HEALTHY NEIGHBORHOODS FUND and STUDY 11/9/ /9/2016 1

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HEALTHY NEIGHBORHOODS FUND and STUDY 11/9/2016 1 11/9/2016 1 1

Mission We use law, science and the market to create solutions that preserve our natural resources, build healthy communities, and sustain a vibrant economy. CLF s Focus Areas Clean Energy & Climate Change Healthy Communities Healthy Forests Oceans 11/9/2016 2 11/9/2016 2 2

Healthy Neighborhoods Equity Fund: Catalyzing Markets, Building Healthy Places Enabling and accelerating real estate development projects that can profoundly impact population health: Mixed-use Mixed-income Near transit, jobs, and services Pedestrian-oriented Green space and recreation Healthy food choices Landscape design by CBA Landscape Architects/Photograph Ed Wonsek 11/9/2016 3 11/9/2016 3 3 3

Health Neighborhoods Study Fund Evaluation and Natural Experiment Research Opportunity Opportunity to learn more about the relationship between changing places and population health, and the mediating factors that drive it in natural experiment. Research Questions 1. Population: What is driving changes in population health? 2. Development: How do intensity and concentration of development impact population health? 3. Human Impact: What changes in health and well-being are people experiencing? 11/9/2016 4 11/9/2016 4 4

Research Design and Project Timeline Multi-site Cohort Study Longitudinal Mixed- Method Inter- Disciplinary Big Data Community Engaged 11/9/2016 5 11/9/2016 5 5

Selecting Measures though a Participatory Process Research Advisory Team Resident Researchers Pathways and Root Causes Theory of Change Variables Measures 11/9/2016 6 6

Theory of Change IF mixed-income, mixed-use transit-oriented developments are built in urban communities with struggling health and economics, that are also walkable and in early to mid-stage transformational redevelopment, THEN exposure and access to health-promoting features will increase, and population level perceptions, health behaviors and ultimately health outcomes will improve over time. 11/9/2016 7 7

Developing Measures: Key Domains NEIGHBORHOOD CONTEXT HEALTH DEVELOPMENT RESIDENT EXPERIENCES 11/9/2016 8 11/9/2016 8 8

Developing Measures Data Partners NEIGHBORHOOD CONTEXT HEALTH Community Research Partners DEVELOPMENT RESIDENT EXPERIENCES 11/9/2016 9 11/9/2016 9 9

Community Action Research (CAR) Goals Human Impact: Measure resident experiences Research Design: Co-create methods and measures that are equally useful, and usable for the research team, community partners and residents Measure: resident experiences, does and exposure, and Changes in the 5Cs, perceptions, behavior, and health Types of Knowledge Experiential Why CAR? CAR Generates actionable usable knowledge based on experiences and insights of communities Cultural CAR Mainstream 11/9/2016 10 11/9/2016 10 10

Community Action Research Team 11/9/2016 11 11/9/2016 11 11

Community Action Research (CAR) Process 1. Scoping Set participation goals and how communities will use the results 2. Knowledge Sharing Use experiential, cultural and community knowledge to develop theory of change 3. Research Design ID constructs for data collection Develop survey, methods and sampling criteria 4. Data Capture IRB, ethics and surveyor training Collect data from residents 5. Analysis Identify trends within and across groups 6. Dissemination Residents/partner organizations: local action Research Team: to inform variable selection 11/9/2016 12 11/9/2016 12 12

Community Action Research: Tools & Measures Surveys & Focus Groups 50-70 resident participants per community Survey Topics (Measurement Domains) Housing Mobility Neighborhood Tenure Community Cohesion Employment Discrimination Ownership of Change Mental and Physical Health Life Priorities & Neighborhood Match 11/9/2016 13 11/9/2016 13 13

Selecting Measures Research Advisory Team Resident Researchers Health Impact Assessment Literature review Case studies Pathways and Root Causes Theory of Change Personal journals Observations Community talks ID & Prioritize Themes Variables ID & Prioritize Themes Existing 2 data Measures Existing & new surveys 11/9/2016 14 11/9/2016 14 14

Example Resident Researchers Health Impact Assessments Literature Reviews Case Studies Pathways and Root Causes Theory of Change Opportunity, Quality of life, Access to healthy options Authentic, meaningful engagement of current residents mediates access and perception Themes Data Inventory Domains & Variables Control, Choice, Cohesion and Connectedness by quality of life and opportunity Existing studies, tools and databases Measures Existing: Health, Discrimination (BRFSS) New: Ownership of Change; Neighborhood match 11/9/2016 15 11/9/2016 15 15

Final List of Variables Included in Dataset NEIGHBORHOOD CONTEXT Redevelopment DEVELOPMENT Built Environment & Features Social Context Planning Context Pipeline and Intensity Population Real Estate Behaviors Development Outcomes Mobility Cost and Burden of Care Health Community Context HEALTH RESIDENT EXPERIENCES 11/9/2016 16 11/9/2016 16 16