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Gonzalez-Jaramillo N, Abbühl D, Roa-Díaz ZM, Kobler-Betancourt C, Frahsa A. COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review. BMJ Open 2024; 14:e084560. [PMID: 38631831 PMCID: PMC11029206 DOI: 10.1136/bmjopen-2024-084560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DESIGN A realist review. DATA SOURCES Embase, PubMed, Dimensions ai and Google Scholar. SETTING High-income countries. DEFINITIONS We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. RESULTS We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. CONCLUSION Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
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Affiliation(s)
| | - Dominik Abbühl
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Zayne Milena Roa-Díaz
- ISPM, University of Bern, Bern, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
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Pomiersky R, Matting L, Haigis D, Eschweiler GW, Frahsa A, Niess A, Thiel A, Sudeck G. Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study. J Aging Phys Act 2024:1-10. [PMID: 38589013 DOI: 10.1123/japa.2023-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 04/10/2024]
Abstract
Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = -0.27, p = .008), body mass index (β = -0.29, p = .002), Barthel Index (β = 0.24, p = .040), and hand grip strength (β = 0.30, p = .048). SB was significantly predicted by body mass index (β = 0.27, p = .008) and Barthel Index (β = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.
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Affiliation(s)
- Rebekka Pomiersky
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Leon Matting
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Daniel Haigis
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Gerhard W Eschweiler
- Center for Geriatric Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Andreas Niess
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Gordon Sudeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
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3
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Hahn LS, Thiel A, Dembeck V, Haigis D, Matting L, Pomiersky R, Eschweiler GW, Nieß AM, Sudeck G, Frahsa A. A 10-step participatory program for developing, implementing, and evaluating physical activity promoting actions in nursing homes in Germany. BMC Public Health 2024; 24:419. [PMID: 38336672 PMCID: PMC10854033 DOI: 10.1186/s12889-024-17727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Since multidimensional barriers challenge nursing homes, a socio-ecological approach is needed for physical activity promotion in this setting. So far, little is known about how such an approach can be transferred into the successful development and implementation of PA-promoting actions together with stakeholders on-site. We aimed to investigate the actions and dimensions of PA-promoting actions and their sustainable implementation. To contribute to closing this gap, we present a 10-step program for co-developing and co-evaluating PA-promoting actions in nursing homes through an integrated counselling approach. METHODS We used a multiple case study approach that built upon manifold data sources, collected in 7 nursing homes over 3 years between 2021 and 2023. We collected fieldnotes and photologs from 14 future workshops (2 per home); 7 evaluation workshops (1 per home); 36 individual counsellings (2 sessions per resident), as well as 87 implementation protocols (action type and frequency), 11 evaluation questionnaires (changes among resources, cooperations, and collaborations); 7 goal attainment scales and 18 individual activity schedules. In addition, we retrieved and documented progress information at regular intervals by phone or email. RESULTS With staff, residents, relatives, and volunteers, we co-developed 112 ideas for PA promotion; from which 54 ideas were implemented and integrated into everyday life, differentiated into "activities of daily living," "structured activities," and "activity-friendly environments."; 18 residents in 4 homes participated in individual counselling to develop individual activity schedules. Eighteen actions were rated as "(much) more successful than expected"; 10 "(much) worse than expected," and 23 "as successful as expected." Three actions were not evaluated. DISCUSSION The participatory integrated counselling approach led to home-specific actions and promoted implementation into everyday life. The number and dimensions of actions implemented largely depended on the mission and vision of the respective home. The lack of staff could partially be compensated for by involving neighbourhoods, volunteers, and community organisations, such as local clubs. CONCLUSION To effectively promote PA in nursing homes, a tailored approach considering structural conditions, locations, volunteer engagement, and organisational visions is essential. Long-lasting partnerships and low-threshold opportunities prove promising. Future research should delve into structural-level change processes and outcomes in this context.
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Affiliation(s)
- Lea-Sofie Hahn
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Viola Dembeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
| | - Daniel Haigis
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Leon Matting
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Rebekka Pomiersky
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | | | - Andreas M Nieß
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
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4
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Haigis D, Wagner S, Pomiersky R, Matting L, Hahn LS, Eschweiler GW, Thiel A, Frahsa A, Sudeck G, Nieß AM. [Sarcopenia, physical activity and sedentary behavior among nursing home residents in Germany]. Z Gerontol Geriatr 2024:10.1007/s00391-023-02275-z. [PMID: 38276995 DOI: 10.1007/s00391-023-02275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Residents in nursing homes show a high prevalence of the musculoskeletal syndrome sarcopenia and tend not to achieve current physical activity recommendations. OBJECTIVE The aim of this study is to identify differences in physical activity and sedentary behavior of sarcopenic residents compared with nonsarcopenic and presarcopenic residents. METHODS Sarcopenia assessment was performed among 63 nursing home residents in Baden-Wuerttemberg (D) using the European Working Group on Sarcopenia in Older People 2 specifications. Structured activity sessions (per week), accelerometer-based physical activity (steps/day), and sedentary behavior (percentual/day) were examined. The group comparisons were determined with Kruskal-Wallis tests and Dunn-Bonferroni post hoc tests. RESULTS Significant differences were found for number of steps (p = 0.005) and percentual sedentary behavior (p = 0.019). Moreover, steps per day presented significant results in group comparison for no sarcopenia (2824.4 [423-14275]) with probable sarcopenia (1703.9 [118-5663]) and confirmed/severe sarcopenia (1571.2 [240-2392]) (both p = 0.022; |r| = 0.34). Sedentary behavior demonstrated significant differences in groups with no sarcopenia (87.9% [69.1-94.3]) and with probable sarcopenia (91.7% [80.4-9835]) (p = 0.018; |r| = 0.35). CONCLUSION Nonsarcopenic residents demonstrated a higher number of steps and lower sedentary behavior compared with presarcopenic and sarcopenic residents. Increasing steps, reducing sedentary behavior and promoting activities of daily living can contribute to the prevention and treatment of sarcopenia in the nursing home setting.
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Affiliation(s)
- Daniel Haigis
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland.
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland.
| | - Silas Wagner
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Rebekka Pomiersky
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Leon Matting
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Lea-Sofie Hahn
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Gerhard W Eschweiler
- Geriatrisches Zentrum, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
| | - Ansgar Thiel
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Annika Frahsa
- Institut für Sozial- und Präventivmedizin, Universität Bern, 3012, Bern, Schweiz
| | - Gorden Sudeck
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
- Institut für Sportwissenschaft, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
| | - Andreas M Nieß
- Abteilung Sportmedizin, Universitätsklinikum Tübingen, 72076, Tübingen, Deutschland
- Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Eberhard Karls Universität Tübingen, 72074, Tübingen, Deutschland
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Bühler N, Frahsa A, Morand Bourqui R, Von Götz N, Bochud M, Panese F. Between data providers and concerned citizens: Exploring participation in precision public health in Switzerland. Public Underst Sci 2024; 33:105-120. [PMID: 37458286 PMCID: PMC10756011 DOI: 10.1177/09636625231183265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
This empirical article explores the dynamics of exchange and reciprocity between cohorters, that is, study organizers, and cohortees, that is, study participants. Drawing on literature on bioeconomy and valuation, we analyze cohortees' expectations in return for the "clinical labor" they perform in the pilot phase of a Swiss precision public health study. Based on an ethnography of this cohort and data from seven focus groups with cohortees (n = 37), we identified four positions: (1) the good citizen participant, (2) the critical participant, (3) the concerned participant, and (4) the self-oriented participant. These reveal that cohortees' participation, still framed in altruistic terms, nevertheless engages expectations about reciprocal obligations of the state and science in terms of public health, confirming the deep entanglement of gift-based, financial, and moral economies of participation. The different values emerging from these expectations-robust scientific evidence about environmental exposure and a socially oriented public health-provide rich indications about stake making which might matter for the future of precision public health.
