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Schroé H, Crombez G, De Bourdeaudhuij I, Van Dyck D. Investigating When, Which, and Why Users Stop Using a Digital Health Intervention to Promote an Active Lifestyle: Secondary Analysis With A Focus on Health Action Process Approach–Based Psychological Determinants. JMIR Mhealth Uhealth 2022; 10:e30583. [PMID: 35099400 PMCID: PMC8845016 DOI: 10.2196/30583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/01/2021] [Accepted: 12/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background Digital health interventions have gained momentum to change health behaviors such as physical activity (PA) and sedentary behavior (SB). Although these interventions show promising results in terms of behavior change, they still suffer from high attrition rates, resulting in a lower potential and accessibility. To reduce attrition rates in the future, there is a need to investigate the reasons why individuals stop using the interventions. Certain demographic variables have already been related to attrition; however, the role of psychological determinants of behavior change as predictors of attrition has not yet been fully explored. Objective The aim of this study was to examine when, which, and why users stopped using a digital health intervention. In particular, we aimed to investigate whether psychological determinants of behavior change were predictors for attrition. Methods The sample consisted of 473 healthy adults who participated in the intervention MyPlan 2.0 to promote PA or reduce SB. The intervention was developed using the health action process approach (HAPA) model, which describes psychological determinants that guide individuals in changing their behavior. If participants stopped with the intervention, a questionnaire with 8 question concerning attrition was sent by email. To analyze when users stopped using the intervention, descriptive statistics were used per part of the intervention (including pre- and posttest measurements and the 5 website sessions). To analyze which users stopped using the intervention, demographic variables, behavioral status, and HAPA-based psychological determinants at pretest measurement were investigated as potential predictors of attrition using logistic regression models. To analyze why users stopped using the intervention, descriptive statistics of scores to the attrition-related questionnaire were used. Results The study demonstrated that 47.9% (227/473) of participants stopped using the intervention, and drop out occurred mainly in the beginning of the intervention. The results seem to indicate that gender and participant scores on the psychological determinants action planning, coping planning, and self-monitoring were predictors of first session, third session, or whole intervention completion. The most endorsed reasons to stop using the intervention were the time-consuming nature of questionnaires (55%), not having time (50%), dissatisfaction with the content of the intervention (41%), technical problems (39%), already meeting the guidelines for PA/SB (31%), and, to a lesser extent, the experience of medical/emotional problems (16%). Conclusions This study provides some directions for future studies. To decrease attrition, it will be important to personalize interventions on different levels, questionnaires (either for research purposes or tailoring) should be kept to a minimum especially in the beginning of interventions by, for example, using objective monitoring devices, and technical aspects of digital health interventions should be thoroughly tested in advance. Trial Registration ClinicalTrials.gov NCT03274271; https://clinicaltrials.gov/ct2/show/NCT03274271 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-019-3456-7
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Affiliation(s)
- Helene Schroé
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
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Compernolle S, De Cocker K, Cardon G, De Bourdeaudhuij I, Van Dyck D. Older Adults' Perceptions of Sedentary Behavior: A Systematic Review and Thematic Synthesis of Qualitative Studies. Gerontologist 2021; 60:572-582. [PMID: 31670766 DOI: 10.1093/geront/gnz127] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 07/03/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Reducing sedentary behavior contributes to healthy aging. In order to develop sedentary behavior interventions, insight is needed into older adults' perceptions of (reducing) sedentary behavior. Therefore, this systematic review aims to synthesize qualitative evidence of older adults' perceptions towards (a) the concept of sedentary behavior, (b) barriers and facilitators of sedentary behavior, and (c) solutions and strategies to reduce sedentary behavior. RESEARCH DESIGN AND METHODS A systematic search was conducted in four electronic databases. Inclusion criteria comprised qualitative and mixed-methods studies investigating the perceptions of older adults (mean age: ≥60 years) towards (reducing) sedentary behavior. Quality of the included studies was rated using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist. Relevant data on older adults' perceptions were extracted and imported into NVivo. Two independent reviewers analyzed the data by means of thematic synthesis (line-by-line coding, constructing descriptive (sub)themes, developing analytical themes). RESULTS Fifteen studies were included. Four analytical themes were developed to be considered when aiming to reduce sedentary behavior in older adults: the lack of knowledge on/awareness of sedentary behavior, the habitual nature of sedentary behavior, the importance of enjoyment and convenience, and the key role of aging. DISCUSSION AND IMPLICATIONS The reduction of older adults' sedentary behavior will likely be challenging as sedentary behavior seems to be firmly incorporated into older adults' daily routines, and strongly linked with positive reinforcement. Both aspects deserve thoughtful attention by intervention developers and health care professionals who aim to promote healthy aging by reducing sedentary behavior.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Australia
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
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Compernolle S, De Bourdeaudhuij I, Cardon G, Van Dyck D. Sex-specific typologies of older adults' sedentary behaviors and their associations with health-related and socio-demographic factors: a latent profile analysis. BMC Geriatr 2021; 21:66. [PMID: 33468055 PMCID: PMC7816402 DOI: 10.1186/s12877-021-02011-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/28/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some types of sedentary behaviors tend to cluster in individuals or groups of older adults. Insight into how these different types of sedentary behavior cluster is needed, as recent research suggests that not all types of sedentary behavior may have the same negative effects on physical and mental health. Therefore, the aim of this study was to identify sex-specific typologies of older adults' sedentary behavior, and to examine their associations with health-related and socio-demographic factors. METHODS Cross-sectional data were collected as part of the BEPAS Seniors, and the Busschaert study among 696 Flemish older adults (60+). Typologies of self-reported sedentary behavior were identified using latent profile analysis, and associations with health-related and sociodemographic factors were examined using analyses of variances. RESULTS Five distinct typologies were identified from seven sedentary behaviors (television time, computer time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in men, and three typologies were identified from six sedentary behaviors (television time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in women. Typologies that are characterized by high television time seem to be related to more negative health outcomes, like a higher BMI, less grip strength, and a lower physical and mental health-related quality-of-life. Typologies that are represented by high computer time and motorized transport seem to be related to more positive health outcomes, such as a lower body mass index, more grip strength and a higher physical and mental health-related quality-of-life. CONCLUSIONS Although causal direction between identified typologies and health outcomes remains uncertain, our results suggests that future interventions should better focus on specific types of sedentary behavior (e.g. television time), or patterns of sedentary behavior, rather than on total sedentary behavior.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
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Compernolle S, Cardon G, van der Ploeg HP, Van Nassau F, De Bourdeaudhuij I, Jelsma JJ, Brondeel R, Van Dyck D. Engagement, Acceptability, Usability, and Preliminary Efficacy of a Self-Monitoring Mobile Health Intervention to Reduce Sedentary Behavior in Belgian Older Adults: Mixed Methods Study. JMIR Mhealth Uhealth 2020; 8:e18653. [PMID: 33118951 PMCID: PMC7661260 DOI: 10.2196/18653] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 03/11/2020] [Revised: 07/07/2020] [Accepted: 10/15/2020] [Indexed: 12/18/2022] Open
Abstract
Background Although healthy aging can be stimulated by the reduction of sedentary behavior, few interventions are available for older adults. Previous studies suggest that self-monitoring might be a promising behavior change technique to reduce older adults’ sedentary behavior. However, little is known about older adults’ experiences with a self-monitoring–based intervention aimed at the reduction of sedentary behavior. Objective The aim of this study is to evaluate engagement, acceptability, usability, and preliminary efficacy of a self-monitoring–based mHealth intervention developed to reduce older adults’ sedentary behavior. Methods A mixed methods study was performed among 28 community-dwelling older adults living in Flanders, Belgium. The 3-week intervention consisted of general sedentary behavior information as well as visual and tactile feedback on participants’ sedentary behavior. Semistructured interviews were conducted to explore engagement with, and acceptability and usability of, the intervention. Sitting time was measured using the thigh-worn activPAL (PAL Technologies) accelerometer before and after the intervention. System usage data of the app were recorded. Quantitative data were analyzed using descriptive statistics and paired-samples t tests; qualitative data were thematically analyzed and presented using pen profiles. Results Participants mainly reported positive feelings regarding the intervention, referring to it as motivating, surprising, and interesting. They commonly reported that the intervention changed their thinking (ie, they became more aware of their sedentary behavior) but not their actual behavior. There were mixed opinions on the kind of feedback (ie, tactile vs visual) that they preferred. The intervention was considered easy to use, and the design was described as clear. Some problems were noticed regarding attaching and wearing the self-monitoring device. System usage data showed that the median frequency of consulting the app widely differed among participants, ranging from 0 to 20 times a day. No significant reductions were found in objectively measured sitting time. Conclusions Although the intervention was well perceived by the majority of older adults, no reductions in sitting time were found. Possible explanations for the lack of reductions might be the short intervention duration or the fact that only bringing the habitual sedentary behavior into conscious awareness might not be sufficient to achieve behavior change. Trial Registration ClinicalTrials.gov NCT04003324; https://tinyurl.com/y2p4g8hx
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | | | - Femke Van Nassau
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Judith J Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ruben Brondeel
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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Schroé H, Van Dyck D, De Paepe A, Poppe L, Loh WW, Verloigne M, Loeys T, De Bourdeaudhuij I, Crombez G. Which behaviour change techniques are effective to promote physical activity and reduce sedentary behaviour in adults: a factorial randomized trial of an e- and m-health intervention. Int J Behav Nutr Phys Act 2020; 17:127. [PMID: 33028335 PMCID: PMC7539442 DOI: 10.1186/s12966-020-01001-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [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: 04/22/2020] [Accepted: 07/22/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND E- and m-health interventions are promising to change health behaviour. Many of these interventions use a large variety of behaviour change techniques (BCTs), but it's not known which BCTs or which combination of BCTs contribute to their efficacy. Therefore, this experimental study investigated the efficacy of three BCTs (i.e. action planning, coping planning and self-monitoring) and their combinations on physical activity (PA) and sedentary behaviour (SB) against a background set of other BCTs. METHODS In a 2 (action planning: present vs absent) × 2 (coping planning: present vs absent) × 2 (self-monitoring: present vs absent) factorial trial, 473 adults from the general population used the self-regulation based e- and m-health intervention 'MyPlan2.0' for five weeks. All combinations of BCTs were considered, resulting in eight groups. Participants selected their preferred target behaviour, either PA (n = 335, age = 35.8, 28.1% men) or SB (n = 138, age = 37.8, 37.7% men), and were then randomly allocated to the experimental groups. Levels of PA (MVPA in minutes/week) or SB (total sedentary time in hours/day) were assessed at baseline and post-intervention using self-reported questionnaires. Linear mixed-effect models were fitted to assess the impact of the different combinations of the BCTs on PA and SB. RESULTS First, overall efficacy of each BCT was examined. The delivery of self-monitoring increased PA (t = 2.735, p = 0.007) and reduced SB (t = - 2.573, p = 0.012) compared with no delivery of self-monitoring. Also, the delivery of coping planning increased PA (t = 2.302, p = 0.022) compared with no delivery of coping planning. Second, we investigated to what extent adding BCTs increased efficacy. Using the combination of the three BCTs was most effective to increase PA (x2 = 8849, p = 0.003) whereas the combination of action planning and self-monitoring was most effective to decrease SB (x2 = 3.918, p = 0.048). To increase PA, action planning was always more effective in combination with coping planning (x2 = 5.590, p = 0.014; x2 = 17.722, p < 0.001; x2 = 4.552, p = 0.033) compared with using action planning without coping planning. Of note, the use of action planning alone reduced PA compared with using coping planning alone (x2 = 4.389, p = 0.031) and self-monitoring alone (x2 = 8.858, p = 003), respectively. CONCLUSIONS This study provides indications that different (combinations of) BCTs may be effective to promote PA and reduce SB. More experimental research to investigate the effectiveness of BCTs is needed, which can contribute to improved design and more effective e- and m-health interventions in the future. TRIAL REGISTRATION This study was preregistered as a clinical trial (ID number: NCT03274271 ). Release date: 20 October 2017.
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Affiliation(s)
- Helene Schroé
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium. .,Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
| | - Delfien Van Dyck
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Annick De Paepe
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
| | - Louise Poppe
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wen Wei Loh
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Geert Crombez
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium
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Degroote L, Hamerlinck G, Poels K, Maher C, Crombez G, De Bourdeaudhuij I, Vandendriessche A, Curtis RG, DeSmet A. Low-Cost Consumer-Based Trackers to Measure Physical Activity and Sleep Duration Among Adults in Free-Living Conditions: Validation Study. JMIR Mhealth Uhealth 2020; 8:e16674. [PMID: 32282332 PMCID: PMC7268004 DOI: 10.2196/16674] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 10/14/2019] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 12/29/2022] Open
Abstract
Background Wearable trackers for monitoring physical activity (PA) and total sleep time (TST) are increasingly popular. These devices are used not only by consumers to monitor their behavior but also by researchers to track the behavior of large samples and by health professionals to implement interventions aimed at health promotion and to remotely monitor patients. However, high costs and accuracy concerns may be barriers to widespread adoption. Objective This study aimed to investigate the concurrent validity of 6 low-cost activity trackers for measuring steps, moderate-to-vigorous physical activity (MVPA), and TST: Geonaut On Coach, iWown i5 Plus, MyKronoz ZeFit4, Nokia GO, VeryFit 2.0, and Xiaomi MiBand 2. Methods A free-living protocol was used in which 20 adults engaged in their usual daily activities and sleep. For 3 days and 3 nights, they simultaneously wore a low-cost tracker and a high-cost tracker (Fitbit Charge HR) on the nondominant wrist. Participants wore an ActiGraph GT3X+ accelerometer on the hip at daytime and a BodyMedia SenseWear device on the nondominant upper arm at nighttime. Validity was assessed by comparing each tracker with the ActiGraph GT3X+ and BodyMedia SenseWear using mean absolute percentage error scores, correlations, and Bland-Altman plots in IBM SPSS 24.0. Results Large variations were shown between trackers. Low-cost trackers showed moderate-to-strong correlations (Spearman r=0.53-0.91) and low-to-good agreement (intraclass correlation coefficient [ICC]=0.51-0.90) for measuring steps. Weak-to-moderate correlations (Spearman r=0.24-0.56) and low agreement (ICC=0.18-0.56) were shown for measuring MVPA. For measuring TST, the low-cost trackers showed weak-to-strong correlations (Spearman r=0.04-0.73) and low agreement (ICC=0.05-0.52). The Bland-Altman plot revealed a variation between overcounting and undercounting for measuring steps, MVPA, and TST, depending on the used low-cost tracker. None of the trackers, including Fitbit (a high-cost tracker), showed high validity to measure MVPA. Conclusions This study was the first to examine the concurrent validity of low-cost trackers. Validity was strongest for the measurement of steps; there was evidence of validity for measurement of sleep in some trackers, and validity for measurement of MVPA time was weak throughout all devices. Validity ranged between devices, with Xiaomi having the highest validity for measurement of steps and VeryFit performing relatively strong across both sleep and steps domains. Low-cost trackers hold promise for monitoring and measurement of movement and sleep behaviors, both for consumers and researchers.
