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Harris M, Crone D, Hughes S. Factors That Help and Hinder the Implementation of Community-Wide Behavior Change Programs. Health Promot Pract 2024; 25:428-435. [PMID: 37165856 PMCID: PMC11064465 DOI: 10.1177/15248399231172760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Novel community-wide approaches that gamify physical activity through challenges and competition have become increasingly popular in recent years. However, little is known about the factors that help or hinder their implementation. This qualitative study aimed to address this gap in the literature by systematically investigating the facilitators (organizational and experiential) and barriers to successful implementation of a community-wide intervention delivered in Gloucester, the United Kingdom. A two-phased process evaluation was conducted. Phase 1 involved the thematical analysis of open question feedback from n = 289 adults. Phase 2 included three focus groups conducted with n = 12 participants. This research showed that promoting the initiative through primary education settings was fundamental to enhancing awareness and participation. Social elements of the intervention were identified as a motivating factor for, and a consequential outcome of, participation. A lack of promotion to wider-reaching proportions of the community was perceived to be a significant barrier to implementation, potentially limiting inclusivity and participation in the activity. Game dynamics, timing, and fears regarding sustainability represented further difficulties to implementation.
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Affiliation(s)
- Marc Harris
- Cardiff Metropolitan University, Cardiff, UK
| | - Diane Crone
- Cardiff Metropolitan University, Cardiff, UK
| | - Samantha Hughes
- University of Gloucestershire, Cheltenham, Gloucestershire, UK
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Kamran R, Coletta G, Pritchard JM. Can Undergraduate Students Help Change Older Adults' Confidence for Making Nutrition-Related Decisions in a 45-Minute Nutrition Workshop? CAN J DIET PRACT RES 2021; 82:136-139. [PMID: 34286607 DOI: 10.3148/cjdpr-2021-010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: The Social Cognitive Theory (SCT) suggests health behaviour can be modified by enhancing knowledge of health benefits and outcome expectations of changing behaviour, improving self-efficacy (confidence), and developing goals to overcome barriers to behaviour change. This study aimed to determine the impact of student-led nutrition workshops on participants' confidence related to SCT constructs for making dietary choices that align with evidence-based nutrition recommendations.Methods: Level-4 Science students developed and delivered 9 workshops on nutrition recommendations for the prevention and management of age-related diseases. Participants attending the workshops completed pre- and post-surveys to assess SCT constructs. For each SCT construct, participants rated their confidence on a 10-point Likert scale. The number (%) of participants who rated their confidence as ≥8/10 on the pre- and post-surveys were compared using the χ2 test.Results: Sixty-three community members (60% female, mean ± SD age 71 ± 7 years) attended the workshops. The number of participants rating confidence as ≥8/10 for each SCT construct increased after the workshops (P < 0.05).Conclusion: Undergraduate students can positively influence community members' confidence for making nutrition-related decisions. Involving students in interventions where SCT-structured workshops are used may help conserve health care resources and reach older adults who may not have access to dietitian services.
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Affiliation(s)
- Rakhshan Kamran
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON
| | - Giulia Coletta
- Department of Kinesiology, McMaster University, Hamilton, ON
| | - Janet M Pritchard
- School of Interdisciplinary Science, McMaster University, Hamilton, ON
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Bammann K, Recke C, Albrecht BM, Stalling I, Doerwald F. Promoting Physical Activity Among Older Adults Using Community-Based Participatory Research With an Adapted PRECEDE-PROCEED Model Approach: The AEQUIPA/OUTDOOR ACTIVE Project. Am J Health Promot 2020; 35:409-420. [PMID: 33267636 PMCID: PMC8010898 DOI: 10.1177/0890117120974876] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The PRECEDE-PROCEED model (PPM) is a community-based participatory research (CBPR) framework for health promotion, yet the direct application of the PPM into practice is unclear. This paper describes how the PPM was adapted for the development and application of a pilot intervention study to promote outdoor physical activity (PA) in older adults (OUTDOOR ACTIVE). We illustrate the steps and adaptations we applied to put the PPM into practice and present the developed interventions. DESIGN The PPM was adapted by incorporating a socio-ecological model. This ensured the design of any resultant intervention would explicitly address multi-level determinants of physical activity. The list of possible program components to select from for the design of an intervention was also extended. SETTING Bremen, Germany. PARTICIPANTS Participants in the intervention development were 924 noninstitutionalized older adults, aged 65-75 years (response: 25.2%), living in Bremen-Hemelingen, Germany. For implementation of the intervention and to ensure sustainability, several groups of stakeholders were involved throughout the process. METHODS A mixed method design was employed (e.g., focus groups, quantitative survey) to identify determinants. A round table and participatory workshops were held to involve the target group and community stakeholders in the design of an intervention using the adapted PPM model. RESULTS A conceptual model was developed illustrating the integration of a socio-ecological model into the PPM. The model received ecological validity, as it was affirmed by community stakeholders as an appropriate method for designing a community-level PA intervention. Target goals to address PA determinants were selected by target group members. An intervention to meet the goals was developed and implemented with target group input. CONCLUSION The adapted PPM is a promising starting point for developing multi-level interventions. Steps should be taken to ensure all social groups are participating in the process and all levels of determinants are addressed.
