Obesity prevention and the built environment: examining opportunities and barriers in four Alberta communities

(Présentement, le texte de cette page est disponible seulement en anglais)


Principal Investigator: Nykiforuk, Candace I. J. (University of Alberta)

Co-Investigators: Raine, Kim (University of Alberta); Schopflocher, Don (Alberta Health and Wellness); Vallianatos, Helen (University of Alberta).

This project is funded by the Heart and Stroke Foundation of Canada (HSFC) and the Canadian Institutes of Health Research (CIHR).
Project web site: Community Environment

1. The research question 

Obesity is a major risk factor for chronic diseases such as type 2 diabetes, cancer, and cardiovascular disease - all of which are important public health concerns in Canada. While many of the risk factors for these chronic diseases can be addressed by changes in lifestyle (physical activity, healthy eating), the environment - and what is available (or not) in it - shapes the lifestyle choices people make. What is missing from the scientific work on chronic disease and obesity prevention is an organized look at how people view health opportunities in the built environment, how they access these opportunities, and what aspects of the environment prevent them from accessing "healthy" choices. This "look" needs to consider the whole community in addition to specific programs aimed at lifestyle factors. A study of the connections between health status, programs, services, and opportunities (or barriers) in the built environment is needed, particularly at the community level. This community approach will provide valuable insights for research, health program and service delivery, and local decision-making. Further, understanding change in a community environment over time is important to show how opportunities in the environment and programs to improve access to those opportunities can be linked to changes in risk factors for chronic diseases. The proposed project will address this gap.

2. The objectives

Our purpose is to understand how people access the opportunities for physical activity and healthy eating in the built environment of their community. The intent of this work is to identify how different aspects of a place can help or hinder efforts to improve healthy choices. 
In a way that is meaningful to the communities as well as to health promotion science, we will address three objectives:
1) to identify factors in the environment that are important for developing interventions to help improve access to healthy choices and prevent chronic disease;
2) to explore the linkages between each community's health behaviours and risk factors relative to opportunities and barriers for healthy choices in the built environment;
3) to understand if and how interventions to improve access to healthy choices lead to changes in the built environment of communities.
Our goal is to help understand how obesity is related to a community environment, and how the environment can be changed to reduce obesity and chronic disease.

3. The approach

Our team will study how the built environment influences how people perceive and access physical activity and healthy eating choices. To do this, we will talk to people to better understand the opportunities and barriers for healthy choices in their community. This approach involves four related steps:
1) Collect detailed information about what is or is not available in the community for physical activity and healthy eating;
2) Analyze the data and information on health risk factors of the people living in the community to understand if and how the built environment is related to health;
3) Show how the community information is related to health by using maps and a community report;
4) Share this information with the community in a series of focus groups to better understand the "real-life" situation of each community. 
We have partnered with community organizations and local governments to form a Community Advisory Group. This partnership will help us in collecting and providing information that will be useful to the communities and science.

4. The unique factors

1) "Whole community" approach.
We will examine the social and physical aspects of the built environment in a "whole community" approach, rather than focusing on one part of the picture. This will help health program providers and decision makers use the information in a way that accounts for the bigger picture in the community.
2) Using mapping and traditional research methods to understand opportunities and barriers to healthy choices.
We will share the information with community stakeholders along the way to better understand how this information fits with their "real-life" experiences in the community. This will help us refine our maps and other research information so that it truly reflects each of the communities involved. It will also help us draw lessons from these communities that may be helpful to other communities in dealing with obesity. 
3) Meaningful partnership with local politicians, municipal staff, health and economic community organizations from the start of the project.

5. How the project is relevant to the objectives of the initiative

Our project addresses three objectives of the initiative: (1) social, economic, and policy environment; (2) socio-economic status, gender, ethnicity and age; and (3) policies/standards for community planning, design and implementation. The project also addresses population health at the community level through community planning and local policy development, a priority area of one of the funding partners, CIHR Institute of Population and Public Health.
The "whole community" approach will include all aspects of the environment - physical, social, cultural, economic and political - in data collection and interventions. Also, in order to understand how people access healthy choices, we will need to account for the differences in age, gender, health, ethnicity, and socio-economic status. We will do this by linking our community information with health information from the Healthy Alberta Communities project and census information from Statistics Canada. Finally, decision makers will use the information to improve access to parks and stores through community planning and zoning.