title: The Well London program--a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results.
abstract: BACKGROUND
  The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT). The baseline survey data are reported here.
  
  
  METHODS
  The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs); ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys.
  
  
  RESULTS
  There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of physical activity were higher in the Well London adult population but this is likely to be due to the different measurement tools used in the two surveys.
  
  
  CONCLUSIONS
  Randomization of social interventions such as Well London is acceptable and feasible and in this study the intervention and control arms are well-balanced with respect to the primary outcomes and key sociodemographic characteristics. The matched design has improved the statistical efficiency of the study amongst adults but less so amongst adolescents. Follow-up data collection will be completed 2012.
authors: Institute for Health and Human Development, University of East London, Water Lane, E15 4LZ London, UK. g.phillips@uel.ac.uk
authors: Gemma
authors: G
authors: Phillips
authors: Adrian
authors: A
authors: Renton
authors: Derek G
authors: DG
authors: Moore
authors: Christian
authors: C
authors: Bottomley
authors: Elena
authors: E
authors: Schmidt
authors: Shahana
authors: S
authors: Lais
authors: Ge
authors: G
authors: Yu
authors: Martin
authors: M
authors: Wall
authors: Patrick
authors: P
authors: Tobi
authors: Caroline
authors: C
authors: Frostick
authors: Angela
authors: A
authors: Clow
authors: Karen
authors: K
authors: Lock
authors: Mark
authors: M
authors: Petticrew
authors: Richard
authors: R
authors: Hayes
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D002648:Child; D016000:Cluster Analysis; D003153:Community Health Services; D003863:Depression / Q000453:epidemiology; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D016555:Matched-Pair Analysis; D008603:Mental Health; D009043:Motor Activity; D011203:Poverty; D012107:Research Design; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012931:Social Environment; D011795:Surveys and Questionnaires