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Sense of community-belonging and health-behaviour change in Canada
  1. Perry Hystad1,
  2. Richard M Carpiano2
  1. 1School of Population and Public Health, University of British Columbia, Vancouver, Canada
  2. 2Department of Sociology, University of British Columbia, Vancouver, Canada
  1. Correspondence to Perry Hystad, School of Population and Public Health, University of British Columbia, James Mather Building, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3 Canada; phystad{at}


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.

  • Health-behaviour change
  • community-belonging
  • contextual factors
  • social capital
  • primary prevention
  • health behaviour
  • multilevel modelling

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  • Funding PH acknowledges funding from a Canadian Institute for Health Research Frederick Banting and Charles Best Canada Graduate Scholarship, a Michael Smith Senior Research Trainee Award and a Bridge Fellowship. RMC acknowledges funding from an Investigator Award from the Michael Smith Foundation for Health Research.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.