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Queral J, Wargers A, Llauradó E, Jansen W, Solà R, Tarro L, Mölenberg FJM. Effectiveness of Participatory Research Interventions on Obesity and Obesity-Related Behaviors in Adolescents: A Systematic Review and Meta-analysis. Nutr Rev 2024:nuae067. [PMID: 38976588 DOI: 10.1093/nutrit/nuae067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
CONTEXT Adolescence is an optimal period to promote healthy lifestyles because behavior patterns are established in this stage. It has been suggested that engaging youth increases the effectiveness of interventions, but an overview is lacking. OBJECTIVE This study aims to evaluate the effectiveness of participatory research (PR) interventions, where adolescents (11-18 years old) from high-income countries had a significant role in the intervention development and/or delivery, compared with no (PR) intervention control groups on obesity-related outcomes and healthy lifestyle behaviors (HLBs). DATA SOURCES Eight databases (Embase, Medline ALL, Web of Science Core Collection, PsycINFO, ERIC, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials) and Google Scholar were searched from 1990 to 2024 for randomized controlled trials (RCTs) and non-RCTs (in English). DATA EXTRACTION Two researchers independently performed the data extraction and risk-of-bias assessment. DATA ANALYSIS Sixteen studies were included and outcomes have been narratively described. Seven studies evaluated youth-led interventions, 3 studies evaluated co-created interventions, and 6 studies evaluated the combination of both. Six studies focused on physical activity (PA), 2 on nutrition, and 8 on a combination of PA, nutrition, and/or obesity-related outcomes. Ten studies presented at least 1 significant effect on PA, nutrition, or obesity-related outcomes in favor of the intervention group. Additionally, 12 studies were pooled in a meta-analysis. Whereas a small desired effect was found for fruit consumption, a small undesired effect was found for vegetable consumption. The pooled analysis found no significant effects on moderate-vigorous PA, total PA, and PA self-efficacy. CONCLUSION We found some evidence that youth empowerment in research may have positive effects on obesity-related HLBs, specifically an increased fruit consumption. However, the overall evidence was inconclusive due to limited studies and the heterogeneity of the studies included. This overview may guide future public health interventions that aim to engage and empower adolescents. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration Nº CRD42021254135.
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Affiliation(s)
- Judit Queral
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Annemieke Wargers
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Elisabet Llauradó
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Wilma Jansen
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Social Development, City of Rotterdam, 3000 LP Rotterdam, The Netherlands
| | - Rosa Solà
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
- Internal Medicine, Hospital Universitari Sant Joan de Reus, Reus, 43204, Spain
| | - Lucia Tarro
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Famke J M Mölenberg
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
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Chinapaw MJM, Klaufus LH, Oyeyemi AL, Draper C, Palmeira AL, Silva MN, Van Belle S, Pawlowski CS, Schipperijn J, Altenburg TM. Youth-centred participatory action approach towards co-created implementation of socially and physically activating environmental interventions in Africa and Europe: the YoPA project study protocol. BMJ Open 2024; 14:e084657. [PMID: 38387985 PMCID: PMC10882351 DOI: 10.1136/bmjopen-2024-084657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION The majority of adolescents do not meet guidelines for healthy behaviours, posing major risks for developing multiple non-communicable diseases. Unhealthy lifestyles seem more prevalent in urban than rural areas, with the neighbourhood environment as a mediating pathway. How to develop and implement sustainable and effective interventions focused on adolescent health and well-being in urban vulnerable life situations is a key challenge. This paper describes the protocol of a Youth-centred Participatory Action (YoPA) project aiming to tailor, implement, and evaluate social and physical environmental interventions. METHODS AND ANALYSIS In diverse urban environments in Denmark, the Netherlands, Nigeria and South Africa, we will engage a dynamic group of 15-20 adolescents (12-19 years) growing up in vulnerable life situations and other key stakeholders (eg, policy makers, urban planners, community leaders) in local co-creation communities. Together with academic researchers and local stakeholders, adolescents will take a leading role in mapping the local system; tailoring; implementing and evaluating interventions during participatory meetings over the course of 3 years. YoPA applies a participatory mixed methods design guided by a novel Systems, User perspectives, Participatory co-creation process, Effects, Reach, Adoption, Implementation and Maintenance framework assessing: (i) the local systems, (ii) user perspectives, (iii) the participatory co-creation process, (iv) effects, (v) reach, (vi) adoption, (vii) implementation and (viii) maintenance of interventions. Through a realist evaluation, YoPA will explore why and how specific outcomes were reached (or not) in each setting (n=800-1000 adolescents in total). ETHICS AND DISSEMINATION This study received approval from the ethics committees in Denmark, the Netherlands, Nigeria and South Africa and will be disseminated via various collaborative dissemination activities targeting multiple audiences. We will obtain informed consent from all participants. We envision that our YoPA co-creation approach will serve as a guide for participation of adolescents in vulnerable life situations in implementation of health promotion and urban planning in Europe, Africa and globally. TRIAL REGISTRATION NUMBER NCT06181162.