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Affiliation(s)
| | | | | | | | - Murielle Bochud
- Unisanté, University Center for Primary Care and Public Health, Switzerland
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6
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Hahn LS, Thiel A, Trüb D, Eschweiler GW, Nieß AM, Sudeck G, Frahsa A. Patterns of physical activity among nursing home residents before and during the Covid 19 pandemic-a systematic observation. Eur Rev Aging Phys Act 2023; 20:23. [PMID: 38057739 DOI: 10.1186/s11556-023-00332-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 11/06/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The Covid-19 outbreak in spring of 2020 posed an array of challenges for nursing homes, including promoting resident physical activity (PA). Given the diversity of factors affecting resident PA, we explored how activity patterns outside weekly-scheduled structured activities changed during the pandemic and what factors promoted or inhibited PA during the pandemic. METHODS We conducted systematic direct observations over 823.5 h in eight nursing homes in Southern Germany in 2020 and 2021. RESULTS In 2020, 84.7% of person observation units were classified as sedentary (average activity level: 1.14 MET). In 2021, the percentage increased to 91.6% of observed person units (average activity level: 1.08 MET) (t = 6.947; p = .000). According to tree classification, influencing factors of PA included mealtime and daytime in 2020 and 2021, as well as presence of men residents only in 2020 and guided low threshold activities in 2021. CONCLUSIONS Nursing homes constitute highly sedentary places-an issue exacerbated by access restrictions for external activity experts and significant others as well as behavioural restrictions for residents during the Covid-19 pandemic. Staff could not compensate due to existing time restraints and lack of training in PA promotion. Based on our findings, we recommend future studies to develop feasible and resource-low activities to be integrated into the daily routines of nursing homes.
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Affiliation(s)
- Lea-Sofie Hahn
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Dorothée Trüb
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | | | - Andreas M Nieß
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
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Liwanag HJ, James O, Frahsa A. A review and analysis of accountability in global health funding, research collaborations and training: towards conceptual clarity and better practice. BMJ Glob Health 2023; 8:e012906. [PMID: 38084477 PMCID: PMC10711908 DOI: 10.1136/bmjgh-2023-012906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/21/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Accountability is a complex idea to unpack and involves different processes in global health practice. Calls for accountability in global health would be better translated to action through a better understanding of the concept and practice of accountability in global health. We sought to analyse accountability processes in practice in global health funding, research collaborations and training. METHODS This study is a literature review that systematically searched PubMed and Scopus for articles on formal accountability processes in global health. We charted information on processes based on accountability lines ('who is accountable to whom') and the outcomes the processes were intended for ('accountability for what'). We visualised the representation of accountability in the articles by mapping the processes according to their intended outcomes and the levels where processes were implemented. RESULTS We included 53 articles representing a wide range of contexts and identified 19 specific accountability processes for various outcomes in global health funding, research collaborations and training. Target setting and monitoring were the most common accountability processes. Other processes included interinstitutional networks for peer checking, litigation strategies to enforce health-related rights, special bodies that bring actors to account for commitments, self-accountability through internal organisational processes and multipolar accountability involving different types of institutional actors. Our mapping identified gaps at the institutional, interinstitutional and broader system levels where accountability processes could be enhanced. CONCLUSION To rebalance power in global health, our review has shown that analysing information on existing accountability processes regarding 'who is accountable to whom' and 'accountability for what' would be useful to characterise existing lines of accountability and create lines where there are gaps. However, we also suggest that institutional and systems processes for accountability must be accompanied by political engagement to mobilise collective action and create conditions where a culture of accountability thrives in global health.
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Affiliation(s)
- Harvy Joy Liwanag
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Oria James
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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8
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Mesa-Vieira C, Gonzalez-Jaramillo N, Díaz-Ríos C, Pano O, Meyer S, Menassa M, Minder B, Lin V, Franco OH, Frahsa A. Urban Governance, Multisectoral Action, and Civic Engagement for Population Health, Wellbeing, and Equity in Urban Settings: A Systematic Review. Int J Public Health 2023; 68:1605772. [PMID: 37719658 PMCID: PMC10500609 DOI: 10.3389/ijph.2023.1605772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/21/2023] [Indexed: 09/19/2023] Open
Abstract
Objectives: To identify the validated and reliable indicators and tools to assess good governance for population health, wellbeing, and equity in urban settings, and assess processes of multisectoral action and civic engagement as reported by peer-reviewed articles. Methods: We conducted a systematic review searching six databases for observational studies reporting strategies of either urban health, multisectoral action or civic engagement for wellbeing, health, or equity. Results: Out of 8,154 studies initially identified we included 17. From the included studies, 14 presented information about high-income countries. The general population was the main target in most studies. Multisectoral action was the most frequently reported strategy (14 studies). Three studies used Urban Health Equity Assessment and Response Tool (Urban HEART). Health indicators were the most frequently represented (6 studies). Barriers and facilitators for the implementation of participatory health governance strategies were reported in 12 studies. Conclusion: Data on the implementation of participatory health governance strategies has been mainly reported in high-income countries. Updated and reliable data, measured repeatedly, is needed to closely monitor these processes and further develop indicators to assess their impact on population health, wellbeing, and equity.
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Affiliation(s)
- Cristina Mesa-Vieira
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | | | - Catalina Díaz-Ríos
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Octavio Pano
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sophie Meyer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Marilyne Menassa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Beatrice Minder
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Public Health and Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | - Vivian Lin
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Sauter A, Herbert-Maul A, Abu-Omar K, Thiel A, Ziemainz H, Frahsa A, Linder S, Herrmann-Johns A. Corrigendum: "For me, it's just a piece of freedom"-Increased empowerment through physical activity promotion among socially disadvantaged women. Front Public Health 2023. [PMID: 36866096 PMCID: PMC9972080 DOI: 10.3389/fpubh.2023.1146584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.867626.].
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Affiliation(s)
- Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany,*Correspondence: Alexandra Sauter ✉
| | - Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Heiko Ziemainz
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Stephanie Linder
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
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Punzalan JK, Guingona M, Punzalan MG, Cristobal F, Frahsa A, Liwanag HJ. The Integration of Primary Care and Public Health in Medical Students' Training Based on Social Accountability and Community-Engaged Medical Education. Int J Public Health 2023; 68:1605359. [PMID: 36776739 PMCID: PMC9908606 DOI: 10.3389/ijph.2023.1605359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
Objectives: Primary care and public health comprise the bedrock of health systems, but their divergence has produced two groups of practitioners either focused on individual health or population health. We explored how primary care and public health were integrated in medical students' training in Zamboanga Peninsula, Philippines. Methods: Our qualitative study reviewed community health plans in two municipalities and thematically analyzed the perspectives of medical students, faculty, alumni, and community stakeholders through focus group discussions and in-depth interviews. Results: Integration began by operationalizing a curriculum requiring medical students to serve rural communities during most of their training-a departure from the conventional, hospital-based medical education in the Philippines. The medical students' community immersion provided opportunities for integrating primary care and public health activities that influenced their personal orientations and the health situation in communities. Integration continued after training as alumni found themselves serving as primary care and public health practitioners in the region. Conclusion: Social accountability and community-engaged medical education provided the foundation for medical students to integrate primary care and public health in practice to respond to local needs.
