Neighborhood Audits Research Articles

Design of a Location-Based Case-Control Study of Built Environment Risk Factors for Pedestrian Fatalities in the U.S.

The location-based case-control design is a useful approach for studies where the exposures of interest are aspects of the environment around the location of a health event such as a pedestrian fatality. In this design locations are the unit of analysis and an enumerated cohort of locations are followed through time for the health events of interest and a case-control study of locations is nested within the cohort. Locations where events occurred (case-locations) are compared to matched locations where these events did not occur (control-locations). We describe the application of this design to the issue of pedestrian fatalities using a cohort of 9,612,698 intersections, 17,737,728 road segments, and 222,318 entrance/exit ramp segments that existed in 2017 across all 384 U.S. Metropolitan Statistical Areas. This cohort of locations was followed up from Jan 1, 2017 to Dec 31, 2018 for pedestrian fatalities using the National Highway Traffic Safety Administration Fatality Analysis Reporting System. In total, 10,587 fatalities were identified as having occurred on cohort locations and 21,174 matched control locations were selected using incidence density sampling. Geographic information systems, spatially linked administrative data sets and virtual neighborhood audits via Google Street View are underway to characterize study locations.

Area-level Measures of the Social Environment: Operationalization, Pitfalls, and Ways Forward.

People's mental health is intertwined with the social environment in which they reside. This chapter explores approaches for quantifying the area-level social environment, focusing specifically on socioeconomic deprivation and social fragmentation. We discuss census data and administrative units, egocentric and ecometric approaches, neighborhood audits, social media data, and street view-based assessments. We close the chapter by discussing possible paths forward from associations between social environments and health to establishing causality, including longitudinal research designs and time-series social environmental indices.

Developing and field testing the Neighbourhood Observational Tool for auditing urban community environments (CyNOTes) in the city of Limassol, Cyprus

ABSTRACT Systematic Social Observation provides supplementary information about the micro-scale neighborhood environment. This study explored the feasibility of neighborhood audits for the first time in the city of Limassol, Cyprus (population size, 2021 census: 258.900). The prevalence and variability of audited features were investigated using the 126-item CyNOTes inventory, organised along a typology of 17 domains. Two independent audits, with a repeat in two weeks, were performed across 30 randomly selected street segments, stratified in three groups of neighborhoods according to the educational attainment of residents. Associations with census indicators and survey data on SF-36 Quality of Life among residents aged 45–64 (N = 150) were explored. More adverse conditions were recorded in low educational attainment neighborhoods, with differences apparent in domains with generally high as well as low scores. Neighborhood scores correlated with census indicators of the built environment, while negative correlations where observed with sociodemographic indicators, such as population aged over 65 and non-Cypriot population, suggesting social inequities. In neighborhoods with more adverse features, lower physical and mental health-related quality of life were reported. Overall, the study documented environmental inequity. CyNOTes offers the potential for further development and scaling-up for public health research, policy, and advocacy.

ADAPTING STAKEHOLDER WALKABILITY/WHEELABILITY AUDIT TOOL IN NEIGHBORHOOD FOR SENSORY AND COGNITIVE DISABILITIES

Abstract Neighbourhood accessibility influences health, social inclusion, and overall wellbeing of older adults. It is important to assess neighbourhood accessibility in relation to the diverse needs and challenges brought on by the intersection of aging and disability, particularly sensory and cognitive disabilities. Given the paucity of neighbourhood audit tools tailored for this population, The user-led Stakeholders’ Walkability/Wheelability Audit in Neighbourhoods (SWAN) tool was originally created for people with mobility disabilities and is now being adapted for seniors with sensory and cognitive disabilities to evaluate functionality, safety, appearance, supportive features, and social aspects in their neighbourhoods. In this paper, we present highlights and key takeaways from the process of adapting the SWAN tool for three user groups: people living with 1) Blindness or low vision, 2) Deafness and hearing loss, and 3) Dementia. Key steps in the iterative tool adaptation process include 1) identifying access needs/challenges for the three user groups based on a literature review, 2) online consultation with stakeholders with lived and/or professional experience (N = 4) to prioritize key access needs/challenges that will be captured through the SWAN tool and review draft versions of the tool, and 3) in-person pilot testing of tools with persons with lived experience (N = 2) in two urban/suburban neighbourhoods in British Columbia, Canada. Reflections of team members and input from stakeholders and pilot participants revealed issues that were addressed in tool development, namely 1) length of audit and participant fatigue, 2) legibility of tool, and 3) tailoring audit to participants’ context and needs.

