“Getting Switzerland to move”: E valuation of a new “Sport for All” programme

Objectives  

Even though sports participation in Switzerland appears to be quite elevated, recent research suggests that only about a third of the population are doing enough sports from a health perspective.     

Interventions for physical activity promotion applied to the primary healthcare settings for people living in regions of low socioeconomic level: study protocol for a non-randomized controlled trial

Background

Regular physical activity practice has been widely recommended for promoting health, but the physical activity levels remain low in the population. Therefore, the study of interventions to promote physical activity is essential. Objective: To present the methodology of two physical activity interventions from the “Ambiente Ativo” (“Active Environment”) project.

Methods

12-month non-randomized controlled intervention trial. 157 healthy and physically inactive individuals were selected: health education (n = 54) supervised exercise (n = 54) and control (n = 49). Intervention based on health education: a multidisciplinary team of health professionals organized the intervention in group discussions, phone calls, SMS and educational material. Intervention based on supervised exercise program: consisted of offering an exercise program in groups supervised by physical education professionals involving strength, endurance and flexibility exercises. The physical activity level was assessed by the International Physical Activity Questionnaire (long version), physical activities recalls, pedometers and accelerometers over a seven-day period.

Result

This study described two different proposals for promoting physical activity that were applied to adults attended through the public healthcare settings. The participants were living in a region of low socioeconomic level, while respecting the characteristics and organization of the system and its professionals, and also adapting the interventions to the realities of the individuals attended.

Conclusion

Both interventions are applicable in regions of low socioeconomic level, while respecting the social and economic characteristics of each region.

Trial registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01852981","term_id":"NCT01852981"}}NCT01852981     

Physically active lifestyles for all Americans: A call to action for non-profit organizations

Many nonprofit organizations and non-governmental organizations (NGOs) are strategically poised to encourage and facilitate healthier lifestyles. Non-profit organizations can play leadership roles in improving physical levels among all Americans.     

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).     

A systematic framework to classify physical activity research for individuals with spina bifida

BackgroundIdentifying the types of research conducted in the area of physical activity (PA) for the spina bifida (SB) population is important in order to move research forward to increase PA behaviors and improve health. The Behavioral Epidemiological Framework is a one way to systematically classify PA and SB literature by organizing research into one of five phases: phase 1 research links behaviors to health, phase 2 includes research focused on developing methods for measuring behavior, phase 3 research identifies factors that influence behavior, phase 4 research evaluates interventions to change the behavior, and phase 5 studies translates research into practice.ObjectiveTo systematically classify PA research for individuals with SB by using the Behavioral Epidemiologic Framework and to identify where the research has focused.MethodAn audit of the literature was conducted using search engines and keywords related to PA and SB. Inter-rater reliability was established between the research team coding articles based on established inclusion criteria. Finally, literature was categorized into one of the five phases.ResultsSeventy-seven articles met the inclusion criteria and were categorized. Forty three percent of the articles were categorized in phase 1, 21% in phase 2, 32% in phase 3, 4% in phase 4, and zero in phase 5.ConclusionThe majority of articles are in phase 1, indicating that PA and SB research is still in early stages of development. Future research needs to move beyond phase 1 to examine factors that affect PA behaviors and ways to increase PA behaviors in the SB population.     

Improvements in biometric health measures among individuals with intellectual disabilities: A controlled evaluation of the Fit 5 program

BackgroundIndividuals with intellectual disabilities (ID) have poorer health statuses compared to the general population. Actions are needed to address health disparities and promote healthy lifestyles among individuals with ID. Moreover, studies that consider program settings for this population are needed.ObjectiveThe Special Olympics health program, Fit 5, was evaluated to assess effectiveness in improving health measures for individuals with ID. The settings of programs’ implementation were also considered.MethodsFour Special Olympics basketball teams participated as an intervention group, and three teams as a control group, in a study of the Fit 5 program that was implemented during, and as part of, a regular 8-week basketball season. Resting heart rate (RHR) and blood pressure, and height and weight to calculate Body Mass Index (BMI), were measured before and after the program. Differences in pre- and post-measures were compared between the two groups with paired samples t-tests and ANCOVA.ResultsParticipants in the intervention group had significantly greater improvements in resting systolic and diastolic blood pressures (p = 0.02 and 0.03, respectively) and RHR (p = 0.003). BMI increased for both groups; however, the increase in the intervention group was significantly less (p = 0.006). The Special Olympics setting was considered familiar and supportive and effectively reached individuals with ID.ConclusionThe Fit 5 program positively impacts RHR and blood pressure, and could help reduce extents of BMI increases, in individuals with ID when implemented in a common setting. Further investigation of the impact of Fit 5 and similar programs in additional settings is warranted.     