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Affiliation(s)
- Laurent Degroote
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - Gilles Hamerlinck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Karolien Poels
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Carol Maher
- School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | | - Ann Vandendriessche
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Rachel G Curtis
- School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Ann DeSmet
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium.,Department of Clinical and Health Psychology, Université Libre de Bruxelles, Brussels, Belgium
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Sallis JF, Cerin E, Kerr J, Adams MA, Sugiyama T, Christiansen LB, Schipperijn J, Davey R, Salvo D, Frank LD, De Bourdeaudhuij I, Owen N. Built Environment, Physical Activity, and Obesity: Findings from the International Physical Activity and Environment Network (IPEN) Adult Study. Annu Rev Public Health 2020; 41:119-139. [PMID: 32237990 DOI: 10.1146/annurev-publhealth-040218-043657] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Creating more physical activity-supportive built environments is recommended by the World Health Organization for controlling noncommunicable diseases. The IPEN (International Physical Activity and Environment Network) Adult Study was undertaken to provide international evidence on associations of built environments with physical activity and weight status in 12 countries on 5 continents (n > 14,000). This article presents reanalyzed data from eight primary papers to identify patterns of findings across studies. Neighborhood environment attributes, whether measured objectively or by self-report, were strongly related to all physical activity outcomes (accelerometer-assessed total physical activity, reported walking for transport and leisure) and meaningfully related to overweight/obesity. Multivariable indexes of built environment variables were more strongly related to most outcomes than were single-environment variables. Designing activity-supportive built environments should be a higher international health priority. Results provide evidence in support of global initiatives to increase physical activity and control noncommunicable diseases while achieving sustainable development goals.
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Affiliation(s)
- James F Sallis
- Department of Family Medicine and Public Health, University of California, San Diego, California 92093, USA; ,
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria 3000, Australia; ,
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria 3000, Australia; ,
- School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, California 92093, USA; ,
| | - Marc A Adams
- College of Health Solutions, Arizona State University, Phoenix, Arizona 85004-2135, USA;
| | - Takemi Sugiyama
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria 3000, Australia; ,
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
| | - Lars B Christiansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, DK-5230 Odense, Denmark; ,
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, DK-5230 Odense, Denmark; ,
| | - Rachel Davey
- Health Research Institute, University of Canberra, Bruce, Australian Capital Territory 2617, Australia;
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA;
| | - Lawrence D Frank
- Health and Community Design Lab, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
- Urban Design 4 Health, Inc., Rochester, New York 14612, USA;
| | | | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia;
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Gibson EL, Androutsos O, Moreno L, Flores-Barrantes P, Socha P, Iotova V, Cardon G, De Bourdeaudhuij I, Koletzko B, Skripkauskaite S, Manios Y. Influences of Parental Snacking-Related Attitudes, Behaviours and Nutritional Knowledge on Young Children's Healthy and Unhealthy Snacking: The ToyBox Study. Nutrients 2020; 12:nu12020432. [PMID: 32046193 PMCID: PMC7071198 DOI: 10.3390/nu12020432] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 12/29/2019] [Revised: 01/23/2020] [Accepted: 02/04/2020] [Indexed: 12/25/2022] Open
Abstract
This study investigated parental influences on preschool children's healthy and unhealthy snacking in relation to child obesity in a large cross-sectional multinational sample. Parents and 3-5 year-old child dyads (n = 5185) in a kindergarten-based study provided extensive sociodemographic, dietary practice and food intake data. Parental feeding practices that were derived from questionnaires were examined for associations with child healthy and unhealthy snacking in adjusted multilevel models, including child estimated energy expenditure, parental education, and nutritional knowledge. Parental healthy and unhealthy snacking was respectively associated with their children's snacking (both p < 0.0001). Making healthy snacks available to their children was specifically associated with greater child healthy snack intake (p < 0.0001). Conversely, practices that were related to unhealthy snacking, i.e., being permissive about unhealthy snacking and acceding to child demands for unhealthy snacks, were associated with greater consumption of unhealthy snacks by children, but also less intake of healthy snacks (all p < 0.0001). Parents having more education and greater nutritional knowledge of snack food recommendations had children who ate more healthy snacks (all p < 0.0001) and fewer unhealthy snacks (p = 0.002, p < 0.0001, respectively). In the adjusted models, child obesity was not related to healthy or unhealthy snack intake in these young children. The findings support interventions that address parental practices and distinguish between healthy and unhealthy snacking to influence young children's dietary patterns.
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Affiliation(s)
- Edward Leigh Gibson
- Department of Psychology, University of Roehampton, London SW15 4JD, UK;
- Correspondence:
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Luis Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Paloma Flores-Barrantes
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Piotr Socha
- The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Berthold Koletzko
- Dr von Hauner Children’s Hospital, LMU-Ludwig-Maximilians-University at Munich, D-80337 Munich, Germany;
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
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9
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DeSmet A, De Bourdeaudhuij I, Chastin S, Crombez G, Maddison R, Cardon G. Adults' Preferences for Behavior Change Techniques and Engagement Features in a Mobile App to Promote 24-Hour Movement Behaviors: Cross-Sectional Survey Study. JMIR Mhealth Uhealth 2019; 7:e15707. [PMID: 31859680 PMCID: PMC6942183 DOI: 10.2196/15707] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 07/31/2019] [Revised: 10/13/2019] [Accepted: 10/20/2019] [Indexed: 01/03/2023] Open
Abstract
Background There is a limited understanding of components that should be included in digital interventions for 24-hour movement behaviors (physical activity [PA], sleep, and sedentary behavior [SB]). For intervention effectiveness, user engagement is important. This can be enhanced by a user-centered design to, for example, explore and integrate user preferences for intervention techniques and features. Objective This study aimed to examine adult users’ preferences for techniques and features in mobile apps for 24-hour movement behaviors. Methods A total of 86 participants (mean age 37.4 years [SD 9.2]; 49/86, 57% female) completed a Web-based survey. Behavior change techniques (BCTs) were based on a validated taxonomy v2 by Abraham and Michie, and engagement features were based on a list extracted from the literature. Behavioral data were collected using Fitbit trackers. Correlations, (repeated measures) analysis of variance, and independent sample t tests were used to examine associations and differences between and within users by the type of health domain and users’ behavioral intention and adoption. Results Preferences were generally the highest for information on the health consequences of movement behavior self-monitoring, behavioral feedback, insight into healthy lifestyles, and tips and instructions. Although the same ranking was found for techniques across behaviors, preferences were stronger for all but one BCT for PA in comparison to the other two health behaviors. Although techniques fit user preferences for addressing PA well, supplemental techniques may be able to address preferences for sleep and SB in a better manner. In addition to what is commonly included in apps, sleep apps should consider providing tips for sleep. SB apps may wish to include more self-regulation and goal-setting techniques. Few differences were found by users’ intentions or adoption to change a particular behavior. Apps should provide more self-monitoring (P=.03), information on behavior health outcome (P=.048), and feedback (P=.04) and incorporate social support (P=.048) to help those who are further removed from healthy sleep. A virtual coach (P<.001) and video modeling (P=.004) may provide appreciated support to those who are physically less active. PA self-monitoring appealed more to those with an intention to change PA (P=.03). Social comparison and support features are not high on users’ agenda and may not be needed from an engagement point of view. Engagement features may not be very relevant for user engagement but should be examined in future research with a less reflective method. Conclusions The findings of this study provide guidance for the design of digital 24-hour movement behavior interventions. As 24-hour movement guidelines are increasingly being adopted in several countries, our study findings are timely to support the design of interventions to meet these guidelines.
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Affiliation(s)
- Ann DeSmet
- Clinical and Health Psychology, Université Libre de Bruxelles, Brussels, Belgium.,Research Foundation - Flanders, Brussels, Belgium.,Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | | | - Sebastien Chastin
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.,Glasgow Caledonian University, Glasgow, United Kingdom
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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10
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Van Stappen V, De Lepeleere S, Huys N, Latomme J, Verloigne M, Cardon G, Androutsos O, Manios Y, De Bourdeaudhuij I, De Craemer M. Effect of integrating a video intervention on parenting practices and related parental self-efficacy regarding health behaviours within the Feel4Diabetes-study in Belgian primary schoolchildren from vulnerable families: A cluster randomized trial. PLoS One 2019; 14:e0226131. [PMID: 31826024 PMCID: PMC6905545 DOI: 10.1371/journal.pone.0226131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/19/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effect of integrating a video intervention "Movie Models" within the Feel4Diabetes-study on specific parenting practices and related parental self-efficacy regarding children's physical activity, screen-time and eating behaviour in vulnerable families (i.e. families living in low socioeconomic municipalities and at risk for developing type 2 diabetes). Additionally, there was examination of how the intervention was perceived by the parents. METHODS Within randomly selected low socioeconomic municipalities in Belgium, families were recruited through primary schools. Families at risk for developing type 2 diabetes were identified using the FINDRISC questionnaire (n = 457). Afterwards, the municipalities were randomly assigned to the intervention or control condition. At risk families assigned to the intervention group were invited to participate in six Feel4Diabetes counselling sessions in which families were encouraged to adopt a healthier lifestyle. The "Movie Models" videos were integrated within two sessions by using a face-to-face group discussion approach. Parenting-related factors were assessed before and after the integration of the videos, using a questionnaire. After integrating the videos, some extra evaluation questions were assessed. In total, 126 families were included in a per protocol evaluation and Repeated Measures ANOVAs were conducted to evaluate the potential intervention effects. RESULTS Some favourable intervention effects were found on parenting practices and related parental self-efficacy regarding children's eating behaviours, however almost no effects were found on parenting-related factors regarding children's physical activity and screen-time. In total, 60.0% of the participants indicated that they applied tips regarding parenting practices and 52.0% indicated that discussions with other participants regarding the videos were useful for them. CONCLUSION The integration of "Movie Models" within the Feel4Diabetes-study was effective in improving some parenting-related factors regarding children's health behaviours, however most parenting-related factors could not be improved. The implementation of "Movie Models" as a face-to-face group discussion approach was relatively well received and may be a promising way to improve parenting-related factors in vulnerable families. TRIAL REGISTRATION ClinicalTrials.gov NCT02278809.
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Affiliation(s)
- Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Sara De Lepeleere
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Nele Huys
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Maïté Verloigne
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Kallithea, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Kallithea, Athens, Greece
| | | | - Marieke De Craemer
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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11
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Mitáš J, Cerin E, Reis RS, Conway TL, Cain KL, Adams MA, Schofield G, Sarmiento OL, Christiansen LB, Davey R, Salvo D, Orzanco-Garralda R, Macfarlane D, Hino AAF, De Bourdeaudhuij I, Owen N, Van Dyck D, Sallis JF. Do associations of sex, age and education with transport and leisure-time physical activity differ across 17 cities in 12 countries? Int J Behav Nutr Phys Act 2019; 16:121. [PMID: 31796070 PMCID: PMC6888920 DOI: 10.1186/s12966-019-0894-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 07/31/2019] [Accepted: 11/28/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Leisure-time and transport activity domains are studied most often because they are considered more amenable to intervention, but to date evidence on these domains is limited. The aim of the present study was to examine patterns of socio-demographic correlates of adults' leisure-time and transport physical activity and how these associations varied across 17 cities in 12 countries. METHODS Participants (N = 13,745) aged 18-66 years in the IPEN Adult study and with complete data on socio-demographic and self-reported physical activity characteristics were included. Participants reported frequency and duration of leisure-time and transport activities in the last 7 days using the self-administered International Physical Activity Questionnaire-Long Form. Six physical activity outcomes were examined in relation with age, education, and sex, and analyses explored variations by city and curvilinear associations. RESULTS Sex had the most consistent results, with five of six physical activity outcomes showing females were less active than males. Age had the most complex associations with self-report transport and leisure-time physical activity. Compared to older people, younger adults were less likely to engage in transport physical activity, but among those who did, younger people were likely to engage in more active minutes. Curvilinear associations were found between age and all three leisure-time physical activity outcomes, with the youngest and the oldest being more active. Positive associations with education were found for leisure-time physical activity only. There were significant interactions of city with sex and education for multiple physical activity outcomes. CONCLUSIONS Although socio-demographic correlates of physical activity are widely studied, the present results provide new information. City-specific findings suggest there will be value in conducting more detailed case studies. The curvilinear associations of age with leisure-time physical activity as well as significant interactions of leisure-time activity with sex and education should be further investigated. The findings of lower leisure-time physical activity among females as well as people with low education suggest that greater and continued efforts in physical activity policies and programs tailored to these high-risk groups are needed internationally.
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Affiliation(s)
- Josef Mitáš
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University, Olomouc, Czech Republic.
| | - Ester Cerin
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Rodrigo Siqueira Reis
- Prevention Research Center, Brown School, Washington University in St. Louis, Saint Louis, MO, USA
- Urban Management Graduate Program, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Terry L Conway
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Kelli L Cain
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Marc A Adams
- Global Institute of Sustainability, College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Grant Schofield
- Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand
| | | | - Lars B Christiansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rachel Davey
- Health Research Unit, University of Canberra, Canberra, Australia
| | - Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, Saint Louis, MO, USA
| | | | - Duncan Macfarlane
- Centre for Sports and Exercise, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Adriano Akira F Hino
- Health Technology Graduate Program, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Swinburne University of Technology, Melbourne, Australia
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - James F Sallis
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
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12
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Van Dyck D, Herman K, Poppe L, Crombez G, De Bourdeaudhuij I, Gheysen F. Results of MyPlan 2.0 on Physical Activity in Older Belgian Adults: Randomized Controlled Trial. J Med Internet Res 2019; 21:e13219. [PMID: 31593541 PMCID: PMC6803893 DOI: 10.2196/13219] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 12/21/2018] [Revised: 05/15/2019] [Accepted: 07/09/2019] [Indexed: 12/24/2022] Open
Abstract
Background The beneficial effects of physical activity (PA) for older adults are well known. However, few older adults reach the health guideline of 150 min per week of moderate-to-vigorous PA (MVPA). Electronic health (eHealth) interventions are effective in increasing PA levels in older adults in the short term but, rarely, intermediate-term effects after a period without the support of a website or an app have been examined. Furthermore, current theory-based interventions focus mainly on preintentional determinants, although postintentional determinants should also be included to increase the likelihood of successful behavior change. Objective This study aimed to investigate the effect of the theory-based eHealth intervention, MyPlan 2.0, focusing on pre- and postintentional determinants on both accelerometer-based and self-reported PA levels in older Belgian adults in the short and intermediate term. Methods This study was a randomized controlled trial with three data collection points: baseline (N=72), post (five weeks after baseline; N=65), and follow-up (three months after baseline; N=65). The study took place in Ghent, and older adults (aged ≥65 years) were recruited through a combination of random and convenience sampling. At all the time points, participants were visited by the research team. Self-reported domain-specific PA was assessed using the International Physical Activity Questionnaire, and accelerometers were used to objectively assess PA. Participants in the intervention group got access to the eHealth intervention, MyPlan 2.0, and used it independently for five consecutive weeks after baseline. MyPlan 2.0 was based on the self-regulatory theory and focused on both pre- and postintentional processes to increase PA. Multilevel mixed-models repeated measures analyses were performed in R (R Foundation for Statistical Computing). Results Significant (borderline) positive intervention effects were found for accelerometer-based MVPA (baseline−follow-up: intervention group +5 min per day and control group −5 min per day; P=.07) and for accelerometer-based total PA (baseline−post: intervention group +20 min per day and control group −24 min per day; P=.05). MyPlan 2.0 was also effective in increasing self-reported PA, mainly in the intermediate term. A positive intermediate-term intervention effect was found for leisure-time vigorous PA (P=.02), moderate household-related PA (P=.01), and moderate PA in the garden (P=.04). Negative intermediate-term intervention effects were found for leisure-time moderate PA (P=.01) and cycling for transport (P=.07). Conclusions The findings suggest that theory-based eHealth interventions focusing on pre- and postintentional determinants have the potential for behavior change in older adults. If future studies including larger samples and long-term follow-up can confirm and clarify these findings, researchers and practitioners should be encouraged to use a self-regulation perspective for eHealth intervention development. Trial Registration Clinicaltrials.gov NCT03194334; https://clinicaltrials.gov/ct2/show/NCT03783611.
