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Eltink E, Bröer C. Healthism online: 'What I eat in a day' vlogs before and during COVID-19 restrictions. Heliyon 2024; 10:e23623. [PMID: 38187283 PMCID: PMC10770541 DOI: 10.1016/j.heliyon.2023.e23623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
Objective and setting The COVID-19 pandemic and its restrictions coincide with an increase in body weight and changes in health-related habits worldwide. This study focusses on the way health-related habits are portrayed online in digital food cultures. The study aims to investigate if and how the content of high-profile Dutch 'What I eat in a day' vlogs has changed during the first period of COVID-19 restrictions. We approach changes in digital food culture through the concept of 'healthism' and see vloggers as cultural intermediaries. Design and participants We collected the most watched vlogs of almost all high-profile Dutch influencers pre-post corona and analyzed these in a mixed method approach by using summative and thematic content analysis. Results Pre-COVID vlogs highlight an explicit consciousness of energy balance-related behavior, focusing on calorie counting, avoidance of unhealthy food and the use of tracking apps. In vlogs uploaded in 2020, these themes are less present. Instead, intuitive eating and listening to one's body are more central themes within the vlogs. Conclusions We consider the shift towards intuitive eating as another variant of "wellness diets" rather than a shift away from dieting, furthered by COVID-19 restrictions. The core values of health and self-regulation are upheld within the shift towards intuitive eating. Yet, we nuance the broad claims of healthism in biopolitics and point to relevant cultural changes within foodscapes.
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Affiliation(s)
- Elisa Eltink
- Communication, Health and Life Sciences, Wageningen University, PO Box 8130, 6700 EW, Wageningen, the Netherlands
| | - Christian Bröer
- Department of Sociology, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, the Netherlands
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2
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Mandoh M, Raeside R, Todd A, Redfern J, Mihrshahi S, Cheng HL, Phongsavan P, Partridge SR. Evaluating the effect of a 12-month youth advisory group on adolescent's leadership skills and perceptions related to chronic disease prevention research: a mixed-methods study. BMC Public Health 2023; 23:2344. [PMID: 38012583 PMCID: PMC10680352 DOI: 10.1186/s12889-023-17283-2] [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] [Received: 07/01/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Youth Advisory Groups (YAGs) represent a promising method to engage adolescents in research of relevance to them and their peers. However, YAGs are rarely implemented or evaluated in chronic disease prevention research. The aims of this study were firstly, to evaluate the effect of participation in a 12-month YAG on adolescents' leadership skills and perceptions related to chronic disease prevention research and secondly, to evaluate the process of establishing and facilitating a 12-month YAG and identify barriers and enablers to establishment and facilitation. METHODS This study was a 12-month pre-post study. Eligible participants were adolescents (13-18-years) and current members of an established YAG. Data collection involved online surveys and semi-structured interviews at baseline, six-months and 12-months follow-up. Participatory outcomes such as self-efficacy, leadership skills, and collective participation were derived from Youth Participatory Action Research Principles (YPAR), and the Lansdown-UNICEF conceptual framework for measuring outcomes of adolescent participation. Process evaluation data were captured via meeting minutes, Slack metrics and researcher logs. Quantitative data was analysed using descriptive statistics and qualitative data was thematically analysed using a reflexive thematic analysis approach. RESULTS Thirteen (13/16) YAG youth advisors consented to participate in the evaluation study (mean age 16.0 years, SD 1.3; 62% (8/13) identified as female). Survey data assessing participatory outcomes found an increase in leadership and life skills scores over 12-months (+ 8.90 points). Semi-structured interview data collected over the 12-month term revealed three key themes namely: influence, empowerment, and contribution. Comparison of pre-post themes determined a positive trend at follow-ups, demonstrating improved participatory outcomes. Process indicators revealed that at 12-month follow-up the YAG was implemented as planned. Semi-structured interview data determined barriers to YAG facilitation included time and limited face-to-face components, while enablers to YAG facilitation included flexibility, accessible delivery methods, and a supportive adult facilitator. CONCLUSION This study found that a YAG fostered positive participatory outcomes and unique opportunities for youth participants. A successful YAG based on YPAR principles requires researchers to ensure YAG establishment and facilitation is an iterative process. Taking into consideration important barriers and enablers to YAG facilitation ensures adolescent engagement in a YAG is both meaningful and impactful.
