Co-design workshops with consortium and stakeholders

1  Equal-Life – Deliverable 8.4 Project title: Early Environmental quality and life-course mental health effects Project Number: 874724 Project Acronym: Equal-Life Work package 8 - Deliverable D8.4 Co-design workshops with consortium and stakeholders HISTORY OF CHANGES Version Publication date Change 1.0 20.12.2022 First draft 2.0 13.02.2023 More introduction, definitions, restructures annexes 3.0 23.03.2023 Rewritten into a report format 4.0 15.12.2023 Information from 2023 added 5.0 31.12.2023 Final Ref. Ares(2023)8897295 - 29/12/2023 H2020 program Grant agreement numbers 874724 (Equal-Life) Project start date: Jan 1st 2020 Duration: 60 months Project Coordinator: Irene van Kamp (RIVM) WP (number and title) Equal-Life WP8 Stakeholder involvement and intervention development Deliverable Number Equal-Life D8.4 Deliverable Title Co-design workshops with consortium and stakeholders Due date 31. 12. 2022 Actual date 31. 12. 2023 Dissemination Level Public Lead beneficiary INCHES Responsible author(s) and beneficiary acronym: Peter van den Hazel –INCHES, Miriam Weber – City of Utrecht, Sonja Jeram –NIJZ, Sammie Jansen – RIVM, Roos Teeuwen - TU Delft, Achilleas Psyllidis – TU Delft, Gordana Ristovska – IJZERM, Sarah Benz – ZEUS, Julia Kuhlmann – ZEUS, Anna Sandionigi – Quantia, Marco Balduini – Quantia, Dirk Schreckenberg – ZEUS, Maddie White – UB, Lena GudiMindermann – UB, Jenny Ahrens – UB Work package/task: WP8 / Task 8.1 Document status: Updated final Confidentiality: public Key words: Stakeholder, Co-design, forum, science-policy interface E-mail / phone responsible authors Peter van den Hazel [email protected] Miriam Weber [email protected] Co-authors Sonja Jeram [email protected] Sammie Jansen [email protected] Roos Teeuwen [email protected] Achilleas Psyllidis [email protected] 3  Gordana Ristovska [email protected] Sarah Benz [email protected] Julia Kuhlmann kuhlman[email protected] Anna Sandionigi [email protected] Marco Balduini [email protected] Dirk Schreckenberg [email protected] Maddie White [email protected] Lena Gudi-Mindermann [email protected] Reviewers Maud Dohmen [email protected] Irene van Kamp [email protected] 4  Contents  Summary................................................................................................................................................6 Introduction.....................................................................................................................................7 StakeholderforumLjubljana.........................................................................................................10 2.1Theme1:Scaleonwhichresultsshouldfocus......................................................................10 2.2Theme2:Includingtheimpactofenvironmentalfactorsonmentalhealthfactorsinall policymaking.....................................................................................................................................11 2.3Theme3:Settingupeffectiveyouthparticipation...............................................................11 2.4Mentalhealthplans...............................................................................................................12 Co‐designworkshopSkopje..........................................................................................................12 3.1Theme1:Co‐designtools......................................................................................................13 3.2Theme2:WorkingonapplicationoftoolsbasedonEqual‐liferesults................................14 3.3Theme3:Workingtowardstranslationofscientificresults.................................................14 3.4Theme4:Interventions‘bridgingthegap’asatooltoimprovehealthforall.....................15 3.5Theme5:Spectrumofprevention........................................................................................16 3.6Theme6:Whatarethenextsteps?......................................................................................16 StakeholderforumMilano............................................................................................................16 4.1Equal‐Lifeguidebookandtoolbox.........................................................................................17 4.2WorldcafédiscussionsonEqual‐Lifepresentations.............................................................18 4.3Usingalogicmodelasatooltoencouragethinkingaboutsocialinequalitiesinurban planninginterventions......................................................................................................................18 4.4Evaluatingchildren’saccesstopublicoutdoorplayspace...................................................19 4.5Policyrecommendationperspectives...................................................................................20 4.7Whatarethenextsteps?......................................................................................................20 5Co‐designworkshopComo............................................................................................................20 6StakeholderforumHelsinki...........................................................................................................24 7Conclusion/Nextsteps.................................................................................................................25 8Partners/Equal‐Lifecontactinformation.....................................................................................29 9Annexes.........................................................................................................................................30 Annex1AdditionalnotesonworkshopinLjubljana.............................................................................30 Annex2Co‐designworkshopSkopje....................................................................................................32 Annex3StakeholderforuminMilano..................................................................................................36 5  Annex4Co‐designworkshopinComo..................................................................................................46 Annex5StakeholderforuminHelsinki.................................................................................................50 Annex6Someexamplesofusedpersonas...........................................................................................56 Annex7Co‐designprocesspresentation..............................................................................................58 Annex8Workingonapplicationoftools.............................................................................................61 Annex9researchquestionsusedinComoco‐designworkshop..........................................................63 6  Summary TheEqual‐Lifeprojectaimstoinvestigatethecombinedeffectsofvariousexposuresonchildrenand adolescentmentalhealthacrossdifferentdevelopmentalstages.Importanttothisprojectisthe collaborationwithstakeholders. Thisdeliverableisarepresentationofallactivitiesinfivedifferentmeetings.Eachmeetingwas structuredaccordingtodifferentthemes.ThestakeholderforainLjubljana,MilanoandinHelsinki werestructuredaccordingtodifferentinteractivesessions.Differentworkingmethodswereused.A rangeofpotentialoutcomeswereaddressed. Theoutcomesoftheco‐designworkshopsandstakeholderforasignifyaimportantsteptoward developingasetofpolicyimplementations,atoolboxandguidebook.Theseoutcomesnotonly addressthecomplexitiesofexposomedatabutalsoensuresitspracticalapplicabilityindiverse settings.Thecollaborativeandinclusivenatureofthiseffortreflectsacommitmenttoadvancingour understandingoftheexposome'simpactonchildmentalhealthandcognitivedevelopment.The findingsprovideafoundationforinformedpolicydecisions,promotingtheintegrationofthistoolbox intorelevantresearch,healthcare,andeducationalinitiatives. StakeholdersareinterestedinpracticalimplicationsofEqual‐Liferesults.Stakeholdersregardthe Equal‐LifetoolboxasasetoftoolsthathelpsthoseinterestedintheEqual‐Lifeproject(atvarious levels)toexplore,understand,andreusetheresultingoutcomes.TheEqual‐Lifeguidebookshould accompanythetoolboxasaguideforpracticaluseandhelpconceptualizewhatisbeingpresented.It shouldassistthestakeholderstounderstandtheconnectionsbetweenthemultipleresultsdisplayed andwhattheymeanforoptionsofinterventions. Itisintheinterestofstakeholdersthatresultsshowupoptionsofinterventions.Indifferentcountries (andregions,communities)powerandfinancesareondifferentscales.Therefore,scientific data/results,andrecommendationsforinterventionsshouldbecategorizedbythesescales. Resultsandrecommendationsshouldbepresentedinalanguagethatisunderstoodbystakeholders. Duetothedifferentlanguages,goals,motivations,andsenseofurgency,thecommunicationbetween scientistsandstakeholdersisacomplextask.Forthescientificcommunity,nearnesstodecision‐ makersisimportant.Scientistsshouldmakeuseofcommunicationexpertswereapplicableinorderto communicatetheirdataresultsandrecommendations.  7  Introduction  Thetask“Co‐designworkshopswithconsortiumandstakeholders”relatedtoD8.4hastheobjective toestablishabi‐directionaldialoguebetweentheEqual‐Lifeprojectand(inter)nationalpolicymakers to1)translateprojectresultsintoeffectivechildrenhealthpoliciesand2)injectknowledgeaboutbest practicesandhealthpoliciesintotheproject.Thistaskensuresthatthegeneratedknowledge(on exposome,mechanisms,andhealtheffects)isdevelopedinlinewiththeneedsofthebroadersociety, andthatknowledgeoftheinvolved(publicandprivate)stakeholderswillhelptointerprettheresults. Thisscience‐policyinteractiongivesabetterunderstandingofthesocietalimpactandrelevanceofthe Equal‐Liferesearchbothforthescientistswithintheprojectasforthestakeholders.Wehaveidentified keystakeholder(policymakers,regulatorsandresearchnetworks),andsetupaformalco‐design workshopandtwostakeholderforaandestablishedregularinteractionbetweenscientistsand stakeholders. Inthe36monthsreviewstherequestedactionwastoupdatetheGanntchartandtheDoA.Thefocus ofthedeliverablehasbeenadjustedwithreferencestopreliminaryresults.Thesewereaddressedin thelasttwostakeholdermeetings.Additionally,thedeliverablehasbeengivenexamplesoftheco‐ designprocessandthedescriptionofexpectedoutcomes.Thesewererelatedtothecontextandthe requirementsofthetoolboxandguidebook.ThesehadstronglinkstotheworkofWP9.ThisD8.4was previouslysubmittedinApril2023,butnowupdatedwithinformationfromtwoadditionalstakeholder meetings.Anotherupdateisexpectedinautumn2024. Thisdeliverableisinaformatofademonstrator.Itisarepresentationofallactivitiesinfivedifferent meetings.Eachmeetingwasstructuredaccordingtodifferentthemes.Thestakeholderforain Ljubljana,MilanoandinHelsinkiwerestructuredaccordingtodifferentinteractivesessions.  