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Affiliation(s)
- Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Research Foundation - Flanders, Brussels, Belgium
| | - Karel Herman
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Louise Poppe
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Research Foundation - Flanders, Brussels, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Educational Policy, Ghent University, Ghent, Belgium
| | - Freja Gheysen
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Research and Valorisation, Vives University of Applied Sciences, Kortrijk, Belgium
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13
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DeSmet A, De Bourdeaudhuij I, Walrave M, Vandebosch H. Associations Between Bystander Reactions to Cyberbullying and Victims' Emotional Experiences and Mental Health. Cyberpsychol Behav Soc Netw 2019; 22:648-656. [PMID: 31566447 DOI: 10.1089/cyber.2019.0031] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Bystanders in cyberbullying may play a crucial role in reducing cyberbullying's harm for victims. This study assessed bystander responses, and the associations with adolescent victims' emotional reactions to cyberbullying and victims' mental health outcomes (symptoms of depression, anxiety, and stress; suicidal ideation). A total of 1037 adolescents (49.8 percent female, mean age = 15.17 years) participated in the cross-sectional study and filled out an anonymous questionnaire. Victimization was measured with a single-item scale (cybervictims) and a multiple-item scale with cyberbullying examples (youth experiencing offensive practices). Associations of positive (e.g., defending) and negative (e.g., ignoring) bystander responses with victims' emotions (8 types of emotions rated on 5-point Likert scale) were assessed through correlations; and with victims' mental health outcomes (Depression, Anxiety, Stress Scale [DASS-21], single item for suicidal ideation) using regression analyses, adjusting for the influence of gender and coping styles (KIDCOPE). Cybervictims (single-item scale) showed more victimization experiences, and more negative emotional and mental health outcomes than youth only experiencing offensive practices. Negative bystander responses predicted some mental health outcomes among cybervictims, but not among youth only experiencing offensive practices. Positive bystander behavior did not predict any mental health outcome. There is a clear need for cyberbullying prevention programs to include components that target bystander responses, to alleviate victims' emotional and mental health harm after cyberbullying. Attention is needed to create effective programs to reduce negative bystander behavior, while most current programs are focused on positive bystander behavior.
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Affiliation(s)
- Ann DeSmet
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Michel Walrave
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Heidi Vandebosch
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
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14
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Compernolle S, DeSmet A, Poppe L, Crombez G, De Bourdeaudhuij I, Cardon G, van der Ploeg HP, Van Dyck D. Effectiveness of interventions using self-monitoring to reduce sedentary behavior in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:63. [PMID: 31409357 PMCID: PMC6693254 DOI: 10.1186/s12966-019-0824-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [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: 02/28/2019] [Accepted: 07/24/2019] [Indexed: 11/16/2022] Open
Abstract
Background Sedentary behavior occurs largely subconsciously, and thus specific behavior change techniques are needed to increase conscious awareness of sedentary behavior. Chief amongst these behavior change techniques is self-monitoring of sedentary behavior. The aim of this systematic review and meta-analysis was to evaluate the short-term effectiveness of existing interventions using self-monitoring to reduce sedentary behavior in adults. Methods Four electronic databases (PubMed, Embase, Web of Science, and The Cochrane Library) and grey literature (Google Scholar and the International Clinical Trials Registry Platform) were searched to identify appropriate intervention studies. Only (cluster-)randomized controlled trials that 1) assessed the short-term effectiveness of an intervention aimed at the reduction of sedentary behavior, 2) used self-monitoring as a behavior change technique, and 3) were conducted in a sample of adults with an average age ≥ 18 years, were eligible for inclusion. Relevant data were extracted, and Hedge’s g was used as the measure of effect sizes. Random effects models were performed to conduct the meta-analysis. Results Nineteen intervention studies with a total of 2800 participants met the inclusion criteria. Results of the meta-analyses showed that interventions using self-monitoring significantly reduced total sedentary time (Hedges g = 0,32; 95% CI = 0,14 − 0,50; p = 0,001) and occupational sedentary time (Hedge’s g = 0,56; 95% CI = 0,07 − 0,90; p = 0,02) on the short term. Subgroup analyses showed that significant intervention effects were only found if objective self-monitoring tools were used (g = 0,40; 95% CI = 0,19 − 0,60; p < 0,001), and if the intervention only targeted sedentary behavior (g = 0,45; 95% CI = 0,15-0,75; p = 0,004). No significant intervention effects were found on the number of breaks in sedentary behavior. Conclusions Despite the small sample sizes, and the large heterogeneity, results of the current meta-analysis suggested that interventions using self-monitoring as a behavior change technique have the potential to reduce sedentary behavior in adults. If future – preferably large-scale studies – can prove that the reductions in sedentary behavior are attributable to self-monitoring and can confirm the sustainability of this behavior change, multi-level interventions including self-monitoring may impact public health by reducing sedentary behavior. Electronic supplementary material The online version of this article (10.1186/s12966-019-0824-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.
| | - Ann DeSmet
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
| | - Louise Poppe
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health Amsterdam Public Health research institute Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium
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15
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Poppe L, De Bourdeaudhuij I, Verloigne M, Shadid S, Van Cauwenberg J, Compernolle S, Crombez G. Efficacy of a Self-Regulation-Based Electronic and Mobile Health Intervention Targeting an Active Lifestyle in Adults Having Type 2 Diabetes and in Adults Aged 50 Years or Older: Two Randomized Controlled Trials. J Med Internet Res 2019; 21:e13363. [PMID: 31376274 PMCID: PMC6696857 DOI: 10.2196/13363] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 01/10/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 01/16/2023] Open
Abstract
Background Adopting an active lifestyle plays a key role in the prevention and management of chronic diseases such as type 2 diabetes mellitus (T2DM). Web-based interventions are able to alter health behaviors and show stronger effects when they are informed by a behavior change theory. MyPlan 2.0 is a fully automated electronic health (eHealth) and mobile health (mHealth) intervention targeting physical activity (PA) and sedentary behavior (SB) based on the Health Action Process Approach (HAPA). Objective This study aimed to test the short-term effect of MyPlan 2.0 in altering levels of PA and SB and in changing personal determinants of behavior in adults with T2DM and in adults aged ≥50 years. Methods The study comprised two randomized controlled trials (RCTs) with an identical design. RCT 1 was conducted with adults with T2DM. RCT 2 was performed in adults aged ≥50 years. Data were collected via face-to-face assessments. The participants decided either to increase their level of PA or to decrease their level of SB. The participants were randomly allocated with a 2:1 ratio to the intervention group or the waiting-list control group. They were not blinded for their group allocation. The participants in the intervention group were instructed to go through MyPlan 2.0, comprising 5 sessions with an interval of 1 week between each session. The primary outcomes were objectively measured and self-reported PA (ie, light PA, moderate-to-vigorous PA, total PA, number of steps, and domain-specific [eg, transport-related] PA) and SB (ie, sitting time, number of breaks from sitting time, and length of sitting bouts). Secondary outcomes were self-reported behavioral determinants for PA and SB (eg, self-efficacy). Separate linear mixed models were performed to analyze the effects of MyPlan 2.0 in the two samples. Results In RCT 1 (n=54), the PA intervention group showed, in contrast to the control group, a decrease in self-reported time spent sitting (P=.09) and an increase in accelerometer-measured moderate (P=.05) and moderate-to-vigorous PA (P=.049). The SB intervention group displayed an increase in accelerometer-assessed breaks from sedentary time in comparison with the control group (P=.005). A total of 14 participants of RCT 1 dropped out. In RCT 2 (n=63), the PA intervention group showed an increase for self-reported total PA in comparison with the control group (P=.003). Furthermore, in contrast to the control group, the SB intervention group decreased their self-reported time spent sitting (P=.08) and increased their accelerometer-assessed moderate (P=.06) and moderate-to-vigorous PA (P=.07). A total of 8 participants of RCT 2 dropped out. Conclusions For both the samples, the HAPA-based eHealth and mHealth intervention, MyPlan 2.0, was able to improve only some of the primary outcomes. Trial Registration ClinicalTrials.gov NCT03291171; http://clinicaltrials.gov/ct2/show/NCT03291171. ClinicalTrials.gov NCT03799146; http://clinicaltrials.gov/ct2/show/NCT03799146. International Registered Report Identifier (IRRID) RR2-10.2196/12413
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Affiliation(s)
- Louise Poppe
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | | - Maïté Verloigne
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Samyah Shadid
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | | | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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16
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Schroé H, Van der Mispel C, De Bourdeaudhuij I, Verloigne M, Poppe L, Crombez G. A factorial randomised controlled trial to identify efficacious self-regulation techniques in an e- and m-health intervention to target an active lifestyle: study protocol. Trials 2019; 20:340. [PMID: 31182147 PMCID: PMC6558816 DOI: 10.1186/s13063-019-3456-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/11/2018] [Accepted: 05/20/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Sufficient physical activity and a limited amount of sedentary behaviour can prevent a range of chronic diseases. However, most adults do not meet the recommendations for physical activity and sedentary behaviour. Effective and engaging interventions are needed to change people's behaviour. E- and m-health interventions are promising, but unfortunately they result in small effects and suffer from high attrition rates. Improvements to intervention content and design are required. Qualitative research has revealed the need for clear and concise interventions. Furthermore, many interventions use a range of behaviour-change techniques, and it is yet unknown whether these techniques are equally important to obtain behaviour change. It may well be that a limited set of these techniques is sufficient. In this study, the aim is to experimentally investigate the efficacy of three behaviour-change techniques (i.e. action planning, coping planning and self-monitoring) on physical activity, sedentary behaviour and related determinants among adults. METHODS In a 2 x 2 x 2 factorial trial participants will be randomly allocated to eight groups (including one control group). Each group will receive a different version of the self-regulation-based e- and m-health intervention 'MyPlan 2.0', in which three behaviour-change techniques (i.e. action planning, coping planning, self-monitoring) will be combined in order to achieve self-formulated goals about physical activity or sedentary behaviour. Goal attainment, and levels of physical activity and sedentary behaviour will be measured via self-report questionnaires. DISCUSSION This study should provide insight into the role of various behaviour-change techniques in changing health behaviour and its determinants. Its experimental and longitudinal design, with repeated measures of several determinants of behaviour change, allows an in-depth analysis of the processes underlying behaviour change, enabling the authors to provide guidance for the development of future e- and m-health interventions. TRIAL REGISTRATION This study is registered as MyPlan 2.0 as a clinical trial (ID number: NCT03274271 ). Release date: 20 October 2017.
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Affiliation(s)
- Helene Schroé
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000 Belgium
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, Ghent, 9000 Belgium
| | - Celien Van der Mispel
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000 Belgium
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, Ghent, 9000 Belgium
| | - Ilse De Bourdeaudhuij
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, Ghent, 9000 Belgium
| | - Maïté Verloigne
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, Ghent, 9000 Belgium
| | - Louise Poppe
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000 Belgium
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Faculty of Medicine and Health, Ghent University, Watersportlaan 2, Ghent, 9000 Belgium
| | - Geert Crombez
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, Ghent, 9000 Belgium
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De Cocker K, Chastin SFM, De Bourdeaudhuij I, Imbo I, Stragier J, Cardon G. Citizen Science to Communicate about Public Health Messages: The Reach of a Playful Online Survey on Sitting Time and Physical Activity. Health Commun 2019; 34:720-725. [PMID: 29412005 DOI: 10.1080/10410236.2018.1433955] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is a lack of research on how to communicate public health guidelines. Citizen science (CS) has been an effective way to involve the public in research. This study analyses the reach of a well-established CS experiment, launched during an annual national science event, to understand if it could be used as communication strategy for public health issues. A short playful online survey contained tailored health-related messages associated to an "animal totem" profile, based on the combination of sitting and physical activity levels (koala: high sitting, low activity; gorilla: high sitting, high activity; zebra: low sitting, low activity; bee: low sitting, high activity). Tweets, radio interviews, radio and online advertisements, press articles, and a press conference were used to promote the CS experiment. Google Analytics and Facebook Graph API (application programming interface) (use and spread of experiment) and descriptive statistics (attributes of adults completing the experiment) were used. A total of 6,246 adults completed the experiment, with a peak of views (n = 5,103) and completions (n = 1,209) a couple of days before the event. Completers were mostly female (65.8%), on average 37.5 years old, and had a healthy body mass index (23.8 kg/m2). Nearly half (46.4%) had the most beneficial profile ("bee"), 26.5% had the least healthy profile ("koala"). CS as part of a national science event is a good platform for health communication as 1 in 1,000 Flemish adults were reached. However, those completing the experiment were not representative of the general Flemish adult population and reported to be more physically active. Abbreviations: API: application programming interface; BMI: body mass index; CVD: cardiovascular disease; METs: metabolic equivalents.
