Ride-Hailing and Road Traffic Crashes: A Critical Review.

Ride-hailing businesses, including Uber and Lyft, have reshaped road traffic since they first began operating in the United States approximately a decade ago. It follows that ride-hailing may also alter the incidence and distribution of road traffic crash injuries and deaths. The available evidence relating ride-hailing to crashes is critically reviewed in this article. We present a theoretical model that synthesizes the hypothesized mechanisms, and we identify common methodological challenges and suggest priorities for future research. Mixed results have been reported for the overall incidence of road traffic crash injuries and deaths, likely due to heterogeneous impacts on vehicular traffic flow (e.g., increasing the volume of vehicles); on vehicle-, person-, and event-level characteristics (e.g., reducing alcohol-impaired driver crashes); on road-user types (e.g., increasing pedestrian crashes); and on environmental conditions (e.g., reducing crashes most substantially where public transit access is poorest). The lack of a well-developed theory of human mobility and methodological challenges that are common to many ecological studies impede exploration of these sources of moderation. Innovative solutions are required to explicate ride-hailing's heterogeneous impacts, to guide policy that can take advantage of the public health benefits of ride-hailing, and to ensure that research keeps pace with technological advances that continue to reshape road traffic use.

Trends in inpatient care for psychiatric disorders in NHS hospitals across England, 1998/99-2019/20: an observational time series analysis.

PURPOSE: It is unclear how hospitals are responding to the mental health needs of the population in England, against a backdrop of diminishing resources. We aimed to document patterns in hospital activity by psychiatric disorder and how these have changed over the last 22 years. METHODS: In this observational time series analysis, we used routinely collected data on all NHS hospitals in England from 1998/99 to 2019/20. Trends in hospital admissions and bed days for psychiatric disorders were smoothed using negative binomial regression models with year as the exposure and rates (per 1000 person-years) as the outcome. When linear trends were not appropriate, we fitted segmented negative binomial regression models with one change-point. We stratified by gender and age group [children (0-14 years); adults (15 years +)]. RESULTS: Hospital admission rates and bed days for all psychiatric disorders decreased by 28.4 and 38.3%, respectively. Trends were not uniform across psychiatric disorders or age groups. Admission rates mainly decreased over time, except for anxiety and eating disorders which doubled over the 22-year period, significantly increasing by 2.9% (AAPC = 2.88; 95% CI: 2.61-3.16; p < 0.001) and 3.4% (AAPC = 3.44; 95% CI: 3.04-3.85; p < 0.001) each year. Inpatient hospital activity among children showed more increasing and pronounced trends than adults, including an increase of 212.9% for depression, despite a 63.8% reduction for adults with depression during the same period. CONCLUSION: In the last 22 years, there have been overall reductions in hospital activity for psychiatric disorders. However, some disorders showed pronounced increases, pointing to areas of growing need for inpatient psychiatric care, especially among children.

Effectiveness of cash-plus programmes on early childhood outcomes compared to cash transfers alone: A systematic review and meta-analysis in low- and middle-income countries.

