The CIVISANO protocol: a mixed-method study about the role of objective and perceived environmental factors on physical activity and eating behavior among socioeconomically disadvantaged adults

Abstract

Background Overweight and obesity have a strong socioeconomic profile. Unhealthy behaviors like insufficient physical activity and an unbalanced diet, which are causal factors of overweight and obesity, tend to be more pronounced in socioeconomically disadvantaged groups in high income countries. The CIVISANO project aims to identify objective and perceived environmental factors among different socioeconomic population groups that impede or facilitate physical activity and healthy eating behavior in the local context of two peri-urban Flemish municipalities in Belgium. We also aim to identify and discuss possible local interventions and evaluate the participatory processes of the project. Methods This study (2020–2023) will use community-based participatory tools, involving collaborative partnerships with civic and stakeholder members of the community and regular exchanges among all partners to bridge knowledge development and health promotion for socioeconomically disadvantaged citizens. Furthermore, a mixed-methods approach will be used. A population survey and geographic analysis will explore potential associations between the physical activity and eating behaviors of socioeconomically disadvantaged adults (25–65 years old) and both their perceived and objective physical, food and social environments. Profound perceptive context information will be gathered from socioeconomically disadvantaged adults by using participatory methods like photovoice, walk-along, individual map creation and group model building. An evaluation of the participatory process will be conducted simultaneously. Discussion The CIVISANO project will identify factors in the local environment that might provoke inequities in adopting a healthy lifestyle. The combination of perceived and objective measures using validated strategies will provide a robust assessment of the municipality environment. Through this analysis, the project will investigate to what extent community engagement can be a useful strategy to reduce health inequities. The strong knowledge exchange and capacity-building in a local setting is expected to contribute to our understanding of how to maximize research impact in this field and generate evidence about potential linkages between a health enhancing lifestyle among socioeconomically disadvantaged groups and their physical, food and social environments.

Associations between the objective and perceived food environment and eating behavior in relation to socioeconomic status among adults in peri-urban settings: results from the CIVISANO study in Flanders, Belgium

“…Thus, for the HSES group, a higher density of unhealthy food outlets were associated with a lower consumption frequency of SSBs. This contrasts with prior studies, possibly due to differences in supermarket inclusion and also since SSBs are reportedly most often bought at convenience stores; this type of food outlet is scarce in peri-urban settings [ 40 ].…”

“…In this cross-sectional study, data from respondents in the CIVISANO project was used, a mixed-methods study investigating the role of objective and perceived environmental factors on physical activity and eating behavior among adults residing in two medium-sized peri-urban municipalities, Duffel and Herselt, in Flanders, Belgium [ 40 ]. The study was approved by the Medical Ethics Committee of Ghent University Hospital (BC-248 09260) and conducted in accordance with the recommendations of the Belgian Data Protection Authority.…”

“…To increase accessibility, the questionnaire was read and redacted by Wablieft, a Flemish organization that advocates the accessibility and comprehensibility of the Dutch language for underserved groups [ 45 ]. Full details on the questionnaire and CIVISANO project can be found elsewhere [ 40 ].…”

The role of the perceived environment for recreational walking among adults in socioeconomically disadvantaged situations: A study using walk-along interviews

“…This study is part of the CIVISANO-project, a research project using mixed-methods to investigate the role of objective and perceived environmental factors in PA and eating behaviors among PSEDS in two peri-urban municipalities in Belgium. A detailed description of the complete study protocol can be found elsewhere ( D’Hooghe et al, 2022 ).…”

Associations between the external and personal food environment and eating behavior in relation to socioeconomic status in peri-urban settings: Results from the CIVISANO study in Flanders, Belgium

“…Additionally, other recruitment strategies were also employed such as posting QR-codes to ll in the questionnaire in traditional (local) media and social media and making the questionnaire available in local places such as libraries and medical o ces. Full study details are available elsewhere (25). This recruitment strategy resulted in a study sample of 498 respondents.…”