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Tcymbal A, Messing S, Mait R, Perez RG, Akter T, Rakovac I, Gelius P, Abu-Omar K. Validity, reliability, and readability of single-item and short physical activity questionnaires for use in surveillance: A systematic review. PLoS One 2024; 19:e0300003. [PMID: 38470871 PMCID: PMC10931432 DOI: 10.1371/journal.pone.0300003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Accurate and fast measurement of physical activity is important for surveillance. Even though many physical activity questionnaires (PAQ) are currently used in research, it is unclear which of them is the most reliable, valid, and easy to use. This systematic review aimed to identify existing brief PAQs, describe and compare their measurement properties, and assess their level of readability. METHODS We performed a systematic review based on the PRISMA statement. Literature searches were conducted in six scientific databases. Articles were included if they evaluated validity and/or reliability of brief (i.e., with a maximum of three questions) physical activity or exercise questionnaires intended for healthy adults. Due to the heterogeneity of studies, data were summarized narratively. The level of readability was calculated according to the Flesch-Kincaid formula. RESULTS In total, 35 articles published in English or Spanish were included, evaluating 32 distinct brief PAQs. The studies indicated moderate to good levels of reliability for the PAQs. However, the majority of results showed weak validity when validated against device-based measurements and demonstrated weak to moderate validity when validated against other PAQs. Most of the assessed PAQs met the criterion of being "short," allowing respondents to complete them in less than one minute either by themselves or with an interviewer. However, only 17 questionnaires had a readability level that indicates that the PAQ is easy to understand for the majority of the population. CONCLUSIONS This review identified a variety of brief PAQs, but most of them were evaluated in only a single study. Validity and reliability of short and long questionnaires are found to be at a comparable level, short PAQs can be recommended for use in surveillance systems. However, the methods used to assess measurement properties varied widely across studies, limiting the comparability between different PAQs and making it challenging to identify a single tool as the most suitable. None of the evaluated brief PAQs allowed for the measurement of whether a person fulfills current WHO physical activity guidelines. Future development or adaptation of PAQs should prioritize readability as an important factor to enhance their usability.
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Affiliation(s)
- Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Rachel Mait
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Roberto Galindo Perez
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Taiyeba Akter
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ivo Rakovac
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Peter Gelius
- Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Messing S, Tcymbal A, Abu-Omar K, Gelius P. Research- vs. government-driven physical activity policy monitoring: a systematic review across different levels of government. Health Res Policy Syst 2023; 21:124. [PMID: 38012659 PMCID: PMC10680174 DOI: 10.1186/s12961-023-01068-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 11/01/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Even though the importance of physical activity policy monitoring has increased in the last decade, there is a lack of understanding what different approaches exist and which methodology they employ. In order to address this research gap, this review attempts to map existing approaches of physical activity policy monitoring and to analyse methodological aspects, especially with regards to the roles of governments and researchers. METHODS A systematic search was conducted in five scientific databases (PubMed, Scopus, SportDiscus, Psycinfo, Web of Knowledge) in July 2021, and the identified records were screened independently by two reviewers. Records were included if they (a) focused on the monitoring of public policies to promote PA, (b) allowed to compare policies across time, across nations/regions or across policy sectors, and (c) were written in English, German or Russian. During full text analysis, information on methodological aspects was extracted and studies were categorized based on the level of government involvement. RESULTS The search yielded in a total of 112 studies. 86 of these studies (76.8%) followed a research-driven approach (little or no government involvement) while only two studies (1.8%) were based on a government-driven approach (led by governments). The remaining 24 studies (21.4%) were based on a co-production approach (strong collaboration between researchers and governments). All in all, 18 different tools for physical activity policy monitoring were identified; key examples are the Report Cards on Physical Activity for Children and Youth (research-driven approach), the HEPA Monitoring Framework (government-driven approach) and the HEPA Policy Audit Tool (co-production approach). CONCLUSIONS The level of government involvement in policy monitoring differs significantly, and research-driven, government-driven and co-production approaches can be distinguished. These approaches have different strengths and weaknesses, and can be linked to distinct theories of change and models on research-policy relations. Increasing awareness on the implications of these approaches is key to improve the understanding and further development of physical activity policy monitoring.
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Affiliation(s)
- Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland
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Messing S, Gelius P, Abu-Omar K, Marzi I, Beck F, Geidl W, Grüne E, Tcymbal A, Reimers AK, Pfeifer K. Developing a policy brief on physical activity promotion for children and adolescents. Front Public Health 2023; 11:1215746. [PMID: 37841728 PMCID: PMC10571038 DOI: 10.3389/fpubh.2023.1215746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/29/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction While there are several approaches to collect basic information on physical activity (PA) promotion policies, some governments require more in-depth overviews on the situation in their country. In Germany, the Federal Ministry of Health expressed its interest in collecting detailed data on target group specific PA promotion, as relevant competences are distributed across a wide range of political levels and sectors. This study describes the development of a policy brief on physical activity promotion for children and adolescents in Germany. In particular, it addresses two major gaps in the current literature by systematically assessing good practice examples and "routine practices," i.e., PA promotion activities already taking place on large scale and regular basis. Materials and methods Based on relevant national and international guidelines, the TARGET:PA tool was co-produced by researchers and ministry officials. It includes (1) PA recommendations, (2) national prevalence rates, (3) recommendations for PA promotion, and data on national (4) routine practices, (5) good practice projects and (6) policies. Data were collected for children and adolescents in Germany using desk research, semi-structured interviews and secondary data analysis. Results A policy brief and scientific background document were developed. Results showed that 46% of the 4-5-year-olds fulfil WHO recommendations but only 15% of the 11-17-year-olds, and that girls are less active than boys. Currently, in Germany no valid data are available on the PA behaviour of children under the age of three. An overview of routine practices for PA promotion for children and adolescents was compiled, and experts were asked to critically assess their effectiveness, reach and durability. Overall, 339 target group specific projects for PA promotion were found, with 22 classified as examples of good practice. National PA policies for children and adolescents were identified across different sectors and settings. Conclusion The study provides a comprehensive overview of the current status of PA promotion for children and adolescents in Germany. The co-production of the policy brief was a strength of the study, as it allowed researchers to take the needs of ministry officials into account, and as it supported the immediate uptake of results in the policymaking process. Future studies should test the applicability of the TARGET:PA tool to different target groups and countries.
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Affiliation(s)
- Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Isabel Marzi
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Franziska Beck
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Eva Grüne
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anne Kerstin Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Kardan M, Akter T, Iqbal M, Tcymbal A, Messing S, Gelius P, Abu-Omar K. Cycling in older adults: a scoping review. Front Sports Act Living 2023; 5:1157503. [PMID: 37457855 PMCID: PMC10338922 DOI: 10.3389/fspor.2023.1157503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Regular physical activity provides many health benefits to older adults. As a well-known form of physical activity, cycling can be an appropriate means for older people to meet WHO recommendations and to improve their health. In addition, cycling can help to protect the environment and reduce greenhouse gas emissions. The primary aim of this scoping review is to identify the currently available scientific evidence and gaps of research in this field. Methods A systematic search in seven databases resulted in 7,192 studies. After the exclusion of duplicates, studies were screened by two independent reviewers in a two-stage process. Based on previously defined inclusion criteria, 123 studies were included. Data extraction was based on a descriptive analytical method, and seven categories for the main topics of studies were developed. Data were extracted by three reviewers to analyze different characteristics of included articles such as age range, study design, data type, gender, type of bicycle, and country of origin. Results The included studies covered the following topics: (1) traffic safety, (2) cycling as physical activity or for transport, (3) health benefits, (4) environmental factors, (5) facilitators and barriers, (6) application of technology and (7) promotion of cycling. Results show that the majority of studies were performed in both younger (60-79 years) and older (80+ years) adults. Most studies had an observational study design, used conventional bicycles, and were based on quantitative methods. Researchers from the United States, Netherlands, and Japan published the highest number of studies related to cycling. Discussion Traffic safety was the most prevalent focus of the included studies. Gaps were identified with regard to studies focusing on the promotion of cycling, application of technology, as well as facilitators and barriers of cycling. While research on traffic safety should continue to be a high priority for public health, potentially more research should focus on how to get older people to bicycle more. This is warranted by the proven individual and planetary health benefits of cycling and the urgency of combating climate change.
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den Braver NR, Garcia Bengoechea E, Messing S, Kelly L, Schoonmade LJ, Volf K, Zukowska J, Gelius P, Forberger S, Woods CB, Lakerveld J. The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens. Eur J Public Health 2022; 32:iv71-iv83. [PMID: 36444108 PMCID: PMC9706123 DOI: 10.1093/eurpub/ckac085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This review of reviews aimed to: (1) summarize the evidence from published reviews on the effectiveness of mass-media campaigns to promote physical activity (PA) or PA-related determinants (intermediate psychological and proximal outcomes) and (2) to identify policy-relevant recommendations related to successful PA campaigns. METHODS An extensive literature search was performed on 1 March 2021. Reviews that evaluated the impact of campaigns on distal (e.g. PA) and/or proximal outcomes of PA (awareness, knowledge, etc.) and that targeted the general population or subsets were included. Quality of reviews was assessed using the AMSTAR-2 tool. Policy-relevant recommendations were systematically derived and synthesized and formulated as good practice statements. A protocol was registered beforehand (ID: CRD42021249184). RESULTS A total of 1915 studies were identified, of which 22 reviews were included. The most consistent evidence was found for the effectiveness of mass-media campaigns on proximal outcomes, while the evidence for distal outcomes was mixed. Good practice statements were derived: (1) to achieve behaviour change, mass-media is an important component of larger, multilevel and multicomponent strategies; (2) mass-media strategies should be coordinated and aligned at local- and national-level and be sustained, monitored and resourced at these levels and (3) media should be tailored to reduce socioeconomic inequalities. CONCLUSIONS Mass-media can play an important role in the promotion of PA. In general, evidence was more inconsistent for effectiveness on distal outcomes than for proximal outcomes. Policy-relevant recommendations include that mass-media strategies should be resourced, coordinated, aligned, sustained, monitored and evaluated on the local and national level.
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Affiliation(s)
- Nicolette R den Braver
- Correspondence: Nicolette R. den Braver, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres, De Boelelaan 1089a, 1081HV Amsterdam, The Netherlands, Tel: +31 20 44 430 80, e-mail:
| | - Enrique Garcia Bengoechea
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland,Research and Innovation Unit, Sport Ireland, Ireland
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Linda J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kevin Volf
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Catherine B Woods
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres, Amsterdam, The Netherlands,Upstream Team, Amsterdam, The Netherlands
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Hebestreit A, Do S, Wolters M, Mensink GBM, Garnica-Rosas L, Abu-Omar K, Messing S, Neumann-Podczaska A, Wieczorowska-Tobis K, Lien N, Stanley I, Ahrens W, Murrin C. Towards a harmonized European surveillance for dietary and physical activity indicators in young and adult populations. Eur J Public Health 2022; 32:iv21-iv31. [PMID: 36444107 PMCID: PMC9706124 DOI: 10.1093/eurpub/ckac061] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The Policy Evaluation Network proposes a consolidated approach to measure comparable health indicators across European health surveillance systems to evaluate effectiveness of policy action. METHODS In a stepwise approach, questionnaire items used by the systems for measuring diet and physical activity data to describe health indicators were identified based on their validity, reliability, and suitability to monitor achievement of health recommendations. They were collated to unified questionnaire modules and discussed bilaterally with representatives of these systems to explore barriers and facilitators for implementation. Also, establishment of a methodological competence platform was proposed, in which the surveillance and monitoring systems agree on the priorities and common quality standards for the harmonization process and to coordinate the integration of questionnaire modules into existing systems. RESULTS In total, seven questionnaire modules were developed, of which two diet and two physical activity modules were proposed for implementation. Each module allows measurement of data reflecting only partial aspects of national and WHO recommendations related to diet and physical activity. Main barriers were the requirements of systems to monitor temporal trends and to minimize costs. Main facilitator for implementation was the systems' use of questionnaire items that were comparable to the unified modules. Representatives agreed to participate in a methodological competence platform. CONCLUSION We successfully took first steps in the realization of the roadmap towards a harmonization of European surveillance by introducing unified questionnaire modules allowing the collection of comparable health indicators and by initiating the establishment of a competence platform to guide this process.
