A quasi-experimental study evaluating a health promotion program targeting healthy nutrition, physical activity and social network enhancement for low-income multi-problem households: study protocol


  • Latifa Abidi Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, Netherlands
  • Gera E. Nagelhout Department of Health Promotion, Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, Netherlands; IVO Addiction Research Institute, Rotterdam, Netherlands
  • Renate Spruijt Stimenz, Apeldoorn, Netherlands
  • Hermijn Schutte Leger des Heils (Salvation Army), Apeldoorn, Netherlands
  • Hein de Vries Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, Netherlands




Multi-problem households, Physical activity, Healthy nutrition, Social network


Background: Previous studies have shown that people living in multi-problem households are less physically active, eat less healthy, have unstable social networks, and worse self-perceived general health than other people. The aim of this paper is to describe the development and evaluation of a health promotion program called “Back2Balance” for low-income multi-problem households aimed at improving healthy nutrition, physical activity, social networks, and self-perceived health.

Methods: The Back2Balance program was developed using input from two formative studies and a co-creation process together with the target group and social workers. We used the theoretical domains framework to identify the functional components of our program. The Back2Balance program consists of: 1) a walking group, 2) cooking workshops, 3) motivational talks, 4) discounts on existing health promotion programs, and 5) family trips and children’s activities. In a quasi-experimental study respondents in the intervention group receive the usual social services support for multi-problem households and have the possibility to enroll in the program. Respondents in the control group only receive usual social services support. The program will be evaluated among 272 respondents from low-income multi-problem households living in Apeldoorn, the Netherlands.

Conclusions: This protocol describes the development and evaluation of the Back2Balance program. We hypothesize that the program will lead to increased physical activity, healthy nutrition, social networks enhancement, and self-perceived health. The results of this study can be used as input for other national or international initiatives aiming to increase health of low-income multi-problem households.

Trial registration: NTR6512



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