{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:22:24Z","timestamp":1772166144333,"version":"3.50.1"},"reference-count":127,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Equity Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In this study, we evaluated and forecasted the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion, using a new people-centred methodology with an equity focus. Furthermore, we identified 1\u20132 optimal locations where new services would maximise accessibility. We utilised open data and publicly available big data. Cali is one of South America's cities most impacted by traffic congestion.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methodology:<\/jats:bold>\n                    Using a people-centred approach, we tested a web-based digital platform developed through an iterative participatory design. The platform integrates open data, including the location of radiotherapy services, the disaggregated sociodemographic microdata for the population and places of residence, and big data for travel times from Google Distance Matrix API. We used genetic algorithms to identify optimal locations for new services. We predicted accessibility cumulative opportunities (ACO) for traffic ranging from peak congestion to free-flow conditions with hourly assessments for 6\u201312 July 2020 and 23\u201329 November 2020. The interactive digital platform is openly available.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Primary and secondary outcomes:<\/jats:bold>\n                    We present descriptive statistics and population distribution heatmaps based on 20-min accessibility cumulative opportunities (ACO) isochrones for car journeys. There is no set national or international standard for these travel time thresholds. Most key informants found the 20-min threshold reasonable. These isochrones connect the population-weighted centroid of the traffic analysis zone at the place of residence to the corresponding zone of the radiotherapy service with the shortest travel time under varying traffic conditions ranging from free-flow to peak-traffic congestion levels. Additionally, we conducted a time-series bivariate analysis to assess geographical accessibility based on economic stratum. We identify 1\u20132 optimal locations where new services would maximize the 20-min ACO during peak-traffic congestion.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Traffic congestion significantly diminished accessibility to radiotherapy services, particularly affecting vulnerable populations. For instance, urban 20-min ACO by car dropped from 91% of Cali\u2019s urban population within a 20-min journey to the service during free-flow traffic to 31% during peak traffic for the week of 6\u201312 July 2020. Percentages represent the population within a 20-min journey by car from their residence to a radiotherapy service. Specific ethnic groups, individuals with lower educational attainment, and residents on the outskirts of Cali experienced disproportionate effects, with accessibility decreasing to 11% during peak traffic compared to 81% during free-flow traffic for low-income households. We predict that strategically adding sufficient services in 1\u20132 locations in eastern Cali would notably enhance accessibility and reduce inequities. The recommended locations for new services remained consistent in both of our measurements.\n                  <\/jats:p>\n                  <jats:p>These findings underscore the significance of prioritising equity and comprehensive care in healthcare accessibility. They also offer a practical approach to optimising service locations to mitigate disparities. Expanding this approach to encompass other transportation modes, services, and cities, or updating measurements, is feasible and affordable. The new approach and data are particularly relevant for planning authorities and urban development actors.<\/jats:p>","DOI":"10.1186\/s12939-024-02211-6","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T05:02:25Z","timestamp":1723698145000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2732-5019","authenticated-orcid":false,"given":"Luis Gabriel","family":"Cuervo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7031-8132","authenticated-orcid":false,"given":"Carmen Juliana","family":"Villamizar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3323-9865","authenticated-orcid":false,"given":"Daniel","family":"Cuervo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-5382","authenticated-orcid":false,"given":"Pablo","family":"Zapata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9305-7521","authenticated-orcid":false,"given":"Maria B.","family":"Ospina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4949-6776","authenticated-orcid":false,"given":"Sara Marcela","family":"Valencia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-8067","authenticated-orcid":false,"given":"Alfredo","family":"Polo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1810-7351","authenticated-orcid":false,"given":"\u00c1ngela","family":"Su\u00e1rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0611-0521","authenticated-orcid":false,"given":"Maria O.","family":"Bula","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4738-5468","authenticated-orcid":false,"given":"J. 