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Shrestha A, Tamrakar D, Ghinanju B, Shrestha D, Khadka P, Adhikari B, Shrestha J, Waiwa S, Pyakurel P, Bhandari N, Karmacharya BM, Shrestha A, Shrestha R, Bhatta RD, Malik V, Mattei J, Spiegelman D. Effects of a dietary intervention on cardiometabolic risk and food consumption in a workplace. PLoS One 2024; 19:e0301826. [PMID: 38656951 PMCID: PMC11042715 DOI: 10.1371/journal.pone.0301826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Worksite-based health programs have shown positive impacts on employee health and have led to significant improvements in cardiovascular risk factor profiles. We aimed to determine the effect of cafeteria intervention on cardio-metabolic risk factors diet in a worksite setting (Dhulikhel Hospital) in Nepal. METHODS In this one-arm pre-post intervention study, we recruited 277 non-pregnant hospital employees aged 18-60 with prediabetes or pre-hypertension. The study was registered in clinicaltrials.gov (NCT03447340; 2018/02/27). All four cafeterias in the hospital premises received cafeteria intervention encouraging healthy foods and discouraging unhealthy foods for six months. We measured blood pressure, fasting glucose level, glycated hemoglobin, cholesterol in the laboratory, and diet intake (in servings per week) using 24-hour recall before and six months after the intervention. The before and after measures were compared using paired-t tests. RESULTS After six months of cafeteria intervention, the median consumption of whole grains, mono/polyunsaturated fat, fruits, vegetable and nuts servings per week increased by 2.24(p<0.001), 2.88(p<0.001), 0.84(p<0.001) 2.25(p<0.001) and nuts 0.55 (p<0.001) servings per week respectively. The median consumption of refined grains decreased by 5.07 servings per week (p<0.001). Mean systolic and diastolic blood pressure decreased by 2 mmHg (SE = 0.6; p = 0.003) and 0.1 mmHg (SE = 0.6; p = 0.008), respectively. The low-density lipoprotein (LDL) was significantly reduced by 6 mg/dL (SE = 1.4; p<0.001). CONCLUSION Overall, we found a decrease in consumption of refined grains and an increase in consumption of whole grains, unsaturated fats, fruits, and nuts observed a modest reduction in blood pressure and LDL cholesterol following a 6-month cafeteria-based worksite intervention incorporating access to healthy foods.
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Affiliation(s)
- Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Dipesh Tamrakar
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Bhawana Ghinanju
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Deepa Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Parashar Khadka
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Bikram Adhikari
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Jayana Shrestha
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Suruchi Waiwa
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Prajjwal Pyakurel
- Department of Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Niroj Bhandari
- Department of Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Biraj Man Karmacharya
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Akina Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Rajeev Shrestha
- Department of Pharmacology, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Rajendra Dev Bhatta
- Department of Biochemistry, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Vasanti Malik
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Donna Spiegelman
- Department of Biostatistics and Center of Methods for Implementation and Prevention Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
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Ramires VV, Dos Santos PC, Barbosa Filho VC, Bandeira ADS, Marinho Tenório MC, de Camargo EM, Ravagnani FCDP, Sandreschi P, de Oliveira VJM, Hallal PC, Silva KS. Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews. J Phys Act Health 2023:1-14. [PMID: 37156540 DOI: 10.1123/jpah.2022-0395] [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: 07/23/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents. METHODS We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review's research question. Data charting form included the identification of the study, health outcomes, and PE classes' strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary. RESULTS An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted. CONCLUSIONS These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.
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Affiliation(s)
- Virgílio Viana Ramires
- Department of Physical Education, Federal Institute Sul-rio-grandense-IFSUL, Campus Pelotas, Pelotas, Pelotas, RS,Brazil
| | | | | | | | | | - Edina Maria de Camargo
- Department of Physical Education, Federal University of Paraná-UFPR, Curitiba, PR,Brazil
| | - Fabrício Cesar de Paula Ravagnani
- Department of Physical Education, Institute of Education, Science and Technology of Mato Grosso do Sul-Campus Campo Grande, Campo Grande, MS,Brazil
| | - Paula Sandreschi
- Department of Health Promotion, Ministry of Health of Brazil, Brasília, DF,Brazil
| | - Victor José Machado de Oliveira
- Department of Physical Education, Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Manaus, AM,Brazil
| | - Pedro Curi Hallal
- Department of Epidemiology, Federal University of Pelotas-UFPEL, Pelotas, RS,Brazil
| | - Kelly Samara Silva
- Department of Physical Education, Federal University of Santa Catarina, Florianopolis, SC,Brazil
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Seguin-Fowler RA, Eldridge GD, Graham M, Folta SC, Hanson KL, Maddock JE. COVID-19 Related Protocol Considerations and Modifications within a Rural, Community-Engaged Health Promotion Randomized Trial. Methods Protoc 2023; 6:mps6010005. [PMID: 36648954 PMCID: PMC9844482 DOI: 10.3390/mps6010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 01/06/2023] Open
Abstract
Rural communities are at higher risk for physical inactivity, poor dietary behaviors, and related chronic diseases and obesity. These disparities are largely driven by built environment, socioeconomic, and social factors. A community-based cluster randomized controlled trial of an intervention, the Change Club, aims to address some of these disparities via civic engagement for built environment change. Baseline data collection began in February 2020, only to be paused by the COVID-19 pandemic. In this context, the investigators evaluated multiple approaches for collecting data when the study resumed, focusing on Life’s Simple 7, and additional anthropometric, physiologic, and behavioral outcomes in rural and micropolitan (<50,000 population) communities in Texas and New York. Life’s Simple 7 includes fasting blood glucose, total cholesterol, blood pressure, weight, physical activity, diet, and smoking. Rigor and feasibility were considered across a variety of in-person versus at-home measurement options. After a comprehensive input from participants, partners, staff, researchers, and the funding liaison, the study team chose self-measurement and use of validated questionnaires/surveys to measure the Life’s Simple 7 components. This case provides an example of how a study team might adjust data collection protocol during unexpected and acute events while giving consideration to rigor, feasibility, stakeholder views, and participants’ health and safety.
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Affiliation(s)
- Rebecca A. Seguin-Fowler
- Institute for Advancing Health through Agriculture, Texas A&M AgriLife, College Station, TX 77845, USA
- Correspondence: ; Tel.:+1-979-314-3398
| | - Galen D. Eldridge
- Texas A&M AgriLife Research and Extension Center, Dallas, TX 75252, USA
| | - Meredith Graham
- Texas A&M AgriLife Research and Extension Center, Dallas, TX 75252, USA
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Medford, MA 02155, USA
| | - Karla L. Hanson
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA
| | - Jay E. Maddock
- School of Public Health, Texas A&M University, College Station, TX 77843, USA
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Feasibility and Acceptability of Policies and Environmental Strategies for Improving Physical Activity and Healthy Eating in Japanese Small and Medium Corporations. J Occup Environ Med 2023; 65:39-47. [PMID: 35941735 PMCID: PMC9835672 DOI: 10.1097/jom.0000000000002661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We assessed the implementation status of policies and environmental strategies for increasing physical activity (PA) and healthy eating (HE) in small and medium corporations to identify feasible and acceptable interventions. METHODS An anonymous self-administered questionnaire was administered to 655 small and medium corporations to determine whether they implemented PA (18 items) and HE (17 items) policies and environmental strategies and, if not, their intention to do so in the future. We compared differences in the implementation and intention to implement rate by corporation size. RESULTS The implementation and intention rates of costly items for PA and HE were low, regardless of corporation size, but were significantly lower in small corporations than in medium corporations. CONCLUSIONS To overcome cost barriers, employee participation must be encouraged, and employee knowledge of PA and HE must be improved.
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Saunders RP, Wilcox S, Hutto B. Influence of implementation strategies on implementation outcomes in a statewide dissemination of Faith, Activity, and Nutrition (FAN). HEALTH EDUCATION RESEARCH 2022; 37:420-433. [PMID: 36149635 DOI: 10.1093/her/cyac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/19/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Faith-based organizations are promising settings for implementation science because they can reach populations bearing a disproportionate burden of chronic disease. This study examined how implementation strategies influenced implementation outcomes in Faith, Activity, and Nutrition (FAN) statewide dissemination. Ninety-three (9%) of 985 invited churches enrolled; 91 (98%) and 83 (89%) completed baseline and 12-month assessments. Community Health Advisors trained and provided phone technical assistance to church committees, led by a FAN coordinator. Church committees were charged with developing plans and installing healthy eating (HE) and physical activity (PA) policies, opportunities, messages and pastor support (implementation outcomes). Structural equation modeling examined how implementation strategies influenced implementation outcomes. Nearly all (99%) FAN coordinators and 60% of pastors attended training, 57% of committees submitted program plans and 51%/54% (HE/PA) of committees met 'every few months'. Statistically significant (P < 0.05) model paths showed positive influences of strategies on implementation outcomes: pastor training on HE and PA pastor support; plan completion on HE and PA messages, PA policies and opportunities as well as FAN committee meetings and committee meetings on HE pastor support, HE policies, PA opportunities and HE and PA messages. This study advances implementation science and provides a model applicable to organizations such as worksites and schools.
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Affiliation(s)
- Ruth P Saunders
- Prevention Research Center and Department of Health Promotion, Education, and Behavior, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Sara Wilcox
- Prevention Research Center and Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Brent Hutto
- Prevention Research Center, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
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Seguin-Fowler RA, Hanson KL, Villarreal D, Rethorst CD, Ayine P, Folta SC, Maddock JE, Patterson MS, Marshall GA, Volpe LC, Eldridge GD, Kershaw M, Luong V, Wang H, Kenkel D. Evaluation of a civic engagement approach to catalyze built environment change and promote healthy eating and physical activity among rural residents: a cluster (community) randomized controlled trial. BMC Public Health 2022; 22:1674. [PMID: 36058913 PMCID: PMC9441047 DOI: 10.1186/s12889-022-13653-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prior studies demonstrate associations between risk factors for obesity and related chronic diseases (e.g., cardiovascular disease) and features of the built environment. This is particularly true for rural populations, who have higher rates of obesity, cancer, and other chronic diseases than urban residents. There is also evidence linking health behaviors and outcomes to social factors such as social support, opposition, and norms. Thus, overlapping social networks that have a high degree of social capital and community cohesion, such as those found in rural communities, may be effective targets for introducing and maintaining healthy behaviors. METHODS This study will evaluate the effectiveness of the Change Club (CC) intervention, a civic engagement intervention for built environment change to improve health behaviors and outcomes for residents of rural communities. The CC intervention provides small groups of community residents (approximately 10-14 people) with nutrition and physical activity lessons and stepwise built environment change planning workshops delivered by trained extension educators via in-person, virtual, or hybrid methods. We will conduct process, multilevel outcome, and cost evaluations of implementation of the CC intervention in a cluster randomized controlled trial in 10 communities across two states using a two-arm parallel design. Change in the primary outcome, American Heart Association's Life's Simple 7 composite cardiovascular health score, will be evaluated among CC members, their friends and family members, and other community residents and compared to comparable samples in control communities. We will also evaluate changes at the social/collective level (e.g., social cohesion, social trust) and examine costs as well as barriers and facilitators to implementation. DISCUSSION Our central hypothesis is the CC intervention will improve health behaviors and outcomes among engaged citizens and their family and friends within 24 months. Furthermore, we hypothesize that positive changes will catalyze critical steps in the pathway to improving longer-term health among community residents through improved healthy eating and physical activity opportunities. This study also represents a unique opportunity to evaluate process and cost-related data, which will provide key insights into the viability of this approach for widespread dissemination. TRIAL REGISTRATION ClinicalTrials.gov: NCT05002660 , Registered 12 August 2021.
