Stakeholder Engagement Strategies for Policy and Programmatic Uptake: Lessons from the Drivers of Food Choice Competitive Grants Program

Objectives

This study drew upon experiences of stakeholder engagement in food choice research to advance knowledge about best practices.

Methods

The Drivers of Food Choice Competitive Grants Program aimed to understand food choice in low- and middle-income-countries. All funded proposals included stakeholder engagement strategies. Data were from document review of proposals and reports and semi-structured interviews with the principal investigators of the 15 projects. Interviews were transcribed and uploaded into NVIVO 12. The lead author analyzed interviews thematically using an a priori code list and led discussion of themes and patterns through peer review with co-authors.

Results

Grantees developed and implemented a range of strategies. “Uni-directional” strategies were researcher-driven and informational, did not seek input from the target stakeholder, and included one-way communication such as emails, newsletters, meetings, press releases, technical briefs, newspaper articles, and public engagement efforts. “Bi-directional” strategies sought collaboration with stakeholders. Examples were workshops which sought feedback on stakeholder identification, research questions, methods, results, and recommendations. Grantees used unidirectional strategies to increase buy-in and generate demand for results, which helped promote the use of evidence for decision-making. Bi-directional strategies were integral to knowledge production. Grantees thought that bi-directional engagement enhanced the immediate applicability of the research. Grantees developed more- and less-intensive strategies that involved both bi-and uni-directional engagement, depending on goals for uptake.

Conclusions

This research sheds light on the role of stakeholder engagement strategies in advancing multisectoral nutrition. The current landscape of research and practice is fast-paced and complex; ensuring relevance of research via diverse stakeholder engagement strategies should remain a priority for researchers and funders. Our findings may aid researchers in constructing strategies that are responsive to diverse research programs and goals within complex multisectoral nutrition landscapes.

Funding Sources

UK Government's Department for International Development and Bill & Melinda Gates Foundation.

E, Blake C, Fram M, Murillo-Castro A, Esquivel-Solís V. Promoting Co-Responsibility in the Household and Self-Care Through an Intervention for Food-Insecure Women with Excess Body Weight in Costa Rica

Objectives

This intervention targeted change in gender norms and behaviors regarding co-responsibility in the household and self-care among food-insecure women with excess weight. The objectives of this study were to determine what and how changes occurred in perceived gender norms, attitudes, intentions, and behaviors of women and their family and community members regarding co-responsibility and self-care.

Methods

We conducted a two-arm, 6-month cluster-randomized controlled trial in Alajuela. This qualitative study included 62 women, 34 family members, and 9 community members in the intensive arm. This arm consisted of activities at the individual (12 two-hour sessions, 3 follow-up monthly sessions, and one closing session), household (one workshop with household and community members, and homework with family participation), and community (two brochures and one workshop) levels. Data used were from observations and content analysis of participant comments during the workshops (n = 83), pre- and post-semi-structured interviews (n = 35), and focus groups with participating women (n = 49).

Results

Women and family members changed attitudes, intentions, gender norms, and behaviors related to co-responsibility and self-care. Concerning co-responsibility, at baseline all women reported doing most of the domestic work. Most women perceived working outside home as favorable, but those with children worried about childcare. At end-line, women reached more equitable distributions of the domestic work. Many women either obtained a job or began a small business at home and found solutions to balance their job with childcare. Women explained that these changes occurred because they had increased psychological empowerment which allowed them to ask for help at home, search for a job, or accept jobs rejected before. Concerning self-care, women and family members changed self-care behaviors and improved relationships because 1) women understood that self-care first allowed them to care for others and 2) women changed first so their family members followed.

Conclusions

The intervention changed attitudes, intentions, gender norms, and behaviors related to co-responsibility and self-care, which supported improved food security and weight in women.

Funding Sources

Office of International Affairs, University of Costa Rica.

Role of Social Networks in Maternal Food Choice for Children Ages 1 to 5 Years Old in Rural Mexico

Objectives

To understand the role of mothers’ social networks in the food choices that mothers make for their children ages 1 to 5 years old in rural Mexico.

Methods

In-depth interviews were conducted with 46 participants from 3 rural communities between November and December 2016. The interviews inquired about participants’ child-feeding practices, personal and local beliefs about child feeding, and individuals with whom participants discussed food. All interviews were in Spanish, audio-recorded, transcribed verbatim, verified for quality, and analyzed using the constant comparative method.

