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Casu L, Gillespie S, Nisbett N. Integrating nutrition and physical activity promotion: A scoping review. PLoS One 2020; 15:e0233908. [PMID: 32502158 PMCID: PMC7274388 DOI: 10.1371/journal.pone.0233908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This paper investigates actions that combine nutrition and physical activity which hold potential for 'double duty action' to tackle multiple forms of malnutrition simultaneously. Expanding on previous research on single component actions, we assessed the state of the literature to map integrated interventions across the life course to analyse potential double duty effects, and identify knowledge gaps and needs for future design, implementation, evaluation and research for effective double duty action. METHODS A scoping review of peer-reviewed and grey literature was conducted to explore the pathways that extend from combined physical activity and nutrition promotion interventions, with potential synergistic effects on outcomes other than obesity. Electronic databases were searched for studies published between 1 January 2010 and 31 January 2020. Out of 359 articles retrieved, 31 peer-reviewed and 5 grey literature sources met inclusion criteria. Findings from 36 papers reporting on 34 interventions/initiatives were organised into 6 categories, based on implementation across multiple stages of the life course. Double-duty potential was assessed through a further stage of analysis. FINDINGS This review has identified actions that hold potential for tackling not only obesity, but healthy diets, sedentary behaviour and quality of life more generally, as well as actions that explicitly tackle multiple forms of malnutrition. Importantly, it has identified crucial gaps in current methods and praxis that call for further practice-oriented research, in order to better understand and exploit the synergistic effects of integrated interventions on outcomes other than obesity. CONCLUSIONS Findings from across implementation settings suggest that even in situations where interventions are aimed at, or framed in terms of, obesity prevention and control, there are unexploited pathways for broader outcomes of relevance to nutrition and health and wellbeing more generally. Future design and evaluation of multisectoral approaches will benefit from an explicit framing of interventions as double-duty oriented.
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Affiliation(s)
- Laura Casu
- Institute of Development Studies (IDS), University of Sussex, Brighton, United Kingdom
| | - Stuart Gillespie
- International Food Policy Research Institute (IFPRI), Washington, DC, United States of America
| | - Nicholas Nisbett
- Institute of Development Studies (IDS), University of Sussex, Brighton, United Kingdom
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Abildso CG, Bias TK, Coffman J. Adoption and Reach of a statewide policy, systems, and environment intervention to increase access to fresh fruits and vegetables in West Virginia. Transl Behav Med 2019; 9:847-856. [PMID: 31570923 DOI: 10.1093/tbm/ibz095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Local public health professionals’ consistency, connections, and presence at meetings were critical to making changes in schools, farmers markets, and retail food stores to improve access to fruits and vegetables in rural, low-income food deserts.
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Affiliation(s)
| | - Thomas K Bias
- West Virginia University School of Public Health, Morgantown, USA
| | - Jessica Coffman
- West Virginia University Health Research Center, Morgantown, USA
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Pliakas T, Lock K, Jones A, Aalders S, Egan M. Getting shops to voluntarily stop selling cheap, strong beers and ciders: a time-series analysis evaluating impacts on alcohol availability and purchasing. J Public Health (Oxf) 2019; 41:110-118. [PMID: 29447371 DOI: 10.1093/pubmed/fdy003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 12/13/2017] [Accepted: 01/09/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND 'Reducing the Strength' (RtS) is a public health initiative encouraging retailers to voluntarily stop selling cheap, strong beers/ciders (≥6.5% alcohol by volume). This study evaluates the impact of RtS initiatives on alcohol availability and purchasing in three English counties with a combined population of 3.62 million people. METHODS We used a multiple baseline time-series design to examine retail data over 29 months from a supermarket chain that experienced a two-wave, area-based role out of RtS: initially 54 stores (W1), then another 77 stores (W2). We measured impacts on units of alcohol sold (primary outcome: beers/ciders; secondary outcome: all alcoholic products), economic impacts on alcohol sales and substitution effects. RESULTS We observed a non-significant W1 increase (+3.7%, 95% CI: -11.2, 21.0) and W2 decrease (-6.8%, 95% CI: -20.5, 9.4) in the primary outcome. We observed a significant W2 decrease in units sold across all alcohol products (-10.5%, 95% CI: -19.2, -0.9). The direction of effect between waves was inconsistent for all outcomes, including alcohol sales, with no evidence of substitution effects. CONCLUSIONS In the UK, voluntary RtS initiatives appear to have little or no impact on reducing alcohol availability and purchase from the broader population of supermarket customers.
