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van den Bekerom L, van Gestel LC, Schoones JW, Bussemaker J, Adriaanse MA. Health behavior interventions among people with lower socio-economic position: a scoping review of behavior change techniques and effectiveness. Health Psychol Behav Med 2024; 12:2365931. [PMID: 38903803 PMCID: PMC11188964 DOI: 10.1080/21642850.2024.2365931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/04/2024] [Indexed: 06/22/2024] Open
Abstract
Background Behavior change interventions can unintendedly widen existing socio-economic health inequalities. Understanding why interventions are (in)effective among people with lower socio-economic position (SEP) is essential. Therefore, this scoping review aims to describe what is reported about the behavior change techniques (BCTs) applied within interventions and their effectiveness in encouraging physical activity and healthy eating, and reducing smoking and alcohol consumption according to SEP. Methods A systematic search was conducted in 12 electronic databases, and 151 studies meeting the eligibility criteria were included and coded for health behavioral outcomes, SEP-operationalization, BCTs (type and number) and effectiveness. Results Findings suggest that approaches for measuring, defining and substantiating lower SEP vary. Current studies of behavior change interventions for people of different SEP do not systematically identify BCTs, making systematic evaluation of BCT effectiveness impossible. The effectiveness of interventions is mainly evaluated by overall intervention outcomes and SEP-moderation effects are mostly not assessed. Conclusion Using different SEP-operationalizations and not specifying BCTs hampers systematic evidence accumulation regarding effective (combinations of) BCTs for the low SEP population. To learn which BCTs effectively improve health behaviors among people with lower SEP, future intervention developers should justify how SEP is operationalized and must systematically describe and examine BCTs.
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Affiliation(s)
- Loes van den Bekerom
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
| | - Laurens C. van Gestel
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | - Jan W. Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, the Netherlands
| | - Jet Bussemaker
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- The Institute of Public Administration, Leiden University, Leiden, the Netherlands
| | - Marieke A. Adriaanse
- Health Campus The Hague/Department of Public Health and Primary Care, Leiden University Medical Center, The Hague/Leiden, the Netherlands
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
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Wang Y, Steenbergen B, van der Krabben E, Kooij HJ, Raaphorst K, Hoekman R. The Impact of the Built Environment and Social Environment on Physical Activity: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6189. [PMID: 37372774 DOI: 10.3390/ijerph20126189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
This scoping review aims to provide an overview of the current state of physical activity research, focusing on the interplay between built and social environments and their respective influences on physical activity. We comprehensively searched electronic databases to identify relevant studies published between 2000 and 2022. A total of 35 articles have been reviewed based on the research question. The review found that built and social environments influence physical activity, and consideration of people's perceptions of their surroundings can provide further insight. The literature was summarized, and recommendations were made for future research. Findings suggest that interventions targeting built and social environments can promote physical activity effectively. However, limitations in the literature exist, including a need for more standardization in research methods and consistency in measurement tools.
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Affiliation(s)
- Yiyu Wang
- Behavioral Science Institute, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Bert Steenbergen
- Behavioral Science Institute, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Erwin van der Krabben
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Henk-Jan Kooij
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Kevin Raaphorst
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
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García-Río F, Miravitlles M, Soriano JB, Cosío BG, Soler-Cataluña JJ, Casanova C, de Lucas P, Alfageme I, González-Moro JMR, Sánchez Herrero MG, Ancochea J. Dissociation between physical capacity and daily physical activity in COPD patients. A population-based approach. Respir Med 2023; 207:107115. [PMID: 36610693 DOI: 10.1016/j.rmed.2023.107115] [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: 10/13/2022] [Revised: 11/26/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
BADKGROUND Physical capacity (PC) and daily physical activity (PA) are two crucial factors in the clinical course of COPD, although they do not always maintain a close relationship. The objectives were to evaluate the frequency of PC-PA dissociation in patients with COPD and subjects without airflow limitation (AL) and to identify its risk factors. METHODS A sample of 319 COPD patients and 399 subjects without AL was consecutively obtained from a population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, lung function testing, blood analysis and low-dose computed tomography (CT) scan with evaluation of lung density and airway wall thickness. A distance walked in 6 min > 70% predicted was considered an indicator of normal PC, while a Yale Physical Activity Survey summary index score <51 was used to identify with sedentary lifestyle. RESULTS 166 COPD patients (52.0%) reported a sedentary lifestyle with evidence of preserved PC, while this phenomenon was present in 188 (47.1%) subjects without AL. In the COPD group, symptoms of chronic bronchitis, depression and elevated hematocrit and blood eosinophil count were identified as independent risk factors for PC-PA dissociation. In turn, in the subjects without AL, the risk factors for PC-PA dissociation were low fat-free mass, obesity and anxiety, as well as reduced levels of HDL-cholesterol and the absence of osteoporosis. CONCLUSIONS Almost half of COPD patients and subjects without airflow limitation with preserved PC maintain a sedentary lifestyle, with different risk factors for sedentarism between both groups.
