Intersectoral interventions for people living with obesity: an environmental scan.

Background: Obesity is a major global health challenge rooted in genetic, behavioral, socioeconomic, and environmental factors. Although healthcare influences only twenty percent of health outcomes, most interventions still focus on weight rather than broader social determinants of health (SDH). Addressing obesity effectively requires intersectoral approaches that account for individuals’ life trajectories and bridge health, social, community, and policy domains; yet such collaboration remains limited.

 Launched in 2023 by a citizen partner and a clinical researcher, the COLLAB-INTER-360-Obesity participatory research aims to co-develop an intersectoral learning community uniting people living with obesity (PLWO) and stakeholders from health, community, political, civil society, and academic sectors to better respond to PLWO’s needs. Given limited evidence on how diverse actors engage in such initiatives, an environmental scan was undertaken as a preliminary step.

 

Approach: To identify and characterize intersectoral interventions targeting PLWO in community and primary care settings we conducted a peer-reviewed and grey literatures. Following Arksey and O’Malley’s framework, a comprehensive search was conducted across three academic databases and grey literature sources (May 2024-February 2025). Eligible records described intersectoral interventions developed since 2006 for adults in Commonwealth countries, in English or French. Peer-reviewed studies and grey literature were reviewed through a two-stage process using Covidence and a bilingual Excel template, respectively.

 

Duplicates were removed automatically, and discrepancies were resolved through team consensus. Data extraction followed an adapted conceptual framework based on SDH. Results were synthesized per PRISMA 2020 guidelines, with summary tables describing intervention characteristics. A bibliometric analysis using VOSviewer® refined the conceptual mapping.

 

Results: Twenty-three studies were included (twenty peer-reviewed, three grey literature), mainly from the United States and focused on lifestyle modification programs. Obesity was primarily defined using weight-based metrics with little consideration for SDH. None explicitly defined intersectorality. Collaborations mainly involved health, academic, community, and faith-based actors. Community health workers emerged as key connectors between clinical and social domains. Most interventions targeted minority populations. Outcome measures remained largely biomedical, with minimal integration of SDH indicators. Intersectoral interventions for PLWO remain poorly conceptualized. Implications: Advancing equity and person-centered care requires integrating SDH into evaluation frameworks, formalizing intersectoral governance, and reinforcing the role of community health workers. Findings of this scan will inform community such as COLLAB-INTER-360-Obesity learning community, in designing co-creation workshops that foster integrated, intersectoral approaches to obesity management, an area still underdeveloped within healthcare systems.