GREENSPACE AND COGNITION: EXPLORING SPECIFIC GREENSPACE MEASURES

Abstract Increased exposure to greenspace is potentially associated with lower risk of Alzheimer’s disease and related disorders (ADRD) through increased physical activity, decreased stress, cleaner air, and social cohesion. Previous studies have primarily used global measures of greenspace, thus specific aspects of different types of greenspaces are overlooked. We assess how different measures of greenspaces associate with global cognitive functioning. We examined data from year 10 of the Pittsburgh site of Health, Aging, and Body Composition Study, a longitudinal cohort study of community-dwelling, Black and White adults aged 70–79 years at baseline. Measures derived from the National Land Cover Database (NLCD) use satellite imaging and include total greenspace, forests, and an index of greenspace diversity. Measures from Google Street View virtual neighborhood audits include dedicated greenspace that promotes physical activity, abandoned buildings, and undeveloped land. We measured global cognitive functioning using the Modified Mini-Mental State Examination (3MS). We conducted cross-sectional linear regression models. Covariates included race, education, and neighborhood socioeconomic status. Age was not included as a covariate because the range was narrow, and results did not vary by age. The sample (n=584) was 82.2 years old on average, 57% female, and 35% Black. Total greenspace (F=0.46, p=0.49), forests, and greenspace diversity, dedicated greenspace for physical activity (F=0.87, p=0.35), undeveloped land (F=1.49, p=0.22), and abandoned buildings (F=3.6, p=0.058) were not associated with 3MS, although the relation with abandoned buildings approached significance. We found no association between greenspaces and ADRD, although specific measures, such as abandoned buildings, may need further investigation.

Shared Purpose: Leveraging a Community-Academic Partnership to Increase Local Environmental Health Awareness via Community Science.

Environmental factors can lead to disease and health disparities when the places where people live, learn, work, play and pray are burdened by social inequities. Non-formal programs that explicitly connect local environmental exposures and human health could be of great value to communities at greatest risk. The purpose of this work was to co-create relevant and engaging education with youth and community stakeholders of all ages that more explicitly emphasizes the link between the local environment and community members' health through a hands-on community science experience. Our experiences helped strengthen our community-academic partnership and establish a route to create and tailor informal programming to meet local needs and engage people in community science with academic partners. We generated two distinctly different community science neighborhood audit tools designed to differently engage our community partners and inform community participants of their local environments and its role on their health. Through community meetings, we garnered critical insight from our stakeholders. While neither of the tools and accompanying data collected were deemed to be scientifically generalizable, our ongoing and future work has benefited from important lessons learned from their creation and sharing.

Objective and subjective assessment of the neighborhood health environment, Limassol, Cyprus

Abstract Background While neighborhood audit tools are commonly assessed for inter- and intra-rater reliability, validity and relevance are not always demonstrated. Methods A stratified random sample of 45 neighbourhoods in Limassol were audited with the 150-item Cyprus Neighborhood Observational Tool for urban environments (CyNOTes). Ratings were correlated with census indicators of socioeconomic disadvantage. The extent to which residents' neighborhood assessment (Place Standard, N = 444) and self-rated quality of life (SF-36 in second sample N = 450) differed across neighborhoods classified according to domain were explored in mixed random effect models. Results CyNOTes items are organized in 9 domains (internal consistency=0.5-0.9) with a 3-factor higher structure. In seven, a stepwise pattern of lower mean ratings was observed across increasing socioeconomic disadvantage, for domains rated generally high across neighborhoods (e.g. lack of physical disorder) and low (e.g. outdoor spaces). Though not always statistically significant, a systematic pattern of higher self-rated health was observed in better-off neighborhoods across most domains. “Pedestrian environment” captured the largest difference for both physical (1.34 95%CI 0.42,2.26), p = 0.005 per tertile increase) and mental health (1.46 95% 0.54,2.40; p = 0.003). “Social contact” and “Safety: lack of security-related features” were more likely to be rated favorably in disadvantaged neighborhoods, however no associations with quality of life were observed. While the residents' assessment was often in the expected direction, more for built environment features, this was not always the case. Conclusions The study demonstrated the content, construct, criterion and predictive validity of an audit tool for supplementary profiling the built, physical and social health-related neighbourhood environment. Concurrent validity against residents' perceptions was not always supported, raising questions about differential expectations. Key messages Neighbourhood audits can provide useful supplementary information not captured by other community assessment methods and independent of residents’ perceptions. Depicting the social gradient in the neighborhood microenvironment can trigger and contextualize the conversation about place effects on health among Public Health research and policy community.