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Affiliation(s)
- Mai J M Chinapaw
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leonie H Klaufus
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
- Department of Physiotherapy, Redeemer's University, Ede, Nigeria
| | - Catherine Draper
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - António L Palmeira
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- CIFI2D, Universidade do Porto, Porto, Lisbon
| | - Marlene Nunes Silva
- CIDEFES, Universidade Lusófona, Lisboa, Portugal
- Programa Nacional para a Promoção da Atividade Física, Direcção-Geral da Saúde, Lisboa, Portugal
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Charlotte S Pawlowski
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Teatske M Altenburg
- Public and Occupational Health, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Herstad SH, Grewal NK, Banik A, Klepp KI, Knai C, Luszczynska A, Mendes S, Rito A, Rutter H, Lien N. Adolescents' capacity to take action on obesity: A concurrent controlled before-and-after study of the European CO-CREATE project. Obes Rev 2023; 24 Suppl 2:e13622. [PMID: 37753601 DOI: 10.1111/obr.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/26/2023] [Accepted: 07/06/2023] [Indexed: 09/28/2023]
Abstract
This study evaluated the effect on reported readiness for action and attitudes toward obesity prevention among older adolescents (mean age 17) who took part in a youth-led participatory action research European initiative (CO-CREATE Youth Alliances) compared with a comparison group that acted as controls. This was a concurrent before-and-after controlled study across five countries and took place between September 2019 and October 2020. Adolescents (n = 159) recruited from schools and youth organizations came together with researchers and formed 15 Youth Alliances. An online questionnaire measuring their readiness for action and attitudes toward obesity prevention was administered. Alliance members (n = 62) who filled in the questionnaire at both baseline and postinitiative, and adolescents from the comparison group (n = 132) who completed the questionnaire twice were included in the main analysis. Two-level linear mixed models controlling for country-related variance were fitted. Alliance members scored significantly higher than the comparison group on two factors in each of the readiness for action, responsibility, and drivers of behavior concepts. The findings suggest that involving youth in co-creating policies to prevent obesity may increase adolescents' readiness for action and promote a shift in adolescents' conceptualization of obesity from an individual perspective to a societal responsibility and drivers of behavior.
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Affiliation(s)
| | | | - Anna Banik
- SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Knut-Inge Klepp
- Department of Nutrition, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Cecile Knai
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Sofia Mendes
- Center for Studies and Research on Social Dynamics and Health - CEIDSS, Lisbon, Portugal
| | - Ana Rito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
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Oridota O, Shetty A, Elaiho CR, Phelps L, Cheng S, Vangeepuram N. Perspectives from diverse stakeholders in a youth community-based participatory research project. EVALUATION AND PROGRAM PLANNING 2023; 99:102305. [PMID: 37178515 PMCID: PMC10330503 DOI: 10.1016/j.evalprogplan.2023.102305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
INTRODUCTION TEEN HEED (Help Educate to Eliminate Diabetes) is a community-based youth participatory action research (YPAR) study in which prediabetic adolescents from a predominantly low-income, non-white neighborhood in New York City participated in a peer-led diabetes prevention intervention. The aim of the current analysis is to evaluate the TEEN HEED program through examination of multiple stakeholder perspectives to identify strengths and areas for improvement that may inform other YPAR projects. METHODS We conducted 44 individual in-depth interviews with representatives from six stakeholder groups (study participants, peer leaders, study interns and coordinators, and younger and older community action board members). Interviews were recorded, transcribed, and analyzed using thematic analysis to identify overarching themes. RESULTS Dominant themes identified were: 1) YPAR principles and engagement, 2) Youth engagement through peer education, 3) Challenges and motivations for research participation, 4) Study improvements and sustainability, and 5) Professional and personal impacts of the study. CONCLUSIONS Emergent themes from this study provided insights on the value of youth participation in research and informed recommendations for future YPAR studies.