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Affiliation(s)
- Antje Hebestreit
- Correspondence: Antje Hebestreit, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Achterstrasse 30, 28359 Bremen, Germany, Tel: +49 (0) 421 218 56 849, e-mail: ,
| | - Stefanie Do
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Maike Wolters
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany
| | - Lina Garnica-Rosas
- Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | | | | | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Isobel Stanley
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Woods CB, Kelly L, Volf K, Gelius P, Messing S, Forberger S, Lakerveld J, den Braver NR, Zukowska J, García Bengoechea E. The Physical Activity Environment Policy Index for monitoring government policies and actions to improve physical activity. Eur J Public Health 2022; 32:iv50-iv58. [PMID: 36444111 PMCID: PMC9706113 DOI: 10.1093/eurpub/ckac062] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A multifaceted response, including government action, is essential to improve population levels of physical activity (PA). This article describes the development process of the 'Physical Activity Environment Policy Index' (PA-EPI) monitoring framework, a tool to assess government policies and actions for creating a healthy PA environment. METHODS An iterative process was undertaken. This involved a review of policy documents from authoritative organizations, a PA policy audit of four European countries, and a systematic review of scientific literature. This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries). During this process, consensus workshops were conducted, where quantitative and qualitative data, alongside theoretical and pragmatic considerations, were used to inform PA-EPI development. RESULTS The PA-EPI is conceptualized as a two-component 'policy' and 'infrastructure support' framework. The two-components comprise eight policy and seven infrastructure support domains. The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community. The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development and health-in-all-policies. Forty-five 'good practice statements' or indicators of ideal good practice within each domain conclude the PA-EPI. A potential eight-step process for conducting the PA-EPI is described. CONCLUSIONS Once pre-tested and piloted in several countries of various sizes and income levels, the PA-EPI good practice statements will evolve into benchmarks established by governments at the forefront of creating and implementing policies to address inactivity.
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Affiliation(s)
- Catherine B Woods
- Correspondence: Catherine B. Woods, Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland, Tel: +353 (0) 61 202379, e-mail:
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kevin Volf
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam, Amsterdam Public Health Research institute, Amsterdam, The Netherlands,Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Nicolette R den Braver
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam, Amsterdam Public Health Research institute, Amsterdam, The Netherlands,Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Enrique García Bengoechea
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland,Research and Innovation Unit, Sport Ireland, Dublin, Ireland
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Messing S, Tcymbal A, Abu-Omar K, Richardson D, Gelius P. Methods of policy monitoring in physical activity promotion: a systematic review across different levels of government. Eur J Public Health 2022. [PMCID: PMC9594761 DOI: 10.1093/eurpub/ckac129.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Even though the importance of policy monitoring in public health has increased in the last decades, there is still a lack of understanding what different approaches of policy monitoring exist and which methodology they employ. In order to address this research gap, this review attempts to provide a comprehensive overview about the methods of policy monitoring in the field of physical activity promotion. Methods A systematic search was conducted in five scientific databases, using the terms “physical activity”, “policy” and “monitoring” and their variations. In total, 12.963 studies were identified and, after the elimination of duplicates, screened independently by two reviewers. During full text analysis, information on the methods applied for policy monitoring was extracted and studies were categorized based on their key characteristics (monitoring tool, policy level, and setting). Results The search yielded in a total of 112 studies that were structured into seven categories: Report Cards on Physical Activity for Children and Youth, HEPA Monitoring Framework, HEPA Policy Audit Tool, national policies, subnational policies, school setting, and childcare setting. Across all categories, policy monitoring focused mainly on national level policies in a single country. Differences were identified with regards to the level of government involvement which allowed to differentiate between research-driven approaches (little or no government involvement), government-driven approaches (led by governments), and co-production approaches (strong collaboration between researchers and governments). Conclusions Research-driven, government-driven and co-production approaches have different strengths and weaknesses with regards to the monitoring of policies. Awareness needs to be raised regarding the implications of these approaches, and more research is needed to analyse the impact of policy monitoring on policy-making in public health.
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Affiliation(s)
- S Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - A Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - K Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - D Richardson
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürn , Erlangen, Germany
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Woods C, Kelly L, Volf K, Gelius P, Messing S, Forberger S, Lakerveld J, den Braver N, Zukowska J. The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.270] [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
Abstract
Background
Insufficient physical activity (PA) is a global issue for health. A multifaceted response, including government action, is essential to improve population levels of PA. The purpose of this study was to develop the ‘Physical Activity Environment Policy Index’ (PA-EPI) monitoring framework to assess government policies and actions for creating a healthy PA environment.
Methods
An iterative process was undertaken. This involved a review of policy documents from authoritative organisations, a policy audit of four European countries, and systematic reviews of scientific literature. This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries). During this process, consensus workshops where quantitative and qualitative data alongside theoretical and pragmatic considerations were used to inform PA-EPI development.
Results
The PA-EPI is conceptualised as a two-component ‘policy’ and ‘infrastructure support’ framework. The two components comprise eight policy and seven infrastructure support domains. The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community. The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development, and health-in-all-policies. Forty-five ‘good practice statements’ (GPS) or indicators of ideal good practice within each domain concludes the PA-EPI. A potential eight-step process for conducting the PA-EPI is described.
Conclusions
Once pre-tested and piloted in several countries of various sizes and income levels, the PA-EPI GPS will evolve into benchmarks established by governments at the forefront of creating and implementing policies to address inactivity.
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Affiliation(s)
- C Woods
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - L Kelly
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - K Volf
- Physical Activity for Health Research Cluster, University of Limerick , Limerick, Ireland
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen- Nürnberg , Erlangen, Germany
| | - S Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen- Nürnberg , Erlangen, Germany
| | - S Forberger
- Leibniz Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam , Amsterdam, Netherlands
- Upstream Team, VU University Amsterdam , Amsterdam, Netherlands
| | - N den Braver
- Department of Epidemiology and Data Science, Amsterdam UMC, VU University Amsterdam , Amsterdam, Netherlands
- Upstream Team, VU University Amsterdam , Amsterdam, Netherlands
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Gdansk, Poland
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Gelius P, Messing S, Tcymbal A, Whiting S, Breda J, Abu-Omar K. Policy Instruments for Health Promotion: A Comparison of WHO Policy Guidance for Tobacco, Alcohol, Nutrition and Physical Activity. Int J Health Policy Manag 2022; 11:1863-1873. [PMID: 34634879 PMCID: PMC9808214 DOI: 10.34172/ijhpm.2021.95] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/24/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Policy is an important element of influencing individual health-related behaviours associated to major risk factors for non-communicable diseases (NCDs) such as smoking, alcohol consumption, unhealthy eating and physical inactivity. However, our understanding of the specific measures recommended in NCD prevention policy-making remains limited. This study analysed recent World Health Organization (WHO) documents to identify common policy instruments suggested for national NCD prevention policy and to assess similarities and differences between policies targeting different health-related behaviours. METHODS Evert Vedung's typology of policy instruments, which differentiates between regulatory, economic/ fiscal and soft instruments, served as a basis for this analysis. A systematic search on WHO websites was conducted to identify documents relating to tobacco, alcohol, nutrition and physical activity. The staff of the respective units at the WHO Regional Office for Europe conducted an expert validation of these documents. The resulting documents were systematically searched for policy instruments. A word frequency analysis was conducted to estimate the use of individual instruments in the different policy fields, followed by an additional in-depth coding and content analysis by two independent reviewers. RESULTS Across all health-related behaviours, the following policy instruments were suggested most frequently in WHO guidance documents: laws, regulations, standards, taxes, prices, campaigns, recommendations, partnerships and coordination. The analysis showed that regulatory and economic/fiscal policy instruments are mainly applied in tobacco and alcohol policy, while soft instruments dominate in the fields of nutrition and especially physical activity. CONCLUSION The study confirms perceived differences regarding recommended policy instruments in the different policy fields and supports arguments that "harder" instruments still appear to be underutilized in nutrition and physical activity. However, more comprehensive research is needed, especially with respect to actual instrument use and effectiveness in national-level NCD prevention policy.
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Affiliation(s)
- Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephen Whiting
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | - João Breda
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Woods CB, Kelly L, Volf K, Gelius P, Messing S, Forberger S, Lakerveld J, den Braver NR, Zukowska J, Bengoechea EG. S09-4 The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity. Eur J Public Health 2022. [PMCID: PMC9435359 DOI: 10.1093/eurpub/ckac093.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Insufficient physical activity (PA) is a global issue for health. A multifaceted response, including government action, is essential to improve population levels of PA. The purpose of this study was to develop the ‘Physical Activity Environment Policy Index’ (PA-EPI) monitoring framework to assess government policies and actions for creating a healthy PA environment. Methods An iterative process was undertaken. This involved a review of policy documents from authoritative organisations, a policy audit of four European countries, and systematic reviews of scientific literature. This was followed by an online consultation with academic experts (N = 101; 20 countries, 72% response rate), and policymakers (N = 40, 4 EU countries). During this process, consensus workshops where quantitative and qualitative data alongside theoretical and pragmatic considerations were used to inform PA-EPI development. Results The PA-EPI is conceptualised as a two-component ‘policy’ and ‘infrastructure support’ framework. The two components comprise eight policy and seven infrastructure support domains. The policy domains are education, transport, urban design, healthcare, public education (including mass media), sport-for-all, workplaces and community. The infrastructure support domains are leadership, governance, monitoring and intelligence, funding and resources, platforms for interaction, workforce development, and health-in-all-policies. Forty-five ‘good practice statements’ (GPS) or indicators of ideal good practice within each domain concludes the PA-EPI. A potential eight-step process for conducting the PA-EPI is described. Conclusions Once pre-tested and piloted in several countries of various sizes and income levels, the PA-EPI GPS will evolve into benchmarks established by governments at the forefront of creating and implementing policies to address inactivity.
