chapter 1 objectives, scope, methodology and limitation of study
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4.0 Scope and Methodology
4.0
Sc
op
e a
nd
Me
tho
do
log
y
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
Pa
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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