StakeholderforuminLjubljana,March7‐8,2022  Co‐designworkshopinSkopje,September14‐15,2022  StakeholderforuminMilan,November16‐17,2022  Co‐designworkshopinComo,June29‐30,2023  StakeholderforuminHelsinkiSeptember7‐8,2023  Co‐designworkshop Co‐designistheactofcreatinginteractionwithstakeholders(policymakers,end‐users)specifically withinadesigndevelopmentprocesstoensurethattheresultsmeettheirneedsandareusable.Its aimistocreatesomethingnotonlyforpeople,butalsowiththem.Stakeholderscanbecomecreators ofaproductbeingactivelyinvolvedinthecreationprocess.Co‐designisoftenatransdisciplinary process.Theresultcanbeareport(guidebook,guideline)oraproduct.InEqual‐Lifetheco‐designis atooltoenablestakeholderstouseEqual‐Liferesultsforpolicymakingoreventodraftinterventions. Weconductedoneco‐designworkshopinSkopje(seechapter3). Stakeholderforum 8  StakeholderForummeansaplatformopentorepresentativesofinstitutions,national,regionaland localauthorities,organisedinterestsandindividualentitiesfromdifferentdomains,highereducation, research,associations,civilsocietyandclusterorganisations,aswellasotherinterestedpartiesfrom acrossaselectedknowledgeorpolicyfocus. Thesetupoftheworkprocessofco‐designworkshopsorstakeholderforumissimilar.Theforumaims moreatsendinginformationbetweentheparticipants.Theco‐designworkshopaimsatproducing contentrelatedtotheproductsthatareseenasresultoftheproject. Herewedescribetheworkingprocessofthestakeholderforaandtheco‐designworkshops.This workingprocessispresentedasalist.Thisisfollowedbyadescriptionoftheoutcomesofthe collaborativeeffortbetweentheEqual‐Lifepartnersandthestakeholders.Thisisalsopresentedina list. Outlineoftheworkingprocess Theprocessoftheco‐designworkshopandstakeholderforumusesastructuredapproach.This approachfacilitatesacodesignworkshop/forumaimedatcollaborativelydeveloping1)inputfor policyrecommendations;2)atoolorguidebookwithsupportfromdiversestakeholders.Theprocess emphasizesopencommunication,activeparticipation,anditerativefeedbacktoensureawell‐ roundedandinclusivefinalproduct.Thefollowingstepscanbeidentifiedandhavebeenused. 1.DefiningObjectivesandScope:Theworkshopbeginswithacleararticulationofitspurposeand goals.Thefocusisondefiningthescopeofthetoolorguidebook,establishingboundariestoguide thecollaborativeprocess. 2.IdentifyingStakeholders:Stakeholders,includingend‐users,subjectmatterexperts,anddecision‐ makers,areidentifiedandinvitedtoparticipate.Thegoalistoensureadiverserepresentationthat capturesabroadrangeofperspectives. 3.Pre‐workshopPreparation:Participantsreceiverelevantinformationbeforetheworkshop,along withmaterialsorresourcestoreview.Acommunicationplatformisestablishedtofacilitateongoing collaborationamongstakeholders. 4.WorkshopAgenda:Adetailedagendaoutlinestheworkshopactivities,incorporating introductions,icebreakers,andspecificdesignsessions.Timeisallocatedforbrainstorming, prototyping,andfeedbacksessions. 5.FacilitationTechniques:Facilitationtechniquesareemployedtoencourageopencommunication, activeparticipation,andequalcontribution.Thefacilitatorfostersacollaborativeandinclusive environmentwhereallvoicesareheard. 6.Brainstorming:Structuredbrainstormingsessionsareconductedtogenerateideas.Techniques suchasmindmappingoraffinitydiagramsareemployed,andparticipantsareencouragedtoshare theirperspectivesandinsights. 7.Prototyping:Thedesignisbrokendownintosmallercomponents,andparticipantsworkon creatingprototypesordraftsofthetoolorguidebook.Collaborativetoolsorphysicalmaterialsare usedtovisualizeideas. 8.IterativeFeedback:Regularfeedbacksessionsarefacilitated,allowingstakeholderstoreviewand provideinputonprototypesanddraftdocuments.Constructivecriticismisencouraged,andconcerns areaddressedtorefinethedesign. 9  9.Decision‐Making:Facilitateddecision‐makingsessionshelpprioritizefeatures,content,ordesign elements.Techniqueslikedotvotingorconsensusbuildingareusedtoreachagreementsamong stakeholders. 10.Documentation:Outcomes,decisions,andchangesmadeduringtheworkshoparethoroughly documented.Aroadmaporactionplaniscreatedforthenextstepsinthedevelopmentprocess. 11.Follow‐upandImplementation:Stakeholdersarekeptinformedabouttheworkshopoutcomes. Agreed‐upondesignchangesareimplemented,andstakeholdersarecontinuouslyinvolvedinthe developmentprocess. 12.Communication:Ongoingcommunicationismaintainedwithstakeholdersthroughoutthe developmentprocess.Regularupdatesandinvolvementinfutureiterationsensuresustained collaboration. Byfollowingthesesteps,thecodesignprocessbecameadynamicandinclusivejourney,harnessing thecollectivecreativityandexpertiseofstakeholderstodevelopavaluableandwell‐receivedsteps towardspolicyimplications,atoolorguidebook.  Outlineofthepotentialoutcomes Weaddressedinthedifferentmeetingsthefollowingoutcomes.Thesedemonstratethesignificance andpotentialimpactofthiscollaborativeefforttoimprovetheworkofEqual‐Life. 1.User‐DefinedRequirementsforthepolicydevelopmentandthetoolbox:Stakeholders,including researchers,healthcareprofessionals,non‐governmentalorganisations,andpolicymakers, participateactivelyindefiningspecificrequirementsforpolicyimplementations,thetoolboxand guidebook. 2.PersonaProfiles:Detailedpersonaprofilesreflectthevariousstakeholderswhowillinteractwith theoutcomesofEqual‐Life.Thesepersonasprovideanuancedunderstandingofuserperspectives, guidingthedesignprocesstobeinclusiveandusercentric. 3.ExposomeMappingandVisualizationStrategies:Stakeholderscontributetothedevelopmentof effectiveexposomemappingandvisualizationstrategieswithinthetoolbox.Thisoutcomeensures thatthecomplexdatarelatedtoexposomefactorsandtheirimpactonchildmentalhealthcanbe communicatedinacomprehensibleandinsightfulmanner. 4.Scopeofimpactassessment:Stakeholderscontributetoidentifywhichkindsofimpactassessment areusefultoincorporateintotheirdailypractice.Thisalsoincludesdatasharing. 5.UseCaseScenarios:Collaborativelygeneratedusecasescenariosillustratethepractical applicationsofpoliciesandtheuseofthetoolboxinreal‐worldsituations.Thesescenariosnotonly refinethefunctionalityofthetoolboxbutalsodemonstrateitspotentialvalueacrossdiverse contexts.Casestudiespresentedbystakeholdersarepartofthisoutcome. 6.FeaturePrioritization:Stakeholdersprioritizeexpectationsoffuturepoliciesandthetoolbox featuresbasedontheirperceivedimportance.Thisprioritizationprocessensuresthatthetoolbox focusesoncriticalfunctionalities,aligningcloselywiththeneedsofusersandmaximizingitsimpact. 7.PrototypesandDemonstrator:Prototypesanddemonstratorofthetoolboxaredeveloped, incorporatingtheidentifiedfeaturesanddesignelements.Stakeholdersprovidevaluablefeedback onusabilityandeffectiveness,facilitatinganiterativeimprovementprocess. 16  Thissessionaddresseditem5theuseofcasescenarios.Thefocusofthissessionwasonthesocial exposome.Thiswasregardedasveryimportantbythestakeholders.Additionalnotesonthissession canbefoundinAnnex2.  3.5Theme5:Spectrumofprevention  Thiswasanopensessiontobrainstormonwhatkindofpreventionshouldbeonthepolicyagenda. Also,thequestionwasposedonwhattheexpectedtrendsareinchildren'smentalhealthandcognitive development.And:Whycanresearchbebeneficialtochangepolicy?Whatstudiesandtoolsshould beused? Theparticipantsprovidedsuggestionsonhowtodeveloppreventionstrategies.Seedetailsoftheir answersinAnnex2. Thissessionrelatestotheitemofmakingaworkplanforimplementation(item10)and featuringprioritization(item6).Thesuggestionsshowabroadrangeoftopics.Theseshould beconsiderednfurtherstepsintheEqual‐Lifework.Additionalnotesonthissessioncanbe foundinAnnex2.  3.6Theme6:Whatarethenextsteps?  Theparticipants,bothstakeholderandconsortiummembers,werepositiveabouttheworkshop.They thoughtitwouldbeveryusefultocontinuethiskindofwork.Suggestionsweregivenonstrengthening thenetworkofstakeholders.Communicationtoallstakeholders.Sharecommunicationstrategy.How isthecommunicationflowtoprofessionals?WHO,EU,ministriesofhealth,regionsetc.Have stakeholderstalkingabouttheirwork.CreateandsharemoreconcreteexamplesfromWPs.Rebuilding thedemonstrator.MoreandbetterconnectionstootherWPs.Thereisaneedtoknowwhatisgoing on.Participantsneedafewpreliminaryresultsoroutputsforinvolvingstakeholders.Involveyouthin allWPs,asstakeholders,wearetalkingabouttheirlives.Aswellasparents.Stakeholdercommunity building,informaboutwhoiscomingtothenextmeeting.UseLinkedIn.Regularupdatesonthe (whole)project,likeanewsletter.  Thissessionshowedtheimportanceofdevelopingacommunicationstrategy(item11).  StakeholderforumMilano Introduction TheMilanstakeholderforumaimedtobringtogetherprofessionalsinthedomainsofmentalhealth andenvironmentalhealthtodiscuss1)exposuretothephysicalandsocialenvironmentofchildren;2) theuseoftoolsasastrategytobridgethescienceandpolicydomain;and3)usingthefutureEqual‐ Lifeprojectresultsforimplementingpoliciesorinterventionstoimprovechildren’senvironmentsand 17  mentalhealth.17stakeholderswere(part‐time)present,togetherwith23researchers(5ofthem online)fromtheEqual‐Lifeproject. TheforumtookplaceNovember16‐17,2022,attheStarhotelRitzinMilan,Italy.Thefirstdaywas dedicatedtopresentationsonworkfromEqual‐Liferesearchersandstakeholders,followedbyworld cafédiscussions.Thefirstdaywasclosedwithaworkshoponthelogicmodelthatisdevelopedwithin Equal‐Lifeasatooltoencouragethinkingaboutsocialinequalitiesinurbanplanninginterventions. Theseconddayopenedwithaworkshoponhowtoevaluatechildren’saccesstopublicoutdoorplay space,researchthatisalsoperformedwithinEqual‐Life.Therestofthedaywasdedicatedtodiscussing policyrecommendationsandusefulinterventionsintheenvironmentalmentalhealthdomain. Thehands‐onworkshopsprovidedtheEqual‐Lifeprojectresearcherswithvaluableinputtoimprove thepresentedtools.Someconclusions:  StakeholderswanttohavearoleinEqual‐Life,forexampleinpilotingEqual‐Life(draft) outcomes(knowledgeandtools)andinco‐designingoforcommentingonEqual‐Life deliverables.  