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Affiliation(s)
- Catherine B Woods
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Liam Kelly
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Kevin Volf
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , 91058 Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , 91058 Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS , 28359 Bremen, Germany
| | - Jeroen Lakerveld
- Amsterdam UMC, VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research institute , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
- Upstream Team , www.upstreamteam.nl . Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
| | - Nicolette R den Braver
- Amsterdam UMC, VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research institute , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
- Upstream Team , www.upstreamteam.nl . Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Gdansk 80-213, Poland
| | - Enrique García Bengoechea
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
- Research and Innovation Unit , Sport Ireland, Dublin, Ireland
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Tcymbal A, Gelius P, Abu-Omar K, Messing S, Whiting S, Kremlin W. P01-15 National focal point network for physical activity promotion - experiences from the european union. Eur J Public Health 2022. [PMCID: PMC9421879 DOI: 10.1093/eurpub/ckac095.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background An analysis of currently existing partnerships and cross-country collaboration for physical activity (PA) promotion is valuable for understanding how such partnerships operate, and how they impact national PA promotion efforts. This study aimed to outline the structure of the European Union's (EU) National Physical Activity Focal Point Network, to evaluate its outputs and benefits, and to describe its potential and challenges. Methods We employed a mixed methods approach with three components: (1) document analysis of network meeting reports, (2) semi-structured interviews with key officials who were involved in establishing the network, and (3) an online evaluation survey with the national PA Focal Points. Results The PA Focal Point Network was founded in 2014, and its main task is to coordinate the collection of information for the EU's HEPA Monitoring Framework. Each of the EU Member States nominated a representative to the network. Focal Points usually meet twice a year to discuss issues related to the HEPA Monitoring Framework and to share best practices and plan activities for the promotion of PA within the EU. The results of the evaluation survey show that participation in the network helped members to specify goals for PA promotion, gain knowledge, and identify opportunities to promote PA in their country. From the perspective of the Focal Points, most helpful outputs of the Network activity are the country factsheets on physical activity, the connections within the Network and the opportunity to share their experience with colleagues during meetings and group discussions. Conclusions The study shows that the PA Focal Point Network may serve as an example of successful cross-country collaboration in PA promotion. The network has supported the monitoring of the implementation of the EU Council Recommendation on HEPA across sectors in particular and of PA promotion in the EU in general. It also had positive effects on national PA promotion efforts and on cooperation between countries. All in all, the PA Focal Point Network can serve as an example for other world regions or policy areas that set up similar networks.
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Affiliation(s)
- Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Stephen Whiting
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, World Health Organization Regional Office for Europe , Moscow, Russia
| | - Wickramasinghe Kremlin
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization , Moscow, Russia
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Woods C, Zukowska J, Forberger S, Garcia E, Gelius P, Gobis A, Kelly L, Krajewski P, Lakerveld J, Messing S, denBraver N, Volf K. S09 Insights into the development of the physical activity environment policy index, a tool for benchmarking implementation of public policies to create healthy physical activity policy environments. Eur J Public Health 2022. [PMCID: PMC9421901 DOI: 10.1093/eurpub/ckac093.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The UN Sustainable Development Goals' (https://sustainabledevelopment.un.org/) and the Global Action Plan on Physical Activity (https://www.who.int/ncds/prevention/physical-activity/gappa) highlight the need to move beyond individual behaviour change to broader policy and system approaches, focusing not only on health but also on sustainability. Recently, policy responses to the epidemics of physical inactivity and sedentary behaviour have grown. The Global Observatory for Physical Activity (GoPA) reports that by 2013, 139 countries were members of its physical activity advocacy alliance and 26.6% of these countries had already published a stand-alone physical activity plan. The ‘Policy Evaluation Network' is a multi-disciplinary European research network aimed at understanding the impact of public policy for promoting healthy lifestyles in an effort to prevent non-communicable disease. To understand the progress governments are making in creating healthy policy environments, the benchmarking of best practice has proven effective for advancing the food policy agenda; however its usefulness for physical activity requires evaluation. Individual country results promote mutual learning between countries. This symposium will take a deep look at public policy in physical activity. It will summarise evidence from systematic literature reviews and present a tool for benchmarking progress. It will also discuss the potential next steps for addressing the inactivity, obesity and climate challenges through policy solutions in a systematic way. The Chair will give an overview of context within which this symposium takes place e.g. GAPPA, Policy developments etc. They will also explain the symposium's purpose and objectives, introduce the speakers and direct questions.
Symposium Objectives
1. To review evidence for the contribution of transport, sport and mass media policy to the promotion of physical activity. 2. To show how evidence generate in each of these reviews contributed to the development of the physical activity environment policy index (PA-EPI). 3. To discuss the next steps for addressing inactivity by using policy intervention as a tool to catalyse change. Abstract 1: Which transport policies increase physical activity of the whole of society? A Systematic Review. Abstract 2: The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens. Abstract 3: Evidence of the impact of Sport Policies on physical activity and sport participation: A Systematic Mixed Studies Review. Abstract 4: The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity. The Discussant summarizes the presentations and provides insights on the specific topic area, generating an interactive discussion with the audience for at least 15 minutes, moderated by the Chair. (15 minutes) Conclusions: Some discussion of the possible contribution to, or implications for, the advancement of HEPA related goals.
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Affiliation(s)
- Catherine Woods
- Physical Activity for Health Research Cluster, Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Joanna Zukowska
- Faculty of Civil and Environmenatl Engineering, Gdansk University of Technology , Poland, Gdansk, Poland
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology, Leibniz Institute for Prevention Research and Epidemiology, BIPS , Germany, Bremen, Germany
| | - Enrique Garcia
- Physical Activity for Health Research Cluster, Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
- Sport Ireland, Sport Ireland, The Courtyard, Blanchardstown , Dublin, Dublin, Ireland
| | - Peter Gelius
- Friedrich-Alexander-Universitat, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany, Erlangen, Germany
| | - Anna Gobis
- Faculty of Civil and Environmenatl Engineering, Gdansk University of Technology , Poland, Gdansk, Poland
| | - Liam Kelly
- Physical Activity for Health Research Cluster, Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Piotr Krajewski
- Faculty of Civil and Environmenatl Engineering, Gdansk University of Technology , Poland, Gdansk, Poland
| | - Jeroen Lakerveld
- VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute , De Boelelaan 1089a, Amsterdam, the Netherlands., Amsterdam, The Netherlands
| | - Sven Messing
- Friedrich-Alexander-Universitat, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany, Erlangen, Germany
| | - Nicole denBraver
- VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute , De Boelelaan 1089a, Amsterdam, the Netherlands., Amsterdam, The Netherlands
| | - Kevin Volf
- Physical Activity for Health Research Cluster, Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
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den Braver NR, Bengoechea EG, Messing S, Kelly L, Schoonmade LJ, Volf K, Zukowska J, Gelius P, Forberger S, Woods C, Lakerveld J. S09-2 The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens. Eur J Public Health 2022. [PMCID: PMC9435356 DOI: 10.1093/eurpub/ckac093.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
This review of reviews aims to summarize the evidence from published reviews on the effectiveness of mass-media campaigns to promote physical activity (PA), or PA-related determinants, and identify policy-relevant recommendations related to successful PA campaigns.
Methods
An extensive literature search was performed on March 1st, 2021. Reviews that evaluated the impact of campaigns on distal (e.g., PA) and/or proximal outcomes of PA (awareness, knowledge etc.) and that targeted the general population or subsets were included. Quality of reviews was assessed using the AMSTAR-2 tool. Policy-relevant recommendations were systematically derived and synthesized, and formulated as good practice statements. A protocol was registered beforehand (ID: CRD42021249184).
Results
A total of 1,915 studies were identified, of which 22 reviews were included. Results indicate that the most consistent evidence was found for the effectiveness of mass-media campaigns on proximal outcomes, while the evidence for distal outcomes was mixed. Good practice statements were derived: 1) to achieve behaviour change, mass-media is an important component of larger, multilevel, and multicomponent strategies, 2) mass-media strategies should be coordinated and aligned at local- and national-level, and be sustained, monitored and resourced at these levels, 3) media should be tailored to reduce socioeconomic inequalities.
Conclusions
Mass-media can play an important role in the promotion of PA. In general, evidence was more inconsistent for effectiveness on distal outcomes than for proximal outcomes. The policy-relevant recommendations identified will serve to inform the PA environment policy index (PA-EPI), a tool for monitoring, evaluating and benchmarking government progress in implementing public policies.
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Affiliation(s)
- Nicolette R den Braver
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
- Upstream Team , www.upstreamteam.nl , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
| | - Enrique Garcia Bengoechea
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
- Research & Innovation Unit , Sport Ireland, Ireland
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Gebbertstr. 123b, 91058 Erlangen, Germany
| | - Liam Kelly
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Linda J Schoonmade
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Gebbertstr. 123b, 91058 Erlangen, Germany
| | - Kevin Volf
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Narutowicza 11, Gdansk 80-233, Poland
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Gebbertstr. 123b, 91058 Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, 28359 Bremen , Germany
| | - Catherine Woods
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - J Lakerveld
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
- Upstream Team , www.upstreamteam.nl , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
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Zukowska J, Gobis A, Krajewski P, Morawiak A, Okraszewska R, Woods CB, Volf K, Kelly L, Gelius P, Messing S, Forberger S, Lakerveld J, Bengoechea EG. S09-1 Which transport policies increase physical activity of the whole of society? A Systematic Review. Eur J Public Health 2022. [PMCID: PMC9421807 DOI: 10.1093/eurpub/ckac093.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background There is strong evidence of the links between car-dependence and the global physical inactivity epidemic. If eliminated, physical inactivity would remove between 6% and 10% of major non-communicable diseases that are the leading cause of death globally, killing 38 million people each year. Research consistently shows that unlike passive transport (e.g. driving a car), active transport (i.e., walking, cycling) is associated with higher total daily physical activity (PA). While there are public policies that support PA in transport and, as a result, overall PA levels, the specific quantitative effect of such policies on PA behaviour has not been sufficiently investigated. The aim of this systematic review is to determine the level and type of evidence for policies in the area of transport that contribute to higher PA levels of society at large. Methods Six databases (MEDLINE (Ebsco), SportDiscus, Cinahl, Cochrane library, Web of Science, and Scopus) were searched for key concepts of policy, transport, evaluation and PA. Methodological quality was assessed using standardised tools. The strength of the evidence of policy impact was described based on pre-determined categories of positive, negative, inconclusive or untested. Results 17 of 2,549 studies were included in the data synthesis. The authors identified three main transport policy areas with 60 individual policy actions that had a direct or indirect effect on PA. The policy areas were: convenient transport infrastructure development, active travel promotion and shift of transport mode. These areas correspond to Haddon's methodological approach of the transport system division in to three elements (human, vehicle, road). More than half of the policy actions identified (53%) had a positive effect on PA. Study quality ratings were moderate to good. Conclusions PA levels can be increased by implementing policies that provide convenient, safe, and connected walking and cycling infrastructures, promote active travel and give strong support to public transport. There is also clear evidence that active travel policies work best when implemented in a comprehensive way (very often as a combination of several policies). This may include infrastructure and facility improvements as well as educational programmes to achieve substantial shifts towards active modes of travel.