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Affiliation(s)
- Rebecca A. Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife, College Station, TX 77843 USA
| | - Karla L. Hanson
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Deyaun Villarreal
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Chad D. Rethorst
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Priscilla Ayine
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Sara C. Folta
- grid.429997.80000 0004 1936 7531Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02155 USA
| | - Jay E. Maddock
- grid.264756.40000 0004 4687 2082School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Megan S. Patterson
- grid.264756.40000 0004 4687 2082School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Grace A. Marshall
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Leah C. Volpe
- grid.5386.8000000041936877XDepartment of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853 USA
| | - Galen D. Eldridge
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Meghan Kershaw
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Vi Luong
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Dallas Center, Dallas, TX 75252 USA
| | - Hua Wang
- grid.5386.8000000041936877XJeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY 14853 USA
| | - Don Kenkel
- grid.5386.8000000041936877XJeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY 14853 USA
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Phulkerd S, Thapsuwan S, Chamratrithirong A, Gray RS, Pattaravanich U, Ungchusak C, Saonuam P. Implementing population-wide mass media campaigns: Key drivers to meet global recommendations on fruit and vegetable consumption. PLoS One 2022; 17:e0273232. [PMID: 35976961 PMCID: PMC9385052 DOI: 10.1371/journal.pone.0273232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/04/2022] [Indexed: 11/20/2022] Open
Abstract
While the influence of implementation of mass media and community-based campaigns has been evident elsewhere, this information has been notably absent in Thailand. This study aimed to investigate the association between implementation of mass media campaigns (MMC) and community-based campaigns (CBC) for increased fruit and vegetable (FV) consumption to meet the global recommended level in the Thai population. The sample was obtained from a nationally-representative, longitudinal household survey of the Thai population, Round1 (2018) and Round2 (2019). The study applied a multi-stage sampling design to obtain a sample of persons age 15 years or older. Face-to-face interviews were conducted with 3,010 respondents who successfully participated in both Round1 and Round2 surveys. Information on FV consumption, exposure to Government MMC, ThaiHealth MMC including social marketing (MMSMC) and CBC, and sociodemographic characteristics were collected. Binary logistic regression analysis was used to investigate the association between implementation of those campaigns and increased FV consumption compared to the recommended level. Of the total respondents, only 11.3% had higher FV consumption and also met the minimum requirement. Respondents who lived in rural areas, were farmers, and grew FV at home had the highest probability of increased FV consumption. Exposure to the MMC and CBC was also associated with an increase in FV consumption. Above all, those who had exposure to the MMSMC, who reported either having high level of perception (OR = 1.832, 95% CI 1.259–2.666) or ever heard or seen (OR = 1.770, 95% CI 1.264–2.479) or heard and seen (OR = 1.698, 95% CI 1.131–2.550) campaign information were more likely to have a substantial increase in FV consumption and meeting/exceeding the recommended level than those who were not exposed to these campaigns. Other associated factors include education, occupation and physical activity. Implementation of MMSMC can help the population meet the global recommended level of FV consumption. This study presents its novelty since it was the first to highlight influence of mass media campaigns on increased FV consumption in Asian population. This was also the first study that used data from a population-based longitudinal study. The study suggested that MMC and CBC should also be promoted together with support systems to increase their intensity to a level that can increase population FV consumption to meet the recommended level. Sociodemographic characteristics should be taken into account, and targeted media is needed to effectively reach specific sub-groups of the population.
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Affiliation(s)
- Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
- * E-mail:
| | - Sasinee Thapsuwan
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | | | | | - Umaporn Pattaravanich
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Chantana Ungchusak
- Healthy Lifestyle Promotion Section of Thai Health promotion Foundation, Bangkok, Thailand
| | - Pairoj Saonuam
- Healthy Lifestyle Promotion Section of Thai Health promotion Foundation, Bangkok, Thailand
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Mendoza-Vasconez AS, Landry MJ, Crimarco A, Bladier C, Gardner CD. Sustainable Diets for Cardiovascular Disease Prevention and Management. Curr Atheroscler Rep 2021; 23:31. [PMID: 33970349 DOI: 10.1007/s11883-021-00929-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW Healthy dietary patterns are recommended for prevention of cardiovascular disease, which remains the leading cause of morbidity and mortality globally. In this review, we discuss dietary patterns that are not only optimal for CVD prevention and management but also sustainable in maximizing health, environmental, and economic benefits. RECENT FINDINGS The growing literature on sustainable diets in the context of environmental sustainability includes subtopics of climate change, land use, biodiversity loss, freshwater use, and reactive nitrogen emissions. Similarly, economic sustainability, beyond the retail cost of food, extends to healthcare costs and the economic costs of environmental destruction related to current agricultural practices and food choices. Dietary patterns that are high in plant foods and low in animal foods could maximize health, environmental, and economic benefits; however, questions remain about how to best promote these patterns to achieve wider adoption in an environmentally and economically sustainable way.
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Affiliation(s)
| | - Matthew J Landry
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Anthony Crimarco
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Claire Bladier
- Risk Assessment Department, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
| | - Christopher D Gardner
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
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Canas JA. Mixed carotenoid supplementation and dysmetabolic obesity: gaps in knowledge. Int J Food Sci Nutr 2020; 72:653-659. [PMID: 33345665 DOI: 10.1080/09637486.2020.1852193] [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: 10/22/2022]
Abstract
Dysmetabolic obesity during childhood and adolescence currently represents one of the greatest therapeutic challenge for healthcare systems worldwide. The global rates of obesity have more than doubled in the last 30 years. Recent meta-analysis from national surveys and food composition studies suggest an inverse association between lower carotenoid levels and the prevalence of Metabolic Syndrome in the general population, independent of serum retinol (vitamin A) levels. In children, two double-blind randomised placebo-controlled studies describing the effects of diet vs. mixed carotenoid supplementation on insulin resistance, adipokines and the rate of accrual of subcutaneous abdominal fat, implicate supplementation of these compounds to achieve targetable levels may be useful in the management of obesity accrual in this population. We will discuss the role of carotenoids and their conversion products (retinoids) in adipogenesis, lipolysis, insulin resistance and the pathophysiology of the metabolic syndrome and review the animal studies, which help support these findings.
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Affiliation(s)
- Jose Atilio Canas
- Pediatric Endocrinology and Diabetes, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
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Gelius P, Messing S, Goodwin L, Schow D, Abu-Omar K. What are effective policies for promoting physical activity? A systematic review of reviews. Prev Med Rep 2020; 18:101095. [PMID: 32346500 PMCID: PMC7182760 DOI: 10.1016/j.pmedr.2020.101095] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/14/2020] [Accepted: 04/04/2020] [Indexed: 11/25/2022] Open
Abstract
There is a growing need for evidence on the effectiveness of different policies to promote physical activity. We conducted a systematic literature review to collate the available evidence. We identified 57 reviews with evidence on 53 types of physical activity policies from 7 areas. There is a solid evidence base for the effectiveness of school-based and some infrastructural policies. The evidence for other (e.g. economic) policies remains insufficient.
The importance of policy for promoting physical activity (PA) is increasingly recognized by academics, and there is a push by national governments and international institutions for PA policy development and monitoring. However, our knowledge about which policies are actually effective to promote PA remains limited. This article summarizes the currently available evidence by reviewing existing reviews on the subject. Building on results from a previous scoping review on different types of PA-related evidence, we ran searches for combinations of the terms “physical activity”, “evidence”, “effect”, “review”, and “policy” in six different databases (PubMed, Scopus, SportDiscus, PsycInfo, ERIC, and IBSS). We used EPPI Reviewer 4 to further process the results and conduct an in-depth analysis. We identified 57 reviews providing evidence on 53 types of policies and seven broader groups of policies. Reviews fell into four main categories: 1) setting- and target group-specific; 2) urban design, environment and transport; 3) economic instruments; and 4) broad-range perspective. Results indicate that there is solid evidence for policy effectiveness in some areas (esp. school-based and infrastructural policies) but that the evidence in other areas is insufficient (esp. for economic policies). The available evidence provides some guidance for policy-makers regarding which policies can currently be recommended as effective. However, results also highlight some broader epistemological issues deriving from the current research. This includes the conflation of PA policies and PA interventions, the lack of appropriate tools for benchmarking individual policies, and the need to critically revisit research methodologies for collating evidence on policies.
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Affiliation(s)
- Peter Gelius
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Lee Goodwin
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Diana Schow
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
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LAZZERI G, FERRETTI F, POZZA A, DORI F, VOLPE E, GIOVANNINI V, GUSINU R. The Workplace Health Promotion (WHP) programme in an Italian University Hospital. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E243-E249. [PMID: 31650061 PMCID: PMC6797891 DOI: 10.15167/2421-4248/jpmh2019.60.3.1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/31/2019] [Indexed: 11/17/2022]
Abstract
Introduction Description of the lifestyles of employees of the Siena University Hospital (Azienda Ospedaliera Universitaria Senese: AOUS), as assessed through a Workplace Health Promotion (WHP) project in the two-year period 2017-18; assessment of possible short-term effects of integrated health promotion interventions in the workplace, within the framework of the Tuscany WHP network, as applied in the AOUS and involving about 1,000 workers. Methods A cross-sectional study and a pre-post evaluation of data collected by means of anonymous questionnaires in two phases: before the beginning of the programme and after 12 months. Results Twelve months after the start of the programme regarding diet (consumption of fruit and vegetables) and physical activity, the positive effects that emerged were not statistically significant. No differences were observed between gender or professional categories. The employees’ perception of the programme was satisfactory. Conclusions Albeit within the methodological limits of the assessment, the results showed that the diffusion of some major risk factors for chronic diseases had not decreased after 12 months’ exposure to the programme. However, monitoring of these risk factors needs to be continued over a longer period, in order to detect the appearance of the expected changes in the long term. Moreover, it is essential to continue monitoring by sex and professional category, in order to pick out any differences and, if possible, take remedial actions. Further studies, in collaboration with the pertinent physicians, are desirable, since integrating data collected during health surveillance with a limited set of indicators of general risk factors may help to promptly identify possible health needs among employees.
