Self reported physical activity, public health, and perceived environment: results from a comparative European study

STUDY OBJECTIVE: The focus of physical activity promotion is moving from methods for increasing health enhancing physical activity on the individual level to higher level strategies including environmental and policy approaches. Scientific inquiry, traditionally related to individual-based strategies, requires adaptation and refinement when environmental and policy changes become more relevant. The objective of this study is to investigate the significance for behaviour and health of community-based environments that encourage physical activity. DESIGN AND SETTING: The article presents data and results from a cross sectional comparative survey of the general population in six European countries (Belgium, Finland, Germany (East and West), Netherlands, Spain, Switzerland). Specifically, the relation between perceived community-based opportunities for physical activity, self reported physical activity, and self rated health status is investigated. PARTICIPANTS: Representative samples of general populations (adults 18 years or older). Overall response rate: 53.5%. Sample sizes realised: Belgium: n = 389; Finland: n = 400; Germany (East): n = 913; Germany (West): n = 489; Netherlands: n = 366; Spain: n = 380; Switzerland: n =406. MAIN RESULTS: Analyses show that best opportunities are reported by people who are lightly to moderately physically active. People's self rated health is moderately, but significantly associated with both perceived opportunities, and physical activity itself. These predictors interact in that especially for women, the health impact of physical activity is more pronounced in case of good opportunities. CONCLUSIONS: The paper shows the potential of opportunities within residential and community environments with regard to physical activity, both for behaviour and health. Opportunities may enable the population, especially women, to develop an active lifestyle, and thus improve their health. Future studies with objective indicators for physical activity related environments should test the findings that are based on perceptions.     

Health promotion by sports and physical activity: politics, behavior and infrastructures in a European comparison

ZusammenfassungHintergrund Bei der Gesundheitsförderung durch Sport und körperliche Aktivität ist derzeit ein Perspektivenwechsel von individuumszentrierten Aktivitäten hin zu politik- und infrastrukturbezogenen Ansätzen zu beobachten. Die wissenschaftliche Forschung und Beweislage, die bisher noch weitgehend im herkömmlichen Sinne auf eine individuumsbezogene Betrachtung ausgerichtet ist, muss entsprechend angepasst und differenziert werden, wenn infrastrukturelle und politische Veränderungen als Strategien an Bedeutung gewinnen.Methoden Der Beitrag untersucht Unterschiede bei der Förderung von Bewegungsaktivitäten zwischen sechs europäischen Nationen. Mit Daten einer europäischen Studie zu Gesundheitsförderungspolitik und Gesundheitsverhalten (MAREPS) werden Bewegungsverhalten, wahrgenommene bewegungsrelevante Infrastrukturen und die Bewertung der spezifischen Wirksamkeit der nationalen Gesundheitspolitik seitens der Bevölkerung analysiert.Ergebnisse Die Analysen zeigen signifikante Unterschiede sowohl in den Bewegungsaktivitäten als auch in den bewegungsrelevanten Infrastruckturen zwischen den untersuchten Ländern. Die Bevölkerungen in Finnland, der Schweiz und der Niederlande beteiligen sich vergleichsweise mehr and Sport und körperlicher Aktivität und sehen zugleich auch bessere Bewegungsmöglichkeiten in ihrem Wohnumfeld als die Bevölkerungen in Ost-Deutschland, Belgien, und Spanien. Darüber hinaus berichten die Befragten der erstgenannten Gruppe von Nationen einen deutlich höheren Beitrag der Gesundheitspolitik ihres Landes zur Förderung von Sport und körperlicher Aktivität als die Befragten der zuletzt genannten Gruppe.Schlussfolgerungen Die Ergebnisse unterstützen die empirische Bedeutung von politik- und infrastrukturbezogenen Ansätzen zur Förderung von Sport und körperlicher Aktivität. Durch entsprechende Ansätze können Gelegenheiten für die Bevölkerung geschaffen werden, einen aktiveren Lebensstil zu entwickeln, der die Gesundheit fördert. Weitere Forschung mit Längsschnittdesigns könnte besonders hilfreich sein, möglichen Kausalitäten in der Beziehung von Politik, Infrastruktur und Bewegungsverhalten genauer zu erkunden.

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SummaryObjective The focus of physical activity promotion is moving from measures to increase health-enhancing physical activity on the individual level to higher-level strategies including policy and environmental approaches. Scientific evidence, traditionally related to individual-based strategies, calls for adaptation and refinement when environmental and policy changes become more relevant.Methods This paper investigates differences in physical activity promotion and public policy among six European countries. Data from a European study on public health promotion policy and health behaviours (MAREPS) is analysed to study behaviour, community-based opportunities for physical activity, and populations' perception of the effectiveness of their national policies in promoting physical activity.Results Analyses show significant differences in both involvement in and perceived opportunities for physical activity among the investigated countries. Populations in Finland, Switzerland, and The Netherlands show comparably higher participation and, at the same time, perceive better opportunities for physical activity within the residential environment than people in East Germany, Belgium, and Spain. Moreover, respondents from the former group of nations report considerably greater contribution of health policy in their country to the promotion of physical activity than respondents from the latter group.Conclusions In conclusion, the results provide empirical support for the significance of environmental and policy approaches with regrrd to physical activity. Opportunities created by implementing such approaches may enable populations to develop more active lifestyles conducive to health. Further research employing longitudinal designs could be especially helpful to explore the causalities of the relationship between policy, environment and physical activity.