Associations between neighborhood disinvestment and breast cancer outcomes within a populous state registry.

BackgroundBreast cancer (BrCa) outcomes vary by social environmental factors, but the role of built‐environment factors is understudied. The authors investigated associations between environmental physical disorder—indicators of residential disrepair and disinvestment—and BrCa tumor prognostic factors (stage at diagnosis, tumor grade, triple‐negative [negative for estrogen receptor, progesterone receptor, and HER2 receptor] BrCa) and survival within a large state cancer registry linkage.MethodsData on sociodemographic, tumor, and vital status were derived from adult women who had invasive BrCa diagnosed from 2008 to 2017 ascertained from the New Jersey State Cancer Registry. Physical disorder was assessed through virtual neighborhood audits of 23,276 locations across New Jersey, and a personalized measure for the residential address of each woman with BrCa was estimated using universal kriging. Continuous covariates were z scored (mean ± standard deviation [SD], 0 ± 1) to reduce collinearity. Logistic regression models of tumor factors and accelerated failure time models of survival time to BrCa‐specific death were built to investigate associations with physical disorder adjusted for covariates (with follow‐up through 2019).ResultsThere were 3637 BrCa‐specific deaths among 40,963 women with a median follow‐up of 5.3 years. In adjusted models, a 1‐SD increase in physical disorder was associated with higher odds of late‐stage BrCa (odds ratio, 1.09; 95% confidence interval, 1.02‐1.15). Physical disorder was not associated with tumor grade or triple‐negative tumors. A 1‐SD increase in physical disorder was associated with a 10.5% shorter survival time (95% confidence interval, 6.1%‐14.6%) only among women who had early stage BrCa.ConclusionsPhysical disorder is associated with worse tumor prognostic factors and survival among women who have BrCa diagnosed at an early stage.

112Neighbourhood environment and health-related quality of life, Limassol, Cyprus

Abstract Background The extent and magnitude of socio-geographical inequalities in health in Cyprus is not clear as neither “place” nor “health inequalities” feature on the public health agenda. Methods In the context of a wider Neighbourhood Environment and Health programme, the magnitude of inequality in health-related quality of life (HRQoL) among Limassol citizens was explored in a door-to-door SF-36 survey of residents aged 45-64 (N = 450, 50:50 gender quota) across 45 randomly selected neighbourhoods stratified by socio-economic disadvantage and profiled using a culturally-adapted Systematic Social Observation neighbourhood audit tool. Results The social gradient was steeper for physical than mental component scores of HRQoL irrespective of the indicator of social position. Education and income captured the gradient better in women, and occupational-based social class in men, with large effect (0.7-1 SD) on the SF-36 scale at opposite ends of the continuum. Lower HRQoL and more adverse health behaviours observed in disadvantaged neighborhoods according to census area-level measures and neighbourhood audit profiles, with generally larger differences in women. Conclusions This study profiled the variability in the urban neighbourhood environment,and documented the magnitude of social gradient in health and health-related quality of life in a representative sample of late working-life population in Cyprus. Key messages Social gradient in health behaviours and quality of life in late working-life Cypriot population. Gradient apparent in both men and women across individual and neighborhood measures of social position.

