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Souza Filho AND, Bezerra TA, Bandeira PFR, Cabral LG, Brito A, Guerra PH, Martins CMDL, Carvalho FO. Association between the environment for physical activity in public schools and childhood obesity: a view in the light of complex systems. CIENCIA & SAUDE COLETIVA 2024; 29:e05162023. [PMID: 38896672 DOI: 10.1590/1413-81232024296.05162023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/21/2023] [Indexed: 06/21/2024] Open
Abstract
This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.
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Affiliation(s)
- Anastácio Neco de Souza Filho
- Departamento de Educação Física, Universidade Regional do Cariri. R. Cel. Antônio Luíz 1161, Pimenta. 63105-010 Crato CE Brasil.
| | - Thaynã Alves Bezerra
- Departamento de Educação Física, Universidade Regional do Cariri. R. Cel. Antônio Luíz 1161, Pimenta. 63105-010 Crato CE Brasil.
| | - Paulo Felipe Ribeiro Bandeira
- Departamento de Educação Física, Universidade Regional do Cariri. R. Cel. Antônio Luíz 1161, Pimenta. 63105-010 Crato CE Brasil.
| | - Luciana Gatto Cabral
- Departamento de Educação Física, Universidade Federal da Paraíba. João Pessoa PB Brasil
| | - André Brito
- Departamento de Educação Física, Universidade Federal do Vale do São Francisco. Petrolina PE Brasil
| | - Paulo Henrique Guerra
- Departamento de Medicina, Universidade Federal de Fronteira do Sul. Chapecó RS Brasil
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Gubbels JS, Van Kann DHH, de Vries NK, Thijs C, Kremers SPJ. The next step in health behavior research: the need for ecological moderation analyses - an application to diet and physical activity at childcare. Int J Behav Nutr Phys Act 2014; 11:52. [PMID: 24742167 PMCID: PMC4002539 DOI: 10.1186/1479-5868-11-52] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 04/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ecological perspective holds that human behavior depends on the interaction of different environmental factors and personal characteristics, but it lacks validation and operationalization. In the current paper, an ecological view was adopted to examine the interactive impact of several ecological systems on children's dietary intake and physical activity at childcare or similar facilities. The ecological view was operationalized into three types of interaction: 1) interaction between types of childcare environment (physical, social, political, economic); 2) interaction between micro-systems (the childcare and home environment) in meso-systems; and 3) interaction between childcare environment and child characteristics. The predictive value of each of these interactions was tested based on a systematic review of the literature. DISCUSSION Several studies support the hypothesis that the influence of the childcare environment on children's physical activity and diet is moderated by child characteristics (age, gender), but interaction between environmental types as well as between micro-systems is hardly examined in the field of behavioral nutrition and physical activity. Qualitative studies and general child development research provide some valuable insights, but we advocate quantitative research adopting an ecological perspective on environmental influences. SUMMARY Empirical studies operationalizing a true ecological view on diet and physical activity are scarce. Theorizing and assessment of interaction is advocated to become common practice rather than an exception in behavioral nutrition and physical activity research, in order to move the field forward.
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Affiliation(s)
- Jessica S Gubbels
- Department of Health Promotion, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
- NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
| | - Dave HH Van Kann
- Department of Health Promotion, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
- Academic Collaborative Centre for Public Health Limburg, Regional Public Health Service, PO Box 2022, Geleen, HA, 6160, the Netherlands
- Caphri, School of Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
| | - Nanne K de Vries
- Department of Health Promotion, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
- NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
- Caphri, School of Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
| | - Carel Thijs
- Caphri, School of Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
- Department of Epidemiology, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
| | - Stef PJ Kremers
- Department of Health Promotion, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
- NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
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Helmink JHM, Gubbels JS, van Brussel-Visser FN, de Vries NK, Kremers SPJ. Baseline predictors of maintenance of intervention-induced changes in physical activity and sitting time among diabetic and pre-diabetic patients: a descriptive case series. BMC Res Notes 2013; 6:190. [PMID: 23656718 PMCID: PMC3655840 DOI: 10.1186/1756-0500-6-190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 04/22/2013] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to explore the predictive value of baseline characteristics in relation to changes in physical activity (PA) and sedentary behaviour among diabetic and pre-diabetic patients participating in a primary care based exercise intervention. We used a descriptive case series among diabetic and pre-diabetic patients (n = 119, 50.8% male, mean age 65.5 (SD = 7.8)). Measurements took place with questionnaires at baseline and two years after the start of the intervention. Predictor variables included demographic factors, Body Mass Index, baseline PA and sitting time, and baseline socio-cognitive profile. Results At follow-up, respondents spent more time being physically active than at baseline. For the total group, the average sitting time remained almost unchanged between the two measurements. Further exploration showed that respondents who had relatively high levels of PA at the start of the intervention, increased their total sitting time, while respondents with relatively low levels of PA at the start decreased their sitting time. The socio-cognitive profile did not predict behaviour change. The intervention appeared to be suitable for people with a low-education level, but the results should be interpreted in view of the limitations of the study such as the non-controlled design, self-reported outcomes and selective drop-out of participants. Conclusions Interventions for this specific target group may need to put more emphasis on the prevention of increased sitting time. The finding that the socio-cognitive profile did not predict behaviour change may underline the proposition that decisions to initiate and maintain PA behaviour change are to a large extend non-linear events. Acknowledging the possible non-linearity of the relationship between socio-cognitive determinants and behaviour change will help our understanding of this complex and dynamic process.
