Sociodemographic correlates of physical activity and sport among adults in Germany: 1997–2018

Hypothetical mechanisms driving physical activity levels in ethnic minority groups living in Europe: a systematically identified evidence-based conceptual systems model

BACKGROUND

In Europe, physical activity levels tend to be lower in ethnic minority groups than the general population. Interventions and policies based on research examining isolated determinants of physical activity have had limited success in increasing physical activity levels. This study used systems dynamics theory and the capability approach theoretical framework to develop a conceptual model of how individual characteristics, institutional and physical environments and the migration context may interact to promote or hinder physical activity in ethnic minority groups living in Europe.

METHODS

A systematic update of Langøien et al.'s 2017 review of the determinants of physical activity in ethnic minority groups living in Europe was conducted. Our target population included individuals of all ages who reported a familial migration background from any low- and middle-income countries or belonging to minority indigenous population in Europe. Outcomes pertaining to non-work related physical activity of light, moderate or vigorous intensity performed in any setting were included. Included studies provided an evidence base from which to derive the causal loop diagrams comprising our conceptual model. Sub-system causal loop diagrams were interpreted in co-author review sessions to explicate non-linear system mechanisms, such as reinforcing and balancing feedback loops.

RESULTS

Forty-one studies were identified, of which the majority was qualitative. The conceptual model consisted of 4 causal loop diagrams relating to psychosocial constructs; sociocultural constructs; health and health communication and social and material resources, in interaction with environmental/migration context. Four hypothetical mechanisms were identified, e.g. hypothesizing that participation in organised activities leads to increased self-efficacy, thereby enabling further participation.

CONCLUSIONS

This study contributes an evidence-based conceptual systems model which elucidates how low levels of physical activity in ethnic minority groups in Europe could be supported by reinforcing and balancing mechanisms involving factors relating to physical and institutional environments, migration context and individuals. A pluralistic approach to literature review, integrating complexity methods such as CLDs into more conventional systematic literature review, supports novel insights into how factors could interact to support persistently low levels of activity, moving beyond the identification of potential relationships between isolated factors to indicating the ways in which these relationships are sustained and could be modified by intervention or policy.

Preferences of women in difficult life situations for a physical activity programme: protocol of a discrete choice experiment in the German NU-BIG project

INTRODUCTION

The BIG project ('Bewegung als Investition in die Gesundheit', ie, 'Movement as Investment in Health') was developed in 2005 as a community-based participatory research programme to offer accessible opportunities for physical activity to women in difficult life situations. Since then, the programme has been expanded to eight sites in Germany. A systematic evaluation of BIG is currently being conducted. As part of this effort, we strive to understand the preferences of participating women for different aspects of the programme, and to analyse their willingness to pay.

METHODS AND ANALYSIS

In this protocol, we describe the development and analysis plan of a discrete choice experiment (DCE) to investigate participants' preferences for a physical activity programme for women in difficult life situations. The experiment will be embedded in a questionnaire covering several aspects of participation in the programme (eg, reach, efficacy and further effects) and the socioeconomic characteristics of all active participants. After a thorough search of the literature, BIG documents review and expert interviews, we identified five important attributes of the programme: course times, travel time to the course venue, additional social activities organised by BIG, consideration of wishes and interests for the further planning of courses and costs per course unit. Thereafter, we piloted the experiment with a sample of participants from the target group. After data collection, the experiment will be analysed using a conditional logit model and a latent class analysis to assess eventual heterogeneity in preferences.

ETHICS AND DISSEMINATION

Understanding women's preferences will provide useful insights for the further development of the programme and ultimately increase participation and retention. The questionnaire, the included DCE and the pretest on participants received ethical approval (application no. 20-247_1-B). We plan to disseminate the results of the DCE in peer-reviewed journals, national conferences and among participants and programme coordinators and organisers.