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Affiliation(s)
| | - Anuradha Shetty
- SUNY Downstate Health Sciences University College of Medicine, USA
| | - Cordelia R Elaiho
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, USA
| | - LaTanya Phelps
- TEEN HEED Community Action Board, Icahn School of Medicine at Mount Sinai, USA
| | - Stephen Cheng
- University of New England College of Osteopathic Medicine Icahn School of Medicine at Mount Sinai TEEN HEED Intern, USA
| | - Nita Vangeepuram
- Departments of Pediatrics and Population Health Science and Policy, Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, USA.
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5
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Anselma M, Altenburg TM, Twisk JWR, Wang X, Chinapaw MJM. How to Evaluate the Effectiveness of Health Promotion Actions Developed Through Youth-Centered Participatory Action Research. HEALTH EDUCATION & BEHAVIOR 2023; 50:199-210. [PMID: 34628967 PMCID: PMC10021122 DOI: 10.1177/10901981211046533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most actions targeting children's health behaviors have limited involvement of children in the development, potentially contributing to disappointing effectiveness. Therefore, in the 3-year "Kids in Action" study, 9- to 12-year-old children from a lower-socioeconomic neighborhood were involved as coresearchers in the development, implementation, and evaluation of actions targeting health behaviors. The current study describes the controlled trial that evaluated the effects on children's energy balance-related behaviors, physical fitness, and self-rated health, as well as experienced challenges and recommendations for future evaluations. Primary school children from the three highest grades of four intervention and four control schools were eligible for participation. Outcome measures assessed at baseline, and at 1- and 2-year follow-up were as follows: motor fitness by the MOPER test (N = 656, N = 485, N = 608, respectively), physical activity and sedentary behavior by accelerometry (N = 223, N = 149, N = 164, respectively), and consumption of sugar sweetened beverages and snacks and self-rated health by a questionnaire (N = 322, N = 281, N = 275, respectively). Mixed-model analyses were performed adjusted for clustering within schools and relevant confounders. Significant beneficial intervention effects were found on self-reported consumption of energy/sports drinks at T2 versus T0, and on total time and ≥5-minute bouts of moderate-to-vigorous physical activity at T1 versus T0. Significant adverse effects were found on "speed and agility" and "coordination and upper-limb speed." No other significant effects were found. The inconsistent intervention effects may be explained by the dynamic cohort and suboptimal outcome measures. We advise future studies with a similar approach to apply alternative evaluation designs, such as the delayed baseline design.
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Affiliation(s)
- Manou Anselma
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
- Manou Anselma, Department of Public and
Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam
Public Health research institute, Van der Boechorststraat 7, Amsterdam NL-1081
BT, Netherlands.
| | - Teatske M. Altenburg
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
| | - Jos W. R. Twisk
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
| | - Xinhui Wang
- College of Computer Science, Qinghai
Normal University, Xining, Qinghai, China
| | - Mai J. M. Chinapaw
- Amsterdam UMC, Vrije Universiteit
Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health
research institute, Amsterdam, The Netherlands
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6
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Nesrallah S, Klepp KI, Budin-Ljøsne I, Luszczynska A, Brinsden H, Rutter H, Bergstrøm E, Singh S, Debelian M, Bouillon C, Katanasho MB. Youth engagement in research and policy: The CO-CREATE framework to optimize power balance and mitigate risks of conflicts of interest. Obes Rev 2023; 24 Suppl 1:e13549. [PMID: 36633924 DOI: 10.1111/obr.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023]
Abstract
Including youth in the co-creation of policies that affect them has proven to be particularly impactful in public health. Using youth participatory action research methods, the CO-CREATE project engages European youth 16-18 years old in the co-creation of obesity prevention policies. To discuss the feasibility and implications of the policy, youth are invited to engage in an intergenerational dialogue. Given the youth-adult dynamic and policy discussion, conflicts of interests (COIs) can arise and impact the quality of the dialogue. COI frameworks are a tool that can help identify, mitigate, and address COIs. This paper presents a novel framework to mitigate COIs in intergenerational policy dialogues, with a focus on power imbalance. Following a series of youth consultations, interviews, and examination of existing frameworks, our findings suggest that safe, participatory, and empowering dialogues can take place if appropriate measures are integrated into all phases of a dialogue. The selection of stakeholders, use of accessible language, and youth moderation are all factors that can impact COI risks. Measures that promote mutual empowerment, such as equal representation of youth and adults, were deemed important. This framework provides a roadmap to ensure that youth participation in the formulation of policies is safe and empowering.
