A controlled trial of a school-based environmental intervention to improve physical activity in Dutch children: JUMP-in, kids in motion

Interventions to promote physical activity are important in preventing children from becoming overweight. Many projects have been developed but only a few showed (moderate) effects. JUMP-in is a systematically developed primary-school-based intervention that focuses on the use of theory, environmental changes, parental influences and cooperation with multi-level parties in intervention development. The effects of JUMP-in were evaluated with a quasi-experimental pre-test/post-test research design. In total, 510 children from Grades 4, 5 and 6 of four intervention schools and two control schools in Amsterdam were followed for an intervention period of one school year. Changes in physical activity as well as in the social cognitive determinants were assessed using self-reports. In addition, a process evaluation has been executed. The results show that JUMP-in was effective in influencing physical activity, especially among children from Grade 6. Children in the control group decreased their level of physical activity considerably, while activity levels in intervention children from Grade 6 remained stable. The intervention effects could not be explained by changes in the measured social cognitive determinants. In contrast, process information illuminated differences in intervention effects between the participating schools. The results from the JUMP-in study show the importance of intervention designs that focus on a theory-based mix of relevant environmental and social cognitive factors.     

Testing a workplace physical activity intervention: a cluster randomized controlled trial

Background  

Increased physical activity levels benefit both an individuals' health and productivity at work. The purpose of the current study was to explore the impact and cost-effectiveness of a workplace physical activity intervention designed to increase physical activity levels.     

Grandparents raising grandchildren: a response to a nutrition and physical activity intervention

This pilot study explored the impact of an educational program on nutrition and physical activity knowledge of urban African-American grandparents raising their grandchildren. The program was integrated into a community-based intervention, Project Healthy Grandparents, and was implemented during the first 15 minutes of 10 grandparent support groups and parenting classes. Subjects included 22 grandparents who attended at least six sessions and completed pre- and posttests of nutrition and physical activity knowledge. Participants' posttest scores were significantly higher than their pretest scores (P<0.05), indicating an increase in knowledge. Eighteen grandparents provided insights about diet and physical activity and barriers to lifestyle changes during an audiotaped focus group. Based on analysis of the focus group's discussion, three major influences on healthful eating and physical activity emerged, including financial considerations, presence of grandchildren in the home, and preference for traditional cultural foods. Themes from the focus group were consistent with responses on the nutrition and physical activity knowledge test. Satisfaction with the program was very high and no specific recommendations for improvements were made. Results can guide future nutrition interventions for this target group and potentially contribute to grandparents' improved health and ability to care for their grandchildren.     

Use of MyPyramid Menu Planner for Moms in a weight-loss intervention during lactation

The Internet offers a valuable resource for promotion of healthy eating and Web-based communication between the dietetics practitioner and client. In a 16-week intervention examining the effects of energy restriction (500 kcal/day) and exercise on body composition in overweight/obese lactating women, MyPyramid Menu Planner for Moms was used to support dietary counseling. Random assignment occurred at 4 weeks postpartum to either an Intervention group (n=14) or Minimal Care group (n=13) from 2008 through 2010. Three 24-hour dietary recalls were obtained using the Nutrition Data System at 4 and 20 weeks postpartum. Individual MyPyramid Menu Planner accounts were created for the Intervention group and used in face-to-face dietary counseling. Repeated measures analysis of variance was used to test for differences between groups for change in dietary intake and weight. Changes in energy, saturated fat, and percent of energy from added sugars were significantly different between Intervention group and Minimal Care group (-613 [521] kcal vs -171 [435] kcal; P=0.03; -14.9 [14.0] g vs +0.9 [13.4] g; P<0.01; and -3.5% [5.3%] vs +2.2% [4.8%]; P<0.01, respectively). The Intervention group significantly increased their whole fruit servings and decreased their total grain and milk servings compared with the Minimal Care group (P<0.05). The Intervention group lost significantly more weight (-5.8 [3.5] kg) than the Minimal Care group (-1.6 [5.4] kg) (P=0.03). Although participants must have access to an Internet-based computer and possess basic food knowledge, these results suggest MyPyramid Menu Planner might prove to be an effective dietary counseling support tool for improving dietary intake and promoting weight loss during lactation.     