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Affiliation(s)
- Judith H M Helmink
- Department of Health Promotion, Maastricht University, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht, MD 6200, the Netherlands.
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Buchan DS, Ollis S, Thomas NE, Baker JS. Physical activity behaviour: an overview of current and emergent theoretical practices. J Obes 2012; 2012:546459. [PMID: 22778918 PMCID: PMC3388376 DOI: 10.1155/2012/546459] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 03/30/2012] [Accepted: 05/10/2012] [Indexed: 11/17/2022] Open
Abstract
Physical activity research has been dominated by traditional cognitive rationale paradigms utilized within other domains. Though this approach to physical activity behavior has greatly enhanced our understanding of the key determinants, it has done little to eradicate the health problems we currently face. In order to achieve lasting change though, multilevel interventions may prove effective. Ecological perspectives have been proposed as an effective approach in combating current physical inactivity levels. Nevertheless, this approach is in its infancy and much has still to be learned. The aim of this paper is to provide an overview of the main behavioral models used within the physical activity domain while proposing the need for further models that will embrace the principles presented by ecological and complexity theories.
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Affiliation(s)
- Duncan S. Buchan
- Health and Exercise Sciences, School of Science and Technology, University of the West of Scotland, Hamilton ML3 0JB, UK
- *Duncan S. Buchan:
| | - Stewart Ollis
- Health and Exercise Sciences, School of Science and Technology, University of the West of Scotland, Hamilton ML3 0JB, UK
| | - Non E. Thomas
- School of Human Sciences, Swansea University, Swansea SA2 8PP, UK
| | - Julien S. Baker
- Health and Exercise Sciences, School of Science and Technology, University of the West of Scotland, Hamilton ML3 0JB, UK
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Dissen AR, Policastro P, Quick V, Byrd‐Bredbenner C. Interrelationships among nutrition knowledge, attitudes, behaviors and body satisfaction. HEALTH EDUCATION 2011. [DOI: 10.1108/09654281111144256] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Decision Making in Eating Behavior: State of the Science and Recommendations for Future Research. Ann Behav Med 2009; 38 Suppl 1:S88-92. [DOI: 10.1007/s12160-009-9125-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Palmeira AL, Markland DA, Silva MN, Branco TL, Martins SC, Minderico CS, Vieira PN, Barata JT, Serpa SO, Sardinha LB, Teixeira PJ. Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis. Int J Behav Nutr Phys Act 2009; 6:9. [PMID: 19203389 PMCID: PMC2645358 DOI: 10.1186/1479-5868-6-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 02/09/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Changes in body image and subjective well-being variables (e.g. self-esteem) are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-related variables, i.e., change in weight, quality of life, body image, and subjective well-being, exploring their role as both mediators and outcomes, during a behavioral obesity treatment. METHODS Participants (BMI = 31.1 +/- 4.1 kg/m2; age = 38.4 +/- 6.7 y) were 144 women who attended a 12-month obesity treatment program and a comparison group (n = 49), who received a general health education program. The intervention included regular group meetings promoting lasting behavior changes in physical activity and dietary intake. Body image, quality of life, subjective well-being, and body weight were measured at baseline and treatment's end. Mediation was tested by multiple regression and a resampling approach to measure indirect effects. Treatment group assignment was the independent variable while changes in weight and in psychosocial variables were analyzed alternatively as mediators and as dependent variables. RESULTS At 12 months, the intervention group had greater weight loss (-5.6 +/- 6.8% vs. -1.2 +/- 4.6%, p < .001) and larger decreases in body size dissatisfaction (effect size of 1.08 vs. .41, p < .001) than the comparison group. Significant improvements were observed in both groups for all other psychosocial variables (effect sizes ranging from .31-.75, p < .05). Mediation analysis showed that changes in body image and body weight were concurrently mediators and outcomes of treatment, suggesting reciprocal influences. Weight loss partially mediated the effect of treatment on quality of life and on self-esteem but the reciprocal effect was not observed. CONCLUSION Changes in weight and body image may reciprocally affect each other during the course of behavioral obesity treatment. No evidence of reciprocal relationships was found for the other models under analysis; however, weight changes partially explained the effects of treatment on quality of life and self-esteem. Weight and psychosocial changes co-occur during treatment and will probably influence each other dynamically, in ways not yet adequately understood. Results from this study support the inclusion of intervention contents aimed at improving body image in weight management programs.