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Affiliation(s)
- Francisco García-Río
- Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Marc Miravitlles
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Joan B Soriano
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Borja G Cosío
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain
| | - Juan José Soler-Cataluña
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Universitat de València, Valencia, Spain
| | - Ciro Casanova
- Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Tenerife, Spain
| | - Pilar de Lucas
- Servicio de Neumología, Hospital General Gregorio Marañón, Madrid, Spain
| | - Inmaculada Alfageme
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
| | | | | | - Julio Ancochea
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
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Evaluating physical activity interventions for socioeconomically disadvantaged adults through the RE-AIM framework: A systematic review of experimental and non–/quasi-experimental trials. Prev Med Rep 2022; 29:101943. [PMID: 36161121 PMCID: PMC9502049 DOI: 10.1016/j.pmedr.2022.101943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/30/2022] [Accepted: 08/05/2022] [Indexed: 11/21/2022] Open
Abstract
The review evaluated internal and external validity using the rE-AIM Framework. Results indicate an overall low reporting of validity factors. Information on adoption and maintenance was particularly low. Future studies should improve the reporting across all rE-AIM dimensions. Future studies should consider adaptations during the implementation phase.
The promotion of physical activity in people from lower social strata is a public health priority. Previous reviews of physical activity interventions among socioeconomically disadvantaged adults have focused on intervention effectiveness without considering their translation into practice. This review utilised the RE-AIM framework (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance) to (1) evaluate the extent to which experimental and non–/quasi-experimental trials of interventions to promote physical activity among socioeconomically disadvantaged adults report on issues of internal and external validity and (2) to provide recommendations for future intervention studies. Four databases were searched through June 2021. We included studies published in English or German since 2000 that tested physical activity interventions for socioeconomically disadvantaged adults. Two researchers coded all studies using a validated RE-AIM data extraction tool with 61 indicators referring to internal and external validity. Binary coding (yes = 1/no = 0) was applied to calculate the number and percentage of studies reporting each of the indicators. We included 39 studies of which 22 were non–/quasi-experimental trials. Indicators of reach were most frequently reported (59.2%), followed by implementation (38.9%) and efficacy/effectiveness (28.9%). Dimensions related to external validity were least frequently reported (adoption: 21.9%, maintenance: 17.8%). Few differences were found between experimental and non–/quasi-experimental trials. Analysis showed overall poor reporting of components related to internal and external validity. We recommend that future research should increase attention on reporting indicators of internal and external validity to facilitate their translation and implementation into real world settings. Trial registration: The review was registered with PROSPERO (CRD42021283688).
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Galera R, Mergelina C, Casitas R, Martínez-Cerón E, Río FG. Increased blood eosinophil count is related to less daily physical activity in patients with chronic obstructive pulmonary disease. Arch Bronconeumol 2022; 58:837-839. [DOI: 10.1016/j.arbres.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 11/02/2022]
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Outdoor Community Ambulation Interventions to Improve Physical and Mental Health in Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2022; 30:1061-1074. [PMID: 35418512 DOI: 10.1123/japa.2021-0151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/19/2022] [Accepted: 02/01/2022] [Indexed: 11/18/2022]
Abstract
Limited community ambulation, defined as independent mobility outside the home, predicts adverse outcomes in older adults. We performed a systematic review and meta-analysis to examine outdoor community ambulation intervention effectiveness in older adults. We searched six databases until October 2021. Studies with an evaluative research objective, older adult population, and outdoor community ambulation interventions were eligible. After reviewing 23,172 records, five studies were included. The meta-analysis found no significant difference in walking endurance and depression outcomes between outdoor community ambulation and comparison interventions. For outcomes not suitable for meta-analysis, studies showed no significant difference in walking activity, anxiety, and general and health-related quality of life, and possible improvements in gait speed and lower extremity function and strength. Most evidence was of low to very low certainty. Considering the limited evidence base, the design, implementation, and evaluation of outdoor community ambulation interventions in older adults should be prioritized in primary research.
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Taylor D, Amare AT, Edwards S, Inacio M, Visvanathan R. A vulnerable residential environment is associated with higher risk of mortality and early transition to permanent residential aged care for community dwelling older South Australians. Age Ageing 2022; 51:6540139. [PMID: 35231094 PMCID: PMC8887847 DOI: 10.1093/ageing/afac029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives This study examined the impact of the residential environment, measured by the Healthy Ageing/Vulnerable ENvironment (HAVEN) Index, on risk of mortality or entry into Permanent Residential Aged Care (PRAC). Design A retrospective cohort study using data from the Registry of Senior Australians (ROSA) was conducted. HAVEN Index values were matched to the ROSA by residential postcode. Study setting and Participants Older individuals living in metropolitan Adelaide and receiving their first eligibility assessment for aged care services between 2014 and 2016 (N = 16,944). Main Outcome Measure Time to death and entry into PRAC were the main outcomes. Results A higher HAVEN Index value, which represents a favourable residential environment, was associated with a lower risk of mortality and delayed entry to PRAC. For every 0.1 unit increase in HAVEN Index value, the risk of mortality is 3% lower (adjusted hazard ratio [HR], 95% confidence interval [CI] = 0.97, 0.96–0.99) and the risk of entry to PRAC is 5% lower (adjusted subdistribution HR, 95%CI = 0.95, 0.94–0.97) in the first 2 years following aged care assessment. After 2 years, the HAVEN Index was not associated with the risk of transition to PRAC. Conclusion Place-based health inequalities were identified in Australians seeking aged care services, demonstrating that a better understanding of local neighbourhoods may provide insight into addressing ageing inequalities. Spatial indexes, such as the HAVEN Index, are useful tools to identify areas where populations are more vulnerable to adverse health outcomes, informing responses to prioritise local improvements and health interventions to enable healthy ageing.