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Affiliation(s)
- Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Carina Recke
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Birte Marie Albrecht
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Imke Stalling
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
| | - Friederike Doerwald
- Institute for Public Health and Nursing Sciences (IPP), 9168University of Bremen, Bremen, Germany
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Wong EYS, Lee AH, James AP, Jancey J. Process evaluation of the 'Singapore Physical Activity and Nutrition Study'. EVALUATION AND PROGRAM PLANNING 2020; 83:101847. [PMID: 32916472 DOI: 10.1016/j.evalprogplan.2020.101847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 03/20/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The Singapore Physical Activity and Nutrition Study (SPANS) aimed to improve the physical activity (PA) and nutrition behaviours of Singaporean women aged 50 years and over. The SPANS program consisted of PA classes, nutrition workshops, telephone dietary counselling, health booklets, a health calendar and program ambassadors. This study aimed to assess and understand the implementation of the program strategies and gain insight into process evaluation components to inform future programs. METHODS The evaluation was guided by a process evaluation framework and collected data via questionnaires (n = 209), program ambassador documentation and exit interviews with program completers (n = 13) and non-completers (n = 12). RESULTS In total, 295 participants completed the program (response rate = 84 %). Participants reported high levels of satisfaction with the overall program (99.5 %) and program activities (96.7 %), and also rated program ambassadors highly. Participation rates were highest for telephone dietary counselling sessions. The main reason for not attending program activities was having a 'busy schedule' (n = 158). Participants cited a need for improved recreational centre facilities and increased flexibility around program delivery. CONCLUSIONS The process evaluation showed that the program strategies were implemented as planned and were deemed suitable for supporting behaviour change among Singaporean women aged 50 years and over. The program reached and involved the majority of participants throughout the six months. The combination of practical educational resources and supportive program ambassadors were key strategies that facilitated positive PA and dietary behaviours. However, there needs to be some flexibility in the delivery of programs. The findings of this research may inform other programs in the region.
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Affiliation(s)
- Elaine Yee-Sing Wong
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Andy H Lee
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Anthony P James
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Jonine Jancey
- School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Public Health, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
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Wong EYS, Lee AH, James AP, Jancey J. Physical activity and nutrition intervention for Singaporean women aged 50 years and above: study protocol for a randomised controlled trial. Trials 2018; 19:257. [PMID: 29703218 PMCID: PMC5923190 DOI: 10.1186/s13063-018-2562-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/22/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The majority of the older Singaporean women aged 50 years and above are physically inactive and have unhealthy dietary habits, placing them at 'high risk' of non-communicable diseases (NCDs). The adoption of regular physical activity (PA) and a healthy diet are essential lifestyle behaviours to reduce this risk. This randomised controlled trial (RCT) involves the development, implementation and evaluation of a PA and nutrition programme for community-dwelling Singaporean women who currently attend recreational centres (RCs are public facilities supporting social leisure activities) in their local area. The intervention will be developed after conducting formative evaluation with RC attendees and managers through focus group discussions and pilot testing of resources (i.e. surveys, accelerometers, and health booklets). Programme ambassadors (trained, certified fitness instructors and nutritionists) will deliver all sessions in English and Mandarin; implement classes to meet participants' varying needs; and conduct sessions at different times at convenient venues. Social Cognitive Theory (SCT) has been selected as the theoretical framework to inform intervention strategies as it explores the interactions of human behaviour with the environment and has been found to be valuable when developing behavioural change interventions particularly in older adults (J Gerontol B Psychol Sci Soc Sci 67B(1):18-26, 2012; Obesity Reviews 15(12):983-95, 2014). Its major construct, self-efficacy, is invaluable in achieving successful behaviour change, such as increasing levels of PA or improving dietary intake (Trials. 2017; https://doi.org/10.1186/s13063-016-1771-9 ; Psychol Health Med 18(6):714-24, 2013). METHODS The development and implementation of the PA and nutrition intervention strategies will be guided by SCT and Motivational interviewing (MI) and implemented by trained programme ambassadors at the RCs. Sixty RCs located in Singapore will be selected from five major geographical districts and randomly allocated to the intervention (n = 30) or control (n = 30) cluster. A sample of 600 (intervention n = 300; control n = 300) women aged 50 years and above will then be recruited from these 60 centres and only the intervention group will be enrolled into the PA and nutrition intervention. It is hypothesised that by the end of the intervention, the intervention group participants compared to the control group will show significantly greater improvements in the following outcome variables: PA and dietary behaviours, health-related quality of life, objective measures of PA, anthropometric, lipid and glucose profiles. Data will be collected at baseline and 6 months and analysed using mixed regression models. DISCUSSION It is anticipated that recruitment, retention and compliance of participants will be challenging due to the target group being unfamiliar with such community-based research programmes. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12617001022358. Registered on 14 July 2017. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372984&isReview=true.