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Affiliation(s)
| | - Sebastien F M Chastin
- b School of Health and Life Science , Institute for Applied Health Research, Glasgow Caledonian University
| | | | - Ineke Imbo
- c Department of Administrative Affairs , Ghent University
| | - Jeroen Stragier
- a Department of Movement and Sports Sciences , Ghent University
- d Media, Innovation and Communication Technologies, Department of Communication Sciences , Ghent University
| | - Greet Cardon
- a Department of Movement and Sports Sciences , Ghent University
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18
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Schwarz A, Mertens L, Simons M, Spook JE, Thompson D, Cardon G, De Bourdeaudhuij I, Chastin SF, DeSmet A. Which Game Narratives Do Adolescents of Different Gameplay and Sociodemographic Backgrounds Prefer? A Mixed-Methods Analysis. Games Health J 2019; 8:195-204. [DOI: 10.1089/g4h.2017.0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ayla Schwarz
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Lieze Mertens
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Monique Simons
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Jorinde E. Spook
- Department of Communication, Philosophy and Technology, Centre for Integrative Development, Wageningen University, Wageningen, The Netherlands
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sebastien F.M. Chastin
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Institute for Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Scotland, United Kingdom
| | - Ann DeSmet
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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19
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Van Dyck D, D'Haese S, Plaete J, De Bourdeaudhuij I, Deforche B, Cardon G. Opinions towards physical activity interventions using Facebook or text messaging: Focus group interviews with vocational school-aged adolescents. Health Soc Care Community 2019; 27:654-664. [PMID: 30398291 DOI: 10.1111/hsc.12679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 12/15/2017] [Revised: 09/01/2018] [Accepted: 10/08/2018] [Indexed: 06/08/2023]
Abstract
Feasible and effective interventions to promote physical activity among vocational school-aged adolescents are strongly needed. Text messaging and Facebook are feasible and acceptable delivery modes for PA interventions among youth. However, little is known about the opinion of vocational school-aged adolescents regarding behavioural change techniques that can be applied through Facebook or text messaging. Therefore, our aim was to gain insight into the opinions of vocational school-aged adolescents towards the use of different behaviour change techniques and towards Facebook/text messaging as a delivery mode for PA interventions. Six focus groups were conducted with 41 adolescents from the first grade (12-14 years) of secondary vocational schools in Flanders (Belgium). In total 41 adolescents participated and completed a questionnaire about their text messaging and Facebook use prior to group discussions. Focus group discussions were audio-recorded and analysed using a thematic analysis method in Nvivo. Participants thought that different behaviour change techniques (e.g., providing feedback, goal setting, self-monitoring, social comparison) could be integrated in a PA intervention using text messaging and Facebook and were enthusiastic about participating in such an intervention. They indicated that text messages are an easy way to receive information about PA, and that a group page on Facebook is ideal to share information with others. Participants deemed it very important that the group page on Facebook would only include peers with whom they also share an offline connection. Furthermore, adolescents stressed the importance of having autonomy (e.g., to determine their personal activity goals, to self-monitor their behaviour) and of being active together with friends. This qualitative study revealed that the use of Facebook and text messaging is promising as a delivery method for PA interventions among vocational school-aged adolescents. The adolescents were keen to participate in an intervention that integrates behaviour change techniques using text messaging or Facebook.
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Affiliation(s)
- Delfien Van Dyck
- Research Foundation Flanders, Brussels, Belgium
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sara D'Haese
- Research Foundation Flanders, Brussels, Belgium
- Flemish Institute Healthy Living, Brussels, Belgium
| | | | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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20
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Mackenbach JD, de Groot R, Lakerveld J, De Cocker K, Cardon G, De Bourdeaudhuij I, Compernolle S. What factors explain socioeconomic inequalities in adults' television-related sitting time? Eur J Public Health 2019; 29:248-254. [PMID: 30169565 DOI: 10.1093/eurpub/cky170] [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: 11/14/2022] Open
Abstract
BACKGROUND There are considerable socioeconomic inequalities in television-related sitting time, but there is little evidence for the explanatory mechanisms. We used a cohort of Belgian adults (25-60 years) and older adults (≥65 years) to examine the social cognitive, home environmental and health-related factors contributing to socioeconomic differences in television-related sitting. METHODS We included 301 adults and 258 older adults (total n = 559). Linear regression analyses were used to examine the associations of education and occupational status with television-related sitting time, adjusted for age and gender. We assessed the explanatory power of social cognitive, home environmental and health-related factors using the traditional 'change-in-estimation method'. RESULTS Those with low and medium education, respectively, engaged in 54 and 28 minutes per day more television-related sitting time than those with high education. We found no association between occupational status and television-related sitting time. Social cognitive factors explained 54% of the difference in television-related sitting time between those with low and high education, while home environmental factors only explained 6%, and health-related variables explained 10% of these differences. CONCLUSION We found no occupational inequalities in television-related sitting time. Social cognitive variables such as attitude and modelling of the partner explained a large part of the educational inequalities in television-related sitting time. If confirmed by future studies, a focus on social cognition may help reduce sedentary behaviours in low-educated adults and diminish inequalities in sedentary behaviours.
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Affiliation(s)
- Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Rosa de Groot
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Department of Donorstudies, Sanquin Research, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Katrien De Cocker
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Australia
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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21
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Poppe L, De Bourdeaudhuij I, Verloigne M, Degroote L, Shadid S, Crombez G. A Self-Regulation-Based eHealth and mHealth Intervention for an Active Lifestyle in Adults With Type 2 Diabetes: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e12413. [PMID: 30901002 PMCID: PMC6450483 DOI: 10.2196/12413] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 10/04/2018] [Revised: 12/18/2018] [Accepted: 01/20/2019] [Indexed: 01/25/2023] Open
Abstract
Background Adoption of an active lifestyle plays an important role in the management of type 2 diabetes. Online interventions targeting lifestyle changes in adults with type 2 diabetes have provided mixed results. Previous research highlights the importance of creating theory-based interventions adapted to the population’s specific needs. The online intervention “MyPlan 2.0” targets physical activity and sedentary behavior in adults with type 2 diabetes. This intervention is grounded in the self-regulation framework and, by incorporating the feedback of users with type 2 diabetes, iteratively adapted to its target population.
Objective The aim of this paper is to thoroughly describe “MyPlan 2.0” and the study protocol that will be used to test the effectiveness of this intervention to alter patients’ levels of physical activity and sedentary behavior. Methods A two-arm superiority randomized controlled trial will be performed. Physical activity and sedentary behavior will be measured using accelerometers and questionnaires. Furthermore, using questionnaires and diaries, patients’ stressors and personal determinants for change will be explored in depth. To evaluate the primary outcomes of the intervention, multilevel analyses will be conducted. Results The randomized controlled trial started in January 2018. As participants can start at different moments, we aim to finish all testing by July 2019. Conclusions This study will increase our understanding about whether and how a theory-based online intervention can help adults with type 2 diabetes increase their level of physical activity and decrease their sedentary time. International Registered Report Identifier (IRRID) DERR1-10.2196/12413
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Affiliation(s)
- Louise Poppe
- Physical Activity and Health Research Group, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Ghent Health Psychology Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Physical Activity and Health Research Group, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Maïté Verloigne
- Physical Activity and Health Research Group, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Laurent Degroote
- Physical Activity and Health Research Group, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Ghent Health Psychology Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Samyah Shadid
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Geert Crombez
- Ghent Health Psychology Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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22
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Leask CF, Sandlund M, Skelton DA, Altenburg TM, Cardon G, Chinapaw MJM, De Bourdeaudhuij I, Verloigne M, Chastin SFM. Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions. Res Involv Engagem 2019; 5:2. [PMID: 30652027 PMCID: PMC6327557 DOI: 10.1186/s40900-018-0136-9] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/10/2018] [Indexed: 05/23/2023]
Abstract
PLAIN ENGLISH SUMMARY Background: Society has to cope with a large burden of health issues. There is need to find solutions to prevent diseases and help individuals live healthier lifestyles. Individual needs and circumstances vary greatly and one size fit all solutions do not tend to work well. More tailored solutions centred on individuals' needs and circumstances can be developed in collaboration with these individuals. This process, known as co-creation, has shown promise but it requires guiding principles to improve its effectiveness. The aim of this study was to identify a key set of principles and recommendations for co-creating public health interventions.Methods: These principles were collaboratively developed through analysing a set of case studies targeting different health behaviours (such as reducing sitting and improving strength and balance) in different groups of people (such as adolescent schoolgirls and older adults living in the community).Results: The key principles of co-creation are presented in four stages: Planning (what is the purpose of the co-creation; and who should be involved?); Conducting (what activities can be used during co-creation; and how to ensure buy-in and commitment?); Evaluating (how do we know the process and the outcome are valid and effective?) and Reporting (how to report the findings?). Three models are proposed to show how co-created solutions can be scaled up to a population level.Conclusions: These recommendations aim to help the co-creation of public health interventions by providing a framework and governance to guide the process. ABSTRACT Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible.
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Affiliation(s)
- Calum F. Leask
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- NHS Grampian, Health Intelligence Department, Aberdeen, UK
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
| | - Dawn A. Skelton
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maite Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sebastien F. M. Chastin
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - on behalf of the GrandStand, Safe Step and Teenage Girls on the Move Research Groups
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- NHS Grampian, Health Intelligence Department, Aberdeen, UK
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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23
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Hoenink JC, Lakerveld J, Rutter H, Compernolle S, De Bourdeaudhuij I, Bárdos H, Charreire H, Oppert JM, Mackenbach JD. The Moderating Role of Social Neighbourhood Factors in the Association between Features of the Physical Neighbourhood Environment and Weight Status. Obes Facts 2019; 12:14-24. [PMID: 30673683 PMCID: PMC6465716 DOI: 10.1159/000496118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 01/19/2018] [Accepted: 12/09/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND This paper investigated the independent and joint associations between aspects of the physical neighbourhood environment and social neighbourhood factors with BMI and overweight status in European adults. METHODS Data from 5,199 participants in the SPOTLIGHT survey were analysed. Participants reported on their height, weight and perceptions of the neighbourhood. Objectively measured aspects of the physical neighbourhood environment included: presence of recreational facilities, features of the active transportation environment, neighbourhood aesthetics and presence of different types of food outlets. Social factors included the self-reported variables social network, social cohesion, social trust and perceived crime and the census variable neighbourhood socioeconomic status. Outcome measures were BMI and overweight status. Main associations between physical and social factors and BMI/overweight status were analysed using multilevel regression analyses adjusted for confounders. Moderation analysis was conducted by adding the interaction terms between physical and social neighbourhood factors one by one to the multivariable models. Significant interaction terms were then stratified. RESULTS Significant associations with BMI/overweight status were found for features of the active transportation environment and all social factors, except perceived crime. Several significant interaction terms were detected, but no significant associations between the physical neighbourhood environment and BMI/overweight status were found after stratification. CONCLUSION We did not find consistent interactions between physical and social neighbourhood factors to explain BMI and overweight status.
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Affiliation(s)
- Jody C Hoenink
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, Bath, United Kingdom
| | - Sofie Compernolle
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | | | - Helga Bárdos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Helene Charreire
- Université Paris Est, LabUrba, UPEC, Créteil, France
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
| | - Jean Michel Oppert
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France
- Sorbonne Université Institute of Cardiometabolism and Nutrition, Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU Medical Centre Amsterdam, Amsterdam, The Netherlands,
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Degroote L, De Bourdeaudhuij I, Verloigne M, Poppe L, Crombez G. The Accuracy of Smart Devices for Measuring Physical Activity in Daily Life: Validation Study. JMIR Mhealth Uhealth 2018; 6:e10972. [PMID: 30545810 PMCID: PMC6315254 DOI: 10.2196/10972] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 05/04/2018] [Revised: 08/19/2018] [Accepted: 09/21/2018] [Indexed: 11/26/2022] Open
Abstract
Background Wearables for monitoring physical activity (PA) are increasingly popular. These devices are not only used by consumers to monitor their own levels of PA but also by researchers to track the behavior of large samples. Consequently, it is important to explore how accurately PA can be tracked via these devices. Objectives The aim of this study was, therefore, to investigate convergent validity of 3 Android Wear smartwatches—Polar M600 (Polar Electro Oy, Kempele, Finland), Huawei Watch (Huawei Technologies Co, Ltd, Shenzhen, Guangdong, China), Asus Zenwatch3 (AsusTek Computer Inc, Taipei, Taiwan)—and Fitbit Charge with an ActiGraph accelerometer for measuring steps and moderate to vigorous physical activity (MVPA) on both a day level and 15-min level. Methods A free-living protocol was used in which 36 adults engaged in usual daily activities over 2 days while wearing 2 different wearables on the nondominant wrist and an ActiGraph GT3X+ accelerometer on the hip. Validity was evaluated on both levels by comparing each wearable with the ActiGraph GT3X+ accelerometer using correlations and Bland-Altman plots in IBM SPSS 24.0. Results On a day level, all devices showed strong correlations (Spearman r=.757-.892) and good agreement (interclass correlation coefficient, ICC=.695-.885) for measuring steps, whereas moderate correlations (Spearman r=.557-.577) and low agreement (ICC=.377-.660) for measuring MVPA. Bland-Altman revealed a systematic overestimation of the wearables for measuring steps but a variation between over- and undercounting of MVPA. On a 15-min level, all devices showed strong correlations (Spearman r=.752-.917) and good agreement (ICC=.792-.887) for measuring steps, whereas weak correlations (Spearman r=.116-.208) and low agreement (ICC=.461-.577) for measuring MVPA. Bland-Altman revealed a systematic overestimation of the wearables for steps but under- or overestimation for MVPA depending on the device. Conclusions In sum, all 4 consumer-level devices can be considered accurate step counters in free-living conditions. This study, however, provides evidence of systematic bias for all devices in measurement of MVPA. The results on a 15-min level also indicate that these devices are not sufficiently accurate to provide correct real-time feedback.
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Affiliation(s)
- Laurent Degroote
- Physical Activity & Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Health Psychology, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Physical Activity & Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Maïté Verloigne
- Physical Activity & Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Louise Poppe
- Physical Activity & Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.,Health Psychology, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Health Psychology, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Van Stappen V, Latomme J, Cardon G, De Bourdeaudhuij I, Lateva M, Chakarova N, Kivelä J, Lindström J, Androutsos O, González-Gil E, De Miguel-Etayo P, Nánási A, Kolozsvári LR, Manios Y, De Craemer M. Barriers from Multiple Perspectives Towards Physical Activity, Sedentary Behaviour, Physical Activity and Dietary Habits When Living in Low Socio-Economic Areas in Europe. The Feel4Diabetes Study. Int J Environ Res Public Health 2018; 15:ijerph15122840. [PMID: 30551570 PMCID: PMC6313803 DOI: 10.3390/ijerph15122840] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 10/12/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 12/13/2022]
Abstract
This study investigated barriers towards health behaviours (physical activity, limiting sedentary behaviour and healthy dietary habits) experienced by young European families living in vulnerable areas, from multiple perspectives (parents, teachers, local community workers). Focus groups were conducted in six European countries (Belgium, Bulgaria, Finland, Hungary, Greece and Spain). In each country, three focus groups were conducted with parents, one with teachers and one with local community workers. Data were analysed using a deductive framework approach with a manifest content analysis using the software NVivo. The present study identified barriers on four levels (individual, interpersonal, organisational and macro level) of a socio-ecological model of health behaviour. From parents’ perspectives, both general barriers (e.g., financial limitations and lack of time) and country-specific barriers (e.g., organisational difficulties and inappropriate work environment) were identified. Additional barriers (e.g., lack of parental knowledge and lack of parental skills) were provided by other stakeholders (i.e., teachers and local community workers). The results of this study demonstrate the additional value of including multiple perspectives when developing a lifestyle intervention aiming to prevent type 2 diabetes in vulnerable groups. Future lifestyle interventions are recommended to include multiple components (family, school, and community) and could be implemented across European countries if country-specific adaptations are allowed.
