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Carl J, Abu-Omar K, Bernard P, Lohmann J, White P, Peters J, Sahlqvist S, Ma J, Duncan M, Barnett LM. Physical Literacy in the Context of Climate Change: Is There a Need for Further Refinement of the Concept? J Phys Act Health 2024; 21:316-319. [PMID: 38176406 DOI: 10.1123/jpah.2023-0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Abstract
The concept of physical literacy (PL) has witnessed enormous popularity in recent years and has undergone substantial theoretical evolvement during the last 2 decades. However, the research field pertaining to PL has not yet initiated discussions around the challenges of climate change and the alignment with conceptualizations of planetary health. Therefore, we argue that the consideration of an "ecological domain" for individual physical activity, in the form of ecological awareness, would further evolve the concept. We illustrate how to potentially integrate adjustments within the most frequent PL definitions of the field (eg, those in Australia, Canada, England, Ireland, the United States, or by the International Physical Literacy Association) without questioning the entire integrity of these elaborate conceptualizations. An ecological domain of PL would not only interact with the postulated physical, cognitive, psychological/affective, and social domains of PL but also have important implications for the (re)design of interventions and practices in physical activity contexts. We call the scientific community, both on national and international scales, to intensify the discussions and initiate a research agenda involving an "ecological domain" of PL.
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Affiliation(s)
- Johannes Carl
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Burwood, VIC, Australia
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, University Institute of Mental Health at Montreal, Montreal, QC, Canada
| | - Julia Lohmann
- Institute of Sports Science, Augsburg University, Augsburg, Germany
| | - Peta White
- School of Education, Deakin University, Burwood, VIC, Australia
| | - Jacqui Peters
- School of Education, Deakin University, Burwood, VIC, Australia
| | - Shannon Sahlqvist
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds,VIC, Australia
| | - Jiani Ma
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Michael Duncan
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Lisa M Barnett
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Burwood, VIC, Australia
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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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Kreiml V, Sauter A, Abu-Omar K, Eickmann S, Herrmann-Johns A. "That's like therapy"-A qualitative study on socially disadvantaged women's views on the effects of a community-based participatory research project on their health and health behavior. Front Public Health 2024; 12:1339556. [PMID: 38304180 PMCID: PMC10830699 DOI: 10.3389/fpubh.2024.1339556] [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: 11/16/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Background Regular physical activity has positive effects on both physical and mental health. Nevertheless, socially disadvantaged women are often insufficiently physically active. Through needs-based physical activity offers, community-based participatory research (CBPR) projects have the potential to reach these women and increase the effectiveness of physical activity interventions by supporting women's empowerment, health, and health behaviors. This study aimed to examine socially disadvantaged women's views on the effects of long-term participation in Bewegung als Investition in Gesundheit (BIG, i.e., movement as an investment in health), a long-standing German CBPR project, on their health and health behavior. Methods Semi-structured qualitative interviews were conducted with 30 participating women at five BIG sites across Germany between April and August 2022. The interviews were recorded, transcribed verbatim, and analyzed using framework analysis. Results Women reported that participation in BIG classes contributed to their physical, mental, and social health. For many women, the positive effects on their mental and social wellbeing were most important. In addition to increased fitness and improved physical endurance, many participating women were able to expand their social networks, thus receiving further social support, and improve their self-esteem, self-confidence, and self-efficacy. Furthermore, participation in BIG physical activity classes positively influenced the health awareness of many women helping them to improve their activity level and diet over time. Conclusion Our results suggest that CBPR projects, such as the BIG project, can increase physical activity among socially disadvantaged groups and contribute to their overall health and wellbeing. CBPR projects could thus be considered a key element of health promotion for this target group. Future interventional research is required to confirm and further explore the effects of CBPR interventions and to examine whether the effects can be replicated in other settings.
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Affiliation(s)
- Verena Kreiml
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Sascha Eickmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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Siefken K, Abu-Omar K. Striking a Balance: Physical Activity and Planetary Health. J Phys Act Health 2023; 20:1081-1083. [PMID: 37890840 DOI: 10.1123/jpah.2023-0581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023]
Affiliation(s)
- Katja Siefken
- Institute of Interdisciplinary Exercise Science and Sports Medicine (IIES), MSH Medical School Hamburg, Hamburg, Germany
| | - Karim Abu-Omar
- Division of Physical Activity and Health, Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Mino E, Hanson CL, Naber I, Weissenfels A, McHale S, Saftig J, Klamroth S, Gelius P, Abu-Omar K, Whiting S, Wickramasinghe K, Galea G, Pfeifer K, Geidl W. A systematic review and narrative synthesis of physical activity referral schemes' components. Int J Behav Nutr Phys Act 2023; 20:140. [PMID: 38012688 PMCID: PMC10683187 DOI: 10.1186/s12966-023-01518-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/20/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Physical activity referral schemes (PARS) are complex multicomponent interventions that represent a promising healthcare-based concept for physical activity (PA) promotion. This systematic review and narrative synthesis aimed to identify the constitutive components of PARS and provide an overview of their effectiveness. METHODS Following a published protocol, we conducted a systematic search of PubMed, Scopus, Web of Science, CINAHL, ScienceDirect, SpringerLink, HTA, Wiley Online Library, SAGE Journals, Taylor & Francis, Google Scholar, OpenGrey, and CORE from 1990 to January 2023. We included experimental, quasi-experimental, and observational studies that targeted adults participating in PARS and reported PA outcomes, scheme uptake, or adherence rates. We performed an intervention components analysis using the PARS taxonomy to identify scheme components and extracted data related to uptake, adherence, and PA behavior change. We combined these to provide a narrative summary of PARS effectiveness. RESULTS We included 57 studies reporting on 36 PARS models from twelve countries. We identified 19 PARS components: a patient-centered approach, individualized content, behavior change theory and techniques, screening, brief advice, written materials, a written prescription, referral, baseline and exit consultation, counselling support session(s), PA sessions, education session(s), action for non-attendance, structured follow-up, a PA network, feedback for the referrer, and exit strategies/routes. The PARS models contained a mean of 7 ± 2.9 components (range = 2-13). Forty-five studies reported PA outcome data, 28 reported uptake, and 34 reported adherence rates. Of these, approximately two-thirds of studies reported a positive effect on participant PA levels, with a wide range of uptake (5.7-100.0%) and adherence rates (8.5-95.0%). CONCLUSIONS Physical activity referral scheme components are an important source of complexity. Despite the heterogeneous nature of scheme designs, our synthesis was able to identify 19 components. Further research is required to determine the influence of these components on PARS uptake, adherence, and PA behavior change. To facilitate this, researchers and scheme providers must report PARS designs in more detail. Process evaluations are also needed to examine implementation and increase our understanding of what components lead to which outcomes. This will facilitate future comparisons between PARS and enable the development of models to maximize impact.
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Affiliation(s)
- Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany.
| | - Coral L Hanson
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany
| | - Anja Weissenfels
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany
| | - Sheona McHale
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
| | - Jane Saftig
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany
| | - Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany
| | - Stephen Whiting
- WHO European Office for Prevention and Control of Noncommunicable Diseases (NCD Office), Copenhagen, Denmark
| | - Kremlin Wickramasinghe
- WHO European Office for Prevention and Control of Noncommunicable Diseases (NCD Office), Copenhagen, Denmark
| | - Gauden Galea
- WHO European Office for Prevention and Control of Noncommunicable Diseases (NCD Office), Copenhagen, Denmark
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123B, 91058, 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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Pedron S, Herbert-Maul A, Sauter A, Linder S, Sommer R, Vomhof M, Gontscharuk V, Abu-Omar K, Thiel A, Ziemainz H, Holle R, Laxy M. Preferences of women in difficult life situations for a physical activity programme: protocol of a discrete choice experiment in the German NU-BIG project. BMJ Open 2023; 13:e067235. [PMID: 37460258 DOI: 10.1136/bmjopen-2022-067235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION The BIG project ('Bewegung als Investition in die Gesundheit', ie, 'Movement as Investment in Health') was developed in 2005 as a community-based participatory research programme to offer accessible opportunities for physical activity to women in difficult life situations. Since then, the programme has been expanded to eight sites in Germany. A systematic evaluation of BIG is currently being conducted. As part of this effort, we strive to understand the preferences of participating women for different aspects of the programme, and to analyse their willingness to pay. METHODS AND ANALYSIS In this protocol, we describe the development and analysis plan of a discrete choice experiment (DCE) to investigate participants' preferences for a physical activity programme for women in difficult life situations. The experiment will be embedded in a questionnaire covering several aspects of participation in the programme (eg, reach, efficacy and further effects) and the socioeconomic characteristics of all active participants. After a thorough search of the literature, BIG documents review and expert interviews, we identified five important attributes of the programme: course times, travel time to the course venue, additional social activities organised by BIG, consideration of wishes and interests for the further planning of courses and costs per course unit. Thereafter, we piloted the experiment with a sample of participants from the target group. After data collection, the experiment will be analysed using a conditional logit model and a latent class analysis to assess eventual heterogeneity in preferences. ETHICS AND DISSEMINATION Understanding women's preferences will provide useful insights for the further development of the programme and ultimately increase participation and retention. The questionnaire, the included DCE and the pretest on participants received ethical approval (application no. 20-247_1-B). We plan to disseminate the results of the DCE in peer-reviewed journals, national conferences and among participants and programme coordinators and organisers.
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Affiliation(s)
- Sara Pedron
- Professorship of Public Health and Prevention, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
| | - Alexandra Sauter
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Stephanie Linder
- Department of Sport Science and Sport, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
| | - Raluca Sommer
- Department of Sport Science and Sport, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
| | - Markus Vomhof
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Neuherberg, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Veronika Gontscharuk
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Neuherberg, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Social and Public Health Sciences and Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Heiko Ziemainz
- Department of Sport Science and Sport, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
| | - Rolf Holle
- Institute for Medical Informatics, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Michael Laxy
- Professorship of Public Health and Prevention, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- German Center for Diabetes Research, Neuherberg, Germany
- Institute of Health Economics and Healthcare Management, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Munich, 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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Sauter A, Herbert-Maul A, Abu-Omar K, Thiel A, Ziemainz H, Frahsa A, Linder S, Herrmann-Johns A. Corrigendum: "For me, it's just a piece of freedom"-Increased empowerment through physical activity promotion among socially disadvantaged women. Front Public Health 2023. [PMID: 36866096 PMCID: PMC9972080 DOI: 10.3389/fpubh.2023.1146584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.867626.].
