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Crowdfunding platforms are believed to create a more equal-opportunity environment for fundraising by removing entrance barriers found in traditional entrepreneurial markets. Our work investigates whether in creating more equal opportunities for entrepreneurs to enter the market, crowdfunding platforms also create a more equal distribution of funds across ventures. To this end, we utilized a natural experiment in the form of a policy change on Kickstarter.com that resulted in opening the market to more players. Using platform-level analysis, we show that opening the platform shifted demand toward the head of the distribution: More funds and backers became concentrated in a smaller number of head-offers (the superstar effect). Using individual backer-level analysis, we show that these changes in demand distribution are likely to have resulted from changes in investors' investment behavior, beyond changes in the composition of the demand side (that is, changes in the types of investors entering the market). Together, our results suggest that efforts to level the playing field in crowdfunding platforms can ultimately result in a less equitable distribution of funds across market participants, and drive investors to focus their investments on a smaller set of campaigns. [ABSTRACT FROM AUTHOR]

Measures to reduce transport-related greenhouse gas emissions are of great importance to policy-makers. A recent example is the nationwide KlimaTicket in Austria, a country with a relatively high share of transport-related emissions. The cheap yearly season ticket introduced in October 2021 allows unlimited access to Austria's public transport network. Using the synthetic control and synthetic difference-in-differences methods, we assess the causal effect of this policy on rail travel demand by constructing a data-driven counterfactual out of European railway companies to mimic the number of passengers of the Austrian Federal Railways (ÖBB) without the KlimaTicket. Overall, the results indicate that the KlimaTicket has no short-run passenger growth effects. While passenger numbers recovered faster after the COVID-19 pandemic, in 2023, the passenger growth rate of the ÖBB is even lower than it would be under no treatment. • First paper assessing the causal effect of the KlimaTicket launched in Austria in 2021 on rail travel demand. • Showing that the introduction of a cheap nationwide public transport travel pass in Austria had no passenger growth effects. • Presenting a study design of how comparable pricing measures can be analyzed in the future. [ABSTRACT FROM AUTHOR]

Potential differences in organ preservation between total neoadjuvant therapy (TNT) regimens integrating long-course chemoradiotherapy (LCCRT) and short-course radiotherapy (SCRT) in rectal cancer remain undefined. This natural experiment arose from a policy change in response to the COVID-19 pandemic during which our institution switched from uniformly treating patients with LCCRT to mandating that all patients be treated with SCRT. Our study includes 323 locally advanced rectal adenocarcinoma patients treated with LCCRT-based or SCRT-based TNT from January 2018 to January 2021. Patients who achieved clinical complete response were offered organ preservation with watch-and-wait (WW) management. The primary outcome was 2-year organ preservation. Additional outcomes included local regrowth, distant recurrence, disease-free survival (DFS), and overall survival (OS). Patient and tumor characteristics were similar between LCCRT (n = 247) and SCRT (n = 76) cohorts. Median follow-up was 31 months. Similar clinical complete response rates were observed following LCCRT and SCRT (44.5% versus 43.4%). Two-year organ preservation was 40% [95% confidence interval (CI) 34% to 46%] and 31% (95% CI 22% to 44%) among all patients treated with LCCRT and SCRT, respectively. In patients managed with WW, LCCRT resulted in higher 2-year organ preservation (89% LCCRT, 95% CI 83% to 95% versus 70% SCRT, 95% CI 55% to 90%; P = 0.005) and lower 2-year local regrowth (19% LCCRT, 95% CI 11% to 26% versus 36% SCRT, 95% CI 16% to 52%; P = 0.072) compared with SCRT. The 2-year distant recurrence (10% versus 6%), DFS (90% versus 90%), and OS (99% versus 100%) were similar between WW patients treated with LCCRT and SCRT, respectively. While WW eligibility was similar between cohorts, WW patients treated with LCCRT had higher 2-year organ preservation and lower local regrowth than those treated with SCRT, yet similar DFS and OS. These data support induction LCCRT followed by consolidation chemotherapy as the preferred TNT regimen for patients with locally advanced rectal cancer pursuing organ preservation. [Display omitted] • This natural experiment uniquely compared organ preservation between patients managed with LCCRT- versus SCRT-based TNT. • LCCRT and SCRT cohorts achieved similar clinical complete response (cCR) rates and WW eligibility. • Two-year organ preservation was higher and local regrowth was lower in WW patients treated with LCCRT than SCRT-based TNT. • No differences in OS, DFS, or distant recurrence rates were observed between the WW cohorts. [ABSTRACT FROM AUTHOR]

Research has shown that racial discrimination is detrimental to the ethnic minorities in accommodation and hospitality sectors. However, whether racial discrimination happens during the stage of online booking before check-in remains unclear. Leveraging a natural experiment of the anti-discrimination policy implemented on Airbnb and face recognition techniques to identify the racial information of hosts and guests, this study reveals that racism from hosts against ethnic guests indeed exists during the stage of online booking. The results indicate that the monthly proportion of ethnic guests increases 5% after the launch of anti-discrimination policy. We also find that discrimination exists between ethnic hosts and ethnic guests, which was not documented in previous studies. Moreover, the anti-discrimination policy in relieving racism plays a bigger role among hosts with severe racial discrimination. These findings are critical for online booking platforms to set anti-discrimination policies. [ABSTRACT FROM AUTHOR]

Schools in the United States are increasingly offering ethnic studies classes, which focus on exploring students' ethnic-racial identities (ERI) and critical analysis of systemic racism, to their diverse student bodies, yet scant research exists on their effectiveness for students of different ethnic-racial backgrounds in multiracial classrooms. A policy change to require all high school students in one school district to take an ethnic studies class facilitated a natural experiment for comparing the effects of quasi-random assignment to an ethnic studies class (treatment) relative to a traditional social studies class (control; e.g., U.S. Government, Human Geography). Student surveys and school administrative data were used to compare students' ERI development, well-being, and academic outcomes across ethnic studies and control classes. Participants (N = 535 9th graders; 66.1% ethnic studies) had diverse ethnic-racial (33.5% non-Latine White, 29.5% Black, 21.1% Latine, 10.7% biracial, 2.8% Asian, 2.2% Native American) and gender identities (44.7% female, 7.1% non-binary). Ethnic studies students reported marginally higher ERI exploration and resolution than controls, and sensitivity analyses showed a statistically significant effect on ERI among participants with complete midpoint surveys. Higher resolution was associated with better psychological well-being for all students and higher attendance for White students. Students with low middle school grades (GPA < 2.0) had better high school grades in core subjects when enrolled in ethnic studies than the control class. Overall, the results of this natural experiment provide preliminary support for ethnic studies classes as a method for promoting ERI development, well-being, attendance, and academic achievement for students from diverse ethnic-racial backgrounds. [ABSTRACT FROM AUTHOR]

Problem definition: Opportunity zones (OZs) are designated census tracts in which real estate investments can gain tax benefits. Introduced by the U.S. Tax Cuts and Jobs Act of 2017, the goal of the OZ program is to foster economic development in distressed neighborhoods. In this paper, we investigate and optimize the OZ selection process and examine the impact of OZs by exploiting two data sets: a proprietary real estate data set that includes 36.1 million residential transactions spanning all 50 U.S. states and census-tract demographics data between 2010 and 2019. Methodology/results: We show that census tracts with higher poverty and unemployment rates were more likely to be selected. Counterintuitively, however, tracts with a higher average real estate price were also more likely to be selected. We then apply difference-in-differences, synthetic control, and matching techniques to rigorously assess the impact of the OZ program on two key real estate metrics: price and transaction volume. We find that the OZ program increased real estate prices by 4.03%–6.13% but do not observe a significant effect on the transaction volume. We also find that investors primarily targeted the high-end real estate market, namely, exhibiting a cherry-picking behavior. To better fulfill its intended societal and economic goals, we propose an optimization framework with fairness considerations for OZ assignment decisions. We show that the OZs assigned from our fairness-aware optimization formulation can better serve distressed communities and mitigate investors' cherry-picking behavior. Managerial implications: Our paper underscores the importance of incorporating fairness in OZ designation to achieve a desirable real estate market reaction. Our large-scale empirical analysis provides a comprehensive assessment of the current government OZ assignment, and our fairness-aware optimization framework provides concrete recommendations for policy makers. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2024.0746. [ABSTRACT FROM AUTHOR]

We examine the effect of auditing on dividends in small private firms. We hypothesize that auditing can constrain dividends by way of promoting accounting conservatism. We use register data on private Norwegian firms and random variation induced by the introduction of a policy allowing small private firms to forgo the use of an auditor to estimate the effect of auditing on dividend payout. Identification is obtained by a regression discontinuity around the arbitrary thresholds for the policy. Propensity score matching is used to create a balanced synthetic control. We consistently find that forgoing auditing led to a significant increase in dividends in small private firms. [ABSTRACT FROM AUTHOR]

The National Football League (NFL) sets its regular season schedule to optimize viewership andminimize competitive inequities.One inequity assumed to impact team performance is rest differential, defined as the relative number of days between games. Using Bayesian state space models on both game outcomes and betting market data, we estimate the competitive effect of rest differential in American football. We find that the most commonly referred to inequities--both the bye week rest advantage and the mini-bye week rest advantage--currently show no significant evidence of providing the rested team a competitive edge. Further, we trace a decline in the advantage of a bye week to a 2011 change to the NFL's Collective Bargaining Agreement, which represents a natural experiment to test the relevance of rest and preparation in football. Prior to the agreement, NFL teams off a bye week received a significant advantage (+2.2 points per game), but since 2011, that benefit has been mitigated. Our findings imply that extra days with practice time, and not extra days off alone, are the primary driver of any NFL rest advantage. [ABSTRACT FROM AUTHOR]

