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. 2023 Mar 15;23(1):498.
doi: 10.1186/s12889-023-15388-2.

A natural experiment to assess how urban interventions in lower socioeconomic areas influence health behaviors: the UrbASanté study

Hélène Charreire  1   2 , Benoit Conti  3 , Lucile Bauchard  3 , Ndèye Aïta Cissé  3 , Marlène Perignon  4 , Pascaline Rollet  4 , Coline Perrin  5 , Sophie Blanchard  6 , Céline Roda  7 , Thierry Feuillet  8 , Malika Madelin  9 , Vincent Dupuis  10 , Anne-Sophie Evrard  11 , Anne-Peggy Hellequin  12 , Isabelle Coll  13 , Corinne Larrue  6 , Sophie Baudet-Michel  14 , Gabrielle Vernouillet  15 , Fernande Ntsame-Abegue  16 , Isabelle Fabre  17 , Caroline Méjean  4 , Jean-Michel Oppert  18   19 ; UrbASanté Study Group
Affiliations

A natural experiment to assess how urban interventions in lower socioeconomic areas influence health behaviors: the UrbASanté study

Hélène Charreire et al. BMC Public Health. .

Abstract

Background: Mechanisms underlying the associations between changes in the urban environment and changes in health-related outcomes are complex and their study requires specific approaches. We describe the protocol of the interdisciplinary UrbASanté study, which aims to explore how urban interventions can modify environmental exposures (built, social, and food environments; air quality; noise), health-related behaviors, and self-reported health using a natural experiment approach.

Methods: The study is based on a natural experiment design using a before/after protocol with a control group to assess changes in environmental exposures, health-risk behaviors, and self-reported health outcomes of a resident adult population before and after the implementation of a time series of urban interventions in four contiguous neighborhoods in Paris (France). The changes in environmental exposures, health-related behaviors, and self-reported health outcomes of a resident adult population will be concurrently monitored in both intervention and control areas. We will develop a mixed-method framework combining substantial fieldwork with quantitative and qualitative analytical approaches. This study will make use of (i) data relating to exposures and health-related outcomes among all participants and in subsamples and (ii) interviews with residents regarding their perceptions of their neighborhoods and with key stakeholders regarding the urban change processing, and (iii) existing geodatabases and field observations to characterize the built, social, and food environments. The data collected will be analyzed with a focus on interrelationships between environmental exposures and health-related outcomes using appropriate approaches (e.g., interrupted time series, difference-in-differences method).

Discussion: Relying on a natural experiment approach, the research will provide new insights regarding issues such as close collaboration with urban/local stakeholders, recruitment and follow-up of participants, identification of control and intervention areas, timing of the planned urban interventions, and comparison of subjective and objective measurements. Through the collaborative work of a consortium ensuring complementarity between researchers from different disciplines and stakeholders, the UrbASanté study will provide evidence-based guidance for designing future urban planning and public health policies.

Trial registration: This research was registered at the ClinicalTrial.gov (NCT05743257).

Keywords: Environmental exposures; Lifestyle behaviors; Natural experiment; Self-reported health; Urban intervention.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Overall design of the UrbASanté study. (adapted from Leatherdale et al., 2019)
Fig. 2
Fig. 2
Intervention and control neighborhoods of the study area of the UrbASanté study
Fig. 3
Fig. 3
Flowchart of the survey in the UrbASanté study
See this image and copyright information in PMC

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