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Affiliation(s)
- Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany,*Correspondence: Alexandra Sauter ✉
| | - Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Heiko Ziemainz
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Stephanie Linder
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
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Kohler S, Dippon L, Helsper N, Rütten A, Abu-Omar K, Birkholz L, Pfeifer K, Weber P, Semrau J. Population-based physical activity promotion with a focus on health equity: a review of reviews. Int J Equity Health 2023; 22:18. [PMID: 36703145 PMCID: PMC9878967 DOI: 10.1186/s12939-023-01834-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The extent to which people are physically active is dependent upon social gradients. Numerous studies have shown that especially people with social disadvantages do not meet the physical activity (PA) recommendations. A promising strategy to alleviate this issue are approaches that promote PA in the general population. In addition, several researchers have raised concerns that population-based health interventions may increase health inequities. The aim of the current review of reviews was therefore to identify successful population-based PA promotion approaches with a particular focus on health equity. METHODS Six electronic databases were examined for systematic reviews on population-based PA promotion for the period 2015 to 2021. A reference list and grey literature search were also conducted. Two independent reviewers used inclusion/exclusion criteria to screen titles and abstracts of the potentially relevant literature and conducted a quality assessment for each identified review. All included reviews of population-based approaches for PA promotion with a focus on disadvantaged populations and/or health equity were narratively summarized. RESULTS Our search resulted in 4,411 hits. After a systematic review process, six reviews met the inclusion criteria and were included after they were all rated as high quality. We identified that mass-media campaigns, point-of-decision prompts, environmental approaches, policy approaches, and community-based multi-component approaches can promote PA in the general population. Across populations with social disadvantages mass-media campaigns, point-of-decision prompts and policy approaches are likely to be effective as long as they are tailored. Regarding environmental approaches, the results are inconsistent. None of the reviews on community-based multi-component approaches provided evidence on health equity. CONCLUSION There are several effective approaches to promote PA in the general population but evidence regarding health equity is still sparse. Future studies should therefore pay more attention to this missing focus. Furthermore, there is a lack of evidence regarding the type of tailoring and the long-term impact of population-based approaches to PA promotion. However, this requires appropriate funding programmes, complex study designs and evaluation methods.
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Affiliation(s)
- Simone Kohler
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Lea Dippon
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Natalie Helsper
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Alfred Rütten
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Leonie Birkholz
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Klaus Pfeifer
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Philipp Weber
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
| | - Jana Semrau
- grid.5330.50000 0001 2107 3311Department of Sport Science and Sport, Friedrich-Alexander University Erlangen Nuremberg, Gebbertstr, 123B, 91058 Erlangen, Germany
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Tcymbal A, Abu-Omar K, Hartung V, Bußkamp A, Comito C, Rossmann C, Meinzinger D, Reimers AK. Interventions simultaneously promoting social participation and physical activity in community living older adults: A systematic review. Front Public Health 2022; 10:1048496. [PMID: 36568739 PMCID: PMC9768837 DOI: 10.3389/fpubh.2022.1048496] [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: 09/19/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background In recent years, there has been a global trend toward an increase in life expectancy and the proportion of elderly people among the population. In this regard, it becomes important to promote active and healthy aging. Physical inactivity and social isolation are both risk factors of many chronic illnesses and highly prevalent in older adults. This challenges communities to develop interventions that reduce these risk factors among elderly populations. The main aims of this study were to summarize community-based interventions that aim to simultaneously promote social participation and physical activity in older adults and to examine their effects. Methods We performed a systematic review based on the PRISMA standards. Literature searches were conducted in six scientific databases in July 2021. Articles were included if they had an interventional design, focused on older adults living in the community and measured social participation and physical activity as an outcome. The data were summarized narratively due to the heterogeneity of studies and the variety of outcome measures. Results Overall, 46 articles published in English were included. The studies were grouped in (1) interventions with main focus on physical activity promotion; (2) social activities that included a physical activity component; (3) health behavior interventions/ health education interventions; (4) multicomponent interventions; (5) environmental interventions. The majority of the reviewed studies reported positive effects of interventions on physical activity and/or social participation. No study reported negative effects. Analysis of quantitative studies showed that multicomponent interventions have great positive effects on both outcomes. In qualitative studies positive effects were found regardless of intervention type. Conclusion This review summarizes the evidence about the effects of community-based interventions that aim to promote social participation and physical activity in older adults. Multicomponent interventions seem to be most suitable for simultaneous promotion of physical activity and social participation. However, high variability in measurement methods used to assess both social participation and physical activity in the included studies made it difficult to compare studies and to indicate the most effective. Systematic review registration www.crd.york.ac.uk, identifier: PROSPERO [CRD42021268270].
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Affiliation(s)
- 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
| | - Verena Hartung
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Chiara Comito
- Federal Centre for Health Education (BZgA), Köln, Germany
| | | | - Diana Meinzinger
- 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
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Till M, Abu-Omar K, Ferschl S, Abel T, Pfeifer K, Gelius P. Implementing the capability approach in health promotion projects: Recommendations for implementation based on empirical evidence. Eval Program Plann 2022; 95:102149. [PMID: 36029567 DOI: 10.1016/j.evalprogplan.2022.102149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 05/03/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this paper was to develop a framework for the use of the capability approach in health promotion projects, which could guide future projects as well as improve the comparability of the projects' effectiveness. METHOD The study involved a three-stage process comprising a total of six steps. We first developed a theoretical model and then analyzed data from four empirical studies that had implemented projects using the capability approach between 2015 and 2018 in the settings of kindergartens, schools, vocational training, and communities to promote an active lifestyle. Finally, we developed a framework for the use of the capability approach in health promotion projects based on the analysis of the data. RESULTS We developed a theoretical model of the "capability cycle," which was used for further analysis. There were divergent understandings of the capability approach due to existing theoretical constructs that are commonly used by the scientific teams of the projects. Further, the conceptualization, implementation, and evaluation of the capability approach within the four settings showed discrepancies, which inhibited a comparison of their effectiveness. The developed framework comprises recommendations regarding the planning of a project, its implementation, and especially its evaluation in future comparisons of project effectiveness. CONCLUSION This paper provides a comprehensive analysis of four projects for which we developed a framework using a participatory approach. The findings can help research teams in the conceptualization, implementation, and evaluation of future projects that focus on improving capabilities in the field of health promotion. Further, the established framework will help facilitate comparisons of capability-oriented health promotion projects in terms of their effectiveness.
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Affiliation(s)
- Maike Till
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany.
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany
| | - Susanne Ferschl
- Department of Sport and Health Sciences, Technical University of Munich, Germany
| | - Thomas Abel
- Department of Social and Preventive Medicine, University of Bern, Switzerland
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany
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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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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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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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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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Sandu P, Chereches RM, Papiu A, Gelius P, Abu-Omar K, Takeda N, Oida Y, Onatsu T, Tuunanen K. P01-01 Assessment of local governments’ involvement in sport and physical activity policy promotion – LoGoPAS project. Eur J Public Health 2022. [PMCID: PMC9435625 DOI: 10.1093/eurpub/ckac095.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The involvement of local governments in physical activity (PA) promotion represents a key factor to drive change at grassroots level, based on identified specific needs and solutions, tailored to each local context (needs, resources, etc.). The aim of LoGoPAS, Erasmus + Sport co-financed project (2020-2021), is to assess, promote and support local governments' involvement in PA (policy) promotion.
Methods
A mixed methods approach has been put in place (including thematic document analysis of grey literature, semi-structured stakeholder interviews, group consensus methodologies) to explore and analyze the current legally binding and voluntary activities of local goverments in PA (policy) promotion. The study is being conducted at local level in Finland, France, Germany, Japan and Romania. Already validated instruments to evaluate local PA policy, such as L-PAT (Local Policy Audit Tool), Capla SANTE or TEAviisari will be used to harmonize data collected from each partner country, at local level.
Results
Locally collected data from partner countries reveal significant differences in the organization and delivery of PA related policies with more regulations and structures in the western countries (e.g. Germany or Finland) and more opportunistic and mixed approach (related to the purpose of the PA related projects) in Romania. Also, the currently available instruments for evaluation of local PA policies (those used for data harmonization in our project - see methods section) can benefit from additions in order to capture the complexities of the engagement of local governments in PA promotion.
Conclusion
Although the roles of local governments in PA promotion has been widely acknowledged (e.g. by WHO or the European Comission), there are currently few hands-on instruments for policy-makers and other actors at local level to advance PA promotion agenda and activities. Approaches tailored to local contexts may help engage local governments, while international networking may foster the exchange of experiences and help optimize interventions.
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Affiliation(s)
- Petru Sandu
- Public Health, University Babes-Bolyai , Cluj-Napoca, Romania
- Public Health, University of Medicine and Pharmacy Iuliu Hatieganu , Cluj-Napoca, Romania
| | | | - Antonia Papiu
- Public Health, University Babes-Bolyai , Cluj-Napoca, Romania
| | - Peter Gelius
- Department Sportwissenschaft und Sport, University of Erlangen-Nuremberg (Friedrich-Alexander-Universität Erlangen-Nürnberg) , Erlangen, Germany
| | - Karim Abu-Omar
- Department Sportwissenschaft und Sport, University of Erlangen-Nuremberg (Friedrich-Alexander-Universität Erlangen-Nürnberg) , Erlangen, Germany
| | - Noriko Takeda
- Physical Activity and Health Promotion Studies, Center for Promotion of Higher Education, Kogakuin University , Tokyo, Japan
| | - Yukio Oida
- School of Life Science and Technology, Chukyo University , Nagoya, Japan
| | - Tanja Onatsu
- Fit for life program, LIKES – Research Centre for Physical Activity and Health , Jyväskylä, Finland
| | - Katariina Tuunanen
- Fit for life program, LIKES – Research Centre for Physical Activity and Health , Jyväskylä, Finland
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Till M, Ferschl S, Abu-Omar K, Gelius P. O4-8 Measuring capabilities for physical activity-related health outcomes: A Systematic review. Eur J Public Health 2022. [PMCID: PMC9421856 DOI: 10.1093/eurpub/ckac094.032] [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: 11/15/2022] Open
Abstract
Background Health promotion projects commonly measure health outcomes and behavior to provide proof of effectiveness. An alternative concept that focuses on the real opportunities a person can choose from to influence their health is Amartya Sen's capability approach. Numerous tools have been developed to measure capability change in general, but it remains unclear which ones can be applied specifically to physical activity (PA).We therefore conducted a systematic review to identify appropriate tools to measure capabilities for physical activity and health and provide information on their quality. Methods The review included a total of 6,850 articles published between 2000 and June 2019 that were identified via searches on PubMed, EbscoHost, and ProQuest. Screenings of titles/abstracts and full texts were conducted independently by two researchers using Endnote X9 and Microsoft Excel. Identified tools are currently being analyzed regarding their indicators, evaluation methods, quality, and the extent to which they address capabilities for physical activity. Results The screening resulted in a total of 49 articles included in the analysis. Preliminary results show a diverse use of methods for measuring capabilities for healthy lifestyles. Preliminary results show that three categories of instruments can be identified: (a) Five studies employed secondary data analysis of specific datasets to extrapolate capabilities for healthy living; (b) five articles dealt with measuring capabilities using qualitative approaches (interviews, video recordings); (c) 39 articles reported on a total of 10 different questionnaires to measure capabilities. We identified only one instrument (employing both a questionnaire and qualitative measures) that explicitly measured capabilities for PA, albeit only for a specific target group. Conclusions The identified articles show that capabilities for healthy lifestyles are mostly measured by questionnaire. Available tools are mostly target group- and setting-specific. Currently, there is a dearth of tools that explicitly cover capabilities for PA, especially across settings or target groups. Therefore, more research is needed to work towards the development of universally applicable tools to measure PA capability.
