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Taylor AM, Wessels Q. "Spine to the future"-A narrative review of anatomy engagement. ANATOMICAL SCIENCES EDUCATION 2024; 17:735-748. [PMID: 38587085 DOI: 10.1002/ase.2417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
Anatomy has been integral to medical and health education for centuries, it has also had a significant role in wider public life, as an educational resource, a link to their health, and also as a darker deterrent. Historically, public engagement in anatomy is hallmarked by public dissections of convicted criminals across the globe. Artists, specifically non-medical men, such as Leonardo da Vinci, are reported to have participated in public dissection. Dissection would later rekindle public interest in anatomy as graverobbing led to the reform and regulation of anatomy in many countries. In recent years, there has been growing interest from the public in learning more about their bodies as health and well-being become of paramount importance, particularly following the COVID-19 pandemic. Anatomy sits in a prime position to direct and instigate conversations around health, well-being, and body image. Every human on earth possesses a perfect resource to look at and learn about. Models, art-based anatomical activities, and crafts provide active learning opportunities for the wider public around anatomy. Most recently, apps, games, and extended reality provide novel and insightful learning opportunities for the public relating to the body. Finally, training and resources must also be made available from institutions and professional bodies to anatomists to enable them to deliver engagement in an already congested and educationally heavy schedule. This resurgence of interest in anatomical public engagement sees anatomy re-enter the public spotlight, with more appropriate resources and educational settings to offer engagement with the aim of benefiting the public.
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Affiliation(s)
- Adam M Taylor
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Quenton Wessels
- Division of Anatomy, School of Medicine, University of Namibia, Windhoek, Namibia
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Hoffmann C, Schaller A. Evaluation of the communication strategy for promoting physical activity in a cross-company network in Germany: A mixed-methods analysis. Front Public Health 2022; 10:905451. [PMID: 36589998 PMCID: PMC9799332 DOI: 10.3389/fpubh.2022.905451] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The workplace is considered a promising setting for reaching physically inactive adults, but participation quotes in workplace health promotion (WHP) remain low. Regarding the low participation in WHP, the question emerges concerning the importance of health communication strategies. This paper presents the results from the evaluation of the communication strategy of a cross-company network for promoting physical activity and derives findings for the successful communication of measures. Materials and methods Quantitative and qualitative data sources were used to evaluate the communication strategy. The methods applied included individual semi-structured interviews (n = 14) and the monitoring of the usage of digital communication channels. Results The analysis revealed that the usage of the digital communication channels within this study was subjected to major fluctuations and a variety of factors must be considered when communicating physical activity measures in a cross-company network. It is important to engage in appropriate communication management that explicitly takes the interpersonal communication and the organizational circumstances into account. Conclusion This study revealed which factors may have an influence on the successful communication of physical activity measures in the context of WHP in cross-company networks. Thus, it makes an important contribution to the transfer of science and practice as it captured relevant questions from the field of WHP. Trial registration German Clinical Trials Register (DRKS)-ID: DRKS00020956; Date of registration: 18 June 2020, https://drks.de/search/de/trial/DRKS00020956.
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Affiliation(s)
- Carina Hoffmann
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
- Department Research and Development, Institute for Occupational Health Promotion, Cologne, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
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den Braver NR, Garcia Bengoechea E, Messing S, Kelly L, Schoonmade LJ, Volf K, Zukowska J, Gelius P, Forberger S, Woods CB, Lakerveld J. The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens. Eur J Public Health 2022; 32:iv71-iv83. [PMID: 36444108 PMCID: PMC9706123 DOI: 10.1093/eurpub/ckac085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This review of reviews aimed to: (1) summarize the evidence from published reviews on the effectiveness of mass-media campaigns to promote physical activity (PA) or PA-related determinants (intermediate psychological and proximal outcomes) and (2) to identify policy-relevant recommendations related to successful PA campaigns. METHODS An extensive literature search was performed on 1 March 2021. Reviews that evaluated the impact of campaigns on distal (e.g. PA) and/or proximal outcomes of PA (awareness, knowledge, etc.) and that targeted the general population or subsets were included. Quality of reviews was assessed using the AMSTAR-2 tool. Policy-relevant recommendations were systematically derived and synthesized and formulated as good practice statements. A protocol was registered beforehand (ID: CRD42021249184). RESULTS A total of 1915 studies were identified, of which 22 reviews were included. The most consistent evidence was found for the effectiveness of mass-media campaigns on proximal outcomes, while the evidence for distal outcomes was mixed. Good practice statements were derived: (1) to achieve behaviour change, mass-media is an important component of larger, multilevel and multicomponent strategies; (2) mass-media strategies should be coordinated and aligned at local- and national-level and be sustained, monitored and resourced at these levels and (3) media should be tailored to reduce socioeconomic inequalities. CONCLUSIONS Mass-media can play an important role in the promotion of PA. In general, evidence was more inconsistent for effectiveness on distal outcomes than for proximal outcomes. Policy-relevant recommendations include that mass-media strategies should be resourced, coordinated, aligned, sustained, monitored and evaluated on the local and national level.
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Affiliation(s)
- Nicolette R den Braver
- Correspondence: Nicolette R. den Braver, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres, De Boelelaan 1089a, 1081HV Amsterdam, The Netherlands, Tel: +31 20 44 430 80, e-mail:
| | - Enrique Garcia Bengoechea
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland,Research and Innovation Unit, Sport Ireland, Ireland
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Linda J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kevin Volf
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Catherine B Woods
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres, Amsterdam, The Netherlands,Upstream Team, Amsterdam, The Netherlands
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Thøgersen-Ntoumani C, Litster J, Del Casale R, Stenling A. Is a female physical empowerment campaign effective in improving positive body image, motivation for physical activity, and physical activity behavior in young female adults? A two-study experimental test of "This Girl Can". Body Image 2022; 42:150-159. [PMID: 35717703 DOI: 10.1016/j.bodyim.2022.06.001] [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: 10/18/2021] [Revised: 05/17/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022]
Abstract
This Girl Can is a campaign designed to empower women to increase physical activity. The campaign uses images/videos of women of diverse body weights/shapes, ages and ethnicities being physically active, emphasizing body functionality. First, we examined the effects of multi-session (N = 3) exposures to This Girl Can on body functionality, body appreciation and self-compassion (Study 1). Second, we explored if autonomous motivation for physical activity mediated effects of This Girl Can on physical activity (Study 2). Women (Study 1: N = 186, M (SD) age = 27.55 (14.01); Study 2: N = 153, M (SD) age = 28.31 (11.70)) were randomized to This Girl Can, or control videos/images depicting idealized women of thin/athletic body types being physically active (Study 1), or control videos highlighting physical activity benefits (Study 2). Outcomes were measured at baseline, post-test and 1-week follow-up. Study 1 results showed significant group by time interactions for body functionality (decreasing in the control group), body appreciation and self-compassion (both increased only in the experimental conditions). In Study 2, path analysis revealed no statistically significant mediation effect (ab = 13.18, 95 % CI [-107.92, 152.59]) of autonomous motivation. Future interventions designed to promote positive body image and self-compassion should incorporate media focusing on diverse women engaging in self-chosen physical activity.
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Affiliation(s)
- C Thøgersen-Ntoumani
- Curtin School of Population Health, Curtin University, PO Box U1987, Bentley WA6845, Western Australia, Australia.
| | - J Litster
- Curtin School of Population Health, Curtin University, PO Box U1987, Bentley WA6845, Western Australia, Australia.
| | - R Del Casale
- Curtin School of Population Health, Curtin University, PO Box U1987, Bentley WA6845, Western Australia, Australia.
| | - A Stenling
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden; Department of Sport Science and Physical Education, University of Agder, Postboks 422, 4604 Kristiansand, Norway.
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Das A, Gailey S. Green exercise, mental health symptoms, and state lockdown policies: A longitudinal study. JOURNAL OF ENVIRONMENTAL PSYCHOLOGY 2022; 82:101848. [PMID: 35854909 PMCID: PMC9281454 DOI: 10.1016/j.jenvp.2022.101848] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 07/02/2022] [Accepted: 07/09/2022] [Indexed: 05/03/2023]
Abstract
Lockdown policies aimed at decreasing the transmission of COVID-19 showed unintended mental health consequences; however, natural settings may offer a respite for individuals suffering from depression or anxiety symptoms. Previous cross-sectional literature reports protective effects of outdoor exposure on mental health during the COVID-19 pandemic. We longitudinally assess whether green exercise corresponded with a decline in adverse mental health symptoms, controlling for state lockdown policies. We also examine whether the relation differed by state lockdown status. As our exposure variable, we specificized participation in an outdoor walk, jog, or hike (green exercise). We used, as the outcome variable, the 4-item Patient Health Questionnaire (PHQ-4) to measure anxiety and depression symptoms. We utilized the Understanding America Study (UAS), a nationally representative sample of 8253 adults across 50 states in the US, surveyed biweekly between March 10, 2020-May 26, 2021. Linear fixed effect analyses controlled for time-invariant individual factors, as well as employment status, and household income. Regression results indicate a modest decline in PHQ-4 scores of approximately 0.10 (less mental health symptoms) as a function of green exercise, controlling for state lockdown status. We also find a slightly greater protective effect of green exercise on mental health symptoms during state lockdown policies. Additionally, we find that green exercise, as opposed to indoor exercise, corresponds with a decrease in PHQ-4 scores during lockdown. Contact with nature may improve mood and decrease mental health symptoms, especially during stress-inducing periods such as the COVID-19 pandemic. Green exercise as a recommended behavioral intervention may hold relevance for greater public health.