Children's physical activity levels during school recess: a quasi-experimental intervention study

Background  

Recess provides a daily opportunity for children to engage in moderate-to-vigorous (MVPA) and vigorous physical activity (VPA). Limited research has investigated the effects of recess-based interventions on physical activity using large sample sizes whilst investigating variables that may influence the intervention effect. The aim of the study was to investigate the short-term effects of a playground markings and physical structures intervention on recess physical activity. A secondary aim was to investigate the effects of covariates on the intervention.     

Evidence,Theory and Context: Using intervention mapping to develop a worksite physical activity intervention

Background  

The workplace is an ideal setting for health promotion. Helping employees to be more physically active can not only improve their physical and mental health, but can also have economic benefits such as reduced sickness absence. The current paper describes the development of a three month theory-based intervention that aims to increase levels of moderate intensity physical activity amongst employees in sedentary occupations.     

Long-term effects of a physical activity intervention in high school girls

BACKGROUND: Physical activity (PA) decreases during childhood and adolescence, and PA levels are significantly lower in females than males, particularly during adolescence. Schools are attractive settings in which to implement interventions designed to promote PA in girls and young women, but few studies have tested the sustained effects of such interventions. DESIGN: Cross-sectional. Data were collected in 2002-2003 and analyzed in 2006-2007. SETTING/PARTICIPANTS: 1594 adolescent girls in 22 high schools. INTERVENTION: The intervention, Lifestyle Education for Activity Program (LEAP), was designed to increase physical activity in 9th-grade girls through two channels: changes in instructional practices and changes in the school environment. This study (LEAP 2) examined the extent to which effects of the intervention were maintained when the girls were in the 12th grade. MAIN OUTCOME MEASURES: Number of 30-minute blocks per day of vigorous physical activity. RESULTS: Girls in the intervention schools that most fully implemented and maintained the intervention were more likely than girls in the other schools to participate in an average of one or more blocks of vigorous physical activity per day (p=0.04, odds ratio=1.49, 95% confidence interval=1.01-2.20). CONCLUSIONS: A comprehensive physical activity intervention that is fully implemented and maintained can increase participation in vigorous physical activity by high school girls.     

Health benefits of a pedometer-based physical activity intervention in sedentary workers

BACKGROUND: Inactivity is a leading contributor to chronic health problems. Here, we examined the effects of a pedometer-based physical activity intervention (Prince Edward Island-First Step Program, PEI-FSP) on activity and specific health indices in 106 sedentary workers. METHODS: Participants were recruited from five workplaces where most jobs were moderately-highly sedentary. Using subjects as their own control, physical activity (pedometer-determined steps per day) was compared before and after a 12-week intervention. Changes in body mass index (BMI), waist girth, resting heart rate, and blood pressure were evaluated. RESULTS: The PEI-FSP was completed by 59% of participants. Steps per day increased from 7,029 +/- 3,100 (SD) at baseline to a plateau of 10,480 +/- 3,224 steps/day by 3.96 +/- 3.28 weeks of the intervention. The amount that participants were able to increase their steps per day was not related to their baseline BMI. On average, participants experienced significant decreases in BMI, waist girth, and resting heart rate. Reductions in waist girth and heart rate were significantly related to the increase in steps per day. In contrast, reductions in BMI were predicted by the initial steps per day. CONCLUSIONS: The PEI-FSP increased physical activity in a sedentary population. Importantly, those with a higher BMI at baseline achieved relatively similar increases in their physical activity as participants with a lower BMI.     

HealthKick: a nutrition and physical activity intervention for primary schools in low-income settings

Background  

The burden of non-communicable diseases, including type 2 diabetes, is growing in South Africa. This country has a complex mix of over- and under-nutrition, especially in low-income communities, and concerning levels of physical inactivity in children and youth. This paper describes HealthKick, a school-based nutrition and physical activity intervention in primary schools in these settings aimed at reducing diabetes risk factors.     

