Currently, the engagement of local communities in Health Impact Assessment is becoming more and more important. A scoping review was performed to take stock of visions, methods and experiences in this field.A combined Scopus and Medline search yielded 100 articles in scientific journals. The final selection consisted of 43 papers, including case studies, evaluation studies, reviews, and opinion papers. After analysis, consultation of four experts was performed to check preliminary study outcomes. A grey literature web search was performed to check and complement the results.Results show that community participation is generally considered a core element in HIA. Views as expressed in the papers concern, firstly, the need for and value of local knowledge, secondly, the adherence to or application of democratic values and, thirdly, empowerment of communities. Three categories of methods are used in relation to community participation, often in combination: methods to facilitate knowledge elicitation, to ensure the inclusion of communities in the HIA process, and to build community capacity to participate in policy development. However, the theoretical or practical underpinning of the choice for specific methods is mostly not presented. The experiences described in the papers mainly focus on the access to local knowledge and its usability as a source of evidence in the HIA process. Described effects of community participation are (improved) relations between communities and local agencies, policy makers and professionals and the empowerment of community members. Although these effects are ascribed to community participation, many papers do not provide support for this conclusion beyond the retrospective perception of participants. Expert consultation and additional analysis of the grey literature supported the results derived from the scientific literature and provided more in-depth knowledge. In the grey literature theoretical frameworks, methods and tools for community participation in HIA were more extensively reported as compared to the scientific literature.We conclude that the visions, methods and experiences concerning community participation show that a participative approach may contribute to better, context specific knowledge. It appears that participative HIA has health promotion potential as it helps develop responsive policies.To accomplish this, HIA should, firstly, be better embedded in broader health promotion programmes. Secondly, the methods and approaches for community participation applied in HIA should be theory-informed and well described. The grey literature offers entry points. Finally, more robust and systematic evaluation and research is needed to assess the impact of HIAs on communities and policies.
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This chapter discusses the development of health impact assessment (HIA) in The Netherlands. HIA in The Netherlands began in the early 1990s and developed along two different lines: one shaped by the public health approach and the other stemming from the environmental field. Public health-based HIA evolved according to the paradigm presented by the Lalonde model of health. The HIAs mainly concerned national policies and addressed a variety of policy fields, ranging from tobacco discouragement and health insurance policy to national housing policy and the high-speed rail link. The environmental-based HIA focused on preventing environmentally related health risks and did not consider health in a broader sense. There is no legal obligation for environmental impact assessments to consider health impacts outside an environmental scope. If a first screening of the planned activity points to large health impacts or many concerns about potential health effects, a more detailed quantitative health impact assessment should be carried out.
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Het team van het Healthy Urban Living Lab heeft samen met veel studenten van de Hogeschool van Amsterdam een Health Impact Assessment (HIA) uitgevoerd op de plannen voor het Bajes Kwartier. Dat is een groene, gezonde, duurzameAmsterdamse stadswijk die wordt gebouwd op het terrein van de voormalige Bijlmerbajes, gelegen in Stadsdeel Oost nabij de Amstel. In deze nieuwe wijk komen ongeveer 1.350 koop- en huurwoningen, variërend van betaalbarestarterswoningen tot exclusieve huizen en zorgwoningen. De focus van de HIA lag op drie aspecten die an groot belang zijn voor de gezondheid van inwoners van Amsterdam: bewegen, gezonde voeding en ontmoeten. Daarmeesluit de HIA aan bij de grootste uitdagingen voor de gezondheid van de Amsterdammers, overgewicht en eenzaamheid. Een HIA is een kritische en systematische beschouwing van een project, met als doel de kansen voor gezondheid en onbedoelde aspecten (zoals gezondheidsrisico’s) in kaart te brengen. Om te onderzoeken hoe de ambitie ‘alle bewoners leven hier twee jaar langer en gezonder kan worden gerealiseerd, is het Behaviour Change Wheel van Susan Michie (2011) gebruikt als theoretisch kader. Dit wetenschappelijkonderbouwde gedragsveranderingsmodel wordt ingezet voor het systematisch ontwerpen en evalueren van interventies en voor beleid dat is gericht op gedragsverandering. Het wordt veelal toegepast in de gezondheidsbevordering. Daarbij spelen drie elementen de hoofdrol: Capabilities (fysieke en psychologische vaardigheden), Opportunities (aspecten in de fysieke of sociale leefomgeving) en Motivation (bewuste en onbewuste processen die tot gedrag leiden). Naast een scan van het masterplan voor het Bajes Kwartier – vanuit het oogpunt van gezondheid – is een doelgroepanalyse gemaakt door middelvan een vragenlijst die werd verspreid onder belangstellenden c.q. toekomstige bewoners, een groepsbijeenkomst en doelgroepenonderzoek door studenten. Er is ook een wetenschappelijke literatuurstudie