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Affiliation(s)
- T Pliakas
- National Institute for Health Research School for Public Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, UK
| | - K Lock
- National Institute for Health Research School for Public Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, UK
| | - A Jones
- Suffolk County Council, Ipswich, UK
| | | | - M Egan
- National Institute for Health Research School for Public Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, UK
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Asada Y, Gilmet K, Welter C, Massuda-Barnett G, Kapadia DA, Fagen M. Applying Theory of Change to a Structural Change Initiative: Evaluation of Model Communities in a Diverse County. HEALTH EDUCATION & BEHAVIOR 2018; 46:377-387. [PMID: 30592224 DOI: 10.1177/1090198118818233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Structural change approaches, also called policy, systems, and environmental change approaches, have been increasingly promoted and adopted by public ealth agencies in the past decade. These interventions require attention to multilevel, complex and contextual influences on individual and community health outcomes, requiring a sound theoretical framework that links the many processes and outcomes over time. The Model Communities program of Cook County, Illinois Communities Putting Prevention to Work program employed a theory of change (ToC) framework to inform the evaluations' design and execution. The main objective of this study was to apply findings from the longitudinal multiple case study evaluation to develop an adapted ToC. We conducted 97 key informant interviews across three waves, with a focus on Model Communities program participants', Communities Putting Prevention to Work staff, and technical assistance providers' experiences over time. Four analysts organized and coded the data using qualitative software; exploratory functions and data matrices were employed throughout three waves of analysis. Adaptations to the ToC included the addition of a construct, "change readiness," as well as refinements to constructs: organizational capacity (human capital, technical assistance, informal and formal leadership), local partnerships, and the importance of sustainability. The findings offer a data-informed theoretical framework that may be considered for use in evaluations of structural change interventions in complex and diverse counties.
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Affiliation(s)
- Yuka Asada
- 1 University of Illinois at Chicago School of Public Health, Chicago IL, USA
| | - Kelsey Gilmet
- 1 University of Illinois at Chicago School of Public Health, Chicago IL, USA
| | - Christina Welter
- 1 University of Illinois at Chicago School of Public Health, Chicago IL, USA
| | | | - Devangna A Kapadia
- 1 University of Illinois at Chicago School of Public Health, Chicago IL, USA
| | - Michael Fagen
- 3 Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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O’Neal LJ, Bateman LB, Smith T, Li Y, Dai C, Wallace T, Fouad MN. An Exploration of Multilevel Physical Activity Correlates Among Low-Income African Americans in Alabama and Mississippi. FAMILY & COMMUNITY HEALTH 2018; 41:197-204. [PMID: 30134334 PMCID: PMC6890475 DOI: 10.1097/fch.0000000000000203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Understanding obesity-related health disparities among low-income African Americans in the south requires further research investigating the range of factors influencing health behaviors. This study sought to examine the relationship between meeting the minimum recommendation for moderate physical activity and multilevel, including policy, systems, and environmental, strategies thought to influence health behaviors. We utilize preintervention community survey data from a sample of 256 low-income, predominantly, African Americans in 3 southeastern cities. Results indicate that individual, social, and environmental factors are related to whether participants met the recommended guidelines for physical activity and that sex predicts whether guidelines are met.