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Colombia\u2019s census microdata used in this study and the location of approved selected health services obtained from REPS are publicly available [\n                      \n                      ,\n                      \n                      ].The study protocol does not involve human subjects research and is considered \u201cwithout risk\u201d per Colombian law. The Commission on Ethics in Animal and Human Experimentation (CEEAH) of the Universidad del Valle in Cali and the Vice-Rector for Research, Universitat Aut\u00f2noma de Barcelona (Ref: CEEAH-6100) cleared this project [\n                      \n                      ].Travel-time data used by the AMORE web-based platform is available from OpenScience [July\n                      \n                      and November\n                      \n                      ]. The interactive web-based interface of the AMORE Platform used for this report is publicly available at\n                      \n                      . Readers can interact with changing parameters and testing assumptions. A Padlet\n                      \n                      offers access to the website, tutorials, databases, blogs, and presentations about the AMORE Project.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors and collaborators completed the ICMJE uniform disclosure form and declared no financial support from any organisation for the submitted work. IQuartil SAS provided technical support to develop the AMORE Platform and was subsidised for consulting services by LGC. PZ received consulting fees and time from IQuartil SAS for the AMORE Platform development. DC is a partner at IQuartil SAS and a sibling to LGC. LGC contributed to this work in his own time and capacity. CJ and EMH are LGC\u2019s thesis directors. LGC, CJV, and AS contributed personal time to Driving for Equity, a proposal aligned with the AMORE Project and a finalist at WHO\u2019s 2023 LEAD Innovation Challenge. JM declared that his hiring institutions received the following grants to support other work projects: Alliance for Health Policy and Systems Research (HQHSR1206660), Bloomberg Philanthropies (grant 46129, via University of North Carolina at Chapel Hill School of Public Health), FONDECYT via CIENCIACTIVA\/CONCYTEC, British Council, British Embassy and the Newton-Paulet Fund (223-2018, 224-2018), DFID\/MRC\/Wellcome Global Health Trials (MR\/M007405\/1), Fogarty International Center (R21TW009982, D71TW010877, R21TW011740), Grand Challenges Canada (0335-04), International Development Research Center Canada (IDRC 106887, 108167), Inter-American Institute for Global Change Research (IAI CRN3036), National Cancer Institute (1P20CA217231), National Heart, Lung and Blood Institute (HHSN268200900033C, 5U01HL114180, 1UM1HL134590), National Institute of Mental Health (1U19MH098780), Swiss National Science Foundation (40P740-160366), UKRI BBSRC (BB\/T009004\/1), UKRI EPSRC (EP\/V043102\/1), UKRI MRC (MR\/P008984\/1, MR\/P024408\/1, MR\/P02386X\/1), Wellcome (074833\/Z\/04\/Z, 093541\/Z\/10\/Z, 103994\/Z\/14\/Z, 107435\/Z\/15\/Z, 205177\/Z\/16\/Z, 214185\/Z\/18\/Z, 218743\/Z\/19\/Z) and the World Diabetes Foundation (WDF15-1224). He has also held a contract unrelated to this work with Health Action International. JM participated in these unpaid data safety and monitoring and advisory boards: DSMB, Nigeria Sodium Study (NaSS); Trial Steering Committee, INTEnsive care bundle with blood pressure Reduction in Acute Cerebral haemorrhage Trial (INTERACT 3); International Advisory Board, Latin American Brain Health institute (BrainLat), Universidad Adolfo Ib\u00e1\u00f1ez (Chile); Consultative Board, Programa de Gastronom\u00eda, Facultad de Estudios Interdisciplinarios, Pontificia Universidad Cat\u00f3lica del Per\u00fa; Advisory Board InterAmerican Heart Foundation (IAHF). JM participates in the following unpaid groups: Independent Group of Scientists (IGS), 2023 Global Sustainable Development Report, United Nations; Scientific Expert Committee, Global Data Collaborative for CV Population Health, World Health Federation, Microsoft, and Novartis Foundation; Scientific and Technical Advisory Committee for the Alliance for Health Policy and Systems Research, World Health Organization; WHO Technical Advisory Group on NCD-related Research and Innovation, Noncommunicable Diseases Department, World Health Organization; Advisory Scientific Committee, Instituto de Investigaci\u00f3n Nutricional (Peru). NJO received consulting fees from Cochrane Complementary Medicine, Vivli, and Cochrane. JHR has leadership roles unrelated to this area of study. She sits on the Canadian Medical Foundation and the Pegasus Institute boards. JHR is the co-director of the WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment for Health Equity at the Br\u00f9yere Institute of the University of Ottawa. All other authors have nothing to declare.The opinions conveyed in this article do not necessarily reflect the decisions or policies of the author\u2019s employers, including PAHO\/WHO. Any reproductions of this article must avoid implying endorsement by PAHO\/WHO or other employers for this research or any particular organisation, service, or product. This project was conducted within the context of the doctoral programme in Biomedical Research Methodology and Public Health at the Autonomous University of Barcelona.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"161"}}