Relationships between psychosocial well-being and leisure time physical activity among 160.000 young Finnish men: a cross-sectional study during 2015-2021

Evidence on the relationship between psychosocial well-being and physical activity (PA) is insufficient, especially in young adults between 18 and 29 years. Identifying protective factors for psychosocial well-being as well as factors that may promote PA behaviour in this specific age group is crucial.The aim of the present study was to explore the association between self-reported leisure time physical activity (LTPA) and a number of measures of psychosocial well-being in a large sample of Finnish young men. The sample used for this study is based on registers of the Finnish Defence Forces and consist of questionnaire-based data collected from 159,776 young healthy men (18-29 years, mean age 19 years) who started their military service during the period from 2015 to 2021. Sum scores were calculated for self-esteem and prosocial behaviour. Physical activity, number of friends and the relationship with the parents were each measured with a single question. Unadjusted and adjusted (education, financial situation of the family, family structure) logistic regression models were calculated.A multinominal logistic regression analysis showed that a higher level of LTPA was associated with a higher level of both prosocial behaviour (OR 6.12, 95% CI 5.88-6.36) and self-esteem (OR 4.41 95% CI 4.28-4.54). Further, LTPA had a positive relationship with good social relations, both with peers and parents. The odds ratio for participation in any LTPA weekly was higher (OR 2.74; CI 2.27-3.20) among those who had a close and trustworthy relationship with their parents compared to those men with more challenging relationships with their parents (OR 1.77; CI 1.46-2.14). An inactive lifestyle (PA less than once a week) seemed to be most common among men with no friends. About one third (31%) of men with no friends reported to engage in LTPA less than once a week, while only 10% of men with very many good friends reported to engage in similarly inactive LTPA behaviour.LTPA seems to be positively associated with self-esteem, prosocial behaviour and good social relations among young adult men. Actions aimed at promoting LTPA may have a positive impact on psychosocial well-being among young men, or vice versa. The relationship between PA and psychosocial well-being is complex and interrelated.

Population-based physical activity promotion with a focus on health equity: a review of reviews

BACKGROUND

The extent to which people are physically active is dependent upon social gradients. Numerous studies have shown that especially people with social disadvantages do not meet the physical activity (PA) recommendations. A promising strategy to alleviate this issue are approaches that promote PA in the general population. In addition, several researchers have raised concerns that population-based health interventions may increase health inequities. The aim of the current review of reviews was therefore to identify successful population-based PA promotion approaches with a particular focus on health equity.

METHODS

Six electronic databases were examined for systematic reviews on population-based PA promotion for the period 2015 to 2021. A reference list and grey literature search were also conducted. Two independent reviewers used inclusion/exclusion criteria to screen titles and abstracts of the potentially relevant literature and conducted a quality assessment for each identified review. All included reviews of population-based approaches for PA promotion with a focus on disadvantaged populations and/or health equity were narratively summarized.

RESULTS

Our search resulted in 4,411 hits. After a systematic review process, six reviews met the inclusion criteria and were included after they were all rated as high quality. We identified that mass-media campaigns, point-of-decision prompts, environmental approaches, policy approaches, and community-based multi-component approaches can promote PA in the general population. Across populations with social disadvantages mass-media campaigns, point-of-decision prompts and policy approaches are likely to be effective as long as they are tailored. Regarding environmental approaches, the results are inconsistent. None of the reviews on community-based multi-component approaches provided evidence on health equity.

CONCLUSION

There are several effective approaches to promote PA in the general population but evidence regarding health equity is still sparse. Future studies should therefore pay more attention to this missing focus. Furthermore, there is a lack of evidence regarding the type of tailoring and the long-term impact of population-based approaches to PA promotion. However, this requires appropriate funding programmes, complex study designs and evaluation methods.

Scaling Up Physical Activity Promotion Projects on the Community Level for Women in Difficult Life Situations and Older People: BIG-5 and GET-10—A Study Protocol

Introduction

Physical inactivity is a major risk factor for a population's health, especially among socially disadvantaged groups. Many health promotion projects focus on increasing physical activity among their respective target groups. However, because they are mostly developed and implemented under laboratory conditions, they fail when being scaled to real-world settings. The community-based participatory research projects BIG and GESTALT have demonstrated their effectiveness regarding the physical activity promotion in real-world settings by employing a participatory method.

