Abstract
Objective
Built environment interventions provide structural solutions to complex urban challenges. Though community voices are part of municipal decision-making, planners and public health professionals need tools to better integrate their perspectives for desired changes (what) when implementing built environment interventions (how). We present two simultaneous concept mapping exercises conducted in Montréal, Canada, to facilitate the consideration of these dimensions.
Methods
Community members were prompted about neighbourhood changes that could improve their quality of life; stakeholders were prompted about factors that contribute to successful implementation of interventions. Through each exercise, items were generated, grouped, and rated on importance and feasibility. Concept maps were produced using multidimensional scaling and hierarchical cluster analysis. The clusters identified by community members and stakeholders were combined into a Community × Stakeholder Matrix, which supported discussions on interventions with the research’s Advisory Committee.
Results
Thirty-two community members generated 41 responses, which resulted in 6 clusters: (1) strengthen public transportation, (2) reduce space dedicated to cars, (3) foster local social connections, (4) develop quality cycling infrastructure, (5) improve pedestrian accessibility, and (6) green the city. Thirty-seven stakeholders generated 40 items, which resulted in 5 clusters: (1) collaboration with stakeholders and citizens, (2) planning and evaluation, (3) common vision for the future, (4) regulatory framework and funding, and (5) context-informed approach.
Conclusion
Capturing the collective vision of our urban environments and the processes underlying change through concept mapping can lead to more successful changes. We propose combining understandings of the what and how into a matrix to support evaluation and strategic planning of interventions and better integrate community voices into operational planning.
Résumé
Objectif
Les interventions sur le cadre bâti peuvent offrir des solutions structurelles aux défis urbains complexes. Bien que les communautés fassent partie du processus décisionnel municipal, les urbanistes et les professionnels de la santé publique ont besoin d’outils pour mieux intégrer leurs perspectives sur les changements souhaités (le quoi) dans la mise en œuvre réussie des programmes et des interventions sur l’environnement bâti (le comment). Nous présentons deux exercices simultanés de cartographie conceptuelle menés à Montréal, Canada, visant à capter ces dimensions de mise en œuvre.
Méthodes
Les membres de la communauté ont été sondés sur les changements dans leur quartier qui seraient susceptibles d’améliorer leur qualité de vie, tandis que des acteurs municipaux ont été sondés sur les facteurs qui contribuent à la réussite de la mise en œuvre des interventions urbaines. Pour chaque exercice, des items ont été générés, regroupés et notés en fonction de leur importance et de leur faisabilité. Des cartes conceptuelles ont été produites à l’aide d’analyse multivariée d’étalonnage multidimensionnel et d’une analyse hiérarchique ascendante. Les regroupements identifiés par les membres de la communauté et les acteurs municipaux ont été combinés dans une matrice communauté × acteurs municipaux, qui a encadré une discussion sur les interventions sur le cadre bâti avec le comité consultatif du programme de recherche.
Résultats
Trente-deux membres de la communauté ont généré 41 réponses uniques, qui ont formé 6 regroupements : (1) renforcer les transports en commun, (2) réduire l’espace dédié aux voitures, (3) favoriser le lien social local, (4) développer des infrastructures cyclables de qualité, (5) améliorer l’accessibilité piétonne, et (6) verdir la ville. Trente-sept acteurs municipaux ont généré 40 éléments uniques, qui ont mené à 5 regroupements : (1) collaboration avec les parties prenantes et les citoyens, (2) planification et évaluation, (3) vision commune pour l’avenir, (4) cadre réglementaire et financement, et (5) approche contextuelle.
Conclusion
En captant la vision collective sur nos environnements urbains et la compréhension des processus sous-jacents au changement avec la cartographie conceptuelle, les transformations urbaines peuvent être plus réussies et plus inclusives. Nous proposons de combiner les perspectives sur le quoi et le comment dans une matrice pour soutenir l’évaluation et la planification stratégique d’interventions, tout en promouvant l’intégration des voix de la communauté dans la planification opérationnelle de l’aménagement urbain.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Availability of data and material
The datasets generated and/or analyzed during the current study are not publicly available because they contain sensitive data about participants, but are available from the corresponding author on request.
