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Alliott O, Fairbrother H, Corder K, Wilkinson P, van Sluijs E. Do socioeconomic inequities arise during school-based physical activity interventions? An exploratory case study of the GoActive trial. BMJ Open 2023; 13:e065953. [PMID: 36914195 PMCID: PMC10016273 DOI: 10.1136/bmjopen-2022-065953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE To investigate socioeconomic inequities in the intervention and evaluation process of the GoActive school-based physical activity intervention and demonstrate a novel approach to evaluating intervention-related inequalities. DESIGN Exploratory post-hoc secondary data analysis of trial data. SETTING The GoActive trial was run in secondary schools across Cambridgeshire and Essex (UK), between September 2016 and July 2018. PARTICIPANTS 13-14 years old adolescents (n=2838, 16 schools). METHODS Socioeconomic inequities across six stages in the intervention and evaluation process were evaluated: (1) provision of and access to resources; (2) intervention uptake; (3) intervention effectiveness (accelerometer-assessed moderate-to-vigorous physical activity (MVPA)); (4) long-term compliance; (5) response in evaluation; and (6) impact on health. Data from self-report and objective measures were analysed by individual-level and school-level socioeconomic position (SEP) using a combination of classical hypothesis tests and multilevel regression modelling. RESULTS Stage: (1) There was no difference in the provision of physical activity resources by school-level SEP (eg, quality of facilities (0-3), low=2.6 (0.5); high=2.5 (0.4). (2) Students of low-SEP engaged significantly less with the intervention (eg, website access: low=37.2%; middle=45.4%; high=47.0%; p=0.001). (3) There was a positive intervention effect on MVPA in adolescents of low-SEP (3.13 min/day, 95% CI -1.27 to 7.54, but not middle/high (-1.49; 95% CI -6.54 to 3.57). (4) At 10 months post-intervention, this difference increased (low SEP: 4.90; 95% CI 0.09 to 9.70; middle/high SEP: -2.76; 95% CI -6.78 to 1.26). (5) There was greater non-compliance to evaluation measures among adolescents of low-SEP (eg, % accelerometer compliance (low vs high): baseline: 88.4 vs 92.5; post-intervention: 61.6 vs 69.2; follow-up: 54.5 vs 70.2. (6) The intervention effect on body mass index (BMI) z-score was more favourable in adolescents of low-SEP (low SEP: -0.10; 95% CI -0.19 to 0.00; middle/high: 0.03; 95% CI -0.05 to 0.12). CONCLUSIONS These analyses suggest the GoActive intervention had a more favourable positive effect on MVPA and BMI in adolescents of low-SEP, despite lower intervention engagement. However, differential response to evaluation measures may have biassed these conclusions. We demonstrate a novel way of evaluating inequities within young people's physical activity intervention evaluations. TRIAL REGISTRATION NUMBER ISRCTN31583496.
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Affiliation(s)
- Olivia Alliott
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Kirsten Corder
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Paul Wilkinson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Zhang X, Warner ME. Linking Urban Planning, Community Environment, and Physical Activity: A Socio-Ecological Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2944. [PMID: 36833640 PMCID: PMC9956976 DOI: 10.3390/ijerph20042944] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 05/31/2023]
Abstract
Lack of physical activity is a growing concern among public health advocates and urban planners. Our socio-ecological model incorporates urban planning and World Health Organization actions on physical activity to identify key factors related to leisure-time physical activity at the community level. Our 2019 nationwide US survey of 1312 communities enables examination of the influence of individual, community, and policy levels on physical activity. Individual factors-poverty, aging, minority population, and longer commuting time-result in lower physical activity. Community-level factors have both positive and negative effects. Physical activity is lower in rural and suburban communities, but higher in communities with more transportation services, recreation and social activities, and safety. Communities with mixed-use neighborhoods and complete streets also show higher levels of physical activity. At the policy level, zoning and cross-agency collaboration have an indirect effect on physical activity by increasing these community-level factors. This suggests an alternative approach to promoting physical activity. Local governments can promote transportation, recreation and safety, especially in rural and minority communities lacking active-friendly built environments and facing challenges from aging population, poverty, and longer commuting time. This socio-ecological approach can assess multilevel factors related to physical activity in other countries.
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Affiliation(s)
- Xue Zhang
- Lerner Center for Public Health Promotion and Population Health, Center for Policy Research, Syracuse University, Syracuse, NY 13244, USA
| | - Mildred E. Warner
- Department of City and Regional Planning, Cornell University, Ithaca, NY 14853, USA
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Liu CH, Chang FC, Niu YZ, Liao LL, Chang YJ, Liao Y, Shih SF. Students' perceptions of school sugar-free, food and exercise environments enhance healthy eating and physical activity. Public Health Nutr 2021; 25:1-9. [PMID: 34933694 PMCID: PMC9991674 DOI: 10.1017/s1368980021004961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 11/16/2021] [Accepted: 12/13/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this study was to examine the relationships between students' perceptions of their school policies and environments (i.e. sugar-sweetened beverages (SSB) free policy, plain water drinking, vegetables and fruit eating campaign, outdoor physical activity initiative, and the SH150 programme (exercise 150 min/week at school)) and their dietary behaviours and physical activity. DESIGN Cross-sectional study. SETTING Primary, middle and high schools in Taiwan. PARTICIPANTS A nationally representative sample of 2433 primary school (5th-6th grade) students, 3212 middle school students and 2829 high school students completed the online survey in 2018. RESULTS Multivariate analysis results showed that after controlling for school level, gender and age, the students' perceptions of school sugar-free policies were negatively associated with the consumption of SSB and positively associated with consumption of plain water. Schools' campaigns promoting the eating of vegetables and fruit were positively associated with students' consumption of vegetables. In addition, schools' initiatives promoting outdoor physical activity and the SH150 programme were positively associated with students' engagement in outdoor physical activities and daily moderate-to-vigorous physical activity. CONCLUSIONS Students' perceptions of healthy school policies and environments promote healthy eating and an increase in physical activity for students.
