Letters
• ‘Partially’ recognised (the revised or final plan recognises some but less than 75% of health issues raised in the SSWAHS response letter).
doi: 10.1111/1753-6405.12221
Population health services can influence land use planning
• ‘Not recognised’ (the revised plan does not recognise any of the issues raised in the SSWAHS response letter).
Harrison Ng Chok,1 Mark Thornell,2 Michelle Maxwell,3 Marilyn Wise,4 Peter Sainsbury2 1. Centre for Primary Health Care and Equity, University of New South Wales 2. Population Health, South Western Sydney Local Health District & Sydney Local Health District, New South Wales 3. NSW Office of Preventive Health-– Get Healthy Service 4. Centre for Primary Health Care and Equity, University of New South Wales
Over the past decade, the health sector in New South Wales has increased its engagement with the planning and development sector to create healthy urban environments that are sustainable and equitable.1 This has been done through the health sector’s increased contributions to decisions about urban planning that could create health promoting changes to urban design, development and health equity.2 Local governments play a significant role in ensuring that plans involving the built environment (policies, projects or services) are positive for their populations.3 The health sector has known of, and understood, the need to influence the decisions of local government and other sectors. The efforts to exert this influence have been undertaken in a range of ways. One has been to establish formalised and streamlined systems to effectively respond to consultative requests for advice on draft policies, projects and plans.4 An audit was undertaken of correspondence between Sydney South West Area Health Service (SSWAHS) and local government and other organisations between 2005 and 2010. The purpose of the audit was to explore the extent to which health-related comments submitted by SSWAHS on draft policies and plans relating to land use and development (referred to as ‘plans’ from here) were integrated into revised plans. To assess the influence of SSWAHS’s comments, the revised plans were examined to determine whether the issues raised by SSWAHS were addressed. The following categories were developed for analysis: • ‘Mostly’ recognised (the revised or final plan recognises equal to or more than 75% of health issues raised in the SSWAHS response letter).
290
Although considerable effort was made to identify all relevant correspondence, changes in locations, personnel and the use of different systems for correspondence (e.g. informal email correspondence) meant that it was impossible to be sure that every possible letter was included. A sample of 98 letters was included in this audit (51 incoming and 43 outgoing). The majority of the 51 incoming letters originated from Strategic Planners and General Managers (n=38) of local governments requesting health comments on land-use planning guidelines, urban development and other development strategies. Other organisations that requested comments were the NSW Department of Planning (n=7) and private planning consultants (n=2). The remaining four local government letters were not requests for health input, however, these were follow-up letters to previous health input correspondence. Most of the incoming letters did not explain reasons for requesting health consultation other than to seek health input. However, legislated plans are required to undergo health input before submission for approval to the NSW Department of Planning.5 The majority of requests were instigated from external sources (63%), with SSWAHS potentially being able to comment on any organisation or statutory authorities’ plans from the area. Twelve of the 15 local governments within the SSWAHS region engaged with SSWAHS during this study period. There was an increase in the frequency of request and response letters from 2007 to 2010. This occurred following a memorandum released from the SSWAHS Director to Area Managers and Directors of SSWAHS departments describing the roles, responsibilities and hierarchy for responding to local government issues that range from large regional/population matters to local plans (although the observed change cannot be attributed to the memo).6
by the Director of Population Health, Planning and Performance. In this audit, 47 outgoing correspondence letters from SSWAHS were included. Four were instigative letters sent from SSWAHS to local governments addressing certain health issues in their plans and policies. The remaining 43 SSWAHS letters were sent to local governments and other organisations in response to their initial consultation for health input. The most common health issues addressed concerned social infrastructure, transport and physical connectivity and social cohesion and social connectivity (according to classification using the NSW Healthy Urban Development Checklist).7 Of the 43 plans that SSWAHS responded to, 30 subsequently revised plans (70%) were publicly available from the respective organisations’ websites. Twenty-three of the 30 revised plans (77%) ‘mostly’ recognised the health recommendations addressed in SSWAHS’s response letters. Five of the 30 revised plans (17%) had ‘partially’ recognised the health recommendations addressed in response letters. The remaining two SSWAHS responses requested continued engagement and consultation in future plans. It is difficult to gauge the impact that the health sector has in increasing or decreasing the amount of follow-up requests for comments from local governments. However, the results from this study suggest more than 75% of recommendations were included in 77% of revised plans. The implementation of a records management process and use of a standard tool (HUD Checklist)7 by SSWAHS to ensure advice about planning proposals was provided in a comprehensive, consistent, relevant, coordinated, high-quality and timely manner, appears to have contributed to this. The study reveals that the health sector can influence land use planning although there was little communication with some local governments. We do not know about missed opportunities that the health sector could have potentially provided input for across the unknown number of plans developed during the study period. Currently, work is under way to build stronger relations with all local governments in the area.