BACKGROUND: To strengthen the impact of cash transfers, these interventions have begun to be packaged as cash-plus programmes, combining cash with additional transfers, interventions, or services. The intervention's complementary ("plus") components aim to improve cash transfer effectiveness by targeting mediating outcomes or the availability of supplies or services. This study examined whether cash-plus interventions for infants and children <5 are more effective than cash alone in improving health and well-being. METHODS AND FINDINGS: Forty-two databases, donor agencies, grey literature sources, and trial registries were systematically searched, yielding 5,097 unique articles (as of 06 April 2021). Randomised and quasi-experimental studies were eligible for inclusion if the intervention package aimed to improve outcomes for children <5 in low- and middle-income countries (LMICs) and combined a cash transfer with an intervention targeted to Sustainable Development Goal (SDG) 2 (No Hunger), SDG3 (Good Health and Well-being), SDG4 (Education), or SDG16 (Violence Prevention), had at least one group receiving cash-only, examined outcomes related to child-focused SDGs, and was published in English. Risk of bias was appraised using Cochrane Risk of Bias and ROBINS-I Tools. Random effects meta-analyses were conducted for a cash-plus intervention category when there were at least 3 trials with the same outcome. The review was preregistered with PROSPERO (CRD42018108017). Seventeen studies were included in the review and 11 meta-analysed. Most interventions operated during the first 1,000 days of the child's life and were conducted in communities facing high rates of poverty and often, food insecurity. Evidence was found for 10 LMICs, where most researchers used randomised, longitudinal study designs (n = 14). Five intervention categories were identified, combining cash with nutrition behaviour change communication (BCC, n = 7), food transfers (n = 3), primary healthcare (n = 2), psychosocial stimulation (n = 7), and child protection (n = 4) interventions. Comparing cash-plus to cash alone, meta-analysis results suggest Cash + Food Transfers are more effective in improving height-for-age (d = 0.08 SD (0.03, 0.14), p = 0.02) with significantly reduced odds of stunting (OR = 0.82 (0.74, 0.92), p = 0.01), but had no added impact in improving weight-for-height (d = -0.13 (-0.42, 0.16), p = 0.24) or weight-for-age z-scores (d = -0.06 (-0.28, 0.15), p = 0.43). There was no added impact above cash alone from Cash + Nutrition BCC on anthropometrics; Cash + Psychosocial Stimulation on cognitive development; or Cash + Child Protection on parental use of violent discipline or exclusive positive parenting. Narrative synthesis evidence suggests that compared to cash alone, Cash + Primary Healthcare may have greater impacts in reducing mortality and Cash + Food Transfers in preventing acute malnutrition in crisis contexts. The main limitations of this review are the few numbers of studies that compared cash-plus interventions against cash alone and the potentially high heterogeneity between study findings. CONCLUSIONS: In this study, we observed that few cash-plus combinations were more effective than cash transfers alone. Cash combined with food transfers and primary healthcare show the greatest signs of added effectiveness. More research is needed on when and how cash-plus combinations are more effective than cash alone, and work in this field must ensure that these interventions improve outcomes among the most vulnerable children.

Firearm Homicide Incidence, Within-state Firearm Laws, and Interstate Firearm Laws in US Counties.

BACKGROUND: Firearm homicides occur less frequently in US states with more firearm control laws. However, firearms are easily transported across state lines, and laws in one location may affect firearm violence in another. This study examined associations between within-state firearm laws and firearm homicide while accounting for interference from laws in other nearby states. METHODS: The units of analysis were 3,107 counties in the 48 contiguous US states, arrayed in 15 yearly panels for 2000 to 2014 (n = 46,605). The dependent measure was firearm homicides accessed from the Centers for Disease Control and Prevention (CDC) Compressed Mortality Data. The main independent measures were counts of firearm laws and the proportion of laws within categories (e.g., background checks, child access prevention laws). We calculated these measures for interstate laws using a geographic gravity function between county centroids. Bayesian conditional autoregressive Poisson models related within-state firearm laws and interstate firearm laws to firearm homicides. RESULTS: There were 172,726 firearm homicides in the included counties over the 15 years. States had between 3 and 100 firearm laws. Within-state firearm laws (incidence rate ratio [IRR] = 0.995, 95% confidence interval [CI] = 0.992, 0.997) and interstate firearm laws (IRR = 0.993, 95% CI = 0.990, 0.996) were independently associated with fewer firearm homicides, and associations for within-state laws were strongest where interstate laws were weakest. CONCLUSIONS: Additional firearm laws are associated with fewer firearm homicides both within the states where the laws are enacted and elsewhere in the United States. Interference from interstate firearm laws may bias associations for studies of within-state laws and firearm homicide.