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Affiliation(s)
- António L Palmeira
- Faculty of Human Kinetics, Technical University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal.
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Resnicow K, Page SE. Embracing chaos and complexity: a quantum change for public health. Am J Public Health 2008; 98:1382-9. [PMID: 18556599 DOI: 10.2105/ajph.2007.129460] [Citation(s) in RCA: 187] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Public health research and practice have been guided by a cognitive, rational paradigm where inputs produce linear, predictable changes in outputs. However, the conceptual and statistical assumptions underlying this paradigm may be flawed. In particular, this perspective does not adequately account for nonlinear and quantum influences on human behavior. We propose that health behavior change is better understood through the lens of chaos theory and complex adaptive systems. Key relevant principles include that behavior change (1) is often a quantum event; (2) can resemble a chaotic process that is sensitive to initial conditions, highly variable, and difficult to predict; and (3) occurs within a complex adaptive system with multiple components, where results are often greater than the sum of their parts.
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Affiliation(s)
- Kenneth Resnicow
- University of Michigan, School of Public Health Department of Health Behavior & Health Education, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI 48109-2029, USA.
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Maibach EW, Abroms LC, Marosits M. Communication and marketing as tools to cultivate the public's health: a proposed "people and places" framework. BMC Public Health 2007; 7:88. [PMID: 17519027 PMCID: PMC1888704 DOI: 10.1186/1471-2458-7-88] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Accepted: 05/22/2007] [Indexed: 11/12/2022] Open
Abstract
Background Communication and marketing are rapidly becoming recognized as core functions, or core competencies, in the field of public health. Although these disciplines have fostered considerable academic inquiry, a coherent sense of precisely how these disciplines can inform the practice of public health has been slower to emerge. Discussion In this article we propose a framework – based on contemporary ecological models of health – to explain how communication and marketing can be used to advance public health objectives. The framework identifies the attributes of people (as individuals, as social networks, and as communities or populations) and places that influence health behaviors and health. Communication, i.e., the provision of information, can be used in a variety of ways to foster beneficial change among both people (e.g., activating social support for smoking cessation among peers) and places (e.g., convincing city officials to ban smoking in public venues). Similarly, marketing, i.e., the development, distribution and promotion of products and services, can be used to foster beneficial change among both people (e.g., by making nicotine replacement therapy more accessible and affordable) and places (e.g., by providing city officials with model anti-tobacco legislation that can be adapted for use in their jurisdiction). Summary Public health agencies that use their communication and marketing resources effectively to support people in making healthful decisions and to foster health-promoting environments have considerable opportunity to advance the public's health, even within the constraints of their current resource base.
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Affiliation(s)
- Edward W Maibach
- Department of Prevention and Community Health, George Washington University School of Public Health & Health Services, 2175 K Street, Suite 700, Washington, DC, 20037, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, George Washington University School of Public Health & Health Services, 2175 K Street, Suite 700, Washington, DC, 20037, USA
| | - Mark Marosits
- Worldways Social Marketing, 6030 Greenwood Plaza Blvd., Suite 110, Greenwood Village, CO, 80111, USA
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Ball K. Epiphanies, velcro balls and McDonaldization: highlights from the 5th Meeting of the International Society for Behavioral Nutrition and Physical Activity. Int J Behav Nutr Phys Act 2006; 3:30. [PMID: 16987427 PMCID: PMC1592507 DOI: 10.1186/1479-5868-3-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2006] [Accepted: 09/21/2006] [Indexed: 11/27/2022] Open
Abstract
This commentary provides an overview and selected highlights from the scientific program of the 5th Annual Meeting of the International Society for Behavioral Nutrition and Physical Activity.
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Affiliation(s)
- Kylie Ball
- International Society for Behavioral Nutrition & Physical Activity, Deakin University, Melbourne, Australia.
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