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Affiliation(s)
- Abhery Das
- Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Samantha Gailey
- Minnesota Population Center, University of Minnesota, Twin Cities, Minneapolis, Minnesota, USA
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Willoughby JF, Noar SM. Fifteen Years after a 10-year Retrospective: The State of Health Mass Mediated Campaigns. JOURNAL OF HEALTH COMMUNICATION 2022; 27:362-374. [PMID: 35950540 DOI: 10.1080/10810730.2022.2110627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In 2006, a 10-year retrospective of successful mass mediated health communication campaigns reviewed the field and highlighted strategies for successful campaigns. In the 15 years since the retrospective, there have been dramatic changes in the media environment and advances in health communication research. In this article, we describe changes in the health communication media landscape and in our understanding of mass mediated health communication campaigns in the 15 years since the retrospective. Although the media environment has shifted, we argue that effective principles of health communication have remained relatively constant. We note significant advances in technology since the previous retrospective that can further advance health communication campaigns, with new technologies offering promise as channels for health communication campaigns as well as for campaign planning. We also recommend that campaign researchers report in detail on their use of theory, audience segmentation, channel selection, and the role of formative research when describing campaign efforts; that communicators continue to develop frameworks that integrate principles of effective campaign design; and that additional research focus on understanding how technology can be effectively incorporated into campaign planning, distribution, and evaluation.
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Affiliation(s)
- Jessica Fitts Willoughby
- The Edward R. Murrow College of Communication, Washington State University, Pullman, Washington, United States
| | - Seth M Noar
- University of North Carolina Chapel Hill, Chapel Hill, North Carolina, United States
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Guariguata L, Garcia L, Sobers N, Ferguson TS, Woodcock J, Samuels TA, Guell C, Unwin N. Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000436. [PMID: 36962372 PMCID: PMC10021196 DOI: 10.1371/journal.pgph.0000436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/05/2022] [Indexed: 11/19/2022]
Abstract
Diabetes and obesity present a high and increasing burden of disease in the Caribbean that have failed to respond to prevention policies and interventions. These conditions are the result of a complex system of drivers and determinants that can make it difficult to predict the impact of interventions. In partnership with stakeholders, we developed a system dynamics simulation model to map the system driving diabetes and obesity prevalence in the Caribbean using Jamaica as a test case. The study aims to use the model to assess the magnitude changes necessary in physical activity and dietary intake to achieve global targets set by the WHO Global Action plan and to test scenarios for interventions to reduce the burden of diabetes and obesity. Continuing current trends in diet, physical activity, and demographics, the model predicts diabetes in Jamaican adults (20+ years) to rise from 12% in 2018 to 15.4% in 2030 and 20.9% by 2050. For obesity, it predicts prevalence to rise from 28.6% in 2018 to 32.1% by 2030 and 39.2% by 2050. The magnitude change necessary to achieve the global targets set by the World Health Organization is so great as to be unachievable. However, a combination of measures both upstream (including reducing the consumption of sugar sweetened beverages and ultra processed foods, increasing fruit and vegetable intake, and increasing moderate-to-vigorous activity) at the population level, and downstream (targeting people at high risk and with diabetes) can significantly reduce the future burden of diabetes and obesity in the region. No single intervention reduces the prevalence of these conditions as much as a combination of interventions. Thus, the findings of this model strongly support adopting a sustained and coordinated approach across various sectors to synergistically maximise the benefits of interventions.
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Affiliation(s)
- Leonor Guariguata
- George Alleyne Chronic Disease Research Centre, University of the West Indies, Cave Hill, Barbados
| | - Leandro Garcia
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, United Kingdom
| | - Natasha Sobers
- George Alleyne Chronic Disease Research Centre, University of the West Indies, Cave Hill, Barbados
| | - Trevor S. Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - T. Alafia Samuels
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter Medical School, Cornwall, United Kingdom
| | - Nigel Unwin
- George Alleyne Chronic Disease Research Centre, University of the West Indies, Cave Hill, Barbados
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- European Centre for Environment and Human Health, University of Exeter Medical School, Cornwall, United Kingdom
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Koorts H, Salmon PM, Swain CTV, Cassar S, Strickland D, Salmon J. A systems thinking approach to understanding youth active recreation. Int J Behav Nutr Phys Act 2022; 19:53. [PMID: 35549726 PMCID: PMC9097093 DOI: 10.1186/s12966-022-01292-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background Active recreation contributes to child and adolescent physical activity, however, factors affecting uptake are poorly understood at the systems level. The aims of this study were: (1) to use systems analysis methods to understand youth active recreation in Victoria, Australia, (ii) identify potential system leverage points to enhance active recreation, and (iii) explore stakeholder views of systems analysis methods for informing practice and policy decision-making. Methods Phase 1: Umbrella review of systematic reviews (2013–2018), synthesising evidence for correlates, determinants and intervention evidence for promoting active recreation. Phase 2: Development of three systems models (ActorMap and two ActivMaps), depicting active recreation actors/organisations, correlates, determinants and intervention evidence. Phase 3: Development of causal loop diagrams (CLDs) and identification of leverage points based on the Action Scales Model. Phase 4: Model feedback via stakeholder interviews (n = 23; 16 organisations). Results From the literature, 93 correlates and determinants, and 49 intervention strategies were associated with child and adolescent active recreation; the majority located at a social or individual level. Ten potential system leverage points were identified in the CLDs, which differed for pre-schoolers versus children and adolescents. Only time outdoors (an event leverage point) emerged for all age groups. Changes to the built and natural environment (i.e., land use planning, urban design) as a complete domain was a key structural leverage point for influencing active recreation in children and adolescents. Subject matter experts and stakeholder interviews identified 125 actors operating across seven hierarchical active recreation system levels in Victoria. Stakeholder interviews identified 12 areas for future consideration and recommendations for practice/policy influence. Conclusions Our findings underscore the need for dynamic models of system behaviour in active recreation, and to capture stakeholder influence as more than a transactional role in evidence generation and use. Effective responses to youth inactivity require a network of interventions that target specific leverage points across the system. Our models illustrate areas that may have the greatest system-level impact, such as changes to the built and natural environment, and they provide a tool for policy, appraisal, advocacy, and decision-making within and outside of government. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01292-2.
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Affiliation(s)
- Harriet Koorts
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, Geelong, VIC, 3125, Australia.
| | - Paul M Salmon
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Christopher T V Swain
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, Geelong, VIC, 3125, Australia.,Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Samuel Cassar
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, Geelong, VIC, 3125, Australia
| | - David Strickland
- Sport and Recreation Victoria, Department of Jobs Precincts and Regions, Melbourne, Victoria, Australia
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, 221 Burwood Highway, Burwood, Geelong, VIC, 3125, Australia
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Nyemcsok C, Pitt H, Kremer P, Thomas SL. Young men's perceptions about the risks associated with sports betting: a critical qualitative inquiry. BMC Public Health 2022; 22:867. [PMID: 35501801 PMCID: PMC9059698 DOI: 10.1186/s12889-022-13164-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gambling is an inherently risky activity. New technologies have led to the development of new, online forms of gambling such as sports betting, with round the clock availability and accessibility. While young men have been identified as a group that may be particularly vulnerable to the harms associated with these new online products, few studies have qualitatively explored young men's perceptions of the risks associated with these products. Using concepts associated with the sociology of risk, this paper sought to explore the range of factors that may influence how 18-24 year old young Australian men conceptualise the risks associated with sports betting. METHODS Using a critical qualitative inquiry approach, in-depth interviews were conducted with sixteen participants in Victoria, Australia, who engaged in sports betting at least monthly. The data interpreted for this study included questions relating to awareness of gambling, the contexts associated with early gambling experiences; the factors that influenced current gambling behaviours, and why they engaged in gambling. A reflexive approach to thematic analysis was used to interpreted themes from the data. RESULTS Four key themes were constructed from the data relating to the factors that influenced risk perceptions. These included: 1) 'The role of early experiences', including exposure to gambling advertising in sport, and the gambling behaviours of social networks; 2) 'The influence of peer rivalry and competition', in which sports betting was used to form connections within and across peer groups; 3) 'The normalisation of gambling', including the embedding of gambling in everyday activities; and 4) 'The influence of perceptions of knowledge, skill, and control', including the belief that they could engage in responsible behaviours and stop gambling if they needed to. CONCLUSION This study indicated that a range of factors may influence how young men conceptualise the risks and benefits associated with sports betting. Current public health strategies for gambling that focus on individual determinants and responsibility paradigms must be broadened to target the social and commercial factors that influence young men's attitudes towards, and engagement in sports betting.