InteractionwithEqual‐Liferesearchersandinvolvementofstakeholdersin(specific)work (packages)needtobefacilitatedandincreased,forexamplein(in‐person)meetingsaswellas inone‐to‐onesettingsandonlineworkinggroups. Thisstakeholderforumaddressedthefollowingitemsofthelistofoutcomes. - User‐DefinedRequirementsforthepolicydevelopmentandthetoolbox - ExposomeMappingandVisualizationStrategies - FeaturePrioritization - Scopeofimpactassessment - PrototypesandDemonstrator - FeedbackandIterativeImprovementandexpectations.Thisisalsoappliedforthe policyimplementationprocess. - DocumentationandKnowledgeSharing - WorkPlanforImplementation - CommunicationStrategy  Contentofthemeeting ThreepresentationswereprovidedbyEqual‐Liferesearcherstoprovideanoverviewoftheproject. SeeformoreinformationtheDeliverable8.2.  4.1Equal‐Lifeguidebookandtoolbox Theguidebookandtoolboxsessionwereaparallelactivitythatranthroughouttheforum.Itwas introducedbyashortpresentationthatexplainedtheintentandcurrentdefinitionofwhatwecallthe toolboxandguidebook.Thedefinitionsareundercontinuousdiscussion.Sincethefirststakeholder meetinginMarch2022(Ljubljana,Slovenia)theresponsiblepartnershavebeenrequestingfeedback frominternal(Equal‐Life)andexternal(stakeholders)partners,whichispartofaniterativeprocess. Thecurrentunderstandingofthetoolboxandguidebookareasfollows: 18   Thetoolboxshouldbeatool,orsetoftools,whichhelpsthoseinterestedintheEqual‐Life project(atvariouslevels)toexplore,understand,andreusetheresultingoutcomes.  Theguidebookshouldaccompanythetoolboxasaguidetopracticaluseandhelp conceptualizewhatisbeingpresented.Itshouldassisttheusertounderstandtheconnections betweenthemultipleresultsdisplayed. Theinputreceivedwassimilartothecollectedideasinthepreviousstakeholdermeetingsasitfocuses onthedevelopmentoftoolsthatcanallowguidingandfacilitatedaccesstotheprojectcontentssuch asdeliverables,researchquestions,andfeaturesconsideredintheanalysis.Stronginterestwasalso expressedinexplanationsandtrainingonanalysismethodsandsoftwaredevelopedduringthe project,withconsequentinterestindedicatedtrainingsessions. Thestakeholders’inputwashelpfulfortheoutcomesofPrototypingthetoolbox.  4.2 WorldcafédiscussionsonEqual‐Lifepresentations  ThesectiondescribestheinputgivenbysomePIsoftheEqual‐Lifeproject,andalsobysome stakeholders.TheinteractionwiththestakeholdersprovidedinformationontheFeedbackand IterativeImprovementandexpectations,FeaturePrioritizationandonDocumentationandknowledge sharing. WeusedtheWorldcafémethod.Inannex3areshortdescriptionsofthedifferentsessions.  4.3Usingalogicmodelasatooltoencouragethinkingaboutsocialinequalitiesin urbanplanninginterventions  ForthisworkshopsessionranbyJennyAhrens(UB),thegoalwastoevaluatetheapplicabilityofthe LogicModelforEquityAssessmentusinganexemplaryinterventiononbicycleinfrastructurebasedon theworkshopparticipants’expertise.Todothis,fivegroupswereformed,andeachgroupfocussed onthethreemainpartsofanintervention:Planning–Implementation–Evaluation. Duringthediscussion,thefollowingthreequestionswereourguidingquestions:  Whattoolssimilartothelogicmodelareyoucurrentlyusingatwork(e.g.,guidingquestions, frameworks,othermodels)?  Canyouseethelogicmodelbeingusedinyourwork?  Whatcouldbeaddedorchangedinordertomakethelogicmodelamoreusefultool? Asforthedifferentthreephases,itwasnotedthatanimpactassessmentwouldbevaluablewithin theplanningphaseandthatevaluationneedstobeimplementedwithinallphases. ThemaintakeawayfromthediscussionwithstakeholdersandmembersofEqual‐Lifewasthatitneeds tobemadeveryclearthatthisLogicModelforEquityAssessmentisnotanotherprocess‐modelbutis aboutassessingtheequityaspectsinthethreemainphasesofanintervention.Ideastoimprovethis wastoemphasizethiseveninthevisualmodelbyusing“triggerwords”. 19  ThissessionrelatedtotheScopeofimpactassessment.Basedonthefeedbackthelogicmodelcould beimproved.  4.4Evaluatingchildren’saccesstopublicoutdoorplayspace  InthesessiononEvaluatingChildren’sAccesstoPublicOutdoorPlaySpace,RoosTeeuwenand AchilleasPsyllidis(TUDelft)collectedknowledgefromtheEqual‐Lifestakeholdersinaninteractive workshopsession.TUDelftaimstomeasurechildren’saccesstoplayspacesincities,tobeusedfor theenrichmentoftheEqual‐Lifecohortandschoolstudydatasets.Thegoalofthissessionwas threefold:tocollaborativelyidentifythefactorsthatlimitorpromotechildren’saccesstoplayspace; toconnectthesefactorstoelementsintheurbanenvironment;andtoassessthelatestwork‐in‐ progressapproachofTUDelftinmeasuringchildren’saccesstoplayspace. First,RT(TUD)introducedthetopictothestakeholdersandprovidedthemwithashortoverviewof thetheorythattheworkshopwasbuiltupon.Then,stakeholderswereaskedtocontributewith suggestionsoffactorsthatlimitorthatpromotechildren’saccesstoplayspaceaskeywords,followed byabriefplenarydiscussionofthemostprevalentlimiting(i.e.,lackofsafetyorsecurity,traffic,and lackofplacessuitingageormultiplegenerationsofusers)andpromotingfactors(i.e.,safety,other children,informalplacestoplay,andequipmentforchildrenwithreducedabilities). Second,bothstakeholdersandEqual‐Lifeparticipantssplitinto6groups,eachattheirowntable,to discusschildren’saccessibilityinaspecificurbancase:3tablesfocusedonLjubljana,Slovenia,and3 tablesonMilan,Italy.ParticipantsfamiliarwitheitherMilanorLjubljanawerepresentedwiththe correspondingcity,whileotherswerespreadovertablestoensurevarietyinexpertiseand geographicalbackground.Ateachtable,anEqual‐Lifemoderatorguidedtheprocess.Participants discussedphotosandmapsofthecityathandandpinpointedwhatcouldlimitorpromotechildrento accessplayspaces. Third,participantswerepresentedwithamapoverlayontopofthemapofthesecondround,made byTUDelfttomodelchildren’saccesstoplayspace.Specifically,theseoverlaysshowedplacesthey identifiedthatmayattractchildren’splay(i.e.,playgroundsandsmallparks),orthatmaybeabarrier tochildrenwhowanttoaccessaspacetoplayinthecity(i.e.,transportandnaturalinfrastructures). Participantsdiscussedtowhatextenttheyagreedwiththebarriersandplacespresentedonthemaps, aswellaswhatshouldbeomittedoraddedtobetterreflectpractice. Throughoutthesecondandthirdrounds,participantscontributedtheirknowledgebymeansof annotations,drawings,andstickynotes.Participantsalsoelaboratedonexperiencesfromtheirown lifeortown,whichwerecapturedinaudiorecordings.TUDelftwillusethesetounderstandthe potentialandlimitationsofusingsuchdatatomodelchildren’saccesstoplayspaceintheEqual‐Life project. Preliminarytake‐awaymessagesfromtheparticipantstoTUDinclude:Thesizeandshapeofparks, timeofday,movementtrajectories,andsurroundinglanduseandactivitiesmatterwhenassessing children’saccesstoplayspace;Goodqualityinfrastructureisimportant;Andknowledgefromlocal expertsorchildreniscrucialtogetacompleteunderstandingofchildren’saccesstopublicoutdoor playspaceintheurbanenvironmentathand. 20  ThisoutputofthissessionwillenableTUDtoimprovetheExposomeMappingandVisualization Strategies.  4.5Policyrecommendationperspectives INCHES(PvdHl)introducedthesessionwithashortpresentationontheecologicaldoughnutmodel andtheDPSIRmodel.ThedoughnutmodelbyKateRaworth(2012)isavisualframeworkfor sustainabledevelopment,combiningtheconceptofplanetaryboundarieswiththecomplementary conceptofsocialboundaries.TheDPSIRmodel(drivers,pressures,state,impact,andresponsemodel ofintervention)isacausalframeworkfordescribingtheinteractionsbetweensocietyandthe environment. Thesemodelsweredevelopedinthecontextofplanetaryhealthandtheenvironmentalsciences,to describeandclarifycomplexsystems.Theparticipantswereinvitedtothinkofapplyinganadapted versionoftheDPSIRmodeltothecontextofchildren’smentalhealthandcognitivedevelopment.The resultsfromthediscussionsondrivers,pressures,status,mediators,andoutcomesareonthenext page. Thissessionhadtheaimedtogivethestakeholdersinputforfuturestepsinimplementationofpolicies andinterventions.Thisrelatestodocumentationandknowledgesharing.  4.7Whatarethenextsteps?  Inthisfinalsession,thestakeholdersandEqual‐Liferesearcherssplitintotwoseparategroups.The stakeholdersreflectedonthetipsandtopsofthestakeholderforumfromtheirperspective.TheEqual‐ Liferesearchersdiscussednextstepstotakeinthestakeholderactivities.   5 Co‐designworkshopComo  Aco‐designworkshopinComo,Italywasheldonthe29thand30thofJune2023.Thisworkshop discussedtheprogressandinteractionwithstakeholdersintheEqual‐Lifeproject.Thebestwaysof usingtheexpectedEqual‐Lifeprojectresultsforimplementingpoliciesorinterventionswere discussed.Howshouldwedesignthetools?HowtoincorporatethegenerateddatafromEqual‐Lifein thedesignofpolicies?Whatareyoutheneedsasstakeholdersworkinginthedomainofchildren’s mentalhealth,cognitivedevelopmenttolinkEqual‐Liferesultstotheworkthatstakeholdersdo?How canscienceandcivilsocietyorganisationsbestcooperate? Theworkshopwasaliveworkshop.Atotalof15personsattended(live12,3online.Theworkshop tookplaceatthePolitenicoinComo. Sessionswereconductedonhowtoreadframeworksanddifferentconceptualmodelsonexposures, mediators,settingsandlifecoursestages.Anothersessiondiscussedtheuseoftoolsandhowthese 21  shouldbedesigned.Anothersessiondealtwiththereflectionontheprioritizationofresearch questionsofEqual‐Lifeandtheirlinktodailypracticeofthestakeholders.Asessiononsocialexposome lookedattheintegrationofsocialandphysicaldomain.Thiswasconsideredasveryimportantbythe stakeholders.Twofinalsessionswereconductedon1)Dataandharmonization;and2)Conceptual modellingwithsemantictechnologies.  