Effects of Laws Expanding Civilian Rights to Use Deadly Force in Self-Defense on Violence and Crime: A Systematic Review.

Background. Since 2005, most US states have expanded civilian rights to use deadly force in self-defense outside the home. In most cases, legislation has included removing the duty to retreat anywhere one may legally be, commonly known as stand-your-ground laws. The extent to which these laws affect public health and safety is widely debated in public and policy discourse.Objectives. To synthesize the available evidence on the impacts and social inequities associated with changing civilian rights to use deadly force in self-defense on violence, injury, crime, and firearm-related outcomes.Search Methods. We searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, Sociological Abstracts, National Criminal Justice Reference Service Abstracts, Education Resources Information Center, International Bibliography of the Social Sciences, ProQuest Dissertations and Theses, Google Scholar, National Bureau of Economic Research working papers, and SocArXiv; harvested references of included studies; and consulted with experts to identify studies until April 2020.Selection Criteria. Eligible studies quantitatively estimated the association between laws that expanded or restricted the right to use deadly force in self-defense and population or subgroup outcomes among civilians with a comparator.Data Collection and Analysis. Two reviewers extracted study data using a common form. We assessed study quality using the Risk of Bias in Nonrandomized Studies of Interventions tools adapted for (controlled) before-after studies. To account for data dependencies, we conducted graphical syntheses (forest plots and harvest plots) to summarize the evidence on impacts and inequities associated with changing self-defense laws.Main Results. We identified 25 studies that estimated population-level impacts of laws expanding civilian rights to use deadly force in self-defense, all of which focused on stand-your-ground or other expansions to self-defense laws in the United States. Studies were scored as having serious or critical risk of bias attributable to confounding. Risk of bias was low across most other domains (i.e., selection, missing data, outcome, and reporting biases). Stand-your-ground laws were associated with no change to small increases in violent crime (total and firearm homicide, aggravated assault, robbery) on average across states. Florida-based studies showed robust increases (24% to 45%) in firearm and total homicide while self-defense claims under stand-your-ground law were more often denied when victims were White, especially when claimants were racial minorities.Author's Conclusions. The existing evidence contradicts claims that expanding self-defense laws deters violent crime across the United States. In at least some contexts, including Florida, stand-your-ground laws are associated with increases in violence, and there are racial inequities in the application of these laws.Public Health Implications. In some US states, most notably Florida, stand-your-ground laws may have harmed public health and safety and exacerbated social inequities. Our findings highlight the need for scientific evidence on both population and equity impacts of self-defense laws to guide legislative action that promotes public health and safety for all.Trial Registration. Open Science Framework (https://osf.io/uz68e).

Ridesharing and motor vehicle crashes: a spatial ecological case-crossover study of trip-level data.

BACKGROUND: Ridesharing services (eg, Uber, Lyft) have facilitated over 11 billion trips worldwide since operations began in 2010, but the impacts of ridesharing on motor vehicle injury crashes are largely unknown. - METHODS: This spatial ecological case-cross over used highly spatially and temporally resolved trip-level rideshare data and incident-level injury crash data for New York City (NYC) for 2017 and 2018. The space-time units of analysis were NYC taxi zone polygons partitioned into hours. For each taxi zone-hour we calculated counts of rideshare trip origins and rideshare trip destinations. Case units were taxi zone-hours in which any motor vehicle injury crash occurred, and matched control units were the same taxi zone from 1 week before (-168 hours) and 1 week after (+168 hours) the case unit. Conditional logistic regression models estimated the odds of observing a crash (separated into all injury crashes, motorist injury crashes, pedestrian injury crashes, cyclist injury crashes) relative to rideshare trip counts. Models controlled for taxi trips and other theoretically relevant covariates (eg, precipitation, holidays). RESULTS: Each additional 100 rideshare trips originating within a taxi zone-hour was associated with 4.6% increased odds of observing any injury crash compared with the control taxi zone-hours (OR=1.046; 95% CI 1.032 to 1.060). Associations were detected for motorist injury and pedestrian injury crashes, but not cyclist injury crashes. Findings were substantively similar for analyses conducted using trip destinations as the exposure of interest. CONCLUSIONS: Ridesharing contributes to increased injury burden due to motor vehicle crashes, particularly for motorist and pedestrian injury crashes at trip nodes.

