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Changing the environment to improve population health: a framework for considering exposure in natural experimental studies

Humphreys, David K., Panter, Jenna, Sahlqvist, Shannon, Goodman, Anna and Ogilvie, David 2016, Changing the environment to improve population health: a framework for considering exposure in natural experimental studies, Journal of epidemiology and community health, vol. 70, no. 9, pp. 941-946, doi: 10.1136/jech-2015-206381.

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Title Changing the environment to improve population health: a framework for considering exposure in natural experimental studies
Author(s) Humphreys, David K.
Panter, Jenna
Sahlqvist, ShannonORCID iD for Sahlqvist, Shannon orcid.org/0000-0002-3714-9533
Goodman, Anna
Ogilvie, David
Journal name Journal of epidemiology and community health
Volume number 70
Issue number 9
Start page 941
End page 946
Total pages 6
Publisher BMJ
Place of publication London, Eng.
Publication date 2016
ISSN 1470-2738
Keyword(s) Envrionemtnal epidemiology
Environmental epidemiology
Neighborhood/place
Outcome Research Evaluation
PUBLIC HEALTH
RESEARCH METHODS
Summary There is renewed optimism regarding the use of natural experimental studies to generate evidence as to the effectiveness of population health interventions. Natural experimental studies capitalise on environmental and policy events that alter exposure to certain social, economic or environmental factors that influence health. Natural experimental studies can be useful for examining the impact of changes to 'upstream' determinants, which may not be amenable to controlled experiments. However, while natural experiments provide opportunities to generate evidence, they often present certain conceptual and methodological obstacles. Population health interventions that alter the physical or social environment are usually administered broadly across populations and communities. The breadth of these interventions means that variation in exposure, uptake and impact may be complex. Yet many evaluations of natural experiments focus narrowly on identifying suitable 'exposed' and 'unexposed' populations for comparison. In this paper, we discuss conceptual and analytical issues relating to defining and measuring exposure to interventions in this context, including how recent advances in technology may enable researchers to better understand the nature of population exposure to changes in the built environment. We argue that when it is unclear whether populations are exposed to an intervention, it may be advantageous to supplement traditional impact assessments with observational approaches that investigate differing levels of exposure. We suggest that an improved understanding of changes in exposure will assist the investigation of the impact of complex natural experiments in population health.
Language eng
DOI 10.1136/jech-2015-206381
Field of Research 111712 Health Promotion
111706 Epidemiology
111716 Preventive Medicine
1117 Public Health And Health Services
1604 Human Geography
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, BMJ
Free to Read? Yes
Free to Read Start Date 2016-11-01
Persistent URL http://hdl.handle.net/10536/DRO/DU:30083381

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.