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Affiliation(s)
- Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Poland
| | - Anna Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Poland
| | - Piotr Krajewski
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Poland
| | - Agnieszka Morawiak
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Poland
| | - Romanika Okraszewska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Poland
| | - Catherine B Woods
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick
| | - Kevin Volf
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick
| | - Liam Kelly
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen , Germany
| | - Jeroen Lakerveld
- Amsterdam UMC, VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute , De Boelelaan 1089a, Amsterdam, the Netherlands
- Upstream Team , www.upstreamteam.nl , Amsterdam UMC, VU University Amsterdam, De Boelelaan 1089a, Amsterdam, the Netherlands
| | - Enrique García Bengoechea
- Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick
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Volf K, Kelly L, Bengoechea EG, Casey B, Gelius P, Messing S, Forberger S, Lakerveld J, Den Braver NR, Zukowska J, Woods C. S09-3 Evidence of the impact of Sport Policies on physical activity and sport participation: A Systematic Mixed Studies Review. Eur J Public Health 2022. [PMCID: PMC9435366 DOI: 10.1093/eurpub/ckac093.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Sport is recognised as a potential public health intervention through its influence on physical activity (PA) levels and consequent health benefits. International policy actors such as the Council of Europe, the World Health Organisation and the International Society for Physical Activity and Health have recommended that sport for all is promoted both for public health and as a basic right. Purpose: This review aims to provide evidence to support the development of policies aimed at maximising the opportunity to participate in PA and sporting activity. Methods We systematically searched six electronic databases for quantitative, qualitative, and review studies investigating how public sport policy affects PA and sport participation outcomes”. The scientific literature was screened according to predetermined eligibility criteria. Following study selection and data extraction, the quality was assessed using modified versions of existing quality assessment tools. Results were synthesised narratively. Results Database searches identified 3705 unique articles. A total of 93 full-text articles were assessed, with 31 meeting our inclusion criteria. Fourteen unique policy actions were identified and were categorised into the policy areas Build Sport Facilities, Reduce Financial Barriers, Build Capacity and Establish Partnerships with Sport Sector, and Promote Public Interest in Sports. Conclusions Policy actions to promote physical activity and sport participation have demonstrated qualified success but there is limited evidence of success in reaching hard to reach groups. Therefore, policymakers utilising sport to increase physical activity should treat it as a complementary intervention alongside other policy actions based on a systems perspective.
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Affiliation(s)
- Kevin Volf
- Department of Physical Education and Sport Sciences, University of Limerick
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, University of Limerick
| | - Enrique García Bengoechea
- Department of Physical Education and Sport Sciences, University of Limerick
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick
- Research & Innovation Unit , Sport Ireland, Dublin, Ireland
| | - Bláthín Casey
- Department of Physical Education and Sport Sciences, University of Limerick
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , 91058 Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , 91058 Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, 28359 Bremen , Germany
| | - Jeroen Lakerveld
- Amsterdam UMC, VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
- Upstream Team , www.upstreamteam.nl , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
| | - Nicolette R Den Braver
- Amsterdam UMC, VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
- Upstream Team , www.upstreamteam.nl , De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Narutowicza 11, Gdansk 80-233, Poland
| | - Catherine Woods
- Department of Physical Education and Sport Sciences, University of Limerick
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick
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Gelius P, Messing S, Sarah F, Lakerveld J, Fiona M, Sarah T, Wendel-Vos W, Zukowska J, Woods C. O6-6 The added value of using the HEPA PAT for physical activity policy monitoring: A four-country comparison. Eur J Public Health 2022. [PMCID: PMC9435474 DOI: 10.1093/eurpub/ckac094.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Public policy is increasingly recognized as an important component of physical activity (PA) promotion, as policy actions to address lifestyle behaviours have the potential to in?uence the health and well-being of an entire population. However, our knowledge about the current status, implementation and effectiveness of PA policies in individual countries is still very limited, and there is consequently no clear guidance on which policies governments should preferably use in different settings or under various preconditions. In order to improve the evidence-base, we conducted a detailed assessment of existing PA policies in four EU Member States using WHO's HEPA Policy Audit Tool (PAT) in the context of the Policy Evaluation Network (PEN). Methods We employed a six-step process to administer the HEPA PAT Version 2 in Ireland, the Netherlands, Germany, and Poland. This involved identifying stakeholders, pre-filling parts of the tool using existing survey data and desk-research, approaching select institutions to verify details, and obtaining expert opinion via workshops, interviews, and/or questionnaires. Based on the four completed PATs, we performed a comparative analysis to identify similarities and differences between countries and with previous studies using the tool. Results In all four countries, the health and sport sector were found to be most active in PA promotion, followed by education, transport, and environment/urban planning. All countries have national systems to monitor population PA levels, and three out of four already have national PA recommendations. The study also showed that policy context (e.g. ministry portfolios, importance of subnational governments) varies substantially between countries. This influences policy implementation and made it necessary to employ a bespoke approach in each country to obtain the required information. Conclusions Our findings largely confirm results of previous studies using the PAT in other countries. They also indicate that using the tool in combination with other policy monitoring tools, e.g. the EU Monitoring Framework for HEPA across Sectors, may provide added value and help countries monitor policy progress more consistently. Our experience also confirms some known limitations of the PAT, e.g. regarding subnational policies and a high level of dependence on cooperation from key policy actors.
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Affiliation(s)
- Peter Gelius
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Forberger Sarah
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS , Bremen, Germany
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam UMC , Amsterdam, The Netherlands
| | - Mansergh Fiona
- Health and Wellbeing Programme, Department of Health , Dublin, Ireland
| | - Taylor Sarah
- Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - Wanda Wendel-Vos
- Physical Activity and Health Programme, National Institute for Public Health and the Environment RIVM , Bilthoven, The Netherlands
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology , Gdansk, Poland
| | - Catherine Woods
- Department of Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
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Tcymbal A, Gelius P, Abu-Omar K, Messing S, Whiting S, Wickramasinghe K. Cross-country collaboration for physical activity promotion: experiences from the European Union Physical Activity Focal Points Network. Eur J Public Health 2022; 32:i14-i21. [PMID: 36031826 PMCID: PMC9421415 DOI: 10.1093/eurpub/ckac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background An analysis of currently existing partnerships and cross-country collaboration for physical activity (PA) promotion is valuable for understanding how such partnerships operate, and how they impact national PA promotion efforts. This study aimed to outline the formation and development of the European Union’s (EU) Physical Activity Focal Points Network, to evaluate its outputs and benefits and to describe its potential and challenges. Methods A mixed methods approach were employed, including document analysis, semi-structured interviews with key officials and an online evaluation survey with the focal points. Results The network was founded in 2014. Its main task is to coordinate the national collection of information for the EU’s Health-Enhancing Physical Activity (HEPA) Monitoring Framework. Besides collecting data, focal points usually meet twice a year to share best practices and plan activities for the promotion of PA within the EU. The results of the evaluation survey show that participation in the network helped members specify goals for PA promotion, gain more knowledge regarding how to promote PA, identify more opportunities to promote PA in their country and to join a collaborative project with other countries. Conclusions The study shows that the EU Physical Activity Focal Points Network may serve as an example of successful cross-country collaboration in PA promotion. The network has been able to make a contribution to monitoring the implementation of the EU Council Recommendation on HEPA across sectors in particular and of PA promotion in the EU in general.
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Affiliation(s)
- Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephen Whiting
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation.,EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Kremlin Wickramasinghe
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
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Abu-Omar K, Messing S, Tcymbal A, Fleuren T, Richardson D, Whiting S, Gelius P, Wickramasinghe K. A proposed checklist for climate-friendly sport and exercise programmes. Eur J Public Health 2022; 32:i44-i49. [PMID: 36031818 PMCID: PMC9421404 DOI: 10.1093/eurpub/ckac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fighting the climate crisis is the greatest challenge of our time and will touch all aspects of people's lives. In this context, the United Nations (UN) have called on the sport sector to reduce its negative impacts on the environment and show 'climate leadership'. While some efforts have already been made with regards to mega sport events, there is still a dearth of approaches on limiting the climate impact of recreational sport and exercise programmes. METHODS Based on the UN-Framework 'Sports for Climate Action', literature reviews and additional desk research, a checklist to support local level stakeholders in providing climate-friendly sport and exercise programmes was developed. RESULTS The proposed checklist consists of five dimensions that need to be considered when designing and offering a climate-friendly sport and exercise programme: (i) active transport to exercise programmes, (ii) the carbon footprint of different types of exercises, (iii) low carbon sport clothing and equipment, (iv) instructors as champions for climate action and (v) advertising and communication. These five dimensions result in a 16-item checklist that supports the planning, advertising, implementation and evaluation of climate-friendly sport and exercise programmes. CONCLUSIONS The proposed checklist intends to facilitate the development of climate-friendly sport and exercise programmes. However, additional work is needed to test the implementation of the checklist at the local level. While the sport sector can make its own contributions to reduce its climate impact, intersectoral action is needed to improve infrastructure for active transport and to build sustainable sport facilities.
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Affiliation(s)
- Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Tobias Fleuren
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Diana Richardson
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephen Whiting
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation.,EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Kremlin Wickramasinghe
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
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Volf K, Kelly L, García Bengoechea E, Casey B, Gobis A, Lakerveld J, Zukowska J, Gelius P, Messing S, Forberger S, Woods C. Policy Evaluation Network (PEN): Protocol for systematic literature reviews examining the evidence for impact of policies on physical activity across seven different policy domains. HRB Open Res 2022; 3:62. [PMID: 34805740 PMCID: PMC8567685 DOI: 10.12688/hrbopenres.13089.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity contributes an estimated 9% to this figure. Global responses have included the Sustainable Development Goals (SDGs) and the Global Action Plan on Physical Activity (GAPPA). Both point to policy action on physical activity (PA) to address change, yet the impact of policy on PA outcomes is unknown. The protocol described outlines the methodology for systematic literature reviews that will be undertaken by the Policy Evaluation Network (PEN) to address this knowledge gap. Methods: The seven best investments for promotion of population PA identified in the Toronto Charter highlighted seven policy domains (schools, transport, urban design, primary health care systems, public education, community-wide programmes and sport) which will form the basis of these PEN reviews. Seven individual scientific literature searches across six electronic databases will be conducted. Each will use the key concepts of policy, PA, evaluation and a distinct concept for each of the seven policy domains. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined criteria. Conclusions: Each review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, each review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by GAPPA. Registration: PROSPERO CRD42020156630 (10/07/2020).
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Affiliation(s)
- Kevin Volf
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liam Kelly
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Enrique García Bengoechea
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Bláthín Casey
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anna Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | | | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Catherine Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Policy Evaluation Network (PEN) Consortium
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
- Amsterdam University Medical Center, Amsterdam, The Netherlands
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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21
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Messing S, Forberger S, Woods C, Abu-Omar K, Gelius P. [Policies to promote physical activity in Germany : An analysis based on a policy audit tool from the World Health Organization]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:107-115. [PMID: 34448901 PMCID: PMC8732938 DOI: 10.1007/s00103-021-03403-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Physical inactivity is a key determinant of noncommunicable diseases. Therefore, the World Health Organization (WHO) as well as researchers worldwide have developed different tools to monitor and audit policies to promote physical activity. However, these tools have so far not been used to systematically collect and analyse data on physical activity promoting policies in Germany. AIM This study aims to provide a systematic overview of policies to promote physical activity in Germany. METHODS The study was conducted as part of the Policy Evaluation Network ( www.jpi-pen.eu ). Data from the European Union Physical Activity Monitoring Framework, desk research, and an expert survey were utilised and collected with the WHO's health-enhancing physical activity (HEPA) policy audit tool (PAT). RESULTS The results highlight the wide range of relevant stakeholders and provide an overview of current policies as well as surveillance, evaluation, and funding. Significant accomplishments and persistent challenges are identified. DISCUSSION An international comparison shows that, in contrast to Germany, other countries have formulated measurable goals for physical activity promotion on a national level. However, Germany is among a minority of countries with specific physical activity recommendations for adults with noncommunicable diseases. Further structural development of physical activity promotion in Germany is necessary.