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Affiliation(s)
- Mariam Mandoh
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Rebecca Raeside
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Allyson Todd
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
- The George Institute for Global Health, The University of New South Wales, Camperdown, NSW, 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Hoi Lun Cheng
- Sydney Medical School, Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Westmead, NSW, 2145, Australia
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, NSW, 2145, Australia
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Stephanie R Partridge
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
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3
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Aguiar A, Gebremariam MK, Romanenko E, Önal F, Kopainsky B, Savona N, Brown A, Allender S, Lien N. System dynamics simulation models on overweight and obesity in children and adolescents: A systematic review. Obes Rev 2023; 24 Suppl 2:e13632. [PMID: 37753602 DOI: 10.1111/obr.13632] [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: 03/20/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 09/28/2023]
Abstract
It has increasingly been recognized that developing successful obesity prevention policies and interventions requires understanding of the complex mechanisms driving the obesity pandemic and that models could be useful tools for simulating policies. This paper reviews system dynamics simulation models of mechanisms driving childhood overweight and obesity and/or testing of preventive interventions. A systematic literature search was conducted in six databases from inception to January 2023 using terms related to overweight/obesity, children, and system dynamics. Study descriptives, mechanisms, and where to intervene (the leverage points), as well as quality assessments of the simulation models were extracted by two researchers into a predetermined template and narratively synthesized. Seventeen papers describing 15 models were included. Models describing the mechanisms ranged from only intrapersonal factors to models cutting across multiple levels of the ecological model, but mechanisms across levels were lacking. The majority of interventions tested in the simulation models were changes to existing model parameters with less emphasis on models that alter system structure. In conclusion, existing models included mechanisms driving youth obesity at multiple levels of the ecological model. This is useful for developing an integrated simulation model combining mechanisms at multiple levels and allowing for testing fundamental system changes.
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Affiliation(s)
- Anaely Aguiar
- System Dynamics Group, University of Bergen, Bergen, Norway
| | | | | | - Furkan Önal
- System Dynamics Group, University of Bergen, Bergen, Norway
| | | | - Natalie Savona
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Brown
- Global Centre for Preventive Health and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
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4
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Ulloa MA, Nesrallah S, Shafafi P, Lamar A, Gonçalves PCR, Gonçalves M, Nylander KS, Luszczynska A, Lien N, Bergstrøm E, Rutter H, Marki H, Klepp KI, Bouillon C. Designing a youth-led Dialogue Forum tool: The CO-CREATE experience. Obes Rev 2023; 24 Suppl 2:e13611. [PMID: 37753600 DOI: 10.1111/obr.13611] [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: 04/03/2023] [Revised: 06/04/2023] [Accepted: 07/08/2023] [Indexed: 09/28/2023]
Abstract
While obesity prevention represents an established field of research, the inclusion of young people, who are regularly cited as an important priority group, are rarely actioned in long-term studies. This paper focuses on the development of a dialogue tool intended to tackle this issue, engaging, and eliciting insights on the theme of obesity prevention, by young people and for young people. As part of the CO-CREATE project, this tool was co-developed by designers, public health, and youth participation experts, researchers, and young people. Co-creation is a key methodology in the design of the dialogue tool, as young people were involved in all stages of the development process. This paper elaborates on the process of co-designing a dialogue tool that helps explore obesity prevention policy ideas from multiple perspectives, and describes the design principles that informed the process and the final versions of the tool. The purpose of the Dialogue Forum tool is for youth to engage policymakers and other relevant stakeholders to discuss and refine co-created and youth-initiated ideas for healthier food and physical activity environments. We analyze how specific design principles were integrated into different prototypes and the value of this within the project and the field.