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Affiliation(s)
- Christian Nyemcsok
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
| | - Hannah Pitt
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
| | - Peter Kremer
- Centre for Sport Research, School of Exercise & Nutrition Sciences, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
| | - Samantha L. Thomas
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Gheringhap St, Geelong, Australia
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Bokemper SE, Huber GA, James EK, Gerber AS, Omer SB. Testing persuasive messaging to encourage COVID-19 risk reduction. PLoS One 2022; 17:e0264782. [PMID: 35320285 PMCID: PMC8942219 DOI: 10.1371/journal.pone.0264782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/16/2022] [Indexed: 11/18/2022] Open
Abstract
What types of public health messages are effective at changing people's beliefs and intentions to practice social distancing to slow the spread of COVID-19? We conducted two randomized experiments in summer 2020 that assigned respondents to read a public health message and then measured their beliefs and behavioral intentions across a wide variety of outcomes. Using both a convenience sample and a pre-registered replication with a nationally representative sample of Americans, we find that a message that reframes not social distancing as recklessness rather than bravery and a message that highlights the need for everyone to take action to protect one another are the most effective at increasing beliefs and intentions related to social distancing. These results provide an evidentiary basis for building effective public health campaigns to increase social distancing during flu pandemics.
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Affiliation(s)
- Scott E. Bokemper
- Institution for Social and Policy Studies, Yale University, New Haven, Connecticut, United States of America
- Center for the Study of American Politics, Yale University, New Haven, Connecticut, United States of America
| | - Gregory A. Huber
- Institution for Social and Policy Studies, Yale University, New Haven, Connecticut, United States of America
- Center for the Study of American Politics, Yale University, New Haven, Connecticut, United States of America
- Department of Political Science, Yale University, New Haven, Connecticut, United States of America
| | - Erin K. James
- Institute for Global Health, Yale University, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Alan S. Gerber
- Institution for Social and Policy Studies, Yale University, New Haven, Connecticut, United States of America
- Center for the Study of American Politics, Yale University, New Haven, Connecticut, United States of America
- Department of Political Science, Yale University, New Haven, Connecticut, United States of America
| | - Saad B. Omer
- Institute for Global Health, Yale University, New Haven, Connecticut, United States of America
- Department of Internal Medicine, Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America
- Yale School of Public Health, New Haven, Connecticut, United States of America
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Candio P, Meads D, Hill AJ, Bojke L. Does providing everyone with free-of-charge organised exercise opportunities work in public health? Health Policy 2022; 126:129-142. [PMID: 35034767 DOI: 10.1016/j.healthpol.2022.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Population-level initiatives of free-of-charge organised exercise have been implemented to encourage residents to take up regular physical activity. However, there exists a paucity of evidence on the ability of these interventions to attract and engage residents, especially targeted subgroups. Seeking to contribute to this evidence base, we evaluated a proportionate universal programme providing free exercise sessions, Leeds Let's Get Active. METHODS Descriptive statistics were used to summarise the programme data and participants. Time to event, count and logistic regression models examined how different population subgroups engaged with the programme in terms of number of entries, weekly participation rates and drop-off patterns. RESULTS 51,874 adult residents registered to the programme and provided baseline data (2013-2016). A small proportion (1.6%) attended the free sessions on a weekly basis. Higher participation rates were estimated for the groups of males, retired and non-inactive participants. A neighbourhood-level deprivation status was found to have no marginal effect on the level and frequency of participation, but to be negatively associated with participation drop-off (HR 0.93, 95% CI 0.89-0.97, p = 0.001). CONCLUSIONS Providing everyone with free-of-charge organised exercise opportunities in public leisure centres located in deprived areas can attract large volumes of residents, but may not sufficiently encourage adults, especially inactive residents and those living in disadvantaged neighbourhoods, to take up regular exercise.
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Affiliation(s)
- Paolo Candio
- Centre for Economics of Obesity, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; Leeds Institute of Health Sciences, University of Leeds, United Kingdom.
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, United Kingdom
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, United Kingdom
| | - Laura Bojke
- Centre for Health Economics, University of York, United Kingdom
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Wallhed Finn S, Mejldal A, Baskaran R, Søgaard Nielsen A. The Danish RESPEKT Campaign: Impact of a National Mass Media Campaign Aiming to Increase Treatment Seeking for Alcohol Use Disorders. Subst Use Misuse 2022; 57:1082-1096. [PMID: 35422189 DOI: 10.1080/10826084.2022.2063897] [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] [Indexed: 10/18/2022]
Abstract
Background: A minority of all with alcohol use disorders seek treatment. In Denmark, a media campaign, "RESPEKT," has been broadcast nationwide since 2015. The campaign is unique from an international perspective and aims to increase treatment-seeking. Similar interventions have, up until now, not been scientifically evaluated.Aim: To investigate campaign awareness, understanding, attitudes, and information-seeking pre- and post the campaign period. Also, associations to demographic factors and year of campaign will be investigated.Method: Study design: Repeated cross-sectional studyParticipants: Adults aged 30-70 years, in total n = 9169.Data: Pre- and post the campaign period between 2017 and 2020, an online questionnaire was administered by a market research company. The questionnaire covered demographic data, campaign awareness, understanding, attitudes, and information-seeking about treatment for alcohol use disorders. In addition, complete-case logistic regression was performed to model dichotomous outcomes, and odds ratios were calculated.Results: Campaign awareness varied between 8 and 40% over the different years. Understanding of the main message was high and received higher endorsements over the study period. A majority expressed positive attitudes toward the campaign and support for the main message regarding free treatment. However, very few self-reported seeking information about AUD treatment. Female sex was associated with higher awareness of the campaign, higher understanding and more positive attitudes toward the campaign.Conclusion: The campaign evoked positive attitudes and had an impact on increasing knowledge and changing attitudes. However, no effect on self-reported information seeking about treatment was found.
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Affiliation(s)
- Sara Wallhed Finn
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mejldal
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ruben Baskaran
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,SDU Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, The Faculty of Engineering, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Psychiatric Hospital, University Function, Odense, Denmark
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13
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Gupta CC, Duncan MJ, Ferguson SA, Rebar A, Sprajcer M, Khalesi S, Booker LA, Binks H, Vincent GE. The Discrepancy between Knowledge of Sleep Recommendations and the Actual Sleep Behaviour of Australian Adults. Behav Sleep Med 2021; 19:828-839. [PMID: 33492169 DOI: 10.1080/15402002.2021.1876693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Inadequate sleep is a major public health concern, with large economic, health, and operational costs to Australia. Despite the implementation of public sleep health campaigns, approximately 40% of Australian adults do not obtain the recommended 7-9 hours of sleep. Thus, while people may know how much sleep is required, this knowledge may not be adequately translated to actual sleep behavior. Consequently, this study aims to examine the discrepancy between knowledge of sleep recommendations and self-reported sleep behaviors.Methods: A sample of 1265 Australian adults (54% female, aged 18-65) completed a phone interview as part of the 2017 National Social Survey and were asked questions about their knowledge of sleep guidelines and their actual sleep behavior. Binary logistic regression was used to determine the factors associated with awareness of sleep recommendations and whether this corresponded with reported sleep duration.Results: The final sample size was 998. Although 94% of the sample were aware of current sleep recommendations, 23% of participants did not self-report regularly obtaining 7-9 h sleep per night. These participants were less likely to want to obtain more sleep, less likely to view sleep as a priority before stressful events, and less likely to self-report good health.Conclusion: Although a majority of the sample were aware of sleep recommendations, almost a quarter of the participants' behavior did not align with their knowledge. Future sleep health campaigns should consider options beyond education, including emphasis on practical strategies and modifiable lifestyle factors to assist individuals to obtain the recommended amount of sleep.