447Decoding the effect of neighbourhood on arterial health (DEpICT): Preliminary results on neighbourhood self-evaluation

Abstract Background DEpICT is an ongoing exploratory, observational, cross-sectional study in community-dwelling individuals in Limassol, Cyprus aiming to combine individual-level and community-level risk factors to decode their effect on arterial health (stiffness) as measured with pulse wave velocity (PWV). Methods Participants are >40 years and living in the same address for ≥5 years. They provide personal information on quality of life and mental health (SF-12 and GHQ-12), physical activity (IPAQ), adherence to Mediterranean diet (MedDiet) and sociodemographic. Arterial stiffness is measured as PWV. Neighborhood is self-assessed using the “Place Standard” Tool, as well as independent neighborhood audit with the newly-developed CyNoTes tool. Results Mean age of the first 176 participants (53%male) was 55.2 (±8.6). All participants rated their health between excellent/very good (50.5%) and good/modest (49.5%), however participants with a higher net family income reported significantly better health (p for trend=0.02), with 61.4% reporting very good/excellent health in those earning >2000E Vs 40.2% in those earning ≤ 2000E/m (p = 0.005). Out of 14 constructs in “Place”, “Public transport” and “Participation and sense of control” were rated lowest (3.1 ± 1.9 and 3.1 ± 1.8) and “Identity and sense of belonging” and “Safety” highest (4.1 ± 1.9 and 4.5 ± 1.8). Out of these, family income was associated with “Safety” (p = 0.005) and self-health with “Participation and sense of control”. Conclusions Participants rate social and safety aspects of their neighborhood higher than build aspects. Key messages Participants express the need for more public engagement in community decision-making; sense of lacking control may affect individual health.

337Systematic social observation tool for auditing the physical, built and social health-related urban neighboourhood environment

Abstract Background Several generic or feature-specific neighborhood audit tools have been developed. While inter/intra-observer reliability if commonly assessed, validity is not always considered. Methods A two-phase mixed-methods process was used to develop the Cyprus Neighborhood Observational Tool for urban environments (CyNOTes). Phase I: draft based on literature review, culturally adapted and content validated in focus groups with community professionals and social media ethnographic study of citizens’ experience and feasibility tested across 15 neighbourhoods. Phase II: variability in features across 45 neighbourhoods along the social disadvantage continuum and associations with census area indicators, citizens’ perceptions and health-related quality of life were assessed. Results Content validity was supported by residents’ and professionals’ descriptions of neighbourhood problems, giving rise to a 17-domain, 151-item inventory, 126 from the literature and 25 arising via Nominal Group Technique consensus and content analysis of social media posts. With good inter- and intra-observer agreement, neighborhoods with lower educational attainment scored lower in over half domains. Social gradient and clustering of adverse features observed while in neighbourhoods with adverse features residents reported lower physical and mental health-related quality of life. The social gradient was not always reflected in the perception survey. With the exception of social aspects, residents did not rate the built and physical environment favorably. “Influence and sense of control” was rated lowest while “Citizens’ voice” emerged in the inductive content analysis of residents’ lived experience. Conclusions A culturally relevant audit tool of the health-related neighborhood microenvironment was developed by assessing its content, concurrent, criterion and predictive validity. Key messages There is need for valid audit tools, independent of residents’ perceptions, for supplementary profiling of the health-related neighbourhood microenvironment Neighborhoods audits can trigger and widen conversation among local research community and policy-makers about health and place.

Association between education and self-assessment of the neighborhood environment

Abstract Background DEpICT is an ongoing observational, cross-sectional study in community-dwellers in Limassol, Cyprus aiming to combine individual-level and community-level risk factors to decode their effect on arterial health (stiffness) as measured with pulse wave velocity (PWV). Methods Participants are >40 years who have been living in the same address for ≥5 years. They provide personal information on quality of life and mental health (SF-12 and GHQ-12), physical activity (IPAQ), adherence to Mediterranean diet (MedDiet) and sociodemographic. Anthropometric characteristics are measured on site, as well as arterial stiffness (carotid-femoral PWV) and central blood pressure. Neighborhood is self-assessed using the “Place Standard” Tool, as well as with an independent neighborhood audit using the newly-developed CyNoTes tool. Results Out of the first 176 participants (53% male), 45% had a college/university degree with a further 19% having graduate degrees, while the vast majority (92%) reported home ownership. Education was not associated with net family income (p = 0.3) nor home-ownership (p = 0.28). Out of the 14 constructs in Place standard, “Public transport” and “Participation and sense of control” were rated lowest (3.1 ± 1.9 and 3.1 ± 1.8) and “Identity and sense of belonging” and “Safety” highest (4.1 ± 1.9 and 4.5 ± 1.8). Education was not associated with any construct in “Place” or with total neighbourhood score. Conclusions Participants rate the social and safety aspects of their neighbourhood higher than the build aspects. Educational attainment may not be a good proxy for neighbourhood socioeconomic assessment in Cyprus, given the high rates of university graduates. Key messages Participants express the need for more public engagement in community decision-making; sense of lacking control may affect individual health. Educational attainment is not a good proxy for neighborhood socioeconomic assessment in the cultural context of Cyprus.