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Affiliation(s)
- G. LAZZERI
- University Hospital of Siena, Italy
- Department Molecular and Developmental Medicine University of Siena, Italy
- Correspondence: Giacomo Lazzeri, Department of Molecular and Developmental Medicine, University Hospital of Siena, via Aldo Moro 2, 53100 Siena, Italy - Tel. +39 0577 234156 - Fax +39 0577 234090 - E-mail:
| | - F. FERRETTI
- University Hospital of Siena, Italy
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - A. POZZA
- University Hospital of Siena, Italy
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - F. DORI
- University Hospital of Siena, Italy
| | - E. VOLPE
- University Hospital of Siena, Italy
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Seguin RA, Graham ML, Eldridge G, Nelson ME, Strogatz D, Folta SC, Paul L. Strong Hearts for New York: A multilevel community-based randomized cardiovascular disease risk reduction intervention for rural women. Contemp Clin Trials 2019; 82:17-24. [PMID: 31129372 PMCID: PMC6606389 DOI: 10.1016/j.cct.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/06/2019] [Accepted: 05/22/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rural midlife and older women have high rates of cardiovascular disease (CVD) risk factors and lower access to healthy living resources. The Strong Hearts, Healthy Communities (SHHC) intervention, tailored to the needs of rural women, demonstrated effectiveness on many outcomes. The purpose of the Strong Hearts for New York (SHNY) study is to evaluate the efficacy of an enhanced version of the curriculum (SHHC-2.0). METHODS SHNY is a randomized controlled efficacy intervention, comparing participants receiving the SHHC-2.0 curriculum with a delayed intervention control group. SHHC, informed by formative research, includes core elements from three evidence-based programs. Changes based on extensive outcome and process evaluation data were made to create SHHC-2.0. Classes will meet twice weekly for 24 weeks and include individual, social, and environmental components. Overweight women age 40 and over will be recruited from 11 rural, medically underserved communities in New York; data will be collected at baseline and 12, 24, 36, and 48 weeks across individual, social, and environmental levels. Primary outcome is body weight. Secondary outcomes include Simple 7 (composite CVD risk score), anthropometric, physiologic, biochemical, physical activity, and dietary intake measures; healthy eating and exercise self-efficacy and attitudes; and self-efficacy of the social network of participants. DISCUSSION The aims of this study are to evaluate the efficacy of the enhanced SHHC-2.0 program for participants, changes among participants' social networks, and the difference in outcomes when participants are and are not provided with technological tools (Fitbit and body composition scale).
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Affiliation(s)
- Rebecca A Seguin
- Cornell University, Division of Nutritional Sciences, 412 Savage Hall, Ithaca, NY 14853, USA.
| | - Meredith L Graham
- Cornell University, Division of Nutritional Sciences, 413 Savage Hall, Ithaca, NY 14853, USA.
| | - Galen Eldridge
- Cornell University, Division of Nutritional Sciences, 413 Savage Hall, Ithaca, NY 14853, USA.
| | - Miriam E Nelson
- Hampshire College, 893 West St, Amherst, MA 01002, USA; Tufts University, Friedman School of Nutrition, 150 Harrison Ave, Boston, MA 02111, USA.
| | - David Strogatz
- Bassett Research Institute, One Atwell Rd, Cooperstown, NY 13326, USA.
| | - Sara C Folta
- Tufts University, Friedman School of Nutrition, 150 Harrison Ave, Boston, MA 02111, USA.
| | - Lynn Paul
- Montana State University Extension, 322 Reid Hall, Bozeman, MT 59717, USA
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Redwood D, Mitchell-Box K, Peterson E, Provost E. Improving the Health of Alaska Native People Through Use of a Policy Change Model and Capacity Building. Prev Chronic Dis 2019; 16:E64. [PMID: 31124435 PMCID: PMC6549431 DOI: 10.5888/pcd16.190077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Public health training often includes program and education development but not policy, systems, and environmental (PSE) strategies. The Alaska Native Tribal Health Consortium's Good Health and Wellness in Indian Country program works to build tribal PSE change capacity. Trainings included community health assessment, facilitation and leadership engagement, policy and systems, and digital storytelling. From 2014 to 2017, 30 PSE changes were made: 3 tobacco-free healthcare organization policies; 2 tobacco-free tribal resolutions; 1 tobacco-free school district policy; 3 healthy food policies and environmental changes; 4 improvements in patient-provider communication; 13 prediabetes, obesity, and/or tobacco screening and referral policies; 3 improvements to health care facility signage; and 1 Baby-friendly Hospital application, protecting the health of 46,000 tribal community members. Targeted training and technical assistance moved tribal staff from a focus on direct services to population-based improvements. This increased self-efficacy may increase the sustainability of chronic disease public health efforts and improve tribal health.
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Affiliation(s)
- Diana Redwood
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, 3900 Ambassador Dr, Anchorage, Alaska 99508.
| | - Kristen Mitchell-Box
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Erin Peterson
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | - Ellen Provost
- Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, Alaska
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Warehime S, Coyle B, Abel K, Sedani A, Holes J, Dinkel D. A Qualitative Exploration of a Worksite Wellness Mini-Grant Program. ENVIRONMENTAL HEALTH INSIGHTS 2019; 13:1178630219839016. [PMID: 31168292 PMCID: PMC6484666 DOI: 10.1177/1178630219839016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/31/2019] [Indexed: 06/09/2023]
Abstract
Mini-grant programs are an increasingly popular method for outside organizations (eg, non-profits, state agencies) to support wellness initiatives. However, little is known about mini-grant programs in worksites. The present study explored the implementation and outcomes of a worksite wellness mini-grant program. Semi-structured interviews were conducted with 12 wellness champions representing 12 worksites that were involved in a mini-grant program over a 4-year span. Interviews focused on general use, barriers and facilitators, and outcomes of the mini-grant initiatives. Mini-grants were generally used to support a short-term activity, such as purchasing food, which was not allowed per grant funding, or supporting a one-time event-this type of use diverged from recommended use of funds. Participants reported that outcomes from the mini-grant initiates were largely positive, highlighting culture shifts and increased awareness/perception of employer support for wellness. Barriers included culture (eg, employee attitudes, motivation), environment (eg, infrastructure, weather), and worksite characteristics (eg, multiple locations, number of employees), while facilitators included employee interest and involvement, established wellness culture, awareness and accessibility (eg, providing options, education), and support (eg, employer support, support from outside organizations). There was overlap between certain barriers and facilitators, indicating key areas of focus for future research and mini-grant programs.
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Affiliation(s)
- Shane Warehime
- School of Health and Kinesiology, University of Nebraska Omaha, Omaha, NE, USA
| | - Brian Coyle
- Nebraska Department of Health and Human Services, Lincoln, NE, USA
| | - Kayla Abel
- Nebraska Department of Health and Human Services, Lincoln, NE, USA
| | - Ami Sedani
- Nebraska Department of Health and Human Services, Lincoln, NE, USA
| | | | - Danae Dinkel
- School of Health and Kinesiology, University of Nebraska Omaha, Omaha, NE, USA
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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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Messing S, Rütten A, Abu-Omar K, Ungerer-Röhrich U, Goodwin L, Burlacu I, Gediga G. How Can Physical Activity Be Promoted Among Children and Adolescents? A Systematic Review of Reviews Across Settings. Front Public Health 2019; 7:55. [PMID: 30941342 PMCID: PMC6433781 DOI: 10.3389/fpubh.2019.00055] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/25/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction: A vast majority of children and adolescents are physically inactive. As a result, high obesity rates and related diseases have made physical activity promotion a politically relevant topic. In order to form the basis for political decision making, evidence is required regarding the efficacy and effectiveness of interventions for physical activity promotion. In contrast to previous research, this systematic review of reviews targets three key settings (family and home, childcare, school), and is among the largest to have been conducted. Methods: A systematic review of reviews was conducted as part of a large-scale project to develop national recommendations for physical activity promotion in Germany. Six electronic databases were searched and inclusion criteria were defined. Two independent reviewers screened the titles and abstracts of potentially relevant literature. 213 reviews were identified and categorised by target group. A total of 74 reviews were identified dealing with children and adolescents. Each review underwent a quality assessment. Results: 39 reviews with the highest quality and relevance were analysed. Three reviews focused on the family and home setting, 4 on the childcare setting, 28 on the school setting and 4 on other settings. Evidence revealed the key role played by parents in promoting physical activity in children within each setting. Furthermore, evidence pointed toward the efficacy of multi-component interventions in the childcare and school setting. Several evidence-based intervention strategies were identified for childcare facilities and schools. Discussion: The review of reviews identified a number of promising strategies for PA promotion among children and adolescents. Among reviews, multi-component interventions in childcare facilities and schools stand out prominently. At the same time, the review of reviews indicated that there is still a lack of studies on the efficacy of interventions that go beyond the individual level. We recommend that future research should also target community and policy level interventions and interventions other than the school setting. In order to make more specific recommendations regarding the scale-up of promising intervention strategies, further knowledge about the effectiveness, health equity and cost effectiveness of interventions is needed.
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Affiliation(s)
- Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Lee Goodwin
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ionuţ Burlacu
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Günther Gediga
- Department of Psychology, University of Münster, Münster, Germany
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Shrestha A, Tamrakar D, Karmacharya BM, Shrestha A, Shrestha R, Bhatta RD, Pyakurel P, Khudyakov P, Malik V, Mattei J, Spiegelman D. Nepal Pioneer Worksite Intervention Study to lower cardio-metabolic risk factors: design and protocol. BMC Cardiovasc Disord 2019; 19:48. [PMID: 30819098 PMCID: PMC6393979 DOI: 10.1186/s12872-019-1025-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/19/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To increase cardiovascular disease prevention efforts, worksite interventions can promote healthy food choices, facilitate health education, increase physical activity and provide social support. This pioneer study will measure the effectiveness of a cafeteria and a behavioral intervention on cardio-metabolic risk in a worksite in Nepal. METHODS The Nepal Pioneer Worksite Intervention Study is a two-step intervention study conducted in Dhulikhel Hospital in eastern Nepal. In the first step, we will assess the effectiveness of a 6-month cafeteria intervention on cardio-metabolic risk using a pre-post design. In the second step, we will conduct a 6-month, open-masked, two-arm randomized trial by allocating half of the participants to an individual behavioral intervention based on the 'diabetes prevention program' for the prevention of cardio-metabolic risk. We will recruit 366 full time employees with elevated blood pressure, fasting blood sugar, or glycosylated haemoglobin (HbA1c). At baseline, we will measure their demographic variables, lifestyle factors, anthropometry, fasting blood sugar, HbA1c,and lipid profiles. We will measure cardio-metabolic outcomes at 6 months, 12 months, and 18 months. At 12 months, we will compare the proportion of participants who have attained two or more cardio-metabolic risk factor reduction goals (HbA1c decrease ≥0.5%; systolic blood pressure decrease ≥5 mmHg; or triglycerides decrease ≥10 mg/dL) during the cafeteria intervention period and the control period using generalized estimating equations. At 18 months, we will compare the proportion from the 'cafeteria only arm' to the 'cafeteria and behavior arm' for the same outcome using a chi-square test. DISCUSSION This pioneer study will estimate the effect of environmental-level changes on lowering cardio-metabolic risks; and added benefit of an individual-level dietary intervention. If the study demonstrates a significant effect, a scaled up approach could produce an important reduction in cardiovascular disease burden through environmental and individual level prevention programs in Nepal and similar worksites worldwide. TRIAL REGISTRATION The trial was retrospectively registered on clincaltrials.gov (Identification Member: NCT03447340 ; Date of Registration: February 27, 2018).