The responsibility for developing responses was shared among the Population Health Directorate staff and the letters were signed
Australian and New Zealand Journal of Public Health © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia
2014 vol. 38 no. 3
Letters
Acknowledgement
doi: 10.1111/1753-6405.12224
The Centre for Primary Health Care and Equity (UNSW) was commissioned to conduct this study and it was funded by the South Western Sydney Local Health District Population Health.
References
Jennifer Atkinson,1 Kerry Haynes1
1. Capon A. Health impacts of urban development: key considerations. N S W Public Health Bull. 2007;18(910):155-6. 2. Northridge ME, Freeman LJ. Urban planning and health equity. Urban Health. 2011;88(3):582-97. 3. Whittington V. Public Health in NSW Local Government: Results of Local Government: Public Health Survey. Sydney (AUST): Local Government and Shires Associations of NSW; 2005. 4. World Health Organization. Health Equity through Intersectoral Action: An Analysis of 18 Country Case Studies. Genenva (CHE): WHO; 2008. 5. New South Wales Department of Planning. Guidelines for Major Project Community Consultation. Sydney (AUST): State Government of New South Wales; 2007. 6. Stewart G. Engagement with Local Government and Regional Organisations. Sydney (AUST): Sydney South West Area Health Service; 2007. 7. Sydney South West Area Health Service. Healthy Urban Development Checklist: A Guide for Health Services when Commenting on Development Policies, Plans and Proposals. Sydney (AUST): New South Wales Department of Health; 2009.
Correspondence to: Mr Harrison Ng Chok, Centre for Nursing Research and Practice Development, University of Western Sydney, Nepean Hospital Court Building, Penrith, NSW 2750; e-mail: [email protected]
Standing meeting rooms – exploring enablers and barriers of interventions to reduce sitting time in the workplace 1. Cancer Council Victoria
In many developed countries, a substantial part of the day during work, leisure and commuting is spent sitting.1,2 Research indicates that a sedentary lifestyle, particularly time spent sitting, contributes to an increased risk of chronic disease such as cardiovascular disease, cancer and Type 2 diabetes.3-8 Interest had been expressed by Cancer Council Victoria staff in trialling workplace health promotion interventions. As the organisation focuses on cancer prevention, research and support, with most staff spending most of their day seated, Cancer Council Victoria wanted to explore the enablers and barriers to use of interventions to reduce sedentary behaviour. Much of the research conducted to date centres on individually focused interventions such as sit-to-stand workstations. While these workstations have the benefit of allowing individuals to adjust desk height as required, they are considerably more expensive than standard workstations, so may not be viable for some workplaces. Standing meeting rooms are a lower-cost option, potentially providing opportunities for large numbers of staff to reduce sitting time. In June 2012, three meeting rooms were equipped with height-adjustable meeting tables, giving staff the option of standing during meetings if they wished. The cost of the tables, which accommodate six to eight people, was about $1,100 each. Staff were encouraged to use the meeting tables through posters displayed in common areas; user tips available in each of the meeting rooms (gaining consensus, positioning, best for shorter meetings); and a staff seminar, where the health benefits of reduced sitting time were presented. In September 2012, all staff (420) were invited by email to complete an online survey about their use of the standing meeting rooms. Of the 196 respondents to the online survey, 67% (n=132) had used one of the standing
2014 vol. 38 no. 3