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Affiliation(s)
| | | | | | | | - Pedro Côrte-Real Gonçalves
- CO-CREATE Youth Task Force, Portugal
- CEIDSS Centre for Studies and Research in Social Dynamics and Health, Lisbon, Portugal
| | - Mafalda Gonçalves
- CO-CREATE Youth Task Force, Portugal
- CEIDSS Centre for Studies and Research in Social Dynamics and Health, Lisbon, Portugal
| | | | - Aleksandra Luszczynska
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Nanna Lien
- Department of Nutrition, The Medical Faculty, University of Oslo, Oslo, Norway
| | - Elin Bergstrøm
- Centre for Development and the Environment, University of Oslo, Oslo, Norway
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | | | - 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
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5
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Banik A, Knai C, Klepp KI, Rutter H, Rito A, Lien N, Baillergeau E, Szczuka Z, Boberska M, Kulis E, Luszczynska A. What policies are there and what policies are missing? A Photovoice study of adolescents' perspectives on obesity-prevention policies in their local environment. Obes Rev 2023; 24 Suppl 2:e13617. [PMID: 37753603 DOI: 10.1111/obr.13617] [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: 04/11/2023] [Revised: 06/15/2023] [Accepted: 07/13/2023] [Indexed: 09/28/2023]
Abstract
The aim of this study was to investigate adolescents' critical awareness of whether obesity prevention policies targeting physical activity (PA) and nutrition were operating in their local community. Participants were 41 adolescents (aged 16-18, 90% women) recruited from three communities in Poland. Prior to this study, they were involved in obesity-prevention participatory initiatives (conducted within the CO-CREATE project), where obesity-related public policy limitations were analyzed in a youth-led discussion. A Photovoice exercise was designed to capture obesity-related public policies that were either present or absent in young people's local environments. The photographs (N = 213) were coded and mapped according to the policy themes they illustrated, using the MOVING and NOURISHING frameworks. The public policies represented in the photographs are most frequently related to: healthy retail or food service environments; food advertising or promotion; structures and surroundings that promote PA; and infrastructure and opportunities that support public or active transport. Adolescents are critically aware of the presence and lack of specific public policies operating in their local environment, particularly policies affecting structural aspects of food and PA environments. Policy-oriented photovoice exercises may prompt critical awareness among adolescents and empower them to contribute to obesity prevention policy processes.
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Affiliation(s)
- Anna Banik
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Cecile Knai
- London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, London, UK
| | - 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
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Ana Rito
- Centre for Studies and Research in Social Dynamics and Health - CEIDSS, Lisbon, Portugal
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Evelyne Baillergeau
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Zofia Szczuka
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Monika Boberska
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Ewa Kulis
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Aleksandra Luszczynska
- CARE-BEH Center for Applied Research on Health Behavior and Health, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
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6
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Conway-Moore K, Knai C, Finegood D, Johnston L, Brinsden H, Aguiar A, Kopainsky B, Önal F, Helleve A, Klepp KI, Lien N, Luszczynska A, Rito AI, Rønnestad AM, Ulstein M, Blanchard L, Savona N, Rutter H. Co-creating obesity prevention policies with youth: Policy ideas generated through the CO-CREATE project. Obes Rev 2023; 24 Suppl 2:e13623. [PMID: 37753599 DOI: 10.1111/obr.13623] [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: 05/12/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 09/28/2023]
Abstract
Despite growing recognition of the importance of applying a systems lens to action on obesity, there has only been limited analysis of the extent to which this lens has actually been applied. The CO-CREATE project used a youth-led participatory action research approach to generate policy ideas towards the reduction of adolescent overweight and obesity across Europe. In order to assess the extent to which these youth-generated policy ideas take a systems approach, we analyzed them using the Intervention Level Framework (ILF). The ILF ascribes actions to one of five system levels, from Structural Elements, the least engaged with system change, up to Paradigm, which is the system's deepest held beliefs and thus the most difficult level at which to intervene. Of the 106 policy ideas generated by young people during the CO-CREATE project, 91 (86%) were categorized at the level of Structural Elements. This emphasis on operational rather than systems level responses echoes findings from a previous study on obesity strategies. Analyzing the distribution of systems level responses using the ILF has the potential to support more effective action on obesity by allowing identification of opportunities to strengthen systems level responses overall.