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Affiliation(s)
- Sven Messing
- Department für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123 b, 91058, Erlangen, Deutschland.
| | - Sarah Forberger
- Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Bremen, Deutschland
| | | | - Karim Abu-Omar
- Department für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123 b, 91058, Erlangen, Deutschland
| | - Peter Gelius
- Department für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123 b, 91058, Erlangen, Deutschland
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Gelius P, Tcymbal A, Whiting S, Messing S, Abu-Omar K, Geidl W, Reimers AK, Pfeifer K, Mendes R, Berdzuli N, Breda J. Impact of the First Wave of COVID-19 on Physical Activity Promotion in the European Union: Results From a Policymaker Survey. J Phys Act Health 2021; 18:1490-1494. [PMID: 34702788 DOI: 10.1123/jpah.2021-0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/07/2021] [Accepted: 07/27/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The COVID-19 pandemic is a major challenge for societies and governments around the world that severely affects all aspects of health promotion. This study assesses the potential influence of the first wave of the pandemic on national physical activity promotion policy in the European Union (EU). METHODS Data were collected using an online survey among members of the EU Physical Activity Focal Point Network, which consists of government officials from all EU member states. RESULTS The COVID-19 pandemic has significantly affected physical activity promotion across the EU. In particular, experts indicated that it has negatively impacted opportunities for physical activity in their countries. There have, however, been positive effects of the crisis on public awareness of physical activity. While almost all countries were able to issue physical activity recommendations during quarantine, opinions varied regarding the overall impact of the pandemic on governmental capacities for physical activity promotion and policy. CONCLUSIONS This study shows that the COVID-19 crisis has had both negative and positive effects on physical activity promotion in the EU. The positive experiences reported by some members of the Focal Point Network may assist other countries in identifying potential policy windows and strategies for the ongoing pandemic.
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Hartung V, Messing S, Pfeifer K, Geidl W, Abu-Omar K. [Dissemination of National Physical Activity Recommendations: Participatory Development of Dissemination Strategies in Germany]. Gesundheitswesen 2021; 84:1015-1021. [PMID: 34560798 DOI: 10.1055/a-1547-6667] [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: 10/20/2022]
Abstract
BACKGROUND In 2016, the first evidence-based National Recommendations for Physical Activity and Physical Activity Promotion were published in Germany. These recommendations are primarily intended for experts, decision makers and stakeholders. OBJECTIVES This study aims to describe the development of dissemination strategies for these recommendations. PROCESS To facilitate the co-production of knowledge between practitioners, decision makers, and researchers, a participatory approach was applied. This approach involved the development of target group-specific strategies for disseminating the recommendations. This was achieved in two workshops and one working group phase; 92 professionals and decision makers participated in the process. RESULTS The working groups developed specific dissemination strategies that were grouped into the following strategy types: (1) inform multipliers, (2) activate multipliers, (3) use existing and develop new networks, (4) initiate policy change. CONCLUSION The participatory approach adopted in this project was successful in developing dissemination strategies and is unique from an international perspective. To improve the evaluation of such co-production processes, future research should determine and operationalize appropriate indicators.
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Affiliation(s)
- Verena Hartung
- Department für Sportwissenschaft und Sport Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - Sven Messing
- Department für Sportwissenschaft und Sport Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - Klaus Pfeifer
- Department für Sportwissenschaft und Sport Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - Wolfgang Geidl
- Department für Sportwissenschaft und Sport Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
| | - Karim Abu-Omar
- Department für Sportwissenschaft und Sport Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland
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Woods CB, Volf K, Kelly L, Casey B, Gelius P, Messing S, Forberger S, Lakerveld J, Zukowska J, Bengoechea EG. The evidence for the impact of policy on physical activity outcomes within the school setting: A systematic review. J Sport Health Sci 2021; 10:263-276. [PMID: 33482424 PMCID: PMC8167338 DOI: 10.1016/j.jshs.2021.01.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [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: 07/01/2020] [Revised: 10/24/2020] [Accepted: 11/13/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Despite the well-established health benefits of physical activity (PA) for young people (aged 4-19 years), most do not meet PA guidelines. Policies that support PA in schools may be promising, but their impact on PA behavior is poorly understood. The aim of this systematic review was to ascertain the level and type of evidence reported in the international scientific literature for policies within the school setting that contribute directly or indirectly to increasing PA. METHODS This systematic review is compliant with Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Six databases were searched using key concepts of policy, school, evaluation, and PA. Following title and abstract screening of 2323 studies, 25 progressed to data synthesis. Methodological quality was assessed using standardized tools, and the strength of the evidence of policy impact was described based on pre-determined codes: positive, negative, inconclusive, or untested statistically. RESULTS Evidence emerged for 9 policy areas that had a direct or indirect effect on PA within the school setting. These were whole school PA policy, physical education, sport/extracurricular PA, classroom-based PA, active breaks/recess, physical environment, shared use agreements, active school transport, and surveillance. The bulk of the evidence was significantly positive (54%), 27% was inconclusive, 9% was significantly negative, and 11% was untested (due to rounding, some numbers add to 99% or 101%). Frequency of evidence was highest in the primary setting (41%), 34% in the secondary setting, and 24% in primary/secondary combined school settings. By policy area, frequency of evidence was highest for sport/extracurricular PA (35%), 17% for physical education, and 12% for whole school PA policy, with evidence for shared use agreements between schools and local communities rarely reported (2%). Comparing relative strength of evidence, the evidence for shared use agreements, though sparse, was 100% positive, while 60% of the evidence for whole school PA policy, 59% of the evidence for sport/extracurricular PA, 57% of the evidence for physical education, 50% of the evidence for PA in classroom, and 50% of the evidence for active breaks/recess were positive. CONCLUSION The current evidence base supports the effectiveness of PA policy actions within the school setting but cautions against a "one-size-fits-all" approach and emphasizes the need to examine policy implementation to maximize translation into practice. Greater clarity regarding terminology, measurement, and methods for evaluation of policy interventions is needed.
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Affiliation(s)
- Catherine B Woods
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland.
| | - Kevin Volf
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Bláthín Casey
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91058, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91058, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen 28359, Germany
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research institute, Amsterdam UMC, VU University Amsterdam, Amsterdam 1081 HV, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam 1081 HV, the Netherlands
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk 80-213, Poland
| | - Enrique García Bengoechea
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
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Volf K, Kelly L, García Bengoechea E, Casey B, Gobis A, Lakerveld J, Zukowska J, Gelius P, Messing S, Forberger S, Woods C. Policy Evaluation Network (PEN): Protocol for systematic literature reviews examining the evidence for impact of policies on physical activity across seven different policy domains. HRB Open Res 2021; 3:62. [PMID: 34805740 PMCID: PMC8567685 DOI: 10.12688/hrbopenres.13089.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity contributes an estimated 9% to this figure. Global responses have included the Sustainable Development Goals (SDGs) and the Global Action Plan on Physical Activity (GAPPA). Both point to policy action on physical activity (PA) to address change, yet the impact of policy on PA outcomes is unknown. The protocol described outlines the methodology for systematic literature reviews that will be undertaken by the Policy Evaluation Network (PEN) to address this knowledge gap. Methods: The seven best investments for promotion of population PA identified in the Toronto Charter highlighted seven policy domains (schools, transport, urban design, primary health care systems, public education, community-wide programmes and sport) which will form the basis of these PEN reviews. Seven individual scientific literature searches across six electronic databases will be conducted. Each will use the key concepts of policy, PA, evaluation and a distinct concept for each of the seven policy domains. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined criteria. Conclusions: Each review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, each review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by GAPPA. Registration: PROSPERO CRD42020156630 (10/07/2020).
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Affiliation(s)
- Kevin Volf
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liam Kelly
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Enrique García Bengoechea
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Bláthín Casey
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anna Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | | | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Catherine Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Policy Evaluation Network (PEN) Consortium
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
- Amsterdam University Medical Center, Amsterdam, The Netherlands
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Gelius P, Messing S, Forberger S, Lakerveld J, Mansergh F, Wendel-Vos W, Zukowska J, Woods C. The added value of using the HEPA PAT for physical activity policy monitoring: a four-country comparison. Health Res Policy Syst 2021; 19:22. [PMID: 33588865 PMCID: PMC7885477 DOI: 10.1186/s12961-021-00681-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/19/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Public policy is increasingly recognized as an important component of physical activity promotion. This paper reports on the current status of physical activity policy development and implementation in four European countries based on the Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT) developed by WHO. It compares the findings to previous studies and discusses the general utility of this tool and its unique features in relation to other instruments. METHODS The study was conducted as part of the Policy Evaluation Network ( www.jpi-pen.eu ) in Germany, Ireland, the Netherlands and Poland. Data collection built upon information obtained via the EU Physical Activity Monitoring Framework survey, additional desk research and expert opinion. Data analysis employed Howlett's policy cycle framework to map and compare national physical activity policies in the four countries. RESULTS In all countries under study, policy agenda-setting is influenced by prevalence data from national health monitoring systems, and the sport and/or health sector takes the lead in policy formulation. Key policy documents were located mainly in the health sector but also in sport, urban design and transport. Physical activity programmes implemented to meet policy objectives usually cover a broad range of target groups, but currently only a small selection of major policies are evaluated for effectiveness. National experts made several suggestions to other countries wishing to establish physical activity policies, e.g. regarding cross-sectoral support and coordination, comprehensive national action plans, and monitoring/surveillance. CONCLUSIONS This study provides a detailed overview of physical activity policies in the four countries. Results show that national governments are already very active in the field but that there is room for improvement in a number of areas, e.g. regarding the contribution of sectors beyond sport and health. Using the HEPA PAT simultaneously in four countries also showed that procedures and timelines have to be adapted to national contexts. Overall, the instrument can make an important contribution to understanding and informing physical activity policy, especially when used as an add-on to regular monitoring tools like the EU HEPA Monitoring Framework.