Introductionpresentationonconceptualmodels PresentationWP1(DS‐PartnerZEUS):formulatetheoriesandmechanisms‐>frameworkanddifferent conceptualmodels(exposures,mediators,settings,lifecoursestages). Somementionedhighlights: Socialpracticesaffecttheimpact,aswellassocialandphysicalenvironments.Translatedintoresearch questions,whichare“tested’inin‐depthstudies(sleepstudyandpreschoolstudy)andincohort studies,includingenrichmentofthedata.Resultswillbeavailableendof2023/beginningof2024 (externally). Anidentificationofkeyexposureswithinthehumanexposome;thiscouldforexamplebeexposures likeaccesstoplayareas,noiselevelsduringsleep,andqualityofinteractionbetweenchildandparent, dependinguponthehealthoutcomes. Discussionontheconceptofmediator,suchassleepandstress.Howdostakeholdersusethat? Suggestedbystakeholder:Itisan‘outcome’thatisanentrancepointforunpicking/understanding what’sbehindthis.Aninventoryonstressamongparentsnowincludesaquestiononwhetherone mindsexperiencingstress.Povertyisanessentialfactor,themainfactor,aswell.Povertyispartofthe socialexposome.Housingincombinationwithpoverty. PovertyisnotusedasaterminEqual‐Lifebutcanbefoundinthe‘inequalities’perspectiveofthe research. Addinganothermediator,suchasaccessto(social/health)servicescouldbeconsidered? ThissessionprovidedinsightsonUser‐DefinedRequirementsforthepolicydevelopmentandthe toolbox,theExposomeMappingandVisualizationStrategies,theScopeofimpactassessment (includingdatasharing),thePrototypesandDemonstrator(relatedtothetoolbox),Feedbackand IterativeImprovementandexpectations.Thisisalsoappliedforthescience‐policyimplementation process.FeaturePrioritizationandDocumentationandKnowledgeSharing.  WorkPlanforImplementation  CommunicationStrategy  Sessionontools Makeadistinctionbetweentypesofstakeholders.Whoareyouaddressing?Informationfordecision making.(Inter)nationallevel,citylevel,communitylevelandsettingslevel.Makethetoolaccording tosimplicityprinciples. Seefordetailsonthestakeholderreflectionsannex4. Thissessionprovidedinformationtodeveloptheprototypeanddemonstratortowardsatoolbox.  22  SessiononresearchquestionsmoderatedbyINCHES Tableswiththeresearchquestionsconsideredintheprojectwerepresentedinthediscussion.The questionshadbeensentinadvancetostakeholdersinordertohavetimetoreadandunderstand them. Seefordetailsonthestakeholderreflectionsannex4. Seeannex9fortableswithresearchquestions.Initialusefornamesofstakeholders.  SessiononTranslationofscientificresultsintotoolsmoderatedbyQuantia Theinsightsfromtheco‐creationworkshopinComoprovidedavaluableunderstandingof howstakeholdersutilizetoolsintheirprofessionalenvironmentsandofferedfeedbackon thedemonstrator'sadvantagesanddisadvantages. MaininterestwasseeninalloutputsfromWP4andlowinterestinWP5forstakeholders,exceptfor themaps(andhigherforresearchers). Relatedtothedevelopmentofatoolboxseveralsuggestionswereprovided.Stakeholdersmentioned preferredformats:guidelines,visuals,‘easy’website,policybrief,communicationmaterial, interactivewebpages. Action:raiseimportanceofdiscussingpreliminaryresultswithstakeholdersduringupcomingcatch‐ upsession.Researchersneedtolearntocommunicatewith/tonon‐academics.Makethelanguage workfortheend‐user. Thissessionprovidedinputfortheworkplanonimplementationandinformationtodevelopthe prototypeanddemonstratortowardsatoolbox.  SessiononsocialexposomemoderatedbyUB,INCHESandNIJZ Sessionstartedwithanexplanationaboutthesocialexposome. Socialexposome:anovelconceptualframework.Goalarealisticportrayalofthecomplexsocial environment.Characteristicsoftheframework:Multidimensionality,reciprocityandtimingand continuity.Seepaperat: https://www.sciencedirect.com/science/article/pii/S0013935123012896?via%3Dihub ThreepathwaysareidentifiedinthemodeldevelopedbyUB:empowerment,resilienceand susceptibilityorvulnerability,andembodimentasadditionalfeature. Integrationofsocialandphysicalexposomes.Questionbystakeholder:Whyintegration?Answer:To understandmechanisms/pathwaysthatdrivethepatterning/combinationsofexposuresandhow theytogetherandholisticallyaffecthealth. Startingpointistodevelopreliableandvalidmetricstomeasurethecomplexexternalenvironment, comprisedfromsocialandphysicalindicators. Integrationofsocialandphysicaldomainsleadstoanotherstartingpointtowardsaholisticexternal exposomeconcept. SeeAnnex4ondiscussionnotes,oninteractionsessionandondataharmonizationsession. 23   Thissessionrelatedtoknowledgesharingandfeatureprioritization.Inputisvaluableforadaptingthe socialexposomemodel.  InteractivesessiononPrioritisingdata(categories) Wewantedtoknowwhichcategoriesofdataareimportantintheviewofstakeholders.Different categoriesofdatawerementioned.Prioritisedcategoriesarementalhealth,fluidintelligence,socio‐ demographicfactors,psychosocialstress,relationshipsandsocialsupport,educationalmobility, healthcharacteristics,learningandteachingconditions,livingconditions. Althoughallhave(some)importance. Reflectionsonthis‘exercise’: - Weshouldhavedonethisatthestartoftheresearchproject. - Combiningresearchandpractitioner’sarguments–interdisciplinaryapproach - Combinetheseprioritieswiththeresearchquestionspriorities. Thissessionprovidedinputforthefeatureprioritizationofoutcomesoftheprojectinordertomatch stakeholder’sexpectationswiththepotentialoutputofthetoolbox.  SessiononConceptualmodellingwithsemantictechnologies(MB,Quantia) WithinEqual‐Lifeasemanticknowledgesearchtoolwillbedeveloped:atooltohelpyoufindinga specificdocument.Whatisanontology?Amodelof(someaspectof)theworld.Introducesvocabulary relevanttothedomain.Specifiesmeaning(semantics)ofterms.Formalisedusingsuitablelogic.Shared amongmultipleorganisations. Creatingclasses.Creatingsubclasses.Creatingaclassinstance.Forexample:artistisaclass.Painter andsculptoraresubclassesoftheartistclass.AndLeonardoisapainter(hence,alsoan artist).Leonardoisnotaclass.Andthencreatingadditionalclassinstances:forexample,DaVinci,age, birthdate.Creatingclassinstancesthroughclassproperties,forexample:Leonardopaintsthe Monalisa(painting),MichelangelopaintstheSistineChapel(painting),MichelangelosculptstheDavid (sculpture).AndthenanAItoolcanknowthatLeonardocreatestheMonalisaorthatMichelangelo createstheSistineChapelandtheDavid. Stakeholderhelpneededtoimprove/reflectonthetool. Feedbackstakeholders:searchtheevidenceandbestpractice,taketheoryandimplementthat.Not interestedinwhatisatthebackofthat(website,tooletc).Techniqueversuscontent. Searchengineoptimisation.ConceptualmodelofEqual‐Lifeistheontologyforthetoolprototype.To bevalidatedbystakeholders(e.g.instakeholderforuminHelsinki).HaveapractitionerandITexpert workingsidebyside. Organisingtheinputforthemachinelearningisanimportantstep.Irene:note,therearemore conceptualmodelsinEqual‐Life,thusneedtousethedefinitiondocuments/goalayerdeeper. Suggestion:prepareanexampletofurtherdiscuss/pre‐testwithstakeholders.Startingpointforthe ontologycouldbetheconceptualmodelofWP1. 24  Finalconclusion: ADemonstratorversionofthetoolbox/guidebookwaspreparedandreviewedwithstakeholdersat theWP8co‐creationmeetinginComo.Additionally,anEditorialBoardwasformedtoorganizeand incorporateresultsandfindingsfromtheEqual‐Lifeprojectintothetoolboxandguidebook.This board,adoptingatop‐downapproach,comprisesmemberswithdiverseexpertiseinareassuchas toolsandtraining,knowledgemanagement,guidebookandtoolboxdevelopment,stakeholder expertise,andcommunicationandcoordination.Theirgoalistomaketheproject'soutcomeseasily understandableandrelevanttothepublic.  Sessionwasrelatedtoprototypingofthetoolbox.  6 StakeholderforumHelsinki Astakeholderforumwasconductedat7and8September2023inCityHall,Helsinki.Thismeeting wasorganizedbythestakeholderfromtheCityofHelsinki.Therewere14stakeholderspresentand 14representativesoftheEqual‐Lifeproject. Theaimofthemeetingwastogiveinputtowardsthewayofthedevelopmentofpolicy recommendations,towardsthecontentofthetoolboxandgoodpractices/requirementsfortraining toimplementpolicyrecommendationsandtools.  Thursday7thSeptember ThemeetingstartedwithashortexplanationofEqual‐Liferesearch,theconceptualframeworkand theprogramofthe2‐dayworkshopsorganizedbyWP8(stakeholderinvolvement)andWP9(toolbox andtraining). Anintroductionwasgivenontheconceptualframework,thetotalityofinternal,socialandphysical exposures,overalifetime,onbetterunderstandingthecausesofandprocessesrelatedtomental healthandcognitivefunctioning,withpotentialmediatingpathways,andaboutprovidingapossibility forinterventionsalongthelifecourse. Expectedresults:earlylifeexposuretourbanplanningrelatedfactors(noise,air),socialfactors (parentalstress,socialeconomic),biomarkersrelatedtoenvironmentalandsocialexposures. Presentationsweregivenon: - Overview preliminary results - Measuring access to public spaces - Presentation on enriching the environmental exposome: road traffic flow prediction and noise modelling - Social exposome - Conceptual framework See for details on these presentations Annex 4. These presentation updated the stakeholders on the state of the art of the work done in Equal-Life. Feedback was given by the stakeholders. 25   Friday8thSeptember Presentationsweregivenbystakeholdersontheirworkrelatedtotopicsthatareaddressedinthe Equal‐Lifeproject. Thesessionsarerelatedtoknowledgesharing.ItgivestheEqual‐Lifeconsortiuminsightinwhichkind ofpolicyimplementationsandpotentialinterventionsareimportant.  Toolboxandguidebook(AS,Quantia) ThestakeholderforuminHelsinkiproducedbeneficialfeedbackfortherevisedprototypeofthe toolbox/guidebook. InvolvementofstakeholdersinbroadercommunicationofEqual‐Liferesultsis crucial–andoffered! DiscusseditemsfortheToolboxmodulesarestakeholders,visualization,semanticknowledge exploration,connectionandsharingmodules.InmoredetailtheStakeholdermoduleshouldbean explorativewebsitewithclickableelements.Feedbackhasbeentestedinpreviousstakeholder workshops.Theupdatedwebsiteispresentedinthisworkshopforcomments. Toolsarebroadlydefined,andabroadselectionwillbepresented,butnothostedonthewebsitebut throughlinkagestothe‘owners’ofthespecifictools.Thewebsitewillbeopenforeveryoneandwill haveanexplorativepart. Usestorytelling(workshops)fortheresearchersinordertocollectstories,contentforthewebsite. Suggestions: - Insteadofawebsiteorinadditiontothewebsiteconsiderdevelopinganapp. - LinktootherwebsitesanddashboardssuchasUNICEF.  