Social and physical environmental interventions in low socio-economic neighbourhoods to promote healthy behaviours: determinants of implementation and use
Keywords:Health behaviour, implementation, lifestyle behavioural change, low socio-economic status, social environment, physical environment
AbstractRationale, aims and objectives: Lifestyle dependent risk factors are associated with increased risk of chronic diseases such as type 2 diabetes and cardiovascular diseases. These risk factors are more prevalent in lower socioeconomic groups and are likely to be driven by social and physical environmental factors. To promote healthy lifestyle behaviours, a range of environmental interventions are being implemented in the Netherlands and beyond. It is, however, unknown which strategies, barriers and facilitating factors are associated with successful implementation and use of these interventions. This paper describes the rationale, design and protocol of a project set out to determine success and failure factors for implementation and use of social and physical environmental interventions aiming to improve physical activity and healthy eating in residents of deprived neighbourhoods. Its findings will be of relevance to the development of person-centered care frameworks.Method: 18 implemented environmental interventions in 3 of the 40 most deprived neighbourhoods in the Netherlands will be selected. For these 18 interventions we will assess potential determinants of successful implementation and use, as defined in an extensive implementation model. In addition, expert and target-group panels will judge the intervention’s reach, effectiveness, adoption, implementation and maintenance (RE-AIM). Linking the determinants of the implementation model with the opinions of the expert and target-group panels may identify success and failure factors for implementation and use of those interventions.Discussion: This study will contribute to the evidence base for the effective implementation of environmental interventions in low socio-economic neighbourhoods. Obtaining more insight into how interventions can be successfully implemented and used may support researchers and policymakers in the development and implementation of future environmental interventions.
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