meeting rooms in the previous month. This group (n=132) were asked to provide answers relating to the most recent meeting they had attended in one of the standing meeting rooms. Forty-two per cent reported that all participants had stood at their most recent meeting, while 45% said that everyone had been seated. In 13% of cases there had been a mixture of sitting and standing. Almost half had discussed whether to sit or stand at the beginning of the meeting (48%), and 4% had discussed it prior to the meeting. Nearly one-third (32%) had made the assumption the group would sit and 12% assumed they would stand. The majority of respondents (95%) reported that it was easy to reach agreement about whether participants would sit or stand. The standing meeting rooms had most commonly been used in the previous month for regular team meetings (39%) and project update meetings (33%). The rooms were used to a lesser extent for brainstorming sessions, meetings with external stakeholders, training, interviews and teleconferences. Meetings were attended on average by eight people. The main reason given for choosing the meeting room was convenience (32%). Twenty-one per cent of respondents reported they had chosen the room because they had wanted to try a standing meeting. Overall, 78% of respondents (36% of all staff) were interested in attending a standing meeting in the future. Unsurprisingly, people who had organised meetings in the standing meeting rooms were most likely to want to participate in future standing meetings (89%). The majority of those who had participated – but not organised a meeting – were also interested (78%), as were people who had not yet used any of the rooms (66%). In additional open-ended comments, the majority of respondents were in favour of the initiative, with some saying that standing meetings were more productive because participants were more alert and engaged. Some noted that standing was not suitable for longer meetings, where participants were of different heights, had disabilities or were pregnant, or where extensive note-taking was required. Standing was considered to be more suitable for internal meetings, rather than interviews or meetings with external stakeholders.
Australian and New Zealand Journal of Public Health © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia
291
• ‘Partially’ recognised (the revised or final plan recognises some but less than 75% of health issues raised in the SSWAHS response letter).
doi: 10.1111/1753-6405.12221
Population health services can influence land use planning
• ‘Not recognised’ (the revised plan does not recognise any of the issues raised in the SSWAHS response letter).
Harrison Ng Chok,1 Mark Thornell,2 Michelle Maxwell,3 Marilyn Wise,4 Peter Sainsbury2 1. Centre for Primary Health Care and Equity, University of New South Wales 2. Population Health, South Western Sydney Local Health District & Sydney Local Health District, New South Wales 3. NSW Office of Preventive Health-– Get Healthy Service 4. Centre for Primary Health Care and Equity, University of New South Wales
Over the past decade, the health sector in New South Wales has increased its engagement with the planning and development sector to create healthy urban environments that are sustainable and equitable.1 This has been done through the health sector’s increased contributions to decisions about urban planning that could create health promoting changes to urban design, development and health equity.2 Local governments play a significant role in ensuring that plans involving the built environment (policies, projects or services) are positive for their populations.3 The health sector has known of, and understood, the need to influence the decisions of local government and other sectors. The efforts to exert this influence have been undertaken in a range of ways. One has been to establish formalised and streamlined systems to effectively respond to consultative requests for advice on draft policies, projects and plans.4 An audit was undertaken of correspondence between Sydney South West Area Health Service (SSWAHS) and local government and other organisations between 2005 and 2010. The purpose of the audit was to explore the extent to which health-related comments submitted by SSWAHS on draft policies and plans relating to land use and development (referred to as ‘plans’ from here) were integrated into revised plans. To assess the influence of SSWAHS’s comments, the revised plans were examined to determine whether the issues raised by SSWAHS were addressed. The following categories were developed for analysis: • ‘Mostly’ recognised (the revised or final plan recognises equal to or more than 75% of health issues raised in the SSWAHS response letter).