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Affiliation(s)
| | - Monserrat Guingona
- Ateneo de Zamboanga University School of Medicine, Zamboanga City, Philippines
| | | | - Fortunato Cristobal
- Ateneo de Zamboanga University School of Medicine, Zamboanga City, Philippines
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Harvy Joy Liwanag
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland,*Correspondence: Harvy Joy Liwanag,
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11
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Liwanag HJ, Uy J, Politico MR, Padilla MJ, Arzobal MC, Manuel K, Cagouia AL, Tolentino P, Frahsa A, Ronquillo K. Cocreation in Health Workforce Planning to Shape the Future of the Health Care System in the Philippines. Glob Health Sci Pract 2022; 10:e2200176. [PMID: 36951285 PMCID: PMC9771466 DOI: 10.9745/ghsp-d-22-00176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Philippines passed landmark legislation in 2019 on universal health coverage, including reforms in the development of its health workforce, an essential building block of responsive health care systems. HEALTH WORKFORCE PLANNING COCREATION PROCESS We based our planning process on a model of cocreation defined as sharing power and decision making to solve problems collaboratively and build consensus around action. Through cocreation with policy makers, researchers, and other stakeholders, we performed projection studies on 10 selected health professions and estimated the need for primary care at national and subnational levels, which was the most extensive health workforce projection carried out by the Philippine Department of Health to date. We determined health workforce requirements based on target densities recommended by the World Health Organization and a health needs approach that considered epidemiological and sociodemographic factors. In consultation with stakeholders, we interpreted our analysis to guide recommendations to address issues related to health workforce quantity, skill mix, and distribution. These included a broad range of proposals, including task shifting, expanding scholarships and deployment, reforming health professionals' education, and pursuing a whole-of-society approach, which together informed the National Human Resources for Health Master Plan. CONCLUSIONS Our cocreation model offers lessons for policy makers, program managers, and researchers in low- and middle-income countries who deal with health workforce challenges. Cocreation led to relationship building between policy makers and researchers who jointly performed the research and identified solutions through open communication and agile coordination. To shape future health care systems that are responsive both during normal times and during crises, cocreation would be essential for evidence-informed policy development and policy-relevant research.
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Affiliation(s)
- Harvy Joy Liwanag
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
- Balik Scientist Program, Department of Science and Technology, Philippine Council for Health Research and Development, Taguig, Philippines
| | - Jhanna Uy
- Philippine Institute for Development Studies, Quezon City, Philippines
- Health Sciences Program, School of Science and Engineering, Ateneo de Manila University, Quezon City, Philippines
| | - Mary Ruth Politico
- Health Human Resource Development Bureau, Department of Health, Manila, Philippines
| | - Mary Joy Padilla
- Health Human Resource Development Bureau, Department of Health, Manila, Philippines
| | - Ma Catherine Arzobal
- Health Human Resource Development Bureau, Department of Health, Manila, Philippines
| | - Kaycee Manuel
- Health Human Resource Development Bureau, Department of Health, Manila, Philippines
| | - Angeli Loren Cagouia
- Health Human Resource Development Bureau, Department of Health, Manila, Philippines
| | - Pretchell Tolentino
- Health Human Resource Development Bureau, Department of Health, Manila, Philippines
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Kenneth Ronquillo
- Health Human Resource Development Bureau, Department of Health, Manila, Philippines
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Haigis D, Wagner S, Sudeck G, Frahsa A, Thiel A, Eschweiler GW, Niess AM. Comparison of Habitual and Maximal Gait Speed and their Impact on Sarcopenia Quantification in German Nursing Home Residents. J Frailty Sarcopenia Falls 2022; 7:199-206. [DOI: 10.22540/jfsf-07-199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 12/05/2022] Open
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13
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Abel T, Tadesse L, Frahsa A, Sakarya S. Integrating Patient-reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience. Health Expect 2022; 26:237-244. [PMID: 36416363 PMCID: PMC9854289 DOI: 10.1111/hex.13649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/14/2022] [Accepted: 10/23/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Patient-reported Experience (PRE) is an emerging concept integrating patient perspectives and amplifying voices often marginalized in discussions surrounding health systems. However, it remains a challenge to use and integrate PREs when studying patient agency and access to quality services, particularly with data from multiple sources. In this article, using study materials from the Swiss MIWOCA project, we present and reflect upon a multistage PRE approach to study healthcare access. METHODS The MIWOCA project, a study on healthcare access and quality among immigrant women with chronic illnesses living in Switzerland, provided data from multiple sources for the integration of PRE data. These sources included interviews with women (n = 48), two focus group discussions with women (n = 15), interviews with service providers (n = 12) and observations from stakeholder dialogues (n = 3). In addition, we utilized field notes, focus group illustration maps, patient vignettes and policy briefs to develop a multistage data linking model. PRE data served as starting themes and reference topics in each of the interlinked stages of knowledge production. RESULTS Deploying PREs, we coherently linked the data from preceding stages and used them to inform subsequent stages. This, in turn, enabled us to identify, reflect and rectify factors limiting immigrant women's agency and access to quality services. Ultimately, the approach engaged patients as knowledge co-producers for system-level changes. This knowledge was transformed into a set of practice recommendations and a policy brief addressing ways to improve health systems to better serve immigrant women in Switzerland. CONCLUSIONS Building on PREs to systematically combine multiple data sources and engage patients continuously can improve our understanding of barriers in health systems. Beyond individual patient-doctor encounters, a multistage PRE approach can identify structural problems and provide clues for resolving them at the systems level. The PREs approach presented may serve as an example and encourage more public health experts to consider PREs in future research and practice. PATIENT AND PUBLIC CONTRIBUTION Women with chronic illness and immigration experience contributed to interview-guideline development, provided PREs in interviews, identified priority areas for health-service change and actively participated in the development of practice recommendations.
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Affiliation(s)
- Thomas Abel
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Lidya Tadesse
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland,Johns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Annika Frahsa
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Sibel Sakarya
- Department of Public Health, School of MedicineKoç UniversityIstanbulTurkey
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14
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Gelius P, Sommer R, Ferschl S, Till M, Abu-Omar K, Semrau J, Helsper N, Kohler S, Dippon L, Pfeifer K, Rütten A, Popp J, Carl J, Grüne E, Müller C, Hassel H, Altmeier D, Frahsa A, Thiel A. S11 Improving knowledge co-creation and participation in physical activity promotion: The cooperative planning approach. Eur J Public Health 2022. [PMCID: PMC9421793 DOI: 10.1093/eurpub/ckac093.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
A central problem of current efforts to promote health and physical activity (PA) is that many successful projects remain stuck in the demonstration phase and are not implemented successfully at scale. The use of participatory and/or co-creation approaches has been suggested to avoid this ?pilot project trap? and better adapt interventions to target group needs and setting specificities.
This symposium intends to introduce to an international audience a particular participatory concept that has become increasingly popular in PA promotion in Germany in recent years: The Cooperative Planning approach has been successfully used in sport facility planning, local and regional PA policy development, and various settings of PA promotion (incl. kindergartens, schools, vocational training, and communities). The workshop will shed light on the theoretical background and methodology of Cooperative Planning as well as its specific application in select settings.
The first presentation will introduce the concept of Cooperative Planning, outline potential areas of application, and compare it with other popular participatory and co-creation approaches in PA promotion. Following this, we will provide evidence from ongoing projects employing the approach to promote PA in kindergartens (Presentation 2) and in the community setting (Presentation 3). Presentation 4 will introduce an example from the retirement home setting and also highlight ways of combining Cooperative Planning with other approaches such as photovoice and participatory evaluation. The final presentation will provide an outlook on the future extension of the concept by introducing the idea of the Practice Dive, which may be used to further optimize knowledge co-creation between researchers and practitioners.
A closer look at the Cooperative Planning approach is both timely and relevant for an international audience for a number of reasons: Conceptually, Cooperative Planning is a theory-based framework that combines ideas of participation and co-creation for PA into an innovative whole-of-system approach. From a practical PA promotion perspective, it transcends many existing techniques by focusing both on engaging multipliers and members of the target group, and by involving all of them in the decisive intervention development process (e.g. rather than only via opinion polls or focus groups). This symposium will allow us to combine evidence from four different projects, highlighting both the specificities of working in different settings as well as different aspects and possible extensions of the Cooperative Planning approach.