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Affiliation(s)
- Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Wanda Wendel-Vos
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Catherine Woods
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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Linder S, Abu-Omar K, Geidl W, Messing S, Sarshar M, Reimers AK, Ziemainz H. Physical inactivity in healthy, obese, and diabetic adults in Germany: An analysis of related socio-demographic variables. PLoS One 2021; 16:e0246634. [PMID: 33561175 PMCID: PMC7872299 DOI: 10.1371/journal.pone.0246634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/25/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Adults with diabetes or obesity are more likely to be physically inactive than healthy adults. Physical activity is essential in the management of both diseases, necessitating targeted interventions in these groups. This study analysed physical inactivity (defined as not taking part in leisure-time physical activity) in over 100,000 adults in Germany considering their body mass index and the presence of diabetes. Furthermore, the relationship between specific socio-demographic factors with physical inactivity was investigated, particularly focussing diabetic and obese people, to refine the identification of risk-groups for targeted interventions on physical activity promotion. METHODS Data from 13 population-based health surveys conducted in Germany from 1997 to 2018 were used. The relevant variables extracted from these datasets were merged and employed in the analyses. We included data from 129,886 individuals in the BMI analyses and 58,311 individuals in the diabetes analyses. Logistic regression analyses were performed to identify the importance of six socio-demographic variables (age, sex/gender, education, income, employment, and migration) for the risk of physical inactivity. RESULTS Obese and diabetic people reported a higher prevalence of physical inactivity than those who were not affected. Logistic regression analyses revealed advanced age, low education level, and low household income as risk factors for physical inactivity in all groups. A two-sided migration background and unemployment also indicated a higher probability of physical inactivity. CONCLUSION Similar socio-demographic barriers appear to be important determinants of physical inactivity, regardless of BMI status or the presence of diabetes. However, physical activity promoting interventions in obese and diabetic adults should consider the specific disease-related characteristics of these groups. A special need for target group specific physical activity programmes in adults from ethnic minorities or of advanced age was further identified.
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Affiliation(s)
- Stephanie Linder
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Karim Abu-Omar
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Wolfgang Geidl
- Division of Exercise and Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Sven Messing
- Division of Exercise and Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Mustafa Sarshar
- Division of Health and Physical Activity, Department of Sport Science, Otto-von-Guericke University, Magdeburg, Germany
| | - Anne K. Reimers
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Heiko Ziemainz
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
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Volf K, Kelly L, García Bengoechea E, Casey B, Gobis A, Lakerveld J, Zukowska J, Gelius P, Messing S, Forberger S, Woods C. Policy Evaluation Network (PEN): Protocol for systematic literature review examining the evidence for impact of policies across seven different policy domains. HRB Open Res 2020; 3:62. [PMID: 34805740 PMCID: PMC8567685 DOI: 10.12688/hrbopenres.13089.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 04/06/2024] Open
Abstract
Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity contributes an estimated 9% to this figure. Global responses have included the Sustainable Development Goals (SDGs) and the Global Action Plan on Physical Activity (GAPPA). Both point to policy action on physical activity (PA) to address change, yet the impact of policy on PA outcomes is unknown. The protocol described outlines the methodology for systematic literature reviews that will be undertaken by the Policy Evaluation Network (PEN) to address this knowledge gap. Methods: The seven best investments for promotion of population PA identified in the Toronto Charter highlighted seven policy domains (schools, transport, urban design, primary health care systems, public education, community-wide programmes and sport) which will form the basis of these PEN reviews. Seven individual scientific literature searches across six electronic databases will be conducted. Each will use the key concepts of policy, PA, evaluation and a distinct concept for each of the seven policy domains. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined criteria. Conclusions: Each review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, each review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by GAPPA. Registration: PROSPERO CRD42020156630 (10/07/2020).
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Affiliation(s)
- Kevin Volf
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liam Kelly
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Enrique García Bengoechea
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Bláthín Casey
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anna Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | | | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Catherine Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Policy Evaluation Network (PEN) Consortium
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
- Amsterdam University Medical Center, Amsterdam, The Netherlands
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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29
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Volf K, Kelly L, García Bengoechea E, Casey B, Gobis A, Lakerveld J, Zukowska J, Gelius P, Messing S, Forberger S, Woods C. Policy Evaluation Network (PEN): Protocol for systematic literature review examining the evidence for impact of school policies on physical activity. HRB Open Res 2020; 3:62. [PMID: 34805740 PMCID: PMC8567685 DOI: 10.12688/hrbopenres.13089.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 04/06/2024] Open
Abstract
Introduction: Over 40 million deaths annually are due to noncommunicable diseases, 15 million of these are premature deaths and physical inactivity attributes an estimated 9% to this figure. Global responses have included the sustainable development goals and the global action plan on physical activity. Both point to policy action in physical activity (PA) to address change, yet the impact of policy is unknown. The protocol described outlines a systematic literature review that will be undertaken by the Policy Evaluation Network to address this knowledge gap. Protocol: This review of school PA policies is the first of seven planned reviews. The seven best investments for promotion of population PA identified in the Toronto Charter (whole-of-school programmes, transport policy, urban design policy, primary health care policy, public education policy, community programmes and sport programmes) will form the basis of these reviews. Seven individual scientific literature searches across six electronic databases, using key concepts of policy, PA, evaluation and a distinct concept for each area will be conducted. This will be supplemented with a search of the reference list of included articles. Methodological quality will be assessed and overall effectiveness for each included study will be described according to pre-determined categories. Conclusions: The review will provide policy makers with a list of policy statements and corresponding actions which the evidence has determined impact on PA directly or indirectly. By collating the evidence, and demonstrating the depth of the science base which informs these policy recommendations, this review will provide guidance to policymakers to use evidence-based or evidence-informed policies to achieve the 15% relative reduction in physical inactivity as defined by the 'Global Action Plan on Physical Activity'. Registration: PROSPERO CRD42020156630 (10/07/2020).
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Affiliation(s)
- Kevin Volf
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liam Kelly
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Enrique García Bengoechea
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Bláthín Casey
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anna Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | | | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Catherine Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Policy Evaluation Network (PEN) Consortium
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
- Amsterdam University Medical Center, Amsterdam, The Netherlands
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Volf K, Kelly L, García Bengoechea E, Gobis A, Lakerveld J, Zukowska J, Gelius P, Messing S, Forberger S, Woods C. Systematic review examining the evidence for impact of school policies on physical activity. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1138] [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: 11/12/2022] Open
Abstract
Abstract
Background
Epidemiological evidence has demonstrated that physical activity can have substantive health benefits for children and young people. The 'Policy Evaluation Network' is a multi-disciplinary research network across 7 European countries and New Zealand aimed at building capacity and evaluating the level of impact of policy interventions for promoting healthy lifestyles. The Toronto Charter identified 'whole-of-school' programmes as one of seven key investments for promotion of PA. This paper presents results of a SLR, designed to assess the level of evidence for policies within the school setting that contribute directly or indirectly to increasing PA.
Methods
Researchers searched six online databases for scientific literature regarding PA policy interventions in the school setting using key concepts of policy, school, PA and evaluation. Risk of bias will be assessed with tools appropriate to the design of the studies considered. Evidence of actual or potential positive PA outcomes arising directly or indirectly from policy actions will be catalogued.
Results
Preliminary searches identified 2327 unique scientific articles. 1938 (83.3%) were excluded on first reading and 189 (8.8%) were included for full text analysis. Initial findings suggest that organisational policies, for example avoiding overcrowding in playgrounds during school breaks, may be a promising policy action. Detailed analysis revealing other potential policy actions supported by evidence will be presented (SLR in progress).
Conclusions
Preliminary findings suggest that few studies link policy actions in the school setting to PA outcomes. However, studies that have investigated the effects of changes to the school environment on PA levels may provide evidence for policy actions. Preliminary recommendations include strengthening the evidence base for school-based PA policy by supporting studies into the effects of particular policy or legislative changes on PA outcomes.
Key messages
School physical activity policies are an underappreciated public health intervention. More studies should link policy changes to physical activity outcomes.
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Affiliation(s)
- K Volf
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - L Kelly
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - E García Bengoechea
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - A Gobis
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - J Lakerveld
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - P Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Forberger
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - C Woods
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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Forberger S, Gelius P, Messing S, Volf K, Kelly L, Taylor S, Zukowska J, Lakerveld J, Woods C. Sub-national structures matter when evaluating physical activity promotion: Lessons from Germany. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Public policies are increasingly acknowledged as important part of promoting physical activity (PA). However, especially in states with sub-national administrative structures such as Germany, national and sub-national approaches differ considerably. In Germany, sport for all (SfA) promotion is mostly organized at sub-national level, which is usually not covered in national evaluations. Knowledge of these structures helps to understand national outcomes, enables comparisons and learning within and between countries, and assists in identifying support structures for effective PA promotion.
Methods
Data were collected in the PEN Policy Evaluation Network project. In addition to the WHO HEPA PAT, a questionnaire was sent to the sports representatives of the 16 federal states. Responses of 11 state representatives were included and overarching issues were identified using inductive thematic analysis.
Results
PA promotion in Germany is organized in three areas: SfA, professional sports and school sports. SfA promotion at sub-national level is assigned to different administrative bodies (ministries, senate administration, state chancellery) and policy areas: culture, health and care, home affairs with various aspects, education, social affairs and family. The priorities of the federal states are more diverse and specific compared to the national level. There is an overlap in the topics: urban planning, cycling, health prevention and targeting children. Cooperation mechanisms and partners vary between federal states, but some partners are active at sub-national and national level.
Conclusions
The results provide an insight into the complexity of PA and especially SfA promotion at sub-national level in Germany. Our results suggest that a broader range of approaches is used in the 16 German states than national overviews would suggest. These particularities must be taken into account when assessing and comparing the results from different countries.
Key messages
The promotion of SfA at German sub-national level is much more diverse than represented at national level evaluations. Knowledge of sub-national structures enables the understanding of national outcomes, the promotion of cross-national learning and the identification of supportive structures for effective PA promotion.
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Affiliation(s)
- S Forberger
- BIPS, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - P Gelius
- FAU, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Messing
- FAU, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - K Volf
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - L Kelly
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - S Taylor
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - J Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - J Lakerveld
- VUmc, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - C Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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Abstract
The importance of the global climate crisis requires linking physical activity promotion and climate action. This article provides a first overview of interconnections between physical activity promotion and climate action, potential synergies and discrepancies, aiming to stimulate further discussion about this topic. The analysis is based on the World Health Organization’s Global Action Plan on Physical Activity 2018-2030 (GAPPA). The GAPPA covers five perspectives that are of particular relevance with respect to potential links with climate policy: (1) Infrastructures supporting active transport, (2) green spaces and recreational/exercise facilities, (3) exercise programs, (4) mass communication campaigns and mass participation events and (5) training of professionals. Our analysis demonstrates a considerable alignment between strategies for physical activity promotion and efforts for the reduction of greenhouse gas emissions. However, in some of the areas, this alignment could still be improved. Additionally, more climate-conscious policies, research and surveillance need to be developed in the field of physical activity promotion.
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Affiliation(s)
- Karim Abu-Omar
- Department for Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Peter Gelius
- Department for Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Sven Messing
- Department for Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
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Gelius P, Messing S, Goodwin L, Schow D, Abu-Omar K. What are effective policies for promoting physical activity? A systematic review of reviews. Prev Med Rep 2020; 18:101095. [PMID: 32346500 PMCID: PMC7182760 DOI: 10.1016/j.pmedr.2020.101095] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [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: 07/01/2019] [Revised: 01/14/2020] [Accepted: 04/04/2020] [Indexed: 11/25/2022] Open
Abstract
There is a growing need for evidence on the effectiveness of different policies to promote physical activity. We conducted a systematic literature review to collate the available evidence. We identified 57 reviews with evidence on 53 types of physical activity policies from 7 areas. There is a solid evidence base for the effectiveness of school-based and some infrastructural policies. The evidence for other (e.g. economic) policies remains insufficient.