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Affiliation(s)
| | - Andy H. Lee
- School of Public Health, Curtin University, Perth, WA Australia
| | | | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, (CERIPH), School of Public Health, Curtin University, Perth, WA Australia
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Blackford K, Lee A, James AP, Waddell T, Hills AP, Anderson AS, Howat P, Jancey J. Process evaluation of the Albany Physical Activity and Nutrition (APAN) program, a home-based intervention for metabolic syndrome and associated chronic disease risk in rural Australian adults. Health Promot J Austr 2017; 28:8-14. [PMID: 27426475 DOI: 10.1071/he16027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 06/09/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed The Albany Physical Activity and Nutrition (APAN) study investigated the effects of the APAN program, a home-based intervention on dietary and physical activity behaviours and chronic disease risk for rural Australian adults. This paper reports on the process evaluation to gain insight into the link between intervention elements and outcomes. Methods The APAN program comprised resources to improve participants' diet and physical activity. Printed and online resources were provided to participants, complemented by motivational interviews via telephone. Process evaluation used mixed-methods, with a sample of 201 intervention participants residing in a disadvantaged rural area. Participants were aged 50 to 69 years with, or at risk of, metabolic syndrome. Quantitative data were collected using an online survey (n=73); qualitative data were collected via telephone exit interviews with intervention completers (n=8) and non-completers (n=8), and recruitment notes recorded by research assistants. Results The attrition rate of the program was 18%; major reasons for withdrawal were health and personal issues and a loss of interest. The majority of participants found the printed resources useful, attractive, and suitable to their age group. The website was the least preferred resource. Reasons for completing the program included the desired health benefits, wanting to honour the commitment, and wanting to assist with research. Conclusions Carefully planned recruitment will reduce the burden on resources and improve uptake. Understanding reasons for attrition such as family or personal barriers and health issues will assist practitioners to support participants overcome these barriers. Given participants' preference for printed resources, and the known effectiveness of these in combination with other strategies, investigating methods to encourage use of telephone and online support should be a priority. So what? This process evaluation provided an overview of recruitment challenges and preferred intervention components. It is desirable that future work determines the most effective intervention components for rural adults at risk of chronic disease.