As long as welfare arrangements have been in existence, there has been a strong belief that high‐benefit generosity leads to welfare reliance. In this study, we investigate whether an increase in welfare generosity in Norway resulted in higher social assistance (SA) uptake and decreased engagement in paid work. By utilizing high‐quality administrative data and employing a difference‐in‐difference design, we find no overall effects on SA or work activity. However, we do observe a significant reduction in work activity and an increase in SA for specific predefined high‐risk groups, which are believed to be particularly responsive to financial incentives. Thus, we discover evidence of unfavorable effects for child families, non‐Western immigrants, and the combined group of non‐Western immigrant child families. These latter findings are interpreted in light of the particular socioeconomic circumstances of these groups. [ABSTRACT FROM AUTHOR]

Issues Addressed: Evidence on how COVID‐19 lockdowns impacted physical activity (PA) is mixed. This study explores changes in PA following initial mobility restrictions, and their subsequent relaxation, in a sample of Sydney (Australia) residents using a natural experiment methodology. Methods: Participants' health and travel behaviours were collected pre‐pandemic in late 2019 (n = 1937), with follow‐up waves during the pandemic in 2020 (n = 1706) and 2021 (n = 1514). Linear mixed‐effects models were used to analyse changes in weekly duration of PA between the three waves. Results: Compared with pre‐pandemic, average weekly PA increased in 2021 by 42.6 min total PA (p =.001), 16 min walking PA (p =.02), and 26.4 min moderate–vigorous PA (MVPA) (p =.003). However, average weekly sessions of PA decreased in 2020 and remained lower in 2021. For participants who were sufficiently active in 2019, weekly total PA (−66.3 min) MVPA (−43.8 min) decreased in 2020 compared to pre‐pandemic. Conversely, among participants who were insufficiently active in 2019, average weekly PA increased in both 2020 (total PA, +99.1 min; walking PA, +46.4 min; MVPA +52.8 min) and 2021 (total PA, +117.8 min; walking PA, +58.4 min; MVPA +59.2 min), compared to 2019. Participants who did more work from home increased their average weekly total PA in 2021 compared to pre‐pandemic (+45.3 min). Conclusion: These findings reveal the complex variability in PA behaviour brought about by the pandemic. So What?: Strategies to support the population in achieving sufficient PA must focus on maintaining an appetite for PA as we move out of the pandemic and on promoting more frequent PA sessions. [ABSTRACT FROM AUTHOR]

This article contributes to knowledge of how environmental disasters affect ecomodernist beliefs, i.e. the view that technology can solve environmental problems. Such beliefs in the general public are key to build mass support for environmental policies relying on large‐scale scientific solutions, but their stability is poorly understood. We argue that ecomodernist beliefs are more malleable than assumed and can be altered through events that highlight risks arising from a reliance on technological solutions. This study leverages that the Fukushima‐Daiichi accident happened during the fieldwork of a 2011 public opinion survey in Israel. The analysis suggests that ecomodernist beliefs were negatively affected by this unexpected tragedy. Consistent with expectations, we report stronger impact among people with more education. We document similar effects from a controlled survey experiment in the US and Israel, suggesting that these results are generalizable. Our findings are relevant beyond rare environmental disasters as they have implications for how ecomodernist beliefs might be formed and changed. [ABSTRACT FROM AUTHOR]

Objective: The causal effect of successive population-wide lockdowns in response to increased COVID-19 cases on mental health has yet to be examined using robust methods. A natural experiment design underpinned by objective data can improve our understanding surrounding the definitive impact of social distancing restrictions. Methods: The study employed a natural experiment design underpinned by objective data. Health service cost for visits to general practitioners and psychologists and medication dispensing costs served as objective measures of mental health. Difference-in-difference (DID) estimators, which in this study quantify differences in spending changes between groups over time, were produced based on three comparisons: Victoria 2020 lockdown comparison, Victoria 2021 lockdown comparison, and New South Wales (NSW) 2021 lockdown comparison. Specifically, differences in public health service spending during lockdown periods and the same timeframe in 2019 for Victoria and NSW, and control groups (remaining states and territories), were compared. Results: Positive estimator values indicate that public health service spending for Victoria and NSW increased more during lockdown periods compared to control states and territories. The Victorian lockdowns of 2020 and 2021, but not the NSW lockdown of 2021, resulted in increased public spending for general practitioner mental health consults (2020 DID estimator: $8498.96 [95% CI $4012.84, $12,373.57], 2021 DID estimator: $6630.06 [95% CI $41.27, $13,267.20], all monetary values in AUD$) and short visits to psychologists (2020 DID estimator: $628.82 [95% CI $466.25, $796.00], 2021 DID estimator: $230.11 [95% CI $47.52, $373.98]). The first Victorian lockdown in 2020 and the NSW lockdown in 2021 resulted in greater spending on short visits to clinical psychologists. Spending on long visits to psychologists and clinical psychologists and medication spending did not change. Conclusions: Strict lockdowns can have an adverse impact on population mental health. The impact is particularly evident in those who have a history of previous mental health concerns but does not necessitate extra use of medications, suggesting that psychological care can address the adverse impact of the lockdowns. What is known about the topic? Previous research varied in methodology, using self-reports and healthcare data to understand COVID-19 social distancing public health measures' effects on mental health. What does this paper add? This study introduces robust, objective data via a natural experiment design, examining the impact of successive lockdowns on mental health service usage and medication expenditures in specific Australian regions. What are the implications for practitioners? Findings highlight the need for flexible mental health services that can swiftly respond to increased demands during prolonged restrictions, without necessarily increasing medication use, guiding future policy and resource allocation. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and associated lockdowns disrupted health care worldwide. High-income countries observed a decrease in preterm births during lockdowns, but maternal pregnancy–related outcomes were also likely affected. This study investigates the effect of the first COVID-19 lockdown (March–June 2020) on provision of maternity care and maternal pregnancy–related outcomes in the Netherlands. National quasi-experimental study. Multiple linked national registries were used, and all births from a gestational age of 24+0 weeks in 2010–2020 were included. In births starting in midwife-led primary care, we assessed the effect of lockdown on provision of care. In the general pregnant population, the impact on characteristics of labour and maternal morbidity was assessed. A difference-in-regression-discontinuity design was used to derive causal estimates for the year 2020. A total of 1,039,728 births were included. During the lockdown, births to women who started labour in midwife-led primary care (49%) more often ended at home (27% pre-lockdown, +10% [95% confidence interval: +7%, +13%]). A small decrease was seen in referrals towards obstetrician-led care during labour (46%, −3% [−5%,−0%]). In the overall group, no significant change was seen in induction of labour (27%, +1% [−1%, +3%]). We found no significant changes in the incidence of emergency caesarean section (9%, −1% [−2%, +0%]), obstetric anal sphincter injury (2%, +0% [−0%, +1%]), episiotomy (21%, −0% [−2%, +1%]), or post-partum haemorrhage: >1000 ml (6%, −0% [−1%, +1%]). During the first COVID-19 lockdown in the Netherlands, a substantial increase in homebirths was seen. There was no evidence for changed available maternal outcomes, suggesting that a maternity care system with a strong midwife-led primary care system may flexibly and safely adapt to external disruptions. [ABSTRACT FROM AUTHOR]

This study examines the effect of the allocation of centralised funding on electoral support for the incumbent by utilising the introduction of the "Towns Fund" in England in 2019 as a natural experiment. For causal identification, I leverage a difference-in-difference design to examine the electoral effect of this fund. My findings suggest that providing funding to constituencies significantly increased the vote share of the Conservative Party in the General Election in 2019. However, in a subset of constituencies in which the Labour Party constitutes the incumbent, the findings can not be replicated for all specifications and robustness checks. Furthermore, I do not find consistent support that the effect is stronger in economically deprived constituencies. Similarly, the results suggest that the voting outcome depends on the total amount of funding being received, however, this finding does not reach statistical significance. These results complement the literature by providing empirical evidence for pork barrel as a functioning means for vote buying for the Conservative government in 2019 in England. Furthermore, this paper emphasises that partisanship should be considered as a mediating variable when analysing the political effect of providing place-based funding. [ABSTRACT FROM AUTHOR]

A growing number of birth interventions had led to a concern for potential health consequences. This study investigates the consequences of earlier routine labor induction. It exploits a natural experiment caused by the introduction of new Danish obstetric guidelines in 2011. Consequently, routine labor induction was moved forward from 14 to 10–13 days past the expected due date (EDD) and extended antenatal surveillance was introduced from 7 days past the EDD. Using administrative data, I find that affected mothers on average had a 9–11 percentage points (32%–38%) higher risk of being induced the following years. Yet, mother and child short‐ and medium‐term morbidity were largely unaffected. [ABSTRACT FROM AUTHOR]

