In the heart of Quito, Ecuador, a groundbreaking approach to public health is taking shape, redefining how communities tackle the dual challenges of physical inactivity and poor nutrition. Researchers Morales-Garzón, Chilet-Rosell, Hernández-Enríquez, and their collaborators have embarked on an ambitious project that elevates the voices and active engagement of residents in a low-income neighborhood, aiming to co-create sustainable initiatives centered on physical activity and healthy eating. Their work, published in Global Health Research and Policy, exemplifies a paradigm shift from top-down health interventions to participatory models that foster community ownership and resilience.
Physical inactivity and unhealthy diets are deeply entrenched global health issues contributing significantly to the burden of non-communicable diseases such as diabetes, cardiovascular illnesses, and obesity. These challenges are exacerbated in socioeconomically disadvantaged communities where access to safe spaces for exercise and affordable nutritious food is limited. Recognizing these structural barriers, the researchers set out to collaborate meaningfully with community members in Quito, where poverty intersects with urban life complexities, crafting solutions grounded in local realities and aspirations.
The methodology hinged on participatory action research, a framework that values the knowledge and lived experiences of the community as essential data sources. Over several months, the research team engaged in extensive dialogues, workshops, and focus groups with a diverse cross-section of residents — including youth, elders, local vendors, and health workers. These engagements were designed to unearth the specific obstacles faced, the existing informal physical and dietary practices, and the community’s envisioned improvements.
From a technical standpoint, the researchers employed mixed qualitative methods, incorporating ethnographic observations, thematic content analysis of discussions, and participatory mapping of local resources and deficits. This comprehensive data gathering allowed the team to identify not only the physical and logistical barriers — such as lack of safe walking paths or food deserts — but also social and psychological factors like cultural food preferences and motivations for activity. By intertwining these complex layers of information, the project captured a holistic picture of community health dynamics.
One of the pivotal discoveries was the community’s existing informal networks that already promoted physical activity and healthy eating. For example, local caregivers often organized ad hoc walking groups, and certain food vendors offered healthier options aligned with indigenous culinary traditions. These organic practices became foundational pillars for the co-creation process. By validating and integrating such grassroots efforts, the initiative fostered a sense of pride and self-efficacy among participants, reinforcing that health is not merely a personal responsibility but a collective endeavor.
Leveraging these insights, the co-created interventions took shape in several innovative formats. Safety-focused street redesigns emerged as a priority, with residents proposing enhanced lighting and traffic calming measures to encourage outdoor activities. Nutritional workshops were tailored around local foods, emphasizing affordable, culturally relevant recipes that could be prepared with minimal resources. Importantly, the residents drove the scheduling, locations, and communication strategies for these programs, ensuring accessibility and sustained participation.
The initiative also introduced technology-assisted monitoring tools, such as mobile apps co-designed for tracking physical activity and dietary habits, complete with culturally adapted motivational messages. Integrating technology in a low-income setting posed unique challenges, including intermittent internet access and limited smartphone ownership. To counter these hurdles, the program included digital literacy sessions and community-shared devices, illustrating the feasibility of tech integration without exacerbating inequalities.
This co-creative framework exemplifies an emerging trend in global health where the voices of marginalized populations are not only heard but become architects of their own solutions. It challenges traditional paradigms where external experts dictate interventions with limited local applicability. Instead, it promotes a collaborative model that harnesses community strengths and social capital, thereby fostering more effective and durable health outcomes.
Moreover, the Quito project offers vital lessons for urban planners and policymakers about the nexus between environment, policy, and health behavior. It underscores that infrastructural improvements must be intertwined with community engagement to yield meaningful change. This approach encourages policymakers to move beyond generic public health advisories, toward localized, context-specific strategies that resonate with community identities and practical constraints.
Another technical nuance uncovered relates to measuring success. Traditional health metrics often focus on biomedical indicators, but this research emphasizes process-oriented markers such as community cohesion, empowerment, and participatory governance. The researchers argue that these dimensions are critical precursors to sustainable health improvements, especially in settings marked by socioeconomic vulnerability.
The findings also suggest a cost-effective route to enhancing public health. By mobilizing existing community resources and social networks, the interventions require fewer material inputs and are thus more scalable in financially constrained environments. This aspect holds profound implications for global health initiatives, particularly in low- and middle-income countries facing multiple competing priorities.
Underlying all these elements is a recognition that health behavior change is a complex, multifactorial phenomenon. The Quito initiative reveals that addressing it requires moving beyond simplistic models of information dissemination toward multifaceted strategies incorporating social support, environmental modifications, and cultural resonance. This holistic approach aligns with contemporary theories in health psychology and behavioral economics, which highlight the interplay between individual agency and structural determinants.
Importantly, the project’s successes have already ignited enthusiasm beyond the initial neighborhood, sparking interest in replicating similar co-creative health initiatives in other urban contexts across Latin America. Such scaling could foster knowledge exchange networks and transnational collaborations, amplifying the impact of participatory health promotion.
In conclusion, the work by Morales-Garzón and colleagues stands as a pioneering example of how community-driven health interventions can be methodically designed and implemented in low-income urban settings. Through a blend of rigorous research, innovative participatory methods, and sensitivity to local contexts, they demonstrate a viable pathway towards alleviating some of the most pressing public health challenges of our time. Their research not only enriches the academic discourse but also offers tangible models for policymakers, public health practitioners, and communities worldwide committed to health equity and empowerment.
Subject of Research: Community-based participatory approaches to promoting physical activity and healthy eating in low-income urban neighborhoods.
Article Title: Co-creating community initiatives on physical activity and healthy eating in a low-income neighbourhood in Quito, Ecuador.
Article References:
Morales-Garzón, S., Chilet-Rosell, E., Hernández-Enríquez, M. et al. Co-creating community initiatives on physical activity and healthy eating in a low-income neighbourhood in Quito, Ecuador. Glob Health Res Policy 10, 18 (2025). https://doi.org/10.1186/s41256-025-00412-2
Image Credits: AI Generated