Code availability
Not applicable.
References
Alhassan, J. A. K., Gauvin, L., Judge, A., Fuller, D., Engler-Stringer, R., & Muhajarine, N. (2021). Improving health through multisectoral collaboration: Enablers and barriers. Canadian Journal of Public Health, 112(6), 1059–1068. https://doi.org/10.17269/s41997-021-00534-3
Allen, M. L., Schaleben-Boateng, D., Davey, C. S., Hang, M., & Pergament, S. (2015). Concept mapping as an approach to facilitate participatory intervention building. Progress in Community Health Partnerships: Research, Education, and Action, 9(4), 599–608. https://doi.org/10.1353/cpr.2015.0076
Bouchard, L. (2013). La cartographie conceptuelle des représentations de l’avenir des services de santé en français en situation linguistique minoritaire. Canadian Journal of Public Health, 104(6), S60–S64. https://doi.org/10.17269/cjph.104.3454
Cantinotti, M., Ladouceur, R., & Jacques, C. (2009). Lay and scientific conceptualizations of impaired control at electronic gambling machines. Addiction Research & Theory, 17(6), 650–667. https://doi.org/10.3109/16066350802290623
Carlini, B. H., Garrett, S. B., Matos, P., Nims, L. N., & Kestens, Y. (2024). Identifying policy options to regulate high potency cannabis: A multiple stakeholder concept mapping study in Washington State, USA. International Journal of Drug Policy, 123, 104270. https://doi.org/10.1016/j.drugpo.2023.104270
Charrad, M., Ghazzali, N., Boiteau, V., & Niknafs, A. (2014). NbClust: An R package for determining the relevant number of clusters in a data set. Journal of Statistical Software, 61, 1–36. https://doi.org/10.18637/jss.v061.i06
de Leeuw, E. (2023). Epistemic courage and health political science. Canadian Journal of Public Health, 114(3), 328–330. https://doi.org/10.17269/s41997-023-00769-2
de Leeuw, E., Clavier, C., & Breton, E. (2014). Health policy – Why research it and how: Health political science. Health Research Policy and Systems, 12(1), 55. https://doi.org/10.1186/1478-4505-12-55
Fazli, G. S., Creatore, M. I., Matheson, F. I., Guilcher, S., Kaufman-Shriqui, V., Manson, H., Johns, A., & Booth, G. L. (2017). Identifying mechanisms for facilitating knowledge to action strategies targeting the built environment. BMC Public Health, 17(1), 1–9. https://doi.org/10.1186/s12889-016-3954-4
Firth, C. L., Stephens, Z. P., Cantinotti, M., Fuller, D., Kestens, Y., & Winters, M. (2021). Successes and failures of built environment interventions: Using concept mapping to assess stakeholder perspectives in four Canadian cities. Social Science & Medicine, 268, 113383. https://doi.org/10.1016/j.socscimed.2020.113383
Gaventa, J. (2004). Representation, community leadership and participation: Citizen involvement in neighbourhood renewal and local governance prepared for the Neighbourhood Renewal Unit Office of Deputy Prime Minister. Accessed on March 19, 2024 at https://assets.publishing.service.gov.uk/media/57a08cd8ed915d3cfd001664/JGNRU.pdf
Godschalk, D. R. (2004). Land use planning challenges: Coping with conflicts in visions of sustainable development and livable communities. Journal of the American Planning Association, 70(1), 5–13. https://doi.org/10.1080/01944360408976334
Goodman, N., Zwick, A., Spicer, Z., & Carlsen, N. (2020). Public engagement in smart city development: Lessons from communities in Canada’s Smart City Challenge. Canadian Geographer, 64(3), 416–432. https://doi.org/10.1111/cag.12607
Green, A. E., & Aarons, G. A. (2011). A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping. Implementation Science, 6(1), 1–12. https://doi.org/10.1186/1748-5908-6-104
Griffiths, J., & Rao, M. (2009). Public health benefits of strategies to reduce greenhouse gas emissions. BMJ, 339, b4952. https://doi.org/10.1136/bmj.b4952
Hassmiller Lich, K., Urban, J. B., Frerichs, L., & Dave, G. (2017). Extending systems thinking in planning and evaluation using group concept mapping and system dynamics to tackle complex problems. Evaluation and Program Planning, 60, 254–264. https://doi.org/10.1016/j.evalprogplan.2016.10.008
Kane, M., & Trochim, M. W. (2007). Concept mapping for planning and evaluation. SAGE Publications, Inc. https://doi.org/10.4135/9781412983730
Kaufman, L., & Rousseeuw, P. J. (2005). Finding groups in data : an introduction to cluster analysis. John Wiley & Sons.