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Affiliation(s)
- Archana Shrestha
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA
| | - Dipesh Tamrakar
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal
| | - Biraj Man Karmacharya
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal
| | - Abha Shrestha
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal
| | - Rajeev Shrestha
- Department of Pharmacology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Rajendra Dev Bhatta
- Department of Biochemistry, Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel, Nepal
| | - Prajjwal Pyakurel
- Department of Community Medicine, BP Koirala Institute of Health Science, Dharan, Nepal
| | - Polyna Khudyakov
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, USA
| | - Vasanti Malik
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Donna Spiegelman
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, USA
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Crane M, Bohn-Goldbaum E, Lloyd B, Rissel C, Bauman A, Indig D, Khanal S, Grunseit A. Evaluation of Get Healthy at Work, a state-wide workplace health promotion program in Australia. BMC Public Health 2019; 19:183. [PMID: 30760237 PMCID: PMC6373144 DOI: 10.1186/s12889-019-6493-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Workplace health programs (WHPs) may improve adult health but very little evidence exists on multi-level WHPs implemented at-scale and so the relationship between program implementation factors and outcomes of WHPs are poorly understood. This study evaluated Get Healthy at Work (GHaW), a state-wide government-funded WHP in Australia. METHODS A mixed-method design included a longitudinal quasi-experimental survey of businesses registered with GHaW and a comparison group of businesses surveyed over a 12-month period. Semi-structured interviews and focus groups with key contacts and employees of selected intervention group businesses and the service providers of the program were conducted to assess program adoption and adaptation. RESULTS Positive business-level changes in workplace culture were observed over time among GHaW businesses compared with the control group. Multilevel regression modelling revealed perceptions that employees were generally healthy (p = 0.045 timeXgroup effect) and that the workplace promoted healthy behaviours (p = 0.004 timeXgroup effect) improved significantly while the control group reported no change in work culture perceptions. Changes in perceptions about work productivity were not observed; however only one third of businesses registered for the program had adopted GHaW during the evaluation period. Qualitative results revealed a number of factors contributing to program adoption: which depended on program delivery (e.g., logistics, technology and communication channels), design features of the program, and organisational factors (primarily business size and previous experience of WHPs). CONCLUSIONS Evaluation of program factors is important to improve program delivery and uptake and to ensure greater scalability. GHaW has the potential to improve workplace health culture, which may lead to better health promoting work environments. These results imply that government can play a central role in enabling prioritisation and incentivising health promotion in the workplace.
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Affiliation(s)
- Melanie Crane
- Prevention Research Collaboration, The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006 Australia
- The Australian Prevention Partnership Centre, Ultimo, NSW 2007 Australia
| | - Erika Bohn-Goldbaum
- Prevention Research Collaboration, The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006 Australia
- The Australian Prevention Partnership Centre, Ultimo, NSW 2007 Australia
| | - Beverley Lloyd
- NSW Office of Preventive Health, Liverpool Hospital, Liverpool, NSW 2170 Australia
| | - Chris Rissel
- NSW Office of Preventive Health, Liverpool Hospital, Liverpool, NSW 2170 Australia
| | - Adrian Bauman
- Prevention Research Collaboration, The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006 Australia
- The Australian Prevention Partnership Centre, Ultimo, NSW 2007 Australia
| | - Devon Indig
- Prevention Research Collaboration, The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006 Australia
- The Australian Prevention Partnership Centre, Ultimo, NSW 2007 Australia
| | - Santosh Khanal
- NSW Office of Preventive Health, Liverpool Hospital, Liverpool, NSW 2170 Australia
| | - Anne Grunseit
- Prevention Research Collaboration, The Charles Perkins Centre, Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006 Australia
- The Australian Prevention Partnership Centre, Ultimo, NSW 2007 Australia
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Lin TY, Liao PJ, Ting MK, Hsu KH. Lifestyle characteristics as moderators of the effectiveness of weight control interventions among semiconductor workers. Biomed J 2019; 41:376-384. [PMID: 30709580 PMCID: PMC6361846 DOI: 10.1016/j.bj.2018.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/03/2018] [Accepted: 09/28/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Workers in high technology industry are experiencing stressful environment and have been ranked as a high risk group for adverse health effects. The effectiveness of worksite health promotion is important for occupational health. This study is to investigate the effect of health interventions on body measurement changes while examining the role of their lifestyle factors. METHODS A total of 904 participants aged over 30 years were recruited from 14 semiconductor worksites in Taiwan from 2011 to 2015. A multi-settings, quasi-experimental study was conducted that assigned participants into two intervention programs, including exercise program and diet-plus-exercise program. The outcomes include the changes of body weight, waist circumference, body mass index (BMI), and biophysiological indicators. Lifestyle variables include alcohol consumption, cigarette smoking, and regular exercise. Multiple linear regression analyses were performed to test the association. RESULTS The findings have demonstrated that one kilogram body weight reduction is associated with a decrease of 0.58 mmHg SBP (p < 0.001), 0.29 mmHg DBP (p < 0.001), 3.33 mg/dL triglyceride (p < 0.001), 0.96 mg/dL total cholesterol (p < 0.001), and 0.68 mg/dL LDL (p < 0.001). The diet-plus-exercise group had more significant effect on both weight changes and biophysiological changes than exercise-only group (p < 0.001). Lifestyle factors, including cigarette smoking, alcohol consumption, and regular exercise, were significant moderators of the effectiveness of health interventions. CONCLUSIONS Both exercise and diet interventions are important to the effectiveness of health promotion in occupational sectors. Lifestyle modifications are vital for weight control programs in improving body shape changes and biophysiological indicators.
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Affiliation(s)
- Tzu-Yu Lin
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Ju Liao
- Department of Health Care Administration, Oriental Institute of Technology, New Taipei City, Taiwan; Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Kuo Ting
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Kuang-Hung Hsu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan; Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan.
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The effectiveness of dietary workplace interventions: a systematic review of systematic reviews. Public Health Nutr 2019; 22:942-955. [DOI: 10.1017/s1368980018003750] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AbstractObjectiveTo summarise findings of systematic reviews that distinctively report dietary intervention components and their effects on diet-, health- and economic-related outcomes in the workplace setting.DesignMEDLINE, Embase, CINAHL, Web of Science, Cochrane Library and Google Scholar were searched in December 2014 and the search was updated in August 2017.ResultsThe search identified 1137 titles, of which nineteen systematic reviews from the initial search and two systematic reviews from the updated search met the inclusion criteria (twenty-one systematic reviews, published in twenty-two papers). Most systematic reviews were of moderate quality and focused on dietary behaviour change outcomes and some health-related biomarkers. Evidence was strongest for interventions to increase fruit and vegetable intake, reduce fat intake, aid weight loss and reduce cholesterol. Few reported workplace-related and evaluation outcomes.ConclusionsThese findings suggest that workplace dietary interventions can positively influence diet and health outcomes. Suggestions for effective interventions components have been made.
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Environmental interventions to promote healthier eating and physical activity behaviours in institutions: a systematic review. Public Health Nutr 2019; 22:1518-1531. [PMID: 30702052 DOI: 10.1017/s1368980018003683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The present review evaluated the effectiveness of environmental-based interventions aimed at improving the dietary and physical activity behaviours and body composition indices of adults in institutions. DESIGN A systematic review was conducted. Electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, The Cochrane Library, Web of Science, ProQuest Dissertation and Theses, Scopus and Athena) were searched for relevant articles published between database inception and October 2017. Searching, selecting and reporting were undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. SETTING Military establishments and maritime workplaces.ParticipantsAdults in institutions, aged 18-45 years. RESULTS A total of 27842 articles were screened for eligibility, nine studies (reported in eleven articles) were included in the review. Five studies used multilevel strategies and four used environmental strategies only. Duration of follow-up ranged from 3 weeks to 10 years. Eight of the studies reported significant positive effects on dietary behaviours, but effect sizes varied. The study that targeted physical activity had no effect on activity levels but did have a significant positive effect on physical fitness. No evidence was identified that the studies resulted in improvements in body composition indices. CONCLUSIONS The evidence base appears to be in favour of implementing environmental interventions in institutions to improve the dietary behaviours of adults. However, due to the small number of studies included in the review, and the variable methodological quality of the studies and intervention reporting, further well-designed evaluation studies are required.
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Haire-Joshu D, Hill-Briggs F. The Next Generation of Diabetes Translation: A Path to Health Equity. Annu Rev Public Health 2019; 40:391-410. [PMID: 30601723 DOI: 10.1146/annurev-publhealth-040218-044158] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Disparities in diabetes burden exist in large part because of the social determinants of health (SDOH). Translation research and practice addressing health equity in diabetes have generally focused on changing individual behavior or providing supportive approaches to compensate for, rather than directly target, SDOH. The purpose of this article is to propose a pathway for addressing SDOH as root causes of diabetes disparities and as an essential target for the next generation of interventions needed to achieve health equity in diabetes prevention and treatment. This review describes ( a) the current burden of diabetes disparities, ( b) the influence of SDOH on diabetes disparities, ( c) gaps in and implications of current translation research, and ( d) approaches to achieving health equity in the next generation of diabetes translation.