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Affiliation(s)
- Kaitlin Conway-Moore
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Cécile Knai
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Diane Finegood
- Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, Canada
- Morris J. Wosk Centre for Dialogue, Simon Fraser University, Vancouver, Canada
| | - Lee Johnston
- Morris J. Wosk Centre for Dialogue, Simon Fraser University, Vancouver, Canada
| | | | - Anaely Aguiar
- System Dynamics Group, University of Bergen, Bergen, Norway
| | | | - Furkan Önal
- System Dynamics Group, University of Bergen, Bergen, Norway
| | - 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
| | - Nanna Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Ana Isabel Rito
- National Institute of Health Dr.Ricardo Jorge, Lisbon, Portugal
| | | | | | - Laurence Blanchard
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
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7
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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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8
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Aguiar A, Önal F, Hendricks G, Blanchard L, Romanenko E, Fismen AS, Nwosu E, Herstad S, Savona N, Harbron J, Knai C, Samdal O, Rutter H, Lien N, Jalali MS, Kopainsky B. Understanding the dynamics emerging from the interplay among poor mental wellbeing, energy balance-related behaviors, and obesity prevalence in adolescents: A simulation-based study. Obes Rev 2023; 24 Suppl 2:e13628. [PMID: 37753604 DOI: 10.1111/obr.13628] [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: 04/04/2023] [Revised: 06/16/2023] [Accepted: 07/18/2023] [Indexed: 09/28/2023]
Abstract
Both obesity and poor mental wellbeing have a high prevalence in European youth. Adolescents in six countries identified mental wellbeing factors as main drivers of youth obesity through systems mapping. This study sought to (1) explore the dynamics of the interplay between poor mental wellbeing, energy balance-related behaviors, and adolescent overweight and obesity prevalence and (2) test the effect of intervention point scenarios to reduce adolescent obesity. Drawing on the youth-generated systems maps and a literature synthesis, we built a simulation model that represents the links from major feedback pathways for poor mental wellbeing to changes in dietary, physical activity, and sleep behaviors. The model was calibrated using survey data from Norway, expert input, and literature and shows a good fit between simulated behavior and available statistical data. The simulations indicate that adolescent mental wellbeing is harmed by socio-cultural pressures and stressors, which trigger reinforcing feedback mechanisms related to emotional/binge eating, lack of motivation to engage in physical activity, and sleep difficulty. Targeting a combination of intervention points that support a 25% reduction of pressure on body image and psychosocial stress showed potentially favorable effects on mental wellbeing-doubling on average for boys and girls and decreasing obesity prevalence by over 4%.
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Affiliation(s)
- Anaely Aguiar
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway
| | - Furkan Önal
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway
| | | | - Laurence Blanchard
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Eduard Romanenko
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anne-Siri Fismen
- Department of Health and Caring Services, Western Norway University of Applied Science, Bergen, Norway
| | - Emmanuel Nwosu
- Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Sondre Herstad
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Natalie Savona
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Janetta Harbron
- Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Cécile Knai
- Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Oddrun Samdal
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, Bath, UK
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Mohammad S Jalali
- MGH Institute for Technology Assessment, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Birgit Kopainsky
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway
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9
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Samdal O, Budin-Ljøsne I, Haug E, Helland T, Kjostarova-Unkovska L, Bouillon C, Bröer C, Corell M, Cosma A, Currie D, Eriksson C, Felder-Puig R, Gaspar T, Hagquist C, Harbron J, Jåstad A, Kelly C, Knai C, Kleszczewska D, Kysnes BB, Lien N, Luszczynska A, Moerman G, Moreno-Maldonado C, NicGabhainn S, Pudule I, Rakic JG, Rito A, Rønnestad AM, Ulstein M, Rutter H, Klepp KI. Encouraging greater empowerment for adolescents in consent procedures in social science research and policy projects. Obes Rev 2023; 24 Suppl 2:e13636. [PMID: 37753605 DOI: 10.1111/obr.13636] [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: 06/15/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 09/28/2023]
Abstract
The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co-creating policy with youth (CO-CREATE) and the Health Behaviour in School-aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross-National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12 years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged.
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Affiliation(s)
- Oddrun Samdal
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Isabelle Budin-Ljøsne
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ellen Haug
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Trond Helland
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | | | | | - Christian Bröer
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | - Maria Corell
- Unit for Mental Health, Children and Youth, Public Health Agency of Sweden, Stockholm, Sweden
| | - Alina Cosma
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
| | - Dorothy Currie
- School of Medicine, St. Andrews University, St. Andrews, UK
| | - Charli Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Solna, Sweden
| | - Rosemarie Felder-Puig
- Department of Evidence and Quality Standards, Austrian National Public Health Institute, Vienna, Austria
| | - Tania Gaspar
- Psychology and health Sciences Department, Lusofona University, Lisbon, Portugal
| | - Curt Hagquist
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden
| | - Janetta Harbron
- Research Centre for Health Through Physical Activity, Lifestyle and Sport (HPALS), Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Atle Jåstad
- Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Colette Kelly
- Health Promotion Research Centre, University of Galway, Galway, Ireland
| | - Cecile Knai
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Dorota Kleszczewska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | | | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
| | | | - Gerben Moerman
- Department of Sociology, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Iveta Pudule
- Centre for Disease Prevention and Control, Riga, Latvia
| | - Jelena Gudelj Rakic
- Centre of Health Promotion, Institute of Public Health of Serbia, Beograd, Serbia
| | - Ana Rito
- Centre for Studies and Research in Social Dynamics and Health, Lisbon, Portugal
| | | | | | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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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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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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