Study protocol: evaluation of a community health promotion program in a socioeconomically deprived city district in the Netherlands using mixed methods and guided by action research

Abstract

BackgroundVoorstad on the Move (VoM) is a community health promotion program implemented in a socioeconomically deprived city district in the Netherlands. Based on exploration of the health situation, concurrent views on health promotion, and insights from literature, VoM is grounded in a social-ecological perspective and puts three action principles center core: citizens’ participation, intersectoral collaboration, and a health supportive environment. VoM aims to improve the health of inhabitants, mostly low socioeconomic status (SES) families, and to realize changes in the social and physical environment. This current research, as part of the wider VoM project, aims to study the impacts and action principles of VoM. The main research questions concern the inhabitants’ perceptions on health and health supportive environments, the perceived benefits of citizen participation in terms of health literacy and empowerment, and the factors and mechanisms that contribute to citizen participation and intersectoral collaboration.MethodsThe study has a mixed methods design, including process evaluation and monitoring, and combines qualitative and quantitative data. Research activities include literature study, in-depth interviews, focus group discussions, concept and capacity mapping, document analysis, and health survey data. A prominent strategy is action research, which aims to involve all stakeholders, capturing the different perspectives of citizens and professionals, and engaging low SES groups. The principle of triangulation is continuously applied to optimize the reliability of this study, using multiple methods and multiple sources. Internal validity is enhanced by triangulation of methods and resources. Other verification techniques will also be used, such as expert consultation.DiscussionThe design of the study, with a strong focus on action research, facilitates the involvement of all stakeholders and contributes to the development of capacities, learning, and empowerment, and thus contributes to health. The VoM program is innovative because it adopts an open approach in which activities evolve from citizens’ needs, with a focus on action elements. This study will unravel the mechanisms of the action elements at community level, thereby helping to find ways to reduce health inequities. The findings will further elucidate what works and why it works for low SES groups.

Tobacco-Free Duo Adult-Child Contract for Prevention of Tobacco Use Among Adolescents and Parents: Protocol for a Mixed-Design Evaluation

“…The protocol has several strengths, compared to similar studies. First, it aligns with the current increasing consensus on the importance of mixed methods [ 32 ] and of triangulation approaches in accruing robust evidence in the evaluation of interventions [ 33 - 35 ]. Two aspects of community trials call for triangulation approaches.…”

Tobacco-Free Duo Adult-Child Contract for Prevention of Tobacco Use Among Adolescents and Parents: Protocol for a Mixed-Design Evaluation (Preprint)

“…The protocol has several strengths, compared to similar studies. First, it aligns with the current increasing consensus on the importance of mixed methods [32] and of triangulation approaches in accruing robust evidence in the evaluation of interventions [33][34][35]. Two aspects of community trials call for triangulation approaches.…”

“We Don’t Assume That Everyone Has the Same Idea About Health, Do We?” Explorative Study of Citizens’ Perceptions of Health and Participation to Improve Their Health in a Low Socioeconomic City District

“…This study is part of a larger study in which a community health promotion program—called Voorstad on the Move (VoM)—was developed, facilitated, and evaluated [ 1 ]. In line with national and local health policy [ 38 ], the aim of the program was to contribute to the improvement of health and to find ways to reduce health inequities [ 1 , 39 ]. VoM was implemented between July 2016 and January 2020 in a city district of 10,750 inhabitants in a town in the east of the Netherlands.…”

“…In this study, the health perceptions of citizens in a socioeconomically deprived city district in the Netherlands were explored and subsequently used to develop a community health promotion program that aimed to reduce health disadvantages [ 1 ]. Socioeconomic health inequities persist in the Netherlands, with a 7-year difference in life expectancy between people with low and high socioeconomic status (SES), and an approximate 18-year difference in years lived in good perceived health [ 2 ].…”