RCT) assessed socio-demographic characteristics and a second questionnaire, 21 months later, assessed depressive symptoms, perceived lack of social support, self-reported stress and individual-level assessment of neighbourhood social capital.

PARTICIPANTS

A total of 846 mothers of young children living in deprived areas in Nottingham, UK, enrolled in the control group of an RCT.

RESULTS

One-third of mothers reported high levels of depressive symptoms. Neighbourhood-level deprivation and receiving means-tested benefits were independently associated with maternal depressive symptoms. A lack of social support and high levels of self-reported stress were also strongly associated with depressive symptoms. Individual-level assessment of neighbourhood social capital was not associated with depressive symptoms amongst mothers after adjusting for self-reported stress.

CONCLUSIONS

Neighbourhood- and individual-level variables of deprivation and psychological distress are more important than mother's assessment of the social capital of the neighbourhood in which she lives in determining the risk of depressive symptoms. Interventions aimed at supporting mothers of young children may be more effective at reducing the risks of depressive symptoms and consequent risks to the child's health than interventions aimed at improving a neighbourhood's social capital.