Kruskal, J. B., & Wish, M. (1978). Multidimensional scaling. Sage University paper series on Quantitative Applications in the Social Sciences #11 (pp. 54–56). Sage.
Lobb, R., Pinto, A. D., & Lofters, A. (2013). Using concept mapping in the knowledge-to-action process to compare stakeholder opinions on barriers to use of cancer screening among South Asians. Implementation Science, 8(1), 37. https://doi.org/10.1186/1748-5908-8-37
Maechler, M., Rousseeuw, P., Struyf, A., Hubert, M., Hornik, K., et al. (2012). Cluster: Cluster analysis basics and extensions. R Package Version, 1(2), 56.
Mehdipanah, R., Malmusi, D., Muntaner, C., & Borrell, C. (2013). An evaluation of an urban renewal program and its effects on neighborhood resident’s overall wellbeing using concept mapping. Health and Place, 23, 9–17. https://doi.org/10.1016/j.healthplace.2013.04.009
Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: An interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research, 20(1), 1–8. https://doi.org/10.1186/S12913-020-4999-8
Oksanen, J., Blanchet, F. G., Kindt, R., Legendre, P., Minchin, P. R., O’Hara, R. B., Simpson, G. L., Solymos, P., Stevens, M. H. H., Wagner, H., et al. (2013). Package ‘vegan.’ Community Ecology Package, Version, 2(9), 1–295.
Péladeau, N., Dagenais, C., & Ridde, V. (2017). Concept mapping internal validity: A case of misconceived mapping? Evaluation and Program Planning, 62, 56–63. https://doi.org/10.1016/j.evalprogplan.2017.02.005
Politis, C. E., Mowat, D. L., & Keen, D. (2017). Pathways to policy: Lessons learned in multisectoral collaboration for physical activity and built environment policy development from the Coalitions Linking Action and Science for Prevention (CLASP) initiative. Canadian Journal of Public Health, 108(2), e192–e198. https://doi.org/10.17269/CJPH.108.5758
Pouso, S., Borja, Á., Fleming, L. E., Gómez-Baggethun, E., White, M. P., & Uyarra, M. C. (2021). Contact with blue-green spaces during the COVID-19 pandemic lockdown beneficial for mental health. Science of the Total Environment, 756, 143984. https://doi.org/10.1016/J.SCITOTENV.2020.143984
Rousseeuw, P. J. (1987). Silhouettes: A graphical aid to the interpretation and validation of cluster analysis. Journal of Computational and Applied Mathematics, 20(C), 53–65. https://doi.org/10.1016/0377-0427(87)90125-7
Shipley, R., & Utz, S. (2012). Making it count: A review of the value and techniques for public consultation. Journal of Planning Literature, 27(1), 22–42. https://doi.org/10.1177/0885412211413133
Smith, M., Hosking, J., Woodward, A., Witten, K., MacMillan, A., Field, A., Baas, P., & Mackie, H. (2017). Systematic literature review of built environment effects on physical activity and active transport—An update and new findings on health equity. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 158. https://doi.org/10.1186/s12966-017-0613-9
Trochim, W. M. K. (1989). An introduction to concept mapping for planning and evaluation. Evaluation and Program Planning, 12(1), 1–16. https://doi.org/10.1016/0149-7189(89)90016-5
Vaughn, L. M., Jones, J. R., Booth, E., & Burke, J. G. (2017). Concept mapping methodology and community-engaged research: A perfect pairing. Evaluation and Program Planning, 60, 229–237. https://doi.org/10.1016/j.evalprogplan.2016.08.013
