Sense of community-belonging and health-behaviour change in Canada.
BACKGROUND
Research indicates that primary prevention targeting individual behaviours should incorporate contextual factors. The objectives of this study are to examine the role of community-belonging and contextual factors on health-behaviour change in Canada, and whether the influence of community-belonging on behaviour change varies by specific types of behaviours and contextual factors.


METHODS
Data on individual-level community-belonging, socio-demographics and self-rated health were obtained for 119 693 respondents from the 2007/2008 Canadian Community Health Survey located within 100 health regions across Canada. Contextual factors were based on health-region groupings of socio-economic determinants of health. Multilevel models were used to estimate the influence of community-belonging and health-region contextual factors on general, and specific, health-behaviour changes in the past year.


RESULTS
After controlling for individual and contextual factors, community-belonging showed a positive dose-response relationship with health-behaviour change. Health-region contextual factors were only slightly associated with behaviour change; however, the influence of community-belonging on behaviour change showed significant variability based on health-region contextual factors. The influence of community-belonging also varied by specific health-behaviour changes, but for most prominent health behaviours (exercise, weight loss and improved diet) the effect was consistent.


CONCLUSIONS
Community-belonging was strongly related to health-behaviour change in Canada and may be an important component of population health prevention strategies. Efforts to increase community-belonging, however, need to be considered along with contextual factors.
Hystad
Perry
P
School of Population and Public Health, University of British Columbia, James Mather Building, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3 Canada. phystad@gmail.com
Carpiano
Richard M
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002170:Canada; D002391:Catchment Area, Health; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010379:Peer Group; D011594:Psychometrics; D012111:Residence Characteristics; D012931:Social Environment; D012933:Social Identification; D012944:Social Support; D012959:Socioeconomic Factors