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Affiliation(s)
- Debra Haire-Joshu
- Public Health and Medicine, Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA;
| | - Felicia Hill-Briggs
- Departments of Medicine; Health, Behavior and Society; and Acute and Chronic Care; and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA;
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Nykiforuk CIJ, Atkey K, Brown S, Caldwell W, Galloway T, Gilliland J, Kongats K, McGavock J, Raine KD. Promotion of physical activity in rural, remote and northern settings: a Canadian call to action. Health Promot Chronic Dis Prev Can 2018; 38:419-435. [PMID: 30430816 PMCID: PMC6262980 DOI: 10.24095/hpcdp.38.11.03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The lack of policy, practice and research action on physical activity and features of the physical (built and natural) environments in rural, remote and northern settings is a significant threat to population health equity in Canada. This paper presents a synthesis of current evidence on the promotion of physical activity in non-urban settings, outcomes from a national priority-setting meeting, and a preliminary call to action to support the implementation and success of population-level initiatives targeting physical activity in non-urban settings. METHODS We conducted a "synopses of syntheses" scoping review to explore current evidence on physical activity promotion in rural, remote, northern and natural settings. Next, we facilitated a collaborative priority-setting conference with 28 Canadian experts from policy, research and practice arenas to develop a set of priorities on physical activity in rural, remote and northern communities. These priorities informed the development of a preliminary Canadian call to action. RESULTS We identified a limited number of reviews that focused on physical activity and the built environment in rural, remote and northern communities. At the prioritysetting conference, participants representing rural, remote and northern settings identified top priorities for policy, practice and research action to begin to address the gaps and issues noted in the literature. These priorities include self-identifying priorities at the community level; compiling experiences; establishing consistency in research definitions and methods; and developing mentorship opportunities. CONCLUSION Coordinated action across policy, practice and research domains will be essential to the success of the recommendations presented in this call to action.
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Affiliation(s)
| | - Kayla Atkey
- Alberta Policy Coalition for Chronic Disease Prevention, Edmonton, Alberta, Canada
| | - Sara Brown
- NWT Association of Communities, Yellowknife, Northwest Territories, Canada
| | - Wayne Caldwell
- School of Environmental Design and Rural Development, University of Guelph, Guelph, Ontario, Canada
| | - Tracey Galloway
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | - Jason Gilliland
- Department of Geography, Western University, London, Ontario, Canada
| | - Krystyna Kongats
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Watanabe K, Kawakami N. Effects of a Multi-Component Workplace Intervention Program with Environmental Changes on Physical Activity among Japanese White-Collar Employees: a Cluster-Randomized Controlled Trial. Int J Behav Med 2018; 25:637-648. [PMID: 30194533 DOI: 10.1007/s12529-018-9747-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE This study aimed to investigate effects of a flexible multi-component workplace intervention program for improving physical activity among Japanese white-collar employees in a cluster randomized controlled trial design. METHODS A total of 208 worksites and nested employees were approached. Any worksite interested in a 3-month physical activity promotion intervention and white-collar workers aged 18 years or older were eligible. The worksites were randomly assigned to an intervention or a control, stratified by worksite size. The intervention worksites were offered an intervention program that allows these worksites to select intervention components from a set of options, including environmental changes. The control worksites were offered feedback and basic occupational health services. Physical activity level was measured using a self-reported questionnaire at baseline and at 3 and 6 months of follow-up. RESULTS Three worksites (92 employees) were allocated to the intervention and five worksites (98 employees) to the control worksites. The overall physical activity level in the intervention worksites significantly increased compared with the control worksites (Coeff = 0.45, SE = 0.19, p = 0.018). For subgroup analyses, the intervention effect on the overall physical activity level was significant among medium- and large-sized worksites but not among small-sized worksites. CONCLUSION This trial showed a significant and positive effect of the intervention program on physical activity. The program is unique because of its flexibility and feasibility. However, small worksites might receive less benefit from the program, indicating a need for further support and/or new technologies. TRIAL REGISTRATION UMIN Clinical Trials Registry (ID=UMIN000024069).
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Ablah E, Grilliot E, Okut H, Mailey EL, Rosenkranz SK, Rosenkranz RR. Many Kansas Worksites Offer Few Interventions to Reduce Occupational Sedentary Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081745. [PMID: 30110954 PMCID: PMC6121883 DOI: 10.3390/ijerph15081745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/03/2018] [Accepted: 08/09/2018] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to identify the extent to which sedentary behavior interventions are being implemented in Kansas worksites. The WorkWell KS Physical Activity Assessment was administered online to 111 worksites across Kansas from October 2016 through April 2018. Each worksite identified a point of contact to complete the worksite-level assessment. Four of the WorkWell KS Physical Activity Assessment's items assessed interventions that may reduce employees' sedentary behavior: offering point-of-decision prompts to reduce employees' sedentary behavior, offering a program for employees to reduce their sedentary time at work, having an organizational norm that allows employees to stand, stretch, and/or move during meetings at least every 30 minutes, and offering standing desks. All 111 worksites that participated in the WorkWell KS Physical Activity Workshop completed the WorkWell KS Physical Activity Assessment, resulting in a 100% response rate. Most worksites (59%, n = 65) reported offering no information, program, policy, or environmental change interventions aimed to reduce sedentary behavior. The most commonly reported intervention offered by worksites to reduce employees' sedentary behavior was standing desks (32%, n = 35). Overall, participating worksites reported implementing a few interventions that are designed to reduce sedentary behavior.
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Affiliation(s)
- Elizabeth Ablah
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita; 1010 North Kansas, Wichita, KS 67214, USA.
| | - Elizabeth Grilliot
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita; 1010 North Kansas, Wichita, KS 67214, USA.
| | - Hayrettin Okut
- Office of Research, University of Kansas School of Medicine-Wichita; 1010 North Kansas, Wichita, KS 67214, USA.
| | - Emily L Mailey
- Department of Kinesiology, Kansas State University; Natatorium 8920 Denison Avenue, Manhattan, KS 66506, USA.
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University; 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506, USA.
| | - Richard R Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University; 212 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506, USA.
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Culture and food security. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2018. [DOI: 10.1016/j.gfs.2018.02.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hyun HS, Kim Y. Associations between working environment and weight control efforts among workers with obesity in Korea. J Int Med Res 2018; 46:2307-2316. [PMID: 29623760 PMCID: PMC6023066 DOI: 10.1177/0300060518764212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to investigate the relationship between working environment and weight control efforts among obese workers in Korea. Methods This study was based on the 2011 3rd Korean Working Conditions Survey, which was conducted on workers aged 15 years or older. A sample of 484 obese workers was included in the study. Multivariable logistic regression analysis was used to investigate the relationship between working environment and weight control efforts after controlling for individual variables. Adjusted odds ratios (ORs) and 95% confidence intervals were calculated. Results Of the participants, 63.4% reported that they made efforts to control their weight. After controlling for personal factors, the OR of weight control efforts for individuals working 40-49 hours per week was 2.4 times that for individuals working 60 hours or more per week. The OR of regular employment workers was 2.2 times that of non-regular workers. Conclusion We established that working hours and employment type were significantly related to weight control efforts. Therefore, we recommend that working conditions should be considered in designing effective workplace health promotion programs.
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Affiliation(s)
- Hye Sun Hyun
- Department of Nursing, Sangmyung University, Cheonan, Republic of Korea
| | - Yunyoung Kim
- Department of Nursing, Andong National University, Andong, Republic of Korea
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Watanabe K, Kawakami N, Otsuka Y, Inoue S. Associations among workplace environment, self-regulation, and domain-specific physical activities among white-collar workers: a multilevel longitudinal study. Int J Behav Nutr Phys Act 2018; 15:47. [PMID: 29855392 PMCID: PMC5984456 DOI: 10.1186/s12966-018-0681-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/20/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Psychological and environmental determinants have been discussed for promoting physical activity among workers. However, few studies have investigated effects of both workplace environment and psychological determinants on physical activity. It is also unknown which domains of physical activities are promoted by these determinants. This study aimed to investigate main and interaction effects of workplace environment and individual self-regulation for physical activity on domain-specific physical activities among white-collar workers. METHODS A multi-site longitudinal study was conducted at baseline and about 5-month follow-up. A total of 49 worksites and employees within the worksites were recruited. Inclusion criteria for the worksites (a) were located in the Kanto area, Japan and (b) employed two or more employees. Employee inclusion criteria were (a) employed by the worksites, (b) aged 18 years or older, and (c) white-collar workers. For outcomes, three domain-specific physical activities (occupational, transport-related, and leisure-time) at baseline and follow-up were measured. For independent variables, self-regulation for physical activity, workplace environments (parking/bike, signs/bulletin boards/advertisements, stairs/elevators, physical activity/fitness facilities, work rules, written policies, and health promotion programs), and covariates at baseline were measured. Hierarchical Linear Modeling was conducted to investigate multilevel associations. RESULTS Of the recruited worksites, 23 worksites and 562 employees, and 22 worksites and 459 employees completed the baseline and the follow-up surveys. As results of Hierarchical Linear Modeling, stairs/elevator (γ=3.80 [SE=1.80], p<0.05), physical activity/fitness facilities (γ=4.98 [SE=1.09], p<0.01), and written policies (γ=2.10 [SE=1.02], p<0.05) were significantly and positively associated with occupational physical activity. Self-regulation for physical activity was associated significantly with leisure-time physical activity (γ=0.09 [SE=0.04], p<0.05) but insignificantly with occupational and transport-related physical activity (γ=0.11 [SE=0.16] and γ=-0.00 [SE=0.06]). Significant interaction effects of workplace environments (physical activity/fitness facilities, work rules, and written policies) and self-regulation were observed on transport-related and leisure-time physical activity. CONCLUSIONS Workplace environments such as physical activity/fitness facilities, written policies, work rules, and signs for stair use at stairs and elevators; self-regulation for physical activity; and their interactions may be effective to promote three domain-specific physical activities. This study has practical implications for designing multi-component interventions that include both environmental and psychological approaches to increase effect sizes to promote overall physical activity.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yasumasa Otsuka
- Faculty of Human Sciences, University of Tsukuba, 3-29-1, Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
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Perceived Barriers to Healthy Eating and Physical Activity Among Participants in a Workplace Obesity Intervention. J Occup Environ Med 2018; 59:746-751. [PMID: 28692017 DOI: 10.1097/jom.0000000000001092] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To characterize barriers to healthy eating (BHE) and physical activity (BPA) among participants in a workplace weight management intervention. METHODS Steps to health participants completed a questionnaire to ascertain barriers to physical activity and healthy eating faced. Exploratory factor analysis was used to determine the factor structure for BPA and BHE. The relationships of these factors with accelerometer data and dietary behaviors were assessed using linear regression. RESULTS Barriers to physical activity included time constraints and lack of interest and motivation, and to healthy eating, lack of self-control and convenience, and lack of access to healthy foods. Higher BHE correlated with higher sugary beverage intake but not fruit and vegetable and fat intake. CONCLUSIONS To improve their effectiveness, workplace weight management programs should consider addressing and reducing barriers to healthy eating and physical activity.
