Lotta Palmberg, Kristin Suorsa, Antti Löppönen, Laura Karavirta, Taina Rantanen, Timo Rantalainen
{"title":"24-hour movement behaviors and changes in quality of life over time among community-dwelling older adults: a compositional data analysis.","authors":"Lotta Palmberg, Kristin Suorsa, Antti Löppönen, Laura Karavirta, Taina Rantanen, Timo Rantalainen","doi":"10.1186/s12966-024-01681-9","DOIUrl":"10.1186/s12966-024-01681-9","url":null,"abstract":"<p><strong>Background: </strong>Favorable movement behavior patterns, comprising more physical activity, less sedentary behavior, and sufficient sleep, may promote the maintenance of good quality of life (QoL) with advancing age. The aim of the present study was to investigate whether movement behaviors predict future changes in QoL among community-dwelling older adults over a four-year follow-up.</p><p><strong>Methods: </strong>Participants were 75-, 80- and 85-year-old community-dwelling older adults (n = 203) followed up for 4 years. Participants wore thigh- and trunk-mounted accelerometers for 3-7 days at baseline. Proportion of time-use in physical activity, standing and sedentary behavior were assessed based on body posture and movement intensity. Time in bed was determined using an automated algorithm. QoL was assessed during a home interview using the short Older People's Quality of Life Questionnaire at baseline and follow-up (range 13-65, higher scores indicate higher QoL). Compositional linear regression analysis was used to study whether baseline time-use composition predicts changes in QoL.</p><p><strong>Results: </strong>Over the 4-year follow-up, QoL scores decreased by 5% on average. Higher physical activity in relation to the other movement behaviors was associated with increase in QoL over time (β<sub>ilr</sub> 0.94, p = 0.013), but this association attenuated after adding baseline physical function into the model. Sedentary behavior, standing, and time in bed were not associated with changes in QoL. Theoretical reallocation of 30 min of physical activity into sedentary behavior, standing or time in bed was estimated to decrease QoL by 0.5 (CI 95% -0.6 to -0.4), 0.6 (-0.7 to -0.5) and 0.4 (-0.5 to -0.3) points, respectively.</p><p><strong>Conclusions: </strong>Theoretical reallocation of physical activity into sedentary behavior, standing, and time in bed was found to be associated with prospective decline in QoL among older adults. Engaging more in physical activity and less in more passive activities may promote better QoL with advancing age.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"130"},"PeriodicalIF":5.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janis Baird, Preeti Dhuria, Hannah Payne, Sarah Crozier, Wendy Lawrence, Christina Vogel
{"title":"Implementation of a UK supermarket intervention to increase purchasing of fresh fruit and vegetables: process evaluation of the WRAPPED natural experiment.","authors":"Janis Baird, Preeti Dhuria, Hannah Payne, Sarah Crozier, Wendy Lawrence, Christina Vogel","doi":"10.1186/s12966-024-01679-3","DOIUrl":"10.1186/s12966-024-01679-3","url":null,"abstract":"<p><strong>Background: </strong>Placement interventions, characterised by greater availability and more prominent positioning of healthy food products in supermarkets and other food stores, are associated with healthier patterns of purchasing and diet. The WRAPPED intervention study is a natural experiment that aims to evaluate a supermarket placement intervention to improve fruit and vegetable sales, household purchasing and the dietary quality of women and their children. Process evaluation, alongside the evaluation of outcomes, is essential to understand how interventions are implemented, under what circumstances they are effective, and their mechanisms of impact. This study aimed to assess the implementation of the WRAPPED placement intervention.</p><p><strong>Methods: </strong>The study adopted a convergent mixed-methods design. Quantitative data extracted from study store planograms (visual representation of stores and product placement) before and after intervention implementation were used to assess the positioning of fresh fruit and vegetables in the first aisle from the front entrance (intervention dose). The availability of fresh fruit and vegetables in each study store was examined from stock-keeping unit (SKU) figures before and after intervention implementation. An intervention implementation survey (IIS) completed with store managers and senior supervisors before and 1- and 6-months post-intervention implementation enabled examination of the context across study stores. Semi-structured interviews with store managers and senior supervisors provided qualitative data about store staff experiences and perceptions of the intervention between 6-months post-intervention implementation.