Results

The networks that participants described in relation to food choice were largely interconnected and embedded within the social space of their communities. These networks were household family, non-household family, community, children's initial school, and health and pantry personnel. Participants described the functions of each network for the feeding of their children. These functions ranged from directly intervening on feeding behavior in the most proximal network, i.e., household family, to providing formal feeding and nutritional guidance in the most peripheral network, i.e., health and pantry personnel. Some networks had unique functions that no other network had, while some functions were shared across networks. Across the networks, professionals, participants’ mothers and mothers-in-law, community senior women, and other women with children emerged as trusted figures whom mothers would turn to for child-feeding advice. Participants were in constant interaction with their social networks and rarely turned to only one advisor. Participants expressed striking a balance between the input received, what they make of it, and eventually weighing their children's responses, resources available, and situations in which interactions occur and food choice is made for children.

Conclusions

Social networks have vital functions in establishing norms for food choices made for children. The multiplicity of child-feeding advisors may be especially important in strategies that seek to promote healthy food choices for children during developmental years to foster healthy eating patterns.

Funding Sources

SPARC Graduate Research Grant from University of South Carolina.

Yoga for everyone: a qualitative study of a community yoga class for people with disability

Background and Objective: People with mobility impairments face increased barriers to physical activity. The study aimed to understand the lived experiences of individuals with disability who are regular participants in the Yoga for Everyone class to inform future research, intervention and community programs.Methods: A phenomenological qualitative approach utilized semi-structured interviews and class observations. Data was analyzed through iterative inductive thematic analysis.Results: Six people of varied mobility limitations participated. Thematic analysis revealed themes on influential environmental and personal factors, a holistic-focused class environment, physical improvements, mental/emotional impact, and a sense of belonging to community.Conclusion: The Yoga for Everyone class fostered multi-faceted outcomes for people with diverse movement impairments. Focusing on community-clinical partnerships, utilizing a class structure with volunteers, and fostering an ongoing inclusive social environment are potential strategies for success in other community programs for those with disability.

Liquid Chromatographic Method for Determination of Iodine in Milk: Collaborative Study

Nine laboratories participated in an AOAC International/ International Dairy Federation collaborative study on a liquid chromatographic (LC) method for determination of iodine in milk. Liquid milk is passed through a 25 000 MW membrane filter to remove protein and insoluble material. Iodine (in the form of iodide) in the clear filtrate is separated by reversed-phase ion-pair LC and is detected electrochemically. Participants analyzed 2 commercial pasteurized whole milks and 5 nonfat dry milk powders in blind duplicate. Each sample was tested in duplicate on 2 days. Repeatability and reproducibility standard deviations (sr and SR, respectively) and repeatability and reproducibility relative standard deviations (RSDr and RSDR, respectively) for determinations of iodine in whole milk (mean recovery, 86.7%) were as follows: sr, 22 μg/L; SR, 22 μg/L; RSDr, 8.2%; and RSDR, 8.3%. For powdered milk (mean recovery, 91 %), the values were as follows: sr, 0.14 μg/g; SR, 0.22 μg/g; RSDr, 9.0%; and RSDR, 12.7%. The method was adopted first action by AOAC International.

Double Burden of Malnutrition: The Role of Framing in Development of Political Priority in the Context of Rising Diet-related Non-communicable Diseases in Tamil Nadu, India (P22-005-19)

Objectives

In low- and middle-income countries, non-communicable disease (NCD) prevalence is increasing while undernutrition persists, resulting in a double-burden of malnutrition. How policy actors frame malnutrition may shape policy, programming, and investment. In India, where NCDs are rising rapidly and undernutrition persists throughout the country, much of food and health policy is decentralized, but little is known of how the double burden of malnutrition is understood at the state level. This study aimed to identify and compare frames and priorities for nutrition used by relevant policy actors to help understand the narrative emerging around policy solutions for the double burden of malnutrition.

Methods

Key informants in the health, nutrition, and agriculture fields were identified from policy documents and purposive and snowball sampling. In-depth, semi-structured interviews were held with 28 key informants including international policy advocates, government officials, and state-level implementers in Tamil Nadu. Interviews were audio-recorded, transcribed, and coded with Nvivo 12. Major themes were identified using elements from prior published work: actor power, internal frame, issue characteristics, evaluative dimensions of target populations, priorities emphasized, and potential effects of the frame or likely policy result.