Sports and physical activity in the elderly: social structural context and relation to health

ZusammenfassungFragestellung Im folgenden Beitrag wird zum einen der sozialstrukturelle Kontext von sportlichen und körperlichen Aktivitäten im Alter analysiert; zum anderen wird die Beziehung des Sports und nicht-utilitärer körperlicher Aktivität zur Gesundheit bei alten Menschen (60 Jahre und älter) untersucht.Methoden Die Daten stammen aus einer Telefon-Umfrage basierend auf einem Zufalls-Sample von 436 realisierten Fällen in den kreisfreien Städten des westlichen Ruhrgebiets und repräsentieren damit Verhältnisse in hoch-urbanisierten Gebieten.Ergebnisse In der Hauptfrage um die gesundheitliche Bedeutung des Sports und körperlicher Aktivität im Alter ergeben sich positive Zusammenhänge zwischen Sportintensität und dem durch Fortgeschrittene Aktivitäten des täglichen Lebens gemessenen funktionalen Status sowie zwischen Sport als Lieblingsbeschäftigung und der subjektiven Gesundheit. Im Hinblick auf soziodemographische Variablen zeigt sich, dass Sport und körperliche Aktivität mit dem Alter und dem Geschlecht variieren. Einstellungen wie geringere externale gesundheitliche Kontrollüberzeugungen und auch die positive Bewertung äusserer Erscheinung weisen darüber hinaus starke Beziehungen zur Beteiligung am Sport im Alter auf. Die sozialstrukturellen Variablen sind demgegenüber mit Ausnahme des Einkommens weitgehend unbedeutend.Schlussfolgerungen Die z.T. nich kongruenten Befunde machen einen weiteren Forschungsbedarf hinsichtlich der Beziehung zwischen Sport und Gesundheit im Alter deutlich.

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SummaryObjectives The following contribution analyses the sociostructural context of sport as well as the relationship between sport/physical activity and health among older people (60 years).Methods The data are part of a telephone-survey by random sample with 436 realised cases in the independent cities of the Western Ruhr-District and thus represent a situation in highly urbanised areas.Results In the cardinal question concerning the meaning of sport and physical activity for health a positive relationship was found, in particular between sport intensity and health measured by Advanced Activities of Daily Living (AADL) as well as for sport as hobby, which showed a highly significant relationship with subjective health. With regard to sociodemographic variables results show that sport and physical activity vary with gender and age. Apart from that attitudes like low external control for one's health as well as the value of appearance show strong relationships with sport participation. Stratification variables with the exception of income only show weak effects.Conclusions The results, which are partly not congruent, indicate that further research is needed in the field of sport and health among the aged.

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RésuméObjectifs Utilisant une méthode socio-épidémiologique et les données d'une enquête, la contribution suivante analyse le contexte socio-structurel ainsi que la relation du sport et l'activité physique à la santé des gens âgés de 60 ans ou plus.Méthodes Les données sont part d'une interview au téléphone par sondage au hasard de 436 cas dans les villes urbaines de l'ouest du district du Ruhr. L'enquête fut dirigée, en premier lieu, vers la relation de la santé au statut social; elle a aussi mesuré un nombre d'indicateurs de la santé et variables de sport et activité physique. Ainsi, les données permettent l'analyse du contexte socio-structurel et la relation sport/activité physique avec la santé physique et psychique.Résultats Dans la cardinale question concernant la signifiance du sport et activité physique pour la santé objective une positive relation fut trouvée, en particulier pour l'intensité du sport et la santé objective-mesurée par AADL-ainsi que pour sport hobby qui a montré une relation très signifiante avec la santé subjective. En ce qui concerne le contexte socio-structurel, le sport et l'activité physique des gens âgés sont determinés par âge et genre. En outre attitudes comme peu du control externe pour la santé et la valeur de l'apparition expliquent l'intensité de la participation au sport. Une remarquable rejection du control externe est liée à ceux utilisant sport pour leur santé. Les variables de la stratification ne sont pas important, à l'exception du revenu.Conclusions Les résultats sont partiellement non coïncidents et indiquent évidemment le besoin en recherche par rapport à la relation du sport et santé dans le vieil âge.

     

城市体力活动相关建成环境的评价工具进展

体力活动水平是影响个体健康重要的、可干预的因素之一[1].经常进行体力活动能够有效减少诸多慢性病,如心血管疾病等发病风险[2,3].建成环境(built environment)指人为建设改造的各种建筑物、场所,尤其指那些可以通过政策、人为行为改变的环境[4].近年来,国外研究者越来越多关注建成(物理)环境对个体体力活动水平的影响[5],以健康生态学模型为理论指导,开展了一系列建成环境与个体体力活动之间的关联研究,在研究内容和方法学上做了有益的探讨和拓展.国外的多项研究结果发现两者之间存在关联[6].     