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Affiliation(s)
- Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium.
| | | | - Mina Lateva
- Clinic of Paediatric Endocrinology, Medical University Varna, 9002 Varna, Bulgaria.
| | - Nevena Chakarova
- Clinical Center of Endocrinology, Medical University of Sofia, 1431 Sofia, Bulgaria.
| | - Jemina Kivelä
- National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Jaana Lindström
- National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 76 Athens, Greece.
| | - Esther González-Gil
- Growth, Exercise, Nutrition and Development (GENUD), University of Zaragoza, 50009 Zaragoza, Spain.
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD), University of Zaragoza, 50009 Zaragoza, Spain.
| | - Anna Nánási
- Debreceni Egyetem (UoD), University of Debrecen, 4002 Debrecen, Hungary.
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 76 Athens, Greece.
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium.
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Mertens L, Van Dyck D, Deforche B, De Bourdeaudhuij I, Brondeel R, Van Cauwenberg J. Individual, social, and physical environmental factors related to changes in walking and cycling for transport among older adults: A longitudinal study. Health Place 2018; 55:120-127. [PMID: 30551993 DOI: 10.1016/j.healthplace.2018.12.001] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 11/28/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022]
Abstract
To date, no longitudinal studies examined the change in walking and cycling for transport as distinct outcomes over time and investigated the predictors of those changes. Therefore, this present study examined the change in odds of engagement in walking and cycling for transport as distinct outcomes among Belgian older adults over a three-year follow-up period, and examined factors (i.e. socio-demographics, psychosocial, perceived social and physical environmental characteristics) related to these changes in engaging in walking and cycling for transport. Against our expectations, we found significantly higher odds of engaging in cycling for transport among older adults at follow-up compared to baseline and no significant differences in the odds of engaging in walking for transport. Interventions should assist older adults to increase their self-efficacy towards PA, their perceived benefits of PA, and their perception of land use mix diversity in their neighborhood in order to increase the engagement in walking/cycling for transport over time, or help to decrease their perceived barriers towards PA or their perception to have a lot of physical barriers to walk/cycle in their neighborhood. Future longitudinal studies with larger samples are warranted investigating interaction effects between different predictors at various levels to find out which factors can be further integrated into active transport interventions in older adults.
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Affiliation(s)
- Lieze Mertens
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium; Research Foundation Flanders (FWO), Belgium.
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium; Research Foundation Flanders (FWO), Belgium
| | - Benedicte Deforche
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4k3, B-9000 Ghent, Belgium; Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium
| | - Ruben Brondeel
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium; Research Foundation Flanders (FWO), Belgium
| | - Jelle Van Cauwenberg
- Research Foundation Flanders (FWO), Belgium; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4k3, B-9000 Ghent, Belgium
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27
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Lambrinou CP, van Stralen MM, Androutsos O, Moreno LA, Iotova V, Socha P, Koletzko B, De Bourdeaudhuij I, Manios Y. Mediators of the Effectiveness of an Intervention Promoting Water Consumption in Preschool Children: The ToyBox Study. J Sch Health 2018; 88:877-885. [PMID: 30392186 DOI: 10.1111/josh.12696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/03/2018] [Accepted: 02/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The ToyBox-intervention has increased preschool children's water consumption. This study aimed to examine if family-related determinants mediate the effects of the ToyBox-intervention on preschoolers' water consumption. METHODS Overall, 6290 preschoolers and their families from 6 European countries participated in the ToyBox-intervention and returned parental questionnaires in May/June 2012 and 2013. This study included the 3725 preschoolers/families who had complete data on water consumption, all mediators, and confounders. Mediation effects were assessed with bootstrapping procedure. RESULTS Regarding the intervention effects on family-related determinants, the ToyBox-intervention significantly increased water availability during meals, parental water consumption, parental encouragement to their children to drink water, and parental knowledge on water recommendations. In the multiple mediator model, all factors were independently associated with preschoolers' water consumption and mediated the intervention effect on preschoolers' water consumption (total mediation effect = 40%). After including all mediators into the model, the direct intervention effect remained significant. CONCLUSIONS The effect of the ToyBox-intervention on preschool children's water consumption was mediated by most family-related determinants examined in this study (ie, availability, parental modeling, parental encouragement, and parental knowledge). Interventions aiming to promote water in preschoolers should target these mediators to enhance their effectiveness.
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Affiliation(s)
| | | | | | - Luis A Moreno
- Universidad de Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Violeta Iotova
- Medicak University of Varna, Clinic of Paeditric Endocrinology - Head, UMHAT "St. Marina", 1 "Hr. Smirnenski" Boulevard, Varna 9010, Bulgaria
| | - Piotr Socha
- The Children's Memorial Health Institute, Warsaw, Poland, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität München, Dr. von Hauner Children's Hospital, Univ. of Munich Medical Center, Campus Innenstadt, Lindwurmstr. 4, D-80337 Muenchen, Germany
| | | | - Yannis Manios
- Harokopio University, El. Venizelou 70, Kallithea, 17676, Athens, Greece
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28
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De Lepeleere S, De Bourdeaudhuij I, Van Stappen V, Huys N, Latomme J, Androutsos O, Manios Y, Cardon G, Verloigne M. Parenting Practices as a Mediator in the Association Between Family Socio-Economic Status and Screen-Time in Primary Schoolchildren: A Feel4Diabetes Study. Int J Environ Res Public Health 2018; 15:ijerph15112553. [PMID: 30441837 PMCID: PMC6265875 DOI: 10.3390/ijerph15112553] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/09/2018] [Accepted: 11/11/2018] [Indexed: 11/16/2022]
Abstract
The aim of this study was to examine the mediating effects of specific parenting practices on the association between family socio-economic status (SES) and screen-time of 6- to 9-year-old children from families with an increased risk of developing type 2 diabetes. This cross-sectional study, focusing on families with an increased risk of developing type 2 diabetes, used the Belgian baseline data of the Movie Models intervention, integrated within the European Feel4Diabetes intervention, and included 247 parents (57.6% lower SES family; 78.0% mothers) who completed a questionnaire. Mediating effects were tested using MacKinnon's product-of-coefficients test via multilevel linear regression analyses. Being consistent concerning rules about gaming (β = 0.127; standard error = 0.055; 95% CI = 0.020; 0.234) and avoiding negative role modeling concerning TV-time (β = -0.082; standard error = 0.040; 95% CI = -0.161; -0.003) significantly mediated the inverse association between family SES and children's screen-time. Parents from lower SES families were more consistent concerning rules about gaming and watched more TV nearby their child compared to parents from higher SES families, and these parenting practices were related to more screen-time. No other parenting practices were found to mediate this association. Thus, parents from lower SES families with a higher risk for developing type 2 diabetes might limit their own TV-time nearby their child to reduce their child's screen-time. Future research should examine other possible mediating factors to develop effective interventions targeting this important at-risk group.
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Affiliation(s)
- Sara De Lepeleere
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
| | - Nele Huys
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
| | - Julie Latomme
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
- Research Foundation Flanders (FWO), Egmontstraat 1, 1000 Brussel, Belgium.
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 70 El. Venizelou, 17671 Kallithea, Athens, Greece.
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 70 El. Venizelou, 17671 Kallithea, Athens, Greece.
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
| | - Maïté Verloigne
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
- Research Foundation Flanders (FWO), Egmontstraat 1, 1000 Brussel, Belgium.
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29
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Owen N, Sugiyama T, Koohsari MJ, De Bourdeaudhuij I, Hadgraft N, Oyeyemi A, Aguinaga-Ontoso I, Mitáš J, Troelsen J, Davey R, Schofield G, Cain KL, Sarmiento OL, Reis R, Salvo D, Macfarlane DJ, Sallis JF, Cerin E. Associations of neighborhood environmental attributes with adults' objectively-assessed sedentary time: IPEN adult multi-country study. Prev Med 2018; 115:126-133. [PMID: 30145352 DOI: 10.1016/j.ypmed.2018.08.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 08/10/2018] [Accepted: 08/21/2018] [Indexed: 12/13/2022]
Abstract
Neighborhood environmental attributes have been found to be associated with residents' time spent walking and in physical activity, in studies from single countries and in multiple-country investigations. There are, however, mixed findings on such environmental relationships with sedentary (sitting) time, which primarily have used evidence derived from single-country investigations with self-reported behavioral outcome measures. We examined potential relationships of neighborhood environmental attributes with objectively-assessed sedentary time using data from 5712 adults recruited from higher and lower socio-economic status neighborhoods in 12 sites in 10 countries, between 2002 and 2011. Ten perceived neighborhood attributes, derived from an internationally-validated scale, were assessed by questionnaire. Sedentary time was derived from hip-worn accelerometer data. Associations of individual environmental attributes and a composite environmental index with sedentary time were estimated using generalized additive mixed models. In fully adjusted models, higher street connectivity was significantly related to lower sedentary time. Residential density, pedestrian infrastructure and safety, and lack of barriers to walking were related to higher sedentary time. Aesthetics and safety from crime were related to less sedentary time in women only. The predicted difference in sedentary time between those with the minimum versus maximum composite environmental index values was 71 min/day. Overall, certain built environment attributes, including street connectivity, land use mix and aesthetics were found to be related to sedentary behavior in both expected and unexpected directions. Further research using context-specific measures of sedentary time is required to improve understanding of the potential role of built environment characteristics as influences on adults' sedentary behavior.
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Affiliation(s)
- Neville Owen
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Swinburne University of Technology, Melbourne, Australia.
| | - Takemi Sugiyama
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Mohammad Javad Koohsari
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | | | - Nyssa Hadgraft
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia; Swinburne University of Technology, Melbourne, Australia
| | - Adewale Oyeyemi
- Department of Physiotherapy, University of Maiduguri, Maiduguri, Nigeria
| | | | - Josef Mitáš
- Faculty of Physical Culture, Palacký Universitsy, Olomouc, Czech Republic
| | - Jens Troelsen
- Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rachel Davey
- Centre for Research and Action in Public Health, University of Canberra, Canberra, Australia
| | - Grant Schofield
- Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
| | - Kelli L Cain
- Department of Family and Preventive Medicine, University of California, San Diego, USA
| | - Olga L Sarmiento
- Universidad de los Andes, Department of Public Health, School of Medicine, Bogotá, Colombia
| | - Rodrigo Reis
- School of Health and Biosciences, Pontificia Universidade Catolica do Parana, Curitiba, Brazil; Division of Public Health Sciences, Washington University School of Medicine, St. Louis, USA
| | - Deborah Salvo
- Washington University in St. Louis, Brown School, Prevention Research Center, St. Louis, Missouri, USA; Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Duncan J Macfarlane
- Institute of Human Performance, The University of Hong Kong, Hong Kong, China
| | - James F Sallis
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Department of Family and Preventive Medicine, University of California, San Diego, USA
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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30
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Poppe L, Van der Mispel C, Crombez G, De Bourdeaudhuij I, Schroé H, Verloigne M. How Users Experience and Use an eHealth Intervention Based on Self-Regulation: Mixed-Methods Study. J Med Internet Res 2018; 20:e10412. [PMID: 30274961 PMCID: PMC6231831 DOI: 10.2196/10412] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/05/2018] [Accepted: 06/28/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND eHealth interventions show stronger effects when informed by solid behavioral change theories; for example, self-regulation models supporting people in translating vague intentions to specific actions have shown to be effective in altering health behaviors. Although these theories inform developers about which behavioral change techniques should be included, they provide limited information about how these techniques can be engagingly implemented in Web-based interventions. Considering the high levels of attrition in eHealth, investigating users' experience about the implementation of behavior change techniques might be a fruitful avenue. OBJECTIVE The objective of our study was to investigate how users experience the implementation of self-regulation techniques in a Web-based intervention targeting physical activity and sedentary behavior in the general population. METHODS In this study, 20 adults from the general population used the intervention for 5 weeks. Users' website data were explored, and semistructured interviews with each of the users were performed. A directed content analysis was performed using NVivo Software. RESULTS The techniques "providing feedback on performance," "action planning," and "prompting review of behavioral goals" were appreciated by users. However, the implementation of "barrier identification/problem solving" appeared to frustrate users; this was also reflected by the users' website data-many coping plans were of poor quality. Most users were well aware of the benefits of adopting a more active way of living and stated not to have learned novel information. However, they appreciated the provided information because it reminded them about the importance of having an active lifestyle. Furthermore, prompting users to self-monitor their behavioral change was not sufficiently stimulating to make users actually monitor their behavior. CONCLUSIONS Iteratively involving potential end users offers guidance to optimally adapt the implementation of various behavior change techniques to the target population. We recommend creating short interventions with a straightforward layout that support users in creating and evaluating specific plans for action.