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Affiliation(s)
- Maike Till
- Department of Sportscience and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Susanne Ferschl
- Department of Sportscience and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sportscience and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
| | - Peter Gelius
- Department of Sportscience and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg , Erlangen, Germany
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Kohler S, Semrau J, Helsper N, Dippon L, Abu-Omar K, Pfeifer K, Ruetten A. P08-05 Community-based interventions to promote physical activity among individuals with social disadvantages. Eur J Public Health 2022. [PMCID: PMC9436190 DOI: 10.1093/eurpub/ckac095.118] [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
The extent to which people are physically inactive is dependent upon social gradients. Numerous studies have proven that individuals with social disadvantages are not active enough. Parallel to this, several researchers have raised concerns that public health interventions may increase inequalities in the population. However, little is known about the success of community-based physical activity promotion among individuals with social disadvantages. Hence, our goal was to identify the characteristics of successful interventions within this field.
Methods
From March 2015 to March 2019, a search for systematic reviews dealing with community-based physical activity promotion was carried out using the databases PubMed, Scopus, PsycInfo/SPORTDiscus (via Ebscohost), ERIC and IBSS (via ProQuest). Only articles written in English or German were included. Studies without information about socially disadvantaged groups or physical activity promotion in low and middle-income countries were excluded. Checking of the reference lists of included reviews completed the research. Two authors independently conducted the screening, selection and data extraction. Results were synthesized narratively.
Results
In the first step, a total of 2,610 articles were identified. After the screening, 20 publications could be considered, while only six involved individuals with social disadvantages. In particular, these articles described environmental interventions, tailoring, and involvement of the target group, as effective among individuals with social disadvantages. In addition, strategies for gaining political support, intersectionality strategies, and the creation of access routes to reach individuals with social disadvantages were specified as requirements for effectiveness.
Conclusion
The current state of research concerning physical activity interventions in a community setting for individuals with social disadvantages is very limited. Because the target group is so broad, the evidence of successful approaches is heterogeneous. In order to assess the characteristics of physical activity promotion interventions, additional studies that focus on various groups of people with social disadvantages in real-world community settings are needed.
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Affiliation(s)
- Simone Kohler
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen, Germany
| | - Jana Semrau
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen, Germany
| | - Natalie Helsper
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen, Germany
| | - Lea Dippon
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen, Germany
| | - Alfred Ruetten
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg , Erlangen, Germany
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21
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Naber I, Mino E, Klamroth S, Weissenfels A, Geidl W, Gelius P, Abu-Omar K, Pfeifer K. P07-12 Stakeholders perspectives on exercise referral schemes in Germany. Eur J Public Health 2022. [PMCID: PMC9421779 DOI: 10.1093/eurpub/ckac095.112] [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: 11/15/2022] Open
Abstract
Background There is a growing popularity of exercise referral schemes (ERS) and they are widely implemented in nations such as New Zealand and Sweden. To this point, the German health care system (GHCS) is not utilising a structurally implemented ERS, but a research project is currently conducted to develop and test a German ERS. In the first project phase, the aim was to introduce the topic of ERS to relevant stakeholders of the GHCS and to gather their expert opinions on such a potential ERS. Further, the aim was to familiarise the stakeholders to the project and its collaborative approach in developing and testing an ERS. Methods Semi-structured interviews were conducted with 12 relevant stakeholder of the GHCS. In each case, two researchers conducted the interviews between June to September 2019. Main topics addressed during the interviews were potential target groups for an ERS, their own role within an ERS, PA counselling and dropouts that would be expected. During the interviews, stakeholders were encouraged to sketch their ideas for how to organise an ERS on paper. In the analysis, we digitalised these sketches into flow-chart diagrams. Results The analysis of the interviews showed that the sketches proposed innovative additions and alternative PA promotion strategies within the GHCS. The stakeholders identified barriers within the GHCS such as the rigid costing of treatments and performance measurements. Some reoccurring important core elements for an ERS in Germany were suggested: having a supportive person, implementing PA behaviour impact, utilising existing PA programs and tailoring individual PA counselling. Some stakeholders envisioned an ERS focusing on their perspectives and desired role within the ERS while others outlined ERS that largely excluded them. Conclusions All stakeholders clearly expressed the need for collaboration to develop and test an ERS in Germany. Previous studies have been focused on factors that influence effectiveness, as uptake and adherence. In contrast, these interviews resulted in the identification of concrete barriers and facilitators from the administrative perspective within the GHCS. Different stakeholders show varying degrees of interest in being part of an ERS. This information is highly valuable for the upcoming collaborative process.
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Affiliation(s)
- Inga Naber
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
| | - Sarah Klamroth
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
| | - Anja Weissenfels
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport - Physical Activity and Health, Friedrich-Alexander University , Erlangen, Germany
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22
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Whiting S, Buoncristiano M, Gelius P, Abu-Omar K, Pattison M, Hyska J, Duleva V, Milanović SM, Zamrazilová H, Hejgaard T, Rasmussen M, Nurk E, Shengelia L, Kelleher CC, Heinen MM, Spinelli A, Nardone P, Abildina A, Abdrakhmanova S, Aitmurzaeva G, Usuopva Z, Pudule I, Petrauskiene A, Angelo VFS, Kujundzic E, Popovic S, Fismen AS, Bergh IH, Fijalkowska A, Rito AI, Cucu A, Brinduse LA, Peterkova V, Gualtieri A, García-Solano M, Gutiérrez-González E, Abdurrahmonova Z, Boymatova K, Yardim N, Tanrygulyyeva M, Weghuber D, Schindler K, Stojisavljević D, Hadžiomeragić AF, Ionnaidu EM, Ahrens W, Hassapidou M, Kovacs VA, Ostojic SM, Ticha L, Starc G, Jonsson KR, Spiroski I, Rutter H, Mendes R, Williams J, Rakovac I, Breda J. S02-1 Physical activity and sedentary behaviour of children aged 6-9 in Europe: an analysis within the Childhood Obesity Surveillance Initiative (COSI). Eur J Public Health 2022. [PMCID: PMC9421738 DOI: 10.1093/eurpub/ckac093.006] [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
Children are becoming less physically active for a variety of interrelated reasons. The availability of opportunities for safe active playgrounds, recreational activities and active transport has decreased, while time spend on sedentary screen-based activities has increased. This study aimed to evaluate physical activity (PA), sedentary and sleep behaviours of children aged 6-9 years in Europe using data from the WHO Childhood Obesity Surveillance Initiative (COSI).
Methods
The fourth COSI data collection round was conducted in 36 countries from 2015-2018 using a standardized protocol including a family form completed by parents with specific questions about diet and physical activity-related behaviours.
Results
Nationally representative data from the 24 countries, who filled in the non-mandatory family record form, were included. Information on PA, screen-time and sleep behaviours of 137,807 children were analysed. Pooled analysis showed that: one in two children walked or cycled to school every day; one in two children were members of a sport or dancing club; around 40 % of children spent at least two hours per day watching TV or using electronic devices; around four in five children were actively or vigorously playing each day; around 88 % of children slept for at least nine hours per night. Country specific analyses showed pronounced differences in prevalence estimates between countries.
Conclusions
While the severity of the problem varies between countries, physical inactivity and sedentary behaviours are common across the European Region. Policy makers across the Region must do more in order to increase opportunities for young people to participate in daily activities. Furthermore, they should explore solutions to reduce the amount of time spend on sedentary activities, in order to halt the rise in overweight and obesity.
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Affiliation(s)
- Stephen Whiting
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
| | - Marta Buoncristiano
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Peter Gelius
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Mary Pattison
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health , Tirana, Albania
| | - Vesselka Duleva
- National Center of Public Health and Analyses , Sofia, Bulgaria
| | - Sanja Musić Milanović
- School of Medicine, University of Zagreb, Croatian Institute of Public Health , Zagreb, Croatia
| | - Hana Zamrazilová
- Institute of Endocrinology, Obesity Management Centre , Prague, Czechia
| | | | - Mette Rasmussen
- National Institute of Public Health, University of Southern Denmark , Copenhagen, Denmark
| | - Eha Nurk
- National Institute for Health Development , Tallinn, Estonia
| | - Lela Shengelia
- National Center for Disease Control and Public Health , Tbilisi, Georgia
| | - Cecily C Kelleher
- National Nutrition Surveillance Centre, University College Dublin , Dublin, Ireland
| | - Mirjam M Heinen
- National Nutrition Surveillance Centre, University College Dublin , Dublin, Ireland
| | | | | | - Akbota Abildina
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan , Nur-Sultan, Kazakhstan
| | - Shynar Abdrakhmanova
- National Centre of Public Health of the Ministry of Health of the Republic of Kazakhstan , Nur-Sultan, Kazakhstan
| | | | | | - Iveta Pudule
- Ministry of Health, Centre for Disease Prevention and Control , Riga, Latvia
| | - Aušra Petrauskiene
- Lithuanian University of Health Sciences, Health Research Institute and Department of Preventive Medicine , Kaunas, Lithuania
| | | | - Enisa Kujundzic
- Institute of Public Health of Montenegro , Podgorica, Montenegro
| | - Stevo Popovic
- Faculty for Sport and Physical Education, University of Montenegro , Niksic, Montenegro
| | - Anne-Siri Fismen
- Department of Health Promotion, Norwegian Institute of Public Health , Bergen, Norway
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health , Bergen, Norway
| | - Anna Fijalkowska
- Department of Cardiology, Institute of Mother and Child , Warsaw, Poland
| | - Ana Isabel Rito
- National Institute of Health Dr Ricardo Jorge I.P ., Lisbon, Portugal
| | - Alexandra Cucu
- National Institute of Public Health , Bucharest, Romania
| | | | | | - Andrea Gualtieri
- Health Authority San Marino , San Marino
- Republic of San Marino , San Marino
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Health , Madrid, Spain
| | | | - Zulfinissio Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population , Duschanbe, Tajikistan
| | | | - Nazan Yardim
- Diabetes and Metabolic Disorders Department, Ministry of Health, Public Health Institution , Ankara, Turkey
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health , Ashgabat, Turkmenistan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University , Salzburg, Austria
| | | | - Dragana Stojisavljević
- Public Health Institute of Republic of Srpska, the University of Banja Luka, Faculty of Medicine , Banja Luka
- Bosnia and Herzegovina , Banja Luka
| | - Aida Filipović Hadžiomeragić
- Institute of Public Health of Federation of Bosnia and Herzegovina , Banja Luka
- Bosnia and Herzegovina , Banja Luka
| | | | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Institute of Statistics, University of Bremen , Bremen, Germany
| | | | | | - Sergej M Ostojic
- Faculty of Sport and PE, University of Novi Sad , Novi Sad, Serbia
| | - Lubica Ticha
- National Institute of Children Diseases, Medical Faculty of Comenius University , Bratislava, Slovakia
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana , Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden , Solna, Sweden
| | - Igor Spiroski
- Department of Physiology and Monitoring of Nutrition, Institute of Public Health , Skopje, Republic of Macedonia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath , Bath, UK
| | - Romeu Mendes
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
| | - Julianne Williams
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Ivo Rakovac
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - João Breda
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
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Ferschl S, Gelius P, Abu-Omar K, Abel T. P08-11 Capabilities and capitals for leisure-time physical activity among young adults: findings from Switzerland. Eur J Public Health 2022. [PMCID: PMC9421739 DOI: 10.1093/eurpub/ckac095.124] [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: 11/20/2022] Open
Abstract
Background The association between physical activity (PA) and social, economic and psychological factors in young adults is well documented. By contrast, the mechanisms by which their perceived options to be active in life shape their actual PA behavior are less well understood. By taking into account individual competences as well as social, economic and cultural resources, Sen's capability approach and Bourdieu's theory of capitals may contribute to a better understanding of how PA levels depend on the chances young adults have to realize activity in daily life. This study explores the influence of a set of PA-related capabilities, conversion factors and different forms of capitals on leisure-time PA among young Swiss adults. Methods We analyzed data from the Swiss Federal Survey of Adolescents (YASS), specifically the 2010/11 and 2014/15 panels, to explore capabilities for PA among young Swiss adults (N = 21894; aged 18-25 years). We applied stepwise linear regression analyses to explore the association between continuous PA scores, capabilities to be active, cultural (parental education, parental cultural objects), economic (household equivalent income) and social resources (social connections of parents), as well as individual conversion factors (self-efficiency, own education, health literacy). Results Preliminary findings suggest that higher capabilities to be physically active, being female, having a higher education, having parents with a higher education or a higher number of cultural objects, scoring higher on the health literacy scale and being more self-efficient have a statistically significant positive effect on leisure-time PA. Conclusions In line with Sen's capability approach and Bourdieu's theory of capitals, our findings indicate positive associations between leisure-time PA, the perceived capabilities to be active in life, different resources and conversion factors. This implies that these approaches may serve as a good theoretical foundation for conceptualizing interventions to effectively promote PA among young adults.
