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Neighbourhood effects on obesity: scoping review of time-varying outcomes and exposures in longitudinal designs.

Planning and Development Research Center, Université Laval, Quebec city, Québec, Canada. Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Quebec city, Québec, Canada. School of Nutrition, Université Laval, Quebec city, Québec, Canada. Quebec Heart and Lung Institute Research Centre, Université Laval, Quebec city, Québec, Canada. Departement of Surgery, Université Laval, Quebec city, Québec, Canada. Department of Civil, Geological and Mining Engineering, Polytechnique Montreal, Montreal, Québec, Canada. Planning and Development Research Center, Université Laval, Quebec city, Québec, Canada alexandre.lebel@criucpq.ulaval.ca.

BMJ open. 2020;(3):e034690
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Abstract

CONTEXT AND OBJECTIVES Neighbourhood effect research on obesity took off in the early 2000s and was composed of mostly cross-sectional observational studies interested in various characteristics of the built environment and the socioeconomic environment. To limit biases related to self-selection and life course exposures, many researchers apply longitudinal designs in their studies. Until now, no review has specifically and exclusively examined longitudinal studies and the specific designs of these studies. In this review, we intend to answer the following research question: how are the temporal measurements of contextual exposure and obesity outcomes integrated into longitudinal studies that explore how neighbourhood-level built and socioeconomic environments impact adult obesity? DESIGN A systematic search strategy was designed to address the research question. The search was performed in Embase, Web of Science and PubMed, targeting scientific papers published before 1 January 2018. The eligible studies reported results on adults, included exposure that was limited to neighbourhood characteristics at the submunicipal level, included an outcome limited to obesity proxies, and reported a design with at least two exposure measurements or two outcome measurements. RESULTS This scoping review identified 66 studies that fit the eligibility criteria. A wide variety of neighbourhood characteristics were also measured, making it difficult to draw general conclusions about associations between neighbourhood exposure and obesity. We applied a typology that classified studies by whether exposure and outcome were measured as varying or fixed. Using this typology, we found that 32 studies reported both neighbourhood exposure and obesity outcomes that were varying in time; 28 reported varying outcomes but fixed exposures; and 6 had fixed outcomes and varying exposures. CONCLUSION Our typology illustrates the variety of longitudinal designs that were used in the selected studies. In the light of our results, we make recommendations on how to better report longitudinal designs and facilitate comparisons between studies.