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Affiliation(s)
- Louise Poppe
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Celien Van der Mispel
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Helene Schroé
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Ghent Health Psychology Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Maïté Verloigne
- Research Group Physical Activity and Health, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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31
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Verloigne M, Ridgers ND, De Bourdeaudhuij I, Cardon G. Effect and process evaluation of implementing standing desks in primary and secondary schools in Belgium: a cluster-randomised controlled trial. Int J Behav Nutr Phys Act 2018; 15:94. [PMID: 30261883 PMCID: PMC6161341 DOI: 10.1186/s12966-018-0726-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 06/12/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background Children and adolescents spend a lot of time sitting at school. Implementing standing desks in the classroom is one potential strategy to reduce and break up sitting time. The first aim was to evaluate the effect of implementing standing desks in classrooms in primary and secondary schools on pupils’ sitting-related behaviour and determinants. The second aim was to quantitatively and qualitatively evaluate the process of implementing the desks in the classroom. Methods We conducted a cluster-randomised controlled trial with a pre-, mid-, and post-test design including 10 intervention schools (5 primary, 5 secondary schools) and 9 control schools (5 primary, 4 secondary schools) across Flanders, Belgium. Three standing desks were placed in one class in each intervention school for 6 months. At pre-, mid- and post-test, all pupils (n = 311; 54.5% girls) completed a questionnaire whilst a subsample of three pupils per class wore an activPAL inclinometer for one school week. Focus groups with pupils and interviews with teachers were conducted at mid-test. Process evaluation questions were added to the mid- and post-test questionnaire for the intervention group. Qualitative data were analysed using NVivo 11. Multilevel regression analyses were conducted in MLwiN 2.31. Results Few significant intervention effects were observed, although activPAL data showed favourable intervention effects on primary school pupils’ sitting and standing time and bouts. Focus groups and interviews showed a generally positive attitude towards using standing desks in both teachers and pupils, although some barriers and suggestions for future implementation were noted, for example regarding the amount of desks per classroom. Quantitative process evaluation data showed a low individual use of standing desks (between 57 and 83 min per week), which significantly decreased across the school year for primary school pupils only. Conclusions Although pupils and teachers were generally positive about the desks, relatively few intervention effects were found. Future studies should consider how to optimise the use of standing desks in classrooms to impact on sitting time, by for example, determining the most feasible intervention design and by encouraging the continued use of standing desks throughout the school year. Moreover, additional intervention strategies (e.g. educational strategies) might be needed. Trial registration NCT03163004. ClinicalTrials.gov. Registered 22 May 2017 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12966-018-0726-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maïté Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium. .,Research Foundation (FWO), Egmontstraat 1, 1000, Brussel, Belgium.
| | - Nicola D Ridgers
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
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32
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Deforche B, Mommen J, Hublet A, De Roover W, Huys N, Clays E, Maes L, De Bourdeaudhuij I, Van Cauwenberg J. Evaluation of a Brief Intervention for Promoting Mental Health among Employees in Social Enterprises: A Cluster Randomized Controlled Trial. Int J Environ Res Public Health 2018; 15:E2107. [PMID: 30257476 PMCID: PMC6210353 DOI: 10.3390/ijerph15102107] [Citation(s) in RCA: 6] [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: 07/10/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 11/30/2022]
Abstract
Evidence on the effectiveness of workplace mental health promotion for people with disabilities is limited. This study aimed to evaluate the effectiveness of a brief mental health promotion intervention in social enterprises. It had a non-blinded cluster randomized controlled trial design with follow-up one and four months after the intervention. In total 196 employees agreed to participate (86 intervention and 110 control). Empowerment was the main outcome; secondary outcomes were resilience, palliative behavior, determinants of four coping strategies of mental health, quality of life, and life satisfaction. A brief participant satisfaction survey was conducted after the intervention. No significant intervention effect on empowerment was found. However, at one month follow-up, significant favorable effects were found on perceived social support for coping strategies for mental health and on palliative behavior. At four months follow-up, favorable intervention effects were found on quality of life, but unfavorable effects were found on unjustified worrying. In addition, the intervention was well received by the employees. This brief intervention might be a promising first step to improve mental health in people with disabilities working in social enterprises. Nevertheless, additional monitoring by professionals and managers working in the organizations might be needed to maintain these effects.
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Affiliation(s)
- Benedicte Deforche
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Jasmine Mommen
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Anne Hublet
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Winnie De Roover
- Vlaams Instituut Gezond Leven (Flemish Institute Healthy Living), Gustave Schildknechtstraat 9, 1020 Brussels, Belgium.
| | - Nele Huys
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
| | - Els Clays
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Lea Maes
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
| | - Jelle Van Cauwenberg
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
- Research Foundation⁻Flanders (FWO), Egmontstraat 5, B-10000 Brussels, Belgium.
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Compernolle S, Van Dyck D, De Cocker K, Palarea-Albaladejo J, De Bourdeaudhuij I, Cardon G, Chastin SFM. Differences in Context-Specific Sedentary Behaviors According to Weight Status in Adolescents, Adults and Seniors: A Compositional Data Analysis. Int J Environ Res Public Health 2018; 15:E1916. [PMID: 30177645 PMCID: PMC6163347 DOI: 10.3390/ijerph15091916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 08/09/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 12/19/2022]
Abstract
To develop effective sedentary behavior interventions aimed at people who are overweight/obese, detailed insight is needed into the contexts of sedentary behavior of these people. Therefore, the aims of this study were to describe the composition of sedentary behavior and to compare context-specific sedentary behaviors between different weight groups. Cross-sectional data were used from a study conducted in 2013⁻2014 among a Flemish sample of adolescents (n = 513), adults (n = 301), and seniors (n = 258). Sixteen context-specific sedentary behaviors were assessed using a validated questionnaire during the week and weekend. Compositional descriptive statistics were performed to determine the relative contribution of context-specific sedentary behaviors in the three age groups. Compositional multivariate analysis of covariance and pairwise comparisons were conducted to examine weight group differences in context-specific sedentary behaviors. The compositional means indicated that the highest proportion of sedentary time was spent at school, at work, and while watching television. Statistically significant differences were found in the composition of sedentary behaviors between healthy weight and overweight/obese participants. In all age groups, socially engaging sedentary behaviors were more prevalent in healthy weight people, whereas socially disengaging behaviors were more prevalent in overweight/obese people. Consequently, the findings of this study suggest that future overweight/obesity interventions should no longer focus on total sedentary time, as not all context-specific sedentary behaviors are associated with overweight/obesity. Instead, it might be better to target specific contexts of sedentary behaviors-preferably those less socially engaging-when aiming to reduce overweight/obesity.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium.
| | - Katrien De Cocker
- Physically Active Lifestyles Research Group, Institute for Resilient Regions, University of Southern Queensland, Springfield, QLD 4300, Australia.
| | | | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Sebastien F M Chastin
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
- School of Health and Life Science, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow G12, UK.
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Simons D, De Bourdeaudhuij I, Clarys P, De Cocker K, Vandelanotte C, Deforche B. Effect and Process Evaluation of a Smartphone App to Promote an Active Lifestyle in Lower Educated Working Young Adults: Cluster Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e10003. [PMID: 30143477 PMCID: PMC6128958 DOI: 10.2196/10003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 01/31/2018] [Revised: 05/16/2018] [Accepted: 05/29/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Mobile technologies have great potential to promote an active lifestyle in lower educated working young adults, an underresearched target group at a high risk of low activity levels. OBJECTIVE The objective of our study was to examine the effect and process evaluation of the newly developed evidence- and theory-based smartphone app "Active Coach" on the objectively measured total daily physical activity; self-reported, context-specific physical activity; and self-reported psychosocial variables among lower educated working young adults. METHODS We recruited 130 lower educated working young adults in this 2-group cluster randomized controlled trial and assessed outcomes at baseline, posttest (baseline+9 weeks), and follow-up (posttest+3 months). Intervention participants (n=60) used the Active Coach app (for 9 weeks) combined with a Fitbit activity tracker. Personal goals, practical tips, and educational facts were provided to encourage physical activity. The control group received print-based generic physical activity information. Both groups wore accelerometers for objective measurement of physical activity, and individual interviews were conducted to assess the psychosocial variables and context-specific physical activity. Furthermore, intervention participants were asked process evaluation questions and generalized linear mixed models and descriptive statistics were applied. RESULTS No significant intervention effects were found for objectively measured physical activity, self-reported physical activity, and self-reported psychosocial variables (all P>.05). Intervention participants evaluated the Active Coach app and the combined use with the Fitbit wearable as self-explanatory (36/51, 70.6%), user friendly (40/51, 78.4%), and interesting (34/51, 66.7%). Throughout the intervention, we observed a decrease in the frequency of viewing graphical displays in the app (P<.001); reading the tips, facts, and goals (P<.05); and wearing the Fitbit wearable (P<.001). Few intervention participants found the tips and facts motivating (10/41, 24.4%), used them to be physically active (8/41, 19.6%), and thought they were tailored to their lifestyle (7/41, 17.1%). CONCLUSIONS The lack of significant intervention effects might be due to low continuous user engagement. Advice or feedback that was not perceived as adequately tailored and the difficulty to compete with many popular commercial apps on young people's smartphones may be responsible for a decrease in the engagement. A stand-alone app does not seem sufficient to promote an active lifestyle among lower educated working young adults; therefore, multicomponent interventions (using both technological and human support), as well as context-specific sensing to provide tailored advice, might be needed in this population. TRIAL REGISTRATION ClinicalTrials.gov NCT02948803; https://clinicaltrials.gov/ct2/show/results/NCT02948803 (Archived by WebCite at http://www.webcitation.org/71OPFwaoA).
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Affiliation(s)
- Dorien Simons
- Unit Health Promotion and Education, Department of Public Health, Ghent University, Ghent, Belgium.,Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Peter Clarys
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School for Health, Medical and Applied Science, Central Queensland University, Rockhampton, Australia
| | - Benedicte Deforche
- Unit Health Promotion and Education, Department of Public Health, Ghent University, Ghent, Belgium
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Gheysen F, Poppe L, DeSmet A, Swinnen S, Cardon G, De Bourdeaudhuij I, Chastin S, Fias W. Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis. Int J Behav Nutr Phys Act 2018; 15:63. [PMID: 29973193 PMCID: PMC6032764 DOI: 10.1186/s12966-018-0697-x] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [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: 02/08/2018] [Accepted: 06/25/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Aging-related cognitive decline and cognitive impairment greatly impacts older adults' daily life. The worldwide ageing of the population and associated wave of dementia urgently calls for prevention strategies to reduce the risk of cognitive decline. Physical activity (PA) is known to improve cognitive function at older age through processes of neuroplasticity. Yet, emerging studies suggest that larger cognitive gains may be induced when PA interventions are combined with cognitive activity (CA). This meta-analysis evaluates these potential synergistic effects by comparing cognitive effects following combined PA + CA interventions to PA interventions (PA only), CA interventions (CA only) and control groups. METHODS Pubmed, Embase, PsycInfo, CINAHL and Sportdiscus were searched for English peer-reviewed papers until April 2018. Data were extracted on cognition and factors potentially influencing the cognitive effects: mode of PA + CA combination (sequential or simultaneous), session frequency and duration, intervention length and study quality. Differences between older adults with and without mild cognitive impairments were also explored. RESULTS Forty-one studies were included. Relative to the control group, combined PA + CA intervention showed significantly larger gains in cognition (g = 0.316; 95% CI 0.188-0.443; p < .001). Studies that compared combined PA + CA with PA only, showed small but significantly greater cognitive improvement in favor of combined interventions (g = 0.160; 95% CI 0.041-0.279; p = .008). No significant difference was found between combined PA + CA and CA only interventions. Furthermore, cognitive effects tended to be more pronounced for studies using simultaneous designs (g = 0.385; 95%CI 0.214-0.555; p < .001) versus sequential designs (g = 0.114; 95%CI -0.102- 0.331, p = .301). Effects were not moderated by session frequency, session duration, intervention length or study quality. Also, no differences in effects were found between older adults with and without mild cognitive impairments. CONCLUSION Findings of the current meta-analysis suggest that PA programs for older adults could integrate challenging cognitive exercises to improve cognitive health. Combined PA + CA programs should be promoted as a modality for preventing as well as treating cognitive decline in older adults. Sufficient cognitive challenge seems more important to obtain cognitive effects than high doses of intervention sessions.
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Affiliation(s)
- Freja Gheysen
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Louise Poppe
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ann DeSmet
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Stephan Swinnen
- Movement Control and Neuroplasticity Research Group, KU Leuven, Leuven, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sebastien Chastin
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Institute of Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Glasgow, UK
| | - Wim Fias
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
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Verhoeven H, Ghekiere A, Van Cauwenberg J, Van Dyck D, De Bourdeaudhuij I, Clarys P, Deforche B. Subgroups of adolescents differing in physical and social environmental preferences towards cycling for transport: A latent class analysis. Prev Med 2018; 112:70-75. [PMID: 29634973 DOI: 10.1016/j.ypmed.2018.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 03/16/2018] [Accepted: 04/06/2018] [Indexed: 11/27/2022]
Abstract
In order to be able to tailor environmental interventions to adolescents at risk for low levels of physical activity, the aim of the present study is to identify subgroups of adolescents with different physical and social environmental preferences towards cycling for transport and to determine differences in individual characteristics between these subgroups. In this experimental study, 882 adolescents (12-16 years) completed 15 choice tasks with manipulated photographs. Participants chose between two possible routes to cycle to a friend's house which differed in seven physical micro-environmental factors, cycling distance and co-participation in cycling (i.e. cycling alone or with a friend). Latent class analysis was performed. Data were collected from March till October 2016 across Flanders (Belgium). Three subgroups could be identified. Subgroup 1 attached most importance to separation of the cycle path and safety-related aspects. Subgroup 2 attached most importance to being able to cycle together with a friend and had the highest percentage of regular cyclists. In subgroup 3, the importance of cycling distance clearly stood out. This subgroup included the lowest percentage of regular cyclists. Results showed that in order to stimulate the least regular cyclists, and thus also the subgroup most at risk for low levels of active transport, cycling distances should be as short as possible. In general, results showed that providing well-separated cycle paths which enable adolescents to cycle side by side and introducing shortcuts for cyclists may encourage different subgroups of adolescents to cycle for transport without discouraging other subgroups.
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Affiliation(s)
- Hannah Verhoeven
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium; Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium; Research Foundation - Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium.
| | - Ariane Ghekiere
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Jelle Van Cauwenberg
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium; Research Foundation - Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium.
| | - Delfien Van Dyck
- Research Foundation - Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium; Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium.
| | - Peter Clarys
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
| | - Benedicte Deforche
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, B-9000 Ghent, Belgium; Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
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Carraça EV, Mackenbach JD, Lakerveld J, Rutter H, Oppert JM, De Bourdeaudhuij I, Compernolle S, Roda C, Bardos H, Teixeira PJ. Lack of interest in physical activity - individual and environmental attributes in adults across Europe: The SPOTLIGHT project. Prev Med 2018; 111:41-48. [PMID: 29474850 DOI: 10.1016/j.ypmed.2018.02.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 01/25/2018] [Accepted: 02/19/2018] [Indexed: 01/11/2023]
Abstract
A considerable proportion of European adults report little or no interest in physical activity. Identifying individual-level and environmental-level characteristics of these individuals can help designing effective interventions and policies to promote physical activity. This cross-sectional study additionally explored associations between level of interest and physical activity, after controlling for other individual and environmental variables. Measures of objective and perceived features of the physical environment of residence, self-reported physical activity and other lifestyle behaviors, barriers towards physical activity, general health, and demographics were obtained from 5205 European adults participating in the 2014 online SPOTLIGHT survey. t-Tests, chi-square tests, and generalized estimating equations with negative binomial log-link function were conducted. Adults not interested in physical activity reported a higher BMI and a lower self-rated health, were less educated, and to a smaller extent female and less frequently employed. They were more prone to have less healthy eating habits, and to perceive more barriers towards physical activity. Only minor differences were observed in environmental attributes: the non-interested were slightly more likely to live in neighborhoods objectively characterized as less aesthetic and containing more destinations, and perceived as less functional, safe, and aesthetic. Even after controlling for other individual and environmental factors, interest in physical activity remained a significant correlate of physical activity, supporting the importance of this association. This study is among the first to describe characteristics of individuals with reduced interest in physical activity, suggesting that (lack of) interest is a robust correlate of physical activity in several personal and environmental conditions.