The need for evidence-based improvements at the workplace Work is an important social determinant of health (1). Decades of research on a wide range of different types of exposure, such as chemical, physical, biological, and psychosocial exposures at the workplace, has shown how poor working conditions are associated with adverse health outcomes and disparities in health. This has been well illustrated in the 2024 Discussion Paper series celebrating `50 years of research` in the Scandinavian Journal of Work, Environment & Health (2–9). With this rapidly increasing body of knowledge, it is quite disappointing to note that the increasing number of high-quality studies on identifying occupational risk factors are not matched by a similar number of high-quality studies aimed to design and evaluate measures that promote workers’ health and prevent work-related disease and disability (2). There is a scarcity of evidence-based workplace interventions that can guide appropriate workplace policies, programs, and practices. A linked issue is that, in situations when sufficient evidence seems available, there is a lack of urgency in utilizing research findings in the practice of occupational safety and health (OSH). A European Union report argued that, in order for research to have an impact on workers’ safety and health, there is a great need to improve the translation of OSH research findings into practice, both in the occupational health services and at workplaces (10). Both the lack of evidence-based guidance for healthy and safe workplaces as well as lack of implementation of available knowledge in practice can be partly attributed to the complexity of the workplace, given its multiple organizational levels, variety of settings and contextual factors, and required level of flexibility and adaptivity of interventions in order to be successful (11). Complex interventions require different research strategies, shifting the focus from the traditional binary question of effectiveness of a precisely defined intervention towards a broader understanding of mechanisms, processes, and outcomes of relevance to workers, companies, and OSH professionals (12). Rise and demise of the RCT Many researchers have been trained that randomized controlled trials (RCT) provide the most rigorous evidence on beneficial effects of preventive, diagnostic, and therapeutic interventions (13). With the rise of the evidence-based medicine approach, the RCT design became the gold standard, demonstrating with high quality and reliability the causal effects of the intervention. In the past 40 years, this gold standard has increasingly been critiqued and – in the era of complex system thinking and complex interventions – the status of the RCT is eroding (13,14). There is strong evidence that if evidence-based health care is limited to RCT, the evidence will favor individual-based over multicomponent interventions, highly standardized simple interventions over complex ones, and short- over long-term interventions (14). In occupational health, it has long been acknowledged that interventions often have an organizational or work environment context that hampers – or even excludes the possibility of – individual-level randomization and also makes cluster randomization very difficult (15). Very successful interventions in occupational health, eg, the introduction of a complete ban on asbestos (3) and the substitution of organic solvents in paints (4), would not have happened if knowledge from an RCT would have been the required level of evidence. Alternative study designs and research methods In recent years, there has been a big debate around which study designs are needed for a valid interpretation of an intervention`s effects. At the heart of the discussion is the inherent trade-off between causal estimation of an intervention effect and estimation of an intervention effect that matters for practice. Opinions remain strongly divided. Some researchers claim that observational studies will always be affected by bias and, thus, causal evidence can only be derived from experiments or trails emulated in observational studies (16). An experiment with randomization ensures exchangeability in that both groups are comparable for all known and unknown factors and, thus, these factors cannot bias the intervention effect. In the absence of an RCT, researchers have applied the ‘experimental causal inference’ framework to particular situations that may be interpreted as happening at random. These so-called `natural experiments` have specific statistical methods that try to ensure that the intervention of interest can be interpreted as an exogenous source (17). These natural experiment approaches include, among others, methods such as propensity-score matching, difference-in-differences, interrupted time series, instrumental variables, and regression discontinuity. An illustrative example is the introduction of a new nationwide graded return-to-work program whereby propensity-score matching demonstrated an increasing labor force participation and reduced permanent disability as a result of this intervention (18). Laaksonen and colleagues (19) used the regression discontinuity approach to show that vocational rehabilitation, assigned based on a threshold in earnings in past few years, increased paid employment, but results were far from being statistically significant. A difference-in-differences approach comparing trends before and after the introduction of a work reintegration program demonstrated reductions in the number of disability days, most notably among longer duration episodes (20). Jan Vandenbroucke and colleagues (21) have eloquently criticized this ‘causal inference’ movement, stating that truly natural experiments are rare and those that happen are usually not widely generalizable. Hence, complete reliance on natural experiments and linked statistical methods will limit much needed evidence in occupational health tremendously (22). On the other side of the spectrum, researchers argue for a paradigm shift towards more practice-relevant evidence with a system lens on multiple factors that interact in dynamic and unpredictable ways in the complex world of real data (23, 24). It is proposed to determine whether an intervention contributes, along with other factors, to a desirable outcome, acknowledging that multiple components of the intervention might each contribute to an overall beneficial effect through heterogeneous effects on disparate causal pathways (23). Such a question can often not be answered by a specific research design, but requires a myriad of new types of data, analytical methods, and interdisciplinary work (24). It will be of interest to see in the next few years whether the ‘experimentalists’ and the ‘system thinkers’ can bridge the huge gap in their appreciation of what is considered solid evidence. When is evidence strong enough to take action? Societal impact of our research requires research that matters, ie, research that provides compelling arguments to implement specific improvements in order to contribute to the health and wealth of workers and communities. Working longer in good health is an example of a key societal challenges in many countries (25), and, thus, researchers in occupational health are in the fortunate position to create societal impact by identifying determinants of healthy working-life expectancy and designing interventions that promote working longer in good health. However, this requires that scientific scrutiny for valid results does not result in postponing highly needed programs and policies in the workplace. Several articles celebrating `50 years of research` in the Journal have documented that some preventive measures have been delayed unnecessarily, sometimes in a deliberate strategy by industry to manufacture uncertainty (4, 26). Delays in taking necessary action can also be the result of scientists hesitating too long about the correct interpretation of results. A classic example is the infamous crocidolite-chrysotile asbestos debate during the 1980s and 1990s, whereby proponents of the `chrysotile is safe` argument delayed the ban on asbestos (3). In an earlier editorial, we have argued that causal inference considerations should hamper neither development nor implementation of evidence-based recommendations in occupational health when the evidence-base is reasonable (27). There are no golden rules to determine when our knowledge is sufficient to require preventive measures. I can only refer to the wise words of Sir Bradford Hill in his seminal address to the Royal Society of Medicine, describing the purpose of the newly-founded section of occupational medicine: “All scientific work is incomplete—whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge we already have or to postpone action that it appears to demand at a given time (28)." With these words in mind, we look forward to research that provides compelling information on how to tackle the current challenges in occupational health and studies that document how this knowledge has guided successfully preventive measures at the workplace. Hopefully, we can redress the imbalance between risk-oriented research and intervention studies and create a long-lasting positive societal impact on workers’ health. References 1. Frank J, Mustard C, Smith P, et al. Work as a social determinant of health in high-income countries: past, present, and future. Lancet 2023;402:1357-67. https://doi.org/10.1016/S0140-6736(23)00871-1 2. Burdorf A, Rugulies R. Fifty years of research in the Scandinavian Journal of Work, Environment & Health. Scand J Work Environ Health 2024;50:3-10. https://doi.org/10.5271/sjweh.4135 3. Järvholm B, Burdorf A. Asbestos and disease - a public health success story? Scand J Work Environ Health 2024;50:53-60. https://doi.org/10.5271/sjweh.4146 4. Albin M, Johanson G, Hogstedt C. Successful prevention of organic solvent induced disorders: history and lessons. Scand J Work Environ Health 2024;50:135-41. https://doi.org/10.5271/sjweh.4155 5. Härmä M, Kecklund G, Tucker P. Working hours and health - key research topics in the past and future. Scand J Work Environ Health 2024;50:233-43. https://doi.org/10.5271/sjweh.4157 6. Kuijer PPFM, van der Wilk S, Evanoff B, Viikari-Juntura E, Coenen P. What have we learned about risk assessment and interventions to prevent work-related musculoskeletal disorders and support work participation? Scand J Work Environ Health 2024;50:317-28. https://doi.org/10.5271/sjweh.4172 7. Boot CRL, LaMontagne AD, Madsen IEH. Fifty years of research on psychosocial working conditions and health: From promise to practice. Scand J Work Environ Health 2024;50:395-405. https://doi.org/10.5271/sjweh.4180 8. Turner MC, Straif K, Kogevinas M, Schubauer-Berigan MK. Five decades of occupational cancer epidemiology. Scand J Work Environ Health 2024;50:489-502. https://doi.org/10.5271/sjweh.4190 9. Ropponen A, Rugulies R, Burdorf A. Towards the year 2049. The next 25 years of years of occupational health and safety research. 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This article investigates the impact of background binaural music on educational attainment within the context of a natural experiment. In a university business school, 73 undergraduate students participated in this study, providing a maximum of 707 observations at 16 points in time. The students were divided into three groups (Microeconomics A and B, and International Economics) and were further categorized into control and experimental groups at different stages of the courses. All students attended classes from January to June 2021, with the addition of binaural music as a treatment in either the first or second part of the courses (divided into three parts). After each lecture, students completed a multiple-choice quiz designed to assess their learning during the lecture. Utilizing t-tests for mean comparisons and panel data econometric techniques, the study found that the scores of the experimental groups were significantly higher than those of the control groups. Overall, binaural music was observed to increase quiz scores by 8 to 20 basis points.

Abstract Background The Ultra-Low Emission Zone (ULEZ), introduced in Central London in April 2019, aims to enhance air quality and improve public health. The Children's Health in London and Luton (CHILL) study evaluates the impact of the ULEZ on children's health. This analysis focuses on the one-year impacts on the shift towards active travel to school. Methods CHILL is a prospective parallel cohort study of ethnically diverse children, aged 6–9 years attending 84 primary schools within or with catchment areas encompassing London’s ULEZ (intervention) and Luton (non-intervention area). Baseline (2018/19) and one-year follow-up (2019/20) data were collected at school visits from 1992 (58%) children who reported their mode of travel to school ‘today’ (day of assessment). Multilevel logistic regressions were performed to analyse associations between the introduction of the ULEZ and the likelihood of switching from inactive to active travel modes, and vice-versa. Interactions between intervention group status and pre-specified effect modifiers were also explored. Results Among children who took inactive modes at baseline, 42% of children in London and 20% of children in Luton switched to active modes. For children taking active modes at baseline, 5% of children in London and 21% of children in Luton switched to inactive modes. Relative to the children in Luton, children in London were more likely to have switched from inactive to active modes (OR 3.64, 95% CI 1.21–10.92). Children in the intervention group were also less likely to switch from active to inactive modes (OR 0.11, 0.05–0.24). Moderator analyses showed that children living further from school were more likely to switch from inactive to active modes (OR 6.06,1.87–19.68) compared to those living closer (OR 1.43, 0.27–7.54). Conclusions Implementation of clean air zones can increase uptake of active travel to school and was particularly associated with more sustainable and active travel in children living further from school.