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Affiliation(s)
- Krysten Blackford
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Andy Lee
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Anthony P James
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Tracy Waddell
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Andrew P Hills
- School of Health Sciences, University of Tasmania, Locked Bag 1322, Newnham Drive, Launceston, Tas. 7250, Australia
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, Division of Cancer Research, Level 7, Mailbox 7, Ninewells Medical School, Dundee DD1 9SY, Scotland
| | - Peter Howat
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), Curtin University, GPO Box U1987, Perth, WA 6845, Australia
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Meader N, King K, Wright K, Graham HM, Petticrew M, Power C, White M, Sowden AJ. Multiple Risk Behavior Interventions: Meta-analyses of RCTs. Am J Prev Med 2017; 53:e19-e30. [PMID: 28258777 DOI: 10.1016/j.amepre.2017.01.032] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 12/05/2016] [Accepted: 01/23/2017] [Indexed: 11/17/2022]
Abstract
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease, cancer, or Type 2 diabetes. A systematic review, meta-analysis, and meta-regression of the effectiveness of multiple risk behavior interventions was conducted. EVIDENCE ACQUISITION Six electronic databases including MEDLINE, EMBASE, and PsycINFO were searched to August 2016. RCTs of non-pharmacologic interventions in general adult populations were selected. Studies targeting specific at-risk groups (such as people screened for cardiovascular risk factors or obesity) were excluded. Studies were screened independently. Study characteristics and outcomes were extracted and risk of bias assessed by one researcher and checked by another. The Behaviour Change Wheel and Oxford Implementation Index were used to code intervention content and context. EVIDENCE SYNTHESIS Random-effects meta-analyses were conducted. Sixty-nine trials involving 73,873 individuals were included. Interventions mainly comprised education and skills training and were associated with modest improvements in most risk behaviors: increased fruit and vegetable intake (0.31 portions, 95% CI=0.17, 0.45) and physical activity (standardized mean difference, 0.25; 95% CI=0.13, 0.38), and reduced fat intake (standardized mean difference, -0.24; 95% CI=-0.36, -0.12). Although reductions in smoking were found (OR=0.78, 95% CI=0.68, 0.90), they appeared to be negatively associated with improvement in other behaviors (such as diet and physical activity). Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change. But most studies assessed simultaneous rather than sequential change in risk behaviors; therefore, comparisons are sparse. Follow-up period and intervention characteristics impacted effectiveness for some outcomes. CONCLUSIONS Interventions comprising education (e.g., providing information about behaviors associated with health risks) and skills training (e.g., teaching skills that equip participants to engage in less risky behavior) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity. Although on average smoking was reduced, it appeared changes in smoking were negatively associated with changes in other behaviors, suggesting it may not be optimal to target smoking simultaneously with other risk behaviors.
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Affiliation(s)
- Nick Meader
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Kristelle King
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Hilary M Graham
- Department of Health Sciences, University of York, York, United Kingdom
| | - Mark Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chris Power
- Population, Policy, and Practice, UCL Institute of Child Health, London, United Kingdom
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Amanda J Sowden
- Centre for Reviews and Dissemination, University of York, York, United Kingdom.
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Tran VD, Jancey J, Lee A, James A, Howat P, Thi Phuong Mai L. Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation. EVALUATION AND PROGRAM PLANNING 2017; 61:128-133. [PMID: 28063345 DOI: 10.1016/j.evalprogplan.2016.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/23/2016] [Accepted: 12/27/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50-65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN. METHODS Data were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n=163); qualitative data via face-to-face exit interviews with intervention program completers (n=10) and non-completers (n=10), and brief post education session discussions. RESULTS Most participants (87%-96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy. CONCLUSION The evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population.
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Affiliation(s)
- Van Dinh Tran
- Department of Community Health and Network Coordination, National Institute of Hygiene and Epidemiology, No. 1, Yersin Street, Hanoi, Vietnam; School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
| | - Jonine Jancey
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; Collaboration for Evidence, Research and Impact in Public Health, GPO Box U1987, Perth, WA 6845, Australia.
| | - Andy Lee
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
| | - Anthony James
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
| | - Peter Howat
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia; Collaboration for Evidence, Research and Impact in Public Health, GPO Box U1987, Perth, WA 6845, Australia.
| | - Le Thi Phuong Mai
- Department of Community Health and Network Coordination, National Institute of Hygiene and Epidemiology, No. 1, Yersin Street, Hanoi, Vietnam.
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Tran VD, Lee AH, Jancey J, James AP, Howat P, Thi Phuong Mai L. Community-based physical activity and nutrition programme for adults with metabolic syndrome in Vietnam: study protocol for a cluster-randomised controlled trial. BMJ Open 2016; 6:e011532. [PMID: 27256094 PMCID: PMC4893929 DOI: 10.1136/bmjopen-2016-011532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular diseases and type II diabetes. In Vietnam, more than one-quarter of its population aged 50-65 have MetS. This cluster-randomised controlled trial aims to evaluate the effectiveness of interventions to increase levels of physical activity and improve dietary behaviours among Vietnamese adults aged 50-65 years with MetS. METHOD AND ANALYSIS This 6-month community-based intervention includes a range of strategies to improve physical activity and nutrition for adults with MetS in Hanam, a province located in northern Vietnam. 600 participants will be recruited from 6 communes with 100 participants per commune. The 6 selected communes will be randomly allocated to either an intervention group (m=3; n=300) or a control group (m=3; n=300). The intervention comprises booklets, education sessions, resistance bands and attending local walking groups that provide information and encourage participants to improve their physical activity and healthy eating behaviours during the 6-month period. The control group participants will receive standard and 1-time advice. Social cognitive theory is the theoretical concept underpinning this study. Measurements will be taken at baseline and postintervention to evaluate programme effectiveness. ETHICS AND DISSEMINATION The research protocol was approved by the Curtin University Human Research Ethics Committee (approval number: HR139/2014). The results of the study will be disseminated through publications, reports and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12614000811606.