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Affiliation(s)
- Peter Gelius
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Raluca Sommer
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Susanne Ferschl
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Maike Till
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Jana Semrau
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Nathalie Helsper
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Simone Kohler
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Lea Dippon
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Johanna Popp
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Johannes Carl
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Eva Grüne
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Christina Müller
- Institut für angewandte Gesundheitswissenschaften, Coburg University of Applied Sciences and Arts , Coburg, Germany
| | - Holger Hassel
- Institut für angewandte Gesundheitswissenschaften, Coburg University of Applied Sciences and Arts , Coburg, Germany
| | - Dorothee Altmeier
- Institut für Sportwissenschaft, Universität Tübingen , Tübingen, Germany
| | - Annika Frahsa
- Institut für Sportwissenschaft, Universität Tübingen , Tübingen, Germany
| | - Ansgar Thiel
- Institut für Sportwissenschaft, Universität Tübingen , Tübingen, Germany
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15
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Affiliation(s)
- Annelies Wilder-Smith
- Institute of Social and Preventive Medicine, University of Berne, Berne, 3012, Switzerland.
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Berne, Berne, 3012, Switzerland
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16
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Sauter A, Herbert-Maul A, Abu-Omar K, Thiel A, Ziemainz H, Frahsa A, Linder S, Herrmann-Johns A. "For me, it's just a piece of freedom"-Increased empowerment through physical activity promotion among socially disadvantaged women. Front Public Health 2022; 10:867626. [PMID: 35968425 PMCID: PMC9363839 DOI: 10.3389/fpubh.2022.867626] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Community-based participatory research (CBPR) is an effective health promotion approach for reaching socially disadvantaged groups. However, there is limited evidence on how such interventions and their effects can be reproduced across time and place. The present study examines the effects of BIG (i.e., movement as an investment in health), a long-standing German CBPR project. Since 2005, BIG has aimed to empower women in difficult life situations to increase control over their health determinants and reduce social inequalities by promoting physical activity. One of BIG's key features is its implementation in several German municipalities since 2005. This study explores (a) whether participation could change women's empowerment, and (b) how increased empowerment affects other areas of women's lives. Methods With a total of 63 interviewees (i.e., 40 participating women, 7 trainers, 3 project coordinators, and 13 stakeholders), we conducted 53 semi-structured qualitative interviews in five BIG communities between 2007 and 2011. Some interviews were conducted with two people simultaneously. The interview guide contained questions on various dimensions of empowerment (e.g., project engagement, increased self-efficacy, and developed competencies). Framework analysis was used for the analytical process. Results BIG contributed to women's empowerment in various ways, including increased self-efficacy, social network promotion, competency development, and increased motivation to change physical activity behavior. Women who took on added tasks and became more involved in project planning also strengthened their organizational empowerment. Furthermore, increased empowerment had a positive influence on the women's quality of life, family, and professional lives. Conclusion The novel findings helped in understanding the effects of a complex empowerment-based approach that promoted physical activity among women in difficult life situations. Future research should focus on the long-term effects of these programs and their transferability to other sites. Further effort is necessary in the area of public health policy.
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Affiliation(s)
- Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Heiko Ziemainz
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Stephanie Linder
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
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Stock C, Dias S, Dietrich T, Frahsa A, Keygnaert I. Editorial: How can We Co-Create Solutions in Health Promotion With Users and Stakeholders? Front Public Health 2021; 9:773907. [PMID: 34957026 PMCID: PMC8692254 DOI: 10.3389/fpubh.2021.773907] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christiane Stock
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
| | - Sonia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa and Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - Timo Dietrich
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Southport, QLD, Australia
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ines Keygnaert
- Faculty of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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18
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Haigis D, Matting L, Wagner S, Sudeck G, Frahsa A, Thiel A, Eschweiler G, Nieß AM. Identification of Sarcopenic Obesity in German Nursing Home Residents-The Role of Body Composition and Malnutrition in the BaSAlt Cohort-Study. Nutrients 2021; 13:nu13113791. [PMID: 34836048 PMCID: PMC8625583 DOI: 10.3390/nu13113791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Sarcopenic obesity (SO) is a phenotype, which is defined by reduced muscle strength, muscle mass, and obesity. Limited mobility leads to increased sedentary behavior and decreased physical activity. Both sarcopenia and obesity are aggravated by these factors. In combination, SO is an additional challenge for the setting nursing home (NH). Previous studies have shown a low prevalence of residents with SO in comparable settings, such as community-dwelling. We hypothesize that the BaSAlt cohort also has a small proportion of residents with SO. Methods: For the analysis, 66 residents (women: 74.2%) aged ≥ 65 years from NH, were screened for SO based on EWGSOP2 specifications and cut-off values to classify obesity. Results: Severe sarcopenia was quantified in eleven residents (16.7%). The majority of sarcopenic residents were women (n = 10) compared to men (n = 1). However, no SO could be identified by assessment of body mass index, fat mass in percentage, and fat mass index. Conclusion: As expected, the setting-specific cohort showed a low number of SO. Furthermore, no case of SO was identified in our study. Sarcopenia was associated with an increased fat-free mass in NH residents. Nevertheless, sarcopenia and obesity play important roles in the preservation of residents’ health.
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Affiliation(s)
- Daniel Haigis
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Correspondence:
| | - Leon Matting
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Silas Wagner
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
| | - Gorden Sudeck
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Annika Frahsa
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Bern, 3012 Bern, Switzerland
| | - Ansgar Thiel
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
- Institute of Sport Science, Faculty of Economics and Social Sciences, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Gerhard Eschweiler
- Centre for Geriatric Medicine, Faculty of Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
| | - Andreas Michael Nieß
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany; (S.W.); (A.M.N.)
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (L.M.); (G.S.); (A.F.); (A.T.)
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19
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Thiel A, Sudeck G, Niess A, Eschweiler GW, Altmeier D, Haigis D, Pomiersky R, Schmid J, Frahsa A. BaSAlt - A mixed-methods study protocol on setting-based physical activity promotion and counseling in nursing homes. Contemp Clin Trials Commun 2021; 23:100828. [PMID: 34401598 PMCID: PMC8350408 DOI: 10.1016/j.conctc.2021.100828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/07/2021] [Accepted: 07/30/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction Physical activity (PA) is a major contributor to healthy aging. However, physical inactivity is prevalent among the elderly in Germany, particularly in institutionalized settings such as nursing homes. This paper aims to describe the study objectives, design, methods, assessment types, collection schedules and considerations for analyzing the data within the BaSAlt study on facilitators and barriers for PA promotion in nursing homes. Methods We designed the BaSAlt study as a participatory intervention study with multiple measurement points in six to eight nursing homes with a total of approx. 200 residents using four main modules: (1) setting-level analysis of physical activity patterns, physical activity-related climate and physical activity-related interaction with ‘significant others,’ and organizational facilitators and barriers to physical activity, (2) physical-activity related individual-level analysis of objective and self-reported physical activity and sedentary behavior, a geriatric assessment with established procedures, assessment of people's activity and health biographies (biographical mapping) as well as their motivational, subjective well-being and distress status, and (3) a counseling module that integrates counseling at the setting level as well as individual physical activity counseling for residents. In module (4) evaluation, the effects of integrated counseling with regard to the implementation of PA promotion strategies are analyzed. Discussion This study will extend our knowledge of physical activity promotion in German nursing homes. Its findings will inform governmental authorities, care professionals, and academics on how to reach a particular group, characterized by inactivity, multimorbidity, and a high prevalence of dementia, residing in nursing homes, a setting that will gain further relevance in the future.