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Seguin RA, Paul L, Folta SC, Nelson ME, Strogatz D, Graham ML, Diffenderfer A, Eldridge G, Parry SA. Strong Hearts, Healthy Communities: A Community-Based Randomized Trial for Rural Women. Obesity (Silver Spring) 2018; 26:845-853. [PMID: 29634086 PMCID: PMC5915907 DOI: 10.1002/oby.22158] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/02/2018] [Accepted: 02/11/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate a multilevel cardiovascular disease (CVD) prevention program for rural women. METHODS This 6-month, community-based, randomized trial enrolled 194 sedentary rural women aged 40 or older with BMI ≥ 25 kg/m2 . Intervention participants attended 6 months of twice-weekly exercise, nutrition, and heart health classes (48 total) that included individual-, social-, and environment-level components. An education-only control program included didactic healthy lifestyle classes once a month (six total). The primary outcome measures were change in BMI and weight. RESULTS Within-group and between-group multivariate analyses revealed that only intervention participants decreased BMI (-0.85 units; 95% CI: -1.32 to -0.39; P = 0.001) and weight (-2.24 kg; 95% CI: -3.49 to -0.99; P = 0.002). Compared with controls, intervention participants decreased BMI (difference: -0.71 units; 95% CI: -1.35 to -0.08; P = 0.03) and weight (1.85 kg; 95% CI: -3.55 to -0.16; P = 0.03) and improved C-reactive protein (difference: -1.15 mg/L; 95% CI: -2.16 to -0.15; P = 0.03) and Simple 7, a composite CVD risk score (difference: 0.67; 95% CI: 0.14 to 1.21; P = 0.01). Cholesterol decreased among controls but increased in the intervention group (-7.85 vs. 3.92 mg/dL; difference: 11.77; 95% CI: 0.57 to 22.96; P = 0.04). CONCLUSIONS The multilevel intervention demonstrated modest but superior and meaningful improvements in BMI and other CVD risk factors compared with the control program.
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Affiliation(s)
- Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Lynn Paul
- College of Education, Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Sara C Folta
- Friedman School of Nutrition, Tufts University, Boston, Massachusetts, USA
| | - Miriam E Nelson
- Sustainability Institute, University of New Hampshire, Durham, New Hampshire, USA
| | - David Strogatz
- Center for Rural Community Health, Bassett Research Institute, Cooperstown, New York, USA
| | - Meredith L Graham
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Anna Diffenderfer
- Montana Dietetic Internship, Montana State University, Bozeman, Montana, USA
| | - Galen Eldridge
- Montana State University Extension, Montana State University, Bozeman, Montana, USA
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, New York, USA
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Schepps MA, Shiroma EJ, Kamada M, Harris TB, Lee IM. Day length is associated with physical activity and sedentary behavior among older women. Sci Rep 2018; 8:6602. [PMID: 29700376 PMCID: PMC5920095 DOI: 10.1038/s41598-018-25145-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 04/10/2018] [Indexed: 02/01/2023] Open
Abstract
Physical activity may be influenced by one’s physical environment, including day length and weather. Studies of physical activity, day length, and weather have primarily used self-reported activity, broad meteorological categorization, and limited geographic regions. We aim to examine the association of day length and physical activity in a large cohort of older women, covering a wide geographic range. Participants (N = 16,741; mean (SD) age = 72.0 (SD = 5.7) years) were drawn from the Women’s Health Study and lived throughout the United States. Physical activity was assessed by accelerometer (ActiGraph GT3X+) between 2011 and 2015. Day length and weather information were obtained by matching weather stations to the participants’ location using National Oceanic and Atmospheric Administration databases. Women who experienced day lengths greater than 14 hours had 5.5% more steps, 9.4% more moderate-to-vigorous physical activity, and 1.6% less sedentary behavior, compared to women who experienced day lengths less than 10 hours, after adjusting for age, accelerometer wear, temperature, and precipitation. Day length is associated with physical activity and sedentary behavior in older women, and needs to be considered in programs promoting physical activity as well as in the analyses of accelerometer data covering wide geographic regions.
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Affiliation(s)
- Mitchell A Schepps
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, MD, USA
| | - Eric J Shiroma
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, MD, USA.
| | - Masamitsu Kamada
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, MD, USA
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Kim SS, Roopnaraine T, Nguyen PH, Saha KK, Bhuiyan MI, Menon P. Factors influencing the uptake of a mass media intervention to improve child feeding in Bangladesh. MATERNAL AND CHILD NUTRITION 2018; 14:e12603. [PMID: 29644807 PMCID: PMC6055868 DOI: 10.1111/mcn.12603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 12/22/2017] [Accepted: 02/04/2018] [Indexed: 11/29/2022]
Abstract
Mass media are increasingly used to deliver health messages to promote social and behaviour change, but there has been little evidence of mass media use for improving a set of child feeding practices, other than campaigns to promote breastfeeding. This study aimed to examine the factors influencing the uptake of infant and young child feeding messages promoted in TV spots that were launched and aired nationwide in Bangladesh. We conducted a mixed‐methods study, using household surveys (n = 2,000) and semistructured interviews (n = 251) with mothers of children 0–23.9 months and other household members. Factors associated with TV spot viewing and comprehension were analysed using multivariable logistic regression models, and interview transcripts were analysed by systematic coding and iterative summaries. Exposure ranged from 36% to 62% across 6 TV spots, with comprehension ranging from 33% to 96% among those who viewed the spots. Factors associated with comprehension of TV spot messages included younger maternal age and receipt of home visits by frontline health workers. Three direct narrative spots showed correct message recall and strong believability, identification, and feasibility of practicing the recommended behaviours. Two spots that used a metaphorical and indirect narrative style were not well understood by respondents. Understanding the differences in the uptake factors may help to explain variability of impacts and ways to improve the design and implementation of mass media strategies.
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Affiliation(s)
- Sunny S Kim
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA
| | | | - Phuong H Nguyen
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA
| | - Kuntal K Saha
- Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
| | - Mahbubul I Bhuiyan
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Dhaka, Bangladesh
| | - Purnima Menon
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, New Delhi, India
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Nudelman G, Shiloh S. Connectionism and Behavioral Clusters: Differential Patterns in Predicting Expectations to Engage in Health Behaviors. Ann Behav Med 2018; 52:890-901. [DOI: 10.1093/abm/kax063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gabriel Nudelman
- Faculty of Psychology, Philipps University of Marburg, Marburg, Hesse, Germany
| | - Shoshana Shiloh
- The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
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Peyman N, Rezai-Rad M, Tehrani H, Gholian-Aval M, Vahedian-Shahroodi M, Heidarian Miri H. Digital Media-based Health Intervention on the promotion of Women's physical activity: a quasi-experimental study. BMC Public Health 2018; 18:134. [PMID: 29334970 PMCID: PMC5769504 DOI: 10.1186/s12889-018-5025-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 01/02/2018] [Indexed: 11/15/2022] Open
Abstract
Background Technological advances have caused poor mobility and lower physical activity among humankind. This study was conducted to assess the impact of a digital media-based (multi-media, internet, and mobile phone) health intervention on promotion of women’s physical activity. Methods In this quasi-experimental study, 360 women were divided into case and control groups. The digital media-based educational intervention was conducted in two months in the case group electronically, using mail and Internet and telephone platforms. Physical activity was measured using International Physical Activity Questionnaire (IPAQ) that estimated women’s physical activity rate in the previous week. Data was analyzed using descriptive and analytical statistics (ANOVA, chi-square, paired and independent t-tests) using SPSS 20. Results The mean score of knowledge, attitude and level of physical activity in the control group were not significantly different before and after the intervention. While in the case group, this difference before and after the intervention was significant (p < 0.001), and mean scores of the above-mentioned factors increased after the intervention. Conclusions Using innovative and digital media-based health education can be effective in improving health-based behavior such as physical activity. Therefore, it seems necessary to develop user-based strategies and strengthen the behavioral change theories and hypotheses based on digital media for effective influence on behavior. Trial registration Iranian Registry of Clinical Trials (IRCT), IRCT20160619028529N5. Registered December 24, 2017 [retrospectively registered].
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Affiliation(s)
- Nooshin Peyman
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Rezai-Rad
- Health Care Management, Visiting Professor of Faculty of Management, Islamic Azad University, South Tehran Branch, Tehran, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mahdi Gholian-Aval
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hamid Heidarian Miri
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Barriers and facilitators of exercise experienced by cancer survivors: a mixed methods systematic review. Support Care Cancer 2017; 26:685-700. [DOI: 10.1007/s00520-017-3964-5] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 11/07/2017] [Indexed: 12/23/2022]
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Shrestha A, Pyakurel P, Shrestha A, Gautam R, Manandhar N, Rhodes E, Tamrakar D, Karmacharya BM, Malik V, Mattei J, Spiegelman D. Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study from Nepal. HEART ASIA 2017; 9:e010956. [PMID: 29225703 PMCID: PMC5708323 DOI: 10.1136/heartasia-2017-010956] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/03/2017] [Accepted: 10/13/2017] [Indexed: 01/06/2023]
Abstract
Objective Worksite interventions can serve as a potential platform for translating existing knowledge of diabetes prevention and facilitate healthy food choices. The study explored perceptions about healthy eating as well as potential facilitators and barriers to healthy eating among employees in a wire manufacturing factory in Nepal. Methods and materials We conducted a cross-sectional exploratory qualitative study in a wire manufacturing industry in eastern Nepal. We conducted three focus group discussions (FGDs) with a total of 26 employees and four in-depth interviews (IDIs) with cafeteria operators/managers from a wire manufacturing factory in eastern Nepal. FGDs and IDIs were audio-recorded, transcribed verbatim and analysed using the thematic method. Results Most employees defined healthy eating as the consumption of food prepared and maintained using hygienic practices and fresh foods in general. Major barriers to healthy eating included unavailability of healthy foods, difficulty in changing eating habits, the preference for fried foods in Nepali culture and the high costs of some healthy foods. The most commonly reported facilitator of healthy eating was the availability of affordable healthy food options in worksite cafeterias. Conclusion Availability of healthy food options at an affordable price could lead to healthier food choices in the worksite.