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Affiliation(s)
- Danielle Taylor
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing and Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville, SA, Australia
- Basil Hetzel Institute of Translational Health Research, The Queen Elizabeth Hospital Woodville South, SA, Australia
- Corresponding Author: Dr Danielle Taylor, National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Basil Hetzel Institute of Translational Health Research, The Queen Elizabeth Hospital DX 465701, 28 Woodville Rd, Woodville South, SA, Australia, 5011.
| | - Azmeraw T Amare
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing and Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville, SA, Australia
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Suzanne Edwards
- Adelaide Health Technology Assessment (AHTA), School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Maria Inacio
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Renuka Visvanathan
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing and Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville, SA, Australia
- Basil Hetzel Institute of Translational Health Research, The Queen Elizabeth Hospital Woodville South, SA, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
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Moreno-Agostino D, Prina M, Chua KC, Jotheeswaran AT, Sadana R, Officer A, Kamenov K, Cieza A. Measuring functional ability in healthy ageing: a nationwide cross-sectional survey in the Philippine older population. BMJ Open 2021; 11:e050827. [PMID: 34635522 PMCID: PMC8506858 DOI: 10.1136/bmjopen-2021-050827] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To analyse the empirical support of the functional ability concept in the healthy ageing framework developed by the WHO in a sample of the Philippine older population. According to this framework, environmental factors may enhance or hinder functional ability, which is the person's ability to do what they value, broadly represented by subjective well-being. Moreover, this network of relationships may be moderated by personal characteristics such as gender. DESIGN Cross-sectional observational study. SETTING Philippines, general population. PARTICIPANTS Respondents of the 2016 National Disability Prevalence Survey/Model Functioning Survey aged 50+ (N=2825). PRIMARY AND SECONDARY OUTCOME MEASURES Latent (unobserved) measures of functional ability, environmental factors (physical environmental factors and social network and support) and subjective well-being (positive affect, negative affect and evaluative well-being) were obtained from different items from the survey questionnaire using a SEM framework. RESULTS We found that the relationship between environmental factors and the three components of subjective well-being considered in this study was partially explained by differences in functional ability. The portion of those effects accounted for by functional ability was comparatively larger for the physical than for the social environmental factors. We found no evidences of gender differences in this network of relationships. CONCLUSIONS These findings suggest the relevance of functional ability at explaining the relationship between environmental factors and subjective well-being in older adults. Future studies may replicate these findings longitudinally and including other relevant measures as the person's objective level of intrinsic capacity.
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Affiliation(s)
- Dario Moreno-Agostino
- Health Service and Population Research, King's College London, London, UK
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Matthew Prina
- Health Service and Population Research, King's College London, London, UK
| | - Kia-Chong Chua
- Health Service and Population Research, King's College London, London, UK
| | | | - Ritu Sadana
- Ageing and Health Unit, Maternal, Newborn, Child & Adolescent Health & Ageing Department, World Health Organization, Geneva, Switzerland
| | - Alana Officer
- Demographic Change and Healthy Ageing Unit, Social Determinants of Health Department, World Health Organization, Geneve, Switzerland
| | - Kaloyan Kamenov
- Sensory Functions, Disability and Rehabilitation Unit, Department of Noncommunicable Diseases, World Health Organization, Geneve, Switzerland
| | - Alarcos Cieza
- Sensory Functions, Disability and Rehabilitation Unit, Department of Noncommunicable Diseases, World Health Organization, Geneve, Switzerland
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Perceived Neighborhood and Walking Among Older Brazilian Adults Living in Urban Areas: A National Study (ELSI-Brazil). J Aging Phys Act 2020; 29:431-441. [PMID: 33091874 DOI: 10.1123/japa.2020-0227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/27/2020] [Accepted: 08/07/2020] [Indexed: 11/18/2022]
Abstract
The study goal was to examine the association between perceived neighborhood characteristics and walking in urban older adults in Brazil. A cross-sectional study including 4,027 older adults from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) was performed. Walking was measured using the International Physical Activity Questionnaire. Neighborhood characteristics were questions about physical disorder, noise pollution, safety, violence, social cohesion, services, concerns with community mobility, and pleasantness. Multinomial logistic regression was used. Concern about taking the bus, subway, or train was inversely associated with walking for men. Violence (victim of theft, robbery, or had home broken into) and social cohesion (trust in neighbors) were positively and inversely associated with walking for women, respectively. A significant interaction term between social cohesion and number of chronic diseases was observed for women. These findings demonstrate the need for sex-specific interventions and policies to increase the walking levels among older Brazilian adults.
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