Patient Access, Utilization, and Perceptions of Neighborhood and Built Environment Resources

Obes Surg. 2022 Feb;32(2):416-427. doi: 10.1007/s11695-021-05788-x. Epub 2021 Nov 16.


Purpose: There is a critical need to explore bariatric patients' perceptions of existing neighborhood and built environment resources and supports to assist with postoperative behavior change and weight loss maintenance. The objective of this study was to survey postoperative patients to determine neighborhood food retail, fitness facility, and options for outdoor activity access, utilization, satisfaction, and perceptions of resources.

Materials and methods: A convenience sample of postoperative patients from a single academic surgical center in the USA (N = 44) completed an online survey about access, utilization, satisfaction, and safety for food retail, fitness facility, and outdoor activity options in their neighborhoods. Analysis included descriptives (frequency, percent, Chi-square), and independent samples t tests and ANOVA determined differences based on race, insurance status, geographic location, and receipt of governmental assistance programs. Open-ended questions were analyzed using summative content analysis.

Results: Patients reported the highest access to lower-cost national food retailers and fitness facilities. The most prevalent challenge in finding food products to meet patients' goals was financial (39%). Patients' top suggestions for fitness facilities included training staff/facilities (59%) and trainers (35%) in postoperative patient care and exercise. The highest access for outdoor activity options was for walking/running trails, city/metro parks, and sidewalks. Significant differences in access, utilization, and safety were found based on geographic location, receipt of at least one assistant program, and race.

Conclusion: The development of targeted resources may benefit patients in non-suburban areas and who receive governmental assistant programs to increase safety of outdoor options and access to lower-cost food retailers and to increase utilization of lower-cost fitness facilities.

Keywords: Bariatric surgery; Build environment; Neighborhood; Resources; Social determinants of health; Support.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Built Environment
  • Environment Design*
  • Humans
  • Obesity, Morbid* / surgery
  • Residence Characteristics
  • Walking