The condition-care scale: A practical approach to monitoring progress in vacant lot stewardship programs

Condition and care are key expressions of landscape stewardship and are especially important in managing vacant urban lands. In this context, visible signs of stewardship have been associated with increased neighborhood sense of place whereas signs of physical disorder reflect perceived and actual crime. To date, assessments of condition/care and disorder using neighborhood audits have shown good reliability in field and virtual assessments but are often labor-intensive, particularly when repeated over time or applied across multiple study areas. Integrating the research traditions of neighborhood audits and visual landscape quality assessment, we propose an alternative approach, the “condition-care scale,” and pilot test this seven-point rating scale to assess longitudinal and cross-sectional patterns of stewardship in response to a vacant land reuse program. Lots purchased by nearby residents through the Chicago Large Lot Program were rated on the scale using Google Street View imagery, field photography, and field visits in 2014 (before purchase), 2015, 2016, and 2018 (1–4 years after purchase). Lab and field assessments showed strong intra- and inter-rater scale reliability, and independent measures of lot condition and care from parallel visual and social assessments support the scale’s validity. Longitudinal analyses showed that the greatest improvements were made in the first year after purchase but that improvement levels increased steadily over five years. Cross-sectional comparisons showed significant differences between some community areas. We discuss the utility of our approach for evaluating progress in vacant land reuse programs and its generalizability to other needs of urban greening professionals.

Spatial predictive properties of built environment characteristics assessed by drop-and-spin virtual neighborhood auditing

BackgroundVirtual neighborhood audits have been used to visually assess characteristics of the built environment for health research. Few studies have investigated spatial predictive properties of audit item responses patterns, which are important for sampling efficiency and audit item selection. We investigated the spatial properties, with a focus on predictive accuracy, of 31 individual audit items related to built environment in a major Metropolitan region of the Northeast United States.MethodsApproximately 8000 Google Street View (GSV) scenes were assessed using the CANVAS virtual audit tool. Eleven trained raters audited the 360° view of each GSV scene for 10 sidewalk-, 10 intersection-, and 11 neighborhood physical disorder-related characteristics. Nested semivariograms and regression Kriging were used to investigate the presence and influence of both large- and small-spatial scale relationships as well as the role of rater variability on audit item spatial properties (measurement error, spatial autocorrelation, prediction accuracy). Receiver Operator Curve (ROC) Area Under the Curve (AUC) based on cross-validated spatial models summarized overall predictive accuracy. Correlations between predicted audit item responses and select demographic, economic, and housing characteristics were investigated.ResultsPrediction accuracy was better within spatial models of all items accounting for both small-scale and large- spatial scale variation (vs large-scale only), and further improved with additional adjustment for rater in a majority of modeled items. Spatial predictive accuracy was considered ‘Excellent’ (0.8 ≤ ROC AUC < 0.9) for full models of all but four items. Predictive accuracy was highest and improved the most with rater adjustment for neighborhood physical disorder-related items. The largest gains in predictive accuracy comparing large- + small-scale to large-scale only models were among intersection- and sidewalk-items. Predicted responses to neighborhood physical disorder-related items correlated strongly with one another and were also strongly correlated with racial-ethnic composition, socioeconomic indicators, and residential mobility.ConclusionsAudits of sidewalk and intersection characteristics exhibit pronounced variability, requiring more spatially dense samples than neighborhood physical disorder audits do for equivalent accuracy. Incorporating rater effects into spatial models improves predictive accuracy especially among neighborhood physical disorder-related items.