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Affiliation(s)
- Susanne Ferschl
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg , Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg , Erlangen, Germany
| | - Thomas Abel
- Institute of Social and Preventive Medicine, University of Bern , Bern, Switzerland
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24
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Whiting S, Mendes R, Abu-Omar K, Gelius P, Crispo A, McColl K, Simmonds P, Fedkina N, Andreasyan D, Gahraman H, Migal T, Sturua L, Obreja G, Abdurakhmanova Z, Saparkulovna IN, Erguder T, Ekinci B, Keskinkilic B, Shukurov S, Yuldashev R, Berdzuli N, Rakovac I, Breda J. S02-5 Physical inactivity in nine Eastern European and Central Asian countries: results from the WHO STEPwise approach to NCD risk factor surveillance. Eur J Public Health 2022. [PMCID: PMC9421875 DOI: 10.1093/eurpub/ckac093.010] [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: 11/17/2022] Open
Abstract
Background Physical inactivity is a major risk factor for noncommunicable diseases. This paper explores patterns of physical inactivity in Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Moldova, Tajikistan, Türkiye and Uzbekistan. Methods Nationally-representative data were collected through the WHO STEPwise survey of noncommunicable disease risk factors, which utilizes the Global Physical Activity Questionnaire (GPAQ) to estimate population physical inactivity. Results The prevalence of physical inactivity varied across the region, from 11.4 to 44.7%, and was higher among women than men in all countries except for Armenia, Belarus and Moldova. In most countries, the highest proportion of physical activity levels were registered during work time and appeared to vary according to the countries’ level of development. For both sexes and across all populations, time spent on leisure or recreational physical activity was low. Conclusions These results have important implications for policy, including actions to promote active travel and leisure-time physical activity as countries develop economically. Investments in workplace physical activity programmes and infrastructure are needed as populations transition to sedentary from more physically active occupations. The results reiterate the need for multisectoral policies, programmes and interventions to promote physical activity tailored to the local context.
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Affiliation(s)
- 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
| | - Romeu Mendes
- WHO European Office for the Prevention and Control of Noncommunicable Diseases , Moscow, Russian Federation
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto , Porto, Portugal
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, FAU , Erlangen, Germany
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale , Napoli, Italy
| | - Karen McColl
- WHO European Office for the Prevention and Control of Noncommunicable Diseases , Moscow, Russian Federation
| | - Phillipa Simmonds
- WHO European Office for the Prevention and Control of Noncommunicable Diseases , Moscow, Russian Federation
| | - Natalia Fedkina
- WHO European Office for the Prevention and Control of Noncommunicable Diseases , Moscow, Russian Federation
| | - Dianne Andreasyan
- National Institute of Health, National Health Information Analytic Centre, National Institute of Health , Yerevan, Armenia
| | | | - Tatyana Migal
- Department of Health Care Organization of the Ministry of Health , Minsk, Belarus
| | - Lela Sturua
- National Center for Disease Control and Public Health , Tbilisi, Georgia
| | - Galina Obreja
- Department of Social Medicine and Health Management, State University of Medicine and Pharmacy , Chisinau, Republic of Moldova
| | | | | | | | - Banu Ekinci
- General Directorate of Public Health, Ministry of Health , Ankara, Turkey
| | - Bekir Keskinkilic
- General Directorate of Public Health, Ministry of Health , Ankara, Turkey
| | - Shukhrat Shukurov
- Central Bureau for the implementation of the Health-3 project , Tashkent, Uzbekistan
| | - Rustam Yuldashev
- Central Bureau for the implementation of the Health-3 project , Tashkent, Uzbekistan
| | - Nino Berdzuli
- Division of Country Health Programmes, WHO Regional Office for Europe , Copenhagen, Denmark
| | - Ivo Rakovac
- WHO European Office for the Prevention and Control of Noncommunicable Diseases , Moscow, Russian Federation
| | - Joao Breda
- WHO European Office for the Prevention and Control of Noncommunicable Diseases , Moscow, Russian Federation
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25
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Klamroth S, Naber I, Mino E, Geidl W, Gelius P, Abu-Omar K, Pfeifer K. P07-11 Physical activity promotion in the German healthcare system - Establishing pathways of exercise referral for persons with noncommunicable diseases. Eur J Public Health 2022. [PMCID: PMC9436219 DOI: 10.1093/eurpub/ckac095.111] [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: 11/25/2022] Open
Abstract
Background Exercise referral schemes (ERS) are embedded in the routine practice of healthcare systems in many countries (e.g. Sweden and New Zealand). In primary healthcare, ERS are recommended to sustainably increase physical activity (PA) levels among patients with noncommunicable diseases (NCD). Yet, the German health care system currently only incorporates interventions that primarily focus on improving functional outcomes but hardly aim at increasing PA levels. This presentation introduces an ongoing research project that aims to develop, implement and evaluate an ERS to promote PA for persons with NCD within the German healthcare system. Methods In the first phase of the project, a concept of an ERS was developed using a participatory research approach that involved relevant stakeholders such as physicians, funding agencies, PA providers, and patient representatives. The development process comprised three steps: 1) interviews to gather stakeholders' ideas of an ERS; 2) a literature review to collect evidence on key elements of international ERS; 3) three stakeholder meetings to combine scientific evidence with stakeholders' perspectives (co-creation). Subsequently, the ERS will be implemented, tested and evaluated in a regional pilot project using a pragmatic trial design. Finally, a concept for scaling-up the ERS to the German national level will be developed. Results As result of the co-creation process, the following key elements were defined to be part of the ERS: Screening, short counselling and provision of a referral form by a physician; initial assessment, counselling, individual PA recommendations, re-assessment and follow-up by exercise professionals. Additional aspects considered important for the implementation of the ERS were ensuring good communication and feedback between all participating health professionals, as well as an overview of all local physical activity offers and exercise professionals (database). These preliminary findings were combined into a draft of the ERS. Conclusions The participatory research approach employed by our project yielded the first draft of an ERS with a specific focus on PA promotion among persons with NCD within the German healthcare system. In the upcoming project stage, this ERS concept will be further elaborated and prepared for implementation and evaluation at a regional level.
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Affiliation(s)
- Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg , Erlangen, Germany
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26
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Gelius P, Sommer R, Ferschl S, Till M, Abu-Omar K, Semrau J, Helsper N, Kohler S, Dippon L, Pfeifer K, Rütten A, Popp J, Carl J, Grüne E, Müller C, Hassel H, Altmeier D, Frahsa A, Thiel A. S11 Improving knowledge co-creation and participation in physical activity promotion: The cooperative planning approach. Eur J Public Health 2022. [PMCID: PMC9421793 DOI: 10.1093/eurpub/ckac093.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
A central problem of current efforts to promote health and physical activity (PA) is that many successful projects remain stuck in the demonstration phase and are not implemented successfully at scale. The use of participatory and/or co-creation approaches has been suggested to avoid this ?pilot project trap? and better adapt interventions to target group needs and setting specificities.
This symposium intends to introduce to an international audience a particular participatory concept that has become increasingly popular in PA promotion in Germany in recent years: The Cooperative Planning approach has been successfully used in sport facility planning, local and regional PA policy development, and various settings of PA promotion (incl. kindergartens, schools, vocational training, and communities). The workshop will shed light on the theoretical background and methodology of Cooperative Planning as well as its specific application in select settings.
The first presentation will introduce the concept of Cooperative Planning, outline potential areas of application, and compare it with other popular participatory and co-creation approaches in PA promotion. Following this, we will provide evidence from ongoing projects employing the approach to promote PA in kindergartens (Presentation 2) and in the community setting (Presentation 3). Presentation 4 will introduce an example from the retirement home setting and also highlight ways of combining Cooperative Planning with other approaches such as photovoice and participatory evaluation. The final presentation will provide an outlook on the future extension of the concept by introducing the idea of the Practice Dive, which may be used to further optimize knowledge co-creation between researchers and practitioners.