Material and Analysis

Within the context of the BIG-5 and GET-10 projects, these previously implemented and tested participatory projects are scaled to 15 additional settings in Bavaria, Germany. By applying an overarching mixed-methods evaluation framework, the aim is to gain insights into a) the recruitment of communities for scale-up; b) the specific results of the projects according to the RE-AIM framework. In the recruitment of communities, standardized information on the first contact, the consultation process, the person in charge, and previously implemented health promotion projects are collected. A systematic web search will complete information on each community and their health promotion activities. Results will be compared with information on those communities most in need, here according to the deprivation index of communities in Bavaria, Germany. The scale-up process and its results will be measured using semi-structured interviews with project coordinators. A standardized questionnaire will be used with the course's participants. Applying the RE-AIM framework, the collected data will be analyzed deductively.

Discussion

We expect the results to be highly relevant for the effective scale-up of any health promotion project. The study will enhance the understanding of how to reach those communities most in need of health promotion projects and will identify the barriers coordinators face in reaching socially disadvantaged groups.

Conclusion

Although participatory projects are often used as individual projects, little is known about the scaling up of participatory health promotion projects. This cross-cutting evaluation of two projects aims at producing data on the barriers and facilitators for the reach of settings most in need, and those success factors for a durable implementation.

Sports Activity Levels of Sexual Minority Groups in Germany

It is widely assumed that LGBT+ people may feel insecure and unwelcome in sports settings, which are often characterized by a binary gender order and a culture of heteronormativity. Previous research also suggests that LGBT+ individuals experience homophobia in the context of sport. Despite these findings, reliable quantitative data on the sports participation levels of sexual minority groups are scarce. The paper addresses this academic void by analyzing sports activity data of sexual minority groups. The 2019 wave of the German Socio-Economic Panel (SOEP) study is analyzed, which includes a novel LGBT+ boost sample of respondents who self-identify as lesbian, gay, bisexual, transgender, or non-binary with regard to gender. The analysis of this sample shows that sports activity levels (with regard to frequency and duration) of homo- and bisexual individuals are comparable to the heterosexual majority. Although findings show that a high share of homo- and bisexual individuals experience sexual discrimination, discrimination is not associated with lower participation rates in sports. We thus conclude that the domain of sport—although by no means free of discrimination—offers sufficient participation opportunities for LGBT+ people.

Co-producing an action-oriented framework for community-based Physical Activity Promotion in Germany

German National Recommendations for Physical Activity (PA) and PA Promotion recommend community-based approaches to promote PA at the local level with a focus on health equity. In addition, the German Federal Prevention Act addresses health equity and strengthens setting-based health promotion in communities. However, the implementation of both in the local context remains a challenge. This article describes Phase 1 of the KOMBINE project that aims to co-produce an action-oriented framework for community-based PA promotion focusing on structural change and health equity. (i) In a series of workshops, key stakeholders and researchers discussed facilitators, barriers and needs of community-based PA promotion focusing on health equity. (ii) The research team used an inductive approach to cluster all findings and to identify key components and then (iii) compared the key components with updated literature. (iv) Key components were discussed and incorporated into a gradually co-produced framework by the participants. The first result of the co-production process was a catalog of nine key components regarding PA-related health promotion in German communities. The comparison of key components with scientific evidence showed a high overlap. Finally, a six-phase action-oriented framework including key components for community-based PA promotion was co-produced. The six-phase action-oriented framework integrates practice-based and scientific evidence on PA-related health promotion and health equity. It represents a shared vision for the implementation of National Recommendations for PA and PA Promotion in Germany. The extent to which structural changes and health equity can be achieved is currently being investigated in pilot-studies.