</p><p><strong>Results: </strong>The placement intervention was implemented with close adherence to the study protocol. There were marked differences, post-intervention implementation, in the positioning of fresh fruit and vegetables in intervention stores compared with control stores: median distance in intervention stores was 8.0 m (IQR 5.0 to 10.0) compared with 23.8 m (IQR 21.0 to 30.0) in control stores (P < 0.0001). The availability of varieties of fresh fruit and vegetables increased in intervention stores post-intervention compared with control stores: median (IQR) among intervention stores was 72 (51, 84) compared with 56.5 (50, 62) in control stores (P = 0.03). The mean change from baseline to post-implementation in number of different fruit and vegetables available in intervention stores was 15.3 (SD 16.7) (P = 0.01). IIS and interview data demonstrated little difference between intervention and store contexts over time. Reinforcing factors for intervention implementation included: head-office leadership, store staff views and attitudes and increased awareness of the importance of offering healthy food in prominent locations within stores.</p><p><strong>Conclusion: </strong>This study demonstrated that placement interventions which promote fresh f","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"128"},"PeriodicalIF":5.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yue Zhang, Mika Kivimäki, Rodrigo M Carrillo-Larco, Yangyang Cheng, Yaguan Zhou, Hui Wang, Changzheng Yuan, Xiaolin Xu
{"title":"Correction: Diurnal patterns of accelerometer-measured physical activity and sleep and risk of all-cause mortality: a follow-up of the National Health and Nutrition Examination Surveys (NHANES).","authors":"Yue Zhang, Mika Kivimäki, Rodrigo M Carrillo-Larco, Yangyang Cheng, Yaguan Zhou, Hui Wang, Changzheng Yuan, Xiaolin Xu","doi":"10.1186/s12966-024-01680-w","DOIUrl":"https://doi.org/10.1186/s12966-024-01680-w","url":null,"abstract":"","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"129"},"PeriodicalIF":5.6,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Elena Ugaz, Christina L Meyer, Angela M Jackson-Morris, Daphne Wu, M Michelle Jimenez, Carlos Rojas-Davila, Carlos Orlando Zegarra Zamalloa, Elizabeth F Ludwig-Borycz, D'Arcy Williams, Jo Jewell
{"title":"The case for investment in nutritional interventions to prevent and reduce childhood and adolescent overweight and obesity in Peru: a modelling study.","authors":"Maria Elena Ugaz, Christina L Meyer, Angela M Jackson-Morris, Daphne Wu, M Michelle Jimenez, Carlos Rojas-Davila, Carlos Orlando Zegarra Zamalloa, Elizabeth F Ludwig-Borycz, D'Arcy Williams, Jo Jewell","doi":"10.1186/s12966-024-01677-5","DOIUrl":"10.1186/s12966-024-01677-5","url":null,"abstract":"<p><strong>Background: </strong>Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5-19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.</p><p><strong>Methods: </strong>A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.</p><p><strong>Results: </strong>Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.</p><p><strong>Conclusions: </strong>The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study's findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"127"},"PeriodicalIF":5.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennie C Parnham, Kiara Chang, Fernanda Rauber, Renata B Levy, Anthony A Laverty, Jonathan Pearson-Stuttard, Martin White, Stephanie von Hinke, Christopher Millett, Eszter P Vamos
{"title":"Evaluating the impact of the universal infant free school meal policy on the ultra-processed food content of children's lunches in England and Scotland: a natural experiment.","authors":"Jennie C Parnham, Kiara Chang, Fernanda Rauber, Renata B Levy, Anthony A Laverty, Jonathan Pearson-Stuttard, Martin White, Stephanie von Hinke, Christopher Millett, Eszter P Vamos","doi":"10.1186/s12966-024-01656-w","DOIUrl":"10.1186/s12966-024-01656-w","url":null,"abstract":"<p><strong>Background: </strong>The Universal Infant Free School Meal (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4-7 years, leading to an increase in school meal uptake. UK school meals are known to be healthier and less industrially processed than food brought from home (packed lunches). However, the impact of the UIFSM policy on the quantity of ultra-processed food (UPF) consumed at school during lunchtime is unknown. This study aimed to evaluate the impact of the UIFSM policy on lunchtime intakes of UPF in English and Scottish schoolchildren.