The importance of policy for promoting physical activity (PA) is increasingly recognized by academics, and there is a push by national governments and international institutions for PA policy development and monitoring. However, our knowledge about which policies are actually effective to promote PA remains limited. This article summarizes the currently available evidence by reviewing existing reviews on the subject. Building on results from a previous scoping review on different types of PA-related evidence, we ran searches for combinations of the terms “physical activity”, “evidence”, “effect”, “review”, and “policy” in six different databases (PubMed, Scopus, SportDiscus, PsycInfo, ERIC, and IBSS). We used EPPI Reviewer 4 to further process the results and conduct an in-depth analysis. We identified 57 reviews providing evidence on 53 types of policies and seven broader groups of policies. Reviews fell into four main categories: 1) setting- and target group-specific; 2) urban design, environment and transport; 3) economic instruments; and 4) broad-range perspective. Results indicate that there is solid evidence for policy effectiveness in some areas (esp. school-based and infrastructural policies) but that the evidence in other areas is insufficient (esp. for economic policies). The available evidence provides some guidance for policy-makers regarding which policies can currently be recommended as effective. However, results also highlight some broader epistemological issues deriving from the current research. This includes the conflation of PA policies and PA interventions, the lack of appropriate tools for benchmarking individual policies, and the need to critically revisit research methodologies for collating evidence on policies.
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Affiliation(s)
- Peter Gelius
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Lee Goodwin
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Diana Schow
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstraße 123b, 91058 Erlangen, Germany
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Abstract
In order to counteract risk factors for non-communicable diseases, promotion of physical activity has become increasingly relevant. This article outlines recent developments in this field, adopting a perspective based on Zygmunt Bauman's concepts of liquid modernity and liquid life. Five trends in physical activity promotion are identified: (Trend 1) The expansion of physical activity recommendations from a narrow focus on exercise to a broad concept of 24-h movement guidelines, (Trend 2) the increasing number of population groups targeted by these recommendations, (Trend 3) the ascent of efforts for physical activity promotion to the global level, (Trend 4) the emancipation of physical activity promotion from an add-on to a stand-alone public health topic, and (Trend 5) the ongoing conflict between sport, health and other sectors about the leading role in physical activity promotion. Based on these developments, physical activity might be classified as 'liquid' in Bauman's sense, that is, as being elusive and in a constant state of flux.
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Affiliation(s)
- Karim Abu-Omar
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Department of Sport Science and Sport, Erlangen, Germany
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Department of Sport Science and Sport, Erlangen, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Department of Sport Science and Sport, Erlangen, Germany
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Gelius P, Messing S, Abu-Omar K. Nine types of recommendations, guidelines and policies: an exploratory test of a proposed typology of physical activity promotion documents. ACTA ACUST UNITED AC 2019; 77:52. [PMID: 31827791 PMCID: PMC6886183 DOI: 10.1186/s13690-019-0381-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022]
Abstract
Background The field of physical activity abounds with recommendations, guidelines, action plans and other documents published by experts, organizations and institutions at the national and international level. However, working with these documents is difficult since similar names (e.g. "recommendations") may be used to label substantially different contents, while identical topics may hide behind different monikers (e.g. "guidelines" and "strategy"). Methods We built on an existing framework conceptualizing categories of physical activity evidence and on the Doern continuum for policy instruments to develop a nine-field matrix that classifies physical activity-related publications based on their evidence type and degree of coercion. We used a selection of eleven physical activity documents to perform an exploratory test of the functions and utility of the typology. Results Placing central physical activity documents into the typology shows that recommendations, guidelines, and policies are found across the entire matrix, regardless of their denomination. It also suggests that some documents transcend boundaries between types by falling into more than one category, and that some categories may be underrepresented in current physical activity promotion. Conclusions A typology to classify physical activity guidelines, recommendations, and policies can help us acquire a better overview of the landscape of existing physical activity documents than simple distinctions based on document names. It may guide both current initiatives and future development work in the field. It could also serve as a point of departure for future research, as conducting systematic overviews of the literature based on this typology may help reveal important gaps in current physical activity promotion.
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Affiliation(s)
- Peter Gelius
- FAU Erlangen-Nürnberg, Department of Sport Science and Sport, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Sven Messing
- FAU Erlangen-Nürnberg, Department of Sport Science and Sport, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- FAU Erlangen-Nürnberg, Department of Sport Science and Sport, Gebbertstraße 123b, 91058 Erlangen, Germany
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Messing S, Rütten A, Abu-Omar K, Ungerer-Röhrich U, Goodwin L, Burlacu I, Gediga G. How Can Physical Activity Be Promoted Among Children and Adolescents? A Systematic Review of Reviews Across Settings. Front Public Health 2019; 7:55. [PMID: 30941342 PMCID: PMC6433781 DOI: 10.3389/fpubh.2019.00055] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [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: 12/20/2017] [Accepted: 02/25/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction: A vast majority of children and adolescents are physically inactive. As a result, high obesity rates and related diseases have made physical activity promotion a politically relevant topic. In order to form the basis for political decision making, evidence is required regarding the efficacy and effectiveness of interventions for physical activity promotion. In contrast to previous research, this systematic review of reviews targets three key settings (family and home, childcare, school), and is among the largest to have been conducted. Methods: A systematic review of reviews was conducted as part of a large-scale project to develop national recommendations for physical activity promotion in Germany. Six electronic databases were searched and inclusion criteria were defined. Two independent reviewers screened the titles and abstracts of potentially relevant literature. 213 reviews were identified and categorised by target group. A total of 74 reviews were identified dealing with children and adolescents. Each review underwent a quality assessment. Results: 39 reviews with the highest quality and relevance were analysed. Three reviews focused on the family and home setting, 4 on the childcare setting, 28 on the school setting and 4 on other settings. Evidence revealed the key role played by parents in promoting physical activity in children within each setting. Furthermore, evidence pointed toward the efficacy of multi-component interventions in the childcare and school setting. Several evidence-based intervention strategies were identified for childcare facilities and schools. Discussion: The review of reviews identified a number of promising strategies for PA promotion among children and adolescents. Among reviews, multi-component interventions in childcare facilities and schools stand out prominently. At the same time, the review of reviews indicated that there is still a lack of studies on the efficacy of interventions that go beyond the individual level. We recommend that future research should also target community and policy level interventions and interventions other than the school setting. In order to make more specific recommendations regarding the scale-up of promising intervention strategies, further knowledge about the effectiveness, health equity and cost effectiveness of interventions is needed.
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Affiliation(s)
- Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | - Lee Goodwin
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ionuţ Burlacu
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Günther Gediga
- Department of Psychology, University of Münster, Münster, Germany
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Rütten A, Abu-Omar K, Messing S, Weege M, Pfeifer K, Geidl W, Hartung V. How can the impact of national recommendations for physical activity be increased? Experiences from Germany. Health Res Policy Syst 2018; 16:121. [PMID: 30547824 PMCID: PMC6295091 DOI: 10.1186/s12961-018-0396-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 07/29/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clearly stated national recommendations for physical activity (PA) are available in many nations. Yet, their impact on national level policy-making might be considered modest at best. This paper analyses the approach selected to curtail this problem in Germany. MAIN TEXT Academics, government institutions and relevant stakeholders worked in collaboration to produce a series of national recommendations for PA and PA promotion published in 2016. Since their publication, these recommendations have achieved a measurable political impact through a systematic approach focused on dissemination and implementation strategies. For example, the German Conference of Health Ministers has acknowledged the national recommendations, endorsed their dissemination and proposed that they are included in measures within the Federal Prevention Act. CONCLUSION Since their publication, the national recommendations have yielded satisfactory political impact. The contributing aspects might partially be explained by the Multiple Streams Approach.
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Affiliation(s)
- Alfred Rütten
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Mayra Weege
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Verena Hartung
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Gebbertstraße 123b, 91058 Erlangen, Germany
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Kovacs VA, Sarkadi-Nagy E, Sandu P, Duleva V, Spinelli A, Kaposvari C, Hassapidou M, Janssen D, Grochowska-Niedworok E, Messing S, Martos E. Good practice criteria for childhood obesity prevention in kindergartens and schools-elaboration, content and use. Eur J Public Health 2018; 28:1029-1034. [PMID: 29986012 DOI: 10.1093/eurpub/cky129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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 In accordance with the policy actions that address childhood overweight and obesity at European level and as a contribution to the EU Action Plan on Childhood Obesity 2014-20, a Joint Action on Nutrition and Physical Activity (JANPA) was established. As part of JANPA work package 6, an evaluation framework to identify good practices, targeting childhood obesity prevention in kindergartens and schools, was developed. This article describes the WP 6 JANPA framework of good practice criteria and its development, compares it to other frameworks and discusses its potential for future use. Methods Based on the analysis of scientific literature, a set of 47 potential good practice criteria was drafted, that was then revised and complemented through a series of online Delphi consultations. Results A final list of 48 good practice criteria (9 of which were rated as core criteria) was developed and grouped into three categories: intervention characteristics (n = 17), implementation (n = 17) and monitoring and evaluation (n = 14). Conclusion The identified JANPA framework of good practice criteria complements the existing frameworks by focussing on kindergarten- and school-based initiatives and provides guidance for evaluators, programme planners and decision makers bearing in mind that a one-size-fits-all approach is inadequate. To ensure the effectiveness of future practices, programme planners should endeavour to meet at least the nine JANPA core criteria.