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Affiliation(s)
- Charlotte C Gupta
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia
| | - Mitch J Duncan
- School of Medicine & Public Health; Faculty of Health and Medicine, The University of Newcastle, University Drive, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Adelaide, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia
| | - Amanda Rebar
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia
| | - Madeline Sprajcer
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia
| | - Saman Khalesi
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia
| | - Lauren A Booker
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia.,University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Victoria, Australia
| | - Hannah Binks
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, Australia
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14
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Pettigrew S, Jongenelis MI, Rai R, Jackson B, Newton RU. Communicating with older people about physical activity. Aust N Z J Public Health 2021; 45:587-591. [PMID: 34648225 DOI: 10.1111/1753-6405.13173] [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: 04/01/2021] [Revised: 08/01/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Little is known about how to effectively encourage higher levels of activity among older people. This study tested the effectiveness of a public service advertisement designed according to recommendations for communicating with older audiences and featuring five types of moderate-to-vigorous physical activity: tennis, line dancing, cycling, swimming and jogging. METHODS A survey administered to 1,200 Australians aged 50+ years assessed effects of the public service advertisement on: motivation (intrinsic and extrinsic); perceived believability, relevance, and effectiveness; and feelings elicited (e.g. interest, hope, guilt). Open-ended questions enabled respondents to describe aspects of the ad they considered to be most and least effective. RESULTS Moderate to high scores were obtained on the motivation measures and the ad evaluation criteria of perceived effectiveness, likeability, believability and personal relevance. Mean scores for the feelings measures were generally low, with the exception of the positive feelings of being interested, inspired, hopeful and determined. CONCLUSIONS The results suggest physical activity promotion ads can be motivating across age and socioeconomic subgroups of older people. Implications for public health: Ads aiming to encourage older people to be more physically active may be accepted and effective if they depict everyday older people enjoying a range of relevant activities.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales
| | - Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Victoria
| | - Rajni Rai
- School of Population Health, Curtin University, Perth, Western Australia
| | - Ben Jackson
- School of Human Sciences, University of Western Australia, Perth, Western Australia.,Telethon Kids Institute, Perth, Western Australia
| | - Robert U Newton
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia
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15
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Rogers D, Snyder LB, Rego M. The Impact of Mass Media-Delivered Family Planning Campaigns in Low- and Middle-Income Countries: A Meta-Analysis of Advertising and Entertainment-Education Format Effects. Stud Fam Plann 2021; 52:439-465. [PMID: 34585400 DOI: 10.1111/sifp.12175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Effective family planning methods are shown to save lives, contribute to gender equality, and boost economic development. Mass media communication campaigns in low- and middle-income countries have been effective in increasing contraceptive use, although the strategies that increase the likelihood of success are unclear. The present study uses meta-analyses to uncover the average effect of media campaigns on family planning behaviors in low- and middle-income countries and to examine the effectiveness of two communication strategies: entertainment-education and advertising/public service announcements. Results indicated that mass media-delivered family planning campaigns have a positive impact on family planning behaviors: d = 0.19, 95% CI [0.15, 0.24] for women (k = 64), d = 0.16, 95% CI [0.11, 0.21] for men (k = 27), and d = 0.20, 95% CI [0.17, 0.23] for an undifferentiated target group of men and women (k = 37). The use of an entertainment-education format, often in addition to campaign advertising messages, was associated with greater campaign success rates for women. Men, however, responded negatively to education-entertainment and positively to campaigns using only advertising and public service announcement formats. Recommendations for future family planning mass media campaigns and academic research opportunities are discussed.
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Affiliation(s)
- Dana Rogers
- is at the Southern Connecticut State University, New Haven, CT, 06515, USA
| | | | - Michelle Rego
- is at the Johnson & Wales University, RI, 02903, USA
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16
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Faghy MA, Arena R, Stoner L, Haraf RH, Josephson R, Hills AP, Dixit S, Popovic D, Smith A, Myers J, Bacon SL, Niebauer J, Dourado VZ, Babu AS, Maden-Wilkinson TM, Copeland RJ, Gough LA, Bond S, Stuart K, Bewick T, Ashton REM. The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network. Prog Cardiovasc Dis 2021; 67:2-10. [PMID: 33549590 PMCID: PMC7859729 DOI: 10.1016/j.pcad.2021.01.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 12/14/2022]
Abstract
COVID-19 is one of the biggest health crises that the world has seen. Whilst measures to abate transmission and infection are ongoing, there continues to be growing numbers of patients requiring chronic support, which is already putting a strain on health care systems around the world and which may do so for years to come. A legacy of COVID-19 will be a long-term requirement to support patients with dedicated rehabilitation and support services. With many clinical settings characterized by a lack of funding and resources, the need to provide these additional services could overwhelm clinical capacity. This position statement from the Healthy Living for Pandemic Event Protection (HL-PIVOT) Network provides a collaborative blueprint focused on leading research and developing clinical guidelines, bringing together professionals with expertise in clinical services and the exercise sciences to develop the evidence base needed to improve outcomes for patients infected by COVID-19.
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Affiliation(s)
- Mark A Faghy
- Human Sciences Research Centre, College of Science and Engineering, University of Derby, UK; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA.
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, USA
| | - Lee Stoner
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Exercise and Sport Science, University of North Carolina, USA
| | - Rebecca H Haraf
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Richard Josephson
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals, Cleveland Medical Centre, Hospitals Cleveland, OH, USA
| | - Andrew P Hills
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; School of Health Sciences, University of Tasmania, Australia
| | - Snehil Dixit
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Medical Rehabilitation Sciences, King Khalid University, Saudi Arabia
| | - Dejana Popovic
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Clinic for Cardiology, University Clinical Centre Serbia, University of Belgrade, Serbia
| | - Andy Smith
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Unaffiliated Independent Exercise Scientist, York, UK
| | - Jonathan Myers
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; VA Palo Alto Health Care System, Stanford University School of Medicine, California, USA
| | - Simon L Bacon
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Health, Kinesiology, and Applied Physiology (HKAP), Concordia University, Montreal, Canada; Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Canada
| | - Josef Niebauer
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria; Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Victor Z Dourado
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Human Movement Sciences, Federal University of São Paulo, Santos, SP, Brazil; Department of Global Health and Population, Lown Scholars in Cardiovascular Health Program at Harvard T.H. Chan School of Public Health, USA
| | - Abraham S Babu
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Thomas M Maden-Wilkinson
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Robert J Copeland
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Lewis A Gough
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Centre for Life and Sport Sciences (CLaSS) Research Centre, School of Health Sciences, Birmingham City University, Birmingham, UK
| | - Sam Bond
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, USA
| | - Kaz Stuart
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Centre of Research in Health and Society, University of Cumbria, Carlisle, UK
| | - Thomas Bewick
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Respiratory Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Ruth E M Ashton
- Human Sciences Research Centre, College of Science and Engineering, University of Derby, UK; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
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- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
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17
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Ide N, Ajenikoko A, Steele L, Cohn J, J. Curtis C, Frieden TR, Cobb LK. Priority Actions to Advance Population Sodium Reduction. Nutrients 2020; 12:nu12092543. [PMID: 32842580 PMCID: PMC7551205 DOI: 10.3390/nu12092543] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 12/22/2022] Open
Abstract
High sodium intake is estimated to cause approximately 3 million deaths per year worldwide. The estimated average sodium intake of 3.95 g/day far exceeds the recommended intake. Population sodium reduction should be a global priority, while simultaneously ensuring universal salt iodization. This article identifies high priority strategies that address major sources of sodium: added to packaged food, added to food consumed outside the home, and added in the home. To be included, strategies needed to be scalable and sustainable, have large benefit, and applicable to one of four measures of effectiveness: (1) Rigorously evaluated with demonstrated success in reducing sodium; (2) suggestive evidence from lower quality evaluations or modeling; (3) rigorous evaluations of similar interventions not specifically for sodium reduction; or (4) an innovative approach for sources of sodium that are not sufficiently addressed by an existing strategy. We identified seven priority interventions. Four target packaged food: front-of-pack labeling, packaged food reformulation targets, regulating food marketing to children, and taxes on high sodium foods. One targets food consumed outside the home: food procurement policies for public institutions. Two target sodium added at home: mass media campaigns and population uptake of low-sodium salt. In conclusion, governments have many tools to save lives by reducing population sodium intake.
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18
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Ntenda PAM, Kazambwe JF. A multilevel analysis of overweight and obesity among non-pregnant women of reproductive age in Malawi: evidence from the 2015-16 Malawi Demographic and Health Survey. Int Health 2020; 11:496-506. [PMID: 30517652 DOI: 10.1093/inthealth/ihy093] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/28/2018] [Accepted: 10/25/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Overweight and obesity are well-known risk factors for non-communicable diseases such as cardiovascular disease, diabetes, some cancers and musculoskeletal disorders. In Malawi, the proportion of women who are overweight/obese has doubled, from 10% in 1992 to 21% in 2015-16. Therefore we aimed to explore the individual- and community-level factors associated with overweight and obesity among non-pregnant women of child-bearing age. METHODS Secondary analysis of the 2015-16 Malawi Demographic and Health Survey was conducted. Overweight was defined as a body mass index (BMI) of 25 to <30 kg/m2, while obesity was defined as a BMI ≥30 kg/m2. Two-level multilevel multivariable logistic regression models were constructed using a logit-link function with a binomial distribution on 7326 women living in 850 different communities. RESULTS At the individual level, the adjusted multilevel regression results showed that women 15-19 y of age as well as women from the poorest households had reduced odds of being overweight/obese. However, women with white collar jobs and women who were affiliated with the Church of Central Africa Presbyterian and the Roman Catholic church had increased odds of being overweight/obese. At the community level, women from urban areas and women who resided in communities with a low percentage of media exposure had increased odds of being overweight or obese. While women from poor communities had reduced odds of being overweight and obese, the proportion change in variance showed that 56, 77 and 78% of total variations in the odds of overweight, obese and overweight/obese across the communities were explained by both individual- and community-level factors. The median odds ratio showed that the likelihood of maternal overweight, obese and overweight/obese increased by 63, 39 and 84% when the women moved from low- to high-risk neighbourhoods. CONCLUSIONS Older women, Christian women, women with white collar jobs and women from the richest households should be targeted during policy formulation. At the community level, media coverage should be spread evenly so that health awareness messages, consequences and means of overweight and obesity prevention are getting to the targeted women. Our study revealed evidence of clustering effects of overweight and obesity at the community level, hence neighbourhood variations with respect to maternal overweight and obesity should be taken into account when designing nutritional policies.