Long-term Exposure to Neighborhood Deprivation and Intimate Partner Violence Among Women: A UK Birth Cohort Study.

BACKGROUND: Intimate partner violence is the most common form of violence perpetrated against women. To our knowledge, the effect of neighborhood disadvantage on intimate partner violence against women has never been investigated prospectively outside the United States. METHODS: We used data from the Avon Longitudinal Study of Parents and Children in the United Kingdom, which followed our target sample, 7,219 women, from birth and their mothers (from pregnancy). At age 21, 2,128 participants self-reported the frequency of experiencing physical, psychological, or sexual intimate partner violence since age 18. Participants' exposure to neighborhood-level deprivation and family-level socioeconomic characteristics (e.g., income) were measured at 10 time points from baseline (gestation) until children were 18 years old. We estimated the effect of cumulative exposure to greater neighborhood-level deprivation on the risk of experiencing intimate partner violence using marginal structural models with stabilized inverse probability weights, accounting for time-varying confounding by socioeconomic indicators and sample attrition. RESULTS: A one-unit increase in cumulative exposure to more severe neighborhood deprivation was associated with a 62% increase in participants' frequency of experiencing intimate partner violence (95% confidence interval 11%, 237%) and 36% increase in their risk of experiencing any intimate partner violence (95% confidence interval 1%, 85%). CONCLUSIONS: In our study, cumulative exposure to greater neighborhood deprivation over the first 18 years of life was associated with women's increased risk of experiencing intimate partner violence in early adulthood. Future studies should test this association across contexts, including underlying mechanisms, and evaluate preventive strategies that target structural disparities.

Evaluating the impact of penalising the use of mobile phones while driving on road traffic fatalities, serious injuries and mobile phone use: a systematic review.

BACKGROUND: A vast literature has demonstrated that using mobile phones while driving increases the risk of road traffic crashes. In response, policy-makers have introduced bans and harsher penalties on using mobile phones while driving. Even though emerging evidence suggests that such measures may reduce mobile phone use and crashes, the literature has not been systematically reviewed and synthesised. OBJECTIVE: To evaluate the impact of penalising mobile phone use while driving on road traffic fatalities, serious injuries and the prevalence of mobile phone use while driving. METHODS: We employed a comprehensive search strategy using electronic databases, websites, handsearching and other sources to locate studies evaluating legislation on mobile phone use while driving. Randomised controlled trials, interrupted time series', controlled before-after studies with control(s) not exposed to harsher sanctions and panel data designs were included if they measured the outcomes of fatalities, serious injuries or the prevalence of mobile phone use while driving. Eligible studies were critically appraised. Due to substantial heterogeneity, the results were synthesised narratively. The synthesis structured studies according to the type of legislation and outcome measure. RESULTS: Of the 7420 studies retrieved, 32 were included. The evidence on the effects of penalising mobile phone use while driving was weak, and somewhat inconsistent, but pointed to a potential decrease in the prevalence of mobile phone use and fatalities for all-driver primary enforcement hand-held bans and texting bans. CONCLUSIONS: Preventing fatalities from risky driving practices may be helped by implementing harsher laws that penalise mobile phone use while driving.

Increasing adolescent firearm homicides and racial disparities following Florida's 'Stand Your Ground' self-defence law.