A closer look at the Cooperative Planning approach is both timely and relevant for an international audience for a number of reasons: Conceptually, Cooperative Planning is a theory-based framework that combines ideas of participation and co-creation for PA into an innovative whole-of-system approach. From a practical PA promotion perspective, it transcends many existing techniques by focusing both on engaging multipliers and members of the target group, and by involving all of them in the decisive intervention development process (e.g. rather than only via opinion polls or focus groups). This symposium will allow us to combine evidence from four different projects, highlighting both the specificities of working in different settings as well as different aspects and possible extensions of the Cooperative Planning approach.
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Affiliation(s)
- Peter Gelius
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Raluca Sommer
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Susanne Ferschl
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Maike Till
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Jana Semrau
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Nathalie Helsper
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Simone Kohler
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Lea Dippon
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Johanna Popp
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Johannes Carl
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Eva Grüne
- Department of Sport Science and Sport, FAU Erlangen-Nürnberg , Erlangen, Germany
| | - Christina Müller
- Institut für angewandte Gesundheitswissenschaften, Coburg University of Applied Sciences and Arts , Coburg, Germany
| | - Holger Hassel
- Institut für angewandte Gesundheitswissenschaften, Coburg University of Applied Sciences and Arts , Coburg, Germany
| | - Dorothee Altmeier
- Institut für Sportwissenschaft, Universität Tübingen , Tübingen, Germany
| | - Annika Frahsa
- Institut für Sportwissenschaft, Universität Tübingen , Tübingen, Germany
| | - Ansgar Thiel
- Institut für Sportwissenschaft, Universität Tübingen , Tübingen, Germany
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Mino E, Naber I, Klamroth S, Weissenfels A, Geidl W, Gelius P, Abu-Omar K, Pfeifer K. P07-04 A systematic review of key interventional elements in international exercise referral schemes. Eur J Public Health 2022. [PMCID: PMC9421753 DOI: 10.1093/eurpub/ckac095.104] [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 With the first initiatives dating back to the 1990s, the past two decades have seen a rapid increase in the use of exercise referral schemes (ERS) worldwide. Despite the accumulating evidence on their effectiveness, there are currently no international guidelines available to inform the design of such interventions. The key elements and processes employed vary both within and between countries. This systematic review aims to address this frequently overlooked topic by identifying elements that are predominant in international ERS. Methods Scientific databases (PubMed, Scopus) and grey literature sources were systematically searched. In order to collect the information relevant for understanding and visualizing all ERS models, a broad spectrum of document types was considered eligible for inclusion, i.e. randomized controlled or pragmatic trials, cohort studies, case-control studies, case series, case reports, qualitative studies, economic evaluations, mixed designs, policy documents, and official governmental reports. We extracted data on scheme components, contents, and main actors involved in scheme delivery. Cross-functional flowcharts were employed to facilitate comparison between different ERS designs: Firstly, the collected data were visualized in flowcharts indicating the pathway a patient follows from beginning to end of an individual ERS. Secondly, elements that appeared more frequently across all included ERS were identified. Results Preliminary results identified 18 models of ERS that were eligible for data analysis, including Green Prescription (New Zealand), Hreyfiseðill (Iceland), National Exercise Referral Scheme (Wales). Program designs ranged from short advice by a primary healthcare professional to physical activity prescription and/or further referral to affiliated health professionals. The prevailing actors involved in scheme delivery were physicians, nurses, physiotherapists, training experts, physical activity providers, and coordinators. Seven predominant elements emerged from the comparison between ERS designs: assessment, counselling, individualized physical activity recommendations, written prescription, behavior change techniques, support person, and follow-up. Conclusions To the best of our knowledge, this is the first study that takes a closer look at the design characteristics of ERS across the world. Our preliminary results indicate that there are seven key elements. The contribution of these elements on the effectiveness of ERS needs to be explored in future research.
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Affiliation(s)
- Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Anja Weissenfels
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen, Germany
| | - Peter Gelius
- 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
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen, Germany
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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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Weissenfels A, Klamroth S, Carl J, Naber I, Mino E, Geidl W, Gelius P, Abu-Omar K, Pfeifer K. Effectiveness and implementation success of a co-produced physical activity referral scheme in Germany: study protocol of a pragmatic cluster randomised trial. BMC Public Health 2022; 22:1545. [PMID: 35964042 PMCID: PMC9375362 DOI: 10.1186/s12889-022-13833-2] [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: 06/28/2022] [Accepted: 07/20/2022] [Indexed: 11/22/2022] Open
Abstract
Background While effective physical activity referral schemes (PARSs) and related structures for promoting physical activity (PA) already exist in several countries, in Germany, PARSs have not yet been implemented systematically and nationwide. Through a co-production approach with relevant actors in the German healthcare system, a PARS was developed, and an implementation plan was created (e.g. financing). This study protocol aims to evaluate the developed PARS for people with non-communicable diseases (NCDs) in Germany regarding its potential effectiveness and implementation success. Methods To evaluate the effectiveness and implementation success of the PARS, we will apply a pragmatic cluster-randomised controlled trial (cRCT) in Hybrid II design by comparing two intervention groups (PARS vs PA advice [PAA]). The trial will take place in the Nürnberg metropolitan region, with 24 physician practices recruiting 567 people with NCDs. Both groups will receive brief PA advice from a physician to initially increase the participants’ motivation to change their activity level. Subsequently, the PARS group will be given individualised support from an exercise professional to increase their PA levels and be transferred to local exercise opportunities. In contrast, participants in the PAA group will receive only the brief PA advice as well as information and an overview of regional PA offerings to become more active at their own initiative. After 12 and 24 weeks, changes in moderate to vigorous PA and in physical activity-related health competence (movement competence, control competence, self-regulation competence) will be measured as primary outcomes. Secondary outcomes will include changes in quality of life. To measure implementation success, we refer to the RE-AIM framework and draw on patient documentation, interviews, focus groups and surveys of the participating actors (physicians, exercise professionals). Discussion Through a between-group comparison, we will investigate whether additional individual support by an exercise professional compared to brief PA advice alone leads to higher PA levels in people with NCDs. The acceptance and feasibility of both interventions in routine care in the German healthcare system will also be evaluated. Trial registration ClinicalTrials.gov, NCT04947787. Registered 01 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13833-2.
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Affiliation(s)
- Anja Weissenfels
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany.
| | - Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
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Sauter A, Abu-Omar K, Linder S, Sommer R, Herrmann-Johns A. Resiliente Communities? Eine qualitative Interviewstudie zur
Aufrechterhaltung eines Bewegungsprojektes für Frauen in schwierigen
Lebenslagen (BIG-Projekt) während den ersten beiden Jahren der COVID-19
Pandemie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753816] [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: 12/12/2022]
Affiliation(s)
- A Sauter
- Universität Regensburg, Professur für Medizinische
Soziologie, Regensburg, Deutschland
| | - K Abu-Omar
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department Sportwissenschaft und Sport, Erlangen, Deutschland
| | - S Linder
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department Sportwissenschaft und Sport, Erlangen, Deutschland
| | - R Sommer
- Friedrich-Alexander-Universität Erlangen-Nürnberg,
Department Sportwissenschaft und Sport, Erlangen, Deutschland
| | - A Herrmann-Johns
- Universität Regensburg, Professur für Medizinische
Soziologie, Regensburg, Deutschland
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Sauter A, Herbert-Maul A, Abu-Omar K, Thiel A, Ziemainz H, Frahsa A, Linder S, Herrmann-Johns A. "For me, it's just a piece of freedom"-Increased empowerment through physical activity promotion among socially disadvantaged women. Front Public Health 2022; 10:867626. [PMID: 35968425 PMCID: PMC9363839 DOI: 10.3389/fpubh.2022.867626] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Community-based participatory research (CBPR) is an effective health promotion approach for reaching socially disadvantaged groups. However, there is limited evidence on how such interventions and their effects can be reproduced across time and place. The present study examines the effects of BIG (i.e., movement as an investment in health), a long-standing German CBPR project. Since 2005, BIG has aimed to empower women in difficult life situations to increase control over their health determinants and reduce social inequalities by promoting physical activity. One of BIG's key features is its implementation in several German municipalities since 2005. This study explores (a) whether participation could change women's empowerment, and (b) how increased empowerment affects other areas of women's lives. Methods With a total of 63 interviewees (i.e., 40 participating women, 7 trainers, 3 project coordinators, and 13 stakeholders), we conducted 53 semi-structured qualitative interviews in five BIG communities between 2007 and 2011. Some interviews were conducted with two people simultaneously. The interview guide contained questions on various dimensions of empowerment (e.g., project engagement, increased self-efficacy, and developed competencies). Framework analysis was used for the analytical process. Results BIG contributed to women's empowerment in various ways, including increased self-efficacy, social network promotion, competency development, and increased motivation to change physical activity behavior. Women who took on added tasks and became more involved in project planning also strengthened their organizational empowerment. Furthermore, increased empowerment had a positive influence on the women's quality of life, family, and professional lives. Conclusion The novel findings helped in understanding the effects of a complex empowerment-based approach that promoted physical activity among women in difficult life situations. Future research should focus on the long-term effects of these programs and their transferability to other sites. Further effort is necessary in the area of public health policy.
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Affiliation(s)
- Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Heiko Ziemainz
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Stephanie Linder
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
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Abstract
Hintergrund Von Gesundheitsförderung profitieren häufig vorwiegend sozial privilegierte Personen während sozial Benachteiligte seltener erreicht werden. Ob dieses Präventionsdilemma auch auf kommunaler Ebene besteht, wurde bislang kaum erforscht. Ziel der Arbeit Die Studie untersucht anhand von zwei bayernweiten Projektausschreibungen zur kommunalen Bewegungsförderung, ob sozioökonomisch deprivierte Kommunen, die geringe Angebotsstrukturen der Gesundheitsförderung aufweisen, durch solche Ausschreibungen erreicht werden und welche Faktoren die Bereitschaft zur Beteiligung beeinflussen. Methoden Es werden Bevölkerungsdaten und sozioökonomische Deprivationsdaten von (n = 171) Kommunen aus drei Gruppen (teilnehmende/interessierte Kommunen und deprivierte Vergleichskommunen) verglichen. Durch eine systematische Internetrecherche werden die Gesundheitsförderungsaktivitäten ausgewählter Kommunen erhoben. Barrieren und Förderfaktoren für die Umsetzung der Projekte werden mittels einer Dokumentenanalyse erfasst. Ergebnisse Die teilnehmenden und interessierten Kommunen weisen höhere Einwohnerzahlen und geringere Deprivationswerte als der Durchschnitt der Kommunen in Bayern auf und stellen mehr Angebote der Gesundheitsförderung bereit als deprivierte Vergleichskommunen. Großen Einfluss auf die Teilnahme an den Projekten haben finanzielle Faktoren, politische Unterstützung und engagierte Personen. Diskussion Die Ergebnisse dieser Studie deuten auf ein Präventionsdilemma auf kommunaler Ebene hin. Um gesundheitlichen Ungleichheiten zwischen Kommunen vorzubeugen, sollten benachteiligte Kommunen in die Gestaltung von Förderprogrammen einbezogen werden, um diese Programme an deren Bedürfnisse anzupassen.