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Affiliation(s)
| | - Jane Flora Kazambwe
- NBS House Corner Chipembere Highway & Johnstone Roads, Ginnery Corner Blantyre, PO Box 32251, Chichiri Blantyre 3, Malawi
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19
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Roberts S, Pilard L, Chen J, Hirst J, Rutter H, Greenhalgh T. Efficacy of population-wide diabetes and obesity prevention programs: An overview of systematic reviews on proximal, intermediate, and distal outcomes and a meta-analysis of impact on BMI. Obes Rev 2019; 20:947-963. [PMID: 31039603 DOI: 10.1111/obr.12821] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 01/10/2023]
Abstract
We conducted an overview of systematic reviews and a meta-analysis of the impact on body mass index (BMI) of primary studies of population-wide obesity and diabetes prevention programs, in order to evaluate their efficacy. We searched eight databases for reviews of population-level programs reporting effect on diet, physical activity, BMI, or prevalence of obesity/overweight or type 2 diabetes mellitus (T2DM). Meta-analysis of primary studies within reviews reporting effect on BMI. Interventions were categorized using ANGELO framework and quality assessment using AMSTAR. Fifty-three systematic reviews were included. Primary studies were largely natural experiments or cross-sectional studies of national data. Increased price of sugar-sweetened beverages (SSBs) and fast food, decreased price of fruit and vegetables, food labelling, and grocery store interventions were associated with positive effects on diet. Park and playground renovations and point-of-choice prompts to increase stair use were associated with positive effects on physical activity. Increased price of SSBs, menu labelling, grocery store interventions, and multicomponent interventions were associated with small reductions in BMI. There was insufficient evidence of impact of any interventions on the prevalence of overweight, obesity, or T2DM. We have identified a promising suite of population-wide actions to improve diet, increase physical activity, and reduce BMI. Impact on subsequent incidence of T2DM remains speculative.
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Affiliation(s)
- Samantha Roberts
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Louis Pilard
- The Centre for Sustainable Healthcare, Oxford, UK
| | - Junqiao Chen
- ISCTE-IUL and University of Lisbon, Lisbon, Portugal
| | - Jennifer Hirst
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, Bath, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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20
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Stead M, Angus K, Langley T, Katikireddi SV, Hinds K, Hilton S, Lewis S, Thomas J, Campbell M, Young B, Bauld L. Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07080] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BackgroundMass media campaigns can be used to communicate public health messages at the population level. Although previous research has shown that they can influence health behaviours in some contexts, there have been few attempts to synthesise evidence across multiple health behaviours.ObjectivesTo (1) review evidence on the effective use of mass media in six health topic areas (alcohol, diet, illicit drugs, physical activity, sexual and reproductive health and tobacco), (2) examine whether or not effectiveness varies with different target populations, (3) identify characteristics of mass media campaigns associated with effectiveness and (4) identify key research gaps.DesignThe study comprised (1) a systematic review of reviews, (2) a review of primary studies examining alcohol mass media campaigns, (3) a review of cost-effectiveness evidence and (4) a review of recent primary studies of mass media campaigns conducted in the UK. A logic model was developed to inform the reviews. Public engagement activities were conducted with policy, practitioner and academic stakeholders and with young people.ResultsThe amount and strength of evidence varies across the six topics, and there was little evidence regarding diet campaigns. There was moderate evidence that mass media campaigns can reduce sedentary behaviour and influence sexual health-related behaviours and treatment-seeking behaviours (e.g. use of smoking quitlines and sexual health services). The impact on tobacco use and physical activity was mixed, there was limited evidence of impact on alcohol use and there was no impact on illicit drug behaviours. Mass media campaigns were found to increase knowledge and awareness across several topics, and to influence intentions regarding physical activity and smoking. Tobacco and illicit drug campaigns appeared to be more effective for young people and children but there was no or inconsistent evidence regarding effectiveness by sex, ethnicity or socioeconomic status. There was moderate evidence that tobacco mass media campaigns are cost-effective, but there was weak or limited evidence in other topic areas. Although there was limited evidence on characteristics associated with effectiveness, longer or greater intensity campaigns were found to be more effective, and messages were important, with positive and negative messages and social norms messages affecting smoking behaviour. The evidence suggested that targeting messages to target audiences can be effective. There was little evidence regarding the role that theory or media channels may play in campaign effectiveness, and also limited evidence on new media.LimitationsStatistical synthesis was not possible owing to considerable heterogeneity across reviews and studies. The focus on review-level evidence limited our ability to examine intervention characteristics in detail.ConclusionsOverall, the evidence is mixed but suggests that (1) campaigns can reduce sedentary behaviour, improve sexual health and contribute to smoking cessation, (2) tobacco control campaigns can be cost-effective, (3) longer and more intensive campaigns are likely to be more effective and (4) message design and targeting campaigns to particular population groups can be effective.Future workFuture work could fill evidence gaps regarding diet mass media campaigns and new-media campaigns, examine cost-effectiveness in areas other than tobacco and explore the specific contribution of mass media campaigns to multicomponent interventions and how local, regional and national campaigns can work together.Study registrationThis study is registered as PROSPERO CRD42015029205 and PROSPERO CRD42017054999.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Martine Stead
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Kathryn Angus
- Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Tessa Langley
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Srinivasa Vittal Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Kate Hinds
- Institute of Education, University College London, London, UK
| | - Shona Hilton
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sarah Lewis
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - James Thomas
- Institute of Education, University College London, London, UK
| | - Mhairi Campbell
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Ben Young
- UK Centre for Tobacco and Alcohol Studies, UK
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Linda Bauld
- UK Centre for Tobacco and Alcohol Studies, UK
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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21
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Priebe CS, Latimer-Cheung AE, Berry T, O'Reilly N, Rhodes RE, Spence JC, Tremblay MS, Faulkner G. Make Room for Play: An Evaluation of a Campaign Promoting Active Play. JOURNAL OF HEALTH COMMUNICATION 2019; 24:38-46. [PMID: 30712504 DOI: 10.1080/10810730.2019.1572838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the context of rising screen time, only a third of Canadian children are achieving adequate amounts of active play, an important source of physical activity. ParticipACTION, a national not-for-profit organization, created the "Make Room for Play" campaign targeting parents with television advertisements depicting how screen time takes away from active play. The advertisements featured children engaging in active play (e.g., jump rope) while a black screen progressively sequesters the room for them to play. This study's purpose was to evaluate the campaign using the hierarchy of effects model, a framework for conceptualizing the impact of mass media campaigns. It was hypothesized that recall would relate to intermediate (e.g., cognitions, self-efficacy) and distal (e.g., parental support) factors. Twenty-six percent of the general population and caregiver samples surveyed (N = 1576) recalled (unaided) the advertisement and 45.9% recalled when prompted. Parental support was significantly higher in those recalling the campaign, p = .009. Twenty-four percent of parents reporting unaided recall (versus 14.0% of those not) tried to engage in active play with their children and 21.2% (versus 12.0%) tried to create opportunities for children to engage in play. Strengths and limitations of mass media approaches targeting active play and screen time are discussed.
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Affiliation(s)
- Carly S Priebe
- a School of Kinesiology , University of British Columbia , Vancouver , Canada
| | - Amy E Latimer-Cheung
- b School of Kinesiology and Health Studies , Queen's University , Kingston , Canada
| | - Tanya Berry
- c Faculty of Kinesiology, Sport, and Recreation , University of Alberta , Edmonton , Canada
| | - Norm O'Reilly
- d College of Business and Economics , University of Guelph , Guelph , Canada
| | - Ryan E Rhodes
- e School of Exercise Science, Physical, & Health Education , University of Victoria , Victoria , Canada
| | - John C Spence
- c Faculty of Kinesiology, Sport, and Recreation , University of Alberta , Edmonton , Canada
| | - Mark S Tremblay
- f Department of Pediatrics, Faculty of Medicine , University of Ottawa , Ottawa , Canada
| | - Guy Faulkner
- a School of Kinesiology , University of British Columbia , Vancouver , Canada
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22
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Can Nurturing the Young Be the Key to Tackling Chronic Diseases in the Old? A Narrative Review With a Global Perspective. Ochsner J 2018; 18:364-369. [PMID: 30559622 DOI: 10.31486/toj.18.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background One of the greatest challenges in healthcare today is dealing with a growing burden of multimorbid chronic diseases in an aging population. Awareness is growing that a healthy start in life plays a critical role in reversing this trend, especially for young women, pregnant mothers, and children in their first 2 years of life. Methods We reviewed the international literature on early childhood nutrition and development, based on the landmark Lancet series on maternal and child nutrition and child development, and World Health Organization reports. Results Contemporary literature points to the importance of strategies that focus on early childhood for enhancing both health and socioeconomic outcomes. We discuss programs and initiatives that aim to improve the health of mothers and children at a global level, with a focus on high-income countries such as Australia and the United States. Conclusion Tackling the epidemic of chronic diseases requires a comprehensive life course approach that must include pregnant women and their young children. Healthcare systems and professionals play an important role. The health and well-being of the next generation must be everyone's business.