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Affiliation(s)
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Isabelle Budin-Ljøsne
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Aleksandra Luszczynska
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | | | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Elin Bergstrøm
- Centre for Development and the Environment, University of Oslo, Oslo, Norway
| | - Sudhvir Singh
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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7
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Klepp KI, Helleve A, Brinsden H, Bröer C, Budin-Ljøsne I, Harbron J, Knai C, Lien N, Luszczynska A, Nesrallah S, Oldridge-Turner K, Rito A, Samdal O, Savona N, Stensdal MK, Allender S, Hoelscher DM, Rutter H. Overweight and obesity prevention for and with adolescents: The "Confronting obesity: Co-creating policy with youth" (CO-CREATE) project. Obes Rev 2023; 24 Suppl 1:e13540. [PMID: 36623268 DOI: 10.1111/obr.13540] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/11/2022] [Accepted: 09/27/2022] [Indexed: 01/11/2023]
Abstract
The CO-CREATE project focuses on the need for research on obesity prevention in adolescents to move away from studies of single interventions, toward the investigation of systems-based research incorporating youth involvement. This paper provides an overview of the project, presenting the objectives, design, and novel methodologies applied, as well as findings to date and anticipated outcomes. Adolescents (16-18 years old) in five European countries participated. Methods applied in the project include monitoring and benchmarking of policies, systematic literature reviews, epidemiological surveillance, linking observed overweight and obesity trends to observed policy landscapes, group model building to identify perceived drivers of obesity, alliance building with adolescents, dialog with stakeholders, and system dynamics modelling to explore the potential impact of policy options. Outcomes include tools for developing policy ideas and investigation of prevention strategies with adolescents, including policy databases, system maps of drivers of obesity, protocols for organizing youth alliances, an intergenerational policy dialog tool, and system dynamic models exploring the impacts of cocreated policy ideas. These outcomes make an important contribution to building a pan-European infrastructure for designing and evaluating policies and for providing youth with the opportunity to make their voices heard in the development and implementation of obesity prevention measures.
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Affiliation(s)
- Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Arnfinn Helleve
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Christian Bröer
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Isabelle Budin-Ljøsne
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Janetta Harbron
- Division of Physiological Sciences, Health through Physical Activity, Lifestyle & Sport (HPALS) Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Cecile Knai
- Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Aleksandra Luszczynska
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | | | | | - Ana Rito
- Centre for Studies and Research on Social Dynamics and Health-CEIDSS, Lisbon, Lisbon, Portugal
| | - Oddrun Samdal
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Natalie Savona
- Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Steven Allender
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Melbourne, Australia
| | - Deanna M Hoelscher
- School of Public Health Austin Campus, University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, USA
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
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Budin-Ljøsne I, Ayuandini S, Baillergeau E, Bröer C, Helleve A, Klepp KI, Kysnes B, Lien N, Luszczynska A, Nesrallah S, Rito A, Rutter H, Samdal O, Savona N, Veltkamp G. Ethical considerations in engaging young people in European obesity prevention research: The CO-CREATE experience. Obes Rev 2023; 24 Suppl 1:e13518. [PMID: 36416177 DOI: 10.1111/obr.13518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/05/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022]
Abstract
Engaging youth in obesity prevention research and policy action is essential to develop strategies that are relevant and sensitive to their needs. Research with young people requires critical reflection to safeguard their rights, dignity, and well-being. The CO-CREATE project used various methods to engage approximately 300 European youth aged 15-19 years in the development of policies to prevent adolescent obesity. This paper discusses ethical considerations made in the project pertaining to the youth's voluntary participation, their protection from obesity stigma, respect for their time, data privacy and confidentiality, power balance, and equality of opportunity to participate in the research. We describe measures implemented to prevent or limit the emergence of ethical challenges in our interaction with youth and discuss their relevance based on our experience with implementation. While some challenges seemingly were prevented, others arose related to the youth's voluntary participation, time burdens on them, and the sustainability of participation under the Covid-19 pandemic. Concrete and ongoing ethical guidance may be useful in projects aiming to interact and build collaborative relationships with youth for long periods of time.