Establishing whether specific laws impact rates of firearm homicide in adolescents is critical for identifying opportunities to reduce preventable adolescent death. We evaluated Florida's Stand Your Ground law, enacted October 2005, using an interrupted time series design from 1999 to 2017. We used segmented quasi-Poisson regression to model underlying trends in quarterly rates of adolescent (15-19 years) firearm homicide in Florida and disaggregated by race (Black/White). We used synthetic and negative controls (firearm suicide) to address time-varying confounding. Before Florida's Stand Your Ground law, the mean quarterly rate was 1.53 firearm homicides per 100 000 adolescents. Black adolescents comprised 63.5% of all adolescent firearm homicides before and 71.8% after the law. After adjusting for trends, the law was associated with a 44.6% increase in adolescent firearm homicide. Our analysis indicates that Florida's Stand Your Ground is associated with a significant increase in firearm homicide and may also exacerbate racial disparities.

Assessing the impact of a local community subsidised rideshare programme on road traffic injuries: an evaluation of the Evesham Saving Lives programme.

BACKGROUND: Alcohol-related vehicle crashes pose a significant challenge to public health in suburban communities. The Evesham Saving Lives programme operated between late 2015 and 2019 in two townships (Evesham and Voorhees) in New Jersey. The programme subsidised rideshare (eg, Uber) trips from bars and restaurants between the hours of 21:00 and 02:00 to prevent alcohol-related traffic injuries. METHODS: This study used data from the New Jersey Department of Transportation to examine changes to rates of injury crashes between 2010 and 2018. We used an ecological difference-in-difference design with Bayesian conditional autoregressive Poisson models to compare rates of injury crashes between participating municipalities (n=2) and non-participating municipalities (n=75). Sensitivity analyses included comparison with a weighted synthetic control series. RESULTS: The Evesham Saving Lives programme was associated with 18% fewer injury crashes overall (IRR=0.82, 95% credible interval (CrI): 0.76, 0.88). Reductions in crashes were estimated to be greatest at night (IRR=0.62, 95% CrI: 0.48, 0.79), with moderate reductions in the afternoon (IRR=0.80, 95% CrI: 0.72, 0.88). We estimate that around three lives were saved (95% CrI: 2, 5) and around 371 injuries were prevented (95% CrI: 204, 625), potentially making considerable savings in terms of medical and economic expenses. CONCLUSIONS: These findings support the claim that improving the convenience and reducing the costs of alternative night-time transportation can prevent road traffic injuries. Future studies should aim to replicate these analyses in programmes that have been implemented in other suburban communities across the US.

Risk and Protective Factors for Intimate Partner Violence Against Women: Systematic Review and Meta-analyses of Prospective-Longitudinal Studies.

BACKGROUND: The estimated lifetime prevalence of physical or sexual intimate partner violence (IPV) is 30% among women worldwide. Understanding risk and protective factors is essential for designing effective prevention strategies. OBJECTIVES: To quantify the associations between prospective-longitudinal risk and protective factors and IPV and identify evidence gaps. SEARCH METHODS: We conducted systematic searches in 16 databases including MEDLINE and PsycINFO from inception to June 2016. The study protocol is registered with PROSPERO (CRD42016039213). SELECTION CRITERIA: We included published and unpublished studies available in English that prospectively analyzed any risk or protective factor(s) for self-reported IPV victimization among women and controlled for at least 1 other variable. DATA COLLECTION AND ANALYSIS: Three reviewers were involved in study screening. One reviewer extracted estimates of association and study characteristics from each study and 2 reviewers independently checked a random subset of extractions. We assessed study quality with the Cambridge Quality Checklists. When studies investigated the same risk or protective factor using similar measures, we computed pooled odds ratios (ORs) by using random-effects meta-analyses. We summarized heterogeneity with I2 and τ2. We synthesized all estimates of association, including those not meta-analyzed, by using harvest plots to illustrate evidence gaps and trends toward negative or positive associations. MAIN RESULTS: Of 18 608 studies identified, 60 were included and 35 meta-analyzed. Most studies were based in the United States. The strongest evidence for modifiable risk factors for IPV against women were unplanned pregnancy (OR = 1.66; 95% confidence interval [CI] = 1.20, 1.31) and having parents with less than a high-school education (OR = 1.55; 95% CI = 1.10, 2.17). Being older (OR = 0.96; 95% CI = 0.93, 0.98) or married (OR = 0.93; 95% CI = 0.87, 0.99) were protective. CONCLUSIONS: To our knowledge, this is the first systematic, meta-analytic review of all risk and protective factors for IPV against women without location, time, or publication restrictions. Unplanned pregnancy and having parents with less than a high-school education, which may indicate lower socioeconomic status, were shown to be risk factors, and being older or married were protective. However, no prospective-longitudinal study investigated the associations between IPV against women and any community or structural factor outside the United States, and more studies investigated risk factors related to women as opposed to their partners. Public health implications. This review highlights that prospective evidence for perpetrator- and context-related risk and protective factors for women's experiences of IPV outside of the United States is lacking and urgently needed to inform global policy recommendations. The current evidence base of prospective studies suggests that, at least in the United States, education and sexual health interventions may be effective targets for preventing IPV against women, with young, unmarried women at greatest risk.