Development and Validation of a Google Street View Pedestrian Safety Audit Tool.

Assessing aspects of intersections that may affect the risk of pedestrian injury is critical to developing child pedestrian injury prevention strategies, but visiting intersections to inspect them is costly and time-consuming. Several research teams have validated the use of Google Street View to conduct virtual neighborhood audits that remove the need for field teams to conduct in-person audits. We developed a 38-item virtual audit instrument to assess intersections for pedestrian injury risk and tested it on intersections within 700 m of 26 schools in New York City using the Computer-assisted Neighborhood Visual Assessment System (CANVAS) with Google Street View imagery. Six trained auditors tested this instrument for inter-rater reliability on 111 randomly selected intersections and for test-retest reliability on 264 other intersections. Inter-rater kappa scores ranged from -0.01 to 0.92, with nearly half falling above 0.41, the conventional threshold for moderate agreement. Test-retest kappa scores were slightly higher than but highly correlated with inter-rater scores (Spearman rho = 0.83). Items that were highly reliable included the presence of a pedestrian signal (K = 0.92), presence of an overhead structure such as an elevated train or a highway (K = 0.81), and intersection complexity (K = 0.76). Built environment features of intersections relevant to pedestrian safety can be reliably measured using a virtual audit protocol implemented via CANVAS and Google Street View.

Measuring the Built Environment for Aging in Place: A Review of Neighborhood Audit Tools

What audit tools are available to assess neighborhood suitability for aging in place? Drawing on theories from environmental gerontology, the article outlines physical and social environmental characteristics influencing aging. Eight research audit tools and three community/practitioner tools were identified using a Boolean search strategy. They emphasize walkability and the physical attributes of places. Areas for further development include addressing specific features related to aging, a wider range of environments, additional physical and social dimensions, and conducting audits using technologies and participatory processes to better incorporate aging experiences. For planners, these audit tools raise awareness of how environments can better support aging populations.

Drop-And-Spin Virtual Neighborhood Auditing: Assessing Built Environment for Linkage to Health Studies

Various built environment factors might influence certain health behaviors and outcomes. Reliable, resource-efficient methods that are feasible for assessing built environment characteristics across large geographies are needed for larger, more robust studies. This paper reports the item response prevalence, reliability, and rating time of a new virtual neighborhood audit protocol, drop-and-spin auditing, developed for assessment of walkability and physical disorder characteristics across large geographic areas. Drop-and-spin auditing, a method where a Google Street View scene was rated by spinning 360° around a point location, was developed using a modified version of the virtual audit tool Computer Assisted Neighborhood Visual Assessment System. Approximately 8,000 locations within Essex County, New Jersey were assessed by 11 trained auditors. Using a standardized protocol, 32 built environment items per a location within Google Street View were audited. Test-retest and inter-rater κ statistics were from a 5% subsample of locations. Data were collected in 2017-2018 and analyzed in 2018. Roughly 70% of Google Street View scenes had sidewalks. Among those, two thirds were in good condition. At least 5 obvious items of garbage or litter were present in 41% of Google Street View scenes. Maximum test-retest reliability indicated substantial agreement (κ ≥0.61) for all items. Inter-rater reliability of each item, generally, was lower than test-retest reliability. The median time to rate each item was 7.3 seconds. Compared with segment-based protocols, drop-and-spin virtual neighborhood auditing is quicker and similarly reliable for assessing built environment characteristics. Assessment of large geographies may be more feasible using drop-and-spin virtual auditing.

Dover Micro Open Street Events: Evaluation Results and Implications for Community-Based Physical Activity Programming.

Open Streets events provide opportunities for residents to be active. The current program developed and implemented five smaller scale, Micro Open Streets Events (MOSE) in Dover, DE that provided a range of opportunities for physical activity over a <0.5 miles stretch of closed road. Our objective was to evaluate the capacity of this approach to reach residents and improve knowledge and intention to engage in physical activity once the event was over. We used individual surveys, observational, and neighborhood audit factors to assess MOSE participation and conduciveness to physical activity. Our results showed that MOSE attendance ranged from 40 to 500 adults from a high-risk demographic (i.e., non-Caucasian, middle-age, overweight), who demonstrated a strong liking of the MOSE and increased knowledge of, and intention to engage in physical activity following the event. Our data suggest that where a full-scale Open Streets event is not feasible, a MOSE may be a viable alternative.