Improving nutrition and physical activity in the workplace: a meta-analysis of intervention studies

A comprehensive search of the literature for studies examining physical activity or nutrition interventions in the workplace, published between 1999 and March 2009, was conducted. This search identified 29 relevant studies. Interventions were grouped according to the theoretical framework on which the interventions were based (e.g. education, cognitive-behavioural, motivation enhancement, social influence, exercise). Weighted Cohen's d effect sizes, percentage overlap statistics, confidence intervals and fail safe Ns were calculated. Most theoretical approaches were associated with small effects. However, large effects were found for some measures of interventions using motivation enhancement. Effect sizes were larger for studies focusing on one health behaviour and for randomized controlled trials. The workplace is a suitable environment for making modest changes in the physical activity, nutrition and health of employees. Further research is necessary to determine whether these changes can be maintained in the long term.     

The effect of a school-based active commuting intervention on children's commuting physical activity and daily physical activity

Objective

To investigate the effect of a school-based intervention called Travelling Green (TG) on children's walking to and from school and total daily physical activity.

Method

A quasi-experiment with 166 Scottish children (8-9 years) was conducted in 2009. One group (n = 79) received TG and another group (n = 87) acted as a comparison. The intervention lasted 6 weeks and consisted of educational lessons and goal-setting tasks. Steps and MVPA (daily, a.m. commute, p.m. commute, and total commute) were measured for 5 days pre- and post-intervention using accelerometers.

Results

Mean steps (daily, a.m., p.m., and total commute) decreased from pre- to post-intervention in both groups (TG by 901, 49, 222, and 271 steps/day and comparison by 2528, 205, 120, and 325 steps/day, respectively). No significant group by time interactions were found for a.m., p.m., and total commuting steps. A medium (partial eta squared = 0.09) and significant (p < 0.05) group by time interaction was found for total daily steps. MVPA results were similar to step results.

Conclusions

TG has a little effect on walking to and from school. However, for total daily steps and daily MVPA, TG results in a smaller seasonal decrease than for children who do not receive the intervention.     

Healthy Body/Healthy Spirit: a church-based nutrition and physical activity intervention

African-Americans (AAs) are significantly less likely to be physically active than other Americans, and, like all Americans, they consume fewer than the recommended five fruit and vegetable (F & V) servings per day. This study, titled Healthy Body/Healthy Spirit, has two primary aims: (1) to test the effectiveness of a culturally tailored self-help dietary (focusing on F & V intake) and physical activity (PA) intervention compared to standard health education materials, and (2) to test the effectiveness of using Motivational Interviewing (MI), delivered by telephone, to modify PA and dietary habits. The study is a randomized effectiveness trial with three experimental conditions. Group 1 (comparison) will receive standard (existing commercial) nutrition and PA intervention materials, Group 2 (TX1) will receive a culturally tailored self-help nutrition and PA intervention of similar intensity as Group 1, and Group 3 (TX2) will receive the same intervention as Group 2, plus four telephone counseling calls based on MI. Participants will be AA adults recruited through local black churches. Despite the extensive use of MI to modify addictive behaviors, this represents one of the first controlled field trials to employ MI to address diet and PA. Secondly, this is one of the first studies to test the effectiveness of a self-help diet and PA intervention tailored for an African-American church population.     

The positive effect on determinants of physical activity of a tailored, general practice-based physical activity intervention

PACE (Physician-based Assessment and Counseling for Exercise) is an individualized theory-based minimal intervention strategy aimed at the enhancement of regular physical activity. The aim of this study was to evaluate the effectiveness of a PACE intervention applied by general practitioners (GPs) on potential determinants of physical activity. A randomized controlled trial was conducted in 29 general practices with the following inclusion criteria for patients: aged between 18 and 70 years, diagnosed with hypertension, hypercholesterolemia and/or non-insulin-dependent diabetes mellitus, and not in maintenance stage for regular physical activity. The intervention consisted of two visits with the GP and two telephone booster calls by a physical activity counselor. Determinants of physical activity were assessed with questionnaires at baseline, and at 8-week (short), 6-month (medium) and 1-year (long) follow-up. A significant positive effect was observed on self-efficacy, and on the use of cognitive and behavioral processes of change, at both short- and medium-term follow-up. The intervention respondents also perceived fewer barriers for regular physical activity at short-term and used behavioral processes of change more at long-term follow-up. No intervention effect was observed for perceived benefits of physical activity. In conclusion, this GP-based PACE intervention resulted in positive changes in potential determinants of physical activity.