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Bennie JA, Lee DC, Khan A, Wiesner GH, Bauman AE, Stamatakis E, Biddle SJH. Muscle-Strengthening Exercise Among 397,423 U.S. Adults: Prevalence, Correlates, and Associations With Health Conditions. Am J Prev Med 2018; 55:864-874. [PMID: 30458949 DOI: 10.1016/j.amepre.2018.07.022] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/15/2018] [Accepted: 07/20/2018] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Although muscle-strengthening exercise has multiple independent health benefits, little is known about muscle-strengthening exercise participation and associations with adverse health conditions among U.S. adults. METHODS In 2017, data were analyzed from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone surveys, respondents reported how many times during the past week they engaged in muscle-strengthening exercise. Weighted weekly muscle-strengthening exercise frequencies were calculated for the total sample and across sociodemographic and lifestyle characteristics. A multivariable logistic regression assessed the odds of having self-reported adverse health conditions (e.g., diabetes, coronary heart disease) according to weekly muscle-strengthening exercise frequency. RESULTS Data were available on 397,423 adults (aged 18-80 years). Overall, 30.2% (95% CI=29.9, 30.5) met the muscle-strengthening exercise recommendations (two or more times/week) and 57.8% (95% CI=57.5, 58.2) reported no muscle-strengthening exercise. Older age, insufficient aerobic activity, lower income, lower education, poorer self-rated health, being female, and being overweight/obese were significantly associated with lower odds of meeting the muscle-strengthening exercise recommendations independently of other characteristics. After adjusting for confounders (e.g., age, sex, income, smoking, aerobic activity), when compared with those who did none, muscle-strengthening exercise was associated with lower odds for several adverse health conditions, including prevalent diabetes, cancer (non-skin), poor self-rated health, and obesity. CONCLUSIONS Three in five U.S. adults do not engage in any muscle-strengthening exercise, despite an association for muscle-strengthening exercise with better health conditions. Future muscle-strengthening exercise promotion strategies should target older adults, females, those with low education/income, and those with a poor health status.
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Affiliation(s)
- Jason A Bennie
- Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia.
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, Iowa
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Glen H Wiesner
- Active Living and Public Health Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Victoria, Australia
| | - Adrian E Bauman
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Emmanuel Stamatakis
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Stuart J H Biddle
- Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia
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Kaasalainen K, Kasila K, Komulainen J, Malvela M, Poskiparta M. Changes in Psychosocial Factors and Physical Activity Among Finnish Working-Age Men in the Adventures of Joe Finn Campaign. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 39:39-49. [PMID: 30479194 DOI: 10.1177/0272684x18811018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study evaluated changes in psychosocial factors and self-reported physical activity (PA) among the sample of Finnish men who underwent the fitness tests during the national health campaign. Another aim was to examine whether the fitness test feedback was a meaningful experience for PA change. Baseline data were collected in 2011 by fitness test and questionnaire. Men who had low/moderate fitness along with overweight ( n = 361) were recruited to the postcampaign study in 2014. Data were analyzed with nonparametric tests, logistic regression analysis, and content analysis. The postcampaign survey was completed by 102 men. Positive PA change was associated with high goals, planning skills, and self-efficacy for PA. One fourth of men recalled that they had surprisingly poor fitness at baseline. This experience was not related to positive PA change. A fitness test may awake motivation, but promotion of self-efficacy and self-regulatory skills is needed to support concrete behavior change.
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Affiliation(s)
| | - Kirsti Kasila
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jyrki Komulainen
- 2 Fit for Life Program, LIKES Foundation for Promotion of Physical Activity and Public Health, Finland
| | - Miia Malvela
- 2 Fit for Life Program, LIKES Foundation for Promotion of Physical Activity and Public Health, Finland
| | - Marita Poskiparta
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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Garcia LMT, Diez Roux AV, Martins ACR, Yang Y, Florindo AA. Exploring the emergence and evolution of population patterns of leisure-time physical activity through agent-based modelling. Int J Behav Nutr Phys Act 2018; 15:112. [PMID: 30453997 PMCID: PMC6245872 DOI: 10.1186/s12966-018-0750-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/08/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Most interventions aiming to promote leisure-time physical activity (LTPA) at population level showed small or null effects. Approaching the problem from a systems science perspective may shed light on the reasons for these results. We developed an agent-based model to explore how the interactions between psychological attributes and built and social environments may lead to the emergence and evolution of LTPA patterns among adults. METHODS The modeling process consisted of four stages: (1) conceptual model development, (2) formulation of the agent-based model, (3) parametrization and calibration, and (4) consistency and sensitivity analyses. The model represents a stylized community containing two types of agents: persons and LTPA sites. Persons interact with each other (proximal network and perceived community) and with the built environment (LTPA sites) over time. Decision-making is based on the person's intention to practice LTPA, conditioned to the perceived environment. Each iteration is equivalent to one week and we assessed a period of 10 years. RESULTS The model was able to reproduce population temporal trends of intention and LTPA reported in the literature. Sensitivity analyses indicated that population patterns and trends of intention and LTPA were highly influenced by the relationship between a person's behavior in the preceding week and his current intention, the person's access to built and social environment, and the density of LTPA sites. CONCLUSIONS The proposed agent-based model is suitable to explore the emergence and evolution of LTPA patterns among adults, considering the dynamic interaction between individuals' psychological attributes and the built and social environments in which they live. The model is available at https://doi.org/10.17605/OSF.IO/J2KAS .
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Affiliation(s)
- Leandro M. T. Garcia
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- University of Sao Paulo School of Public Health, Sao Paulo, Brazil
| | - Ana V. Diez Roux
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, USA
| | - André C. R. Martins
- University of Sao Paulo School of Arts, Sciences and Humanities, Sao Paulo, Brazil
| | - Yong Yang
- University of Memphis School of Public Health, Memphis, USA
| | - Alex A. Florindo
- University of Sao Paulo School of Public Health, Sao Paulo, Brazil
- University of Sao Paulo School of Arts, Sciences and Humanities, Sao Paulo, Brazil
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Gonzalez-Viana A, Violan Fors M, Castell Abat C, Rubinat Masot M, Oliveras L, Garcia-Gil J, Plasencia A, Cabezas Peña C. Promoting physical activity through primary health care: the case of Catalonia. BMC Public Health 2018; 18:968. [PMID: 30075720 PMCID: PMC6090750 DOI: 10.1186/s12889-018-5773-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 06/28/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In adults, as little as 10 minutes of moderate physical activity (PA) three times a day can help prevent non-communicable diseases and prolong life expectancy. The aim of the study was to evaluate the process and impact of scaling up a complex intervention (PAFES) implemented in Catalonia, aimed to increase the proportion of adults complying with PA recommendations (especially those with cardiovascular risk factors). METHODS The intervention, piloted in 2005, had three elements: 1) establishing clinical guidelines for PA; 2) identifying local PA resources; 3) PA screening and advice in primary health care (PHC) settings, based on stage of change. Central and local level implementation activities included training, support to municipalities, dissemination through a web page, and promotion of World Physical Activity Day (WPAD). Evaluation followed the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), identifying 3-6 variables for annual evaluation of each dimension. These included coverage of PA screening and advice and individuals with access to a healthy exercise route (Reach), increased PA level between 2006 and 2010-15 (Effectiveness), PAFES adoption by PHC centres and municipalities (Adoption), process evaluation data (Implementation), and cost (Maintenance). RESULTS PHC screening coverage increased from 14.4% (2008) to 69.6% (2015) and advice coverage from 8.3% (2012) to 35.6% (2015). In 2015, 82.5% patients had access to a "healthy route" (Reach). The proportion of patients with at least one cardiovascular risk factor who were "sufficiently active" increased from 2006 to 2010-2013 (Effectiveness). By 2015, PAFES was applied by all PHC teams, 8.3% municipalities and 22.7% PHC centres had organized WPAD events (Adoption). The Plan showed good penetration in all health regions by 2013, with relatively low use of resources and estimated cost (Implementation). By 2013 the Plan was embedded within the health system (Maintenance). CONCLUSIONS In the first application of the RE-AIM framework to evaluate the scaling-up of a PA plan, PAFES showed good results for most RE-AIM indicators. Changes in priority and investment in health promotion programs affect reach, adoption, and effectiveness. It is important to maintain support until programs are strongly embedded into the health system.