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Affiliation(s)
- Van Dinh Tran
- Department of Community Health and Network Coordination, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Jonine Jancey
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
| | - Anthony P James
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Peter Howat
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
| | - Le Thi Phuong Mai
- Department of Community Health and Network Coordination, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
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Blackford K, Jancey J, Lee AH, James AP, Howat P, Hills AP, Anderson A. A randomised controlled trial of a physical activity and nutrition program targeting middle-aged adults at risk of metabolic syndrome in a disadvantaged rural community. BMC Public Health 2015; 15:284. [PMID: 25885657 PMCID: PMC4419409 DOI: 10.1186/s12889-015-1613-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 03/04/2015] [Indexed: 11/17/2022] Open
Abstract
Background Approximately 70% of Australian adults aged over 50 are overweight or obese, with the prevalence significantly higher in regional/remote areas compared to cities. This study aims to determine if a low-cost, accessible lifestyle program targeting insufficiently active adults aged 50-69 y can be successfully implemented in a rural location, and whether its implementation will contribute to the reduction/prevention of metabolic syndrome, or other risk factors for type 2 diabetes, and cardiovascular disease. Methods/Design This 6-month randomised controlled trial will consist of a nutrition, physical activity, and healthy weight intervention for 50–69 year-olds from a disadvantaged rural community. Five hundred participants with central obesity and at risk of metabolic syndrome will be recruited from Albany and surrounding areas in Western Australia (within a 50 kilometre radius of the town). They will be randomly assigned to either the intervention (n = 250) or wait-listed control group (n = 250). The theoretical concepts in the study utilise the Self-Determination Theory, complemented by Motivational Interviewing. The intervention will include a custom-designed booklet and interactive website that provides information, and encourages physical activity and nutrition goal setting, and healthy weight management. The booklet and website will be supplemented by an exercise chart, calendar, newsletters, resistance bands, accelerometers, and phone and email contact from program staff. Data will be collected at baseline and post-intervention. Discussion This study aims to contribute to the prevention of metabolic syndrome and inter- related chronic illnesses: type 2 diabetes mellitus, cardiovascular disease, and some cancers; which are associated with overweight/obesity, physical inactivity, and poor diet. This large rural community-based trial will provide guidelines for recruitment, program development, implementation, and evaluation, and has the potential to translate findings into practice by expanding the program to other regional areas in Australia. Trial registration Australian and New Zealand Clinical Trials Registry [ACTRN12614000512628, registration date 14th May 2014]. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1613-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Krysten Blackford
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Andy H Lee
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Anthony P James
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Peter Howat
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,Centre for Behavioural Research in Cancer Control, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. .,School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Andrew P Hills
- School of Exercise and Nutrition Sciences, Queensland University of Technology, GPO Box 2434, Brisbane, QLD, 4001, Australia.
| | - Annie Anderson
- Centre for Public Health Nutrition Research, Division of Cancer Research, Ninewells Medical School, Level 7, Mailbox 7, Dundee, DD1 9SY, UK.