Thissessionprovidedinputontheprototypingofthetoolbox.Thisisalsorelatedtovisualization, knowledgesharing,communicationandtrainingandothersupportneeds.  7 Conclusion/Nextsteps  Thischapterhighlightstheoutcomesoftheco‐designworkshopsandstakeholderforathatbrought togetherdiversestakeholderstocollaborativelyshapethedevelopmentstepstowardsusingthe projectresultsforpotentialpolicyimplementations.Andmoreover,forthedevelopmentofatoolbox andguidebook.Thetoolboxaimstoadvanceourunderstandingoftheexposome'sroleinchildren’s mentalhealthchangeduringchildhoodandadolescence,andchildren’scognitivedevelopment.The followingoutcomesdemonstratethesignificanceandpotentialimpactofthiscollaborativeeffort. 1.User‐DefinedRequirementsforthepolicydevelopmentandthetoolbox:Stakeholders,including researchers,healthcareprofessionals,non‐governmentalorganisations,andpolicymakers,actively participatedindefiningspecificrequirementsforpolicyimplementations,thetoolboxand guidebook.Thisinclusiveapproachensuresthatthesegoalsaddresstheuniqueneedsand expectationsofdiverseusergroups.Thecontributionbythestakeholdersincreasedtheknowledge 32  Annex2Co‐designworkshopSkopje  Theme3Workingtowardstranslationofscientificresults  Additionalanswersbythestakeholders. Weaskedwhattheproblemsareontheinteractionbetweenstakeholdersandscientists.What barriersdoyousee?  Somemainanswers:  Differenceinlanguagewithinscientificcommunityandincommunicationwithdecision‐ makers.  Policymakersaresometimesimpatient,whilescientisttoolittlesenseofurgency.  Policymakershaveacertaingoalandlookforinformationsupportingthat.Coherencywithin stakeholdergroupsislackingmightaddtothis.  Differentsenseofurgency.Motivationofscientistcandifferfromthoseofpoliticians.  Politiciansdon’tlikeprecautionaryprinciples.  Poorlistening,hearing,duringallphases.Informationduringprojectsandnotattheend.  Additionalbarriersincommunication:changingofpoliticians;differentgoals;educationlevel differences;scienceissometimesnotapplicable;tooexpensive.  Timingisrelevantandmightdifferbetweenscientistsandpolicymakers.  Contactsarenotalwaysone‐to‐one,andthus‘interference’fromothercontactsmightoccur.  Themessageitselfcancreateabarrieraswell.Themeaningofthedatacanbeunclear.  Continuousexposure‐responseinformationneedstobeprovidedversusyes/no/no information.  Creativesolutions:PRcommunicatorsorjournalists,usemedia.  Weneedmediatotransferkeymessagesfromresearchandputmorepressureonpolicy makers.  Decisionmakersneeddifferentkindofinformation(yesorno)thanscientists(can)provide. Thresholdsaresetbaseduponvariousarguments(incl.societal)andthusarealwaysbroader thantheempiricalresults.  Resultsdonotalwayspleasepolicymakers.Policymakersarenot(always)involvedinresearch studies.  Collaborationneedstoaimtosomehowpracticalwisdomandnottoscienceorsolutions.  Scientificproposalscouldbeusedasexamplesofsupporttootherstoapplyforresearch projects.So,lesscompetitionbutmorecollaboration.  Thereisanadditionalbarrierbetweenscientistsandpoliticiansbecausescientificpapersare publishedinscientificjournalswhicharenotvisibleforpoliticians/policymakers.  Thereisaneedforsystematiccapacitybuildingofscientistsontheirroleinpolicymaking processandlearnhowtocommunicatetheirfindingstopoliticians.  Researchhastobeproactivetobringmainfindingsinfrontofmessages.    33  Theme4Interventions‘bridgingthegap’asatooltoimprovehealthforall  Then,mostofthesessionwasaboutconsideringthefollowingthreephases. Phase1:Visualrepresentationofstepsinaninterventionprocess(e.g.alogicmodel) Phase2:Whereareconsiderationsofsocialinequalitiesandanequityperspectiverelevant? Phase3:Questionsrelatingtosocialinequalitiesandanequityperspective.  Theresultsofthediscussioninthesephasesaresummarisedbelow. Phase1:Buildingagenerallogicmodel Inrelationtocontext/monitoring:  workingwithmunicipalities,citizens,professionals/experts/researchers,national governments,EU/internationalgovernments,engineersandNGO´s  includeexpertsliketeachers‐>askthemaboutproblemsandsolutions+bringthetopicto theiragenda  consideringexistingnormsrelatedtothetopic  useKPI´s(‘keyperformanceindicators’)toevaluatespecificproblems  mentionnational‐levelproblems  decidingonatopic(‐>evidence–what´schangeable,what´sintegral?)  considerinnovators&Influencesondifferentgenerations  raiseawarenessontheinterventiontopic‐>communication  Inrelationtoimplementation:  raiseawarenessontheinterventiontopic‐>communication Inrelationtoplanning:  Identifyneeds/problemintheveryfirststep  definetheproblem  decideonthetarget(group)  identificationofaffectedgroups  Includeexpertsliketeachers‐>askthemaboutproblemsandsolutions+bringthetopicto theiragenda  Consideringexistingnormsrelatedtothetopic  setupindividualgoals  interventionsforparentstoeducatethemonthetopic  decideonthephysicalspacesanditsaccess  decideonthepersonswhoexecutetheintervention  Inrelationtoevaluation:  Identifyaffectedgroupstoperformtheevaluationwiththem 34   Inter‐evaluationbetweenthedifferentplanningsteps/phases  planningasaspiralprocedure(planning‐>implementation‐>evaluation‐>re‐planning‐>re‐ implementation‐>re‐evaluation…)  puttingthedefinedprobleminthecentreofevaluation,implementationandplanning  Useso‐calledKPI´s(‘keyperformanceindicators’)toevaluatespecificproblems  Phase2and3: Inrelationtoanequitylens: Thetextsbelowweretranscribedfromhandwrittennotesfromtheparticipants.  Equityperspectivesontheplanningprocess  Equityperspectivesonthetargetgroups‐>planningprocess:Dowecoverwithinterventions peoplewithlowersocio‐economicstatus?  Aretherecertaingroupsthataredisadvantaged?  Who´saffectedbyinterventions?(positiveornegative)  Whobenefits?  Dotargetgroupsgetdisadvantages?  Dopeoplehavetheabilitytoparticipate?  Educationindifferentsocialgroups?  Adhoccommunicationstrategy?(whendecidesoutcome,howtocommunicateaspartofthe intervention,howtocommunicatedependsonsocialfactors)  Moderatingfactors:poorness‐>culturaldifferences,languages)  Tolookatinequityisimportant:duringplanning,duringmonitoring,duringevaluation (parentsintervention),assessmentoftargetpopulation,butreallyeverystep  Settinggoalsintheavailabilityoftheintervention  Decidingonhowit´simplemented,availabilityforeveryone–physical/online  Monitoringtheavailabilityoftheintervention(regionandtimely)  Outcome,share,helping   Theme5Spectrumofprevention  Asummaryofbulletpointsofthesuggestionsbytheparticipants:  Schoolsettingscanhavebothpositiveandnegativeeffects.E.g.highdemands,dresscode (uniforms),schoolsystem(primarytosecondarytohighschoolselection),socialnorms,self‐ managementrequirements/capabilities  Family:education,singleparent,poverty,mentalstatusparents,addiction,violence, crowding,numberofchildren(canbeapositiveeffect),divorce,movinghouse,trauma.  Preventiveprograms,suchasDutchprogram“NuNietZwanger”(notpregnantnow).  Community,housing,services,neighbourhood(playgrounds,green),socialnetworks. 35   Steppingstonesineachlifephase.Weneedtohaveuniversalknowledge,suchashowmany greenareasareneededforchildren’smentalhealth,whatfactorsarerisky?Thingstofixand no‐go’s.  Socialtippingpoints: o 25%ofthepeoplemakeatippingpointoccur. o Examplesaregivenfordifferentsocietalgroups:Anti‐vaxers;Fridaysforfuture;White flight. o Educationofparentsonhowtoimproverelationshipwithchildrenandadolescents. o Forcewillnotwork.Surroundingsareimportant.Smallplans,toobigdoesnotwork. o Collaboratingsocialpsychologists,psychologists,behaviouranalysts–better understandingofhumanbehaviour o Culture,religion,weatherchange,disasters,accidents,newpeoplecomingtothe neighbourhood,crises o Socialnormsaredetrimental,instancesofsuddenchange,significantimplicationsfor welfare o Developmentofcommunicationstrategytopromotepositivebehaviouramong childrenandparents.Children–teachers  Trendwatching Forthissessionweusedthemethodofaskingrepetitive‘whyquestions’.Thestartingquestionwas: Wedonotmeetourgoaltoprotectchildrenfrommentalhealthproblems.Why? Whatdoyouseecoming? Children’smentalhealthisgettingworse.Increaseofdepression,ofanxiety.Butistherearealincrease oranincreaseofawareness,analysing,datacollection?Allowingtheconversationtohappenwillhave highernumbers(andnotsomuchincreasetheoutcomes).Medicalisationcouldbeareason.The global,overallpictureversus(differencesin)regionalpictures.  Theme6 36  Annex3StakeholderforuminMilano  Theme4.2Worldcafésessions Presenter:MK,UniversityofKaiserslautern,CognitiveandDevelopmentalPsychology(online) Titlepresentation:Effectsofenvironmentalexposuresonmentalhealth,well‐being,andcognitionin childrenatthetransitionfromkindergartentoprimaryschool:Conceptofalongitudinalfieldstudy Worldcaféquestions:  Westudytherelationshipbetweengreenspace,noise,airpollution,socialfactors,andthe cognitivedevelopmentofchildrenintheperiodbetweenpreschoolandprimaryschool.  Fromaninterventionperspectivewhatassociationstoanalysewouldbeofmostinterestfor you Worldcafédiscussion: Thepresentationwasregardedasverygood,partlyabithardtounderstand(particularlythedifferent outcomemeasurementsandhowtheyarerelatedtoeachother).Butthestudypresentedwas regardedasquiteillustrativeaboutwhatEqual‐Lifeisdealingwithandisbettertounderstandthan thecohortdata. Topics/discussionpointsmentionedwere:  Identifyqualityaspectsofgreenspacethatareimportanttochildren'sdevelopmentandhow theyrelatetothepreferencesoftheirparents.  Greenspacesinresidentialareasaremostimportantforsmallchildren.  Studytherelationbetweengreenspaces&qualityoftimespentinthosespaces. Atthatpoint,thegroupdiscussedwhatdefinesthebeneficialqualityofgreenspaces(orotherplaces) inrelationtothementalhealthofchildren.ItwasmentionedthattheWP5definitionof"timespent" and"frequencyspent"isprobablyagoodindicatorforanenvironmentbeneficial/attractivefor children‐betterthandefining"highquality"intermsofthephysicalfeatures(vegetation,water…). "Greenspaceneedsmaintenance"wasmentionedhere. ThemoderatorsmentionedthatthePreschoolstudyisalsointerestedinsocialexposure/factors.The groupdiscussion,therefore,shiftedtowardstheroleofgreenspacefordifferent(socio‐economic) targetgroups. Topicsmentionedherebygroup1andthefollowinggroupswere:  IsthereadifferenceintheeffectofgreenspacebetweendifferentSESgroups?  