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Affiliation(s)
| | - Sherria Ayuandini
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Evelyne Baillergeau
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Christian Bröer
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnfinn Helleve
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Bjarte Kysnes
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Aleksandra Luszczynska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | | | | | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Oddrun Samdal
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Natalie Savona
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Gerlieke Veltkamp
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
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9
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Bröer C, Ayuandini S, Baillergeau E, Moerman G, Veltkamp G, Luszczynska A, Budin-Ljøsne I, Rito AI, Stensdal M, Lien N, Klepp KI. Recruiting and engaging adolescents in creating overweight and obesity prevention policies: The CO-CREATE project. Obes Rev 2023; 24 Suppl 1:e13546. [PMID: 36623291 DOI: 10.1111/obr.13546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023]
Abstract
The CO-CREATE project aims to collaborate with adolescents across Europe in developing policy ideas that contribute to overweight and obesity prevention. In this paper, we present the theoretical basis and methodological approach to recruitment and engagement in the project. The principles of youth-led participatory action research were employed to design Youth Alliances in which adolescents and adults could collaborate. These Alliances should serve to promote and support adolescent participation and to develop policy ideas that would contribute to obesity prevention. Alliance members were recruited in two local geographical areas per country with a focus on reaching out to underrepresented youth. We started with fieldwork to assess locally relevant forms of inclusion and exclusion. The methodology entailed a handbook combining existing tools which could be used flexibly, a collaborative organization, and budgets for the alliances. Engagement started in local organizations, that is, schools and scouts, and with peers. Health- and overweight-related challenges were addressed in their immediate surroundings and supported the inclusion of experiential knowledge. Adolescents were then supported to address the wider obesogenic system when designing policy ideas. The CO-CREATE Alliances provide a concrete example of how to engage youth in public health, in a manner that strives to be participatory, transformative, and inquiry based.
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Affiliation(s)
- Christian Bröer
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Evelyne Baillergeau
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Gerben Moerman
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Gerlieke Veltkamp
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Aleksandra Luszczynska
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Isabelle Budin-Ljøsne
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ana Isabel Rito
- Centre for Studies and Research on Social Dynamics and Health-CEIDSS, Lisbon, Portugal
| | - Maja Stensdal
- PRESS, The Youth Organization of Save the Children Norway, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Knut-Inge Klepp
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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Ma L, Wen X, Xue H, Zhao L, Ding Y, Xu F, Ruan G, Li Y, Chang S, Wang Y. National childhood obesity-related intervention systems and intervention programs in China in 1949 to 2020: A narrative review. Obesity (Silver Spring) 2022; 30:320-337. [PMID: 35088555 DOI: 10.1002/oby.23316] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This review examines main government and nongovernmental institutions for childhood obesity prevention and control in China, as well as major national interventions for childhood obesity. METHODS PubMed, China National Knowledge Infrastructure (CNKI), Wanfang, official websites of national governments and professional institutions/associations, Baidu.com, and Google.com were systematically searched in March 2020 to April 2020. A total of 20 international and national experts on childhood obesity were surveyed. RESULTS "Government-led multisector cooperation" obesity-related intervention systems have been formed. National-level interventions were mainly implemented by the Chinese State Council and its administrative departments, along with national professional institutions/associations. Provincial, municipal, and county governments and their subordinate departments coordinated local works. Actions taken by these sectors to fight childhood obesity included developing and implementing regulations and laws, health standards and practice guidelines, surveillance for obesity and related determinants, governmental budget and research funds, and interventions. A total of 14 major national childhood obesity-related interventions were found: comprehensive interventions (e.g., "Healthy Lifestyle for All campaign," 2007), diet and nutrition (e.g., "Chinese Rural Compulsory Education Student Nutrition Improvement Program," since 2011), and physical activity (e.g., "Happy 10 Minutes Program," 2006). CONCLUSIONS Although obesity-related intervention systems and national interventions were implemented, more efforts and stronger government leadership and commitment are needed.