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Affiliation(s)
- Chieh-Hsing Liu
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Yu-Zhen Niu
- Office of Student Affairs, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Kaohsiung City, Taiwan
| | - Yen-Jung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, 162, Ho-Ping E. Rd., Sec.1, Taipei10610, Taiwan
| | - Shu-Fang Shih
- Department of Health Administration, Virginia Commonwealth University, Richmond, USA
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Li J, Zheng C, Ge Q, Yan S, Paranjpe MD, Hu S, Zhou Y. Association between long-term donepezil treatment and brain regional amyloid and tau burden among individuals with mild cognitive impairment assessed using 18 F-AV-45 and 18 F-AV-1451 PET. J Neurosci Res 2021; 100:670-680. [PMID: 34882830 DOI: 10.1002/jnr.24995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 10/16/2021] [Accepted: 11/06/2021] [Indexed: 11/06/2022]
Abstract
This study aims to investigate the association between long-term donepezil treatment and brain neuropathological burden and cognitive function in mild cognitive impairment (MCI) patients. Preprocessed 18 F-AV-45 amyloid and 18 F-AV-1451 tau positron emission tomography (PET) images, magnetic resonance imaging images (MRIs), demographic information, and donepezil use status were downloaded from 255 MCI participants enrolled in the Alzheimer's Disease Neuroimaging Initiative database. Partial volume correction was applied to all PET images. Structural MRIs were used for PET spatial normalization. Regions of interest (ROIs) were defined in standard space, and standardized uptake value ratio (SUVR) images relative to the cerebellum were computed. Multiple linear regression with the least absolute shrinkage selector operator was performed to analyze the effect of long-term donepezil treatment on (a) the SUVR of each 18 F-AV-45 or 18 F-AV-1451 brain PET ROI after adjusting for age, sex, education, ApoE ε4 status, and AD-associated disease risk factors; and (b) cognitive performance after adjusting for age, sex education, ApoE ε4 status, AD-associated disease risk factors, and regional amyloid or tau burden. In adjusted models, long-term donepezil treatment was associated with greater amyloid load in the orbital frontal, superior frontal, parietal, posterior precuneus, posterior cingulate, lateral temporal, inferior temporal and fusiform regions, and tau burden in the posterior cingulate, entorhinal and parahippocampal gyrus. Long-term donepezil treatment was also associated with worse performance on the 13-item Alzheimer's Disease Assessment Scale-Cognitive subscale after adjusting for AD-related risk factors and regional brain amyloid or tau load. These results indicate that long-term donepezil treatment is associated with increased regional amyloid and tau burden and worse cognitive performance among individuals with MCI. Our study highlights the importance of using noninvasive and quantitative 18 F-AV-45 and 18 F-AV-1451 PET to elucidate the consequences of drug administration in AD studies.
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Affiliation(s)
- Jian Li
- Department of Nuclear Medicine (PET Center), Xiangya Hospital Central South University, Changsha, China.,Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chaojie Zheng
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.,Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Qi Ge
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Shaozhen Yan
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Manish D Paranjpe
- Harvard-MIT Program in Health Sciences and Technology, Harvard Medical School, Boston, MA, USA
| | - Shuo Hu
- Department of Nuclear Medicine (PET Center), Xiangya Hospital Central South University, Changsha, China.,Key Laboratory of Biological Nanotechnology of National Health Commission, Xiangya Hospital Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University, Changsha, China
| | - Yun Zhou
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.,Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
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Abay H, Kaplan S. Evaluation of the effectiveness of a training program for coping with PMS symptoms based on IMB model in university students. Women Health 2021; 61:550-561. [PMID: 34074223 DOI: 10.1080/03630242.2021.1927286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Premenstrual syndrome (PMS) is a common health problem that adversely affects young women's quality of life. This paper evaluated the effectiveness of a "Training Program for Coping with PMS Symptoms based on Information-Motivation-Behavioral Skills (IMB) model" in university nursing students. This controlled intervention study was conducted between September 2017 and February 2018. No sampling was performed. The goal was to include all students who met the inclusion criteria. The sample consisted of 95 first-year nursing students from two universities divided into two groups: intervention (n = 40) and control (n = 45) (power of 84.5%, p = .05, effect size = 0.45). The intervention group received the training, followed by individual motivational counseling first and second months after the training. The control group did not participate in the training program. The intervention group had more PMS symptoms coping behaviors (recognizing premenstrual change, performing regular exercises, relaxation techniques, pursuing a healthy diet, communicating with family and friends) than their counterparts in the control group after the training program (p < .05). The intervention group had higher Premenstrual Coping Measure scores (recognizing premenstrual changes, performing self-care, avoiding harm, communicating) after training program (p < .05). Although habits are hard to break, especially at young ages, the training helped university students adopt PMS coping behaviors.
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Affiliation(s)
- Halime Abay
- Department of Nursing, Faculty of Health Sciences, Yildirim Beyazit University, Ankara, Turkey
| | - Sena Kaplan
- Department of Nursing, Faculty of Health Sciences, Yildirim Beyazit University, Ankara, Turkey
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