Ideaforanintervention:addgreenspacetoschools.SchoolyarditselfisanequalizerofSES differences  Thisprovidesequityofaccesstogreenspaceforpupils Moregeneralideasforinterventionfollowed:  Interventionshouldprovideequityinarchitecture&urbandesign  Bringnatureinsidethe(artificial)citytowardcreativity  Also,animalsbringnaturebacktothecity,notthestandardelementsmorecreative 37   Considerthedidacticaspectsofgreenenvironment  Designinganinterventionthatislocatedinagreenspace(freeschoollunchinaparkduring summer–Helsinki)=>provideshealth‐beneficialeffectsofgreenspaceandequitytodifferent socio‐economicgroups Besidesgreenspace,somegroups’memberssuggestedconsideringotherexposuresinthepreschool study,namely:  Includedigitalexposome  Impactofelectromagneticradiationonpreschoolchildren  Alsoincludenoise  Presenter:CG,CentreforCognitiveScienceTUKaiserslauternGermany(online) Titlepresentation:CausalpathmodellinginEqual‐Life.Whathasbeenandwhatwillbedone?  Worldcaféquestion: Howshould(complex)empiricalandstatisticalresultsbecommunicatedtothetargetaudience,and howtopresenttheseresults,toavoidmisconceptions?  Worldcafédiscussion: Stakeholdersdiscussedthattheanswerdependsonwhothetargetaudienceisandthatthereare differentlevelsofinformationthatcanbediscussed.Thestakeholdersexpressedinterestin informationonwhattheresultsrepresentandhowtolinkittointerventionsandpractice.Itis importanttoinformonthecontextoftheresults–whatquestionswereasked,whatdataandmethods wereused,whatdatawasmissing,andhowwastheconclusionreached.Itisalsoimportantforthe stakeholderstoknowhowtheycanchangetheoutcomesintherealworld.Regardingtheformof presentingresults,severalformswerementioned:short(written)summaries,interactivesessionswith stakeholders,cartoonsoranimations,andinteractiveonlinematerials.Theresultsmustbeintroduced properly,communicatedinauser‐friendlyandsimpleway,andtherelevancetothetargetaudience shouldbeclear.  Presenter:AP,TUDelft,theNetherlands Titlepresentation:Newmethodologicalapproachestomeasuringthephysicalenvironment.  Worldcaféquestions: Whatmetrics/indicatorsareyouusinginyourdailypractice(ifatall)toassessaneighbourhood’s walkability/accessibility/encouragementofactivetravelbehaviour,etc.?Whatislacking? Doyouuseanyavailabletools/designguidelinesfromglobalorganizationssuchasWHO,UNHabitat, etc.?Whichones?Whatislacking? Whenitcomestoimprovingchildren’smentalhealthandwell‐being,whichenvironmentalaspectsdo youconsiderthemostimportantandwhy?Onwhatevidencedoyouprioritizethem? Doyouseeanypotentialintheworkwepresentedforyourdailypractice?Whatwouldyouneedto makethishappen?  Worldcafédiscussion: 38  Allparticipantsagreedthatthepresentationwasverygood.Alreadyknowingaboutthiskindof researchisan“eye‐opener”.Membersofthisgroupdiscussionwereimpressedwithalldatagathered andwereinterestedinhowtheycanreachdataatasimilarlevelfortheircases.Theywouldbe interestedinreadingreportsandpublicationstoreadmoreaboutitontheEqual‐Lifewebsite. Regardingthetopic“greenareas”theysuggestedtoaddalsolocationsofschools/kindergartens,and playgrounds.Apartfromthefactthatgreenareasarediscusseditisalsoimportantwhatsuchareas offer,whatareactivitiessupportedinsuchplaces(recreation,useofdigitalapps…).Itwassuggested thatalistofaspectsthatspatialplannersshouldconsiderbeforedecidingonnewinterventions. Plannersneedactiveengagementofseveralstakeholdersincludingresidentsandfeedbackfromusers. Itisimportanttomonitorandevaluatetheuseofthegreenareaandmakeimprovementswithtime. Itisimportanttoknowwhatkindofgreenareasweneedinthecity(safety,activities…).Accessibility isimportant,needtoavoidbarriersorcrossthem(railways…).Itshouldbeadynamicprocess.Tools formunicipalitiesareneededtoconsiderthelistofaspectsthattheyshouldconsider.  Presenter:JA&LG,UniversityofBremen,Germany Titlepresentation:SocialExposome‐Concept,applicationfields,andimplications  Worldcaféquestions:  Doesourresearchinspireanypracticalimplicationsinyourwork?  Doyouseeanyoptionstointegrateourresearchinyourwork?  Doyouseeanygaps,whichshouldbeaddressedinourresearch?  Worldcafédiscussion: Doyouseeanygaps,whichshouldbeaddressedinourresearch?  OneimportantaspectwithinSocialExposomeshouldbedigitalizationandsocialmedia:Social realityishighlydigitalized,andtheincreasingglobaldigitalizationshouldbeconsideredwhen werefertothesocialenvironment,becauseofthehighinterrelatednessbetweentherealand thevirtual/digitalworlds. o Socialrealityistypicallyperceivedthrough‘digitalfilters’(i.e.useofsmartphones,iPads, socialmedia,etc.) o Theomnipresenceofdigitaldevicesdistractsfromtherealworldandinfluencesour relationships:distraction,lossoffocus(e.g.parentsandlittlechildrenparental investment) o Interactioneffectsbetweentheuseofdigitaladviceandsocioeconomic/educational backgrounddigitalliteracyisneeded   WhentalkingabouttheSocialExposomewealsoneedtoconsidercommunityandsocial interactionsattheneighbourhood/districtlevel.  o Qualityofneighbourhoodsdiffersalotwithincitiesanddependshighlyonmovementor employmentpatterns. o Whatcanbeobservedisthatsegregationiswantedbytheprivileged residents/communities: ImportantHowtobreakthroughthisaversionandincreasetolerance/opennessto achieveregenerationwithoutlosingbenefits? 39  o Youngfamiliestypicallyareaconstantinneighbourhoodsmaybeincreaseexchange platformsforchildrentoreachacceptancebetweendiversepopulationsinsight& exchangeoflivingpatterns o Lookforoptionstoincreasecommunityinvolvement(participatoryapproach)   Whentalkingaboutsocialinteractionsweneedtodefinethemeaningofsocialinteractions: qualityandquantityofinteractions o Inpracticeitseemsthatinteractionsoutsidespecificsettings(e.g.school)definethe atmosphereformeaning,becausehereinteractionslosetheirfunctionas“socialroles” (e.g.teacher,pupil)butcangrowinto‘true’relationships.Thus,to‘improve’interactions, weneedtocreateexchangeoptionsoutsidesettings.Thisunderstandingmayalsohelpto improveneighbourhoods/relationswithinneighbourhoods  Formentalhealthsocialinteractionsareofhighrelevance,asweneedtoconsiderboth, perceptionofinteractionsandbehaviourwithininteractions o Toimprovecommunities/neighbourhoodsweneedmoneyand,thus,weneedtoconvince policyanddecision‐makers,weneedtobeoutcome‐related.Butawarenessisalsohighly importantalsocanbeoutcomerelated.  Doyouseeanyoptionstointegrateourresearchintoyourwork?  Qualityofdata:Concreteoperationalizationoptionsneedtobedefinedtocollectgood&clean datatodrawvalidconclusions  Reductionofcomplexitytomakeitfeasibleinthefield–concreteguidelineswouldhelp o E.g.LogicModelforEquityAssessment:nameconcreteevaluationcriteriathataretobe followedinthedevelopmentofinterventions  Presenter:MD,TUEindhoven,theNetherlands Titlepresentation:Definingrelevantsettingsbytime‐activity‐soundexposuremapping  Worldcaféquestions:  Couldyouseethistypeofstudybeingdoneinyourmunicipalityoranotherscaleyouare dealingwithinyourdailywork(neighbourhood/city/province/country)?  Doyouseeanybenefittoapplyourresearchinyourdailywork?  Knowingthetypesofdatawecollected,whatresearchquestionscometomind?(Inother words,canyougiveanyadditions/suggestionstoourwork?)  Worldcafédiscussions: Stakeholdersfoundtheideaofusingbehaviouralpatternsfordatacollectionaninterestingapproach. Theopinionsweredividedonwhetherornottheyseethisstudybeingrepeatedintheirownfieldof work,duetocostsorprivacy.Theinformationthatthestakeholdersthoughtoftobebeneficialfor theirworkwere:SES–noise,qualityoflife–noise,mentalhealth–noise,andthesocialdifferences.It wassuggestedbythestakeholderstoexploretherelationshipbetweendurationandnoise,withthe questionbeing:arelocationswithahighernoiseexposurevisitedforashortertime?Othersuggestions weretoconnectmoredatatotheexistingdatasettoinvestigatethemediationofotherexposures suchasgreenspaceandairqualityandtoincorporatesubjectivesoundexperienceinthefuture. Finally,thestakeholderswouldliketoseesuggestionsforinterventions,guidelinesforwhenasetting is“good”or“bad”andhowtoinformparentsandteachersbetterabouttheeffectsofnoise. 40  Presenter:DK,JožefStefanInstitute,DepartmentofEnvironmentalSciences,Ljubljana,Slovenia Titlepresentation:Children's(mental)healthandparticipatoryresearch:diversityoflevelsofinclusion  Worldcaféquestions:  Howtotranslatefindingsresultingfromvariousparticipatory/CSactivitiesininterventions?  Whichtools(andtheirfeatures)aretobeusedforeffectiveengagementofchildren‐alsoto fostermotivationandconsequentlysustainabilityofactivities?  Isthereroomforintegrationofapproachedpresentedintoschoolcurriculum?  Howtoassessimpactofactivities/interventionconsideringspecificsofparticipants(children) involved?  Howtofostertheupscalingoftheresultsandtheiruptakebypolicyanddecisionmakers?  Worldcafédiscussion: Inthebeginningofthediscussion,someoneaskedforanexplanationonwhatisintervention.Itseems thatthemeaningofthewordisnotsufficientlyclear.Discussionwentindirectionthatresultsfrom theresearchareveryoftennotimplementedinpolicies.Decisionmakerslistenattheresultscoming fromresearch,buttheydonotconsidertheseresultsindecisionmaking.Weagreethatenvironmental sensorsforairpollutionandnoiseexposurecangiveveryvaluabledataandtheyshouldbeshared withlocalauthorities.Peoplearescepticalofimplementingsolutionsonchildren’sscience. Onthetopic‐Whichtools(andtheirfeatures)aretobeusedforeffectiveengagementofchildren‐ alsotofostermotivationandconsequentlysustainabilityofactivities,theparticipantsgavevery interestingproposals.Thesetoolscouldbegames,toolsasamusementforchildren,toolsthatmake childrenresponsibletouse,butstill,theyarenotobligatoryforchildren.Itisalsoimportanttoinvolve teachersandchildren,teacherscouldmakeratingfortheirdevelopmentespeciallyindevelopmentof emotionalskills.Someofthesetoolscouldbeincludedineducationprocessandbecomepartof educationcurriculum,especiallyforenvironmentalpollutionandhumanhealth. Weshouldthinktoincludechildrenintheprocessofdevelopmentoftools—co‐creationandco‐design withchildren. Someonegaveideafordevelopmentofapplicationfordailydiary,sowecangetpicturefortime activitypatterns.  