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Affiliation(s)
- Lu Ma
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA
| | - Hong Xue
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, USA
| | - Li Zhao
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yixin Ding
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Fei Xu
- Nanjing City Center for Disease Control and Prevention, Nanjing, China
| | - Guorui Ruan
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yixuan Li
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Suying Chang
- Child Health Development Section, UNICEF Office for China, Beijing, China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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Jonsson L, Fröberg A, Korp P, Larsson C, Berg C, Lindgren EC. Possibilities and challenges in developing and implementing an empowerment-based school-intervention in a Swedish disadvantaged community. Health Promot Int 2020; 35:232-243. [PMID: 30848788 PMCID: PMC7250500 DOI: 10.1093/heapro/daz021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/10/2019] [Accepted: 02/19/2019] [Indexed: 11/14/2022] Open
Abstract
In this paper, we describe and critically reflect on the possibilities and challenges of developing and implementing an empowerment-based school intervention regarding healthy food and physical activity (PA), involving participants from a Swedish multicultural area characterized by low socioeconomic status. The 2-year intervention was continually developed and implemented, as a result of cooperation and shared decision making among researchers and the participants. All 54 participants were seventh graders, and the intervention comprised health coaching, health promotion sessions and a Facebook group. We experienced that participants valued collaborating with peers, and that they took responsibility in codeveloping and implementing the intervention. Participants expressed feeling listened to, being treated with respect and taken seriously. However, we also experienced a number of barriers that challenged our initial intentions of aiding participation and ambition to support empowerment. Moreover, it was challenging to use structured group health coaching and to work with goal-setting in groups of participants with shared, and sometimes competing, goals, wishes and needs related to food and PA. Successful experiences from this intervention was the importance of acquiring a broad and deep understanding of the context and participants, being open to negotiating, as well as adjusting the intervention.
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Affiliation(s)
- L Jonsson
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - A Fröberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - P Korp
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - C Larsson
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - C Berg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - E-C Lindgren
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
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12
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Vangeepuram N, Angeles J, Lopez-Belin P, Arniella G, Horowitz CR. Youth Peer Led Lifestyle Modification Interventions: A Narrative Literature Review. EVALUATION AND PROGRAM PLANNING 2020; 83:101871. [PMID: 33032025 DOI: 10.1016/j.evalprogplan.2020.101871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/16/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
The prevalence of obesity remains high among school age children and continues to rise among adolescents in the United States. One strategy to address this challenge is to use peer rather than professional leaders to run weight management programs. Youth peer-led lifestyle interventions have become increasingly common over the last few decades, but there is a lack of review and synthesis of these programs. The purpose of this manuscript was to critically review and synthesize results and lessons learned from evaluated youth peer-led lifestyle modification and weight management programs. We searched the PubMed/MEDLINE database to identify articles published between March 2002 and December 2015. We identified 29 interventions including children from kindergarten to 12th grade from different settings and racial/ethnic and economic backgrounds. We first summarized descriptive information about the interventions and then compared outcomes based on intervention type, peer leader characteristics and training, and other related factors. Our review indicated that youth peer-led interventions of varying structure and content can result in positive changes in behavioral influences, diet, physical activity, body measures and other clinical outcomes. We used information from our analysis to formulate recommendations for design of future youth peer-led lifestyle interventions.
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Affiliation(s)
- Nita Vangeepuram
- Departments of Pediatrics and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1202A, New York, NY, 10029, United States.
| | - Jesenia Angeles
- Departments of Pediatrics and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY 10029, United States.
| | - Patricia Lopez-Belin
- TEEN HEED Community Action Board, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place Box 1077, New York, NY 10029, United States.
| | - Guedy Arniella
- Institute for Family Health, 1824 Madison Ave, New York, NY, 10035, United States.
| | - Carol R Horowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY, 10029, United States.
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13
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Hokowhitu B, Oetzel JG, Simpson ML, Nock S, Reddy R, Meha P, Johnston K, Jackson AM, Erueti B, Rewi P, Warbrick I, Cameron MP, Zhang Y, Ruru S. Kaumātua Mana Motuhake Pōi: a study protocol for enhancing wellbeing, social connectedness and cultural identity for Māori elders. BMC Geriatr 2020; 20:377. [PMID: 33008342 PMCID: PMC7530863 DOI: 10.1186/s12877-020-01740-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/30/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The Aotearoa New Zealand population is ageing accompanied by health and social challenges including significant inequities that exist between Māori and non-Māori around poor ageing and health. Although historically kaumātua (elder Māori) faced a dominant society that failed to realise their full potential as they age, Māori culture has remained steadfast in upholding elders as cultural/community anchors. Yet, many of today's kaumātua have experienced 'cultural dissonance' as the result of a hegemonic dominant culture subjugating an Indigenous culture, leading to generations of Indigenous peoples compelled or forced to dissociate with their culture. The present research project, Kaumātua Mana Motuhake Pōī (KMMP) comprises two interrelated projects that foreground dimensions of wellbeing within a holistic Te Ao Māori (Māori epistemology) view of wellbeing. Project 1 involves a tuakana-teina/peer educator model approach focused on increasing service access and utilisation to support kaumātua with the greatest health and social needs. Project 2 focuses on physical activity and cultural knowledge exchange (including te reo Māori--Māori language) through intergenerational models of learning. METHODS Both projects have a consistent research design and common set of methods that coalesce around the emphasis on kaupapa kaumatua; research projects led by kaumātua and kaumātua providers that advance better life outcomes for kaumātua and their communities. The research design for each project is a mixed-methods, pre-test and two post-test, staggered design with 2-3 providers receiving the approach first and then 2-3 receiving it on a delayed basis. A pre-test (baseline) of all participants will be completed. The approach will then be implemented with the first providers. There will then be a follow-up data collection for all participants (post-test 1). The second providers will then implement the approach, which will be followed by a final data collection for all participants (post-test 2). DISCUSSION Two specific outcomes are anticipated from this research; firstly, it is hoped that the research methodology provides a framework for how government agencies, researchers and relevant sector stakeholders can work with Māori communities. Secondly, the two individual projects will each produce a tangible approach that, it is anticipated, will be cost effective in enhancing kaumātua hauora and mana motuhake. TRIAL REGISTRATION Australia New Zealand Clinical Trial Registry ( ACTRN12620000316909 ). Registered 6 March 2020.