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Affiliation(s)
- A Thiel
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - G Sudeck
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - A Niess
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - G W Eschweiler
- Centre for Geriatric Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - D Altmeier
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - D Haigis
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - R Pomiersky
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
| | - J Schmid
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - A Frahsa
- Institute of Sport Science, Eberhard Karls University of Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tübingen, Tübingen, Germany
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20
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Fleuren T, Thiel A, Frahsa A. Identification of Network Promoters in a Regional and Intersectoral Health Promotion Network: A Qualitative Social Network Analysis in Southern Germany. Int J Environ Res Public Health 2021; 18:ijerph18168372. [PMID: 34444123 PMCID: PMC8392189 DOI: 10.3390/ijerph18168372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 11/16/2022]
Abstract
Health in all policies is a key approach to promote health and calls for cooperation between diverse levels of government and different sectors. In this paper, we analyze how a network called ‘Healthy Region Plus’ in Southern Germany addresses intersectoral cooperation at city and county levels. We aim to analyze the different roles of actors involved in the network based on the promoter model. We conducted two socio-material network mappings based on the Net-map approach by Schiffer and Hauck. The analysis followed three steps: data visualization, descriptive analysis of network properties, and interpretation of findings. Our findings reveal a complex intersectoral cooperation structure, with county and city level clusters, with network members who act as diverse power, expert, process, or relationship promoters. We also identified certain relevant sectors not to be part of the network. We discuss that the success of the network depends on the members’ active participation in and their outreach beyond the existing network, between city and county levels, and across sectors to promote health and build health-promoting structures in the region.
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Affiliation(s)
- Tobias Fleuren
- Department of Social and Health Sciences of Sport, Institute of Sport Science, Eberhard Karls Universität Tübingen, 72070 Tübingen, Germany; (T.F.); (A.T.)
| | - Ansgar Thiel
- Department of Social and Health Sciences of Sport, Institute of Sport Science, Eberhard Karls Universität Tübingen, 72070 Tübingen, Germany; (T.F.); (A.T.)
| | - Annika Frahsa
- Department of Social and Health Sciences of Sport, Institute of Sport Science, Eberhard Karls Universität Tübingen, 72070 Tübingen, Germany; (T.F.); (A.T.)
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland
- Correspondence:
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21
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Frahsa A, Abel T, Gelius P, Rütten A. The capability approach as a bridging framework across health promotion settings: theoretical and empirical considerations. Health Promot Int 2021; 36:493-504. [PMID: 32989442 DOI: 10.1093/heapro/daaa076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Health promotion research has increasingly called for transdisciplinary approaches. Such calls ask for bridging frameworks that define comprehensive sets of health determinants and appropriately conceptualize the roles of population groups as well as other relevant actor groups in the co-production of health. This article aims to present the seminal capability approach by Sen and Nussbaum as a potentially suitable framework for such bridging endeavors to guide health promotion research. It highlights domains of the capability approach that appear to be particularly relevant to bridging diverse disciplines and settings. Such domains particularly refer to the agency of decisive actor groups (population groups, professionals, policymakers and researchers) as well as to the differentiation of personal, social and environmental conversion factors that disciplines define within their specific epistemologies and ontologies. The article uses empirical examples from a German research consortium that aimed to promote physical activity in five different settings while fostering cooperation and conceptual alignment between several academic disciplines and sub-disciplines to highlight benefits and challenges of using the capability approach as a bridging framework for transdisciplinary health promotion. We conclude that the capability approach might serve as bridging framework to guide future transdisciplinary research if partners involved continuously exchange to develop a shared understanding of the issues to be researched.
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Affiliation(s)
- Annika Frahsa
- Frahsa Institute of Sport Science, University of Tübingen, Wilhelmstr. 124, 72074 Tübingen
| | - Thomas Abel
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
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Haigis D, Pomiersky R, Altmeier D, Frahsa A, Sudeck G, Thiel A, Eschweiler G, Nieß AM. Feasibility of a Geriatric Assessment to Detect and Quantify Sarcopenia and Physical Functioning in German Nursing Home Residents-A Pilot Study. Geriatrics (Basel) 2021; 6:geriatrics6030069. [PMID: 34287326 PMCID: PMC8293077 DOI: 10.3390/geriatrics6030069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Entering into a nursing home leads to increased immobility and further reductions in physical and cognitive functioning. As a result, there is a risk of sarcopenia, which is characterized by loss of muscle strength, muscle mass and physical functioning. To our knowledge, the feasibility of sarcopenia screening has not yet been performed in the German nursing home setting. Methods: For sarcopenia screening, the specifications of EWGSOP2 were applied. The quantification of sarcopenia was performed according to the corresponding cut-off values. The collection of anthropometric data and the morbidity status were recorded. SARC-F, mini-mental state examination, Barthel Index, Short Physical Performance Battery and Timed Up and Go tests were implemented. Results: In one participant, severe sarcopenia could be identified. The quantification was not possible for four participants. A suspicion of sarcopenia was not confirmed in five participants. Only one person was able to perform all assessments. Conclusions: Sarcopenia screening according to EWGSOP2 presented satisfactory feasibility by nursing home residents. However, further tests to assess the physical functioning of the participants often could not be performed. Moreover, inconsistencies in individual assessments became apparent, leading to inconclusive analyses. The recording of sarcopenia prevalence in German nursing homes should be the goal of further research.
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Affiliation(s)
- Daniel Haigis
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Correspondence:
| | - Rebekka Pomiersky
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Dorotheé Altmeier
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Annika Frahsa
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland
| | - Gorden Sudeck
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Ansgar Thiel
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
- Institute of Sport Science, Eberhard Karls University of Tuebingen, 72074 Tübingen, Germany
| | - Gerhard Eschweiler
- Centre for Geriatric Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
| | - Andreas Michael Nieß
- Department of Sports Medicine, University Hospital of Tuebingen, 72076 Tübingen, Germany;
- Interfaculty Research Institute for Sport and Physical Activity, University of Tuebingen, 72074 Tübingen, Germany; (R.P.); (D.A.); (A.F.); (G.S.); (A.T.)
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Thiel A, Altmeier D, Frahsa A, Eschweiler GW, Nieß A, Sudeck G. Saving lives through life-threatening measures? The COVID-19 paradox of infection prevention in long-term care facilities. Eur Rev Aging Phys Act 2021; 18:11. [PMID: 34154523 PMCID: PMC8215307 DOI: 10.1186/s11556-021-00265-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/31/2021] [Indexed: 11/15/2022] Open
Abstract
The current SARS Cov-2 infection control measures have paradoxical effects. On the one hand, the lockdown measures help to protect vulnerable populations in particular. On the other hand, these measures inevitably have the effect that those who are to be protected not only become socially isolated and are exposed to enormous psychological stress, but also break down physically due to inactivity. Thus, the activation that is omitted in the lockdown is not compensated by external reference groups, which also indicates that important conditions for healthy ageing are not given in long-term care facilities.
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Affiliation(s)
- Ansgar Thiel
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany. .,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany.
| | - Dorothee Altmeier
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Annika Frahsa
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Andreas Nieß
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany.,Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
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Abstract
The functionalisation of play basically stems from the diagnosis of a global childhood inactivity crisis, the so-called "children's obesity pandemic." Hence, in the context of the activity-related guidelines, children's play appears no longer to be unproductive and purpose-free. It is rather considered an anti-obesity tool that will help children to meet physical activity recommendations. It is questionable whether such a functionalised tool can also provide what has been called the salience of the pleasures of free-play for children. Furthermore, a "normalization" of functionalised practices of play, in turn, could stigmatize children who do not or cannot adhere to these practices. Based upon this background, this paper will take a critical sociology perspective to analyse the functionalisation and medicalisation of children's play in an individualized, mediatized, and pedagogised society. In this sense, the paper aims to pay attention to how the primary goal of play in the sense of "simply make children happy" has given way to the goal of making them healthy and functional.
