4.0 Scope and Methodology

4.0

Sc

op

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Me

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The structure of the built environment

and its ability to infl uence the way

people live, move and interact

is integral to human health. This

relationship is multi-dimensional,

crossing spatial, temporal and

discipline boundaries with a complexity

diffi cult to map, monitor and defi ne.

Despite these diffi culties, in order to

achieve the aims of this Review, it is

necessary to identify areas of evidence

paucity and provide tangible guidance

on policy development.

Three key domains of the

healthy built environment relationship

have been identifi ed as the best way

to achieve the aims of the Review.

These domains were initially defi ned

using the knowledge of the HBEP,

with subsequent endorsement

of the Literature Review Steering

Committee. As the work progressed,

the identifi cation of these domains

as the most pertinent and useful was

reinforced. They are:

1. The Built Environment and Getting

People Active.

2. The Built Environment and

Connecting and Strengthening

Communities.

3. The Built Environment and

Providing Healthy Food Options.

These built environment

interventions are the foundations

for supporting human health as they

address the major risk factors for

contemporary chronic disease –

namely, decreased physical activity,

increased stress and social isolation,

and poor nutrition (Booth et al. 2001).

This is articulated in Table One and

Diagram One.

HBEP literature review 4.0 Scope and Methodology 35

4.1 Defi ning the Scope of the Review – the three key

domains of the healthy built environment relationship

The Built Environment and

Getting People Active

The Built Environment

and Connecting and

Strengthening Communities

The Built Environment

and Providing Healthy

Food Options

Table 1: Relationship between Disease Determinants, Risk

Factors and Built Environment Domains

HBEP literature review 4.0 Scope and Methodology

Example disease Relevant disease Example risk factor Relevant domain

risk determinant1 of the health-built

environment

relationship

Type II diabetes Physical Activity Decreased activity The built environment

in daily life can Get People Active

Depression Social Interaction Increased personal The built environment

isolation and fear can Connect and Strengthen Communities

Heart disease Nutrition Reduced access to The built environment can

fresh fruit/vegetables Provide Healthy Food

Options

Physical

Activity

The BEnv can

‘Get People

Active’

Social

Interaction

The BEnv can

‘Connect and

Strengthen

Communities’

NutritionThe BEnv can

‘Provide Healthy

Food Options’

1 Note, the disease risk determinants in this table are those considered most relevant to the three built environment domains

discussed in this Review.

HBEP literature review 4.0 Scope and Methodology 37

Diagram 1: The Domains of Healthy Built Environments

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The methodology for this Review was

systemic and rigorous. The steps

employed are fully detailed here. First,

economic, health, medical, transport

and environmental internet and ‘grey’

literature databases were searched

using terms tailored for each database

(as recommended in Weaver et al.

2002). The parameters for the Review

were also used in defi ning relevant

search terms. The databases and key

word combinations used are listed in

Appendix 1. This part of the Review

took place during April and May, 2010.

The search results were

then screened using article title

and abstract, with duplications and

obviously irrelevant studies removed.

Papers were also sought from experts

in the fi eld, including the project

steering committee. This led to the

compilation of 1,615 references

relevant to the built environment and

health.

The next step in the

methodology was to assess these

references for inclusion in the Review.

This was done using the established

parameters for the Review and

the three key domains of the built

environment-health relationship.

Following this assessment, each

remaining reference was allocated

a code based on its ‘Health-Built

Environment Domain’ and ‘Built

Environment Contribution’ (as

articulated in Diagram 1). The peer

reviewed status of each reference

was also checked against the criteria

of Ulrich’s Periodicals Directory2.

An additional category of ‘other’

was created to classify literature

covering further aspects of healthy

built environments, as well as a new,

emerging body of scholarship. This

was labelled ‘Professional

Development’ and forms part of the

Review.

In total 1,080 references

remained for inclusion in the Review.

The dominance of literature

related to physical activity – Getting

People Active – is illustrated in

Diagram 2. A total of 769 references

were tagged with codes relevant

to physical activity and it was

subsequently decided to use a ‘review

of reviews’ methodology to examine

this literature. Thirty seven literature

reviews were selected for this process.

Selection was based on the knowledge

of the authors and Review committee,

together with a search of the 713

physical activity references for the

word ‘Review’ in the key words or title.

Following an initial overview of

the 37 literature reviews, key themes

were identifi ed and research outcomes

assessed. References from 2010 were

also analysed to ensure that the latest

research was captured.

The same methodology

was used to assess the remaining

primary references in the literature

categorised as relevant to Connecting

and Strengthening Communities

(224 studies) and Providing Healthy

Food Options (138 studies). The only

difference in methodology is the use

of primary references in both of these

categories, rather than the use of

‘review of reviews’.

4.2 Methodology

HBEP literature review 4.0 Scope and Methodology

2 Ulrich’s Periodicals Directory is the standard library directory and database of bibliographic and publisher information for

academic and scholarly research journals. It is trusted as an authoritative and comprehensive source across academic disciplines

and around the world.

A further category ‘other’ was

established. The majority of this

literature relates to Professional

Development with 109 references

identifi ed. This fourth category

includes case studies on best

practice models for policy change,

research on cost benefi t analysis,

and market demand assessment

to encourage policy change. The

category also embraces research

on the interdisciplinary nature of the

health-built environment relationship,

including debates about different types

of research evidence needed for policy

development and implementation. This

is discussed in Section 6.

HBEP literature review 4.0 Scope and Methodology 39

Diagram 2: Breakdown of References Post Categorisation

62%11%

18%

9%

Providing Healthy Food Options

Connecting and Strengthening Communities

Professional Development

Getting People Active