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Affiliation(s)
| | - John G. Oetzel
- University of Waikato, Private Bag 3105, Hamilton, 3240 New Zealand
| | | | - Sophie Nock
- University of Waikato, Private Bag 3105, Hamilton, 3240 New Zealand
| | - Rangimahora Reddy
- Rauawaawa Kaumātua Charitable Trust, 50 Colombo St., Hamilton, 3204 New Zealand
| | - Pare Meha
- Rauawaawa Kaumātua Charitable Trust, 50 Colombo St., Hamilton, 3204 New Zealand
| | - Kirsten Johnston
- Rauawaawa Kaumātua Charitable Trust, 50 Colombo St., Hamilton, 3204 New Zealand
| | | | - Bevan Erueti
- Massey University, Private Bag 11 222, Palmerston North, 4442 New Zealand
| | - Poia Rewi
- University of Otago, PO Box 56, Dunedin, 9054 New Zealand
| | - Isaac Warbrick
- Auckland University of Technology, Private Bag 92006, Auckland, 1142 New Zealand
| | | | - Yingsha Zhang
- University of Waikato, Private Bag 3105, Hamilton, 3240 New Zealand
| | - Stacey Ruru
- University of Waikato, Private Bag 3105, Hamilton, 3240 New Zealand
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Ortiz K, Nash J, Shea L, Oetzel J, Garoutte J, Sanchez-Youngman S, Wallerstein N. Partnerships, Processes, and Outcomes: A Health Equity-Focused Scoping Meta-Review of Community-Engaged Scholarship. Annu Rev Public Health 2020; 41:177-199. [PMID: 31922931 PMCID: PMC8095013 DOI: 10.1146/annurev-publhealth-040119-094220] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In recent decades, there has been remarkable growth in scholarship examining the usefulness of community-engaged research (CEnR) and community-based participatory research (CBPR) for eliminating health inequities.This article seeks to synthesize the extant literature of systematic reviews, scoping reviews, and other related reviews regarding the context, processes, and research designs and interventions underlying CEnR that optimize its effectiveness. Through a scoping review, we have utilized an empirically derived framework of CBPR to map this literature and identify key findings and priorities for future research. Our study found 100 reviews of CEnR that largely support the CBPR conceptual framework.
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Affiliation(s)
- Kasim Ortiz
- Department of Sociology and Criminology, University of New Mexico, Albuquerque, New Mexico 87131, USA;
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Institute for the Study of "Race" and Social Justice, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Jacob Nash
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Logan Shea
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - John Oetzel
- Waikato Management School, University of Waikato, 3240 Hamilton, New Zealand
| | - Justin Garoutte
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Behavioral Health Research Center of the Southwest (BHRCS), Pacific Institute for Research and Evaluation (PIRE), Albuquerque, New Mexico 87106, USA
| | - Shannon Sanchez-Youngman
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Center for Social Policy, University of New Mexico, Albuquerque, New Mexico 87131, USA
- School of Public Administration, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Nina Wallerstein
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
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Anselma M, Chinapaw M, Altenburg T. "Not Only Adults Can Make Good Decisions, We as Children Can Do That as Well" Evaluating the Process of the Youth-Led Participatory Action Research 'Kids in Action'. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020625. [PMID: 31963706 PMCID: PMC7014142 DOI: 10.3390/ijerph17020625] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 11/16/2022]
Abstract
In Youth-led Participatory Action Research (YPAR), youth collaborate with academic researchers to study a problem, develop actions that align with their needs and interests, and become empowered. 'Kids in Action' aimed to develop actions targeting healthy physical activity and dietary behavior among, and together with, 9-12-year-old children as co-researchers. This paper presents the process evaluation of 'Kids in Action' based on eight focus groups with children (N = 40) and eight interviews with community partners (N = 11). Interview guides were based on empowerment theory and the RE-AIM framework, in order to evaluate the study on: empowerment, collaborations, reach, effectiveness, adoption, implementation, and maintenance. Transcripts were analyzed using evaluation and provisional coding. Both children and community partners perceived an increased awareness of healthy behaviors and an improvement in confidence, critical awareness, leadership and collaboration skills, which contributed to increased feelings of empowerment. Community partners valued child participation and the co-created actions. Actions were also well-perceived by children and they liked being involved in action development. The strong relationship of researchers with both children and relevant community partners proved an important facilitator of co-creation. Future studies are recommended to attempt closer collaboration with schools and parents to gain even more support for co-created actions and increase their effectiveness.