Results

Different actors reported differing priorities for the double burden of malnutrition. There was almost universal concern about stunting and anemia in children and women and consensus on sanitation and dietary diversity as causes of undernutrition, but a lack of clarity regarding diet-related NCDs. Respondents were unclear about which populations to target for the double burden, compared to clear targeting of women and children to address undernutrition. They described lack of convergence or clear roles for actors addressing the double burden, unlike for undernutrition.

Conclusions

There is a lack of consensus on the causes, manifestation, and solutions for the double burden of malnutrition within the policy community. Creating a shared narrative is critical for cohesive and efficient programming to address the double burden of malnutrition.

Funding Sources

Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.

Stressful Life Changes Affect Nutrition-Related Health Outcomes Among US Army Soldiers (P18-070-19)

Objectives

This prospective cohort study aimed to determine if experiencing stressful life changes were associated with an earlier onset of adverse nutrition-related health outcomes among US Army Soldiers. An additional aim was to determine which stressful life changes were most associated with these outcomes and if there were gender differences in the magnitude of the associations.

Methods

Stressful life changes were changes in marital status, combat deployment or returning from deployment, relocation, adding a child, change in rank, change in occupation, or development of a physical limitation to duty. Nutrition-related health outcomes were hyperlipidemia diagnosis, substantial weight gain, or weight-related separation from the Army. Using longitudinal data from the Stanford Military Data Repository representing all active-duty Soldiers who were age 17–62 between 2011 and 2014 (n = 827,126), event history analysis was used to model the association of stressful life changes with nutrition-related outcomes.

Results

Marriage was found to raise the odds of substantial weight gain three months later by 1.24 times (95% CI: 1.16, 1.32) for men and 1.68 times (95% CI: 1.51, 1.89) for women. Developing a physical duty limitation raised the odds of hyperlipidemia two months later by 1.42 times (95% CI: 1.15, 0.75) for men and 1.83 times (95% CI: 1.01, 3.32) for women and the odds of substantial weight gain two months later by 3.16 times (95% CI: 2.89, 3.44) in men and 1.69 times (95% CI: 1.36, 2.08) in women.

Conclusions

Differences in the magnitude of associations show stressful life changes affect male and female Soldiers differently. Identifying times after stressful life changes when the risk of developing an undesirable health outcome is highest offers new possibilities for proactively addressing health. Findings could guide the timing of interventions to mitigate the effects of stress on health in military and civilian populations.

Funding Sources

None. Disclaimer: Authors’ views do not reflect official DoD or Army policy.

Association of Food and General Parenting Practices with Young Children's Dietary Behaviors and the Role of Child Difficulty in Self-regulation (OR03-05-19)

Objectives

Understand the association of food and general parenting practices with young children's dietary behaviors and the role of child difficulty in self-regulation in this relationship.

Methods

Data were from the Early Childhood Longitudinal Study – Birth Cohort. Parent-child dyads with non-missing outcomes at age 5 (i.e., weekly frequency of intake of sugar-sweetened beverages, sweet foods and desserts, salty snack foods, fruits, and vegetables) were used (n = 3,250 boys and 3,150 girls). Analyses were done separately for boys and girls. Regression models with full information maximum likelihood were used accounting for clusters in Stata. Each outcome was regressed on food parenting variables at age 4 (i.e., rules about foods, and meal routines of eating as a family and at a regular time) and covariates. General parenting variables at age 4 (i.e., parent-child interaction, difficulty sticking with rules, harsh discipline, rules about watching television, and rules about bedtime), child difficulty in self-regulation at age 4, and their interactions were then added sequentially.

Results

Better food parenting practices at age 4 were associated with less frequent intake of unhealthy and more frequent intake of healthy foods and beverages in both boys and girls at age 5, with some differences by gender. General parenting practices at age 4 were associated with dietary behaviors differently for boys and girls. Difficulty in self-regulation at age 4 significantly modified the association between parenting practices and child's dietary behaviors for boys (evening meals at a regular time and intake of sweet foods and desserts) and girls (parent-child interaction and intake of sugar-sweetened beverages; difficulty sticking with rules and intake of sweet foods and desserts; rules about foods and intake of fruits and vegetables; and harsh discipline and intake of fruits).