290
Although considerable effort was made to identify all relevant correspondence, changes in locations, personnel and the use of different systems for correspondence (e.g. informal email correspondence) meant that it was impossible to be sure that every possible letter was included. A sample of 98 letters was included in this audit (51 incoming and 43 outgoing). The majority of the 51 incoming letters originated from Strategic Planners and General Managers (n=38) of local governments requesting health comments on land-use planning guidelines, urban development and other development strategies. Other organisations that requested comments were the NSW Department of Planning (n=7) and private planning consultants (n=2). The remaining four local government letters were not requests for health input, however, these were follow-up letters to previous health input correspondence. Most of the incoming letters did not explain reasons for requesting health consultation other than to seek health input. However, legislated plans are required to undergo health input before submission for approval to the NSW Department of Planning.5 The majority of requests were instigated from external sources (63%), with SSWAHS potentially being able to comment on any organisation or statutory authorities’ plans from the area. Twelve of the 15 local governments within the SSWAHS region engaged with SSWAHS during this study period. There was an increase in the frequency of request and response letters from 2007 to 2010. This occurred following a memorandum released from the SSWAHS Director to Area Managers and Directors of SSWAHS departments describing the roles, responsibilities and hierarchy for responding to local government issues that range from large regional/population matters to local plans (although the observed change cannot be attributed to the memo).6
by the Director of Population Health, Planning and Performance. In this audit, 47 outgoing correspondence letters from SSWAHS were included. Four were instigative letters sent from SSWAHS to local governments addressing certain health issues in their plans and policies. The remaining 43 SSWAHS letters were sent to local governments and other organisations in response to their initial consultation for health input. The most common health issues addressed concerned social infrastructure, transport and physical connectivity and social cohesion and social connectivity (according to classification using the NSW Healthy Urban Development Checklist).7 Of the 43 plans that SSWAHS responded to, 30 subsequently revised plans (70%) were publicly available from the respective organisations’ websites. Twenty-three of the 30 revised plans (77%) ‘mostly’ recognised the health recommendations addressed in SSWAHS’s response letters. Five of the 30 revised plans (17%) had ‘partially’ recognised the health recommendations addressed in response letters. The remaining two SSWAHS responses requested continued engagement and consultation in future plans. It is difficult to gauge the impact that the health sector has in increasing or decreasing the amount of follow-up requests for comments from local governments. However, the results from this study suggest more than 75% of recommendations were included in 77% of revised plans. The implementation of a records management process and use of a standard tool (HUD Checklist)7 by SSWAHS to ensure advice about planning proposals was provided in a comprehensive, consistent, relevant, coordinated, high-quality and timely manner, appears to have contributed to this. The study reveals that the health sector can influence land use planning although there was little communication with some local governments. We do not know about missed opportunities that the health sector could have potentially provided input for across the unknown number of plans developed during the study period. Currently, work is under way to build stronger relations with all local governments in the area.
The responsibility for developing responses was shared among the Population Health Directorate staff and the letters were signed
Australian and New Zealand Journal of Public Health © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia
2014 vol. 38 no. 3
Letters
Acknowledgement
doi: 10.1111/1753-6405.12224
The Centre for Primary Health Care and Equity (UNSW) was commissioned to conduct this study and it was funded by the South Western Sydney Local Health District Population Health.
References
Jennifer Atkinson,1 Kerry Haynes1
1. Capon A. Health impacts of urban development: key considerations. N S W Public Health Bull. 2007;18(910):155-6. 2. Northridge ME, Freeman LJ. Urban planning and health equity. Urban Health. 2011;88(3):582-97. 3. Whittington V. Public Health in NSW Local Government: Results of Local Government: Public Health Survey. Sydney (AUST): Local Government and Shires Associations of NSW; 2005. 4. World Health Organization. Health Equity through Intersectoral Action: An Analysis of 18 Country Case Studies. Genenva (CHE): WHO; 2008. 5. New South Wales Department of Planning. Guidelines for Major Project Community Consultation. Sydney (AUST): State Government of New South Wales; 2007. 6. Stewart G. Engagement with Local Government and Regional Organisations. Sydney (AUST): Sydney South West Area Health Service; 2007. 7. Sydney South West Area Health Service. Healthy Urban Development Checklist: A Guide for Health Services when Commenting on Development Policies, Plans and Proposals. Sydney (AUST): New South Wales Department of Health; 2009.