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16
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Agdal R, Midtgård IH, Meidell V. Can Asset-Based Community Development with Children and Youth Enhance the Level of Participation in Health Promotion Projects? A Qualitative Meta-Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193778. [PMID: 31597340 PMCID: PMC6801434 DOI: 10.3390/ijerph16193778] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/13/2019] [Accepted: 09/25/2019] [Indexed: 11/16/2022]
Abstract
The asset-based community development (ABCD) approach have been widely used to map local assets and to ensure participation of local communities in public health promotion strategies. Participatory practices, such as ABCD, have been applied to shift public health strategies towards addressing health inequities. In this meta-synthesis, we ask if, and how, ABCD enhance the level of participation for children, youth and schools. Three thousand eight hundred eight titles and abstracts were identified in ten databases and transferred to the online program Rayyan. Through a blinded process we excluded texts that did not meet the inclusion criteria. The twelve included texts on ABCD for children, youth and schools are of varying quality. The research on ABCD for children, youth and schools have not been cumulative. Nevertheless, the texts show that ABCD provides strategies that enhance the participation of children, youth, and schools, in health promotion projects. The projects were categorized according to Robert Hart’s classical participation ladder, and we found that the projects with the highest level of adherence to ABCD principles also had the highest level of participation. The projects with high levels of participation were supported by adult facilitators that created learning environments where children and youth developed their participatory skills.
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Affiliation(s)
- Rita Agdal
- Western Norway University of Applied Sciences, 7030, 5020 Bergen, Norway.
| | | | - Vigdis Meidell
- Western Norway University of Applied Sciences, 7030, 5020 Bergen, Norway.
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17
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Holmberg C, Larsson C, Korp P, Lindgren EC, Jonsson L, Fröberg A, Chaplin JE, Berg C. Empowering aspects for healthy food and physical activity habits: adolescents' experiences of a school-based intervention in a disadvantaged urban community. Int J Qual Stud Health Well-being 2018; 13:1487759. [PMID: 29972679 PMCID: PMC6032021 DOI: 10.1080/17482631.2018.1487759] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This study aimed to describe adolescents' experiences of participating in a health-promoting school-based intervention regarding food and physical activity, with a focus on empowering aspects. Method: The school was located in a urban disadvantaged community in Sweden, characterized by poorer self-reported health and lower life expectancy than the municipality average. Focus group interviews with adolescents (29 girls, 20 boys, 14-15 years) and their teachers (n = 4) were conducted two years after intervention. Data were categorized using qualitative content analysis. RESULTS A theme was generated, intersecting with all the categories: Gaining control over one's health: deciding, trying, and practicing together, in new ways, using reflective tools. The adolescents appreciated influencing the components of the intervention and collaborating with peers in active learning activities such as practicing sports and preparing meals. They also reported acquiring new health information, that trying new activities was inspiring, and the use of pedometers and photo-food diaries helped them reflect on their health behaviours. The adolescents' experiences were also echoed by their teachers. Conclusions: To facilitate empowerment and stimulate learning, health-promotion interventions targeting adolescents could enable active learning activities in groups, by using visualizing tools to facilitate self-reflection, and allowing adolescents to influence intervention activities.
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Affiliation(s)
- Christopher Holmberg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Christel Larsson
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Peter Korp
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Eva-Carin Lindgren
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Linus Jonsson
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fröberg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - John E Chaplin
- Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Berg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
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