verricht. Vanuit de volksgezondheid kent de gezonde leefomgeving een afwisseling van bebouwing met groen, aantrekkelijke, uitdagende en gevarieerde openbare ruimten die uitnodigen tot bewegen, spelen en sport, gezond eten, het ontmoeten vanbuurtgenoten, een breed voorzieningenaanbod (waaronder ook een openbare toiletten en een maximale bereikbaarheid en verkeersveiligheid met de fiets en het openbaar vervoer). Daarnaast is in de leefomgeving sociale steun en socialeveiligheid nodig. Het beschikbaar maken van een leefomgeving die deze elementen bevat, is op zich niet voldoende. Er zijn ook activiteiten en netwerkennodig die bevorderen dat deze wijkinfrastructuur daadwerkelijk wordt benut. Zowel uit de literatuur als uit het doelgroepenonderzoek kwam dit naar voren als een belangrijke sleutel tot het creëren van gezondheidswinst. De conclusies die volgen uit de resultaten van de HIA, resulteren in vijf basisaanbevelingen.1) Focus op de diverse groepen. Iedere bewoner heeft recht op een gezonde omgeving. De gezondheidswinst die te behalen valt is het grootst onder kwetsbare groepen zoals bewoners met een lage sociaal economische status, ouderen en kinderen. 2) Gezond gedrag vereist participatie van bewoners waarbij alle doelgroepen vertegenwoordigd zijn. 3) Verbind de hardware met de software, maak een koppeling tussen de inrichting van de fysieke en de sociale omgeving 4) Zet alle vormen en varianten van nudging in, het helpt bewoners een gezonde leefstijl aan te nemen. 5) Hanteer een integrale aanpak waarbij deverschillende verantwoordelijke stakeholders zoals ontwerpers, planologen, burgers, kennisinstellingen, private partijen (zoals startups), gemeentes, GGD’en, zorgverzekeraars en zorgverleners vanaf het begin in eenruimtelijk planproces samenwerken
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Stakeholder engagement in Environmental Impact Assessment (EIA) and Health Impact Assessment (HIA) provides opportunities for inclusive environmental decision-making contributing to the attainment of agreement about the potential environmental and health impacts of a plan. A case evaluation of stakeholder engagement was carried out to assess its effect in terms of consensus-building. The case consisted in two health impact scoping workshops engaging 20 stakeholders: policy-makers, experts and residents. A Participatory Action Research approach was adopted. Methods included observation, semi-structured questionnaires and interviews. Analysis methods consisted of several coding rounds, in-depth reading and discussion of Atlas.ti output reports, as well as studying questionnaire results. Participants reported a broadening of perspectives on health in relation to the environment and attainment of shared perspectives. Still, meaningful differences remained, indicating that joint learning experiences, trust and mutual respect created a ‘sense of consensus’ rather than a joint view on the issues at stake. To avoid disappointment and conflict in later project development, explicit acknowledgment and acceptance of disagreements should be included as a ground rule in future stakeholder engagement processes.
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Diet related non-communicable diseases (NCDs), as well as micronutrient deficiencies, are of widespread and growing importance to public health. Authorities are developing programs to improve nutrient intakes via foods. To estimate the potential health andeconomic impact of these programs there is a wide variety of models. The aim of this review is to evaluate existing models to estimate the health and/or economic impact of nutrition interventions with a focus on reducing salt and sugar intake andincreasing vitamin D, iron, and folate/folic acid intake. The protocol of this systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42016050873). The final search was conducted onPubMed and Scopus electronic databases and search strings were developed for salt/sodium, sugar, vitamin D, iron, and folic acid intake. Predefined criteria related to scientific quality, applicability, and funding/interest were used to evaluate the publications. In total 122 publications were included for a critical appraisal: 45 for salt/sodium, 61 for sugar, 4 for vitamin D, 9 for folic acid, and 3 for iron. The complexity of modelling the health and economic impact of nutrition interventions is dependent on the purpose and data availability. Although most of the models have the potential to provide projections of future impact, the methodological challenges are considerable. There is a substantial need for more guidance and standardization for future modelling, to compare results ofdifferent studies and draw conclusions about the health and economic impact of nutrition interventions.
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This booklet reports on experiments carried out by Van Hall Larenstein University of Applied Sciences in the context of the VALUE project. It consists of three parts. The first two chapters describe some experiments carried out in the Dutch town of Amersfoort and the students’ input and approach. This is followed by an intermezzo on sources of inspiration outside the Netherlands and examples of the way urban green spaces and elements can provide an impulse for towns and cities. The final two chapters concern the way such a green strategy can be designed in Dutch urban settings. Chapter 5 discusses how local governments can use the added value provided by urban green spaces for new investments:value capturing. Chapter 6 focuses on a new type of planning: Planning by Surprise, which combines dreams and pragmatism. The photo essay at the centre of the book tells the story of the many sides of green spaces in towns and cities. Unintentional, intentional, planned, dreamed of, drawn,remembered, pictured, developed: Planning by Surprise.