Recommendations for the promotion of physical activity in children

Background Despite some methodological difficulties, different studies support the assumption that the physical performance of children has decreased in the last two decades. On the other hand, physical activity should be a normal part of growing up. Furthermore, a physically active lifestyle has direct and indirect health benefits for young people, for instance, by preventing overweight and obesity and establishing healthy lifestyles that may be continued into adulthood.Aim This article presents the current state of existing recommendations for the promotion of physical activity in children.Results The presented recommendations are grouped around the hierarchy of influences on a young person’s life: from home and family; through school, community and the environment; to national and European Union (EU) policies.Conclusion Physical activity is clearly important to health, and national surveillance of physical activity is an important step to counteract the global inactivity. With the recommendations, we have given an overview about the necessary ways and measures to promote the physical activity for children and their close relatives.     

Epidemiology of school accidents during a six school-year period in one region in Poland

Background: The aim of the study was to analyse the incidence of school accidents in relation to school size, urban/rural environment and conditions of physical education classes. Methods: 202 primary schools with nearly 50,000 students aged 7–15 years were studied during a 6-year period in the Wocawek region in Poland. Results: There were in total 3274 school accidents per 293,000 student-years. Accidents during breaks (36.6%) and physical education (33.2%) were most common. Most frequently accidents took place at schoolyard (29.7%), gymnasium (20.2%), and in the corridor and stairs (25.2%). After adjustment for students' age and sex, student–staff ratio and duration of school hours, urban environment increased the probability of accident (OR: 1.25; 95% CI: 1.14–1.38). Middle-size schools (8–23 classes) had similar accident rate as small schools (OR: 0.93; 95% CI: 0.83–1.04), while schools with 24–32 classes (OR: 1.26; 95% CI: 1.10–1.43) and with 33 classes (OR: 1.36; 95% CI: 1.17–1.58) had increased accident rate. Presence of a gymnasium was also associated with increased probability of accident (OR: 1.49; 95% CI: 1.38–1.61). Conclusions: Urban environment, larger school-size and equipment with full-size gymnasium are important and independent risk factors for school accidents. These findings provide some new insights into the epidemiology of school-related accidents and may be useful information for the planning of strategies to reduce accident incidence in schools.     

The delivery of healthy lifestyle interventions for people with disability living in supported accommodation: a scoping review of intervention efficacy and consumer involvement

BackgroundPeople with disability living in supported accommodation experience health disparities that may be partly attributed to sedentary lifestyle behaviors and poor dietary quality. Healthy lifestyle interventions have been suggested as a method of health promotion for this population; however, a synthesis of their efficacy has not yet been conducted.ObjectiveThe primary aims were to (1) identify healthy lifestyle interventions delivered to people with disability living in supported accommodation and (2) examine their efficacy in supporting health and well-being. A secondary aim was to explore whether people with disability have been involved in the codesign of these interventions.MethodsA scoping review was conducted following the Joanna Briggs Institute's guidance for conducting scoping reviews, and six databases were searched from January 2011 to November 2021.ResultsThirty-two studies were included. Identified intervention types included training and education, exercise programs, and multicomponent interventions. A broad range of outcomes were examined; however, findings regarding efficacy were overall mixed and limited due to significant heterogeneity and the underreporting of consistently measured outcomes. The codesign of interventions in consultation with people with disability was underexplored.ConclusionsHealth promotion training for staff and tailored education for people with disability hold promise in creating a care environment that supports a healthy lifestyle. The paucity of interventions developed in consultation with people with disability is concerning and highlights the importance of meaningful co-design. The development of a theoretically informed intervention that is codesigned and addresses the broader social determinants that influence health behavior is recommended.     

The interplay of structure and agency in health promotion: integrating a concept of structural change and the policy dimension into a multi-level model and applying it to health promotion principles and practice

The recent debate in public health about the "inequality paradox" mirrors a long-standing dispute between proponents of structuralist approaches and advocates of action theory. Both views are genuine perspectives of health promotion, but so far they have not been adequately linked by health promotion theory. Using Anthony Giddens's concepts of structure and agency seems promising, but his theory has a number of shortcomings that need to be amended if it is to be applied successfully to health promotion. After briefly assessing Giddens's theory of structuration, this paper proposes to add to it both the concept of structural change as proposed by William Sewell and the policy dimension as described by Elinor Ostrom in her distinction between "operational" and "collective choice" level. On this basis, a multi-level model of the interaction of structure and agency in health promotion is proposed. This model is then connected to central claims of the Ottawa Charter, i.e. "build healthy public policy", "create supportive environments", "strengthen community actions", and "develop personal skills". A case study from a local-level health promotion project in Germany is used to illustrate the explanatory power of the model, showing how interaction between structure and agency on the operational and on the collective choice level led to the establishment of women-only hours at the municipal indoor swimming pool as well as to increased physical activity levels and improved general self-efficacy among members of the target group.     

