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The Communities First (ComFi) study: protocol for a prospective controlled quasi-experimental study to evaluate the impact of area-wide regeneration on mental health and social cohesion in deprived communities
  1. James White1,2,
  2. Giles Greene1,
  3. Frank Dunstan3,
  4. Sarah Rodgers4,
  5. Ronan A Lyons4,
  6. Ioan Humphreys5,
  7. Ann John4,
  8. Chris Webster6,
  9. Stephen Palmer3,
  10. Eva Elliott7,
  11. Ceri J Phillips5,
  12. David Fone3
  1. 1South East Wales Trials Unit (SEWTU), School of Medicine, Cardiff, UK
  2. 2Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Medicine, Cardiff, UK
  3. 3Institute of Primary Care & Public Health, Neuadd Meirionnydd, School of Medicine, Cardiff University, Cardiff, UK
  4. 4Farr Institute, College of Medicine, Swansea University, Swansea, UK
  5. 5Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
  6. 6Faculty of Architecture, Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, Hong Kong
  7. 7Cardiff Institute of Society, Health and Wellbeing (CISHeW), School of Social Sciences, Cardiff University, Cardiff, UK
  1. Correspondence to Dr James White; whitej11{at}


Introduction Recent systematic reviews have highlighted the dearth of evidence on the effectiveness of regeneration on health and health inequalities. ‘Communities First’ is an area-wide regeneration scheme to improve the lives of people living in the most deprived areas in Wales (UK). This study will evaluate the impact of Communities First on residents’ mental health and social cohesion.

Methods and analysis A prospective controlled quasi-experimental study of the association between residence in Communities First regeneration areas in Caerphilly county borough and change in mental health and social cohesion. The study population is the 4226 residents aged 18–74 years who responded to the Caerphilly Health and Social Needs Study in 2001 (before delivery) and 2008 (after delivery of Communities First). Data on the location, type and cost of Communities First interventions will be extracted from records collected by Caerphilly county borough council. The primary outcome is the change in mental health between 2001 and 2008. Secondary outcomes are changes: in common mental disorder case status (using survey and general practice data), social cohesion and mental health inequalities. Multilevel models will examine change in mental health and social cohesion between Communities First and control areas, adjusting for individual and household level confounding factors. Further models will examine the effects of (1) different types of intervention, (2) contamination across areas, (3) length of residence in a Communities First area, and (4) population migration. We will carry out a cost-consequences analysis to summarise the outcomes generated for participants, as well as service utilisation and utility gains.

Ethics and dissemination This study has had approval from the Information Governance Review Panel at Swansea University (Ref: 0266 CF). Findings will be disseminated through peer-review publications, international conferences, policy and practice partners in local and national government, and updates on our study website (


This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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