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Affiliation(s)
- Annika Frahsa
- Institute of Sport Science, University of Tüebingen, Tuebingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tüebingen, Tuebingen, Germany
| | - Ansgar Thiel
- Institute of Sport Science, University of Tüebingen, Tuebingen, Germany.,Interfaculty Research Institute for Sport and Physical Activity, University of Tüebingen, Tuebingen, Germany
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Frahsa A, Farquet R, Bayram T, De Araujo L, Meyer S, Sakarya S, Cattacin S, Abel T. Experiences With Health Care Services in Switzerland Among Immigrant Women With Chronic Illnesses. Front Public Health 2020; 8:553438. [PMID: 33194954 PMCID: PMC7608491 DOI: 10.3389/fpubh.2020.553438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 09/10/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Descriptive data indicate a high burden of chronic illness among immigrant women in Switzerland. Little is known about how immigrant women with chronic illnesses experience healthcare services. This paper presents a methodological approach theoretically informed by Sen's capability approach and Levesque's framework of access to healthcare to study patient-reported experiences (PREs) of Swiss healthcare services among immigrant women with chronic conditions. Methods: We conducted 48 semi-structured qualitative interviews in Bern and Geneva with Turkish (n = 12), Portuguese (n = 12), German (n = 12), and Swiss (n = 12) women. Participants were heterogenous in age, length of stay, SES, and educational attainment, illness types and history. We also conducted semi-structured interviews with healthcare and social service providers (n = 12). Interviewed women participated in two focus group discussions (n = 15). Interviews were transcribed verbatim and analyzed using Atlas.ti software, based on Gale et al.'s framework approach. Findings informed three stakeholder dialogues in which women as well as healthcare providers and policymakers from various territorial levels participated. Results: Our methodological approach succeeded in integrating women's perspectives-from initial data collection in interviews to identify issues, focus group discussions to increase rigor, and stakeholder dialogues to develop tailored recommendations based on PREs. Discussion: This is one of the first studies in Switzerland that used PREs to research healthcare services and healthcare needs among immigrant women with chronic illnesses. This paper provides new insights on how to better understand existing challenges and potentially improve access to and quality of care.
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Affiliation(s)
- Annika Frahsa
- Institute of Sport Science, University of Tübingen, Tübingen, Germany
| | - Romaine Farquet
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Tevfik Bayram
- School of Medicine, Department of Public Health, Marmara University, Istanbul, Turkey
| | - Luna De Araujo
- Institut de Recherches Sociologiques, Université de Genève, Geneva, Switzerland
| | - Sophie Meyer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sibel Sakarya
- School of Medicine, Department of Public Health, Koç University, Istanbul, Turkey
| | - Sandro Cattacin
- Institut de Recherches Sociologiques, Université de Genève, Geneva, Switzerland
| | - Thomas Abel
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Frahsa A, Altmeier D, John JM, Gropper H, Granz H, Pomiersky R, Haigis D, Eschweiler GW, Nieß AM, Sudeck G, Thiel A. "I Trust in Staff's Creativity"-The Impact of COVID-19 Lockdowns on Physical Activity Promotion in Nursing Homes Through the Lenses of Organizational Sociology. Front Sports Act Living 2020; 2:589214. [PMID: 33345161 PMCID: PMC7739680 DOI: 10.3389/fspor.2020.589214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/28/2020] [Indexed: 12/26/2022] Open
Abstract
Objectives: The health-enhancing benefits or regular physical activity (PA) reach into old age. With the emergence of the coronavirus disease of 2019 (COVID-19) pandemic and the associated national lockdowns and restrictions, nursing home residents were restrained from being physically active. In our study, we aimed to assess the impact of the COVID-19-related restrictions on PA promotion in nursing homes from an organizational-sociological lens. Methods: We collected data in eight nursing homes in Germany. Data collection included (i) semistructured interviews focusing on COVID-19-related restrictions and their effects on nursing homes from the home administrators' perspectives; (ii) open-ended surveys with nursing home staff and relatives focusing on daily routines and contact restrictions; and (iii) collection of documents such as care concepts, mission statements, and weekly activity plans. We analyzed all data with a reflexive thematic analysis approach. Results: We identified three stages of COVID-19-related changes in nursing homes that impacted PA promotion, as follows: (1) external closure and search for emergency control, (2) organizational adaptations to create a livable daily life in the internal environment, and (3) slow reintegration of interactions with the external organizational environment. Document analysis revealed that PA promotion was not part of decision programs or internal staff work descriptions. Rather, PA promotion was delegated to external service providers. The assignment of PA promotion to external providers was not structurally anchored in decision programs, which makes PA promotion not sustainable, particularly during unforeseen events that limit access to the organization. During the pandemic, executive staff believed in internal staff to buffer competencies with regard to PA promotion. Thus, executive staff often considered PA promotion relevant, even during the pandemic, but thought that PA promotion is a task that can be fulfilled by unqualified but motivated internal staff. Conclusion: While our study participants showed a high level of coping-capacity belief, it remains unclear which long-term impacts of COVID-19 on PA promotion in nursing homes are to be expected. At the practice level, executive staff in nursing homes that aim to promote PA within their organization should become aware that PA promotion needs to be incorporated into organizational structures to be implemented and continued in challenging times such as in a pandemic.
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Affiliation(s)
- Annika Frahsa
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Dorothee Altmeier
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Jannika M. John
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Hannes Gropper
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Hanna Granz
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Rebekka Pomiersky
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Daniel Haigis
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | | | - Andreas M. Nieß
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
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Herbert-Maul A, Abu-Omar K, Frahsa A, Streber A, Reimers AK. Transferring a Community-Based Participatory Research Project to Promote Physical Activity Among Socially Disadvantaged Women-Experiences From 15 Years of BIG. Front Public Health 2020; 8:571413. [PMID: 33072709 PMCID: PMC7542241 DOI: 10.3389/fpubh.2020.571413] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/18/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Community-based participatory research (CBPR) is an effective approach to health promotion, especially in relation to socially disadvantaged groups. However, the long-term implementation of CPBR-based projects on a broad scale is often challenging, and research regarding the sustainable transfer of participatory research is lacking. This limits the scaling-up and public health impact of CBPR. Therefore, this study examines the mechanisms utilized to transfer and sustain the BIG project, a multifaceted CBPR project aimed at promoting physical activity among women in difficult life situations. Materials and Methods: Borrowing from the RE-AIM framework, we analyzed project documentation and conducted a reflection workshop to investigate methods of transferring BIG to new sites as well as strategies from researchers to support project implementation and the maintenance of program activities at those sites. Moreover, we analyzed the reasons for discontinuing program activities at some former BIG sites and the costs involved in transferring BIG. Results: Since its establishment in 2005, BIG was transferred to and implemented at 17 sites. As of the winter of 2019, the program activities were maintained at eight sites. The average duration of sites that continue to offer program activities was more than 9 years. Discontinued sites maintained project activities for an average of 4 years. According to the study findings, the extent of scientific support, the provision of seed funding, and the local project coordinator, the person managing the project at the site, all have a significant impact on the sustainability of the transfer. A patchwork of funding agencies was needed to finance scientific support and seed funding in BIG. The transfer of BIG projects accrued annual costs of approximately EUR20,000 per site; however, long-term project implementation resulted in a decline in the annual transfer costs of BIG. Discussion and Conclusion: The sustainable transfer of CBPR is challenging but possible, and increased support of research and seed funding can facilitate long-term transfer. Nevertheless, other factors in the implementation setting are beyond scientific control. With scarce financial resources, researchers need to carefully balance the efforts of the sustainability and transfer of CBPR projects. To address this issue, there is a need for further research into the interrelationship of the sustainability and transfer of CBPR projects as well as increased long-term funding.
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Affiliation(s)
- Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany
| | - Annika Frahsa
- Institute of Sports Science, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Anna Streber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany
| | - Anne K Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany
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Frahsa A, Streber A, Wolff AR, Rütten A. Capabilities for Physical Activity by Turkish- and Russian-Speaking Immigrants Aged 65 Years and Older in Germany: A Qualitative Study. J Aging Phys Act 2020; 28:567-579. [PMID: 31914420 DOI: 10.1123/japa.2018-0446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 11/18/2022]
Abstract
This study builds upon Sen's seminal capability approach to analyze the interplay of individual and structural factors for immigrants' physical activity (PA) in old age. The authors conducted software-assisted thematic analysis of group interviews with Turkish- and Russian-speaking immigrants aged 65 years and older in Germany (n = 19). The authors present how interviewees perceive diverse resources, environmental, social, and individual factors that shape their capabilities for PA. Age-related health literacy, family support, and access rules to sport opportunities shape both groups' capabilities for PA. Turkish interviewees' continuous bilocation and Russian interviewees' past experience with PA as workplace exercise are two major differences between those groups. Results indicate that capabilities are ambiguous-managed and shaped by individuals, which makes more static terms like barriers and options less helpful for an analysis. Systematically applying the capability approach in intervention research would allow to analyze interaction and to ultimately better reach underserved groups like immigrants 65 years and older.