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Affiliation(s)
| | | | - Conxa Castell Abat
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain
| | | | - Laura Oliveras
- Department of Preventive Medicine and Epidemiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Juanjo Garcia-Gil
- Blanquerna Health Sciences School, Ramon Llull University, Barcelona, Spain
| | - Antoni Plasencia
- Institute of Global Health Barcelona - IS Global, Barcelona, Spain
| | - Carmen Cabezas Peña
- Public Health Agency of Catalonia, Government of Catalonia, Barcelona, Spain
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Young B, Lewis S, Katikireddi SV, Bauld L, Stead M, Angus K, Campbell M, Hilton S, Thomas J, Hinds K, Ashie A, Langley T. Effectiveness of Mass Media Campaigns to Reduce Alcohol Consumption and Harm: A Systematic Review. Alcohol Alcohol 2018; 53:302-316. [PMID: 29329359 PMCID: PMC5913684 DOI: 10.1093/alcalc/agx094] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/11/2017] [Accepted: 10/24/2017] [Indexed: 12/03/2022] Open
Abstract
AIMS To assess the effectiveness of mass media messages to reduce alcohol consumption and related harms using a systematic literature review. METHODS Eight databases were searched along with reference lists of eligible studies. Studies of any design in any country were included, provided that they evaluated a mass media intervention targeting alcohol consumption or related behavioural, social cognitive or clinical outcomes. Drink driving interventions and college campus campaigns were ineligible. Studies quality were assessed, data were extracted and a narrative synthesis conducted. RESULTS Searches produced 10,212 results and 24 studies were included in the review. Most campaigns used TV or radio in combination with other media channels were conducted in developed countries and were of weak quality. There was little evidence of reductions in alcohol consumption associated with exposure to campaigns based on 13 studies which measured consumption, although most did not state this as a specific aim of the campaign. There were some increases in treatment seeking and information seeking and mixed evidence of changes in intentions, motivation, beliefs and attitudes about alcohol. Campaigns were associated with increases in knowledge about alcohol consumption, especially where levels had initially been low. Recall of campaigns was high. CONCLUSION Mass media health campaigns about alcohol are often recalled by individuals, have achieved changes in knowledge, attitudes and beliefs about alcohol but there is little evidence of reductions in alcohol consumption. SHORT SUMMARY There is little evidence that mass media campaigns have reduced alcohol consumption although most did not state that they aimed to do so. Studies show recall of campaigns is high and that they can have an impact on knowledge, attitudes and beliefs about alcohol consumption.
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Affiliation(s)
- Ben Young
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
| | | | - Linda Bauld
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Martine Stead
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Kathryn Angus
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - James Thomas
- Institute of Education, University College London, London, UK
| | - Kate Hinds
- Institute of Education, University College London, London, UK
| | - Adela Ashie
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
| | - Tessa Langley
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
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Spence JC, Faulkner G, Lee EY, Berry T, Cameron C, Deshpande S, Latimer-Cheung AE, Rhodes RE, Tremblay MS. Awareness of ParticipACTION among Canadian adults: a seven-year cross-sectional follow-up. Health Promot Chronic Dis Prev Can 2018; 38:179-186. [PMID: 29671967 PMCID: PMC5983882 DOI: 10.24095/hpcdp.38.4.04] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION In this cross-sectional follow-up study, we explored Canadian's awareness of ParticipACTION and their levels of physical activity (PA) after seven years of campaigns. METHODS A population-based survey was conducted with 7282 adults over a period of 14 months from February 2014 to May 2015. The survey consisted of questions on the 2014-2015 Physical Activity Monitor relating to awareness and knowledge of ParticipACTION. Weighted logistic models were constructed to examine whether awareness was associated with PA-related beliefs, intentions, and leisure time physical activity (LTPA). RESULTS Approximately 20% of Canadians reported unprompted awareness of ParticipACTION and 82% reported prompted awareness. Education, income, and having children were significant correlates of awareness among Canadians. The adjusted odds of people being aware of ParticipACTION (prompted and unprompted) were greater if they were more educated (OR = 1.57, 95% CI: 1.04-2.39; OR = 2.00, 95% CI: 1.24-3.24), reported higher income (OR = 3.92, 95% CI: 2.35-6.53; OR = 2.29, 95% CI: 1.44-3.62), and had children (OR = 1.93, 95% CI: 1.40-2.66; OR = 1.70, 95% CI: 1.26-2.30). Furthermore, awareness of ParticipACTION was positively associated with outcome expectations and self-efficacy, and negatively associated with LTPA status. CONCLUSION Levels of unprompted awareness of ParticipACTION are higher than previously reported and, in comparison to active Canadians, inactive Canadians are more likely to be aware of the organization. Given that it had primarily targeted parents of inactive children over the past seven years, it appears the organization has been partially effective in achieving its communication goals.
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Affiliation(s)
- John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eun-Young Lee
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Tanya Berry
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christine Cameron
- Canadian Fitness and Lifestyle Research Institute, Ottawa, Ontario, Canada
| | - Sameer Deshpande
- Faculty of Management, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Amy E Latimer-Cheung
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
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Allen LN, Pullar J, Wickramasinghe KK, Williams J, Roberts N, Mikkelsen B, Varghese C, Townsend N. Evaluation of research on interventions aligned to WHO 'Best Buys' for NCDs in low-income and lower-middle-income countries: a systematic review from 1990 to 2015. BMJ Glob Health 2018. [PMID: 29527342 PMCID: PMC5841523 DOI: 10.1136/bmjgh-2017-000535] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Non-communicable diseases (NCDs) are the leading cause of death and disability worldwide, with low-income and middle-income countries experiencing a disproportionately high burden. Since 2010 WHO has promoted 24 highly cost-effective interventions for NCDs, dubbed ‘best buys’. It is unclear whether these interventions have been evaluated in low-income and lower-middle-income countries (LLMICs). Aim To systematically review research on interventions aligned to WHO ‘best buys’ for NCDs in LLMICs. Methods We searched 13 major databases and included papers conducted in the 83 World Bank-defined LLMICs, published between 1 January 1990 and 5 February 2015. Two reviewers independently screened papers and assessed risk of bias. We adopted a narrative approach to data synthesis. The primary outcomes were NCD-related mortality and morbidity, and risk factor prevalence. Results We identified 2672 records, of which 36 were included (608 940 participants). No studies on ‘best buys’ were found in 89% of LLMICs. Nineteen of the 36 studies reported on the effectiveness of tobacco-related ‘best buys’, presenting good evidence for group interventions in reducing tobacco use but weaker evidence for interventions targeting individuals. There were fewer studies on smoking bans, warning labels and mass media campaigns, and no studies on taxes or marketing restrictions. There was supportive evidence that cervical screening and hepatitis B immunisation prevent cancer in LLMICs. A single randomised controlled trial supported polypharmacy for cardiovascular disease. Fourteen of the ‘best buy’ interventions did not have any good evidence for effectiveness in LLMICs. Conclusions We found studies on only 11 of the 24 interventions aligned with the WHO ‘best buys’ from LLMIC settings. Most LLMICs have not conducted research on these interventions in their populations. LLMICs should take action to implement and evaluate ‘best buys’ in their national context, based on national priorities, and starting with interventions with the strongest evidence base.
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Affiliation(s)
- Luke N Allen
- Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jessica Pullar
- Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kremlin Khamarj Wickramasinghe
- Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Julianne Williams
- Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nia Roberts
- Health Library, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Bente Mikkelsen
- Global Coordination Mechanism for Noncommunicable Diseases, WHO, Geneva, Switzerland
| | - Cherian Varghese
- Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, WHO, Geneva, Switzerland
| | - Nick Townsend
- Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Reifegerste D, Rossmann C. Promoting Physical Activity With Group Pictures. Affiliation-Based Visual Communication for High-Risk Populations. HEALTH COMMUNICATION 2017; 32:161-168. [PMID: 27192558 DOI: 10.1080/10410236.2015.1110007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Past research in social and health psychology has shown that affiliation motivation is associated with health behavior, especially for high-risk populations, suggesting that targeting this motivation could be a promising strategy to promote physical activity. However, the effects that affiliation appeals (e.g., pictures depicting companionship during physical activities) and accompanying slogans have on motivating physical activity have been largely unexplored. Hence, our two studies experimentally tested the effects of exposure to affiliation-based pictures for overweight or less active people, as well as the moderating effect of affiliation motivation. The results of these two studies give some indication that group pictures (with or without an accompanying slogan) can be an effective strategy to improve high-risk populations' attitudes, self-efficacy, and intentions to engage in physical activity. Affiliation motivation as a personality trait did not interact with these effects, but was positively associated with attitudes, independent of the group picture effect.
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Affiliation(s)
- Doreen Reifegerste
- a Department of Journalism and Communication Research , Hanover University of Music, Drama and Media
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An R, Xiang X, Yang Y, Yan H. Mapping the Prevalence of Physical Inactivity in U.S. States, 1984-2015. PLoS One 2016; 11:e0168175. [PMID: 27959906 PMCID: PMC5154575 DOI: 10.1371/journal.pone.0168175] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/26/2016] [Indexed: 11/27/2022] Open
Abstract
Background Physical inactivity is a leading cause of morbidity, disability and premature mortality in the U.S. and worldwide. This study aimed to map the prevalence of physical inactivity across U.S. states over the past three decades, and estimate the over-time adjusted changes in the prevalence of physical inactivity in each state. Methods Individual-level data (N = 6,701,954) were taken from the 1984–2015 Behavioral Risk Factor Surveillance System (BRFSS), an annually repeated cross-sectional survey of state-representative adult population. Prevalence of self-reported leisure-time physical inactivity was estimated by state and survey year, accounting for the BRFSS sampling design. Logistic regressions were performed to estimate the changes in the prevalence of physical inactivity over the study period for each state, adjusting for individual characteristics including sex, age, race/ethnicity, education, marital status, and employment status. Results The prevalence of leisure-time physical inactivity varied substantially across states and survey years. In general, the adjusted prevalence of physical inactivity gradually declined over the past three decades in a majority of states. However, a substantial proportion of American adults remain physically inactive. Among the 50 states and District of Columbia, 45 had over a fifth of their adult population without any leisure-time physical activity, and 8 had over 30% without physical activity in 2015. Moreover, the adjusted prevalence of physical inactivity in several states (Arizona, North Carolina, North Dakota, Utah, West Virginia, and Wyoming) remained largely unchanged or even increased (Minnesota and Ohio) over the study period. Conclusions Although the prevalence of physical inactivity declined over the past three decades in a majority of states, the rates remain substantially high and vary considerably across states. Closely monitoring and tracking physical activity level using the state physical activity maps can help guide policy and program development to promote physical activity and reduce the burden of chronic disease.