Abstract Purpose Non-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis. We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor – COV-PPM, and the Oxford Covid-19 Government Response Tracker – OxCGRT. Methods NPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5–25, and C4-C6, weeks 35–52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others). Results During the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries. Conclusion In the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).

Previous studies have shown that police assaults reduce trust in the police among the group affected by the incidents. As the phenomenon of plural policing emerges and the actors in policing become intertwined, blurring the boundaries between them, analysis of the impact of security guards’ actions becomes warranted. This paper investigates the impact of two security guard incidents on trust in the police in Sweden, a high-trust society, using the Unexpected Events During Survey Design, with data from the European Social Survey Wave 9. The results can be interpreted as a causal relationship and point to the fact that immigrant women’s trust in the police significantly reduced as a result of incidents, raising the importance of the fact that the immigrant group is not homogeneous and that those who suffer multiple stigmatisation may be particularly vulnerable to incidents of abuse. Furthermore, our findings highlight the potential for spill-over effects within plural policing even in high-trust societies, and the need for continuous cooperation among the actors in the security network. [ABSTRACT FROM AUTHOR]

Background: The Ultra-Low Emission Zone (ULEZ), introduced in Central London in April 2019, aims to enhance air quality and improve public health. The Children's Health in London and Luton (CHILL) study evaluates the impact of the ULEZ on children's health. This analysis focuses on the one-year impacts on the shift towards active travel to school. Methods: CHILL is a prospective parallel cohort study of ethnically diverse children, aged 6–9 years attending 84 primary schools within or with catchment areas encompassing London's ULEZ (intervention) and Luton (non-intervention area). Baseline (2018/19) and one-year follow-up (2019/20) data were collected at school visits from 1992 (58%) children who reported their mode of travel to school 'today' (day of assessment). Multilevel logistic regressions were performed to analyse associations between the introduction of the ULEZ and the likelihood of switching from inactive to active travel modes, and vice-versa. Interactions between intervention group status and pre-specified effect modifiers were also explored. Results: Among children who took inactive modes at baseline, 42% of children in London and 20% of children in Luton switched to active modes. For children taking active modes at baseline, 5% of children in London and 21% of children in Luton switched to inactive modes. Relative to the children in Luton, children in London were more likely to have switched from inactive to active modes (OR 3.64, 95% CI 1.21–10.92). Children in the intervention group were also less likely to switch from active to inactive modes (OR 0.11, 0.05–0.24). Moderator analyses showed that children living further from school were more likely to switch from inactive to active modes (OR 6.06,1.87–19.68) compared to those living closer (OR 1.43, 0.27–7.54). Conclusions: Implementation of clean air zones can increase uptake of active travel to school and was particularly associated with more sustainable and active travel in children living further from school. [ABSTRACT FROM AUTHOR]

Two-thirds of people living with Alzheimer's disease and related dementias (ADRD) live in low- and middle-income countries, and this figure is expected to rise as these populations are rapidly aging. Since evidence demonstrates links between socioeconomic status and slower rates of cognitive decline, protecting older adults' cognitive function in resource-limited countries that lack the infrastructure to cope with ADRD is crucial to reduce the burden it places on these populations and their health systems. While cash transfers are a promising intervention to promote healthy cognitive aging, factors such as household wealth and level of education often confound the ability to make causal inferences on the impact of cash transfers and cognitive function. This study uses a quasi-experimental design, leveraging an exogenous expansion to the Old Age Pension for men in South Africa, to approximate causal associations with cognitive function. We found evidence that there is a potential benefit of cash transfers at an earlier age for older individuals. As such, transfers such as pensions or other forms of direct basic income transfers may hold promise as potential interventions to promote healthy cognitive aging. [ABSTRACT FROM AUTHOR]

This article investigates the impact of background binaural music on educational attainment within the context of a natural experiment. In a university business school, 73 undergraduate students participated in this study, providing a maximum of 707 observations at 16 points in time. The students were divided into three groups (Microeconomics A and B, and International Economics) and were further categorized into control and experimental groups at different stages of the courses. All students attended classes from January to June 2021, with the addition of binaural music as a treatment in either the first or second part of the courses (divided into three parts). After each lecture, students completed a multiple-choice quiz designed to assess their learning during the lecture. Utilizing t-tests for mean comparisons and panel data econometric techniques, the study found that the scores of the experimental groups were significantly higher than those of the control groups. Overall, binaural music was observed to increase quiz scores by 8 to 20 basis points. [ABSTRACT FROM AUTHOR]

Natural disasters are likely to increase in the near future. How does the emergence of such events influence voting behavior? While the literature has focused on the electoral repercussions after disaster has already struck, we investigate whether imminent disaster influences vote choice. We study the effect of the onset of the COVID-19 pandemic on electoral choice in a setting that allows for causal identification: the local elections in Germany's southern state Bavaria in March 2020, where, at the time of the elections, only an as-if random sample of localities had recorded cases of COVID-19. We find that initial local outbreaks favored the political party governing at the state level and hurt the far right. These findings are most likely driven by a 'strategic alignment' mechanism, whereby voters choose the party or candidate they believe is best placed to help them through the crisis. [ABSTRACT FROM AUTHOR]

This study aims to analyze the effect of prenatal exposure to certain nutritional disruptions in utero on human capital formation. In order to resolve the endogeneity driven by maternal dietary deficiencies, we use the Islamic holy month of Ramadan, during which observers abstain from eating and drinking entirely from sunrise to sunset, as a natural experiment to assess the effects of fetal malnourishment on educational and labor market outcomes. We compare schooling and employment measures of individuals who are prenatally exposed to Ramadan with those who are not using the 2016 round of the Turkish Family Structure Survey dataset. Our results indicate that men who are exposed to Ramadan in utero in the first or third trimester complete 0.53 fewer years of schooling and are less likely to obtain middle school, high school, and college degrees. These effects are stronger when Ramadan coincides with summer. [ABSTRACT FROM AUTHOR]