Conclusions

Better food parenting and general parenting practices at age 4 were associated with children's healthy dietary behaviors at age 5. These associations differed by gender and child difficulty in self-regulation. Interventions to improve children's dietary behaviors should target parents and children to promote positive parenting in food and non-food settings and support children with difficulty in self-regulation.

Funding Sources

None.

Satisfying Children's Desire: A Primary Value Driving Parents’ Food Purchasing Decisions for Elementary-school-aged Children in South Carolina (P10-043-19)

Objectives

This study aimed to understand how parents made food purchasing decisions for their elementary-school-aged children and how they adjudicated among different values to make a purchasing decision.

Methods

Semi-structured qualitative interviews were conducted with 40 parents from low-and middle-income families in South Carolina who were primary food shoppers for their elementary-school-aged children and the households. The interviews were audio-recorded, transcribed verbatim, and open-coded. Coding matrices were used to compare parents’ responses on their decision-making process by race/ethnicity and child age.

Results

Parents adjudicated among nine values when they purchased foods and drinks for their elementary-school-aged children. Satisfying children's desire for a food or drink was the primary value parents identified as driving their food purchasing decisions. Parents also valued nutritional quality of the foods, children's acceptance of the foods, convenience of preparation, cost, health needs of the children, and tradition. Parents wanted their children to eat healthy but reported that they might need to compromise with the healthfulness of the foods because of their children's desire for less healthy foods. Although parents perceived that healthy foods, including fresh fruits and vegetables, are expensive, they wanted to accommodate those foods in their shopping list regardless of the cost if their children desired those foods. Strategies that parents applied to make a balance between children's desire, healthfulness of the foods, and price of the foods included purchasing store brand items, seasonal fruits, and items on sale and promotion, as well as setting rules for the children.

Conclusions

Making food purchasing decision for children is complex as children's desire and acceptance of a food are important in parents’ decisions. Despite that parents valued nutritional quality of foods and health needs, they tend to buy less healthy foods to satisfy their children's desire.

Funding Sources

This study was partially funded by a SPARC grant from the University of South Carolina Office of the Vice President for Research and the Olga I. Ogoussan Doctoral Research Award from the Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina.

Intervention for Women in Costa Rica Who Have Food Insecurity and Excess Body Weight: A Cluster Randomized Trial (P04-017-19)

Objectives

This study aimed to develop, implement, and evaluate an intervention to simultaneously reduce food insecurity and body weight. We hypothesized that, when compared with the non-intensive arm, women in the intensive intervention arm would reduce food insecurity and body weight and improve social support for healthy eating, psychological and economic empowerment, and food and physical activity behaviors.

Methods

We conducted a cluster-randomized controlled trial in the Central Canton of the Province of Alajuela. Randomization was at the level of the catchment area of the first level of health care in Costa Rica. This 6-month study compared two arms. The intensive arm consisted of activities at the individual (12 two-hour sessions, three follow-up monthly sessions, and one closing session), household (one workshop with the participants’ household and community members, and homework with family participation), and community (two brochures and one workshop) levels. The non-intensive arm was comprised of three one-hour sessions about healthy lifestyles.

Results

A total of 171 participants were enrolled (83 in intensive and 88 in non-intensive arm). At 6 months the intensive arm had significantly greater decreases from baseline in food insecurity (P = 0.004), body mass index (P = 0.010), and waist circumference (P = 0.001) compared with the non-intensive arm. The intensive arm also had also significantly greater increases in psychological (P = 0.014) and economic empowerment, including a greater increase in the contribution to household support (P = 0.030) and more women that found a job (P = 0.018), compared with the non-intensive arm. Women in the intervention arm had significantly greater changes from baseline in the expected direction in food consumption of fried foods (P = 0.029), sausages (P = 0.038), sugar drinks (P = 0.032), salads (P = 0.032), and beans (P = 0.004) compared to women in the non-intensive arm. We did not find any significant differences between the arms in social support, exercise, and consumption of fruits, vegetables and fast foods.

Conclusions

This intervention demonstrates that it is possible to simultaneously reduce food insecurity and reduce, rather than exacerbate, excess weight gain.

