A multi-method qualitative evaluation of a health evidence intervention with local government for influencing urban development

Introduction 

Urban development impacts on population health and wellbeing through multiple mechanisms, including housing, green spaces and community infrastructure. However, health is often not prioritised during decision-making in this complex system. Studies are needed that explore how to make health-related evidence more influential in urban development. This requires innovative qualitative methods, as measurable impacts are not easy to demonstrate in the short-term. 

Goals and methods 

The local government of a UK city developed a regeneration framework (plan) for a 15 ha area, changing from predominantly industrial to residential use. An embedded researcher worked with the practitioner team to provide locally-relevant health evidence – provided by economists - at key points in the framework development (October 2020 – February 2024). A two-stage qualitative study design was devised to evaluate the impact of this process.  

Stage 1: The embedded researcher collected observational fieldnotes and structured meeting notes, and conducted semi-structured interviews with 5 practitioners involved in framework development (July-September 2023), to explore the intervention’s influence on design decisions. Stage 2: we will undertake document analysis of submitted development proposals and semi-structured interviews with the developers and planning officers involved (January – May 2025), to explore whether the framework has increased health considerations. Data will be analysed inductively, using a framework approach.  

Results 

Stage 1 analysis showed introducing locally-relevant health evidence during meetings enabled practitioners to incorporate consideration of health outcomes in the framework shared with prospective developers. Stage 2 findings will illuminate whether this resulted in healthier proposals being submitted and approved. 

Conclusions 

Multi-method, innovative qualitative approaches are a valuable way to provide important ‘real-time’ insights into the effectiveness of interventions to improve health in urban development, when health outcomes will not be known for several years.