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Affiliation(s)
- LaToya J. O’Neal
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL
| | - Lori Brand Bateman
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Theolisha Smith
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Yufeng Li
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Chen Dai
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Theresa Wallace
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Mona N. Fouad
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
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Nianogo RA, Kuo T, Smith LV, Arah OA. Associations between self-perception of weight, food choice intentions, and consumer response to calorie information: a retrospective investigation of public health center clients in Los Angeles County before the implementation of menu-labeling regulation. BMC Public Health 2016; 16:60. [PMID: 26801241 PMCID: PMC4722675 DOI: 10.1186/s12889-016-2714-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/08/2016] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although obesity continues to rise and remains a great public health concern in the U.S., a number of important levers such as self-perception of weight and calorie postings at point-of-purchase in restaurants are still not well-characterized in the literature, especially for low-income and minority groups in Los Angeles County (LAC). To study this gap, we examined the associations of self-perception of weight (as measured by body weight discrepancy) with food choice intentions and consumer response to calorie information among low-income adults residing in LAC during the pre-menu labeling regulation era. METHODS Descriptive and multivariable logistic regression analyses were performed to examine the aforementioned associations utilizing data from the 2007-2008 Calorie and Nutrition Information Survey (CNIS). The CNIS was a local health department study of 639 low-income adults recruited from five large, multi-purpose public health centers in LAC. RESULTS Survey participants who reported that their desired weight was less than their current weight (versus desired weight the same as current weight) had (i) higher odds of intending to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase (aOR = 2.0; 95 % CI: 1.0-3.9); and (ii) had higher odds of reporting that it is "very important" to have these calorie postings on food items in grocery stores (aOR = 3.1; 95 % CI: 0.90-10.7) and in fast-food restaurants (aOR = 3.4; 95 % CI: 1.0-11.4). CONCLUSIONS Self-perception of weight was found to be associated with the intention to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase. Future public health efforts to support menu labeling implementation should consider these and other findings to inform consumer education and communications strategies that can be tailored to assist restaurant patrons with this forthcoming federal law.
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Affiliation(s)
- Roch A Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, 90095-1772, CA, USA. .,UCLA Center for Health Policy Research, Los Angeles, CA, USA.
| | - Tony Kuo
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, 90095-1772, CA, USA.,Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA.,Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Lisa V Smith
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, 90095-1772, CA, USA.,Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Onyebuchi A Arah
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, 90095-1772, CA, USA.,UCLA Center for Health Policy Research, Los Angeles, CA, USA.,California Center for Population Research, UCLA, Los Angeles, CA, USA
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Honeycutt S, Leeman J, McCarthy WJ, Bastani R, Carter-Edwards L, Clark H, Garney W, Gustat J, Hites L, Nothwehr F, Kegler M. Evaluating Policy, Systems, and Environmental Change Interventions: Lessons Learned From CDC's Prevention Research Centers. Prev Chronic Dis 2015; 12:E174. [PMID: 26469947 PMCID: PMC4611860 DOI: 10.5888/pcd12.150281] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction The field of public health is increasingly implementing initiatives intended to make policies, systems, and environments (PSEs) more supportive of healthy behaviors, even though the evidence for many of these strategies is only emerging. Our objective was 3-fold: 1) to describe evaluations of PSE-change programs in which the evaluators followed the steps of the Centers for Disease Control and Prevention’s (CDC’s) Framework for Program Evaluation in Public Health, 2) to share the resulting lessons learned, and 3) to assist future evaluators of PSE-change programs with their evaluation design decisions. Methods Seven Prevention Research Centers (PRCs) applied CDC’s framework to evaluate their own PSE-change initiatives. The PRCs followed each step of the framework: 1) engage stakeholders, 2) describe program, 3) focus evaluation design, 4) gather credible evidence, 5) justify conclusions, and 6) ensure use and share lessons learned. Results Evaluation stakeholders represented a range of sectors, including public health departments, partner organizations, and community members. Public health departments were the primary stakeholders for 4 of the 7 evaluations. Four PRCs used logic models to describe the initiatives being evaluated. Their evaluations typically included both process and outcome questions and used mixed methods. Evaluation findings most commonly focused on contextual factors influencing change (process) and the adoption or implementation of PSE-change strategies (outcome). Evaluators shared lessons learned through various channels to reach local stakeholders and broader public health audiences. Conclusion Framework for Program Evaluation in Public Health is applicable to evaluations of PSE-change initiatives. Using this framework to guide such evaluations builds practice-based evidence for strategies that are increasingly being used to promote healthful behaviors.
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Affiliation(s)
- Sally Honeycutt
- Emory Prevention Research Center, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322.
| | - Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolin
| | - William J McCarthy
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California
| | - Lori Carter-Edwards
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heather Clark
- Texas A&M School of Public Health, College Station, Texas
| | - Whitney Garney
- Texas A&M School of Public Health, College Station, Texas
| | - Jeanette Gustat
- Tulane University School of Public Health and Tropical Medicine, Prevention Research Center, New Orleans, Louisiana
| | - Lisle Hites
- University of Alabama at Birmingham Prevention Research Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Faryle Nothwehr
- University of Iowa Prevention Research Center for Rural Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Michelle Kegler
- Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
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