title: Environmental interventions in low-SES neighbourhoods to promote healthy behaviour: enhancing and impeding factors.
abstract: BACKGROUND
  Social and physical environments are important drivers of socioeconomic inequalities in health behaviour. Although many interventions aiming to improve such environments are being implemented in underprivileged neighbourhoods, implementation processes are rarely studied. Acquiring insight into successful implementation may improve future interventions. The present study aimed to investigate factors influencing the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of social and physical environmental interventions aimed at promoting healthy behaviour in underprivileged neighbourhoods in The Netherlands.
  
  
  METHODS
  A large set of theory-based factors of successful implementation was assessed for 18 implemented interventions in three underprivileged neighbourhoods. Expert and target group panels scored the RE-AIM dimensions for each intervention. We analyzed the statistical significance of associations between theory-based factors and the actual RE-AIM in a statistical model, to identify factors associated with increased RE-AIM.
  
  
  RESULTS
  Six factors were identified: effectiveness and implementation success were higher when the target group was involved in the planning process, whereas maintenance increased in the absence of competition with other projects. If the current situation was inventoried during intervention development, the effectiveness, adoption and implementation were higher. These dimensions were also higher when the target group was informed before implementation. Involvement of the target group during implementation resulted in higher reach, effectiveness and adoption. Finally, lack of intervention staff worsened the reach.
  
  
  CONCLUSIONS
  This study contributes to the evidence base for effective implementation of environmental measures aimed at promoting healthy behaviours. In particular, interventions in which the target group was involved in the implementation process were associated with higher RE-AIM outcomes.
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands j.lakerveld@vumc.nl.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Lakerveld
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Lianne
authors.initials: L
authors.lastname: Verstrate
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Bot
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Anja
authors.initials: A
authors.lastname: Kroon
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands2 The National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, Bilthoven, The Netherlands.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Baan
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Aaltje P D
authors.initials: AP
authors.lastname: Jansen
authors.affiliation: 3 Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Mariel
authors.initials: M
authors.lastname: Droomers
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Tineke
authors.initials: T
authors.lastname: Abma
authors.affiliation: 3 Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.affiliation: 1 Department of General Practice and Elderly Care Medicine, The EMGO Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, Amsterdam, The Netherlands.
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
mesh_terms: D004779:Environment Design; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D011203:Poverty; D012923:Social Class; D011795:Surveys and Questionnaires