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Affiliation(s)
| | | | - Petru Sandu
- University Babes-Bolyai, Faculty of Political, Administrative and Communication Sciences, Department of Public Health, Cluj-Napoca, Romania
| | - Vesselka Duleva
- National Centre of Public Health and Analyses, Sofia, Bulgaria
| | | | - Csilla Kaposvari
- National Institute of Pharmacy and Nutrition, Budapest, Hungary.,University of Pécs, Doctoral School, Faculty of Heath Sciences, Pécs, Hungary
| | - Maria Hassapidou
- Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | | | - Sven Messing
- Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Eva Martos
- University of Physical Education, Budapest, Hungary
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Abu-Omar K, Rütten A, Burlacu I, Schätzlein V, Messing S, Suhrcke M. The cost-effectiveness of physical activity interventions: A systematic review of reviews. Prev Med Rep 2017; 8:72-78. [PMID: 28856084 PMCID: PMC5573782 DOI: 10.1016/j.pmedr.2017.08.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [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: 04/26/2017] [Revised: 07/11/2017] [Accepted: 08/15/2017] [Indexed: 11/24/2022] Open
Abstract
Background Despite growing recognition of the need to promote physical activity, the existing evidence base on the cost-effectiveness of relevant interventions appears scant and scattered. This systematic review of reviews set out to take stock of the evidence on the cost-effectiveness of physical activity interventions. Methods Ten literature databases were systematically searched for available reviews on the cost-effectiveness of physical activity interventions, complemented by a hand search. Out of the 515 articles identified, 18 reviews met the inclusion criteria. A quality appraisal of the 18 reviews was undertaken. Results Of the 18 reviews, 4 contained information on the target group of children and adolescents, 12 on adults, 3 on older adults, and 6 on the general population. Across the reviews some intervention strategies were identified as being particularly cost-effective, including certain school-based interventions (children and adolescents), interventions using pedometers (adults), fall prevention programs (older people), mass media campaigns and environmental approaches (general population). However, for some of these approaches (e.g. mass media campaigns), the underlying evidence of being able to change physical activity behavior remains inconsistent. Conclusion Available evidence for the cost-effectiveness of physical activity interventions is scattered, but points towards the cost-effectiveness of certain interventions. Until this moment, cost-effectiveness has more often been studied for individual-level interventions. This is potentially due to some methodological challenges in assessing the cost-effectiveness of population-based interventions. The review of review indicates cost-effectiveness of physical activity interventions Brief interventions in the health care setting, are cost-effective Pedometer based interventions are cost-effective Environmental approaches are cost-effective There remain some methodological challenges in evaluating cost-effectiveness
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Schultze M, Frahsa A, Gelius P, Schätzlein V, Messing S, Rütten A. Transdisziplinäre Aushandlungsprozesse unter WissenschaftlerInnen im Forschungsverbund „Capital4Health – Capabilites for active lifestyles“. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M Schultze
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - A Frahsa
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - P Gelius
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - V Schätzlein
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - S Messing
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
| | - A Rütten
- Universität Erlangen-Nürnberg, Institut für Sport und Sportwissenschaft, Erlangen
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Rütten A, Abu-Omar K, Messing S. [Recommendations for Physical Activity Promotion: Theory and Evidence]. Gesundheitswesen 2017; 79:S40-S44. [PMID: 28399585 DOI: 10.1055/s-0042-123501] [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: 10/19/2022]
Abstract
This article defines a framework for the development of recommendations for physical activity promotion. It aims to provide a theoretical foundation and rationale for classifications of physical activity promotion and approaches for the evidence base of recommendations. Perspectives from contrasting scientific disciplines were compared regarding their theoretical approach for physical activity promotion and their influence on possible classifications. In addition, various approaches of an evidence base were analyzed and integrated into a differentiated concept for the evidence base of recommendations. From a public health perspective, the use of integrative multi-level-models is fundamental as they can be combined both with different classifications, and individual, social, environmental and policy-based approaches. The evidence base should include the efficacy, effectiveness and cost-effectiveness of an intervention.The scientific and political rationale for recommendations for physical activity promotion can be supported by an explicit theoretical framework and a differentiated concept of an evidence base.
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Affiliation(s)
- Alfred Rütten
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Karim Abu-Omar
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Sven Messing
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
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Abu-Omar K, Rütten A, Burlacu I, Messing S, Pfeifer K, Ungerer-Röhrich U. [A Systematic Review of Reviews of Interventions for the Promotion of Physical Activity: Methodology and First Results]. Gesundheitswesen 2017; 79:S45-S50. [PMID: 28399586 DOI: 10.1055/s-0042-123502] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
As part of the development of recommendations for physical activity promotion, a review of reviews was performed. This article presents both the utilised methodology and first results.A systematic review of reviews was performed in PubMed, Scopus, Sport Discus, PsycInfo and other electronic databases. Reviews in English and German were included.213 reviews were identified for further analysis. A large number of reviews were identified for physical activity promotion among children and adolescents (74) and adults (66). In contrast, only 14 reviews dealt with physical activity promotion among older people.This review of reviews allowed for an analysis of the effectiveness regarding different intervention types for physical activity promotion. Depending on the target group and type of intervention, differences in quality of available evidence could be identified.
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Affiliation(s)
- Karim Abu-Omar
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Alfred Rütten
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Ionut Burlacu
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Sven Messing
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Klaus Pfeifer
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
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Messing S, Rütten A. [Quality Criteria for the Conception, Implementation and Evaluation of Interventions for Physical Activity Promotion: A State-Of-The-Art Review]. Gesundheitswesen 2017; 79:S60-S65. [PMID: 28399588 DOI: 10.1055/s-0042-123378] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The success of an intervention for physical activity promotion depends not only on the use of an evidence-based approach, but also on the quality of its implementation in practice. Based on current recommendations from scientists and public health institutions, this state-of-the-art review summarizes the quality criteria for the conception, implementation and evaluation of interventions.A systematic literature search was conducted in the electronic databases PubMed and Scopus. Additionally, guidelines from relevant public health institutions were identified via search engines and websites from governmental and nongovernmental organizations. Based on the analysis of selected documents, quality criteria were listed, grouped and categorized.24 documents, published between 2005 and 2015, provided quality criteria for interventions for physical activity promotion. From the selected documents, 18 quality criteria were defined (conception: 7, implementation: 7, evaluation: 4).This review provides evidence on the relevance of quality criteria within certain stages of an intervention. Future studies could compare the effect of quality criteria on the success of an intervention, or approach the topic from a health-economic perspective.
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Affiliation(s)
- Sven Messing
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
| | - Alfred Rütten
- Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen
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Bakshy E, Messing S, Adamic LA. Exposure to ideologically diverse news and opinion on Facebook. Science 2015; 348:1130-2. [DOI: 10.1126/science.aaa1160] [Citation(s) in RCA: 1174] [Impact Index Per Article: 130.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 04/27/2015] [Indexed: 11/02/2022]
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Langfitt JT, Vickrey BG, McDermott MP, Messing S, Berg AT, Spencer SS, Sperling MR, Bazil CW, Shinnar S. Validity and Responsiveness of Generic Preference-based HRQOL Instruments in Chronic Epilepsy. Qual Life Res 2013; 15:899-914. [PMID: 16721649 DOI: 10.1007/s11136-005-5231-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2005] [Indexed: 11/30/2022]
Abstract
Generic, preference-based instruments are recommended for assessing health-related quality of life (HRQOL) in cost-utility analyses (CUA). We aimed to determine which instrument is the most appropriate for CUA of epilepsy care, using established psychometric criteria. We compared validity and responsiveness of EQ5D (using both UK and US preferences), visual analog scale (VAS), Health Utilities Index Mark II (HUI-2) and Mark III (HUI-3) and SF6D in 165 adults evaluated for epilepsy surgery. SF6D had the strongest or next-strongest associations with seizure severity and seizure control. It was not associated with education or IQ. Only SF6D and HUI-3 discriminated between patients with and without seizures 2 years after baseline evaluation. SF6D was most or next-most responsive to being seizure-free for 2 years, in most responsiveness analyses. VAS was also responsive, but showed less evidence of validity. The QOLIE-89, an epilepsy-targeted profile instrument, had stronger evidence for validity and responsiveness than the preference instruments. SF6D has several key psychometric advantages over four other preference instruments in CUAs of epilepsy care. This may reflect better coverage of HRQOL dimensions affected by epilepsy, greater sensitivity at the upper end of the HRQOL continuum, or both. These findings may not generalize to other chronic conditions.
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Affiliation(s)
- J T Langfitt
- Department of Neurology & Psychiatry, University of Rochester School of Medicine, 601 Elmwood Ave, Box 673, Rochester, NY 14642, USA
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Vitek W, Hoeger K, Han Y, Messing S, Shayne M, Fung C. Systematic review and meta-analysis of GnRH agonist for preservation of ovarian function in women with hormone receptor negative breast cancer after chemotherapy. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pala O, Messing S, Hopkins A, Reed G, Perez-Rivera M, Acosta M, Kremer J, Lozada C, Pappas D. FRI0170 Effect of alcohol on response to therapy with TNF-a inhibitors for rheumatoid arthritis: Results from corrona registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pala O, Messing S, Hopkins A, Reed G, Perez-Rivera M, Acosta M, Kremer J, Lozada C, Pappas D. SAT0147 Effect of smoking on response to therapy with TNF-A inhibitors for rheumatoid arthritis: Results from the corrona registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yang Z, Li W, Tu X, Tang W, Messing S, Duan L, Pan J, Li X, Wan C. Validation and psychometric properties of Chinese version of SF-36 in patients with hypertension, coronary heart diseases, chronic gastritis and peptic ulcer. Int J Clin Pract 2012; 66:991-8. [PMID: 22994333 DOI: 10.1111/j.1742-1241.2012.02962.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The SF-36 is widely used as a significant health outcome or quality of life indicator and validated in many languages versions including Chinese. But the Chinese version of the SF-36 (CSF-36) is rarely used for those patients with hypertension, coronary heart diseases, chronic gastritis and peptic ulcer in China. Therefore, the CSF-36 needs to be validated in patients with chronic diseases. OBJECTIVES This paper is aimed to validate the CSF-36 using an in-patient sample of four chronic diseases from mainland China, with focusing on psychometric properties. METHODS The CSF-36 was used in a longitudinal study consisting of 534 patients in these four chronic disease groups. The psychometric properties of the scale were evaluated by indicators such as validity and reliability coefficients Cronbach α, Pearson r, standardized response mean employing correlational analyses, multi-trait scaling analysis, t-tests, factor analyses and structural equation models. RESULTS Test-retest reliability coefficients for all domains were higher than 0.80 with a range of 0.83 to 0.96; the internal consistency (α) for most domains was higher than 0.70. Five of the eight domains as well as the Physical and Mental Health subscale summaries all had statistically significant changes after treatment with the SRM ranging from 0.18 to 0.28. CONCLUSION The CSF-36 showed good validity and reliability but small responsiveness when used in patients. It is a good and useful instrument for patients with chronic disease at some situations.
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Affiliation(s)
- Z Yang
- School of Public Health, Guangdong Medical College, Dongguan, China
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Lee Y, Fleming FJ, Deeb AP, Gunzler D, Messing S, Monson JRT. A laparoscopic approach reduces short-term complications and length of stay following ileocolic resection in Crohn's disease: an analysis of outcomes from the NSQIP database. Colorectal Dis 2012; 14:572-7. [PMID: 21831174 DOI: 10.1111/j.1463-1318.2011.02756.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM Studies to date examining the impact of laparoscopy in resection for Crohn's disease on short-term morbidity have been limited by small study populations. The aim of this study was to establish the impact of the operative approach (laparoscopic or open) on outcomes after ileocolic resection for Crohn's disease. METHOD Ileocolic resections for Crohn's disease were identified using Current Procedural Terminology (CPT) and International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes from the National Surgical Quality Improvement Program (NSQIP) database (2005-2009). Complications were categorized as major (organ system damage and systemic sepsis) or minor (incisional and urinary infections). Multivariate 30-day outcomes and length of stay were determined using linear models adjusting for patient characteristics, comorbidities and operative approach. RESULTS Of 1917 ileocolic resections, 644 (34%) were performed laparoscopically. At baseline, the open group was significantly older, had more comorbidities, higher American Society of Anesthesiology (ASA) classes, and more intra-operative transfusions (all variables, P<0.05). On multivariate analysis, laparoscopic ileocolic resections were associated with a decrease in major (OR=0.629, 95% CI: 0.430-0.905, P=0.014) and minor (OR=0.576, 95% CI: 0.405-0.804, P=0.002) complications compared with open resections. Laparoscopy was associated with a significant reduction in adjusted length of stay compared with the open approach (-1.08±0.29 days, P=0.0002). CONCLUSION After adjusting for comorbidities and perioperative factors, such as preoperative sepsis, higher ASA class and higher transfusion rates in the open group, laparoscopic ileocolic resection for Crohn's disease was found to be a safer choice than the open approach, resulting in fewer complications and length of stay. All other things being equal, such patients should be offered the laparoscopic approach as a first-choice option.
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Affiliation(s)
- Y Lee
- Division of Colorectal Surgery, Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York 14642, USA
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