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Affiliation(s)
- Archana Shrestha
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Prajjwal Pyakurel
- Department of Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Abha Shrestha
- Department of Community Programs, Dhulikhel Hospital - Kathmandu University Hospital, Dhulikhel, Nepal
| | - Rabin Gautam
- Department of Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nisha Manandhar
- Department of Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Dipesh Tamrakar
- Department of Community Programs, Dhulikhel Hospital - Kathmandu University Hospital, Dhulikhel, Nepal.,Department of Community Medicine, Kathmandu University, Dhulikhel, Nepal
| | - Biraj Man Karmacharya
- Department of Community Programs, Dhulikhel Hospital - Kathmandu University Hospital, Dhulikhel, Nepal.,Department of Cardiology, University of Washington, Seattle, Washington, USA.,Department of Community Medicine, Kathmandu Hospital, Dhulikhel, Nepal
| | - Vasanti Malik
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Donna Spiegelman
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.,Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
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Watanabe K, Kawakami N. Effects of a multicomponent workplace intervention programme with environmental changes on physical activity among Japanese white collar employees: a protocol for a cluster randomised controlled trial. BMJ Open 2017; 7:e017688. [PMID: 29070639 PMCID: PMC5665227 DOI: 10.1136/bmjopen-2017-017688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Physical activity is one of the most important health behaviours as a determinant of physical and mental health. Although intervention strategies for promoting physical activity among workers are needed, evidence for the effectiveness of multilevel workplace interventions with environmental changes on the promotion of physical activity are still limited due to lack of cluster randomised controlled trials (RCTs). The aim of this study is to investigate effects of a 3-month workplace intervention programme with environmental changes on the improvement in physical activity among Japanese white collar employees. METHODS AND ANALYSIS This study will be a two-arm and parallel-group cluster (worksite) RCT. Japanese worksites and employees who are employed by the worksites will be recruited through health insurance associations and chambers of commerce. Worksites that meet the inclusion criteria will be randomly allocated to intervention or control groups. The intervention worksites will be offered the original intervention programme that consists of 13 contents with environmental changes. The control worksites will be able to get three times feedback of the assessment of the amount of physical activity and basic occupational health service in each worksite. The primary outcome will be the total amount of physical activity measured by the Global Physical Activity Questionnaire at baseline, 3 months and 6 months. Multilevel latent growth modelling will be conducted to examine the effectiveness of the intervention programme. ETHICS AND DISSEMINATION This study was ethically approved by the research ethics committee of the Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Japan (No. 11230). Results will be submitted and published in a scientific peer-reviewed journal. TRIAL REGISTRATION NUMBER UMIN000024069; Pre-results.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The Japan Society for the Promotion of Science, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Baker EA, Elliott M, Barnidge E, Estlund A, Brownson RC, Milne A, Kershaw F, Hashimoto D. Implementing and Evaluating Environmental and Policy Interventions for Promoting Physical Activity in Rural Schools. THE JOURNAL OF SCHOOL HEALTH 2017; 87:538-545. [PMID: 28580669 DOI: 10.1111/josh.12522] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 10/17/2016] [Accepted: 01/27/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Schools are an important setting for improving behaviors associated with obesity, including physical activity. However, within schools there is often a tension between spending time on activities promoting academic achievement and those promoting physical activity. METHODS A community-based intervention provided administrators and teachers with a training on evidence-based public health and then collaborated with them to identify and implement environmental (walking track) and local school policy interventions (brain breaks). The evaluation included conducting in-depth interviews and SOPLAY observations to assess the facilitators and barriers and impact of the dissemination of environmental and policy changes. RESULTS Individual, organizational, intervention, and contextual factors influenced dissemination. Teachers reported that brain breaks increased student focus and engagement with classroom material and decreased student behavioral problems. Students decreased sedentary behavior and increased vigorous behavior. Of the 4 schools, 2 increased walking. CONCLUSIONS Active dissemination of environmental and policy interventions by engaging school administrators and teachers in planning and implementation shows potential for increasing physical activity in rural school settings.
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Affiliation(s)
- Elizabeth A Baker
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63130
| | - Michael Elliott
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63130
| | - Ellen Barnidge
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63130
| | - Amy Estlund
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63130
| | - Ross C Brownson
- Brown School, Division of Public Health Sciences and Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130
| | - Anne Milne
- College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO 63130
| | - Freda Kershaw
- Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Ave., St. Louis, MO 63130
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Hipp JA, Dodson EA, Lee JA, Marx CM, Yang L, Tabak RG, Hoehner C, Marquet O, Brownson RC. Mixed methods analysis of eighteen worksite policies, programs, and environments for physical activity. Int J Behav Nutr Phys Act 2017; 14:79. [PMID: 28615024 PMCID: PMC5471708 DOI: 10.1186/s12966-017-0533-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 06/02/2017] [Indexed: 01/04/2023] Open
Abstract
Background This study examined whether specific worksite supports for physical activity (PA) were associated with total and domain-specific PA. Methods A cross-sectional, telephone-based study was conducted in four Missouri, USA, metropolitan areas in 2012 and 2013. Outcome variables included total PA and sub-domains (leisure, work, travel) measured using the International Physical Activity Questionnaire. Logistic regression determined odds of meeting PA recommendations, given access to and use of 18 unique PA worksite supports. A subsample of 119 participants also wore hip accelerometry for seven consecutive days and maintained a wear-time diary. Access to worksite supports were associated with odds of meeting objective moderate and vigorous (MV) PA above 150 min per week. Results Among 2013 survey participants, meeting PA recommendations while performing work-related tasks was significantly associated with several supports (e.g., walking maps, stair prompts), as was meeting recommendations during travel (e.g., flextime for PA, incentives for public transportation, walking/bicycling to work). Access to 11 worksite supports increased odds of meeting PA recommendations through leisure-time PA; five supports were associated with total PA. There were significant differences between access to and use of supports. Using objective MVPA, access to worksite challenges and bike storage were significantly associated with five and three times greater odds of meeting 150 min of MVPA per week, respectively. Conclusions Worksite wellness plans are increasing across the US and employers are eager for evidence-based supports for increasing PA. This study provides insights into the utility of multiple worksite supports for PA to increase odds that employees meet PA recommendations.
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Affiliation(s)
- J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, College of Natural Resources, and Fellow, Center for Human Health and the Environment, North Carolina State University, Campus Box 8004, Raleigh, NC, 27695, USA.
| | - Elizabeth A Dodson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Jung Ae Lee
- Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, AR, 72701, USA
| | - Christine M Marx
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO, 63110, USA
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1st Floor, 1090, Vienna, Austria
| | - Rachel G Tabak
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | | | - Oriol Marquet
- Department of Parks, Recreation, and Tourism Management and Center for Geospatial Analytics, College of Natural Resources, North Carolina State University, Campus Box 8000, Raleigh, NC, 27695, USA
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
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Buller DB, Dobbinson S, English DR, Wakefield M, Buller MK. Rationale, design, and baseline data of a cross-national randomized trial on the effect of built shade in public parks for sun protection. Contemp Clin Trials 2017; 55:47-55. [PMID: 28185996 DOI: 10.1016/j.cct.2017.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/30/2017] [Accepted: 02/04/2017] [Indexed: 02/03/2023]
Abstract
Environments can be structured to reduce solar ultraviolet radiation (UV) exposure to prevent skin cancer. A prospective randomized trial is being conducted to test whether introducing shade sails in passive recreation areas (PRAs) in public parks will increase use and decrease UV exposure in the shaded compared to unshaded PRAs. Shade effects will be compared between Melbourne, Australia and Denver, USA. The trial enrolled 145 public parks with PRAs suitable for shade construction and randomized parks to intervention or control in a 1:3 ratio. Use of PRAs and UV levels were recorded at each park by trained observers during 30-minute periods on four weekend days in each of two summers (pretest and posttest). Shade sails were constructed between the summers. Given low numbers of users at pretest, the outcome measure was modified to use of the PRA (use vs. no use) and unit of analysis to the individual observation. Observations (n=580) occurred on average 29days from the summer solstice and 55min from solar noon in warm weather (mean=26.2°C) with some cloud cover but only slight or no wind. Typically, PRAs had benches and picnic tables and were located near playgrounds. PRAs were in use during 13.3% of observations (mean=0.41 users). UV over 30-minutes at the PRA boundary (mean=3.2 standard erythemal dose [SED]) and center (mean=3.3 SED) was high. Shade for skin cancer prevention has been understudied. This study will address this gap by determining whether purpose-built shade structures promote greater use of shaded areas within public parks.
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Affiliation(s)
| | - Suzanne Dobbinson
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Dallas R English
- Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia
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Cauchi D, Glonti K, Petticrew M, Knai C. Environmental components of childhood obesity prevention interventions: an overview of systematic reviews. Obes Rev 2016; 17:1116-1130. [PMID: 27432025 DOI: 10.1111/obr.12441] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/05/2016] [Accepted: 05/23/2016] [Indexed: 02/05/2023]
Abstract
Childhood obesity has a complex multi-factorial aetiology grounded in environmental and individual level factors that affect behaviour and outcomes. An ecological, systems-based approach to addressing childhood obesity is increasingly being advocated. The primary aim of this review is to summarize the evidence reported in systematic reviews on the effectiveness of population-level childhood obesity prevention interventions that have an environmental component. We conducted a systematic review of reviews published since 1995, employing a standardized search strategy in nine databases. Inclusion criteria required that reviews be systematic and evaluated at least one population-level, environmental intervention in any setting aimed at preventing or reducing obesity in children (5-18 years). Sixty-three reviews were included, ten of which were of high quality. Results show modest impact of a broad range of environmental strategies on anthropometric outcomes. Systematic reviews vary in methodological quality, and not all relevant primary studies may be included in each review. To ensure relevance of our findings to practice, we also report on relevant underlying primary studies, providing policy-relevant recommendations based on the evidence reviewed. Greater standardization of review methods and reporting structures will benefit policymakers and public health professionals seeking informed decision-making.
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Affiliation(s)
- D Cauchi
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - K Glonti
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - M Petticrew
- Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - C Knai
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Onufrak SJ, Watson KB, Kimmons J, Pan L, Khan LK, Lee-Kwan SH, Park S. Worksite Food and Physical Activity Environments and Wellness Supports Reported by Employed Adults in the United States, 2013. Am J Health Promot 2016; 32:96-105. [PMID: 27597795 DOI: 10.1177/0890117116664709] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the workplace food and physical activity (PA) environments and wellness culture reported by employed United States adults, overall and by employer size. DESIGN Cross-sectional study using web-based survey on wellness policies and environmental supports for healthy eating and PA. SETTING Worksites in the United States. PARTICIPANTS A total of 2101 adults employed outside the home. MEASURES Survey items were based on the Centers for Disease Control and Prevention Worksite Health ScoreCard and Checklist of Health Promotion Environments and included the availability and promotion of healthy food items, nutrition education, promotion of breast-feeding, availability of PA amenities and programs, facility discounts, time for PA, stairwell signage, health promotion programs, and health risk assessments. ANALYSIS Descriptive statistics were used to examine the prevalence of worksite environmental and facility supports by employer size (<100 or ≥100 employees). Chi-square tests were used to examine the differences by employer size. RESULTS Among employed respondents with workplace food or drink vending machines, approximately 35% indicated the availability of healthy items. Regarding PA, 30.9% of respondents reported that their employer provided opportunities to be physically active and 17.6% reported worksite exercise facilities. Wellness programs were reported by 53.2% working for large employers, compared to 18.1% for smaller employers. CONCLUSION Employee reports suggested that workplace supports for healthy eating, PA, and wellness were limited and were less common among smaller employers.