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Affiliation(s)
- Eliana V Carraça
- Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, The Netherlands
| | - Harry Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jean-Michel Oppert
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France; Sorbonne Université, Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Célina Roda
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Paris 13, Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France
| | - Helga Bardos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary
| | - Pedro J Teixeira
- Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
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Manios Y, Androutsos O, Katsarou C, Vampouli EA, Kulaga Z, Gurzkowska B, Iotova V, Usheva N, Cardon G, Koletzko B, Moreno LA, De Bourdeaudhuij I. Prevalence and sociodemographic correlates of overweight and obesity in a large Pan-European cohort of preschool children and their families: the ToyBox study. Nutrition 2018; 55-56:192-198. [PMID: 30121021 DOI: 10.1016/j.nut.2018.05.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 10/05/2017] [Revised: 02/26/2018] [Accepted: 05/04/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Health inequalities are observed among different regions and socioeconomic groups. The present study aimed to record the prevalence of overweight and obesityamong preschoolers across six European countries in relation to sociodemographic and family factors. METHODS A total of 7554 preschool-aged children and their parents participated in the ToyBox-study. Children's weight and height were measured and parents self-reported their weight, height, and family sociodemographic data using questionnaires. Data were obtained in May and June 2012. RESULTS The prevalence of overweight and obesity ranged from 10.0% in Germany to 20.6% in Greece and was found to be higher in children from low socioeconomic status (SES) families as well as children with two overweight or obese parents. Children from low-SES families and children with overweight or obese parents were more likely to be overweight or obese compared with their peers from medium- or high-SES families or those with normal-weight parents, respectively. CONCLUSIONS In a large sample of European preschoolers, the prevalence of overweight and obesity was found to be higher in Southern and Eastern European countries compared with Central and Northern European countries. Higher prevalence was recorded among low-SES families and in children with overweight or obese parents, which indicates that these areas and vulnerable groups need to be prioritized to close the gap in health and social inequalities and provide more effective prevention of early childhood obesity.
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Affiliation(s)
- Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece.
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Christina Katsarou
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Eleni Anna Vampouli
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | | | | | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Natalya Usheva
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Berthold Koletzko
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Luis A Moreno
- Growth, Exercise, NUtrition and Development Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
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Poppe L, Crombez G, De Bourdeaudhuij I, Van der Mispel C, Shadid S, Verloigne M. Experiences and Opinions of Adults with Type 2 Diabetes Regarding a Self-Regulation-Based eHealth Intervention Targeting Physical Activity and Sedentary Behaviour. Int J Environ Res Public Health 2018; 15:ijerph15050954. [PMID: 29748460 PMCID: PMC5981993 DOI: 10.3390/ijerph15050954] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 04/13/2018] [Revised: 05/07/2018] [Accepted: 05/07/2018] [Indexed: 11/18/2022]
Abstract
Background: Online interventions targeting a healthy lifestyle in adults with type 2 diabetes are more effective when informed by behaviour change theories. Although these theories provide guidance in developing the content of an intervention, information regarding how to present this content in an engaging way is often lacking. Consequently, incorporating users’ views in the creation of eHealth interventions has become an important target. Methods: Via a qualitative interview study with 21 adults with type 2 diabetes who had completed an online self-regulation-based intervention (‘MyPlan 2.0’), we assessed participants’ opinions regarding the usefulness of the implemented self-regulation techniques, the design of the programme as well as their knowledge regarding physical activity and sedentary behaviour. A directed content analysis was performed to synthesize the interview data. Results: Participants experienced difficulties completing the coping planning component. The simple design of the website was considered helpful, and most participants were aware of the beneficial effects of an active lifestyle. Conclusions: ‘MyPlan 2.0’ was well-accepted by the majority of participants. However, the coping planning component will need to be adapted. Based on these findings, recommendations on how to tailor eHealth interventions to the population of adults with type 2 diabetes have been formulated.
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Affiliation(s)
- Louise Poppe
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium.
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | | | - Celien Van der Mispel
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium.
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Samyah Shadid
- Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
| | - Maïté Verloigne
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium.
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Deliens T, Verhoeven H, De Bourdeaudhuij I, Huybrechts I, Mullie P, Clarys P, Deforche B. Factors associated with fruit and vegetable and total fat intake in university students: A cross-sectional explanatory study. Nutr Diet 2018; 75:151-158. [PMID: 29314564 DOI: 10.1111/1747-0080.12399] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 10/06/2017] [Accepted: 11/02/2017] [Indexed: 11/29/2022]
Abstract
AIM This study assessed sociodemographics, general health, personal and environmental factors associated with fruit and vegetable (F&V) and total fat intake in Belgian university students. METHODS In total, 185 students completed a self-reported online questionnaire assessing daily F&V and fat intake, as well as sociodemographic, personal and environmental variables related to F&V and fat intake. Mean F&V and fat consumption were compared with Belgian recommendations. Multiple linear regression analyses were conducted to identify factors associated with F&V and fat intake. RESULTS Respectively, 90.3 and 50.8% of students failed to meet the recommendations for F&V and fat consumption. Agreeing more with the fact that one should eat F&V on most days of the week (individual subjective norm), finding it less difficult to eat F&V at home or at university (perceived behavioural control) and experiencing more modelling were associated with higher F&V consumption. Increasing age, higher educational level of the father and higher individual subjective norm about eating low-fat foods were associated with lower fat intake. CONCLUSIONS Future interventions aiming to improve dietary intake among university students should focus on younger students with lower socioeconomic status and should enhance students' subjective norm and behavioural control concerning healthy eating.
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Affiliation(s)
- Tom Deliens
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Hannah Verhoeven
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
| | | | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), Dietary Exposure Assessment Group, Lyon, France
| | - Patrick Mullie
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- International Prevention Research Institute (iPRI), Lyon, France
| | - Peter Clarys
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Benedicte Deforche
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
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Simons D, De Bourdeaudhuij I, Clarys P, De Cocker K, Vandelanotte C, Deforche B. A Smartphone App to Promote an Active Lifestyle in Lower-Educated Working Young Adults: Development, Usability, Acceptability, and Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e44. [PMID: 29463491 PMCID: PMC5840478 DOI: 10.2196/mhealth.8287] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 06/23/2017] [Revised: 11/22/2017] [Accepted: 12/09/2017] [Indexed: 01/08/2023] Open
Abstract
Background Physical activity (PA) levels are problematic in lower-educated working young adults (18-26 years). To promote PA, smartphone apps have great potential, but there is no evidence for their effectiveness in this population. To increase the likelihood that a newly developed app will be effective, formative research and user testing are required. Objective The aim of this study was to describe the development, usability, acceptability, and feasibility of a new theory- and evidence-based smartphone app to promote an active lifestyle in lower-educated working young adults. Methods The new app was developed by applying 4 steps. First, determinants important to promote an active lifestyle in this population were selected. Second, evidence-based behavior change techniques were selected to convert the determinants into practical applications. Third, a new smartphone app was developed. Fourth, volunteers (n=11, both lower and higher educated) tested the app on usability, and lower-educated working young adults (n=16) tested its acceptability and feasibility via (think aloud) interviews, a questionnaire, and Google Analytics. The app was accordingly adapted for the final version. Results A new Android app, Active Coach, was developed that focused on knowledge, attitude, social support, and self-efficacy (based on outcomes from step 1), and that applied self-regulation techniques (based on outcomes from step 2). The app consists of a 9-week program with personal goals, practical tips, and scientific facts to encourage an active lifestyle. To ensure all-day and automatic self-monitoring of the activity behavior, the Active Coach app works in combination with a wearable activity tracker, the Fitbit Charge. Issues detected by the usability test (eg, text errors, wrong messages) were all fixed. The acceptability and feasibility test showed that participants found the app clear, understandable, and motivating, although some aspects needed to be more personal. Conclusions By applying a stepwise, user-centered approach that regularly consulted the target group, the new app is adapted to their specific needs and preferences. The Active Coach app was overall positively evaluated by the lower-educated working young adults at the end of the development process.
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Affiliation(s)
- Dorien Simons
- Health Promotion and Education Unit, Department of Public Health, Ghent University, Ghent, Belgium.,Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Peter Clarys
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Physically Active Lifestyles Research Group, Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School for Health, Medical and Applied Science, Central Queensland University, Rockhampton, Australia
| | - Benedicte Deforche
- Health Promotion and Education Unit, Department of Public Health, Ghent University, Ghent, Belgium
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42
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Degroote L, Plaete J, De Bourdeaudhuij I, Verloigne M, Van Stappen V, De Meester A, Poppe L, Van der Mispel C, Crombez G. The Effect of the eHealth Intervention 'MyPlan 1.0' on Physical Activity in Adults Who Visit General Practice: A Quasi-Experimental Trial. Int J Environ Res Public Health 2018; 15:E228. [PMID: 29385770 PMCID: PMC5858297 DOI: 10.3390/ijerph15020228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 12/08/2017] [Revised: 01/23/2018] [Accepted: 01/26/2018] [Indexed: 11/16/2022]
Abstract
Physical inactivity is one of the major risk factors for poor health in the world. Therefore, effective interventions that promote physical activity are needed. Hence, we developed an eHealth intervention for adults, i.e., 'MyPlan 1.0', which includes self-regulation techniques for behaviour change. This study examined the effect of 'MyPlan 1.0' on physical activity (PA) levels in general practice. 615 adults (≥18 years) were recruited in 19 Flemish general practices, for the intervention group (n = 328) or for the wait-list control group (n = 183). Participants in the intervention group received the web-based intervention 'MyPlan 1.0' and were prompted to discuss their personal advice/action plan with their general practitioner. Participants in the wait-list control group only received general advice from the website. Self-reported physical activity was assessed with the International Physical Activity Questionnaire (IPAQ) at baseline and after one month. A three-level (general practice, adults, time) regression analysis was conducted in MLwiN. Significant intervention effects were found for total PA and moderate to vigorous PA with an increase for the intervention group compared to a decrease in the control condition. However, there was a high dropout rate in the intervention group (76%) and the wait-list control group (57%). Our self-regulation intervention was effective in increasing physical activity levels in adults. Future studies should consider strategies to prevent the large dropout from participants.
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Affiliation(s)
- Laurent Degroote
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
| | - Jolien Plaete
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Maïté Verloigne
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - An De Meester
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
| | - Louise Poppe
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
| | - Celien Van der Mispel
- Department of Movement and Sports Sciences, Ghent University, 9000 Gent, Belgium; (J.P.); (I.D.B.); (M.V.); (V.V.S.); (A.D.M.); (L.P.); (C.V.d.M.)
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Gent, Belgium;
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43
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Arvidsson L, Eiben G, Hunsberger M, De Bourdeaudhuij I, Molnar D, Jilani H, Thumann B, Veidebaum T, Russo P, Tornatitis M, Santaliestra-Pasías AM, Pala V, Lissner L. Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study. BMC Public Health 2017; 17:926. [PMID: 29237434 PMCID: PMC5729410 DOI: 10.1186/s12889-017-4920-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 12/19/2016] [Accepted: 11/16/2017] [Indexed: 01/12/2023] Open
Abstract
Background In children the relationship between a healthy diet and psychosocial well-being has not been fully explored and the existing evidence is inconsistent. This study investigates the chronology of the association between children’s adherence to healthy dietary guidelines and their well-being, with special attention to the influence of weight status on the association. Methods Seven thousand six hundred seventy five children 2 to 9 years old from the eight-country cohort study IDEFICS were investigated. They were first examined between September 2007 and June 2008 and re-examined again 2 years later. Psychosocial well-being was measured using self-esteem and parent relations questions from the KINDL® and emotional and peer problems from the Strengths and Difficulties Questionnaire. A Healthy Dietary Adherence Score (HDAS) was calculated from a 43-item food frequency questionnaire as a measure of the degree to which children’s dietary intake follows nutrition guidelines. The analysis employed multilevel logistic regression (country as random effect) with bidirectional modeling of dichotomous dietary and well-being variables as both exposures and outcomes while controlling for respective baseline values. Results A higher HDAS at baseline was associated with better self-esteem (OR 1.2, 95% CI 1.0;1.4) and fewer emotional and peer problems (OR 1.2, 95% CI 1.1;1.3 and OR 1.3, 95% CI 1.2;1.4) 2 years later. For the reversed direction, better self-esteem was associated with higher HDAS 2 years later (OR 1.1 95% CI 1.0;1.29). The analysis stratified by weight status revealed that the associations between higher HDAS at baseline and better well-being at follow-up were similar in both normal weight and overweight children. Conclusion Present findings suggest a bidirectional relation between diet quality and self-esteem. Additionally, higher adherence to healthy dietary guidelines at baseline was associated with fewer emotional and peer problems at follow-up, independent of children’s weight status. Electronic supplementary material The online version of this article (10.1186/s12889-017-4920-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise Arvidsson
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden.
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden
| | - Monica Hunsberger
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden
| | | | - Denes Molnar
- Department of Paediatrics, Clinical Center, University of Pécs, Pecs, Hungary
| | - Hannah Jilani
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 283 59, Bremen, Germany
| | - Barbara Thumann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 283 59, Bremen, Germany
| | | | - Paola Russo
- Institute of Food Sciences, CNR Via Roma, 64-83100, Avellino, Italy
| | | | - Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition, and Development) Research group, University of Zaragoza; Instituto Agroalimentario de Aragón (IA2); Instituto de Investigación Sanitaria Aragón (IIS Aragón); Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain
| | - Valeria Pala
- Nutritional Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 405 30, Gothenburg, Sweden
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44
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Muellmann S, Steenbock B, De Cocker K, De Craemer M, Hayes C, O'Shea MP, Horodyska K, Bell J, Luszczynska A, Roos G, Langøien LJ, Rugseth G, Terragni L, De Bourdeaudhuij I, Brug J, Pischke CR. Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project. BMC Public Health 2017; 17:932. [PMID: 29207993 PMCID: PMC5718005 DOI: 10.1186/s12889-017-4929-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [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: 10/21/2016] [Accepted: 11/20/2017] [Indexed: 12/15/2022] Open
Abstract
Background The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland. Methods Six interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher. Results Active involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured. Conclusions Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies. Electronic supplementary material The online version of this article (10.1186/s12889-017-4929-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saskia Muellmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Berit Steenbock
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Katrien De Cocker
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Catherine Hayes
- Department of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Miriam P O'Shea
- Department of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Karolina Horodyska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Justyna Bell
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Aleksandra Luszczynska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Trauma, Health, & Hazards Center, University College of Applied Sciences Colorado, Colorado Springs, CO, USA
| | - Gun Roos
- Consumption Research Norway - SIFO, Oslo and Akershus, Oslo, Norway
| | - Lars Jørun Langøien
- Department for Physical Education, Norwegian School of Sports Science, Oslo, Norway
| | - Gro Rugseth
- Department for Physical Education, Norwegian School of Sports Science, Oslo, Norway
| | - Laura Terragni
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | | | - Johannes Brug
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Claudia R Pischke
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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45
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Androutsos O, Moschonis G, Ierodiakonou D, Karatzi K, De Bourdeaudhuij I, Iotova V, Zych K, Moreno LA, Koletzko B, Manios Y. Perinatal and lifestyle factors mediate the association between maternal education and preschool children's weight status: the ToyBox study. Nutrition 2017; 48:6-12. [PMID: 29469021 DOI: 10.1016/j.nut.2017.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 07/24/2017] [Revised: 09/29/2017] [Accepted: 11/01/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This study aimed to explore the associations among perinatal, sociodemographic, and behavioral factors and preschool overweight/obesity. METHODS Data were collected from 7541 European preschoolers in May/June 2012. Children's anthropometrics were measured, and parents self-reported all other data via questionnaires. Level of statistical significance was set at P ≤ 0.05. RESULTS Certain perinatal factors (i.e., maternal prepregnancy overweight/obesity, maternal excess gestational weight gain, excess birth weight, and "rapid growth velocity"), children's energy balance-related behaviors (i.e., high sugar-sweetened beverage consumption, increased screen time, reduced active-play time), family sociodemographic characteristics (i.e., Eastern or Southern Europe, low maternal and paternal education), and parental overweight/obesity were identified as correlates of preschoolers' overweight/obesity. Furthermore, maternal prepregnancy overweight/obesity, children's "rapid growth velocity," and increased screen time mediated by 21.2%, 12.5%, and 5.7%, respectively, the association between maternal education and preschoolers' body mass index. CONCLUSION This study highlighted positive associations of preschooler's overweight/obesity with excess maternal prepregnancy and gestational weight gain, excess birth weight and "rapid growth velocity," Southern or Eastern European region, and parental overweight/obesity. Moreover, maternal prepregnancy overweight/obesity, children's "rapid growth velocity," and increased screen time partially mediated the association between maternal education and preschoolers' body mass index. The findings of the present study may support childhood obesity prevention initiatives, because vulnerable population groups and most specifically low-educated families should be prioritized. Among other fields, these intervention initiatives should also focus on the importance of normal prepregnancy maternal weight status, normal growth velocity during infancy, and retaining preschool children's screen time within recommendations.