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Affiliation(s)
- Annika Herbert-Maul
- Department für Sportwissenschaft und Sport, Friedrich-Alexander Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Deutschland
| | - Karim Abu-Omar
- Department für Sportwissenschaft und Sport, Friedrich-Alexander Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Deutschland
| | - Maike Till
- Department für Sportwissenschaft und Sport, Friedrich-Alexander Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Deutschland
| | - Tobias Fleuren
- Department für Sportwissenschaft und Sport, Friedrich-Alexander Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Deutschland
| | - Andrea R. Wolff
- Koordinierungsstelle gesundheitliche Chancengleichheit, Landeszentrale für Gesundheit in Bayern, München, Deutschland
| | - Anne K. Reimers
- Department für Sportwissenschaft und Sport, Friedrich-Alexander Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Deutschland
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Till M, Abu-Omar K, Herbert-Maul A, Fleuren T, Reimers AK, Ziemainz H. Scaling Up Physical Activity Promotion Projects on the Community Level for Women in Difficult Life Situations and Older People: BIG-5 and GET-10—A Study Protocol. Front Public Health 2022; 10:837982. [PMID: 35493370 PMCID: PMC9046678 DOI: 10.3389/fpubh.2022.837982] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/15/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Physical inactivity is a major risk factor for a population's health, especially among socially disadvantaged groups. Many health promotion projects focus on increasing physical activity among their respective target groups. However, because they are mostly developed and implemented under laboratory conditions, they fail when being scaled to real-world settings. The community-based participatory research projects BIG and GESTALT have demonstrated their effectiveness regarding the physical activity promotion in real-world settings by employing a participatory method. Material and Analysis Within the context of the BIG-5 and GET-10 projects, these previously implemented and tested participatory projects are scaled to 15 additional settings in Bavaria, Germany. By applying an overarching mixed-methods evaluation framework, the aim is to gain insights into a) the recruitment of communities for scale-up; b) the specific results of the projects according to the RE-AIM framework. In the recruitment of communities, standardized information on the first contact, the consultation process, the person in charge, and previously implemented health promotion projects are collected. A systematic web search will complete information on each community and their health promotion activities. Results will be compared with information on those communities most in need, here according to the deprivation index of communities in Bavaria, Germany. The scale-up process and its results will be measured using semi-structured interviews with project coordinators. A standardized questionnaire will be used with the course's participants. Applying the RE-AIM framework, the collected data will be analyzed deductively. Discussion We expect the results to be highly relevant for the effective scale-up of any health promotion project. The study will enhance the understanding of how to reach those communities most in need of health promotion projects and will identify the barriers coordinators face in reaching socially disadvantaged groups. Conclusion Although participatory projects are often used as individual projects, little is known about the scaling up of participatory health promotion projects. This cross-cutting evaluation of two projects aims at producing data on the barriers and facilitators for the reach of settings most in need, and those success factors for a durable implementation.
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Marzi I, Tcymbal A, Gelius P, Abu-Omar K, Reimers AK, Whiting S, Wickramasinghe K. Monitoring of physical activity promotion in children and adolescents in the EU: current status and future perspectives. Eur J Public Health 2022; 32:95-104. [PMID: 34791137 PMCID: PMC8807108 DOI: 10.1093/eurpub/ckab193] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Policy action is required to address physical inactivity in boys and girls. This action can be supported by international data collection, comparisons and sharing of good practices. Thus, this study aims to present and discuss the ongoing monitoring of physical activity (PA) indicators in children and adolescents in the 28 EU Member States. METHODS Data on PA recommendations, PA prevalence, physical education (PE) and PA promotion programs for children and adolescents were provided by governments in a joint EU/WHO survey on the implementation status of the EU Council Recommendation on Health-Enhancing Physical Activity (HEPA) across Sectors. RESULTS In 23 countries, national recommendations on PA are available. Detailed PA prevalence data among children and adolescents was available in 27 countries, in most cases separately for sex/gender and age groups. The total amount of PE lessons in schools differed greatly between countries and lessons were predominantly mandatory. After-school HEPA promotion programs were mostly implemented in EU Member States (78.6%), followed by active school breaks (57.1%), active travel to school (57.1%) and active breaks during school lessons (53.6%). CONCLUSIONS This study summarizes the monitoring of PA indicators among children and adolescents in all EU Member States by providing a comprehensive overview of the status of PA promotion and monitoring across the region. Based on our findings, it could be concluded that the current EU monitoring system on PA promotion should be adapted to provide evidence that can inform future policy development.
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Affiliation(s)
- Isabel Marzi
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Anne K Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Stephen Whiting
- European Office for the Prevention and Control of Noncommunicable Diseases, Regional Office for Europe, World Health Organization, Moscow, Russian Federation
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Kremlin Wickramasinghe
- European Office for the Prevention and Control of Noncommunicable Diseases, Regional Office for Europe, World Health Organization, Moscow, Russian Federation
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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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Kohler S, Helsper N, Dippon L, Rütten A, Abu-Omar K, Pfeifer K, Semrau J. Co-producing an action-oriented framework for community-based Physical Activity Promotion in Germany. Health Promot Int 2021; 36:ii93-ii106. [PMID: 34905612 PMCID: PMC8672938 DOI: 10.1093/heapro/daab159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
German National Recommendations for Physical Activity (PA) and PA Promotion recommend community-based approaches to promote PA at the local level with a focus on health equity. In addition, the German Federal Prevention Act addresses health equity and strengthens setting-based health promotion in communities. However, the implementation of both in the local context remains a challenge. This article describes Phase 1 of the KOMBINE project that aims to co-produce an action-oriented framework for community-based PA promotion focusing on structural change and health equity. (i) In a series of workshops, key stakeholders and researchers discussed facilitators, barriers and needs of community-based PA promotion focusing on health equity. (ii) The research team used an inductive approach to cluster all findings and to identify key components and then (iii) compared the key components with updated literature. (iv) Key components were discussed and incorporated into a gradually co-produced framework by the participants. The first result of the co-production process was a catalog of nine key components regarding PA-related health promotion in German communities. The comparison of key components with scientific evidence showed a high overlap. Finally, a six-phase action-oriented framework including key components for community-based PA promotion was co-produced. The six-phase action-oriented framework integrates practice-based and scientific evidence on PA-related health promotion and health equity. It represents a shared vision for the implementation of National Recommendations for PA and PA Promotion in Germany. The extent to which structural changes and health equity can be achieved is currently being investigated in pilot-studies.
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Affiliation(s)
- Simone Kohler
- Department of Sport Science and Sport,
Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstr.
123b, Erlangen D-91058, Germany
| | - Natalie Helsper
- Department of Sport Science and Sport,
Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstr.
123b, Erlangen D-91058, Germany
| | - Lea Dippon
- Department of Sport Science and Sport,
Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstr.
123b, Erlangen D-91058, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport,
Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstr.
123b, Erlangen D-91058, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport,
Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstr.
123b, Erlangen D-91058, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport,
Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstr.
123b, Erlangen D-91058, Germany
| | - Jana Semrau
- Department of Sport Science and Sport,
Friedrich-Alexander University Erlangen-Nuremberg, Gebbertstr.
123b, Erlangen D-91058, Germany
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Abu-Omar K, Weissenfels A, Mino E, Naber I, Klamroth S, Geidl W, Pfeifer K. Coproduction to improve preventive health services-experiences from Germany. Health Promot Int 2021; 36:ii107-ii113. [PMID: 34905607 PMCID: PMC8672924 DOI: 10.1093/heapro/daab162] [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] [Indexed: 12/02/2022] Open
Abstract
Due to the beneficial impact of regular physical activity (PA) on
non-communicable diseases, the number of countries integrating exercise referral
schemes (ERSs) into their healthcare systems is growing. Owing to the
limitations of existing PA promotion concepts in Germany’s healthcare
system, efforts are currently being made towards developing a nationwide
referral pathway. A research group at the Friedrich-Alexander-University
Erlangen-Nürnberg is coordinating these efforts within a project funded
by the Federal Ministry of Health. The aim is to develop, implement and evaluate
a regional-level ERS that has the potential to be scaled up across Germany in
the event of its demonstrated effectiveness. The project is based on an adapted
Cooperative Planning approach requiring interaction between the academic sector
and different actors of the healthcare sector. The present commentary reflects
on challenges faced in the early stages of the co-production process. Besides
the development of an adequate co-production methodology, it critically
discusses stakeholder participation, knowledge gaps and actors’
willingness to take responsibility. In addition, although patients are
represented by dedicated organizations, their perspective cannot be adequately
captured using a co-production approach. Despite the joint development of an
ERS, there remain important questions regarding the appropriateness of the
co-production approach in a healthcare setting. Regular physical activity (PA) reduces one’s risk of developing various
diseases and also plays a favourable role in managing symptoms and preventing
further complications. Nationally and internationally, there exist different
concepts on how to increase PA in the population at large. The
Friedrich-Alexander-University Erlangen-Nürnberg is currently working on
a project that focuses on promoting PA in primary care. This project involves
collaboration among various actors in the German healthcare system, such as
healthcare insurances, representatives of physicians, patients and exercise
specialists, who represent different interests and are experts in their fields
of knowledge. During this process, various barriers have come to light, which
yield important lessons for further studies. For example, there are differences
in actors’ levels of knowledge of the healthcare system and their
willingness to take responsibility and initiative in the collaborative process.
This article should give an impression of the joint development of exercise
referral schemes, show the strengths and weaknesses and encourage exchanges of
similar experiences of co-production processes.
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Affiliation(s)
- Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Anja Weissenfels
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Gebbertstraße 123b, 91058 Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Gebbertstraße 123b, 91058 Erlangen, Germany
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Gelius PC, Sommer RM, Abu-Omar K, Schätzlein V, Suhrcke M. Toward the economic evaluation of participatory approaches in health promotion: lessons from four German physical activity promotion projects. Health Promot Int 2021; 36:ii79-ii92. [PMID: 34905608 PMCID: PMC8670626 DOI: 10.1093/heapro/daab158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 11/14/2022] Open
Abstract
Health promotion increasingly employs participatory approaches, but the question arises whether the likely higher costs of participation also translate into greater benefits. This article takes a first step toward a full health economic evaluation by comprehensively reporting the costs of a specific participatory approach, Cooperative Planning, in a German research consortium to promote physical activity. We conducted a costing analysis of Cooperative Planning at 22 sites across six settings. Project teams used a custom template to record resource use. We calculated average costs per meeting, site and setting using the opportunity costs approach, and obtained feedback from participating researchers. A total of 144 planning meetings with an average of nine participants were conducted. Costs per meeting varied significantly across settings. Differences were mostly attributable to varying meeting duration, preparation time and numbers of participants. Across settings, human resources accounted for roughly 95% of the costs. Implementing researchers reported challenges regarding the logic and methods of the health economic analysis. A participatory approach to physical activity promotion may cause substantially varying costs in different settings despite similar cost structures. However, their value for money could turn out comparably favorable if (and only if) the expected benefits is indeed forthcoming. Despite some challenges implementing the costing exercise into the logistics of ongoing participatory projects, this analysis may pave the way toward a full health economic evaluation, and the template may be useful to future participatory health promotion projects.
