Building healthy communities with the dual goal of chronic disease prevention and promoting environmental sustainability

Background

Non communicable Diseases (NCDs), such as cardiovascular disease (CVD), begin in early life, progress slowly, and are often undetected until symptoms occur in adulthood. Childhood obesity is increasing globally, which increases CVD risk. NCDs are largely preventable, but develop from multiple complex pathways through non-modifiable and modifiable risk factors. Prevention requires a lifecourse approach. Here we propose to conduct a multilevel NCD risk factor prevention program co-designed, implemented, and evaluated in Kingston, Jamaica, and lower socioeconomic neighbourhoods in Hamilton and Calgary, Canada. We will co-design interventions that combine healthy active living (HAL) behaviours with sustainability practices to reduce the risks of obesity, hypertension and type 2 diabetes in youths and adults living in vulnerable communities, and the impact of food production on climate change.

Aims

Among high-risk communities in Kingston (Jamaica), and low-income new immigrant communities in Hamilton and Calgary (Canada), we will conduct a multiple methods study to characterize key contextual factors and use them to guide the implementation of a Sustainable Healthy Active Living (SHAL) intervention. The objectives of this research program are:

1. To co-design with youth, a program that increases knowledge and tools for action to increase opportunities for sustainable practices (i.e., land stewardship, recycling) and healthy active living (i.e., including production and consumption of local fruits and vegetables, decreasing UPF consumption) that can be delivered in schools, places of worship and through community groups and clubs (4-H, Rotary);

2. To create and assess the impact of a policy roundtable in each community, focused on reducing barriers to SHAL implementation, and ensuring program longevity. We will assess which policy changes are most likely to contribute to sustained SHAL over time.

3. To assess the impact of the SHAL intervention, we will assess how knowledge, attitudes, and practices (K-A-P); and selected NCD risk factors in youth and adults, change over a 3-year period using a before and after design, and compare this to a matched control neighbourhood.

Project plan

Multilevel interventions that incorporate individual, environmental, and policy components will be co-designed, implemented, and evaluated with measurements tailored to their settings, goals, and purpose. We will use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to implement and evaluate the intervention, implemented as a before-and-after study.

The proposed research programme will co-design and evaluate the implementation of an approach to SHAL that addresses individual, community, and policy levels, and considers environmental impact. Engaging with local interested parties and community members early will ensure that the program is contextually relevant, and highly likely to succeed.

Publications and output

To access publications and other outputs relating to this project, see our publications webpage.

Funding organisations

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