Background: Globally alcohol consumption is a leading risk factor for premature death and disability and is associated with crime, social and economic consequences. Local communities may be able to play a role in addressing alcohol-related issues in their area. Objectives: To evaluate the effectiveness and cost–benefit of an asset-based community development approach to reducing alcohol-related harm and understand the context and factors that enable or hinder its implementation. Design: A mixed-methods evaluation. Area-level quasi-experimental trial analysed using four different evaluation methods (a stepped-wedge design where each area was a control until it entered the intervention, comparison to matched local/national controls and comparison to synthetic controls), alongside process and economic evaluations. Setting: Ten local authorities in Greater Manchester, England. Participants: The outcomes evaluation was analysed at an area level. Ninety-three lay persons representing nineareas completed questionnaires, with 12 follow-up interviews in five areas; 20 stakeholders representing ten areas were interviewed at baseline, with 17 follow-up interviews in eight areas and 26 members of the public from two areas attended focus groups. Interventions: Professionals in a co-ordinator role recruited and supported lay volunteers who were trained to become alcohol health champions. The champion's role was to provide informal, brief alcohol advice to the local population and take action to strengthen restrictions on alcohol availability. Main outcome measures: Numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs, street-level crime and antisocial behaviour in the intervention areas (area size: 1600–5500 residents). Set-up and running costs were collected alongside process evaluation data exploring barriers and facilitators. Data sources: Routinely collected quantitative data on outcome measures aggregated at the intervention area and matched control and synthetic control areas. Data from policy documents, licensing registers, meeting notes, invoices, time/cost diaries, training registers, questionnaires, interviews, reflective diaries and focus groups. Results: The intervention rolled out in nine out of ten areas, seven of which ran for a full 12 months. Areas with better-established infrastructure at baseline were able to train more champions. In total, 123 alcohol health champions were trained (95 lay volunteers and 28 professionals): lay volunteers self-reported positive impact. Champions engaged in brief advice conversations more readily than taking action on alcohol availability. There were no consistent differences in the health and crime area-level indicators between intervention areas and controls, as confirmed by using three different analysis methods for evaluating natural experiments. The intervention was not found to be cost-beneficial. Limitations: Although the sequential roll-out order of the intervention was randomised, the selection of the intervention areas was not. Self-reported impact may have been subject to social desirability bias due to the project's high profile. Conclusions: There was no measurable impact on health and crime outcomes. Possible explanations include too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes. Future work: Future similar interventions should use a coproduced community outcomes framework. Other natural experiment evaluations should use methodological triangulation to strengthen inferences about effectiveness. Trial registration: This trial is registered as ISRCTN81942890. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information. Plain language summary: What was the question?: Alcohol consumption puts an individual's health and social relationships at risk of harm. The more a person drinks, the more harmful it is. The harmful effects can place a burden on emergency services and hospitals. We wanted to find out whether community members can make a difference by taking action to address alcohol harm in their local area. What did we do?: Local councils in Greater Manchester developed a project called Communities in Charge of Alcohol, where volunteers in targeted local areas were trained to become 'alcohol health champions'. Alcohol health champions gave alcohol-related brief advice to people to help them drink less. They had a say about when, where and how alcohol is sold by reporting issues to their local council. We compared numbers of alcohol-related hospital admissions, accident and emergency attendances, ambulance call-outs and reports of crime and antisocial behaviour between areas that had alcohol health champions with other similar areas in England that did not. We calculated how much it costs to run and whether Communities in Charge of Alcohol could save society money. What did we find?: Not as many volunteers came forward to become an alcohol health champion as hoped for. Those who did give alcohol-related brief advice to people. They preferred not to report issues about alcohol sales to their local council, either because it was too complicated or because they did not want to be called a 'grass'. We did not find levels of alcohol harm changed in the Communities in Charge of Alcohol areas. Because of this, we could not demonstrate that Communities in Charge of Alcohol could save society money. What does this mean?: Getting involved in alcohol licensing decisions needs to be made easier for communities, with more anonymity, through the support of professionals. More work needs to be done to understand whether giving brief advice can reduce alcohol harm in whole communities. Scientific summary: Background: The availability of, and access to, alcohol is a key determinant of alcohol harm, and powers exist within the Licensing Act 2003 of England and Wales that enable the public to influence the local sale and supply of alcohol. At an individual level, implementing programmes to promote early risk identification and brief advice have the potential to reduce alcohol consumption and prevent alcohol-related harm, but there is a dearth of evidence to determine the feasibility and effectiveness of lay people having a role. The Greater Manchester (GM) Combined Authority (GMCA) and Greater Manchester Health and Social Care Partnership (GMHSCP) designed a new programme, 'Communities in Charge of Alcohol' (CICA) in 2017 to train lay volunteers to become alcohol health champions (AHCs), who would be able to (1) give alcohol-related brief advice to individuals and (2) help communities influence alcohol availability and strengthen restrictions in alcohol risk environments. Overall aims: To evaluate the effectiveness and cost–benefit of implementing a locally delivered AHC intervention and understand the context and factors that enable or hinder the intervention. Objectives: Relating to the outcome evaluation: to determine the effect on area-level key health performance indicators: alcohol-related hospital admissions (narrow measure), weekend accident and emergency (A&E) attendances (Friday 3 p.m.–Sunday 3 p.m.), weekday A&E attendances (Monday–Friday 9 a.m.–5 p.m. each day), weekend ambulance call-outs (Friday 3 p.m.–Sunday 3 p.m.), weekday ambulance call-outs (Monday–Friday 9 a.m.–5 p.m. each day) to determine the effect on key crime indicators (street-level crime data) at the weekend (Friday 3 p.m.–Sunday 3 p.m.) and weekday (Monday–Friday 9 a.m.–5 p.m. each day) to determine the effect on key antisocial behaviour (ASB) indicators (police recorded calls for service were classified as ASB according to the National Standard for Incident Recording). Relating to the process evaluation: to explore policy context and variation in licensing practice, including any impact of devolution in GM to explore barriers and facilitators at key stages of the implementation of the intervention: recruitment of AHCs to initial training and cascade training, delivery of initial training and cascade training, use of skills beyond the training in AHC activity, retention of AHCs to explore responses to AHC training, modelling of health behaviours, perceptions of community cohesion and development to determine numbers of brief interventions applied and community awareness events organised/participated in to examine and quantify the amount and success of community involvement in licensing issues to determine whether there was a change in composite measures of alcohol availability. Relating to the economic evaluation: to identify set-up and running costs using a standardised costing exercise to resolve costs by sector (health, ambulance and police) before, during and after set-up to quantify benefits due to reduced hospital admissions, ambulance call-outs, A&E use, crime and ASB. Methods: Communities in Charge of Alcohol was a complex intervention already planned by the GMCA in 10 small local authority areas (~1600–5500 residents each) and was outside direct researcher control. Intervention areas were chosen by each local authority public health team as having high levels of alcohol harm in comparison to the rest of the local authority. All intervention areas were at the bottom of the deprivation index, in deprivation decile 1 or 2. Using a stepped-wedge design, researchers were able to randomise the order of roll-out of intervention areas to bring a quasi-experimental approach to the evaluation. Two additional evaluation designs were used in order to triangulate findings, namely comparison to matched controls and comparison to synthetic controls. Ethical approval was received from the University of Salford Research Ethics Committee on 17 May 2017 (reference number: HSR1617–135) and obtained from the University of Bristol on 16 May 2019 (reference number: 82762). Outcome evaluation data sources: Routinely collected data at the lower-layer super output area (LSOA) level for intervention areas was compared with control areas. Data sources were as follows: alcohol-related hospital admissions data – Public Health England (now Office for Health Improvement and Disparities) accident and emergency department attendance data – NHS Digital ambulance call-out data – North West Ambulance Service reported crime and ASB data – GM Police. Analysis spanned a 10-year period (7 years pre intervention and a maximum of 3 years post implementation), ending in January 2020. Data were analysed using log-rate growth models and time series analyses to quantify the effect of the CICA programme on key performance indicators. Process evaluation data sources: Pre-implementation phase document review of local Statements of Licensing Policy (n = 9), alcohol availability composite score of on- and off-licensed premises (n = 9 areas), roll-out preparatory meeting notes. Train-the-Trainer attendance registers by area (n = 5, representing 9 areas, attended by 48 lay participants and 25 professional participants). Cascade training attendance registers by area (n = 11, representing 7 areas, attended by 47 lay participants and 3 professional participants). Pre- and post-training questionnaires (n = 93 lay people, 98% response rate). Baseline interviews with stakeholders (n = 20) (initial implementation phase); interviews with lay volunteer AHCs (n = 5, representing 3 areas) within 3–6 months of initial training (implementation phase). Follow-up interviews (12 months) with stakeholders (n = 11, representing eight areas), licensing officers (n = 6, representing six areas) and lay volunteer AHCs (n = 7, representing four areas); follow-up questionnaires with AHCs (n = 11); focus groups with local residents (n = 3 groups, representing two areas, with a total of 26 participants). Economic evaluation data sources: Time and transportation costs incurred during project meetings aggregated from meeting minutes and stakeholder time/cost diaries. Invoices for the design, development and delivery of training packages and accreditation fees. Invoices for the qualification and assessment fees, time and miscellaneous (transportation, room hire, catering, printing costs). AHC time and costs aggregated from volunteer diaries and stakeholder time/cost diaries. Invoices for engagement materials (AUDIT-C scratchcards). Greater Manchester Combined Authority research team's (formerly New Economy) cost–benefit analysis (CBA) tool was populated using aggregated outcome evaluation data to resolve costs for each key performance indicator before, during and after CICA setup. Results: Nine out of 10 local authorities rolled out the CICA intervention on their given start date: seven areas completed a full year, carrying out cascade training in the first 12 months, two areas withdrew at 6 and 9 months and one area withdrew in the pre-implementation phase. There were 118 [interquartile range (IQR): 60–205] alcohol-related hospital admissions per month per pre-intervention LSOA , rising to 134 (IQR : 67–203) post intervention. Some outcomes had very small counts at the LSOA level; notably, there were only 2 (IQR : 1–3) weekend crimes per month pre-intervention and 4 (IQR : 2–6) post intervention. The primary, stepped-wedge analyses provide weak evidence of an average increase in alcohol-related hospital admissions following the implementation of CICA of about 13%, corresponding to about 20 admissions weekly, although the confidence interval was wide, −1.98 to 31.39, and not statistically significant (p~0.09), while the analysis that made use of local controls suggested a bigger effect, at 16.4% (7.33–26.16, p < 0.001). However, the other methods of analysis (national controls and counterfactuals) indicated much smaller effect sizes and confidence intervals, including unity: 3.42% (−4.56 to 12.07; p = 0.41) and 7.14% (−9.76 to 24.04; p = 0.41), respectively. The other quantitative outcomes (A&E admissions, or ambulance call-outs to the area, nor to reported crimes or reported ASB incidents) showed some were individual statistically significant effects (with some methods and some indicators), but these were more often not in favour of the intervention. Triangulation of three methods of analysis did not indicate any consistent differences between control and intervention areas. The pre-implementation phase was defined as the period leading up to the roll-out of the first Train-the-Trainer event. Several facilitating contextual factors were identified a priori. The total number of these factors in place at baseline correlated with numbers trained in the first year (Rs = 0.77, p = 0.01). Specifically, areas with a healthcare provider to co-ordinate the intervention (p = 0.02); a pool of other volunteers to recruit from (p = 0.02); a contract in place with a commissioned service (p = 0.02); and formal volunteer arrangements (p = 0.03) trained more AHCs. Across all nine areas, fewer volunteers were recruited than the anticipated target of 35 per area. In total, 123 AHCs were trained and gained a Royal Society for Public Health Level 2 qualification. Of these, 95 were lay volunteers from the intervention areas. The majority identified as white (70%), with ages ranging from 18 to 65+, and almost half aged between 41 and 60 (48%). Slightly more women volunteered compared to men (61%). Most AHCs self-reported being in the lower-risk drinking category (66% scored 0–4 on AUDIT-C). Post-training questionnaires suggested that volunteers felt more confident to talk about the harms associated with alcohol and give alcohol-related brief advice than they did pre training (91.4% compared with 79.6%, p < 0.001) and that they felt more confident to raise issues about venues selling alcohol (90.3% compared with 74.2% pre training, p < 0.001). Intervention areas that recorded AHC activity (n = 5) captured 1100 conversations, 251 AUDIT-Cs completed and 65 community events attended. Time/cost diaries suggested that AHCs spent on average 11 minutes having an informal brief advice conversation. Interviews with AHCs on self-reported activity were consistent with time/cost and reflective diaries: AHCs put into practice brief advice conversations more than community action to influence licensing. Interviews with stakeholders indicated several enabling factors to consider when rolling out and embedding an AHC intervention: a clear understanding of the place-based focus; commissioned provider services needing a clear understanding of own roles and the anticipated outcomes; and co-ordinators having the skills and capacity to support inexperienced volunteer groups. The importance of infrastructure was reflected in interviews, recognising that preparing the ground at a hyperlocal level takes time, needing to be well in advance of the formal implementation period. Recruitment strategies need to be multipronged, and stakeholders need to be prepared to provide a sustained period of support for new and existing champions. In the follow-up phase, 12 months post intervention, interviews with stakeholders revealed how the local co-ordinators' ability to operationalise and sustain CICA was significantly impacted by their lack of capacity to sustain the levels of support, as well as the complexity of skills required of the role. After 12 months, there was strong consistency in findings from follow-up interviews with stakeholders, AHCs and focus groups with members of the public. Communities in Charge of Alcohol's intended mechanism of action was to reduce alcohol-related harm through secondary prevention interventions; however perceptions of those most in need of an AHC conversation were 'problem drinkers' to signpost into tertiary interventions. Quality of local alcohol treatment services was considered to be poor, with multiple barriers to help and information seeking. Conclusions: To our knowledge, CICA is the first alcohol-focused champion role of its kind to be investigated and across multiple intervention sites. It is also the first evaluation of a health champion programme that uses methodological triangulation to strengthen inferences about effectiveness. There was evidence that lay people trained as AHCs were able to have conversations with members of their communities who were consuming alcohol at higher risk levels, demonstrating a level of skill and confidence that can sometimes be absent in health professionals. AHCs, their co-ordinators and the public valued the role. However, significant infrastructure is needed to support an intervention such as CICA , and time is needed to develop and embed a group of volunteers. Despite evidence (from the process evaluation) of the planned activity taking place at local level, we were not able to show that CICA was effective, nor was it cost-effective. There are likely to be two main reasons for this. Firstly, the number of champions trained was too small to have a sufficient number of brief advice conversations to generate any measurable effect at the area level of analysis. Moreover, brief interventions may not directly impact on primary health and crime outcomes at a population level. Secondly, the AHCs were less willing (and had less opportunity) to get involved with alcohol licensing decisions. Since licensing policies theoretically have an impact at an area level, this theoretically would have been more likely to generate a significant area-level effect. The evidence from this study is that communities continue to struggle to influence statutory processes that affect alcohol availability where they live, and further consideration of how to enable increased community engagement is necessary. Recommendations for future research (numbered in priority order): natural experiment evaluations should include methodological triangulation to guard against overinterpretation of spurious results investigate coproducing a community outcomes framework to measure reductions in alcohol harm evaluate whether rebalancing local licensing policy to be community-centred might increase community engagement in the local licensing decision-making process investigate the effectiveness of CICA in areas where indicators of alcohol harm are increasing but are not at the highest level of harm within the local authority a wider range of external contextual factors could be tested in the pre-implementation phase of a complex intervention, incorporating methods to combine factors into mean scores, to test relationships between process indicators and outcomes. Trial registration: This trial is registered as ISRCTN81942890. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 15/129/03) and is published in full in Public Health Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information. [ABSTRACT FROM AUTHOR]