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Affiliation(s)
- Ruopeng An
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
- * E-mail:
| | - Xiaoling Xiang
- Feinburg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Yan Yang
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Hai Yan
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
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Säfvenbom R, Buch R, Aandstad A. Eagerness for Physical Activity Scale: Theoretical background and validation. APPLIED DEVELOPMENTAL SCIENCE 2016. [DOI: 10.1080/10888691.2016.1184095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kye SY, Kwon JH, Kim YC, Shim M, Kim JH, Cho H, Jung KW, Park K. Cancer risk factors in Korean news media: a content analysis. Asian Pac J Cancer Prev 2015; 16:731-6. [PMID: 25684516 DOI: 10.7314/apjcp.2015.16.2.731] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the news coverage of cancer risk factors in Korea. This study aimed to examine how the news media encompasses a wide array of content regarding cancer risk factors and related cancer sites, and investigate whether news coverage of cancer risk factors is congruent with the actual prevalence of the disease. MATERIALS AND METHODS A content analysis was conducted on 1,138 news stories covered during a 5-year period between 2008 and 2012. The news stories were selected from nationally representative media in Korea. Information was collected about cancer risk factors and cancer sites. RESULTS Of various cancer risk factors, occupational and environmental exposures appeared most frequently in the news. Breast cancer was mentioned the most in relation to cancer sites. Breast, cervical, prostate, and skin cancer were overrepresented in the media in comparison to incidence and mortality cases, whereas lung, thyroid, liver, and stomach cancer were underrepresented. CONCLUSIONS To our knowledge, this research is the first investigation dealing with news coverage about cancer risk factors in Korea. The study findings show occupational and environmental exposures are emphasized more than personal lifestyle factors; further, more prevalent cancers in developed countries have greater media coverage, not reflecting the realities of the disease. The findings may help health journalists and other health storytellers to develop effective ways to communicate cancer risk factors.
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Affiliation(s)
- Su Yeon Kye
- Cancer Information and Education Branch, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea E-mail :
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Gainforth HL, Jarvis JW, Berry TR, Chulak-Bozzer T, Deshpande S, Faulkner G, Rhodes RE, Spence JC, Tremblay MS, Latimer-Cheung AE. Evaluating the ParticipACTION “Think Again” Campaign. HEALTH EDUCATION & BEHAVIOR 2015; 43:434-41. [DOI: 10.1177/1090198115604614] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction. ParticipACTION’s 2011 “Think Again” campaign aimed to draw parents’, and specifically mothers’, attention to the amount of physical activity (PA) their children do relative to the national guidelines (physical activity guidelines [PAG]). Purpose. To evaluate ParticipACTION’s “Think Again” campaign in the context of the hierarchy of effects model. Methods. Data were drawn from “Think Again” campaign evaluations conducted among two cohorts of parents with children ages 5 to 11 years (3 months postcampaign launch [T1], n = 702; 15 months postlaunch [T2], n = 670). Results. At T2, campaign awareness was weakly associated with parents agreeing that their children were not active enough ( p = .01, d = .18). Parents who were aware of the campaign showed greater knowledge of PAG ( ps < .01, ϕs > .14), had higher outcome expectations about their children engaging in PA ( p < .01, d = .16), had stronger intentions to help their child meet the guidelines ( p < .01, d = .18), and engaged in more parental support behaviors ( p < .001, d = .31) as compared with parents who were not aware. At T1, parents aware of the campaign had greater perceived behavioral control (PBC) to influence their child’s PA participation ( p < .01, d = .22), whereas parents not aware of the campaign had greater PBC to find practical ways to help their child be active ( p < .01, d = .26). Parental awareness of the campaign was not associated with children meeting the PAG at either time point ( ps > .05). Conclusions. The campaign appeared marginally effective for increasing parental knowledge of PAG and for creating realistic awareness of children’s PA levels. Additional intervention strategies are needed to produce larger effects and to change parental behavior.
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Affiliation(s)
| | - Jocelyn W. Jarvis
- Queen’s University, Kingston, Ontario, Canada
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Ontario, Canada
| | | | | | | | - Guy Faulkner
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Ryan E. Rhodes
- University of Victoria, Victoria, British Columbia, Canada
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Taylor AW, Dal Grande E, Wu J, Shi Z, Campostrini S. Ten-year trends in major lifestyle risk factors using an ongoing population surveillance system in Australia. Popul Health Metr 2014; 12:31. [PMID: 25379026 PMCID: PMC4222399 DOI: 10.1186/s12963-014-0031-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/13/2014] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Understanding how risk factors (tobacco, alcohol, physical inactivity, unhealthy diet, high blood pressure, and high cholesterol) change over time is a critical aim of public health. The associations across the social gradient over time are important considerations. Risk factor surveillance systems have a part to play in understanding the epidemiological distribution of the risk factors so as to improve preventive measures and design public health interventions for reducing the burden of disease. METHODS Representative, cross-sectional data were collected in South Australia using telephone interviews, conducted on a minimum of 600 randomly selected people (of all ages) each month. Data were collected from January 2004 to December 2013. Unadjusted prevalence over time, the relative percentage change over the 10 years, and the absolute change of the risk factors with sex, age group, and socio-economic status (SES) estimates are presented. RESULTS In total 55,548 adults (≥18 years) were interviewed (mean age = 47.8 years, 48.8% male). Decreases were apparent for insufficient physical activity, inadequate fruit and vegetables, smoking, and soft drink consumption of ≥500 ml/day. Increases were found over the 10 years for obesity, high cholesterol, diabetes, and for those with no risk factors. Apparent differences were noticeable by different sex, age, and SES categories. While increases in physical activity and fruit and vegetable consumption and decreases in smoking prevalence and multiple risk factors are to be expected in 2020-2021, the prevalence of obesity, high blood pressure, high cholesterol, and diabetes are expected to increase. CONCLUSIONS Public health efforts in increasing the proportion of the population undertaking appropriate risk factor behavior are showing signs of success, with data from 2004 to 2013 showing encouraging trends. Deriving comparable trends over time by key demographics and SES variables provides evidence for policymakers and health planners to encourage interventions aimed at preventing chronic disease.
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Affiliation(s)
- Anne W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia ; Ca' Foscari University, Venice, Italy
| | - Eleonora Dal Grande
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia
| | - Jing Wu
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia
| | - Zumin Shi
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia
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Hackley B, Kennedy HP, Berry DC, Melkus GD. A mixed-methods study on factors influencing prenatal weight gain in ethnic-minority women. J Midwifery Womens Health 2014; 59:388-98. [PMID: 24986225 DOI: 10.1111/jmwh.12170] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Gaining too much weight in pregnancy is associated with perinatal complications and increases the risks of future obesity for both women and their infants. Unfortunately, women enrolled in intervention trials have seen little improvement in adherence to prenatal weight gain recommendations compared to women receiving standard prenatal care. Therefore, the purpose of this descriptive mixed-methods study was to explore factors related to excessive weight gain in pregnancy. METHODS Nonpregnant nulliparous women, currently pregnant women, and postpartum women (N = 43) were recruited from a health center serving an inner-city minority community. Women completed questionnaires on knowledge, self-efficacy, and behaviors related to nutrition, exercise, and prenatal weight gain. Fifteen of these women participated in focus groups. Focus group data were analyzed using ATLAS.ti (Scientific Software Development GmbH, Berlin, Germany). Codes were created, themes were identified, and consensus was reached through multiple iterations of the analysis by study personnel. RESULTS Excessive weight gain was common. Nutritional knowledge was poor and significantly lower among nonpregnant nulliparous women. Women felt sure that they could engage in healthy behaviors, but few did so. Participants in focus groups identified multiple barriers to healthy behaviors in pregnancy and made suggestions on how to help women more readily make improvements in these behaviors. DISCUSSION Strategies identified in this study such as providing focused education directed at nonpregnant nulliparous women, stressing portion control, helping women better manage their cravings, and providing more pragmatic support and resources need to be explored in future research.
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Abstract
The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify key health enablers that could ultimately be leveraged by technology. The key health enablers discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior-change intervention, and (5) the role of peer and social networks on change. This report summarizes leading evidence and the group consensus on evidence-based practices with respect to the key enablers in creating healthy behavior change.
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