Social and physical environmental interventions in low socio-economic neighbourhoods to promote healthy behaviours: determinants of implementation and use

Main Article Content

Jeroen Lakerveld
Lianne Verstrate Lianne Verstrate
Caroline Baan
Johannes Brug
Danielle Jansen
Mariel Droomers
Tineke Abma
Karien Stronks
Giel Nijpels


Rationale, 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.

Article Details

Health Promotion


Mackenbach, J. P. & Howden-Chapman, P. (2003). New perspectives on socioeconomic inequalities in health. Perspectives in Biology and Medicine 46 (3) 428-444.

Hoeymans, N., Melse, J. M. & Schoemaker, C. G. (2010). Gezondheid en determinanten. Deelrapport van de VTV 2010: Van gezond naar beter. RIVM, (270061006).

Choiniere, R., Lafontaine, P. & Edwards, A. C. (2000). Distribution of cardiovascular disease risk factors by socioeconomic status among Canadian adults. Canadian Medical Association Journal 162 (Supplement 9) S13-S24.

Giskes, K., Avendano, M., Brug, J. & Kunst, A. E. (2009). A systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight/obesity conducted among European adults. Obesity Reviews 11 (6) 413-429.

Kamphuis, C. B., van Lenthe, F. J., Giskes, K., Huisman, M., Brug, J. & Mackenbach, J. P. (2009). Socioeconomic differences in lack of recreational walking among older adults: the role of neighbourhood and individual factors. International Journal of Behavioral Nutrition and Physical Activity 6, 1.

Lovasi, G. S., Hutson, M. A., Guerra, M. & Neckerman K. M. (2009). Built environments and obesity in disadvantaged populations. Epidemiologic Reviews 31, 7-20.

Patton, M.Q. (2002). Qualitative research and evaluation methods. 3rd edition. California: Sage Publications, Inc.

Grol, R. & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients' care. Lancet 362 (9391) 1225-1230.

Dzewaltowski, D. A., Glasgow, R. E., Klesges, L. M., Estabrooks, P. A. & Brock E. (2004). RE-AIM: evidence-based standards and a Web resource to improve translation of research into practice. Annals of Behavioral Medicine 28 (2) 75-80.

Judge, K. & Bauld, L. (2006). Learning from policy failure? Health action zones in England. European Journal of Public Health 16 (4) 341-343.

van Oers, H. & Verkleij, H. (2008) Sterke wijken, gezonde wijken. Tijdschrift voor Gezondheidswetenschappen 85 (7) 357.

Verweij, A., van der Lucht, F. & Droomers, M. (2008). Health in forty deprived neighbourhoods [Gezondheid in veertig Krachtwijken]. RIVM report, nr. 270951001.