</p><p><strong>Methods: </strong>Data from the UK National Diet and Nutrition Survey (2008-2019) were used to conduct a difference-in-difference (DID) natural experiment. Outcomes included school meal uptake and the average intake of UPF (% of total lunch in grams (%g) and % total lunch in Kcal (%Kcal)) during school lunchtime. The change in the outcomes before and after the introduction of UIFSM (September 2014 in England, January 2015 in Scotland) in the intervention group (4-7 years, n = 835) was compared to the change in an unexposed control group (8-11 years, n = 783), using linear regression. Inverse probability weights were used to balance characteristics between intervention and control groups.</p><p><strong>Results: </strong>Before UIFSM, school meal uptake and consumption of UPFs were similar in the intervention and control groups. The DID model showed that after UIFSM, school meal uptake rose by 25%-points (pp) (95% CI 14.2, 35.9) and consumption of UPFs (%g) decreased by 6.8pp (95% CI -12.5,-1.0). Analyses indicated this was driven by increases in minimally processed dairy and eggs, and starchy foods, and decreases in ultra-processed salty snacks, bread and drinks. The differences were larger in the lowest-income children (-19.3 UPF(%g); 95% CI -30.4,-8.2) compared to middle- and high-income children. Analyses using UPF %Kcal had similar conclusions.</p><p><strong>Conclusions: </strong>This study builds on previous evidence suggesting that UIFSM had a positive impact on dietary patterns, showing that it reduced consumption of UPFs at school lunchtime, with the greatest impact for children from the lowest-income households. Universal free school meals could be an important policy for long term equitable improvements in children's diet.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"124"},"PeriodicalIF":5.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adewale L Oyeyemi, Raphael H O Araujo, Umar A Hassan, Edward Ofori, Chad Stetcher, André O Werneck
{"title":"Secular trends and sociodemographic disparities in physical activity among adults in eleven African countries: WHO STEPS 2003-2020.","authors":"Adewale L Oyeyemi, Raphael H O Araujo, Umar A Hassan, Edward Ofori, Chad Stetcher, André O Werneck","doi":"10.1186/s12966-024-01675-7","DOIUrl":"10.1186/s12966-024-01675-7","url":null,"abstract":"<p><strong>Background: </strong>Mortality from physical inactivity-related non-communicable diseases (NCDs) is projected to surpass deaths from communicable diseases by 2030 in Africa. Monitoring physical activity (PA) is important for planning public health interventions addressing NCDS and planetary health, but there is a dearth of evidence on PA trends in Africa. This study explored the secular trends in overall and domains of PA (leisure, occupation, and transport), and examined the gender, age, and education disparities in PA trends across African countries.</p><p><strong>Methods: </strong>We utilized data from the STEPwise approach to NCDs risk factor surveillance in eleven African countries (Algeria, Benin, Botswana, Cabo Verde, Eritrea, Eswatini, Malawi, Mali, Central Africa Republic, Sao Tome and Principe, and Zambia) with at least two surveys conducted between 2003/2010 (first-wave) and 2010/2020 (second-waves). A total of 29,282 and 40,147 adults (18-69 years) in the first and second waves, respectively, completed PA interviews using the Global Physical Activity Questionnaire. Gender, age, and education status were self-reported. Weighted individual-country PA prevalence and 95% confidence interval (95%CI) were obtained. Random-effect meta-analysis was conducted to assess pooled estimates of PA trends across countries. Gender, age, and education disparities in PA trends were also investigated.</p><p><strong>Results: </strong>Country-specific results showed significant upward trends in total PA in eight countries. Seven countries showed significant increasing trends in some leisure-time PA (2.0% - 13.9% increase) and ≥ 150 min/week transport PA (4.0% - 24.5% increase), while five countries recorded significant increasing trends in occupational PA (6.6% - 56.9% increase). Gender, age and education disparities in meeting the WHO PA guidelines remained relatively stable over time, but disparities in leisure, transport and occupational PA increased in most countries.</p><p><strong>Conclusions: </strong>The prevalence of overall PA among African adults has marginally increased over 17 years. There are still many adults, especially women and people with lower education, not doing well in domain specific PA. Policy and environmental interventions are needed to improve PA and to reduce gender, age, and education disparities in leisure, transport, and occupational PA in African countries.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"126"},"PeriodicalIF":5.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophie Marie Jones, Ana Porroche-Escudero, Katie Shearn, Ruth F Hunter, Leandro Garcia