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Affiliation(s)
- Stephen J Onufrak
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathleen B Watson
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joel Kimmons
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Liping Pan
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Kettel Khan
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Seung Hee Lee-Kwan
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sohyun Park
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Thielscher C, Hahn E, Klumpp M, Lindenberg B, Matusiewicz D. [Backache in insurance companies : Occupational health management]. DER ORTHOPADE 2016; 45:1045-1049. [PMID: 27518118 DOI: 10.1007/s00132-016-3316-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM OF THE STUDY The article examines how big German insurance companies handle back pain in terms of occupational health management (OHM). METHODOLOGY Narrative interviews with experts from 8 out of the 20 biggest enterprises were conducted. RESULTS Musculoskeletal diseases are the number one or number two reason for sick leave. All enterprises offer OHM; there is a variety of measures, e. g., sport, massage, advice, ergonomics, healthy food and leadership training. The measures are hardly ever evaluated. DISCUSSION The literature is controversial whether or which OHM measures are effective. In our sample few measures were evaluated; for more evidence based treatment this should be changed.
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Affiliation(s)
- C Thielscher
- FOM Hochschule für Oekonomie & Management gemeinnützige GmbH, Sigsfeldstr. 5, 45141, Essen, Deutschland.
| | - E Hahn
- FOM Hochschule für Oekonomie & Management gemeinnützige GmbH, Sigsfeldstr. 5, 45141, Essen, Deutschland
| | - M Klumpp
- FOM Hochschule für Oekonomie & Management gemeinnützige GmbH, Sigsfeldstr. 5, 45141, Essen, Deutschland
| | - B Lindenberg
- FOM Hochschule für Oekonomie & Management gemeinnützige GmbH, Sigsfeldstr. 5, 45141, Essen, Deutschland
| | - D Matusiewicz
- FOM Hochschule für Oekonomie & Management gemeinnützige GmbH, Sigsfeldstr. 5, 45141, Essen, Deutschland
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Promoting physical activity for children and adolescents in low- and middle-income countries: An umbrella systematic review: A review on promoting physical activity in LMIC. Prev Med 2016; 88:115-26. [PMID: 27068650 DOI: 10.1016/j.ypmed.2016.03.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 02/01/2016] [Accepted: 03/29/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE It is unknown how much previous reviews on promoting physical activity (PA) for children and adolescents (aged 6-18years) take into account studies from low- and middle-income countries (LMIC, based on the World Bank definition) and the level of evidence of the effect of PA interventions in this population. This study aims to answer such questions using an umbrella systematic review approach. METHODS We searched for peer-reviewed systematic reviews and original studies in eight electronic databases, screening of reference lists and expert contacts. Information in systematic reviews on PA interventions for children and adolescents from LMIC was discussed. Original studies on PA interventions (randomized-controlled trials [RCT], cluster-RCT and non-RCT) with children and adolescents from LMIC were eligible. We assessed the methodological quality in all studies, and the evidence level of effect on PA in intervention studies. RESULTS Fifty systematic reviews (nine meta-analyses) and 25 original studies (20 different interventions) met eligibility criteria. Only 3.1% of mentioned studies in previous reviews were from LMIC. Strong and LMIC-specific evidence was found that school-based, multicomponent, and short-term (up to six months) interventions, focused on adolescents primarily (aged 13-18years), can promote PA in children and adolescents from LMIC. Other intervention characteristics had inconclusive evidence due to the low number of studies, low methodological quality, and/or small sample size. CONCLUSION A minimal part of PA interventions mentioned in previous reviews are from LMIC. Our LMIC-specific analyses showed priorities of implementation and practical implication that can be used in public policies for PA promotion in LMIC.
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Konchak JN, Moran MR, O'Brien MJ, Kandula NR, Ackermann RT. The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act. Curr Diab Rep 2016; 16:55. [PMID: 27145778 PMCID: PMC5210175 DOI: 10.1007/s11892-016-0742-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Type 2 diabetes is a major public health problem in the USA, affecting over 12 % of American adults and imposing considerable health and economic burden on individuals and society. There is a strong evidence base demonstrating that lifestyle behavioral changes and some medications can prevent or delay the onset of type 2 diabetes in high risk adults, and several policy and healthcare system changes motivated by the Patient Protection and Affordable Care Act (ACA) have the potential to accelerate diabetes prevention. In this narrative review, we (1) offer a conceptual framework for organizing how the ACA may influence diabetes prevention efforts at the level of individuals, healthcare providers, and health systems; (2) highlight ACA provisions at each of these levels that could accelerate type 2 diabetes prevention nationwide; and (3) explore possible policy gaps and opportunity areas for future research and action.
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Affiliation(s)
- Juleigh Nowinski Konchak
- Preventive Medicine Residency, Cook County Health and Hospitals System, 1900 W Polk Street, Room 901, Chicago, IL, 60612, USA
| | - Margaret R Moran
- Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA
| | - Matthew J O'Brien
- Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA
| | - Namratha R Kandula
- Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA
- American Medical Association, Improving Health Outcomes, 330 N Wabash, Chicago, IL, 60611, USA
| | - Ronald T Ackermann
- Department of Medicine, Feinberg School of Medicine, 750 N. Lake Shore Drive, Suite 680, Chicago, IL, 60611, USA.
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Krug RDR, Del Duca GF, Silva KSD, Bertuol C, Nahas MV, Oliveira ESAD, Barros MVGD. Sociodemographic differences in walking for leisure and for commuting in Brazilian workers. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-6574201600020008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rütten A, Schow D, Breda J, Galea G, Kahlmeier S, Oppert JM, van der Ploeg H, van Mechelen W. Three types of scientific evidence to inform physical activity policy: results from a comparative scoping review. Int J Public Health 2016; 61:553-63. [PMID: 27113707 PMCID: PMC4947117 DOI: 10.1007/s00038-016-0807-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 01/15/2016] [Accepted: 01/20/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This paper presents a typology of available evidence to inform physical activity policy. It aims to refine the distinction between three types of evidence relating to physical activity and to compare these types for the purpose of clarifying potential research gaps. METHODS A scoping review explored the extent, range and nature of three types of physical activity-related evidence available in reviews: (I) health outcomes/risk factors, (II) interventions and (III) policy-making. A six-step qualitative, iterative process with expert consultation guided data coding and analysis in EPPI Reviewer 4. RESULTS 856 Type I reviews, 350 Type II reviews and 40 Type III reviews were identified. Type I reviews heavily focused on obesity issues (18 %). Reviews of a systematic nature were more prominent in the Type II (>50 %). Type III reviews tended to conflate research about policy intervention effectiveness and research about policymaking processes. The majority of reviews came from the United States, United Kingdom, Australia and Canada. CONCLUSIONS Although evidence gaps exist regarding evidence Types I and II, the most prominent gap regards Type III, i.e. research pertaining to physical activity policymaking. The findings presented herein will be used to inform physical activity policy development and future research.
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Affiliation(s)
- Alfred Rütten
- Institute of Sport Science and Sport, Friedrich Alexander University, Erlangen, Germany.
| | - Diana Schow
- Institute of Sport Science and Sport, Friedrich Alexander University, Erlangen, Germany
| | - João Breda
- Division of Noncommunicable Diseases and Life-course, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Gauden Galea
- Division of Noncommunicable Diseases and Life-course, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Sonja Kahlmeier
- Physical Activity and Health Unit, Epidemiology, Biostatistics, and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Jean-Michel Oppert
- Department of Nutrition, University Pierre et Marie Curie - Paris 6, Pitie-Salpetriere hospital (AP-HP), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Hidde van der Ploeg
- Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health and EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
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Schuna JM, Tudor-Locke C, Proença M, Barreira TV, Hsia DS, Pitta F, Vatsavai P, Guidry RD, Magnusen MR, Cowley AD, Martin CK. Validation of an integrated pedal desk and electronic behavior tracking platform. BMC Res Notes 2016; 9:74. [PMID: 26857115 PMCID: PMC4746820 DOI: 10.1186/s13104-016-1882-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 01/22/2016] [Indexed: 11/18/2022] Open
Abstract
Background This study tested the validity of revolutions per minute (RPM) measurements from the Pennington Pedal Desk™. Forty-four participants (73 % female; 39 ± 11.4 years-old; BMI 25.8 ± 5.5 kg/m2 [mean ± SD]) completed a standardized trial consisting of guided computer tasks while using a pedal desk for approximately 20 min. Measures of RPM were concurrently collected by the pedal desk and the Garmin Vector power meter. After establishing the validity of RPM measurements with the Garmin Vector, we performed equivalence tests, quantified mean absolute percent error (MAPE), and constructed Bland–Altman plots to assess agreement between RPM measures from the pedal desk and the Garmin Vector (criterion) at the minute-by-minute and trial level (i.e., over the approximate 20 min trial period). Results The average (mean ± SD) duration of the pedal desk trial was 20.5 ± 2.5 min. Measures of RPM (mean ± SE) at the minute-by-minute (Garmin Vector: 54.8 ± 0.4 RPM; pedal desk: 55.8 ± 0.4 RPM) and trial level (Garmin Vector: 55.0 ± 1.7 RPM; pedal desk: 56.0 ± 1.7 RPM) were deemed equivalent. MAPE values for RPM measured by the pedal desk were small (minute-by-minute: 2.1 ± 0.1 %; trial: 1.8 ± 0.1 %) and no systematic relationships in error variance were evident by Bland–Altman plots. Conclusion The Pennington Pedal Desk™ provides a valid count of RPM, providing an accurate metric to promote usage.
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Affiliation(s)
- John M Schuna
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA. .,School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
| | - Catrine Tudor-Locke
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA. .,Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - Mahara Proença
- Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil. .,CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, 70040-020, Brazil.
| | - Tiago V Barreira
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA. .,Department of Exercise Science, Syracuse University, 900 S. Crouse Ave., Syracuse, NY, 13210, USA.
| | - Daniel S Hsia
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| | - Fabio Pitta
- Laboratório de Pesquisa em Fisioterapia Pulmonar (LFIP), Departamento de Fisioterapia, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
| | | | | | | | - Amanda D Cowley
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
| | - Corby K Martin
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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Perez A, Fleury J, Belyea M. Environmental Resources in Maintenance of Physical Activity 6 Months Following Cardiac Rehabilitation. Clin Nurs Res 2016; 25:391-409. [PMID: 26826141 DOI: 10.1177/1054773815627277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined differences in weekly time spent in physical activity by level of perceived environmental resources, 6 months following graduation from cardiac rehabilitation. A descriptive, longitudinal design used standardized measures to evaluate perceived environmental resources and physical activity levels. Repeated measures analysis of variance was used to examine mean differences in weekly time spent in physical activity by level of perceived environmental resources. Adults 51 to 86 years old (N = 150) diagnosed with coronary heart disease were included. There was a significant change over time in physical activity as measured by minutes per week, F(2, 148) = 7.915, p = .001, where activity increased between baseline and 3 months, and then dropped slightly at 6 months. This change over time differed by the level of perceived neighborhood resources, F(2, 148) = 3.545, p = .032. Home and neighborhood resources may positively influence physical activity maintenance following cardiac rehabilitation.
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