Howtofostertheupscalingoftheresultsandtheiruptakebypolicyanddecisionmakers? Forthisquestionallparticipantswereveryscepticalthatresultswillbeimplementedinthepolicies.  Presenter:KB,senioradvisorchild&adolescentpublichealth,theNetherlands Titlepresentation:MentalHealthintheDutchPublicHealthsector  Worldcaféquestions:  Areyoumissingitemsinthewishlist? o Well‐beingasabasicconditionatschool o Moretargetgroup‐orientedinterventions o Moreaccessibleinterventions;morepreventiveinterventions o Attentiontosocialandphysicalfactorsinrelationtomentalhealth o Dataabout:‐youngadults;‐migrants;‐lowsocio‐economicstatus o Morequalitativedatainthefieldofmentalhealth.  Aretherealreadyqualitativedataaboutmentalhealththatyouwouldsuggest? 41   Whichqualitativedataaremostrelevant?  Aretherealreadynationalresearchagenda’sMentalHealthonchildren’smentalhealth?  CanEqual‐Lifebeofanysupport?  Worldcafédiscussion: Consideringthetime,nodiscussionwasheldonKarin’spresentation.  Presenter:ES,CityofHelsinki,Finland Titlepresentation:Implementingevidence‐basedpsychosocialinterventions:anexamplefrom Helsinki,Finland  Worldcaféquestions:  Whatkindofnationalguidanceisofferedinyourfieldofwork?  Howwouldyouapplyyourexperiencesinourwork?  Worldcafédiscussion: First,timewastakentoanswerquestionsabouttheIPC‐Aintervention.Forexample,questionsabout theFinnishhealthcaresysteminwhichbasichealthcaretochildrenisprovidedthroughtheschool system,andthattheIPC‐Aisanindividualinterventionthatcanbeprovidedbyanyonewhohas completedthetraining.AnimportantquestionforEmmaishowtogetmanagersintheschooland healthcaresystemtoadopttheIPC‐Aintervention.Theinterventionisalreadyinthenational guidelines;however,thisnationalguidanceisnotenforced.BarriersinFinlandarethatmanagersdo notfeelthatimplementinghealthcareinterventionsispartoftheirjobdescription,asthelawismore focusedonpreventionthaninterventions. Afewexperiencesfromothercountrieswiththisissuewereshared:oneparticipantproposedto informparentsabouttheimportanceofthisinterventionsothattheywillaskschoolstoimplementit. AGermanparticipantproposedtostartscreeningformentalhealthproblemstoshowthemagnitude oftheproblemandcreatemoresupportforimplementingIPC‐Aorotherinterventions.Another Germanparticipantsuggestedthatitmighthelptoconvinceinsurersthattheinterventioniscost‐ efficient,theymightthenlobbyfortheinterventioninschoolsandhealthcaresettings.Aparticipant fromItalyproposedthatitmighthelptoinformuniversitystudentsabouttheimportanceofthis interventionandtheimportancetoworkinterdisciplinary,sothattheymightchangetheeducational andhealthcaresystemsofthefutureandwillseethevalueoftheseinterventionswhentheyenter professionallife.InSloveniatheyencountersimilardifficultiesinimplementinginterventions,their barriersaremainlyalackofresources,people,andmotivation,andwhohastheresponsibilityforthe implementationofinterventionsisnotclear.  Presenter:MW,NCJ,theNetherlands Titlepresentation:Yourbrainincontrol?!Universalpreventiontowardsmentalhealthinadolescents  Worldcaféquestions: IsthereawayinwhichEqual‐Lifecanhelpmeasuringthechangesweaimforwiththisinterventionat school?  weexpecttoseemoreinteractionbetweenstudents,outsideclassesandlunchbreaks 48  Interactionsession:Social‐environmentaldimensionscircle(tapedonthefloor). Ljubljana:includingsocialaspectsandhealthimpactassessmentsinspatialplanning. IntegratingEqual‐Liferesultsintohealthimpactassessmentsregardingmentalhealthandcognitive developmentoutcomes.   SessiononDataandharmonizationpresentedbyJS(KI) Apresentationwasgivenonmappingofexistingcontentinthecohortsandharmonization(protocol) andcodebook. ThereareAnalysisteamson:diagnosisteam(mentalhealth),internalizing/externalizing(mental health),cognition,well‐being,andonbiomarkers.Selectionoflifephasewhereoutcomesare(most) relevant. Analysisplan: - Whichresidential(maternal)physicalandsocialexposuresduringpregnancyareassociated withADHDdiagnosis? - Whichresidentialphysicalandsocialexposuresatage0‐3yearsareassociatedwithanADHD diagnosis? - WhatistheassociationbetweenprenatalphysicalandsocialexposomeandanADHD diagnosis?Towhatextentisthisassociationmediatedbypretermbirth/SGA/LBW? - Whatistheassociationbetweenphysicalandsocialexposomeatage0‐3yearsandanAHDH diagnosis?Towhatextentisthisassociationmediatedbystress/sleep(measuredatage0‐3 year)? - Whichresidential(maternal)physicalandsocialexposuresduringpregnancyareassociated withautismdiagnosis? - Whichresidentialphysicalandsocialexposuresatage0‐3yearsoldareassociatedwithan autismdiagnosis? - Whatistheassociationbetweenprenatalphysicalandsocialexposomeandanautism diagnosis? - Whatistheassociationbetweenphysicalandsocialexposomeatage0‐3yearsandan autismdiagnosis?Towhatextentisthisassociationmediatedbystress/sleep(measuredat age0‐3years)?  49  Stakeholders’rolewasparticularlyrelevantandvaluableininterpretingtheanalysisoutcomes.Move awayfromstatisticsintointerpretation(RIVM‐IrenevanKamp). Relatedtodatahandlingandfutureimplementationofresults.   50  Annex5StakeholderforuminHelsinki  Summariesofpresentationsanddiscussionsonthefirstday  Presentation:Overviewofpreliminaryresults/updates(DS,Zeus) AimofWP1(onmechanisms)istoformulatetheoriesandmechanisms,forhowexposomelinksto mentalhealthandcognitivedevelopmentofchildrenandadolescentsandtounderstandhowstress/ restoration,self‐regulation/copingandsleepmayaffecttheserelationships. Researchquestionsarestudiedin‐depthinsleepandpre‐schoolstudiesandinthecohortstudies (data),enrichedwithnewdata.Examplesofdataavailableinthecohortsand/orareillustrated. Reflectionsfromstakeholders:coping,digitalenvironmentanddaylightare(yet)missinginresearch. Outcomesinfluencetheexposome;thatarrow/linkis‘missing’intheconceptualframework.Thiscan bemodelledthough(inWP7). Thissessionprovidesfeedbackfromthestakeholderstobringfocusintheongoinganalysisofthe results.  Presentation:Measuringaccesstopublicspaces(TUD) Thisworkshopconsistedoftwoparts. Part1:Inthefirstpart,weexaminewhichfactorsinfluencepedestrianaccesstopublicspaces andforwhom.Usinganinteractivecardgame,wewillprioritizedifferentfactorsthataffectpedestrian accessibilityanddiscusshowwecanpracticallymeasurethem. Part2:Inthissecondpartwefocusonhowtoassesschildren’saccesstogreenspaceinthecity asaplacetoplay,socialize,beactive,andsoon,ultimatelycontributingtohealthyurban environments.Usinginteractivetools,wewillcollaboratetocreateidealmetricsforchildren’saccess togreenspaceanddiscussseveralmetricsthathavebeenimplementedbyTUDsofar. Relatedtopart1:SDGs,target7:by2030provideuniversalaccesstosafe,inclusiveandaccessible, greenandpublicspacesinparticularforwomenandchildren,olderpersonsandpersonswith disabilities.Howtoidentify,assess,establish/maintaintheseareas?Groupworkonwhatfactorsand forwhom?Andonmeasuringgreenspace. Identifyingandprioritizingurbanfactors:overlapinfactors,importanceofproximity,shadow,safety, lightandamenities.Mostimportantfactorsaretraffic,safety,followedbyenvironmentalfactors, green,shade.Attractivenessandaccessibilityarekey.Otherfactorsmentionedareseasonofthe year,availabilityoftime,education/practice/norms. Mostimportantfactorsoftenarehardtomeasure,whereasthoselessimportantareeasierto measure.Forexample:whatis‘safety’,howtomeasurethis? Reprioritizingspecificallyforparticularpopulationgroups: - forelderlynewfactorswereidentifiedsuchasfreepublictransport,ice‐freeroutes - forchildrenaswellnewfactorswereidentifiedsuchaspeers,distancefromhome, sidewalks/bikelanes 51  - forwomennotmanychangesoccurred - forpersonswithdisabilities:accessibilityismostimportantforthisgroup,aswellas safetransport.  Relatedtopart2: Measuringgreenspaceforprimaryschoolagedchildren.Whatinformationwouldyouneed?For example,geographicalsizeanddetail,atneighbourhoodleveland/ornationallevel? Suggestions:addingwearablesinordertocollectdatafromchildren’smovements,addingchildren’s voiceandperceptionongoodenvironments.Anotherpresentationwasoncyclingtowork,addingdata onprivateandpublicland,affordability,subsidizedtravelinformation,bicyclestorageandseasonal maps.Andanotheridea:“Let’splayandmovemoreoutside”,aschildrenarenotgettingoutside anymore.Avarietyofpublicplacesandincreasedattractiveness,voiceofparentsandofchildren.And planandmeasurewiththechildren. TUDelftproposals: - children’sindependentaccesstogreenspace.Itisgoodforchildrentogooutdoors independently;cantheyreacha(green)spacetoplaywithoutcrossingbarriers? - daytodaygreenspaces.Childrengotoschooleveryday,butwhichstreetsdothey passandhowvegetatedarethose? - crowd‐sourcedperceivedgreenspaces.Aredataongreenspaces,suchas OpenStreetMapandsatelliteimages,complete?Ordotheymissgreenspaces?  Improvementsuggestions:(social)safetyofplayareas,attractivenessofstreets,addchildren’svoice, useofblackspaceandwhythesearenotused(yet). Thissessionwasrelatedonhowtousecasescenariosrelatedtoaccesstopublicspaces.Thefeedback ofthestakeholdersisenablingTUDtofurtherimprovethemodelling.  Presentationonenrichingtheenvironmentalexposome:roadtrafficflowpredictionandnoise modelling(ULEIC) Roadtrafficnoisere‐modellingandincludingincohortstudies(whereneeded).Europeanstandard modellingmethod(CNOSSOS‐EU)isusedtocalculatenoiseexposuresatfacadesofdwellings(and indirectlyofindividuals)frommainroads.Inepidemiologicalstudiesweneedexposuredatafor smaller/minorroads,forindividualdwellings,andthusthisapproachaccordingtotheEnvironmental NoiseDirective(END)isnotideal.Equal‐Lifeistryingtofillinthesegapsbyusingstatisticalmethods withaselectednumberofvariables(theso‐calledgeneralizedlinearmixedeffectsregressionmodel). Suchasroadtype,averagedailytrafficcount,population,numberofterminal/dead‐endroads, nearestmajorroadjunction,gradientoftheroad,connectivitytootherroadtypes,numberofpeople thatcandrivewithin5minutestoaparticularlocation/drivetime.Roadtrafficflowpredictionshave beentestedinUK,Barcelona;nowusedfor3Dnoisemodelling. Questions:Whatistheinfluenceofelectricvehicles?Whataboutlownoiseemissionzones?Dominant sourceandbackgroundnoisedifferperroadtype,thusataresidentialroadyouwillhearrollingnoise whereasatamajorroadthatwillbeenginenoise. 