{"title":"Thinking about inequalities in physical activity as an emergent feature of complex systems.","authors":"Sophie Marie Jones, Ana Porroche-Escudero, Katie Shearn, Ruth F Hunter, Leandro Garcia","doi":"10.1186/s12966-024-01659-7","DOIUrl":"10.1186/s12966-024-01659-7","url":null,"abstract":"<p><p>Inequalities in physical activity are well documented, especially between socioeconomic groups. However, progress on reducing these inequalities is proving challenging. In this commentary, we argue that a complex system perspective is needed, specifically to reorient our thinking of inequalities in physical activity to be emergent features of complex systems. Operationalising this perspective involves acknowledging the multiple dynamic and non-linear interactions which take place between system parts and, over time aggregate to become macro patterns such as physical activity inequalities. We argue that this framing will enhance our understanding of the emergence of inequalities in physical activity and, therefore, provide interventions better suited to the subgroups of the population they are designed to help.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"125"},"PeriodicalIF":5.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miranda Pallan, Marie Murphy, Breanna Morrison, Alice Sitch, Ashley Adamson, Suzanne Bartington, Alexandra Dobell, Rhona Duff, Emma Frew, Tania Griffin, Kiya Hurley, Emma Lancashire, Louise McLeman, Sandra Passmore, Irina Pokhilenko, Maisie Rowland, Vahid Ravaghi, Suzanne Spence, Peymane Adab
{"title":"National school food standards in England: a cross-sectional study to explore compliance in secondary schools and impact on pupil nutritional intake.","authors":"Miranda Pallan, Marie Murphy, Breanna Morrison, Alice Sitch, Ashley Adamson, Suzanne Bartington, Alexandra Dobell, Rhona Duff, Emma Frew, Tania Griffin, Kiya Hurley, Emma Lancashire, Louise McLeman, Sandra Passmore, Irina Pokhilenko, Maisie Rowland, Vahid Ravaghi, Suzanne Spence, Peymane Adab","doi":"10.1186/s12966-024-01672-w","DOIUrl":"10.1186/s12966-024-01672-w","url":null,"abstract":"<p><strong>Background: </strong>Many countries have introduced school food standards to improve the dietary intakes of school-aged children. England has school food standards (SFS) legislation in place but little is known about how well secondary schools comply with this. We aimed to assess compliance with the SFS legislation in English secondary schools and explore the impact of the SFS on pupils' nutritional intake.</p><p><strong>Methods: </strong>We conducted a cross-sectional study with English secondary schools from 2019 to 2022. We compared SFS compliance and pupil nutritional intake in schools mandated or not mandated to comply with the SFS legislation, and explored the association between school compliance and pupil nutritional intake. We assessed the percentage of SFS (%SFS) complied with by reviewing school food menus and observing food served in school canteens. We assessed pupil nutritional intake using a 24-hour dietary recall measure (Intake24) and estimated intakes of free sugar (primary outcome) and other nutrients/foods. We used adjusted multilevel models to compare pupil intakes in the SFS-mandated and SFS-non-mandated schools, and to explore the association between school SFS compliance and pupil intakes.</p><p><strong>Results: </strong>36 schools (23 not mandated and 13 mandated to comply with the SFS) and 2,273 pupils participated. The median %SFS complied with was 63.9% (interquartile range 60.0-70.0%). This was similar for SFS-non-mandated (64.5%) and SFS-mandated schools (63.3%). Compliance was highest for standards applying to lunchtime (median = 81.3%) and lowest for those applying across the whole school day (median = 41.7%). It was also lower for standards restricting high fat, sugar and energy-dense items (median = 26.1%) than for standards aiming to increase dietary variety (median = 92.3%). Pupils from SFS-mandated schools had a lower mean lunchtime intake of free sugar (g) (adjusted mean difference: -2.78g; 95% CI: -4.66g to -0.90g). There were few significant associations between %SFS complied with and pupil nutritional intake.</p><p><strong>Conclusions: </strong>English secondary schools do not fully comply with SFS legislation regardless of whether they are mandated to comply. Schools and caterers may require monitoring and support to fully comply. There is little evidence that SFS compliance is associated with better pupil nutritional intake. Food environments outside of school also need to be considered.</p><p><strong>Study registration: </strong>ISRCTN68757496 (17-10-2019).</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"123"},"PeriodicalIF":5.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacob Szeszulski, Laura J Rolke, Priscilla Ayine, Regan Bailey, Margaret Demment, Galen D Eldridge, Sara C Folta, Meredith L Graham, Alexandra L MacMillan Uribe, Andrew McNeely, Miriam E Nelson, Kristin Pullyblank, Chad Rethorst, David Strogatz, Rebecca A Seguin-Fowler
