Improving health related behavior in deprived neighborhoods

The core of this thesis describes the evaluation of the community intervention "Wijkgezondheidswerk", a community health behavior intervention program to improve health related behavior in deprived neighborhoods in the city of Eindhoven. Besides this evaluation study, we were able to investigate other important additional topics. The baseline data of the evaluation study were used to examine determinants ofhealth related behavior in deprived neighborhoods and also a systematic review of the literature was conducted. The community intervention "Wijkgezondheidswerk" is a joint project with a number of partners involved in either intervention implementation or intervention evaluation. The lead agency is the municipal health service of Eindhoven. Other main partners in Eindhoven are the municipal task force of social development, local grassroots organizations, and community social work organizations. Main partners involved in the evaluation component of the project are the Department ofSocial Sciences of the Wageningen University and the Department of Public Health of the Erasmus University Medical Center Rotterdam. The project was evaluated by means of a community intervention trial and has a quasi-experimental design. Beforehand, the municipal health services assigned the intervention to two neighborhoods and to have an evaluation design with concurrent control neighborhoods, three matched comparison neighborhoods* were selected prior to intervention implementation. A longitudinal sample survey and repeated cross sectional sample surveys were used to measure changes in key outcomes. In addition to the impact evaluation, the program was supported by participatory action research and a process evaluation. This combination of quantitative and qualitative methods should provide powerful evidence of effectiveness. Details on the design of process and impact evaluation are described in chapter 5 and 6 respectively. The participatory action research was conducted by the Wageningen University and not discussed in this thesis.

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