Ville de Montréal. (2021). Montréal Durable 2016–2020 | “Succès et apprentissages.” Accessed on March 19, 2024 at https://www.youtube.com/watch?v=Bduf4e9Ju2Y&ab_channel=Maisondud%C3%A9veloppementdurable%7CMontr%C3%A9alQC
Wamsler, C., Alkan-Olsson, J., Björn, H., Falck, H., Hanson, H., Oskarsson, T., Simonsson, E., & Zelmerlow, F. (2020). Beyond participation: When citizen engagement leads to undesirable outcomes for nature-based solutions and climate change adaptation. Climatic Change, 158(2), 235–254. https://doi.org/10.1007/s10584-019-02557-9
Wasfi, R., Poirier Stephens, Z., Sones, M., Laberee, K., Pugh, C., Fuller, D., Winters, M., & Kestens, Y. (2021). Recruiting Participants for Population Health Intervention Research: Effectiveness and Costs of Recruitment Methods for a Cohort Study. Journal of Medical Internet Research, 23(11), e21142. https://doi.org/10.2196/21142
Wiek, A., & Iwaniec, D. (2014). Quality criteria for visions and visioning in sustainability science. Sustainability Science, 9(4), 497–512. https://doi.org/10.1007/s11625-013-0208-6
Acknowledgements
We would like to thank the research staff who made this work possible: Marina Najjar and Benoît Thierry. We also thank trainee Ludmilla Pommier-Morel, who contributed to the project. Finally, we thank all participants who were involved in this work.
Funding
The INTErventions, Research and Action in Cities Team (INTERACT) study is funded by the Canadian Institutes of Health Research (CIHR) (IP2-1507071C). MW was supported by a Michael Smith Foundation for Health Research Scholar Award. DF was supported by a Canadian Research Chair in Population Physical Activity. YK was supported by a CIHR Applied Public Health Chair in Urban Interventions and Population Health.
Author information
Authors and Affiliations
Contributions
ZPS led analysis, visualization, and writing of manuscript. CLF contributed to investigation and analysis. MC contributed to conceptualization. DF and MW provided investigation and writing—review. YK led conceptualization, investigation, and writing—review.
Corresponding author
Ethics declarations
Ethics approval
Ethics approval was received by the Comité d’éthique de recherche at CHUM (2017–7024, CE 16.397—ID).
Consent to participate
Informed consent was obtained from all individual participants included in the study.
Consent for publication
Not applicable.
Conflict of interest
Kestens holds shares in Polygon Co. (www.polygon.company), a spin-off company that markets an online survey platform. It hosts Insight Forming (concept mapping application) used in the INTERACT project. A previous version (eKogito) was filed as an invention at Aligo (www.aligo.ca) in 2013, through Université du Québec à Trois-Rivières.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Stephens, Z.P., Firth, C.L., Cantinotti, M. et al. Imagining and implementing healthy city interventions: Combined results from parallel concept mapping exercises in Montreal with community members and stakeholders. Can J Public Health (2024). https://doi.org/10.17269/s41997-024-00883-9
Received:
Accepted:
Published:
DOI: https://doi.org/10.17269/s41997-024-00883-9