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Baugh Littlejohns L, McKee G, Rasali D, Naiman D, Mee J, Osborne T, Dang P, Winters M, Lear SA, Nelson D, McGinley S, Faulkner G. Follow the Arrows: Using a Co-Created Causal Loop Diagram to Explore Leverage Points to Strengthen Population Physical Activity Promotion in British Columbia, Canada. J Phys Act Health 2024; 21:765-777. [PMID: 38729618 DOI: 10.1123/jpah.2023-0740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/21/2024] [Accepted: 03/20/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Population physical activity promotion (PPAP) is one of the most effective noncommunicable disease prevention strategies, yet coordination is lacking around the world. Whole-of-system approaches and complex systems methods are called for to advance PPAP. This paper reports on a project which (1) used an Attributes Framework with system mapping (group model building and causal loop diagramming of feedback loops) and (2) identified potential leverage points to address the challenge of effective coordination of multisectoral PPAP in British Columbia. METHODS Key findings from stakeholder interviews and workshops described the current system for PPAP in terms of attributes and dimensions in the framework. These were translated into variables and used in group model building. Participants prioritized the importance of variables to address the coordination challenge and then created causal loop diagrams in 3 small groups. One collective causal loop diagram was created, and top priority variables and associated feedback loops were highlighted to explore potential leverage points. RESULTS Leverage points included the relationships and feedback loops among priority variables: political leadership, visible policy support and governance, connectivity for knowledge translation, collaborative multisector grants, multisector collaboration, and integrating co-benefits. Leveraging and altering "vicious" cyclical patterns to increase coordinated multisector PPAP are key. CONCLUSIONS The Attributes Framework, group model building and causal loop diagrams, and emergent feedback loops were useful to explore potential leverage points to address the challenge of multisectoral coordination of PPAP. Future research could apply the same methods in other jurisdictions and compare and contrast resultant frameworks, variables, feedback loops, and leverage points.
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Affiliation(s)
- Lori Baugh Littlejohns
- University of British Columbia, Vancouver, BC, Canada
- BC Centre for Disease Control, Vancouver, BC, Canada
| | | | - Drona Rasali
- University of British Columbia, Vancouver, BC, Canada
| | | | - Jennafer Mee
- University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Phuc Dang
- BC Centre for Disease Control, Vancouver, BC, Canada
| | | | | | - Diane Nelson
- West Vancouver School District, West Vancouver, BC, Canada
| | | | - Guy Faulkner
- University of British Columbia, Vancouver, BC, Canada
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Petro-Petro J, Arango-Paternina CM, Patiño-Villada FA, Ramirez-Villada JF, Brownson RC. Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review. BMC Public Health 2024; 24:1101. [PMID: 38649855 PMCID: PMC11034017 DOI: 10.1186/s12889-024-18615-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents. METHODS The scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method. RESULTS Most SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings. CONCLUSIONS The analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).
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Affiliation(s)
- Jose Petro-Petro
- Instituto de Educación Física, Universidad de Antioquia, Carrera 75 Nº 65-87 - Bloque 45, Medellín, Colombia.
- Departamento de Cultura Física, Universidad de Córdoba, Montería, Colombia.
| | - Carlos Mario Arango-Paternina
- Research Group on Physical Activity for Health (AFIS), Instituto Universitario de Educación Física y Deportes; Universidad de Antioquia, Ciudadela Robledo, Medellín, Colombia
| | - Fredy Alonso Patiño-Villada
- Research Group on Physical Activity for Health (AFIS), Instituto Universitario de Educación Física y Deportes; Universidad de Antioquia, Ciudadela Robledo, Medellín, Colombia
| | - Jhon Fredy Ramirez-Villada
- Research Group on Physical Activity for Health (AFIS), Instituto Universitario de Educación Física y Deportes; Universidad de Antioquia, Ciudadela Robledo, Medellín, Colombia
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University, St. Louis, MO, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine; Washington University, St. Louis, MO, USA
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Prince SA, Lang JJ, de Groh M, Badland H, Barnett A, Littlejohns LB, Brandon NC, Butler GP, Casu G, Cerin E, Colley RC, de Lannoy L, Demchenko I, Ellingwood HN, Evenson KR, Faulkner G, Fridman L, Friedenreich CM, Fuller DL, Fuselli P, Giangregorio LM, Gupta N, Hino AA, Hume C, Isernhagen B, Jalaludin B, Lakerveld J, Larouche R, Lemon SC, Loucaides CA, Maddock JE, McCormack GR, Mehta A, Milton K, Mota J, Ngo VD, Owen N, Oyeyemi AL, Palmeira AL, Rainham DG, Rhodes RE, Ridgers ND, Roosendaal I, Rosenberg DE, Schipperijn J, Slater SJ, Storey KE, Tremblay MS, Tully MA, Vanderloo LM, Veitch J, Vietinghoff C, Whiting S, Winters M, Yang L, Geneau R. Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users. Int J Behav Nutr Phys Act 2023; 20:144. [PMID: 38062460 PMCID: PMC10704660 DOI: 10.1186/s12966-023-01533-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). METHODS Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. RESULTS From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. CONCLUSIONS Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Adelaide, South Australia
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
| | - Hannah Badland
- Social and Global Studies Centre, RMIT University, Melbourne, Australia
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Lori Baugh Littlejohns
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Population and Public Health, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Gregory P Butler
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
| | - Géna Casu
- Association pour la santé publique du Québec (ASPQ), Montréal, Québec, Canada
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Rachel C Colley
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | | | - Iryna Demchenko
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | | | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Liraz Fridman
- Department of Mechanical and Industrial Engineering, Faculty of Applied Science and Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Daniel L Fuller
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Lora M Giangregorio
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
| | - Neeru Gupta
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Adriano A Hino
- Health Sciences Graduate Program, School of Medicine and Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Clare Hume
- School of Public Health, University of Adelaide, Adelaide, Australia
| | | | - Bin Jalaludin
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Behaviours and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands
- Upstream Team, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Stephenie C Lemon
- Prevention Research Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | | | - Jay E Maddock
- School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- School of Planning, Architecture, and Landscape, University of Calgary, Calgary, Alberta, Canada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Aman Mehta
- Maroondah City Council, Victoria, Australia
| | - Karen Milton
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jorge Mota
- Research Center in Physical Activity, health and Leisure (CIAFEL)-Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Victor D Ngo
- Canadian Institute of Planners, Ottawa, Ontario, Canada
| | - Neville Owen
- Swinburne University of Technology, Melbourne, Victoria, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Adewale L Oyeyemi
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | | | - Daniel G Rainham
- Healthy Populations Institute, Dalhousie University, Halifax, Nova Scotia, Canada
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Nicola D Ridgers
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Adelaide, South Australia
| | | | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sandra J Slater
- Bachelor of Science in Public Health Program, School of Pharmacy, Concordia University Wisconsin, Mequon, Wisconsin, USA
| | - Kate E Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Mark S Tremblay
- Outdoor Play Canada, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Mark A Tully
- School of Medicine, Ulster University, Londonberry, United Kingdom
| | - Leigh M Vanderloo
- ParticipACTION, Toronto, Ontario, Canada
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | | | - Stephen Whiting
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Linchuan Yang
- Department of Urban and Rural Planning, School of Architecture, Southwest Jiaotong University, Chengdu, China
| | - Robert Geneau
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada
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