In 2020 the tragic murder of George Floyd at the hands of law enforcement ignited and intensified nationwide protests, demanding changes in police funding and allocation. This happened during a budgeting feedback exercise where residents of Austin, Texas were invited to share opinions on the budgets of various city service areas, including the Police Department, on an online platform designed by our team. Daily responses increased by a hundredfold and responses registered after the "exogenous shock" overwhelmingly advocated for reducing police funding. This opinion shift far exceeded what we observed in 14 other Participatory Budgeting elections on our Participatory Budgeting Platform, and can't be explained by shifts in the respondent demographics. Analysis of the results from an Austin budgetary feedback exercise in 2021 and a follow-up survey indicates that the opinion shift from 2020 persisted, with the opinion gap on police funding widening. We conclude that there was an actual change of opinion regarding police funding. This study not only sheds light on the enduring impact of the 2020 events and protests on public opinion, but also showcases the value of analysis of clustered opinions as a tool in the evaluation toolkit of survey organizers. [ABSTRACT FROM AUTHOR]

Objectives: Test the immediate and sustained impact of suspending a police K9 program on officer injury, suspect injury, and suspect resistance rates. Methods: A large municipal policing agency housing one of the oldest K9 programs in the USA suddenly terminated the program at the close of summer 2020. We exploit this change as a natural experiment to test three hypotheses related to rates of injuries (officer and suspect) and resisting arrest. We use Bayesian modeling in an interrupted time series analysis to measure the immediate and long-term effects of the K9 apprehension program's suspension on our hypotheses. Results: The sudden suspension of K9 apprehension was not associated with a statistical increase in officer or suspect injury, or suspect resistance, during felony arrests. Conclusions: As police agencies, communities, and stakeholders renegotiate the risks of policing, constraints on using police K9s are unlikely to impact aggregate officer or suspect safety negatively. [ABSTRACT FROM AUTHOR]

This paper investigates the ramifications of information feed integration on user engagements and contributions in online content-sharing platforms by exploiting a natural experiment occurred in a leading knowledge-sharing platform that integrated informal social posts with professional knowledge content in one feed. Our results show that the juxtaposition of incongruous types of content increased mindset switching and cognitive strain, thus hurting user engagements. We also reveal a novel crowding-out effect, viz., the integration heightened concerns that posting informal social posts would dilute the contributor's professional image, thus inhibiting user contributions. Our findings hold important practical implications for all platforms that host (or are considering hosting) diverse types of user-generated content (UGC). Additional content curation tools can potentially enhance user engagement and retention, but their effectiveness hinges on a foundational and crucial element—the presentation format of heterogeneous content types. Essentially, the value of curating informal social posts in a knowledge-sharing platform would diminish when those content intrudes upon and conflict with the professional domain. This insight underscores that any UGC platforms, when adopting a diversity-oriented strategy, should pay close attention to heterogeneity between different content types for the purpose of optimizing user experiences and promoting user contributions. Many online communities that rely on effortful, voluntary content contributions offer additional content curation tools to facilitate social interactions and encourage user contributions. Any platform that offers two or more heterogeneous content types (e.g., expert knowledge and social posts) faces a choice about the presentation format: whether to display the content types separately or in an integrated information feed. We leverage a natural experiment on Zhihu, a Q&A platform that offers a social-interaction-oriented functionality called Ideas. Zhihu initially presented answers (expert knowledge content) and ideas (social posts) in two different information feeds, but the platform integrated ideas into the same information feed as answers in June 2019. We find that information feed integration significantly decreased user engagement with and contribution of both ideas and answers. We hypothesize that users decreased their engagement because the juxtaposition of incongruous types of content increased mindset switching and cognitive strain. This hypothesis is supported by an additional laboratory experiment. We also present evidence showing that contributions decreased both because of the decrease in engagement (weaker social recognition incentives) and because integration heightened concerns that posting ideas would dilute the contributor's professional image. Our findings have important theoretical and practical implications for any platform that hosts heterogeneous content. History: Xiaoquan (Michael) Zhang served as the senior editor and Yili (Kevin) Hong served as associate editor for this article. Funding: Z. Cao acknowledges this research was funded by National Natural Science Foundation of China [Grants 72201238, 72192823]. G. Li acknowledges this research was funded by National Natural Science Foundation of China [Grant 72102047] and Shanghai Pujiang Program [Grant 21PJC006]. Supplemental Material: The e-companion is available at https://doi.org/10.1287/isre.2022.0043. [ABSTRACT FROM AUTHOR]

Widening income inequality is a serious social concern in many countries. We examine the causal effect of a negative demand shock on executive compensation and worker wages using a quasi-natural experiment, considering Japanese firms that experienced a sudden and substantial export decline following the global financial crisis in the late 2000s. Worker wages tended to decline significantly more relative to executive compensation after the crisis in firms depending more on exports, causing a wider pay differential. We establish the robustness of our difference-in-difference results by considering selection into exporters, excluding sporadic exporters, and controlling for foreign ownership or liquidity. [ABSTRACT FROM AUTHOR]

While the importance of fostering individual taxpayers' (hereafter taxpayers) trust in government to encourage tax compliance is widely acknowledged, how policy actions can increase trust in government remains unclear. Thus, the main purpose of our research is to see whether policy actions that signal government benevolence during a crisis can quickly increase trust in government, and its positive implications for tax compliance intentions. Another goal of our research is to see whether such a quick change of trust is driven by emotions. To test this, we use the British COVID-19 Self-Employment Income Support Scheme (hereafter SEISS) as a natural experiment. Right after the SEISS was launched to the British public, we recruited a sample of 500 British self-employed taxpayers via Prolific. Our results suggest that receiving (vs. not receiving) government support increases trust in government and enhances tax compliance intentions. In addition, trust in government mediates the positive impact of receiving (vs. not receiving) government support on tax compliance intentions. More important, our results suggest that policy actions that signal government benevolence during a crisis can increase trust in government quickly because it is driven by taxpayers' emotions such as gratitude. These results have important implications for governments to efficiently deal with the sharp rise in public debts caused by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This article investigates the extent to which policy variation matters for refugee integration, focusing on two parallel local integration programs varying in intensity and comprehensiveness and their effects on refugees’ economic and socio-cultural integration. We employ 3-wave panel data including detailed information on Syrian refugees from the moment they were granted asylum status in the Netherlands up to four years later. After accounting for treatment assignment bias using coarsened exact matching, random effects analyses showed a significant increase over time in refugees’ Dutch language proficiency, identification with the host community, self-reliance, participation in volunteer or paid work, and welfare independence. However, we did not find convincing evidence to suggest that refugees’ integration process developed differently depending on the integration program. We discuss possible explanations for our findings and advance policy interventions that aim to foster refugee integration. [ABSTRACT FROM AUTHOR]