Regional differences in the impact of the "Stand Your Ground" law in Florida.

In October 2005, Florida relaxed restrictions on the use of lethal force in self-defense with the Florida stand your ground law (SYG). We examined whether and how the impact of the Florida SYG varied based on the demographic and economic conditions of each of its counties. Using data from the Florida Universal Crime Reports on homicides and firearm homicides from 1999 to 2014, we found that the impact differed significantly by county urbanization, unemployment, and pre-law homicide rates. The largest increases in homicide and firearm homicide occurred in proportionally safer, richer, and less ethnically diverse suburban counties. These findings reveal that the law may have had the opposite effect than intended, and more strongly impacted counties considered safe, suburban and economically successful.

What works to promote walking at the population level? A systematic review.

OBJECTIVE: Interventions to promote walking have focused on individual or group-based approaches, often via the randomised controlled trial design. Walking can also be promoted using population health approaches. We systematically reviewed the effectiveness of population approaches to promote walking among individuals and populations. DESIGN: A systematic review. DATA SOURCES: 10 electronic databases searched from January 1990 to March 2017. ELIGIBILITY CRITERIA: Eligibility criteria include pre-experimental and postexperimental studies of the effects of population interventions to change walking, and the effects must have been compared with a 'no intervention', or comparison group/area/population, or variation in exposure; duration of ≥12 months of follow up; participants in free-living populations; and English-language articles. RESULTS: 12 studies were identified from mostly urban high-income countries (one focusing on using tax, incentivising the loss of parking spaces; and one using policy only, permitting off-leash dogs in city parks). Five studies used mass media with either environment (n=2) or community (n=3) approaches. Four studies used environmental changes that were combined with policies. One study had scaled up school-based approaches to promote safe routes to schools. We found mass media, community initiatives and environmental change approaches increased walking (range from 9 to 75 min/week).

Questioning the application of risk of bias tools in appraising evidence from natural experimental studies: critical reflections on Benton et al., IJBNPA 2016.

We recently read the article by Benton et al. which reviewed risk of bias in natural experimental studies investigating the impact of the built environment on physical activity (Benton et al., 2016; Int J Behav Nutr Phys Act 13:107). As a technical exercise in assessing risk of bias to understand study quality, we found the results of this study both interesting and potentially useful. However, it prompted a number of concerns with the use of risk of bias tools for assessing the quality of evidence from studies exploiting natural experiments. As we discuss in this commentary, the rigid application of such tools could have adverse effects on the uptake and use of natural experiments in population health research and practice.

Sexual Violence Among Higher Education Students in the United Kingdom: Results from the Oxford Understanding Relationships, Sex, Power, Abuse and Consent Experiences Study.

