Shimmin, P; Watters, C; Osborn, D; (2018) Open Spaces for Health: Concluding Report. (GOSH Project ). Sussex Community Development Association (SCDA): Newhaven, UK.

Text Green Open Spaces for Health Concluding Report v5.pdf - Published Version Access restricted to UCL open access staff Download (2MB)

Abstract

Summary Green Open Spaces for Health: Concluding Report Rationale and Partnership 1. For some people, making use of green space for enjoyment and leisure activities is embedded in their lives on a near daily basis. These would include members of rambling, sports and nature and heritage groups. At the opposite end of the spectrum are those people who never contemplate using green space in this way. They are likely to be forgoing the range of benefits they might get from doing activities in green space. 2. The Green Open Spaces for Health project (GOSH) was focused on helping this second group of people make better use of the green space in their neighbourhood and nearby it. 3. The project was managed by the Sussex Community Development Association, with funding from a range of stakeholders including the South Downs National Park and East Sussex County Council, Brighton and Hove NHS Trust and Rampion. In kind support came from a number of other local bodies. 4. In kind academic support came from The University of Sussex and University College London. Aims and Objectives 5. The two aims of the project were to: (a) encourage access to the South Downs National Park and other green spaces in Sussex by groups of people who might ordinarily not use green open spaces and (b) undertake research into the impact that activities on the Downs and other green space have on people’s health and wellbeing. 6. Specific objectives covered engaging and supporting people to use green space, co-producing group-based activities to meets participants, evaluating of health and wellbeing impacts based on an appropriate method developed during GOSH and suggesting ways by which the findings from GOSH might be mainstreamed into policy and practice. Engaging communities and overcoming barriers 7. During a pilot phase, work with focus groups drawn from communities that did not use green space showed there were a number of important barriers to be overcome if people were to make better use of green space in and near their neighbourhood. These included: perceptions of rights of access to green space especially perhaps those areas outside towns; anxieties about using green space and practical issues concerned with safety, comfort and convenience. These barriers were not perceived by a comparator group for whom the use of green space was already embedded in their daily lives. 8. During the pilot phase and in the first year, barriers were overcome by following best practice developed over a number of years by SCDA. This meant engaging communities in small group activities each with a facilitator assigned to co-produce a set of activities around green space and to work with the group to overcome barriers concerning perceptions, anxieties and practicalities. Activities included physical, social and cultural ones and were followed for at least 8 weeks. Several groups became fully self-sustaining being led by trained volunteers rather than a facilitator from SCDA. Other groups have with only occasional input from SCDA. Evaluating impacts: Contribution to health and wellbeing 9. In the first, second and third year of the projects qualitative information was collected from a set of semi-structured interviews as part of the research methodology developed to evaluate impacts on health and wellbeing from GOSH participants. SCDA field workers also collected additional material from working with the groups, monitored how groups became self-sustaining and the role of volunteering. They also kept track of some of the GOSH spin-out activities. No other evaluation methods (e.g. WEMWEBS) worked as well as semi-structured interviews. 10. Analysis of semi-structured interviews guided by Bradford-Hill criteria for public health provided some quantitative measure of (a) the life challenges and barriers participants felt contributed to their not making use of green space and (b) a measure of the physical, environmental, cultural and social benefits that they obtained as a result of taking part in GOSH programmes of activity in and around green and open space. A control or comparator group who reported neither challenges nor many benefits from GOSH-type activities emerged naturally from the data. 11. Importantly, those with the greatest need benefited most from GOSH. 12. Combining the analysis of semi-structured interviews with the experience of SCDA staff in facilitating groups indicates the level of facilitation needed to help groups gain benefits and what guidance is needed for groups to become. In summary, groups for whom green and open space is already embedded needed no facilitation; groups with low to moderate needs require facilitation but may well become self-sustaining; groups with higher level of need require the most facilitation but benefit greatly. 13. Over 1200 people have already taken part in GOSH activities and all of these have improved their wellbeing (in terms of the Five Ways to Wellbeing) as participation meant almost all were making significant progress towards meeting the WHO criteria for physical activity; many had improved their connectedness in their community and had engaged in a range of learning and cultural activities involving taking more notice of their local environment. Some had given much to others by being supportive to other group members or by giving their time to train as volunteers and to help lead the fully self-sustaining groups. 14. Viewed through the lens of Patient Activation many participants would likely have started GOSH programmes at level 1 or 2 and many would have ended at level 3 or even 4 (e.g. the volunteers). Value for money: Contribution to the economy 15. Economic benefits from GOSH are a likely to have a minimum value of between £113,358 and £226,716. This would be a benefit:cost ratio of between 1.8:1 and 3.6:1. GOSH easily pays for itself. This is a very good for a project that had not only to deliver benefits but also do development work (e.g. to determine how to overcome the barriers that were identified in the pilot phase and subsequently) at the same time as the programme delivered to a wide range of social groups most of whom did not initially use green and open space. 16. If all 1277 participants in GOSH were to eventually benefit as those in the 5 volunteer led groups are probably doing then benefits would amount to between £332,020 and £664,040 per annum or between £980,736 and £1,992,120 over three years. This is against an initial outlay of £63,000. This would be a benefit:cost ratio of between 16:1 and 32:1. Mainstreaming GOSH findings and approaches 17. Three elements for mainstreaming GOSH findings are needed to help commissioners develop sufficient confidence in green space intervention to fund programmes such as GOSH on a sustainable basis: • A toolkit that indicates how to deliver a programme of green and open space interventions for the most vulnerable groups in society – this has been provided • A roadmap or framework that sets out how investing in green and open space interventions delivers policy and practice needs of funding or commissioning organisation – this has been drafted in outline only as it needs developing in consultation • Confidence in the value for money of green and open space interventions – this can be built through partnership working.

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