Funding Sources

Office of International Affairs, University of Costa Rica.

Role of Interpersonal Relationships in Mothers’ Foods Choice Decisions for Children Ages 1 < 5 Years in Rural Mexico (P10-051-19)

Objectives

To understand how mothers’ interpersonal relationships influence food choice decisions they make to feed children ages 1 to <5 years old in rural Mexico.

Methods

Semi-structured interviews were conducted with 46 mothers from 3 rural communities in Mexico in November and December 2016. Mothers were asked about their daily activities, their own knowledge about child feeding, the social ties from which they obtain information about child feeding, and local normative beliefs about food. Interviews were audio-recorded, transcribed verbatim, and analyzed using the constant comparative method. Thematic coding was used to identify the underlying values and meanings mothers ascribed to foods and the influential figures in their social circle to understand how interpersonal relationships influenced child feeding decisions.

Results

Most mothers had no formal employment and spent their day in activities such as upkeep of home, caring for their children, getting food, preparing meals, looking after their animals, and harvesting. Most mothers lived in multigenerational households or near relatives. Mothers’ knowledge about child feeding had a foundation in practices from their own mothers, being child caregivers to their siblings, employment as child caregivers in urban settings, and having older children. Mothers had prominent figures who influenced their decisions about child feeding. These figures were older women living in the household, other mothers within their social circle, health and social program personnel, children's fathers, and children themselves. Mothers described specific foods and preparations locally acceptable to feed to children, noting that some beliefs and practices might conflict with others. In making decisions about what to feed their children, mothers appraised who their social ties were and their feeding practices. For example, mothers took in information from other mothers based on their perception of whether the child was well-fed, which included child appearance.

Conclusions

Mothers’ interpersonal relationships played an important role in their child feeding decisions. When designing a program to improve food choice, identifying and accounting for mothers’ key social ties regarding child feeding could enhance positive behavior change.

Funding Sources

SPARC Graduate Research Grant from University of South Carolina.

Farming characteristics and self-reported health outcomes of Irish farmers

Background

Irish farmers represent a 'high-risk' group for non-communicable diseases, which, arguably, pose a greater occupational health challenge for farmers. To date, there has been little exploration of the farming characteristics associated with farmers' poor health outcomes.

Aims

To examine the relationship between farming and male farmers' self-reported health outcomes and to compare the study findings to national health studies to explore which factors specifically are associated with Irish farmers' poorer health outcomes relative to the general population.

Methods

This cross-sectional survey research used self-reported quantitative data on the health outcomes and health behaviours of male farmers from the South-East of Ireland. Data were entered into SPSS and descriptive and binary regression techniques were used for data analysis.

Results

There were 314 participants (99% response rate). Age, full-time farming and dairy farming significantly impacted self-reported health outcomes and health behaviours. There was a high prevalence of self-reported arthritis compared with the national average of Irish males. 'Younger' farmers (<45 years) were more likely to engage in harmful health behaviours such as smoking and 'binge-drinking' one or more times per week.

Conclusions

This study identified self-reported patterns of risky lifestyle behaviours among particular subgroups of Irish farmers for whom targeted health interventions are warranted. Interventions are particularly important for younger farmers who may see themselves as invincible and impregnable to ill-health.

Mirror therapy and treadmill training for patients with chronic stroke: a pilot randomized controlled trial

BACKGROUND

Previous lower-limb mirror therapy research has focused on non-weight bearing interventions.

OBJECTIVES

The primary aim of this study was to investigate the effect and feasibility of a combination of mirror therapy and treadmill training on post-stroke lower-limb recovery compared to a placebo intervention.

METHODS

All patients (N = 30) walked on a treadmill for 30 min per day, 3 days per week, for 4 weeks. The mirror therapy and treadmill training group (n = 15) walked on the treadmill while viewing a reflection of their non-paretic limb in a mirror positioned in their mid-sagittal plane. The placebo group (n = 15) received no mirror visual feedback due to an altered mirror position.

PRIMARY OUTCOME MEASURES

Ten Metre Walk Test (10MWT) and Six Minute Walk Test (6MWT).

SECONDARY OUTCOME MEASURES

Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment-Lower Extremity (FMA-LE). Feasibility was appraised by examining participant compliance and any adverse events.