{"title":"Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women.","authors":"Jacob Szeszulski, Laura J Rolke, Priscilla Ayine, Regan Bailey, Margaret Demment, Galen D Eldridge, Sara C Folta, Meredith L Graham, Alexandra L MacMillan Uribe, Andrew McNeely, Miriam E Nelson, Kristin Pullyblank, Chad Rethorst, David Strogatz, Rebecca A Seguin-Fowler","doi":"10.1186/s12966-024-01670-y","DOIUrl":"10.1186/s12966-024-01670-y","url":null,"abstract":"<p><strong>Background: </strong>Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns. This study evaluated the delivery of SHHC-2.0 to prepare the intervention for further dissemination.</p><p><strong>Methods: </strong>This process evaluation was guided by the Medical Research Council recommendations and engaged program leaders and participants (i.e., women over age 40) using quantitative and qualitative methods. The quantitative evaluation included examination of enrollment and retention data, a participant survey, and a fidelity checklist completed after classes. Descriptive and comparative statistics were used to assess implementation measures: program reach, participant attendance, dose delivered, program length, perceived effectiveness, fidelity, and participant satisfaction. The qualitative evaluation included focus groups (n = 13) and interviews (n = 4) using semi-structured guides; audio was recorded and transcripts were deductively coded and analyzed using directed content analysis and iterative categorization approaches. Comparisons across towns and between intervention and waitlist control groups were explored.</p><p><strong>Results: </strong>Average reach within towns was 7.5% of the eligible population (range 0.7-15.7%). Average attendance was 59.8% of sessions (range 42.0-77.4%). Average dose delivered by leaders was 86.4% of curriculum components (range 73.5-95.2%). Average session length was 51.8 ± 4.8 min across 48 sessions. Leaders' perceived effectiveness rating averaged 4.1 ± 0.3 out of 5. Fidelity to curricular components was 81.8% (range 67.4-93.2%). Participants reported being \"more than satisfied\" with the overall program (88.8%) and the health benefits they obtained (72.9%). Qualitative analysis revealed that participants: (1) gained new knowledge and enjoyable experiences; (2) perceived improvements in their physical activity, nutrition, and/or health; (3) continued to face some barriers to physical activity and healthy eating, with those relating to social support being reduced; and (4) rated leaders and the group structure highly, with mixed opinions on the research elements.</p><p><strong>Conclusions: </strong>SHHC-2.0 had broad reach, was largely delivered as intended, and participants expressed high levels of satisfaction with the program and its health benefits. Our findings expand on best practices for implementing cardiovascular disease prevention programs in rural communities.</p><p><strong>Clinical trials registration: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov #NCT03059472.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"122"},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danielle Harris, Schenelle Dayna Dlima, Ashley Gluchowski, Alex Hall, Emma Elliott, Luke Munford
{"title":"The effectiveness and acceptability of physical activity interventions amongst older adults with lower socioeconomic status: a mixed methods systematic review.","authors":"Danielle Harris, Schenelle Dayna Dlima, Ashley Gluchowski, Alex Hall, Emma Elliott, Luke Munford","doi":"10.1186/s12966-024-01666-8","DOIUrl":"10.1186/s12966-024-01666-8","url":null,"abstract":"<p><strong>Background: </strong>Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status?</p><p><strong>Methods: </strong>This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings.</p><p><strong>Results: </strong>Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status.</p><p><strong>Conclusions: </strong>Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312 .</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"21 1","pages":"121"},"PeriodicalIF":5.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}