Leveraging Neighborhood-Level Interventions to Improve Cardiovascular Health: A Scoping Review

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Abstract
Cardiovascular disease remains the leading cause of death globally. Neighborhood characteristics such as food environments, green space access, and housing conditions shape cardiovascular health by influencing environmental exposures, resource access, and chronic stress, with disproportionate impacts on socially vulnerable populations. This scoping review aims to identify and evaluate neighborhood-level interventions designed to promote cardiovascular health and determine which strategies are most effective in improving health outcomes. A comprehensive and reproducible search was conducted across PubMed, ScienceDirect, Web of Science, and OVID Medline for studies published between 2015 and 2025. Keywords related to neighborhood-level interventions and cardiovascular health were used to identify relevant articles. Neighborhood-level interventions were defined as strategies that modify the physical, social, or economic environment of geographically defined areas. Outcomes included cardiovascular health behaviors, cardiometabolic risk factors, and clinical cardiovascular outcomes. Twenty studies were included, including 15 randomized controlled trials and 5 quasi-experimental studies. Interventions targeted built environments, food retail environments, housing mobility, or employed multicomponent approaches that coupled environmental intervention with individual or community-level support. Overall, 55% of studies demonstrated beneficial cardiovascular outcomes, 20% showed mixed effects, and 25% showed null effects. Dietary behavior outcomes showed the greatest benefit (73%), followed by physical activity (63%), while cardiometabolic risk factors showed limited improvement. Interventions were particularly effective when they integrated environmental changes with support across multiple levels, including education, peer support, and community resources. Multicomponent interventions coupling neighborhood environmental modifications with either individual or community-level support show promise for improving cardiovascular health behaviors, particularly physical activity and diet in disadvantaged populations. Future work should prioritize long-term studies on interventions that integrate these elements to understand sustainability and measure cost-effectiveness to facilitate implementation of strategies and policy changes that sustain long-term health improvements.

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