RESULTS

No significant between group differences were demonstrated for the 10MWT, 6MWT or FMA-LE at post-training or 3-month follow-up assessment. A significant between group difference on the MAS was demonstrated in the reduction of ankle dorsiflexion muscle tone (p = 0.006) and ankle plantarflexion muscle tone (p = 0.01) in the mirror therapy group compared to the placebo group at post-training assessment but not at 3-month follow-up.

CONCLUSION

Our study reveals that in our group of patients with chronic stroke, mirror therapy combined with treadmill training facilitated significant reductions in ankle muscle tone (p < 0.05) compared to a placebo intervention.

Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis

BACKGROUND

Mirror therapy has been proposed as an effective intervention for lower limb rehabilitation post stroke.

RESEARCH QUESTION

This systematic review with meta-analysis examined if lower limb mirror therapy improved the primary outcome measures of muscle tone and motor function and the secondary outcome measures balance characteristics, functional ambulation, walking velocity, passive range of motion (PROM) for ankle dorsiflexion and gait characteristics in patients with stroke compared to other interventions.

METHODS

Standardised mean differences (SMD) and mean differences (MD) were used to assess the effect of mirror therapy on lower limb functioning.

RESULTS

Nine studies were included in the review. Among the primary outcome measures there was evidence of a significant effect of mirror therapy on motor function compared with sham and non-sham interventions (SMD 0.54; 95% CI 0.24-0.93). Furthermore, among the secondary outcome measures there was evidence of a significant effect of mirror therapy for balance capacity (SMD -0.55; 95% CI -1.01 to -0.10), walking velocity (SMD 0.71; 95% CI 0.35-1.07), PROM for ankle dorsiflexion (SMD 1.20; 95% CI 0.71-1.69) and step length (SMD 0.56; 95% CI -0.00 to 1.12).

SIGNIFICANCE

The results indicate that using mirror therapy for the treatment of certain lower limb deficits in patients with stroke may have a positive effect. Although results are somewhat positive, overly favourable interpretation is cautioned due to methodological issues concerning included studies.

Analysis of head impacts during sub-elite hurling practice sessions

The reported incidence of head and neck injuries in hurling is 0.12 per 1000 hours, but no previous research has quantified head impact characteristics in this sport. Here, a wireless accelerometer and gyroscope captured head impacts, in 20 senior club level hurling players. Peak linear and rotational acceleration and impact location were recorded during three hurling training sessions, each player participating once. A mean of 27.9 impacts (linear acceleration >10g) per player, per session were recorded; 1314 impacts during a total exposure time of 247 minutes. Only 2.6% impacts had peak linear acceleration of >70g and 6.2% had peak rotational acceleration >7900 rad/s². There were significant differences in the number and magnitude of impacts, quantified by the accelerometer, between three training sessions of differing intensity (ŋ2 0.03-0.09, p < 0.001). This study represents a first step in quantifying head impacts during hurling, demonstrating the feasibility of this technology in the field. The sensors were able to discriminate between sessions of varying intensity. These data can be used to develop athlete monitoring protocols and may be useful in developing innovative helmet-testing standards for hurling. The potential for this technology to provide feedback has clinical utility for team medical personnel.

Attacking 22 entries in rugby union: running demands and differences between successful and unsuccessful entries

Global Positioning System (GPS) technology is commonly utilized in team sports, including rugby union. It has been used to describe the average running demands of rugby union. This has afforded an enhanced understanding of the physical fitness requirements for players. However, research in team sports has suggested that training players relative to average demands may underprepare them for certain scenarios within the game. To date, no research has investigated the running demands of attacking 22 entries in rugby union. Additionally, no research has been undertaken to determine whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries in rugby union. The first aim of this study was to describe the running intensity of attacking 22 entries. The second aim of this study was to investigate whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries. Running intensity was measured using meters per minute (m min^-1 ) for (a) total distance, (b) running distance, (c) high-speed running distance, and (d) very high-speed running distance. This study provides normative data for the running intensity of attacking 22 entries in rugby union. Forwards achieved greater high-speed running intensity in successful (3.6 m min^-1 ) compared to unsuccessful (1.8 m min^-1 ) attacking 22 entries. Forwards should try and achieve greater high-speed running intensity in attacking 22 entries to increase the likelihood of successful outcomes during this period of gameplay.