Loneliness contributes to mortality risk, comparable to the risks associated with smoking and obesity, although the causal determinants of loneliness remain less clear. This paper leverages mandatory stay-at-home orders in Australia as a natural experiment and employs data from a panel study to investigate the causal link between physical isolation and loneliness. By analyzing variations in the number of lockdown days experienced by respondents up until their interview dates, and utilizing difference-in-differences analyses with individual, region, and year fixed-effects estimations, we find, contrary to expectations, that the number of days in lockdown does not significantly impact loneliness. Our study examines cumulative, concurrent, and non-linear effects, and assesses external validity through community morale and peer effects during lockdowns using spatial analysis. Additionally, we delve into heterogeneous effects across various factors, such as income, age, personality, living arrangements, and remoteness, finding statistically and empirically insignificant effects. However, for extroverts and young people, we observe weak statistical significance. We investigate exclusion restrictions by analyzing factors including social contacts, internet access, job industry, and household characteristics in relation to loneliness; as well as time use and relationship satisfaction to better understand the underlying mechanism. Our study challenges the notion that 'being alone' and 'being lonely' are interchangeable concepts, providing the first empirical causal evidence of no links between the two. Furthermore, our findings refine earlier understandings of social isolation, highlighting that it likely encompasses factors beyond physical isolation. [ABSTRACT FROM AUTHOR]

Delays at court are an everlasting and potentially consequential reality of criminal justice systems, although most would agree that the timely adjudication of cases is needed from both administrative, judicial, and individual perspectives. This paper uses administrative data and a policy reform in Denmark in 2007 to measure the unconfounded association between court delays – or, more specifically, time to adjudication – and criminal recidivism within 5 years. Results show that although court delays do not push more people into recidivism, the delays matter for how many crimes recidivists end up being convicted of. Also, criminality tends to be muted during the period from charge to adjudication (even in a context with low use of pretrial detention and no bail system), whereby court delays also matter for the timing of new crimes – a finding with important theoretical implications. [ABSTRACT FROM AUTHOR]

Income is a relevant factor for explaining outbound tourism demand. However, when working with regional- or country-level data, it is difficult to disentangle the role of income in stimulating tourism travelling from other factors that correlate with greater income levels. This paper exploits a natural experiment from Spanish Christmas Lottery to estimate the causal effect of income shocks on outbound tourism. We leverage the staggered and quasi-random assignment of lottery winnings across Spanish regions to estimate the elasticity of outbound annual trips and expenditure to windfall gains. Using difference-in-differences with the amount of lottery prizes as an indicator of treatment intensity, we show that lottery winnings per capita increase both the annual number of tourism trips and expenditure per capita. This effect operates during the first 2 years following the draw, which is likely explained by bandwagon and income multiplier effects. [ABSTRACT FROM AUTHOR]

Live oyster reefs are considered a critical recruitment habitat for estuarine faunal populations as localized in situ or mesocosm studies have demonstrated many faunal species prefer live oyster habitat. It has therefore been assumed that the loss of live oyster habitat would precipitate faunal population declines, but this has been largely untested at large (estuary) scales. Here, we assessed how estuary‐wide faunal populations were affected by a 95% loss of live oyster habitat following the 2012 oyster collapse of Apalachicola Bay, FL, which previously supported one of the largest oyster fisheries in the United States. We standardized long‐term fisheries‐independent monitoring seine and trawl data to create relative indices of resident, associated, and transient faunal species' overall abundance and recruit abundance (restrictive to sizes between 15% and 35% of L∞$$ {L}_{\infty } $$). We expected that both relative abundance indices would decrease following the oyster collapse, particularly among species that reside on or recruit to oyster reefs. However, analyses via a series of one‐sided Bayesian t tests did not indicate that faunal recruitment or overall abundance significantly declined in 2012 post‐collapse. As the response of the faunal population could be lagged relative to the 2012 collapse, we also conducted change point analyses to search for lagged declines. Of the 24 relative abundance time series, only two had significant change points post‐collapse, and only black sea bass overall relative abundance declined with an associated change point at the end of the time series. The surprising paucity of faunal decline following oyster loss may be due to the use of alternative habitat types, exceptionally lagged faunal responses, or, perhaps most compelling, a disconnect between preferred and required habitats. Our failure to detect faunal consequences following an oyster population collapse suggests that assumptions of habitat loss (or restoration) effects on estuarine fauna at ecosystem scales are not straightforward and the extrapolation of sub‐estuary‐scale studies may result in poor predictions of future outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Recent years have witnessed an increase in highly publicized attacks targeting members of ethnoracial and religious minority groups. To date, existing research has primarily focused on the tendency for such "trigger events" to generate violent aftershocks. We argue that beyond such ripple effects, highly salient trigger events significantly increase hate-crime related stress among racial and ethnic minorities. Additionally, we explore whether these effects are limited to the group most clearly targeted, or if they "spill over" to other minoritized communities. Methods: To study reactions to hate crimes, we draw upon national survey data (N = 1,122) in combination with a natural experiment involving the Unite the Right rally and vehicle attack in Charlottesville, Virginia in August 2017. We employ an "unexpected event during survey" design to estimate the causal effect of the Charlottesville rally on stress about hate crimes. Results: We first show that there was an increase in anti-Black hate crimes in the 2 weeks following the Charlottesville incident. We also find a corresponding increase in stress due to the perception of personal vulnerability to hate crimes among African-Americans. However, we do not observe a significant increase in levels of stress following the trigger event among Hispanics and Asian Americans. Discussion: Our results suggest that highly publicized instances of intergroup violence can have significant impacts on stress about hate crime victimization within the target group. However, we find that this effect is short-lived, and that both violent aftershocks and the general climate of fear spurred by hate crimes may be racially bounded. [ABSTRACT FROM AUTHOR]

As disasters increase due to climate change, population density, epidemics, and technology, information is needed about postdisaster consequences for people's mental health and how stress-related mental disorders affect multiple spheres of life, including labor-market attachment. We tested the causal hypothesis that individuals who developed stress-related mental disorders as a consequence of their disaster exposure experienced subsequent weak labor-market attachment and poor work-related outcomes. We leveraged a natural experiment in an instrumental variables model, studying a 2004 fireworks factory explosion disaster that precipitated the onset of stress-related disorders (posttraumatic stress disorder, anxiety, and depression) among individuals in the local community (N = 86,726). We measured labor-market outcomes using longitudinal population-level administrative data: sick leave, unemployment benefits, early retirement pension, and income from wages from 2007 to 2010. We found that individuals who developed a stress-related disorder after the disaster were likely to go on sickness benefit, both in the short-and long-term, were likely to use unemployment benefits and to lose wage income in the long term. Stress-related disorders did not increase the likelihood of early retirement. The natural experiment design minimized the possibility that omitted confounders biased these effects of mental health on work outcomes. Addressing the mental health and employment needs of survivors after a traumatic experience may improve their labor-market outcomes and their nations' economic outputs. [ABSTRACT FROM AUTHOR]

Natural experiments provide remarkable opportunities to test the large-scale effects of human activities. Widespread energy blackouts offer such an 'experiment' to test the impacts of artificial light at night (ALAN) on wildlife. We use the situation in South Africa, where regular scheduled blackouts are being implemented, to highlight this opportunity. [ABSTRACT FROM AUTHOR]

Does leader age matter for the likelihood of interstate conflict? Many studies in biology, psychology, and physiology have found that aggression tends to decline with age throughout the adult lifespan, particularly in males. Moreover, a number of major international conflicts have been attributed to young leaders, including the conquests of Alexander the Great and the ambitious military campaigns of Napoleon. However, the exact nature of the relationship between leader age and international conflict has been difficult to study because of the endogeneity problem. Leaders do not come to power randomly. Rather, many domestic and international factors influence who becomes the leader of a country, and some of these factors could correlate with the chances of interstate conflict. For instance, wary democratic publics might favor older leaders when future international conflict seems likely, inducing a relationship between older leaders and interstate conflict. This article overcomes such confounding by using a regression discontinuity design. Specifically, it looks at close elections of national leaders who had large differences in age. It finds that when older candidates barely defeated younger ones, countries were much less likely to engage in military conflict. Its sample is also fairly representative of democracies more broadly, meaning that the findings likely hold true for cases outside the sample. The results demonstrate the important role that individuals play in shaping world politics. They also illustrate the value of design-based inference for learning about important questions in the study of international relations and peace science. [ABSTRACT FROM AUTHOR]

This study examines the effectiveness of collaborative platforms in supporting local collaborations for natural resource management. It also explores how governmental and non-governmental lead organizations adopt differing collaborative implementation approaches and how these variations influence outcomes. Utilizing a natural experiment and a difference-in-differences estimator, we evaluate if the Department of Energy's Clean Cities program functions as a collaborative platform to foster local-level Clean Cities Collaborations across the US, thereby improving air quality. Our findings suggest that Clean Cities Collaborations have a substantial and enduring impact on reducing air pollution. A series of subgroup analyses suggests that these environmental improvements are most noticeable in collaborations led by non-profits and regional government councils, rather than those directed by state and local governments. A complementary content analysis provides exploratory evidence that issue definition, collaborative group structure, and inclusive decision-making processes are crucial managerial factors that contribute to the environmental improvements. These insights pave the way for more effective management of collaborative governance on a larger scale. [ABSTRACT FROM AUTHOR]