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Ashe MC, Winters M, Hoppmann CA, Dawes MG, Gardiner PA, Giangregorio LM, Madden KM, McAllister MM, Wong G, Puyat JH, Singer J, Sims-Gould J, McKay HA. "Not just another walking program": Everyday Activity Supports You (EASY) model-a randomized pilot study for a parallel randomized controlled trial. Pilot Feasibility Stud 2015; 1:4. [PMID: 27175291 PMCID: PMC4862805 DOI: 10.1186/2055-5784-1-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Maintaining physical activity is an important goal with positive health benefits, yet many people spend most of their day sitting. Our Everyday Activity Supports You (EASY) model aims to encourage movement through daily activities and utilitarian walking. The primary objective of this phase was to test study feasibility (recruitment and retention rates) for the EASY model. METHODS This 6-month study took place in Vancouver, Canada, from May to December 2013, with data analyses in February 2014. Participants were healthy, inactive, community-dwelling women aged 55-70 years. We recruited through advertisements in local community newspapers and randomized participants using a remote web service. The model included the following: group-based education and social support, individualized physical activity prescription (called Activity 4-1-1), and use of a Fitbit activity monitor. The control group received health-related information only. The main outcome measures were descriptions of study feasibility (recruitment and retention rates). We also collected information on activity patterns (ActiGraph GT3X+ accelerometers) and health-related outcomes such as body composition (height and weight using standard techniques), blood pressure (automatic blood pressure monitor), and psychosocial variables (questionnaires). RESULTS We advertised in local community newspapers to recruit participants. Over 3 weeks, 82 participants telephoned; following screening, 68% (56/82) met the inclusion criteria and 45% (25/56) were randomized by remote web-based allocation. This included 13 participants in the intervention group and 12 participants in the control group (education). At 6 months, 12/13 (92%) intervention and 8/12 (67%) control participants completed the final assessment. Controlling for baseline values, the intervention group had an average of 2,080 [95% confidence intervals (CIs) 704, 4,918] more steps/day at 6 months compared with the control group. There was an average between group difference in weight loss of -4.3 [95% CI -6.22, -2.40] kg and reduction in diastolic blood pressure of -8.54 [95% CI -16.89, -0.198] mmHg, in favor of EASY. CONCLUSIONS The EASY pilot study was feasible to deliver; there was an increase in physical activity and reduction in weight and blood pressure for intervention participants at 6 months. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01842061.
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Affiliation(s)
- Maureen C Ashe
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; Department of Family Practice, University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Meghan Winters
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 11522, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| | - Christiane A Hoppmann
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; UBC Department of Psychology, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada
| | - Martin G Dawes
- Department of Family Practice, University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Paul A Gardiner
- School of Public Health, The University of Queensland, Level 3, Public Health Building, Herston Rd, Herston, Queensland 4006, Australia; Translating Research Into Practice (TRIP) Centre, Mater Research Institute-The University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Lora M Giangregorio
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, Ontario N1H 8 K4, Canada
| | - Kenneth M Madden
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; UBC Department of Medicine, Division of Geriatric Medicine, Room 7185, 2775 Laurel Street, Vancouver, BC N2L 3G1, Canada
| | - Megan M McAllister
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; Department of Family Practice, University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Gillian Wong
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; Department of Family Practice, University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Joseph H Puyat
- UBC School of Population and Public Health, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada; Centre for Health Evaluation and Outcomes Sciences, 588-1081 Burrard Street, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Joel Singer
- UBC School of Population and Public Health, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada; Centre for Health Evaluation and Outcomes Sciences, 588-1081 Burrard Street, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Joanie Sims-Gould
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; Department of Family Practice, University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1 M9, Canada; Department of Family Practice, University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada; UBC Department of Orthopaedics, 3114-910 West 10th Avenue, Vancouver, BC V5Z 1 M9, Canada
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Tucker P, Vanderloo LM, Irwin JD, Mandich AD, Bossers AM. Exploring the nexus between health promotion and occupational therapy: synergies and similarities. The Canadian Journal of Occupational Therapy 2014; 81:183-93. [PMID: 25154132 DOI: 10.1177/0008417414533300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The similarities between health promotion and occupational therapy have been recognized. Both are based on perspectives that share a goal of enabling individuals and populations to improve control over their health. Consequently, it is logical that the principles of health promotion complement the practice of occupational therapy. PURPOSE This paper highlights the affinity between occupational therapy and health promotion, and discusses ways in which health promotion principles can be incorporated into occupational therapy practice. KEY ISSUES Some Canadian occupational therapists may be unaware of the current discourse in health promotion and, thus, may not be incorporating its principles into practice. Steps are warranted to expand the current knowledge and practice of therapists to include health promotion, with specific attention to providing services for the population. IMPLICATIONS Incorporating health promotion principles into occupational therapy perspectives will facilitate the implementation of the domains of practice within the occupational therapy profile. This paper highlights how the principles of health promotion can impact practice at the individual and community level.
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Monteiro SMDR, Jancey J, Howat P. Physical activity and nutrition intervention for mothers of young children: Process evaluation. Health (London) 2014. [DOI: 10.4236/health.2014.63033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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