Evidence-based physical activity promotion - HEPA Europe, the European Network for the Promotion of Health-Enhancing Physical Activity

There has been a world-wide increase in scientific interest in health-enhancing physical activity (HEPA). The importance of a physically active lifestyle has now been well established both on the individual and on the population level. At the same time, physical inactivity has become a global problem. While sports for all has a long history, only a few examples of long-term integrated physical activity promotion strategies have been in place in Europe until recently, namely in Finland, the Netherlands and England. A number of countries have now begun to develop their own activities. However, there has been a noticeable lack of a platform for sharing the development and implementation of evidence-based policies and strategies. In order to fill this gap, HEPA Europe, the European Network for the Promotion of Health-Enhancing Physical Activity, was founded in May 2005 in Gerlev, Denmark. The goal of the network is to strengthen and support efforts and actions that increase participation in physical activity and improve the conditions favourable to a healthy lifestyle, in particular with respect to HEPA. The Network is working closely with the WHO Regional Office for Europe (). The network focuses on population-based approaches for the promotion of HEPA, using the best-available scientific evidence, and is currently implementing its first projects. HEPA Europe has established collaboration with EU Commission projects and Agita Mundo. Priorities for future work have been defined, and interested organisations and institutions have the opportunity to join the network and participate in the process.Members of the Steering Committee of HEPA Europe.Representatives of the European Commission Working Party on Lifestyle (DM, MS), and the European Commission Network Project Task Force on Public Health Nutrition and Physical Activity (JMO, HR, JMZ, DM, PO, MS).     

Determinants of health policy impact: a theoretical framework for policy analysis

Summary This paper addresses the role of policy and evidence in health promotion. The concept of von Wrights logic of events is introduced and applied to health policy impact analysis.According to von Wright (1976), human action can be explained by a restricted number of determinants: wants, abilities, duties, and opportunities. The dynamics of action result from changes in opportunities (logic of events). Applied to the policymaking process, the present model explains personal wants as subordinated to political goals. Abilities of individual policy makers are part of organisational resources. Also, personal duties are subordinated to institutional obligations. Opportunities are mainly related to political context and public support. The present analysis suggests that policy determinants such as concrete goals, sufficient resources and public support may be crucial for achieving an intended behaviour change on the population level, while other policy determinants, e.g., personal commitment and organisational capacities, may especially relate to the policy implementation process. The paper concludes by indicating ways in which future research using this theoretical framework might contribute to health promotion practice for improved health outcomes across populations.     

Systematic framework to evaluate the status of physical activity research for persons with multiple sclerosis

BackgroundExploring the current state of health behavior research for individuals with multiple sclerosis is essential to understanding the next steps required to reducing preventable disability. A way to link research to translational health promotion programs is by utilizing the Behavioral Epidemiological Framework, which describes a sequence of phases used to categorize health-related behavioral research.ObjectiveThis critical audit of the literature examines the current state of physical activity research for persons with multiple sclerosis by utilizing the proposed Behavioral Epidemiological Framework.MethodsAfter searching MEDLINE, PUBMED, PsycINFO, Google Scholar and several major areas within EBSCOHOST (2000 to present), retrieved articles were categorized according to the framework phases and coding rules.ResultsOf 139 articles, 49% were in phase 1 (establishing links between behavior and health), 18% phase 2 (developing methods for measuring behavior), 24% phase 3 (identifying factors influencing behavior and implications for theory), and 9% phase 4 and 5 (evaluating interventions to change behavior and translating research into practice).ConclusionsEmphasis on phase 1 research indicates the field is in its early stages of development. Providing those with multiple sclerosis with necessary tools through health promotion programs is needed to reduce secondary conditions and co-morbidities. Reassessment of the field of physical activity and multiple sclerosis in the future could provide insight into whether the field is evolving over time or remaining stagnant.     

Web-based interventions to promote physical activity by older adults: promising perspectives for a public health challenge

Regular physical activity is associated with a wide range of health benefits. As population age, promotion of physical activity should specifically target older adults, an expanding group involving potential higher health care costs in the near future. Innovative interventions focusing on physical activity behaviors of senior adults exposed promising results, most recently through the use of the Internet. If seniors and Internet are generally considered as two opposite concepts, arguments in favour of bringing them together in a public health perspective have been identified by the recent literature. Older adults are the fastest growing group of Internet users and are more prone than younger to use it for health-related subjects. Web-based interventions are effective in many health promotion sectors, including physical activity. This is particularly true when interventions target the environmental determinants of each senior citizen and are specifically designed for this population. Those early research findings must clearly be extended, particularly regarding to the long term effects of Web-based physical activity interventions. Solutions that will reduce the high dropout rate recorded in the existing literature must also be considered as a priority in order to ensure the development of this forward-looking field of research.