52  Nodataontrees(canopies)isincludedinthemodelling.Mostchallengingisthetemporalaspect (andthusdata)ofroadtraffic. Thissessionprovideknowledgeandwasanexampleofexposomemapping.  Socialexposome(NIJZ) Startingpointbeforethepresentationwasthedescriptionoftwomaintoolsforthe toolbox/guidebookplannedfromWP4: 1)Forthetargetgroupofresearchers:ConceptualFrameworkoftheSocialExposomeandits implicationsforresearch.Ashortintroductionwillbegiven,theconceptualframeworkisalready published(Gudi‐Mindermannetal.(2023).Integratingthesocialenvironmentwithanequity perspectiveintotheexposomeparadigm:AnewconceptualframeworkoftheSocialExposome. EnvironmentalResearch.DOI:https://doi.org/10.1016/j.envres.2023.116485). 2)Forthetargetgroupofpolicymakers/urbanplanners/otherstakeholders:LogicModelforEquity ImpactAssessmentanditsimplicationsforinterventionplanningandevaluation.Afterashort introductionaCaseStudyonNoiseLegislationinSloveniawaspresented. Explanationofthesocialexposomeconceptualframework,theintegrationofphysicalandsocial exposomesandthehealthoutcomesandhealthinequalities.Thisisbetestedincohortstudiesand resultsexpectedin/aftersummer2024.Forthetargetgroupofpolicymakers,urbanplanners,public healthauthoritiesandothersisthelogicmodelawaytomakeanequityimpactassessment.Thisisa tooltohelpembedanequityperspectiveintheplanning,implementationandevaluationprocessof universalinterventionstoimprovethebuiltenvironment.Publicationforeseen. Suggestion:includea‘#when?’questionaswell,inadditiontoHow,Who,WhatandWhere. CasestudiesconductedinEqual‐Lifewere(i)reductionofenvironmentalnoiseexposuresinSlovenia, (ii)improvementofbicycleinfrastructureandincreaseofcyclingbehaviourinMacedonia,(iii)mobility hubsand(iv)playareasinUtrecht,theNetherlands.Theenvironmentalnoisecasestudyisfurther explained,seethehandout/ICBENconferencepaperaswell. Inthissessionthestakeholdersgavefeedbackoncasestudiesandamodelonthesocialexposome. Thissessionispartoftheworkplanforimplementationinpractice.  Discussiononconceptualframework(INCHES) Theaimofthisdiscussionwastogetapictureof:(i)what'type'ofinformationcanthedifferent stakeholdersapplyintheirwork?,(ii)whichdataorresults(exposures,mediators)arerelevanttothe workofstakeholders?,(iii)dostakeholdersrecognizetheirowndilemmasandquestionsthattheyhave inthefirstresultsanddeviatethisfromwhatstakeholdersexpected,intheirwork?(e.g.whatarethe maincausesandperhapsmediatorsformentalhealthinchildren,accordingtotheEqual‐Life researchersandaccordingtothestakeholders?). Aninteractivegamewasplayedtogetanideawhichkindofexposureswereprioritizedbythe stakeholders:physicalexposures,mediatorsorsocialexposures.Inaddition,stickynoteswere produced.Someoutcomeswere: Socialexposureswerehighlyratedasbeingimportant. 53  Children’svoicesneedtobeandcanbeheard. Whereismostimpacttobeexpected?Inthedecision‐makingsystems.Therechangecanbebest achieved. Thissessionispartoftheworkplanforimplementationinpractice.  Summariesofpresentationsanddiscussionsonthesecondday  Casestudy:Citycollaborationtrack,Improvingyoungpeople’ssenseofsafetyinthecity(MV) BloombergandHarvardCityLeadershipInitiativesupport,inHelsinki.Publicvaluestatement:enabling asafeandwelcomingenvironmentforchildrenthroughoutthedayisgoodforeachindividualandthe community.Tacklingtheissuebybreakingitdownintosubcausesandidentifyingcomplexitiesbyan interdisciplinaryteam.E.g.lackofsafefreetimeactivitiesfortheyoung,behaviouralissuesamongthe youngatschoolandinthestreets.Growingnumberofconfrontationsbetweengroups,lackofsupport andsenseofbelongingforfamilies. Threeentrypointshavebeenselected: - Servicesaredesignedfor‘average’users o Hobbyplatform o Co‐createserviceswithchildren o Newarea‐basedleadershipmodel o Etc. - Lackofsafefreetimeactivitiesforyoung o Familieshaveknowledgeaboutfreetimepossibilitiesforchildren o Proactiveleisureservicesfindyoungpeoplewithouthobbies o Etc. - Publicspaces(inclschools)areexperiencedasunsafe o Interveningandsolvingeverycaseofbullyingandharassment o Publicspaceimprovementsandnewschoolbuildingareprioritized o Placemakinginterventionswithchildren o Etc.  Lessonsareintegratedintoregularworkpractices. ProblemDrivenInteractiveAdaptation(PDIA)process(Harvard)steps:Initialproblemanalysis;Identify actionsteps;Takeaction;Check‐in;Sustainauthorityandlegitimacy;Adaptanditerate. Keyresultsandtakeaways: - Wemanagedtocompletenumeroussimultaneousjoinedinterventionsintheareain matterofmonths.Initialresultsindicatethatantisocialbehaviourhasdecreasedin thearea. - Startwiththeproblemandtherootcauses.Stoppingatthecommonproblemwas worththetime–thisenhancedpeople’sownershipandfromanearlystagethey startedseeingtheirroleinthesolutionstoo. 54  - Makesureyouhavetherightpeopleatthetable.Havingthemandatetobringabout concretechangeandinterventionswascrucial. - Interventionswerebasedonwideparticipationofstakeholdersandasolid knowledgebase.  Qualitativedatacollection(anduse)needstobeimproved.Qualitativedatawillbecombinedwith theexisting(quantitative)datainthemunicipality.Thenadecisiononform(at)ofdatacollectionwill betaken. Whathappensnext? - Resultsarecompiledandpresentedtothecityleadership.Decisionsareyettobe madeaboutscaling. - Allcitydivisionsarecommittedtostrengtheningarea‐basedwork,utilizingthetools andprocesstrialedinthearea. - Goodworkcontinuesintheareaandsimilarworkwillbeexpandedtothe surroundingneighborhoods - Keychallengetoaddress:thecoregroupof8peopleputalotoftimeintothisand receivedcoachingthroughouttheprocess–howdoweutilizethemethodsin existingcooperationstructures?  Casestudy:infantmentalhealth(TL‐HealthyCitiesCork) Corkcity:Let’sgrowtogether!Variousinterconnectedstrategies:infantmentalhealthandwell‐ being;speechlanguagecommunicationandliteracy.  Earlyenvironmentalquality:presentationpreliminaryresults(JS,KarolinskaInst.) Acombinationofbirthcohortdataanddatafromschoolstudies. FAIRcohort:ADHDmostimportantvariables(duringpregnancy)arebirthyear,income,smoking, populationdensity,roadintersectioncloseness,educationoffather,roaddistance,etc.ForAutismthe mostimportantvariablesareincome,greenurbanareas,build‐uparea,roadnoise,greenurbanarea, foreigncitizenship,etc.OtherresultsareavailablefromtheALPINE,PIAMAandWALNUTScohorts. Question:howtocommunicatetheresults? - Communicatetheresultspercohortorallpooledcohorts? - Visualizetheimportanceofthevariables.Oratoptenpresentation. - Infographic - Moreinformationisneeded,forexampleoncausality,howtointerprettherelation betweenthevariableandtheoutcome. - Involvestakeholdersinreviewingpapers!Inordertogivemeaningtoresearch outcomes.  PresentationbyLAonPersonallisteningandITdevicesandtheirrelationtolifestyleofadolescentsin theSlovakRiskBehaviouralSurvey ThestudyisbasedonabilateralUS‐Slovakprojecttoevaluatetheimpactofselectedbehavioral, psychological,andsocioeconomicfactorsonadolescenthealthintheBratislavaagglomeration.Special 55  attentionispaidtotheuseofselectedITdevices(TV,PC‐personalcomputers,personalmusicplayers ‐PMPs).Thedatafrom525students(185boys)attending8secondaryschoolsinBratislava,aged15‐ 20yearsarepresented. Themostimportanthealthriskbehaviorsinthestudents’samplewere identified,90.9%ofstudentslistentoPMPonaveragefor405minutesandusemobilephonesfor384 minutesperweek,significantlymoregirls.About50%ofstudentslistentoPMPsmorethan200 minutesaweek.ThosestudentshaveaworselifestylethanthoselisteningtoPMPslessthan200 minutesaweek.AhighpercentageofPCusagehasbeenobserved,especiallyduringtheweekend (72.1%morethanthreehoursperday),andlessinterestinwatchingTV.StudentsusethePCmore thantheirparentsandwatchlessTV,butwhenwatchingit,theycopythebehaviorofbothparents. Thestudypresentsachallengefortheanalysisandforfuturepreventionaswellasintervention activitiestoprotectandpromotethehealthofchildrenandyouth.  PlaceStandardToolforChildrenandYoungPeople(JH,CityofGlasgow) ThePlaceStandardtool(PSt)waslaunchedin2015andinresponsetoon‐goingfeedbacka versionforchildrenandyoungpeoplewasco‐producedandpublishedin2022. Thistool providesapracticalsolutiontohelpyoungercommunitiesidentifyinacollaborativeand inclusivemannerwhatworkswellwithintheirplace,whatneedsimprovingandthesolutions toaddressthese.Thetoolismadeupof14placedimensionswhichalignwiththeUNSDGs andthisrelationshipcoupledwiththesuccessfulapplicationofthetoolacrossEuropehasled toaninvitationfromWHOtoPublicHealthScotland(PHS)tohostanewCollaboratingCentre forPlacefrom2024onwards. ThelessonslearnedfromtheEqualLifeProjectwouldbe invaluablecontributiontotheCollaboratingCentre’sprogramme. Thesessionsabovearerelatedtoknowledgesharing.ItgivestheEqual‐Lifeconsortiuminsightin whichkindofpolicyimplementationsandpotentialinterventionsareimportant.    56  Annex6Someexamplesofusedpersonas 57  64  InadditiontothemainresearchquestionsinEqual‐Life,inTable3,wehavegatheredquestionsthatarespecifictostudyingtheassociationsbetweendifferent typesofexposomes(e.g.,socialexposome,physicalexposome).  Ashomeworkwewouldliketoaskyoutochooseforeachtablethethreequestionsthatyouconsiderthemostrelevant. Youmayhavespecificcriteriathatsupportyourdecision.Pleasetakenoteofyourargumentstoselectyourpreferencequestions. Youmightconsiderargumentsbasedonfeasibilitytomakeinterventions,onthebiggesthealthimpact,oncost‐benefitreasons,onsupportingcurrent projects,oranyotherreason.Youalsohaveargumentswhysomeresearchquestionsarenotgood,notfeasibleormaybenotjustorethical. Doyouconsiderresearchquestionsassucharevaluableforstakeholderslikepolicymakersoronlytheresults?  CanyoubringyourfilledinformstoComo. However,wepreferitifyoucouldsendusyourfilledinformstwodaysbeforesowecanprintthemout.  InthesessionrelatedtotheEqual‐Lifequestionswewilldiscussyourfeedbackontheresearchquestions. 65    66     67    68   69   70    71    72    73    80    81   82    83    84   85    86    87    88  