A natural experiment reveals that an ad ban reduces sales of a grocery retailer by 6% but does not affect overall market size. Advertising bans typically target products that deceive consumers in ways that can threaten their physical and mental health. An alternative policy objective might seek environmental protection through a ban on print advertising. Such measures would profoundly affect grocery retailers relying on printed leaflets to communicate weekly promotions. We measure the causal effect of banning advertising on retail performance by studying a temporary advertising ban implemented in a German federal state during the COVID-19 pandemic. The ban resulted in the suspension of all print advertising by grocery retailers, and the exogenous variation in advertising created by this natural experiment serves as our identification strategy. We apply difference-in-differences regressions to data from a national grocery retailer and find that the ban resulted in a 6% sales decrease in the treated state compared with an adjacent state. GfK Household Panel data reveal no effect of the advertising ban on the market level but a negative impact on retailers offering and advertising weekly promotional product assortments. We study the sensitivity of these results to the COVID pandemic and find that neither changes in COVID-19 incidence, vaccination rates, nor customers' mobility moderate the ad ban effect. The findings offer practical insights for regulators and retailers regarding the impact of ad bans and the value of advertising. History: Catherine Tucker served as the senior editor for this article. This paper was accepted through the Marketing Science: Frontiers review process. Conflict of Interest Statement: None of the authors have any financial or non-financial interests in this manuscript's subject matter or materials. Sebastian Gabel consults with a company linked to the retailer that provided the data. Access to the GfK Household Panel data is provided by AiMark (http://www.aimark.org), which is a not-for-profit foundation that supports top academic research with scanner data provided by its data partners GfK and Kantar. Funding: This work was supported by Deutsche Forschungsgemeinschaft (CRC TRR 190 [Project Number 280092119]) and Nederlandse Organisatie voor Wetenschappelijk Onderzoek. S. Gabel acknowledges funding from the Dutch Research Council (NWO) under a Veni grant. M. Spann acknowledges funding from the German Research Foundation. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mksc.2023.0019. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the relationship between network position and innovation under major environmental turbulence. Design/methodology/approach: The authors use a difference-in-differences identification approach using the 2009 Industry Revitalization Plan in response to the global financial crisis as a natural experiment with a sample of Chinese listed firms from 2001 to 2017. Findings: The findings show that a major environmental turbulence can facilitate firm innovation, and firms that occupy central positions in the interlock network show worse innovation performance while firms with high brokerage show better innovation performance. Originality/value: The literature on environmental implication has largely focused on the threats and overlooked the potential opportunities. Moreover, social network literature has elaborated on the benefits and constraints of network positions from a static perspective but largely overlooked their implications facing environmental change. By exploring the bright side of major environmental turbulence and including this factor as a key contingency in exploring the effects of centrality and brokerage, this study integrates external environmental context with social network research and provides empirical evidence responding to the call for more attention to network dynamics and extends our understanding of the context-contingent network effects on firm innovation. [ABSTRACT FROM AUTHOR]

We combine panel household data with the introduction of an increasing block tariffs (IBT) for residential electricity in three experimental regions of Russia to analyze the relationship between the IBT and the propensity of households to purchase dirty fuels. Using a difference-in-differences empirical specification, we find that the propensity to purchase dirty fuels has increased in the regions where the IBT schemes were introduced. The size of the increase varies from 3.8 percentage points for the full sample of households to 13.4 percentage points when restricting the sample to households that do not have access to district heating networks. [ABSTRACT FROM AUTHOR]

Population-level efforts are needed to increase levels of physical activity and healthy eating to reduce and manage chronic diseases such as obesity, cardiovascular disease, and type 2 diabetes. Interventions to increase public transit use may be one promising strategy, particularly for low-income communities or populations of color who are disproportionately burdened by health disparities and transportation barriers. This study employs a natural experiment design to evaluate the impacts of a citywide zero-fare transit policy in Kansas City, Missouri, on ridership and health indicators. In Aim 1, comparison to 9 similar cities without zero-fare transit is used to examine differential changes in ridership from 3 years before to 4 years after the adoption of zero-fare. In Aim 2, Kansas City residents are being recruited from a large safety net health system to compare health indicators between zero-fare riders and non- riders. Longitudinal data on BMI, cardiometabolic markers, and economic barriers to health are collected from the electronic health record from 2017 to 2024. Cross-sectional data on healthy eating and device-measured physical activity are collected from a subsample of participants as part of the study procedures (N = 360). Numerous baseline characteristics are collected to account for differences between Kansas City and comparison city bus routes (Aim 1) and between zero-fare riders and non-riders within Kansas City (Aim 2). Evidence on how zero-fare transit shapes population health through mechanisms related to improved economic factors, transportation, physical activity, and healthy eating among low-income groups is expected.

The National Football League (NFL) sets its regular season schedule to optimize viewership and minimize competitive inequities. One inequity assumed to impact team performance is rest differential, defined as the relative number of days between games. Using Bayesian state space models on both game outcomes and betting market data, we estimate the competitive effect of rest differential in American football. We find that the most commonly referred to inequities—both the bye week rest advantage and the mini-bye week rest advantage— currently show no significant evidence of providing the rested team a competitive edge. Further, we trace a decline in the advantage of a bye week to a 2011 change to the NFL's Collective Bargaining Agreement, which represents a natural experiment to test the relevance of rest and preparation in football. Prior to the agreement, NFL teams off a bye week received a significant advantage (+2.2 points per game), but since 2011, that benefit has been mitigated. Our findings imply that extra days with practice time, and not extra days off alone, are the primary driver of any NFL rest advantage.

Background and objectives Schools play a crucial role in facilitating physical activity among children, but the COVID-19 pandemic has affected both children’s physical activity and the school environment. It is essential to understand between-school differences in children’s physical activity post lockdown, to determine if and how the role of schools has changed. Design and participants Active-6 is a natural experiment comparing postlockdown accelerometer-estimated physical activity to a pre-COVID-19 comparator group. Accelerometer and individual data were collected on 1296 children aged 10–11 pre-COVID-19 (2017–8), with school characteristics collected from the 50 schools they attended. Post lockdown, we collected accelerometer, individual and school data from 393 children in 23 of the same schools and 436 children in 27 of the same schools in 2021 (Wave 1) and 2022 (Wave 2), respectively. Methods Sources of variation (between-school, between-pupil and within-pupil) in child weekday moderate to vigorous physical activity at each wave were modelled using linear mixed-effects models with school-level wave random coefficients. We extended the model to estimate the proportion of between-school variation explained by school policy, curriculum and physical environment factors and school-aggregated pupil characteristics. We also explored the extent to which postlockdown differences in moderate to vigorous physical activity were mediated by individual or school factors. Results Between-school variation comprised 13% of the total variation pre-COVID-19, 7% in Wave 1 and 13% in Wave 2. School factors associated with moderate to vigorous physical activity were the following: whether physical education was compromised due to space (often: 9 minutes lower moderate to vigorous physical activity; sometimes: 5.4 minutes lower); high after-school club attendance (7 minutes higher moderate to vigorous physical activity for each additional club attended on average in the school); cycle training policy (4 minutes higher moderate to vigorous physical activity); and higher prevalence of active travel (1 minute higher moderate to vigorous physical activity for each 10% point increase in prevalence). These factors explained 22% of the between-school variation pre-COVID-19, and 72% at Wave 2. The relative importance changed, with cycle training policy and active travel being the most important pre-COVID-19 and cycle training policy, active after-school clubs and compromised physical education space most important in Wave 2. No factors were found to mediate the postlockdown differences in moderate to vigorous physical activity, except compromised physical education space, which had a suppressor effect in Wave 2. Limitations Only 27 of the initial 50 schools participated post lockdown, limiting our ability to make comparisons across waves. Sample sizes were additionally affected by missing data for some variables. Conclusions and future work While schools continue to play an important role in facilitating children’s physical activity, the factors that contribute to this have changed post-COVID-19, with cycle training, active after-school clubs and ensuring physical education is prioritised even when space is limited now explaining nearly three-quarters of the between-school variation in children’s moderate to vigorous physical activity. School-level interventions that focus on these areas, and policies that support them, may offer the potential to increase children’s physical activity. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR131847. Plain language summary What was the question? Schools are important in helping children to be physically active. How active children are differs between schools. We wanted to know whether this has changed after the COVID-19 lockdowns. We also looked at features of the school, like equipment in the playground or being active in lessons, that might explain these differences. What did we do? We collected activity data from 10- to 11-year-olds from 50 schools around Bristol (United Kingdom) before and after the COVID-19 lockdowns. Children also told us about how they travelled to school and whether they went to after-school sports or exercise clubs. We asked schools about their policies and lessons. Finally, we collected data on the playground and surroundings. What did we find? In the first 6 months after lockdowns, schools had a much smaller role in children’s activity. But after a year, schools were once again an important influence on how active children were. We found that the school features that affected children’s activity had changed. Before the pandemic, the things that helped children most to be active were learning to ride a bike at school, and walking or cycling to school. After the pandemic, offering lots of after-school sports clubs was more important. Schools that struggled with physical education lessons because of a lack of space had fewer active pupils. What does this mean? Schools continue to play an important role in helping children be active. But this role has changed after the lockdowns. In the future, schools could help keep children active by offering plenty of after-school clubs and help children to learn to ride a bike. Also, it is important to make sure that physical education lessons are a priority, even when there is not much space.