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Affiliation(s)
- Peter C Gelius
- Department for Sports Science and Sport, Friedrich-Alexander University of Erlangen-Nuremberg, Gebbertstrasse 123b, 91058 Erlangen, Germany
| | - Raluca M Sommer
- Department for Sports Science and Sport, Friedrich-Alexander University of Erlangen-Nuremberg, Gebbertstrasse 123b, 91058 Erlangen, Germany
| | - Karim Abu-Omar
- Department for Sports Science and Sport, Friedrich-Alexander University of Erlangen-Nuremberg, Gebbertstrasse 123b, 91058 Erlangen, Germany
| | - Valentin Schätzlein
- Department for Sports Science and Sport, Friedrich-Alexander University of Erlangen-Nuremberg, Gebbertstrasse 123b, 91058 Erlangen, Germany
| | - Marc Suhrcke
- Centre for Health Economics (CHE), University of York, Heslington, York, YO10 5DD, UK
- Luxembourg Institute of Socio-Economic Research (LISER), Maison des Sciences Humaines, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg
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Duffey K, Barbosa A, Whiting S, Mendes R, Yordi Aguirre I, Tcymbal A, Abu-Omar K, Gelius P, Breda J. Barriers and Facilitators of Physical Activity Participation in Adolescent Girls: A Systematic Review of Systematic Reviews. Front Public Health 2021; 9:743935. [PMID: 34722450 PMCID: PMC8553996 DOI: 10.3389/fpubh.2021.743935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/17/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Persistent low physical activity (PA) levels among adolescent girls constitute a public health concern that calls for immediate and evidence-based policy action. This systematic review (SR) aimed to summarize evidence from SRs examining the barriers and facilitators of PA participation in adolescent girls. The objectives were to provide a synthesis of the available evidence and identify key areas for fostering gender-responsive action and policy implications. Methods: A comprehensive search of relevant SR and meta-analyses were performed in PubMed and Cochrane Library, until February 2021. Studies were included if they were SRs or meta-analyses, included adolescent girls aged between 10 and 19 years, and described barriers or facilitators of PA. Two independent authors performed the screening of potentially eligible studies and both assessed the methodological quality of included studies using the AMSTAR 2 tool. The barriers and facilitators were synthesized at environmental, interpersonal, and individual levels. Results: A total of eight SRs were included in the qualitative synthesis. The most frequent barriers identified were the lack of support from peers, family, and teachers, and the lack of time. The most reported facilitators were weight loss, and support from peers, family, and teachers. Key areas for action and policy implementation include an inclusive approach to curriculum development to address gender norms; adequate training of professionals so they have a range of skills to ensure inclusion of adolescent girls; environmental changes in and out of schools to stimulate participation, to allow adolescent girls to be active in a safe and attractive environment; multistakeholder support at local, regional, and national level in incorporating a gender-responsive approach toward PA participation. Conclusion: The results highlight a variety of factors that influences the PA participation of adolescent girls. For the attainment of effective policies that increase PA levels in adolescent girls, it is essential to engage several stakeholders at different levels in incorporating a gender-responsive approach toward PA participation. Systematic Review Registration: PROSPERO, identifier: CRD42020204023.
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Affiliation(s)
- Keeva Duffey
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Ana Barbosa
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark.,Epidemiology Research Unit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Stephen Whiting
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark.,Epidemiology Research Unit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Romeu Mendes
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark.,Epidemiology Research Unit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | | | - Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - João Breda
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
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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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Whiting S, Mendes R, Abu-Omar K, Gelius P, Crispo A, McColl K, Simmonds P, Fedkina N, Andreasyan D, Gahraman H, Migal T, Sturua L, Obreja G, Abdurakhmanova Z, Saparkulovna IN, Erguder T, Ekinci B, Keskinkilic B, Shukurov S, Yuldashev R, Berdzuli N, Rakovac I, Breda J. Physical inactivity in nine European and Central Asian countries: an analysis of national population-based survey results. Eur J Public Health 2021; 31:846-853. [PMID: 34405879 PMCID: PMC8504998 DOI: 10.1093/eurpub/ckab028] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Physical inactivity is a major risk factor for non-communicable diseases. However, recent and systematically obtained national-level data to guide policy responses are often lacking, especially in countries in Eastern Europe and Central Asia. This article describes physical inactivity patterns among adults in Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan. Methods Data were collected using the Global Physical Activity Questionnaire drawing nationally representative samples of adults in each country. The national prevalence of physical inactivity was calculated as well as the proportional contribution to total physical activity (PA) during work, transport and leisure-time. An adjusted logistic regression model was applied to analyze the association of age, gender, education, household status and income with physical inactivity. Results National prevalence of physical inactivity ranged from 10.1% to 43.6%. The highest proportion of PA was registered during work or in the household in most countries, whereas the lowest was during leisure-time in all countries. Physical inactivity was more likely with older age in eight countries, with female gender in three countries, and with living alone in three countries. There was no clear pattern of association with education and income. Conclusion Prevalence of physical inactivity is heterogeneous across the region. PA during leisure-time contributes minimally to total PA in all countries. Policies and programs that increase opportunities for active travel and leisure-time PA, especially for older adults, women and people living alone will be an essential part of strategies to increase overall population PA.
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Affiliation(s)
- 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
| | - Romeu Mendes
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation.,EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Karim Abu-Omar
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, FAU, Erlangen, Germany
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | - Karen McColl
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Phillipa Simmonds
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Natalia Fedkina
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Dianne Andreasyan
- National Institute of Health, National Health Information Analytic Centre, National Institute of Health, Yerevan, Armenia
| | | | - Tatyana Migal
- Department of Health Care Organization of the Ministry of Health, Minsk, Belarus
| | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Galina Obreja
- Department of Social Medicine and Health Management, State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | | | | | | | - Banu Ekinci
- General Directorate of Public Health, Ministry of Health, Ankara, Turkey
| | - Bekir Keskinkilic
- General Directorate of Public Health, Ministry of Health, Ankara, Turkey
| | - Shukhrat Shukurov
- Central Bureau for the implementation of the Health-3 project, Tashkent, Uzbekistan
| | - Rustam Yuldashev
- Central Bureau for the implementation of the Health-3 project, Tashkent, Uzbekistan
| | | | - Ivo Rakovac
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Joao Breda
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
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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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Herbert-Maul A, Abu-Omar K, Streber A, Majzik Z, Hefele J, Dobslaw S, Werner H, Wolf A, Reimers AK. Scaling Up a Community-Based Exercise Program for Women in Difficult Life Situations in Germany-The BIG Project as a Case-Study. Int J Environ Res Public Health 2021; 18:9432. [PMID: 34574356 PMCID: PMC8468862 DOI: 10.3390/ijerph18189432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 11/21/2022]
Abstract
Scaling up community-based participatory research (CBPR) remains challenging. This case-study reports on how, and under which conditions, a CBPR project aiming at promoting exercise among socially disadvantaged women (BIG) scaled up at four project sites. As part of BIG, researchers support city administrations in implementing a participatory project to reach socially disadvantaged women for exercise. The case study was conducted in winter 2020 in southern Germany and is based on a co-creative process involving city administrators and researchers. Following Kohl and Cooley's scaling up dimensions, scaling up BIG was investigated at the four sites using a mixed-method approach. Course registrations and offers were analysed, and qualitative interviews (n = 4) with administrative staff members were conducted and analysed using content analysis. The geographical coverage of exercise classes, the addressed groups, and the utilisation of participatory methods by city administrations are described. All four sites managed to scale-up project activities. Three of the four sites reported that further growth of the project was no longer possible due to limited resources. All sites attempted to reach a larger number of, and more diverse, women. One site managed to scale-up the use of participatory methods within the city administration. The following important facilitators for scaling up CBPR projects were reported: advertisements tailored to the needs of the addressed women, utilising participatory approaches, and equipping project coordinators with sufficient resources.
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Affiliation(s)
- Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-University, 91058 Erlangen-Nuremberg, Germany; (K.A.-O.); (A.K.R.)
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University, 91058 Erlangen-Nuremberg, Germany; (K.A.-O.); (A.K.R.)
| | - Anna Streber
- Matrix GmbH & Co. KG, 91301 Forchheim, Germany; (A.S.); (Z.M.)
| | | | - Jeanette Hefele
- Office for Sport and Health Promotion, City of Erlangen, 91054 Erlangen, Germany;
| | - Stephanie Dobslaw
- Health Department, District Administration of Regensburg, 93059 Regensburg, Germany;
| | - Hedi Werner
- Women’s Representative, Office for Social Services, City of Straubing, 94351 Straubing, Germany;
| | - Alexandra Wolf
- Office for Children, Youth, Families and Integration, City of Bayreuth, 95445 Bayreuth, Germany;
| | - Anne K. Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-University, 91058 Erlangen-Nuremberg, Germany; (K.A.-O.); (A.K.R.)
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Gelius P, Till M, Ferschl S, Abu-Omar K, Pfeifer K. Capital4Health: Handlungsmöglichkeiten für aktive Lebensstile: Ein Forschungsnetzwerk für interaktiven Wissensaustausch in der Gesundheitsförderung. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732111] [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: 10/20/2022]
Affiliation(s)
- P Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - M Till
- Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - S Ferschl
- Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - K Abu-Omar
- Friedrich-Alexander-Universität Erlangen-Nürnberg
| | - K Pfeifer
- Friedrich-Alexander-Universität Erlangen-Nürnberg
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Mino E, Geidl W, Naber I, Weissenfels A, Klamroth S, Gelius P, Abu-Omar K, Pfeifer K. Physical activity referral scheme components: a study protocol for systematic review and meta-regression. BMJ Open 2021; 11:e049549. [PMID: 34145021 PMCID: PMC8215250 DOI: 10.1136/bmjopen-2021-049549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION In its attempt to establish effective physical activity promotion methods, research on physical activity referral schemes (PARS) is attracting significant attention. Sometimes known as physical activity on prescription schemes, PARS involve a well-defined procedure whereby a primary healthcare professional introduces a participant to the topic of physical activity and employs prescription or referral forms to connect the participant to physical activity opportunities, such as local fitness offers. The planned systematic review will focus on these referral routes and scheme components and how they are integrated into various PARS models worldwide. We seek to identify the evidence-based core components that play the most important roles in the effectiveness of PARS. METHODS AND ANALYSIS The development and reporting of the protocol follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We plan to conduct a systematic main literature search on PubMed, Scopus, Web of Science, CINAHL, HTA, SpringerLink and other databases. We will include studies that report outcomes on physical activity, PARS uptake and adherence rates or descriptive information about PARS models. We intend for all review stages, citation screening, data extraction and risk of bias assessment to be conducted by at least two independent reviewers. As a broad spectrum of study designs, including randomised and non-randomised studies of interventions and mixed methods, will be eligible, we will use three separate tools to assess the risk of bias in individual studies. The data will be primarily synthesised narratively, following Intervention Component Analysis. If the data allow, we will perform a random-effects meta-analysis and meta-regression to investigate the impact of specific PARS components on effect sizes. ETHICS AND DISSEMINATION This systematic review does not require formal ethics approval. The results will be submitted to a peer-reviewed journal and international conferences to reach the scientific community. PROSPERO REGISTRATION NUMBER CRD42021233229.