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Frahsa A, Farquet R, Abel T. The co-design approach in the MIWOCA project. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
MIWOCA study group
Background
The project MIWOCA researches how chronically ill women of Portuguese, Turkish and German origin and women without a migration background subjectively experience, understand, interpret and use the Swiss health care system.
Methods
We conducted 48 qualitative semi-structured interviews with chronically ill women between the ages of 23 and 85 in Bern and Geneva (n = 36 with German, Portuguese and Turkish migrant backgrounds) and n = 12 Swiss women. In addition, n = 12 stakeholder interviews were conducted (doctors, nurses, social workers, psychologists, physiotherapists). In focus groups with interviewed women in Bern and Geneva, results are reflected back, identified topics from the interviews prioritized and representatives named for the cooperative planning. In a participatory planning approach, affected women in the canton of Bern, together with stakeholders from the Swiss healthcare system selected by a systematic stakeholder analysis (e.g. Swiss Medical Association, Red Cross Switzerland, Spitex, Federal Office of Public Health), develop recommendations for improving the quality of care and concrete dissemination strategies.
Results
Interviewees had multiple and chronic diseases and resulting extensive experience with the Swiss healthcare system. Relevant aspects referred to issues such as quality of specific services, complexity of the healthcare system, costs of care, role of family and social support, and multidimensional stigmatization (migration, chronic illness, alleged overuse of the care system). Findings are incorporated in evidence briefs and narrative stories for focus groups and participatory planning.
Conclusions
MIWOCA contributes to a targeted and differentiated improvement of structures and options for action in health care for specific groups. Results will be relevant for planning in the health system and may be incorporated into academic teaching and practical training in PH, medicine and social sciences.
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Affiliation(s)
- A Frahsa
- Institute of Sport Science, University of Tübingen, Tübingen, Germany
| | - R Farquet
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - T Abel
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Rütten A, Frahsa A, Abel T, Bergmann M, de Leeuw E, Hunter D, Jansen M, King A, Potvin L. Co-producing active lifestyles as whole-system-approach: theory, intervention and knowledge-to-action implications. Health Promot Int 2019; 34:47-59. [PMID: 28973298 DOI: 10.1093/heapro/dax053] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Population health interventions tend to lack links to the emerging discourse on interactive knowledge production and exchange. This situation may limit both a better understanding of mechanisms that impact health lifestyles and the development of strategies for population level change. This paper introduces an integrated approach based on structure-agency theory in the context of 'social practice'. It investigates the mechanisms of co-production of active lifestyles by population groups, professionals, policymakers and researchers. It combines a whole system approach with an interactive knowledge-to-action strategy for developing and implementing active lifestyle interventions. A system model is outlined to describe and explain how social practices of selected groups co-produce active lifestyles. Four intervention models for promoting the co-production of active lifestyles through an interactive-knowledge-to-action approach are discussed. Examples from case studies of the German research network Capital4Health are used to illustrate, how intervention models might be operationalized in a real-world intervention. Five subprojects develop, implement and evaluate interventions across the life-course. Although subprojects differ with regard to settings and population groups involved, they all focus on the four key components of the system model. The paper contributes new strategies to address the intervention research challenge of sustainable change of inactive lifestyles. The interactive approach presented allows consideration of the specificities of settings and scientific contexts for manifold purposes. Further research remains needed on what a co-produced knowledge-to-action agenda would look like and what impact it might have for whole system change.
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Affiliation(s)
- Alfred Rütten
- Institute of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany
| | - Annika Frahsa
- Institute of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany
| | - Thomas Abel
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Matthias Bergmann
- Institute for Social-Ecological Research, Frankfurt a. Main, Germany
| | - Evelyne de Leeuw
- Centre for Health Equity Training Research and Evaluation (CHETRE), University of New South Wales, Sydney, Australia
| | - David Hunter
- Centre for Public Policy and Health, Durham University, Durham, UK
| | - Maria Jansen
- School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Abby King
- School of Medicine, Stanford University, Stanford, USA
| | - Louise Potvin
- Department of Social and Preventive Medicine, University of Montréal, Montréal, Canada
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Schultze M, Frahsa A, Gelius P, Schätzlein V, Messing S, Rütten A. Transdisziplinäre Aushandlungsprozesse unter WissenschaftlerInnen im Forschungsverbund „Capital4Health – Capabilites for active lifestyles“. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M Schultze
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - A Frahsa
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - P Gelius
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - V Schätzlein
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - S Messing
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - A Rütten
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
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Frahsa A, Rütten A. Herausforderungen und Lösungen bei der Förderung von Handlungsmöglichkeiten für aktive Lebensstile in einem Netzwerk zum interaktiven Wissensaustausch in der Gesundheitsförderungsforschung. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wolff A, Majzik Z, Frahsa A, Rütten A. Wissenschafts-Praxis-Partnerschaften – was stärkt wen? Welche Strukturentwicklung findet statt? Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1387069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Frahsa A, Rütten A. Comparative analysis and specifies of contexts in physical activity behaviour,- supportive environments, community action, and policy in eight EU Member States. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rütten A, Frahsa A, Rosenhäger N, Wolff A. [Structural Change, Contextuality, and Transfer in Health Promotion--Sustainable Implementation of the BIG Project]. Gesundheitswesen 2013; 77 Suppl 1:S135-6. [PMID: 23572467 DOI: 10.1055/s-0032-1331736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The BIG approach aims at promoting physical activity and health among socially disadvantaged women. BIG has been developed and sustainably implemented in Erlangen/Bavaria. Subsequently, it has been transferred to other communities and states in Germany. Crucial factors for sustainability and transfer in BIG are (1) lifestyle and policy analysis, (2) assets approach, (3) empowerment of target group, (4) enabling of policy-makers and professionals.
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Affiliation(s)
- A Rütten
- Institut für Sportwissenschaft und Sport Arbeitsbereich Public Health und Bewegung, Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - A Frahsa
- Institut für Sportwissenschaft und Sport Arbeitsbereich Public Health und Bewegung, Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - N Rosenhäger
- Institut für Sportwissenschaft und Sport Arbeitsbereich Public Health und Bewegung, Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - A Wolff
- Institut für Sportwissenschaft und Sport Arbeitsbereich Public Health und Bewegung, Friedrich-Alexander-Universität Erlangen-Nürnberg
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Walter U, Nöcker G, Plaumann M, Linden S, Pott E, Koch U, Pawils S, Altgeld T, Dierks ML, Frahsa A, Jahn I, Krauth C, Pomp M, Rehaag R, Robra BP, Süß W, Töppich J, Trojan A, von Unger H, Wildner M, Wright M. [Memorandum prevention research - research areas and methods]. Gesundheitswesen 2012; 74:e99-e113. [PMID: 23165608 DOI: 10.1055/s-0032-1327759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
From 2004 to 2012, the German Ministry of Education and Research (BMBF) established its first funding programme for the promotion of prevention research. 60 projects on primary prevention and health promotion and the meta-project entitled "Cooperation for Sustainable Prevention Research" (KNP) received BMBF grants under this programme during this period. The experience and knowledge gained and recommendations arising from the research funded under this programme are compiled in memorandum format. The "Memorandum on Prevention Research - Research Areas and Methods" highlights 5 research areas that are considered to be especially relevant from the perspective of the involved scientists and practice partners.The promotion of structural development and sustainability enhancement in disease prevention and health promotion are central areas that should branch out from existing nuclei of crystallization. Improving the health competence of the population and of specific subpopulations is another major area. Research in these areas should contribute to the development of theoretical concepts and to the empirical testing of these concepts. The transfer of knowledge for effective use of developed disease prevention and health promotion programmes and measures is still a scarcely researched area. Among other things, studies of the transfer of programmes from one context to another, analyses of the coop-eration between politics and science, and the continued theoretical and conceptual development of transfer research are needed. Long-term data on the effects of intervention studies are also needed for proper evaluation of sustainability. The latter dem-onstrates the importance of method development in disease prevention and health promotion research as an area that should receive separate funding and support. This research should include, in particular, studies of the efficacy of complex interventions, health economic analyses, and participative health research.