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Pieter Gillislezing van Universiteit van Antwerpen In deze lezing vraagt van der Heijden zich af hoeveel openheid een samenleving kan verdragen. Op een manier waarin hij zowel zijn journalistieke als zijn historische kwaliteiten laat zien, toont hij aan dat de drang naar een open samenleving niet op zichzelf kan staan, wil die open samenleving duurzaam zijn. De zoektocht naar openheid moet geflankeerd worden door een authentiek zoeken naar wat we met die openheid willen doen. Ruimte moet gevuld worden, wil ze niet verworden tot leegte
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Background: Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland. Methods: Fifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence. Results: Results show adaptations mainly focused on experiential and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect those typical in German speaking countries. Conceptual equivalence mainly addressed aspects of “involvement” and “environment” of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions. Conclusions: This study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. Using a modified cultural adaptation process, a culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.
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Background: Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Participation and Environment Measure for Children and Youth (PEM-CY) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The aim of this study was to cross-culturally translate and adapt the PEM-CY into German as it is used in Germany, Austria and Switzerland. Methods: Fifteen parents of children and adolescents with disabilities from three German speaking countries participated in three rounds of think-aloud interviews. We followed the procedure of cultural equivalence guidelines including two additional steps. Data was analyzed by content analysis using semantic, idiomatic, experiential and conceptual equivalence. Results: Results show adaptations mainly focused on experiential and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Examples of experiential equivalence included adapting the examples of activities in the PEM-CY to reflect those typical in German speaking countries. Conceptual equivalence mainly addressed aspects of “involvement” and “environment” of children and adolescents and was reached through adaptations such as enhanced instructions and structures, and additional definitions. Conclusions: This study presents a cross-cultural translation and adaptation process to develop a German version of the PEM-CY that is suitable for Germany, Austria and Switzerland. Using a modified cultural adaptation process, a culturally adapted version of PEM-CY (German) is now available for research, practice and further validation.
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SummarySocial impact assessment (SIA) developed alongside EIA in the early 1970s as a mechanism to consider the social impacts of planned interventions. The early understanding tended to limit the practical application of SIA to the project level, usually within the context of regulatory frameworks, and primarily considered only the direct negative impacts. However, like other types of impact assessment, SIA has evolved over time and has diverged considerably from EIA. Nowadays, SIA has widened its scope to become a“philosophy about development and democracy”. Ideally SIA considers the pathologies, goals, and processes of development. In this broad understanding, it now focuses on the management of all social issues, intending to bring about a more sustainable and equitable biophysical and human environment.The SIA field defines “social” very broadly, as “anything that affects people and their communities”. Thus,for example, all environmental impacts are also social impacts because people depend on the environment for their livelihoods as well as their physical and spiritual well-being. Social impact concepts include people’s way of life, their culture, community, political systems, environment, health and wellbeing, personal and property rights, and their fears and aspirations.Formerly seen as a regulatory tool required by regulatory agencies but resented by proponents, SIA, for a variety of reasons, is now increasingly being embraced by corporations and used as an internal process for managing social issues. Such a shift towards corporate acceptance, of course, does not guarantee that SIA will always be done properly, or that it is able to adequately influence company operations.Several other shifts have been observed: greater consideration of benefits; moving towards developing and implementing Social Impact Management Plans; communities themselves actively commissioning, or doing, their own SIA studies; SIA playing an important part in ensuring “free, prior and informed consent” and gaining a “sociallicense to operate”.Health issues have a central place in SIA. Many of the social impacts of projects could also be described as health impacts, and all health impacts would be regarded as social impacts in SIA. In SIA, health impacts are considered amongst a wide range of impacts on people and communities. SIA practitioners are supposed to look from an integrated perspective. Arguably, this means that the determinants of health should be addressed when SIA is carried out properly. Nevertheless, SIA guidelines do not typically require a detailed analysis of the origins of, or pathways to, specific health conditions. There is, however, a strong awareness of indirect effects and cumulative effects.In actual practice, the SIA approach used highly depends on the type of policy, plan or project being considered, as well as on the legal and cultural context, on client requirements, and on the commitment of the individual practitioner or consultancy. The SIA case studies considered in this chapter usually discussed the broader determinants of health but did not necessarily recognize them as such. The pathways from social impacts to health, and the linkages between health and social impacts, were not explicitly part of the analysis. Overall, the input of health expertise into SIAs seemed to be lacking. However, given the close connections between the HIA and SIA approaches, more cooperation and crossfertilization between these two types of impact assessment can be expected in the future.
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