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Affiliation(s)
- Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Anja Weissenfels
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
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Ferschl S, Till M, Abu-Omar K, Pfeifer K, Gelius P. Scientific Cooperation and the Co-production of Scientific Outcomes for Physical Activity Promotion: Results From a Transdisciplinary Research Consortium. Front Public Health 2021; 9:604855. [PMID: 34178910 PMCID: PMC8232050 DOI: 10.3389/fpubh.2021.604855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 05/04/2021] [Indexed: 11/29/2022] Open
Abstract
Background: To tackle complex societal challenges such as the high prevalence of physical inactivity, research funding is increasingly channeled toward cross-disciplinary research consortia. This study focused on exchange and cooperation (E&C) among the scientists of a 5-year transdisciplinary research initiative in Germany. Researchers' perceptions of E&C were combined with numbers of collaborative products during the project's life to make the developments of E&C and the quality of collaborative products visible. Methods: We applied a mixed-methods design including a qualitative content analysis of pre-interviews, focus-group interviews, and documents as well as a quantitative analysis of research (scientific publications, books, conference participations) and training outcomes (supervised bachelor's, master's, and Ph.D. theses). Inductive and deductive approaches were combined to analyze factors of collaborative readiness and to identify perceptions of E&C among project teams. Based on Hall et al.'s “Conceptual Model for Evaluation of Collaborative Initiatives,” the project period was separated into phases of “collaborative readiness,” “collaborative capacity,” and “collaborative products.” Results: Our findings revealed a discrepancy between the objectively assessed concepts of collaborative readiness and researchers' reported perceptions of E&C during the early project stage. A set of E&C hindering factors identified during the initial project phase remained present until the final project stage. Further, E&C among scientists increased over time, as reflected by researchers' perceptions. Reports of scientists also showed that outcomes were co-produced at the final project stage for the first time, while knowledge integration had not yet been achieved. Generally, the number of collaborative products (particularly scientific publications) also substantially increased over time. E&C was supported and promoted by the efforts of the coordinating sub-project. Conclusion: Scientific E&C is a learning process and needs time to develop. A participatory research approach taking into account the perspectives on and requirements for E&C during the project's design might lay the ground for suitable, supportive, and transparent conditions for effective and successful E&C. Despite their time- and resource-consuming nature, cross-disciplinary research initiatives provide a fertile context in which to generate new solutions for pressing societal issues given that long-term funding and the establishment of an overarching coordination organ is assured.
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Affiliation(s)
- Susanne Ferschl
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Maike Till
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
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Whiting S, Mendes R, Morais ST, Gelius P, Abu-Omar K, Nash L, Rakovac I, Breda J. Promoting health-enhancing physical activity in Europe: Surveillance, policy development and implementation 2015-2018. Health Policy 2021; 125:1023-1030. [PMID: 34120770 PMCID: PMC8450183 DOI: 10.1016/j.healthpol.2021.05.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/09/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022]
Abstract
Study of trends in physical activity policy development in Europe. National physical activity policy development has advanced. Increased national policy actions in the health and education sectors. Monitoring and surveillance has expanded but needs to be standardised.
In the European Union (EU), the low levels of health-enhancing physical activity (HEPA) and high levels of sedentary behaviour are a concerning public health issue common to all Member States. In 2013, the Council of the EU recognized the need for more data related to HEPA to support policymaking across the region and proposed a monitoring framework that included 23 indicators covering different themes relevant to HEPA promotion in the EU context. In 2014, the EU Physical Activity Focal Points Network was established to support the implementation of the monitoring framework and in 2015 and 2018 surveys were conducted to collect epidemiological and policy information related to HEPA for each Member State. This paper aims to provide an update on the status of HEPA policies and surveillance in the EU and describe the changes that have occurred since 2015. In 2018, all countries had implemented more than 10 indicators, 8/28 had implemented 20 or more indicators, and only one country had completed all 23 indicators. From 2015 to 2018, 19 indicators improved, one remained unchanged, and three regressed. From the country perspective, 17 improved the number of accomplished indicators, five maintained the indicators, and five worsened the number of indicators. Overall, there has been a clear increase in the number of countries implementing HEPA policies and strategies across the different sectors, although some heterogeneity between Members Sates was still observed. Implementation of regional physical activity strategies and the establishment of the EU-wide monitoring framework appears to have had an overall positive impact on HEPA policy development and implementation.
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Affiliation(s)
- Stephen Whiting
- World Health Organization Regional Office for Europe, Copenhagen, Denmark; European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
| | - Romeu Mendes
- World Health Organization Regional Office for Europe, Copenhagen, Denmark; European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | | | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Lea Nash
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Ivo Rakovac
- World Health Organization Regional Office for Europe, Copenhagen, Denmark; European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization Regional Office for Europe, Copenhagen, Denmark; European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation
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Tcymbal A, Gelius P, Abu-Omar K, Foster C, Whiting S, Mendes R, Titze S, Dorner TE, Halbwachs C, Duclos M, Toussaint JF, Wendel-Vos W, Baxter B, Ferschl S, Breda JJ. Development of national physical activity recommendations in 18 EU member states: a comparison of methodologies and the use of evidence. BMJ Open 2021; 11:e041710. [PMID: 33858863 PMCID: PMC8054104 DOI: 10.1136/bmjopen-2020-041710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were chosen for detailed case study analysis of development processes. DESIGN Cross-sectional survey. PARTICIPANTS The representatives of the 28 EU member state governments to the EU physical activity Focal Point Network. OUTCOME MEASURES From national documents we extracted data on (1) the participants of the development process, (2) the different methods used during development, and (3) on which sources national PA recommendations were based. An additional survey for case study countries provided details on (1) anonymised information on the participants of development process, (2) methods employed and rationale for choosing them, (3) development process and timeline, and (4) main source documents used for recommendation development. RESULTS Eighteen national documents on PA recommendations contained information about development process. The results showed that countries used different approaches to develop national recommendations. The main strategies were (1) adoption of WHO 2010 recommendations or (2) a combination of analysis and adoption of other national and international recommendations and literature review. All of the five case study countries relied on review processes rather than directly adopting WHO recommendations. CONCLUSIONS While there are arguments for the use of particular strategies for PA recommendation development, there is currently no evidence for the general superiority of a specific approach. Instead, our findings highlight the broad spectrum of potential development methods, resources utilisation and final recommendations design currently available to national governments. These results may be a source of inspiration for other countries currently planning the development or update of national PA recommendations.
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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
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Stephen Whiting
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Romeu Mendes
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Sylvia Titze
- Institute of Sports Science, University of Graz, Graz, Austria
| | - Thomas Ernst Dorner
- Centre for Public Health, Institute of Social Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Martine Duclos
- Department of Sport Medicine and Functional Exploration, University Hospital CHU G. Montpied, INRA, UNH, CRNH Auvergne, University of Auvergne, Clermont-Ferrand, France
| | - Jean-Francois Toussaint
- IRMES (Institut de Recherche bioMédicale et d'Epidémiologie du Sport/INSEP), Université de Paris, Paris, France
| | - Wanda Wendel-Vos
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Beelin Baxter
- Population Health, United Kingdom Department of Health and Social Care, London, UK
| | - Susanne Ferschl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Joao Joaquim Breda
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization Regional Office for Europe, Moscow, Russian Federation
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Abu-Omar K, Ziemainz H, Loss J, Laxy M, Holle R, Thiel A, Herbert-Maul A, Linder S, Till M, Sauter A. The Long-Term Public Health Impact of a Community-Based Participatory Research Project for Health Promotion Among Socially Disadvantaged Women-A Case Study Protocol. Front Public Health 2021; 9:628630. [PMID: 33912528 PMCID: PMC8075296 DOI: 10.3389/fpubh.2021.628630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/12/2020] [Accepted: 03/11/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Community-based participatory research (CBPR) is considered to be of high potential for health promotion among socially disadvantaged groups. However, the long-term implementation and transfer of these approaches remain challenging, and the public health impact they achieve is difficult to study. This also pertains to the potential health effects and cost-effectiveness of CBPR. This study protocol describes the follow-up case study (NU-BIG) after 15 years of the BIG project (“movement as investment in health”), a project to promote physical activity among socially disadvantaged women. Through a participatory approach, BIG empowers the addressed women to plan and implement low-threshold physical activity offers. Since the project started in 2005, it was transferred to 17 communities in Germany. Materials and Analysis: NU-BIG intends to examine the long-term effects, including economic aspects, of the BIG project on individual and structural levels at all project sites, as well as its long-term implementation and transfer. NU-BIG is a cross-sectional and longitudinal study using a mixed method approach. For the longitudinal section, we re-analyze existing data from former BIG evaluations. For cross-sectional data collection, we use questionnaires and conduct qualitative interviews and focus groups. Women who take part in BIG program offers are part of the research team and will use the photo-voice approach to report on the effects of BIG. The study population consists of about 800 women who participate in BIG project offers and 50 persons involved in the implementation of the BIG project at local sites. Discussion: The expected results from NU-BIG are highly relevant for studying the long-term public health impact of CBPR. In particular, this project intends to answer questions on how the transfer of such projects can succeed and which factors determine if a CBPR project can be sustained at the community level. Eventually, these results can contribute to the further development of participatory approaches to provide effective health promotion among socially disadvantaged groups. Conclusion: Although CBPR is seen of having the potential to reduce health disparities, there is still a lack of research on its long-term effects and public health impact. NU-BIG aims at generating knowledge about the economic effects, reach, efficacy, adoption, implementation, and maintenance of a CBPR project. The expected results could be of high interest for BIG and other CBPR-projects.
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Affiliation(s)
- Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Heiko Ziemainz
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Michael Laxy
- Department of Sport and Health Sciences, Entrepreneurial University Munich, Munich, Germany
| | - Rolf Holle
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Annika Herbert-Maul
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Stephanie Linder
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Maike Till
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Alexandra Sauter
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University Regensburg, Regensburg, Germany
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