Understanding healthy eating and physical activity community-centred behaviour change interventions for underserved populations: A mixed methods rapid review

Purpose: Community behaviour change interventions are a promising strategy for addressing unhealthy eating and physical activity behaviours in underserved populations. This review explores these interventions' characteristics by focusing on behaviour change techniques, evaluates their behaviour change effectiveness and examines participant experiences. Methods: A mixed-methods rapid review was conducted. Five databases and the grey literature were searched and supplemented by hand searching. Results were screened, assessed for methodological quality and data extracted using the Behaviour Change Techniques Ontology. A convergent segregated approach was used to synthesize the results. Results: Twenty-one studies were included. Commonly used behaviour change techniques were social support, guidance on how to perform the behaviour and monitoring. Intervention effects on healthy eating and physical activity behaviour change were small, but outcomes that measured influences on behaviour change (e.g., social support) improved. Participants reported largely positive experiences, mostly attributed to the intervention's tailoring to the target population's contexts and the engagement and expertise of those who delivered the intervention. Conclusions: Evidence of direct behaviour change remains limited; there is stronger evidence for improvements in factors that influence behaviour change. Qualitative evidence highlights the value of tailoring interventions to participants' lives and using relatable, knowledgeable sources for delivery. This could enhance engagement and contribute to improved outcomes over time. Further research is needed on how contextual tailoring is implemented and how the characteristics of those delivering interventions influence effectiveness and experience. Findings support the potential of community-centred approaches, but long-term evaluations in underserved contexts are needed.