Correspondence to: Mr Harrison Ng Chok, Centre for Nursing Research and Practice Development, University of Western Sydney, Nepean Hospital Court Building, Penrith, NSW 2750; e-mail: [email protected]
Standing meeting rooms – exploring enablers and barriers of interventions to reduce sitting time in the workplace 1. Cancer Council Victoria
In many developed countries, a substantial part of the day during work, leisure and commuting is spent sitting.1,2 Research indicates that a sedentary lifestyle, particularly time spent sitting, contributes to an increased risk of chronic disease such as cardiovascular disease, cancer and Type 2 diabetes.3-8 Interest had been expressed by Cancer Council Victoria staff in trialling workplace health promotion interventions. As the organisation focuses on cancer prevention, research and support, with most staff spending most of their day seated, Cancer Council Victoria wanted to explore the enablers and barriers to use of interventions to reduce sedentary behaviour. Much of the research conducted to date centres on individually focused interventions such as sit-to-stand workstations. While these workstations have the benefit of allowing individuals to adjust desk height as required, they are considerably more expensive than standard workstations, so may not be viable for some workplaces. Standing meeting rooms are a lower-cost option, potentially providing opportunities for large numbers of staff to reduce sitting time. In June 2012, three meeting rooms were equipped with height-adjustable meeting tables, giving staff the option of standing during meetings if they wished. The cost of the tables, which accommodate six to eight people, was about $1,100 each. Staff were encouraged to use the meeting tables through posters displayed in common areas; user tips available in each of the meeting rooms (gaining consensus, positioning, best for shorter meetings); and a staff seminar, where the health benefits of reduced sitting time were presented. In September 2012, all staff (420) were invited by email to complete an online survey about their use of the standing meeting rooms. Of the 196 respondents to the online survey, 67% (n=132) had used one of the standing
2014 vol. 38 no. 3
meeting rooms in the previous month. This group (n=132) were asked to provide answers relating to the most recent meeting they had attended in one of the standing meeting rooms. Forty-two per cent reported that all participants had stood at their most recent meeting, while 45% said that everyone had been seated. In 13% of cases there had been a mixture of sitting and standing. Almost half had discussed whether to sit or stand at the beginning of the meeting (48%), and 4% had discussed it prior to the meeting. Nearly one-third (32%) had made the assumption the group would sit and 12% assumed they would stand. The majority of respondents (95%) reported that it was easy to reach agreement about whether participants would sit or stand. The standing meeting rooms had most commonly been used in the previous month for regular team meetings (39%) and project update meetings (33%). The rooms were used to a lesser extent for brainstorming sessions, meetings with external stakeholders, training, interviews and teleconferences. Meetings were attended on average by eight people. The main reason given for choosing the meeting room was convenience (32%). Twenty-one per cent of respondents reported they had chosen the room because they had wanted to try a standing meeting. Overall, 78% of respondents (36% of all staff) were interested in attending a standing meeting in the future. Unsurprisingly, people who had organised meetings in the standing meeting rooms were most likely to want to participate in future standing meetings (89%). The majority of those who had participated – but not organised a meeting – were also interested (78%), as were people who had not yet used any of the rooms (66%). In additional open-ended comments, the majority of respondents were in favour of the initiative, with some saying that standing meetings were more productive because participants were more alert and engaged. Some noted that standing was not suitable for longer meetings, where participants were of different heights, had disabilities or were pregnant, or where extensive note-taking was required. Standing was considered to be more suitable for internal meetings, rather than interviews or meetings with external stakeholders.
Australian and New Zealand Journal of Public Health © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia
291
