Understanding the patterns and health impact of indoor air pollutant exposures in Bradford, UK: a study protocol

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Abstract

Introduction

Relative to outdoor air pollution, there is little evidence examining the composition and concentrations of indoor air pollution and its associated health impacts. The INGENIOUS project aims to provide the comprehensive understanding of indoor air pollution in UK homes.

Methods and analysis

‘Real Home Assessment’ is a cross-sectional, multimethod study within INGENIOUS. This study monitors indoor air pollutants over 2 weeks using low-cost sensors placed in three rooms in 300 Born in Bradford (BiB) households. Building audits are completed by researchers, and participants are asked to complete a home survey and a health and behaviour questionnaire, in addition to recording household activities and health symptoms on at least 1 weekday and 1 weekend day. A subsample of 150 households will receive more intensive measurements of volatile organic compound and particulate matter for 3 days. Qualitative interviews conducted with 30 participants will identify key barriers and enablers of effective ventilation practices. Outdoor air pollution is measured in 14 locations across Bradford to explore relationships between indoor and outdoor air quality. Data will be analysed to explore total concentrations of indoor air pollutants, how these vary with building characteristics, and whether they are related to health symptoms. Interviews will be analysed through content and thematic analysis.

Ethics and dissemination

Ethical approval has been obtained from the NHS Health Research Authority Yorkshire and the Humber (Bradford Leeds) Research Ethics Committee (22/YH/0288). We will disseminate findings using our websites, social media, publications and conferences. Data will be open access through the BiB, the Open Science Framework and the UK Data Service.

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Most cited references 35

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Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2014)

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The PHQ-9: validity of a brief depression severity measure.

K Kroenke, R L Spitzer, J. Williams (2001)

While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.

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Is Open Access

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

Susan Michie, Maartje M. van Stralen, Robert H. West (2012)

Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2023

Publication date (Electronic): 30 November 2023

Volume: 13

Issue: 12

Electronic Location Identifier: e081099

Affiliations

[1 ] departmentBradford Institute for Health Research, Born in Bradford , Ringgold_1906Bradford Teaching Hospitals NHS Foundation Trust , Bradford, UK

[2 ] departmentDepartment of Chemistry, Wolfson Atmospheric Chemistry Laboratories , Ringgold_8748University of York , York, UK

[3 ] departmentDepartment of Psychology , Ringgold_7315The University of Sheffield , Sheffield, UK

[4 ] departmentYusuf Hamied Department of Chemistry , Ringgold_2152University of Cambridge , Cambridge, UK

[5 ] departmentDepartment of Earth and Environmental Science, School of Natural Sciences, Centre for Atmospheric Science , Ringgold_5292The University of Manchester , Manchester, UK

[6 ] departmentNational Centre for Atmospheric Science , Ringgold_8748University of York , York, UK

[7 ] City of Bradford Metropolitan District Council , Bradford, UK

[8 ] departmentDepartment of Environment and Geography , Ringgold_8748University of York , York, UK

Author notes

[Correspondence to ] Erika Ikeda; erika.ikeda@ 123456bthft.nhs.uk

Author information

Erika Ikeda http://orcid.org/0000-0001-6999-3918

Tiffany C Yang http://orcid.org/0000-0003-4549-7850

Chiara Giorio http://orcid.org/0000-0001-7821-7398

Article

Publisher ID: bmjopen-2023-081099

DOI: 10.1136/bmjopen-2023-081099

PMC ID: 10711829

PubMed ID: 38056942

SO-VID: 4c741e36-4715-468f-a017-5d0ed4c5df7b

License:

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

History

Date received : 18 October 2023

Date accepted : 14 November 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000277, Department for Environment, Food and Rural Affairs, UK Government;

Award ID: Air Quality Grant

Funded by: FundRef http://dx.doi.org/10.13039/501100000270, Natural Environment Research Council;

Award ID: NE/W002256/1

Award ID: PANORAMA Doctoral Training Program

Funded by: National Institute for Health and Care Research Applied Collaboration for Yorkshire and Humber;

Award ID: NHIR200166

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ScienceOpen disciplines: Medicine

Keywords: epidemiologic studies,health equity,observational study,public health,qualitative research,surveys and questionnaires

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ScienceOpen disciplines: Medicine

Keywords: epidemiologic studies, health equity, observational study, public health, qualitative research, surveys and questionnaires

Understanding the patterns and health impact of indoor air pollutant exposures in Bradford, UK: a study protocol

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Abstract

Introduction

Methods and analysis

Ethics and dissemination

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PLOS Global Public Health

Most cited references 35

Using thematic analysis in psychology

The PHQ-9: validity of a brief depression severity measure.

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

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