Sources of support. This research was conducted within the MAREPS-project (Methodology for the Analysis of the Rationality and Effctiveness of Prevention and Health Promotion Strategles), a Concerted Action funded within the BIOMED 2-program by the European Union (European Commission, Brussels, Belgium; Contract N^o BMH4-CT96-0304; Contractor: Technical University of Chemnitz; Associated Contractors; Limburg University Centre [Diepenbeek, Belgium]; University of Javäskylä [Jyväskylä, Finland]; Netherlands Institute of Primary Health Care [Utrecht, The Netherlands]; University of Valenda [Valencia, Spain], sub-contractor: University of Barcelona [Barcelona, Spain]; University of Bern [Bern, Switzerland]). Field work was supported by grants from: Ministry of the Flemish Community, Cabinet of the Flemish Minister of Finance, Budget and Health Policy (Brussels, Belglum); Ministry of Education and Ministry of Social Affairs Health and Family Affairs (Dresden, Germany); Health Research and Development Councill ('s-Gravenhage, The Netherlands); Federal Office for Public Health and Federal Office for Education and Science (Bern, Switzerland).     

Social reproduction of physical activity: Implications for health promotion in young people

Using a health promotion perspective, nationwide surveys onhealth behaviours and life-styles were carried out in 11 countriesin 1985–1986. The surveys were part of the study 'HealthBehaviour in School-aged Children (HBSC), a World Health Organizationcross-national survey'. The analyses of these survey data from13 and 15 year olds in Austria, Norway and Wales indicated thathigh levels of participation in physical activity by adolescentsare associated with the physical activity levels of their parentsand best friends, finding it easy to make new friends and likingschool. Intervention aimed at increasing the number of adolescentswho adopt and maintain participation in leisure-time physicalactivities is likely to be more successful if a greater numberof strategies in several different settings are applied. Thefindings are explained as being a result of the social reproductionprocess and it is suggested that awareness about how this processaffects the development of health behaviour and life-stylesis vital in establishing realistic goals when planning and evaluatingyouth health promotion efforts.     

Promoting physical activity in women: evaluation of a 2-year community-based intervention in Sydney, Australia

Women are less likely than men to reach recommended levels of physical activity and have unequal access to active leisure time. Studies in Australia have consistently found that women are only half as likely as men to be adequately active. A community-based multi-strategic health promotion intervention, 'Concord, A Great Place to be Active', was implemented from 1997 to 1999. It aimed to increase the physical activity levels of women aged 20-50 years living in the Concord Local Government Area (LGA), an inner-western region of Sydney, Australia. A key feature of this intervention was a partnership between Concord Council (the local government) and the Central Sydney Health Promotion Unit (CSHPU). The project was evaluated using qualitative and quantitative methods. Key informant interviews and focus groups were conducted to inform the development of the intervention and to assess the impact of the project on Concord Council. Pre- and post-intervention telephone surveys of the target group were also conducted. Following the intervention, there was a statistically significant (6.4%) reduction in the proportion of sedentary women. Further, there were a number of positive enhancements in the Council's capacity to promote physical activity in the community. These findings demonstrate that a community-based intervention targeting a specific population can achieve positive changes in physical activity and that a local government has the capacity to be involved in and sustain physical activity interventions.     

A survey to assess physical activity promotion by Registered Dietitians

Background Convincing evidence has emerged in recent years for the role of physical activity (PA) in the prevention and treatment of many chronic diseases. These include both physical and mental health problems, which are likely to be encountered by practicing dietitians. This study aimed to identify whether NHS based Registered Dietitians (RDs) currently promote PA to their patients and if so, how they do it and with which patients. Method An anonymous questionnaire sent to 516 RDs in NHS teaching hospitals achieved a 77% (n = 397) return rate. Results Ninety‐three per cent of respondents reported regularly promoting PA particularly with new patients. Among active PA promoters, 87% reported encouraged daily accumulation of PA, 50% focused on sport and exercise and 52% referred patients to GPs or Physiotherapists for advice. Distinctive levels and styles of PA promotion were found to be related to levels of recent training in the field although fewer than one in four had actually received any formal training. Conclusions A high interest in further PA‐specific training (95% of all respondents), together with high variability in the type and quality of advice suggests the need to develop further in‐service training specifically for RDs.     

Looking inside and out: perceptions of physical activity in childcare spaces

This study addresses the need to better understand how providers' perceptions of indoor and outdoor childcare settings can set the stage for arranging play spaces to optimise children's moderate-to-vigorous physical play. Childcare providers' perceptions of the level of physical activity, safety, and quality that children experience in childcare settings were examined. Childcare providers rated coloured photographs of indoor and outdoor childcare centres and family childcare homes. The providers rated higher levels of physical activity outdoors as compared with indoors and in childcare centres as compared with family childcare homes. When asked to select specific features of the childcare settings that contributed to their physical activity, safety, and quality ratings, open space was frequently selected, among other features. The findings also suggest that prior provider training on physical activity promotion results in providers' greater sensitivity when critiquing the physical environment.