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Affiliation(s)
- Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - George Moschonis
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Melbourne, Australia
| | - Despo Ierodiakonou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Kalliopi Karatzi
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | | | - Violeta Iotova
- Department of Pediatrics, Medical University Varna, Varna, Bulgaria
| | - Kamila Zych
- The Children's Memorial Health Institute, Warsaw, Poland
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität Munich, Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece.
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46
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Edney S, Plotnikoff R, Vandelanotte C, Olds T, De Bourdeaudhuij I, Ryan J, Maher C. "Active Team" a social and gamified app-based physical activity intervention: randomised controlled trial study protocol. BMC Public Health 2017; 17:859. [PMID: 29096614 PMCID: PMC5667488 DOI: 10.1186/s12889-017-4882-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 07/13/2017] [Accepted: 10/26/2017] [Indexed: 01/28/2023] Open
Abstract
Background Physical inactivity is a leading preventable cause of chronic disease and premature death globally, yet over half of the adult Australian population is inactive. To address this, web-based physical activity interventions, which have the potential to reach large numbers of users at low costs, have received considerable attention. To fully realise the potential of such interventions, there is a need to further increase their appeal to boost engagement and retention, and sustain intervention effects over longer periods of time. This randomised controlled trial aims to evaluate the efficacy of a gamified physical activity intervention that connects users to each other via Facebook and is delivered via a mobile app. Methods The study is a three-group, cluster-RCT. Four hundred and forty (440) inactive Australian adults who use Facebook at least weekly will be recruited in clusters of three to eight existing Facebook friends. Participant clusters will be randomly allocated to one of three conditions: (1) waitlist control condition, (2) basic experimental condition (pedometer plus basic app with no social and gamification features), or (3) socially-enhanced experimental condition (pedometer plus app with social and gamification features). Participants will undertake assessments at baseline, three and nine months. The primary outcome is change in total daily minutes of moderate-to-vigorous physical activity at three months measured objectively using GENEActive accelerometers [Activeinsights Ltd., UK]. Secondary outcomes include self-reported physical activity, depression and anxiety, wellbeing, quality of life, social-cognitive theory constructs and app usage and engagement. Discussion The current study will incorporate novel social and gamification elements in order to examine whether the inclusion of these components increases the efficacy of app-based physical activity interventions. The findings will be used to guide the development and increase the effectiveness of future health behaviour interventions. Trial registration This trial was registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12617000113358, date of registration 23 January, 2017).
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Affiliation(s)
- Sarah Edney
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, GPO Box 2471, Adelaide, South Australia, Australia
| | - Ronald Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, Advance Technology Centre, Level 3, The University of Newcastle, Newcastle, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Human Health and Social Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Tim Olds
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, GPO Box 2471, Adelaide, South Australia, Australia
| | | | - Jillian Ryan
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, GPO Box 2471, Adelaide, South Australia, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, GPO Box 2471, Adelaide, South Australia, Australia.
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Mackenbach JD, Lakerveld J, van Oostveen Y, Compernolle S, De Bourdeaudhuij I, Bárdos H, Rutter H, Glonti K, Oppert JM, Charreire H, Brug J, Nijpels G. The mediating role of social capital in the association between neighbourhood income inequality and body mass index. Eur J Public Health 2017; 27:218-223. [PMID: 27679765 DOI: 10.1093/eurpub/ckw157] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Neighbourhood income inequality may contribute to differences in body weight. We explored whether neighbourhood social capital mediated the association of neighbourhood income inequality with individual body mass index (BMI). Methods A total of 4126 adult participants from 48 neighbourhoods in France, Hungary, the Netherlands and the UK provided information on their levels of income, perceptions of neighbourhood social capital and BMI. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. Neighbourhood income inequality was defined as the ratio of the amount of income earned by the top 20% and the bottom 20% in a given neighbourhood. Two single mediation analyses-using multilevel linear regression analyses-with neighbourhood social networks and neighbourhood social cohesion as possible mediators-were conducted using MacKinnon's product-of-coefficients method, adjusted for age, gender, education and absolute household income. Results Higher neighbourhood income inequality was associated with elevated levels of BMI and lower levels of neighbourhood social networks and neighbourhood social cohesion. High levels of neighbourhood social networks were associated with lower BMI. Results stratified by country demonstrate that social networks fully explained the association between income inequality and BMI in France and the Netherlands. Social cohesion was only a significant mediating variable for Dutch participants. Conclusion The results suggest that in some European urban regions, neighbourhood social capital plays a large role in the association between neighbourhood income inequality and individual BMI.
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Affiliation(s)
- Joreintje D Mackenbach
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Yavanna van Oostveen
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Sofie Compernolle
- Department of Movement and Sport Sciences, Ghent University, Gent, Belgium, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Gent, Belgium, Ghent, Belgium
| | - Helga Bárdos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Hungary, Hungary
| | - Harry Rutter
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - Ketevan Glonti
- ECOHOST - The Centre for Health and Social Change, London School of Hygiene and Tropical Medicine, London, UK
| | - Jean-Michel Oppert
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, Université Pierre et Marie Curie, Université Paris 06; Institute of Cardiometabolism and Nutrition, Paris, France
| | - Helene Charreire
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Université Paris 13, Bobigny, France.,Paris Est University, Lab-Urba, UPEC, Urban School of Paris, Créteil Cedex, France
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Giel Nijpels
- Department of General Practice and Elderly Care, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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48
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Compernolle S, Busschaert C, De Bourdeaudhuij I, Cardon G, Chastin SFM, Van Cauwenberg J, De Cocker K. Cross-Sectional Associations between Home Environmental Factors and Domain-Specific Sedentary Behaviors in Adults: The Moderating Role of Socio-Demographic Variables and BMI. Int J Environ Res Public Health 2017; 14:ijerph14111329. [PMID: 29088089 PMCID: PMC5707968 DOI: 10.3390/ijerph14111329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 09/22/2017] [Revised: 10/27/2017] [Accepted: 10/29/2017] [Indexed: 11/16/2022]
Abstract
Despite the negative health effects of too much sitting, the majority of adults are too sedentary. To develop effective interventions, insight is needed into home environmental correlates of adults' sedentary behaviors, and into the susceptibility of population subgroups to these home environmental cues. In total, 559 Flemish adults reported socio-demographics, weight and height, home environmental factors and domain-specific sedentary behaviors. Generalized linear modeling was conducted to examine main associations between home environmental factors and domain-specific sedentary behaviors, and to test the moderating role of socio-demographics and BMI on these associations. In case of significant interactions, stratified analyses were performed. Results showed that, among those who did use a computer/laptop during the last week, a one-unit increase in the number of computers or laptops was associated with 17% (OR = 1.17; 95% CI = 1.02, 1.34) and 24% (OR = 1.24; 95% CI = 1.08, 1.43) more minutes computer time per day, respectively. The proximity of the remote controller (p < 0.001) and the number of televisions (p = 0.03) were positively associated with television time, and the number of motorized vehicles (95% CI = 0.001, 0.12) was positively associated with the odds of participation in transport-related sitting time. The latter two associations were moderated by BMI, with significant positive associations limited to those not overweight. To conclude, home environmental factors were associated with domain-specific sedentary behaviors, especially in healthy weight adults. If confirmed by longitudinal studies, public health professionals should encourage adults to limit the number of indoor entertainment devices and motorized vehicles.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Cedric Busschaert
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Sebastien F M Chastin
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
- School of Health and Life Science, Institute of Applied Health Research, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
| | - Jelle Van Cauwenberg
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium.
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium.
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D'Haese S, Cardon G, De Bourdeaudhuij I, Deforche B, De Meester F, Van Dyck D. Changes in Individual and Social Environmental Characteristics in Relation to Changes in Physical Activity: a Longitudinal Study from Primary to Secondary School. Int J Behav Med 2017; 23:539-52. [PMID: 26993643 DOI: 10.1007/s12529-016-9545-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Indexed: 01/14/2023]
Abstract
PURPOSE Physical activity (PA) strongly decreases when children make the transition from primary to secondary school. The study aimed to investigate how individual and social environmental factors toward PA changed when children (11-12 years) made the transition from primary to secondary school (13-14 years) and how changes in these factors were related to changes in different PA domains. METHODS In total, 321 children (48.9 % girls) and one of their parents both filled out a questionnaire concerning individual (i.e., attitude, self-efficacy, perceived benefits, and barriers of PA) and social environmental factors related to PA (parental support, friend's co-participation, parental trust in child's ability to be physically active, and social norm) in the last grade of primary school and 2 years later. Children wore an activity monitor for 7 days and self-reported different domains of PA. RESULTS Most individual and social factors became less positive toward PA after the transition to secondary school. Among girls, a more positive attitude and an increase in self-efficacy were related to an increase in average daily steps and sports during leisure, respectively. Among boys, a decrease in perceived barriers (lack of time and parental reported lack of transportation to sport activities) was related to a decrease in average daily steps. An increase in parental support and a decrease in the parental perceived barrier of not liking sports were related to an increase in sports during leisure. CONCLUSIONS The prevention of adverse changes in individual and social factors toward physical activity may lead to a smaller decrease or an increase in physical activity.
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Affiliation(s)
- Sara D'Haese
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, Brussels, 1000, Belgium
| | - Greet Cardon
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Benedicte Deforche
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
- Faculty of Physical Education and Physiotherapy, Department of Human Biomechanics and Biometry, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussel, Belgium
| | - Femke De Meester
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
- Flemish Institute for Health Promotion and Disease Prevention (VIGeZ), Gustave Schildknechtstraat 9, 1020, Brussels (Laken), Belgium
| | - Delfien Van Dyck
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, Brussels, 1000, Belgium
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50
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De Craemer M, Verloigne M, De Bourdeaudhuij I, Androutsos O, Iotova V, Moreno L, Koletzko B, Socha P, Manios Y, Cardon G. Effect and process evaluation of a kindergarten-based, family-involved cluster randomised controlled trial in six European countries on four- to six-year-old children's steps per day: the ToyBox-study. Int J Behav Nutr Phys Act 2017; 14:116. [PMID: 28851434 PMCID: PMC5576230 DOI: 10.1186/s12966-017-0574-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 12/19/2016] [Accepted: 08/20/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The ToyBox-intervention is a theory- and evidence-based intervention delivered in kindergartens to improve four- to six-year-old children's energy balance-related behaviours and prevent obesity. The current study aimed to (1) examine the effect of the ToyBox-intervention on increasing European four- to six-year-old children' steps per day, and (2) examine if a higher process evaluation score from teachers and parents was related to a more favourable effect on steps per day. METHODS A sample of 2438 four- to six-year-old children (51.9% boys, mean age 4.75 ± 0.43 years) from 6 European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain) wore a motion sensor (pedometer or accelerometer) for a minimum of two weekdays and one weekend day both at baseline and follow-up to objectively measure their steps per day. Kindergarten teachers implemented the physical activity component of the ToyBox-intervention for 6 weeks in total, with a focus on (1) environmental changes in the classroom, (2) the child performing the actual behaviour and (3) classroom activities. Children's parents received newsletters, tip cards and posters. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and the six intervention countries separately. In addition, process evaluation questionnaires were used to calculate a total process evaluation score (with implementation and satisfaction as a part of the overall score) for teachers and parents which was then linked with the physical activity outcomes. RESULTS No significant intervention effects on four- to six-year-old children' steps per weekday, steps per weekend day and steps per average day were found, both in the total sample and in the country-specific samples (all p > 0.05). In general, the intervention effects on steps per day were least favourable in four- to six-year-old children with a low teachers process evaluation score and most favourable in four- to six-year-old children with a high teachers process evaluation score. No differences in intervention effects were found for a low, medium or high parents' process evaluation score. CONCLUSION The physical activity component of the ToyBox-intervention had no overall effect on four- to six-year-old children' steps per day. However, the process evaluation scores showed that kindergarten teachers that implemented the physical activity component of the ToyBox-intervention as planned and were satisfied with the physical activity component led to favourable effects on children's steps per day. Strategies to motivate, actively involve and engage the kindergarten teachers and parents/caregivers are needed to induce larger effects.
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Affiliation(s)
- Marieke De Craemer
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Maïté Verloigne
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, Harokopio University, School of Health Science & Education, E. Venizelou 70, 17671 Athens, Greece
| | - Violeta Iotova
- Medical University Varna, Clinic of Paediatric Endocrinology, UMHAT “St. Marina”, “Hr. Smirnenski” Blvd, Varna, Bulgaria
| | - Luis Moreno
- University of Zaragoza, GENUD (Growth, Exercise, Drinking behaviour and Development), C/Corona de Aragón 42, 50009 Zaragoza, Spain
| | - Berthold Koletzko
- University of Munich Medical Centre, Dr. von Hauner Children’s Hospital, Lindwurmstr.4, 80337 Munich, Germany
| | - Piotr Socha
- Children’s Memorial Institute, Al. Dzieci Polskich 20, 04–730 Warsaw, Poland
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, School of Health Science & Education, E. Venizelou 70, 17671 Athens, Greece
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
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