Sexual violence (SV) experienced by higher education students is a prevalent public health problem. Collecting data on SV through self-report surveys in higher education institutions (HEIs) is essential for estimating the scope of the problem, the first step to adequately resourcing and implementing prevention and response programming and policies. However, in the United Kingdom, data is limited. We used data from the cross-sectional Oxford Understanding Relationships, Sex, Power, Abuse and Consent Experiences survey, administered to all students at a university in the United Kingdom in May 2021 (n = 25,820), to estimate the past year prevalence of SV. We analyzed data from respondents who answered at least one question on SV (n = 1,318) and found that 20.5% of respondents experienced at least one act of attempted or forced sexual touching or rape, and 52.7% of respondents experienced at least one act of sexual harassment (SH). We found that women experienced the highest rates of SV. Attempted forced sexual touching was far more common than forced sexual touching, or rape. Sexist remarks or jokes were the most common act of SH. Most acts of SV took place at the university. These findings reveal that the prevalence of SV in HEIs in the United Kingdom could be far higher than what is experienced in the general population. While this study reflects the context in only one institution, it underlines the need for continued monitoring to develop rigorous, evidence-based, and targeted prevention and response strategies.

Impact and Equity of New York City's Tobacco Retail Reduction Initiative.

INTRODUCTION: High levels of tobacco retailer density in communities is associated with a range of tobacco use behaviors and is a key structural driver of tobacco-related disparities. This study evaluates the impacts of New York City's (NYC) novel policy intervention to cap tobacco retail licenses on tobacco retailer density levels and neighborhood inequities in tobacco access. METHODS: Using geocoded tobacco retail licensing data from 2010 to 2022, Bayesian conditional autoregressive Poisson panel models estimated the association between policy implementation in 2018 and retailer density per 1,000 population, controlling for neighborhood-level sociodemographic factors. Data were analyzed in 2023. RESULTS: The number of tobacco retail licenses decreased from 9,304 in 2010 to 5,107 in 2022, with the rate of decline significantly accelerating post-policy (-14·2% versus -34·2%). Policy effects were stronger in districts with lower income and greater proportions of non-Hispanic Black residents. CONCLUSIONS: NYC's policy substantially reduced tobacco retailer density and appeared to close longstanding patterns of inequity in tobacco access, serving as a rare example of a tobacco control policy that may effectively reduce tobacco-related disparities. This emergent approach to restructure tobacco retail in communities may reach populations that have not benefitted from traditional tobacco control policies and should be considered by other localities.

Synthesising evidence for equity impacts of population-based physical activity interventions: a pilot study.

BACKGROUND: This study applied an equity lens to existing research to investigate what is known about the impact of population-level physical activity interventions on social inequalities. METHODS: We performed a pilot systematic review to assess the availability of information on the social distribution of intervention effects, the targeting or allocation of interventions, and the baseline characteristics of participants. This comprised (i) a rapid review of systematic reviews and (ii) a review and synthesis of a sample of primary studies included in the eligible systematic reviews. RESULTS: We found 19 systematic reviews of environmental and policy interventions. Relatively few of these (26%, n=5) were prospectively designed to examine effects on inequalities, and none were able to fully synthesise evidence of distributional effects. Over 40% of primary studies reported subgroup intervention effects; 18% reported socio-demographic interaction effects. Studies most often compared effectiveness by gender, followed by age, ethnicity, and socio-economic status. For gender, effects appeared to be evenly distributed overall, although heterogeneity in gradients between studies suggested that some interventions affect males and females differently. CONCLUSIONS: Our findings suggest that it is feasible to generate better evidence about how public health interventions may affect health inequalities using existing data and innovative methods of research synthesis.

Associations between active commuting and physical and mental wellbeing.

