ACCEPTABILITY OF BUILT ENVIRONMENT INTERVENTIONS AIMED AT PROMOTING A HEALTHY DIET AND PHYSICAL ACTIVITY IN URBAN NEIGHBOURHOODS OF SASKATCHEWAN, CANADA

Abstract

Background: Physical activity and diet play a critical role in the primary and secondary prevention of several chronic diseases. In Saskatchewan, 35% of adults are reported to be obese, which is partly attributable to physical inactivity and an unhealthy diet. In addition, individuals living in urban areas are faced with an increased risk of an unhealthy lifestyle due to the structure of the built environment (BE). Regardless, attempts to transform BE have met with mixed results. An essential contributor to the heterogeneity found in the success of the BE interventions is ‘public acceptability’. However, current knowledge about the acceptability of diverse BE interventions is limited. Additionally, information on how individual and neighbourhood-level factors influence acceptability is lacking. Purpose: The purpose of this study was to estimate the current level of public acceptability of diverse built environment interventions varying in intrusiveness that support healthy eating and physical activity in Saskatoon and Regina and to identify individual and neighbourhood-level factors associated with the level of acceptability of diverse interventions. Method: This study used a subset of data from “THEPA” - Targeting Healthy Eating & Physical Activity: Citizens' perspectives, with linkage to respondents’ neighbourhood-level factors using data from the Canadian Urban Environmental Health Research Consortium (CANUE). A sample of 2133 respondents was analysed using multi-level logistic regression. Missing observations were treated by multiple imputation procedure. Outcome variables were ‘agreement’ to implement 12 and 26 BE interventions related to food and physical activity. Independent variables were individual and neighbourhood-level factors. Interventions were ordered according to the level of intrusiveness as per Nuffield’s intervention ladder. iii Results: Overall, individuals were more agreeable to implementing the least intrusive interventions in both the food and physical activity domain; even so, the public support differed by the type of intervention. In addition, the likelihood of support across different levels of the intervention varied by gender, immigration status, Indigenous status, employment, education, and neighbourhood ethnic concentration. Notably, women showed a higher likelihood of support for all levels of interventions. However, no strong relationship between neighbourhood-level attributes and acceptability was detected. Conclusion: Individual factors strongly influence public acceptability, and the degree of support varies for different levels of intrusion. This study provides previously lacking evidence on the acceptability of diverse BE interventions, the influence of intervention intrusion, and individual and neighbourhood attributes on acceptability. Further investigation, including the individuals’ lived experiences, is needed for better understanding of the variations observed.