Development and optimisation of an intervention to increase the intention to act on health and health equity within the private sector of urban development: an evidence, theory and Person-Based Approach

Abstract

Background There is growing evidence that exposure to unhealthy urban environments increases the risk of developing non-communicable diseases (e.g. diabetes, cardiovascular disease, and respiratory illness), with marginalised communities bearing the greatest burden. However, to date, evidence alone has not been sufficient to make health a top priority in the development of urban environments. Methods The aim of this study was to develop and optimise an intervention to increase the intention to act on health and health inequalities by private sector professionals working in urban development, with a focus on consultants and developers. The ‘Changing Mindsets’ intervention was developed through an iterative co-production process using the Person-Based Approach method, drawing on evidence and a novel theoretical framework. Results Intervention development consisted of three stages. Stage 1 involved the collation of theory and evidence, which included the development of a novel theoretical framework, primary mixed methods research and stakeholder engagement. Stage 2 was the intervention modelling phase, where the findings from Stage 1 were integrated through the guiding principles and behavioural analysis tables, which informed the logic model. Stage 3 involved iterative intervention optimisation with members of the target population. The intervention was comprised of two elements: 1) An intervention session consisting of a presentation with group discussion presented by one of the two industry partners working in the private sector of urban development, and 2) A website signposting to tools and resources, networks to support prioritising and integrating health into urban development, and examples of how other organisations have done so. Conclusions We have provided insights into how complex interdisciplinary theory can be combined with evidence of the target group’s needs, issues and challenges using established methodology from the Person-Based Approach and behavioural science. Changing Mindsets is currently being evaluated for its effectiveness and acceptability in the target population. Subsequent to this, there are plans to adapt the intervention to increase the intention to act on other social issues and for other populations.