Concept mapping of diet and physical activity: uncovering local stakeholders perception in the Quebec City region

Overweight and obesity are major public health concerns that are neither evenly distributed among the population nor between regions. Many studies suggest that beyond individual characteristics, the place where one lives influences lifestyle choices that underpin overweight and obesity. We observed such a situation in the province of Quebec (Canada), and because data availability from surveys was limited to a local level, the observed overweight disparities between local communities could not be entirely explained. Aiming to uncover local factors not captured by national survey data sets and in order to aid local level intervention, we investigated how the overweight problem was perceived by stakeholders through a concept mapping methodology. Concept mapping is a mixed method that relies upon stakeholders' perception as well as statistical techniques to draw a synthesis of the problem in the form of a conceptual map. A total of 45 stakeholders working in four areas with contrasting overweight prevalence in the Quebec City region were involved in the process. The map enables a global understanding of stakeholders' perception. This perception is not necessarily in line with public health knowledge however. For example, key concepts on the map suggest that physical activity is perceived to be much more important than diet with regards to population overweight and that urban design elements seem to be of low concern. Concept mapping is an innovative tool for planning and evaluation and can help stakeholders to develop adapted interventions to promote healthy lifestyle. It also provides relevant information to enhance the comprehension of local health disparities with a geographical perspective where data availability is limited.