OBJECTIVE: To examine whether a relationship exists between active commuting and physical and mental wellbeing. METHOD: In 2009, cross-sectional postal questionnaire data were collected from a sample of working adults (aged 16 and over) in the Commuting and Health in Cambridge study. Travel behaviour and physical activity were ascertained using the Recent Physical Activity Questionnaire (RPAQ) and a seven-day travel-to-work recall instrument from which weekly time spent in active commuting (walking and cycling) was derived. Physical and mental wellbeing were assessed using the Medical Outcomes Study Short Form survey (SF-8). Associations were tested using multivariable linear regression. RESULTS: An association was observed between physical wellbeing (PCS-8) score and time spent in active commuting after adjustment for other physical activity (adjusted regression coefficients 0.48, 0.79 and 1.21 for 30-149 min/week, 150-224 min/week and ≥ 225 min/week respectively versus < 30 min/week, p=0.01 for trend; n=989). No such relationship was found for mental wellbeing (MCS-8) (p=0.52). CONCLUSION: Greater time spent actively commuting is associated with higher levels of physical wellbeing. Longitudinal studies should examine the contribution of changing levels of active commuting and other forms of physical activity to overall health and wellbeing.

The Prevalence of Sexual Assault Among Higher Education Students: A Systematic Review With Meta-Analyses.

Sexual assault among higher education students has detrimental impacts on the health and educational outcomes of survivors. This systematic review aims to describe and synthesize the available quantitative evidence on sexual assault prevalence among this population. We searched Medline, EMBASE, Global Health, PsycINFO, Web of Science, ERIC, and CINAHL for studies published in English, French, Italian, and Spanish from database inception to August 2020 (updated May 2022). We screened studies using prespecified inclusion criteria for the population and context (registered higher education students), condition (self-reported sexual assault), and study design (quantitative survey). The Joanna Briggs Institute Critical Appraisal Checklist was used to assess study quality. Prevalence estimates disaggregated by type of sexual assault, gender identity, and world region were meta-analyzed using a random-effects model and reported following PRISMA guidance. We identified 131 articles, from 21 different countries. The meta-analyzed prevalence of sexual assault was 17.5% for women, 7.8% for men, and 18.1% for transgender and gender diverse people. Four types of sexual assault were identified: rape, attempted rape, forced sexual touching, and coercive sex. Forced sexual touching was the most common act experienced. The African Region had the highest prevalence estimates for women's sexual assault, and the Western Pacific region had the highest prevalence estimates for men's sexual assault. Higher education institutions, especially those outside of the United States, should commit to the implementation of surveys to monitor sexual assault prevalence and dedicate increased resources to supporting student survivors of sexual assault.

Self-Report Survey Measures of Alcohol-Impaired Driving: A Systematic Review.

OBJECTIVE: Alcohol-impaired driving is a major contributor to motor vehicle crash deaths and injury. Many survey studies include self-report measures of alcohol-impaired driving, but no guidance is available to help researchers select from among available measures. The aims of this systematic review were to compile a list of measures that researchers have used previously, to compare performance between measures, and to identify the measures with highest validity and reliability. METHOD: Literature searches of PubMed, Scopus, and Web of Science identified studies that assessed alcohol-impaired driving behavior through self-report. The measures from each study and, if available, indices of reliability or validity were extracted. Using the measures' text, we developed 10 codes to group similar measures and compare them. For example, the "alcohol effects" code refers to driving while feeling dizzy or lightheaded after drinking, and the "drink count" code pertains to the number of drinks someone consumed before driving. For measures with multiple items, each item was categorized separately. RESULTS: After screening according to the eligibility criteria, 41 articles were included in the review. Thirteen articles reported on reliability. No articles reported on validity. The self-report measures with the highest reliability coefficients contained items from multiple codes, namely alcohol effects and drink count. CONCLUSIONS: Self-report alcohol-impaired driving measures with multiple items evaluating distinct aspects of alcohol-impaired driving show better reliability than measures using a single item. Future work investigating the validity of these measures is needed to determine the best approach for conducting self-report research in this area.