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Affiliation(s)
- U Walter
- Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Hannover.
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Frahsa A, Rütten A, Roeger U, Abu-Omar K, Schow D. Enabling the powerful? Participatory action research with local policymakers and professionals for physical activity promotion with women in difficult life situations. Health Promot Int 2012; 29:171-84. [PMID: 22987843 DOI: 10.1093/heapro/das050] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Enabling is a concept central to health promotion. It is perceived as a mechanism that can help people gain control over determinants of health. Little is known, however, about enabling among policy-makers and professionals. This case study investigates enabling among policy-makers and professionals who engaged in a specific participatory approach, cooperative planning. We define 'enabling' as creating action situations that allow policy-makers and professionals to (i) build individual capacities for health promotion and to (ii) apply these capacities to concrete organizational and political action at the institutional level. This case study followed policy-makers and professionals as they participated in a local physical activity promotion action research project in Germany. We conducted a secondary analysis of qualitative data gathered in that project (2005-2011). Methods included participant observation, document analysis, focus groups and qualitative interviews. All data were revisited for the case study and analyzed using qualitative content analysis. Findings include examples of enabling among policy-makers and professionals related to the cooperative planning process. Individual capacities were developed in perceived project roles, interactions with target groups and decision-making procedures. Findings also demonstrated municipal policy changes. Access to physical activity infrastructures improved, and an intersectoral job position was funded to support physical activity promotion among target group participants. Findings were analyzed using a model that links cooperative planning with a framework on policy change from a political science perspective. We conclude that cooperative planning might be a pathway to negotiated agreements that foster systematic enabling and health-promoting policy change.
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Frahsa A, Rütten A, Abu-Omar K, Wolff A. Movement as Investment for Health: integrated evaluation in participatory physical activity promotion among women in difficult life situations. Glob Health Promot 2011; 18:31-3. [PMID: 21721298 DOI: 10.1177/1757975910393168] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Movement as Investment for Health (Bewegung als Investition in Gesundheit or BIG) was a multidimensional research study in participatory physical activity promotion among socially disadvantaged women in a deprived neighbourhood in Erlangen, Germany. It aimed at making full use of health-promoting effects of movement and developing integrated evaluation through approaches from different disciplines. We defined the target population through national health survey data, and determined important intervention and evaluation dimensions through meta-analyses. A co-operative planning group of women, researchers, policy-makers, and local experts made decisions on the most appropriate procedures. Integrated evaluation in participatory approaches is promising. It calls for context-specific evaluation, requires adaptation of existing approaches or even development of its own evidence base.
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Affiliation(s)
- Annika Frahsa
- Institute of Sport Science and Sport, Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Germany.
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Frahsa A, Rütten A. Wer wird hier befähigt? Zum Einfluss partizipativer Ansätze in der Gesundheitsförderung auf politische Entscheidungsträger(innen) und lokale Expert(inn)en. Gesundheitswesen 2011. [DOI: 10.1055/s-0031-1283454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Rütten A, Abu-Omar K, Frahsa A, Morgan A. Assets for policy making in health promotion: overcoming political barriers inhibiting women in difficult life situations to access sport facilities. Soc Sci Med 2009; 69:1667-73. [PMID: 19800160 DOI: 10.1016/j.socscimed.2009.09.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Indexed: 10/20/2022]
Abstract
Although the need for intersectoral policy making in health promotion has been commonplace and a high priority for several decades, there is still a lack of appropriate methods available to assess the inputs, processes, and outcomes associated with the effectiveness of such approaches, particularly in relation to sectors outside of health. This paper demonstrates how asset based models to intersectoral policy making in health promotion can improve the effectiveness of projects aiming to improve health and related outcomes. In particular, it summarises how asset based approaches to the planning and implementation of health promotion programmes can be used to develop our methods for assessing intersectorial actions. The paper is based on the findings from a local neighbourhood project based in Erlangen, Germany, aiming to improve the opportunities for physical activity among women in difficult life situations. The neighbourhood was characterised by high rates of unemployment, social welfare recipients, and migrants. Ethnographic methods enabled us to highlight the range of health related assets available in the neighbourhood which could be activated to improve access to and uptake of physical activity amongst the target population. Results indicate that intersectoral policies seeking to improve health outcomes, are more likely to be successful if they maximise the opportunities for making the most of the assets that exist in individuals, communities and organisations. This study demonstrates how the asset model was used to create the supportive environments which facilitated women from the target population to work with policy makers on an equal footing. Their involvement in project planning and implementation helped to achieve the structural changes required to achieve the aims of the project. These included the establishment of a new job position at the city office for sports and improved access to sport facilities for women in difficult life situations.
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Affiliation(s)
- Alfred Rütten
- Institute of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Germany.
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Rütten A, Frahsa A, Abu-Omar K, Röger U. Teilhabe und Befähigung von Frauen in schwierigen Lebenslagen durch BIG – einem Projekt zur Gesundheitsförderung durch Sport und Bewegung. Gesundheitswesen 2009. [DOI: 10.1055/s-0029-1239066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rütten A, Röger U, Abu-Omar K, Frahsa A. Assessment of organizational readiness for health promotion policy implementation: test of a theoretical model. Health Promot Int 2009; 24:243-51. [PMID: 19493861 DOI: 10.1093/heapro/dap016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Models explaining the engagement of organizations in different policy sectors in health promotion policy implementation often utilize retrospective data. The current study attempted to model determinants of organizational readiness (goals, resources, obligation, opportunities) in supporting health policy implementation prospectively. Twenty qualitative interviews with representatives of organizations from different policy sectors, levels of government and organizational legal entities were conducted at the beginning of a project for the promotion of physical activity among women in difficult life situations. Organizational support in developing, implementing and disseminating the project was documented over 36 months. Results indicated that in most organizations, determinants were not favorable for health promotion policy action for physical activity among women in difficult life situations. Six organizations did not report any favorable determinant, and two organizations reported four. The other 12 organizations reported positive results for some of the determinants. Project work received support from 6 out of the 20 organizations. A case study of three organizations indicated that engagement or disengagement of organizations in health promotion policy actions might be partly explained by the theoretical model. The prospective assessment of organizational readiness in implementing health promotion policy is highly relevant for health promotion. Considering the proposed theoretical framework may aid in advancing our understanding of factors that are related to organizational engagement in health promotion actions.
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Affiliation(s)
- A Rütten
- Institute of Sport Science and Sport, University of Erlangen Nuremberg, Gebbertstrasse 123b, Erlangen 91058, Germany.
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Abstract
BIG is a project for the promotion of physical activity among women in difficult life situations. Following the main health promotion principles of the WHO, the women shall be enabled or empowered to take control of determinants of their health. A comprehensive participatory approach was applied and women were included in planning, implementing and evaluating the project. For measuring the effects of BIG on the empowerment of participating women, qualitative semi-structured interviews with 15 women participating in BIG were conducted. For data analysis, qualitative content analysis was used. Results showed the empowerment of the women on the individual level as they gained different competencies and perceived self-efficacy. These effects were supported through the empowerment process on the organizational and community levels where women gained control over their life situations and over policies influencing them. Therefore, the participatory approach of BIG is a key success factor for empowerment promotion of women in difficult life situations.
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Affiliation(s)
- A Rütten
- Institut für Sportwissenschaft und Sport, Universität Erlangen-Nürnberg.
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