Citizens’ perceptions of the health-related neighbourhood environment in Limassol, Cyprus

Abstract Background “Place” can impact on health and quality of life. There is a growing interest in neighbourhood audits. In the context of developing the CyNOTes audit tool, a residents’ perception of the neighbourhood environment survey was performed. Methods A systematic random sample of ten adult residents (N = 150) across a stratified sample of fifteen neighbourhoods according to educational attainment as per census data responded to the “Place Standard” tool which assesses 14 aspects of the physical, built and social neighbourhood environment. Neighbourhoods were also audited using the 126-item CyNOTes. Results Three in four participants were home owners and lived in the neighbourhood for over 10 years. With the exception of “identity and sense of belonging” (M = 5.8, SD = 2.0) and “opportunities for social interaction” (M = 5.3, SD = 2.1), physical and built aspects of the environment were rated close to the middle point on a scale 1: large to 7: little room for improvement. “Parks, playgrounds and green space” and “garbage, animal droppings and other physical disorder” were the most commonly mentioned priorities for action in the free text by one in three participants. The lowest score was recorded for “influence and sense of control” (M = 3.4, SD = 2.4). While on a 1-10 subjective perception of neighbourhood position, residents in lower education neighbourhoods gave a rating of 6.6 on average compared to 8.1 in the higher group, they tended to rate aspects of their neighbourhood more favourably. Even though the audit revealed a systematic pattern of less favourable conditions along the socio-economic continuum, the perception survey revealed a U-pattern with residents in the middle category more likely to give less favourable ratings. Conclusions The extent to which perceptions surveys may be affected by differential expectations across social groups is not clear. Neighborhood audits provide supplementary profiles of “place” independent of the perceptions of residents. Key messages Based on the Place Standard tool, Limassol residents’ rate social aspects of their neighbourhood environment more favourably than aspects of the built and physical environment. Neighbourhood observed-based audits, independent of residents’ perceptions surveys can supplement each other in city health profiling.

“Is anyone walking in our neighborhoods?”: Citizens’ experience of the neighbourhood environment

Abstract Background Several generic or feature-specific neighbourhood audit tools have been developed in recent years. In the context of developing the Cyprus Neighbourhood Observation Tool for auditing urban environments (CyNOTes), a virtual ethnographic study of citizens’ perceptions of their neighbourhood environment was performed. Methods The municipality and mayor’s Facebook were reviewed for posts related to neighbourhood environment over a 12-month period (e.g. regeneration projects). Comments were content analysed using a deductive as well as an inductive approach to gain an in-depth understanding of citizens’ perceptions of neighbourhood environment. Results 348 comments to 27 relevant posts were identified. The unit of analysis was sentences or short phrases and 289 CMU were identified. The central theme was “Citizens’ voice”. Six themes and several sub-themes emerged. “Comparisons” to contrast the differing conditions between high-profile locations versus “left out” residential neighbourhoods (“Yes, the city centre, the waterfront is a jewel, what about the neighborhoods?”) or to compare their experience to “another place-another time”. They express “Mixed feelings” ranging from “hope” to “disbelief” about proposed actions. Citizens are referring to “Consequences” of neighbourhood adverse environment on “Quality of Life” or “Local ecomomy and housing” and identify “Causes” in “Money and Power” or “Lack of vision and planning”. They are placing “Responsibility” in both “Authorities’ inaction” as well as “Everyone’s role”. “Suggestions” included measures related to “Law and Order” as well as “Citizens’ participation”. Conclusions Citizens voice their experiences of the neighbourhood environment lack of influence and control and demand for more involvement in decision-making. They blame authorities for neighbourhood problems but also recognize the lack of individual responsibility, suggesting policing and punitive measures and stronger collective action. Key messages A virtual ethnographic study of citizens’ comments on social media offers an in-depth understanding of the neighbourhood experience. Citizens want to have a “voice” to express their concerns about neighbourhood problems as well as to participate in decision-making.