Sunday, December 10, 2017

Views of policy makers and professionals on implementation and maintenance of diet & PA interventions

The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. In an exploratory study just published in BMC Public Health with Saskia Muelmann from the Leibniz Institute for Prevention Research and Epidemiology (BIPS) aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors that facilitate adoption, implementation, and maintenance of comprehensive interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland.
Six interventions and six policies were explored by means of semi-structured interviews with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies.
Active involvement of relevant stakeholders in all phases of intervention/policy development and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementatio
n of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured.
Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identified very similar factors facilitating adoption, implementation, and maintenance of these interventions and policies. This study was part of the Determinants of Diet and Physical Activity (DEDIPAC) knowledge hub, the first joint action of the Joint Programming Initiative 'A Healthy Diet for a Healthy Life'.

Tuesday, November 7, 2017

Determinants of diet and physical activity: a summary of findings

The establishment of the Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub, 2013–2016, was the first action taken by the ‘Healthy Diet for a Healthy Life’ European Joint Programming Initiative (HDHL). DEDIPAC aimed to provide better insight into the determinants of diet, physical activity and sedentary behavior across the life course, i.e. insight into the causes of the causes of important, non-communicable diseases across Europe and beyond. DEDIPAC was launched in late 2013, and delivered its final report in December 2016. In a paper just published in International Journal of Behavioral Nutrition and Physical Activity -the same journal in which we presented the DEDIPAC plans a few year earlier-, we give an overview of what was achieved in terms of furthering measurement and monitoring, providing overviews of the state-of-the-art in the field, and building toolboxes for further research and practice. Additionally, we propose some of the next steps that are now required to move forward in this field, arguing in favor of 1) sustaining the Knowledge Hub and developing it into a European virtual research institute and knowledge centre for determinants of behavioural nutrition and physical activity with close links to other parts of the world; 2) establishing a cohort study of families across all regions of Europe focusing specifically on the individual and contextual determinants of major, non-communicable disease; and 3) furthering DEDIPAC’s work on nutrition, physical activity, and sedentary behavior policy evaluation and benchmarking across Europe by aligning with other international initiatives and by supporting harmonization of pan-European surveillance. This last recommendation is now being followed up by the HDHL Policy Evaluation Network (PEN).

Wednesday, October 25, 2017

Towards FAIR data sharing in behavioural nutrition and physical activity research

The utilisation of available cross-European data for secondary data analyses on physical activity, sedentary behaviours and their underlying determinants may benefit from the wide variation that exists across Europe in terms of these behaviours and their determinants. Such reuse of existing data for further research requires Findable; Accessible; Interoperable; Reusable (FAIR) data management and stewardship. In a paper just published in BMJ Open -with Dr. Jeroen Lakerveld as first author- we describe the inventory and development of a comprehensive European dataset compendium and the process towards cross-European secondary data analyses of pooled data on physical activity, sedentary behaviour and their potential determinants across the life course.
A five-step methodology was followed by the European Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub, covering the (1) identification of relevant datasets across Europe, (2) development of a compendium including details on the design, study population, measures and level of accessibility of data from each study, (3) definition of key topics and approaches for secondary analyses, (4) process of gaining access to datasets and (5) pooling and harmonisation of the data and the development of a data harmonisation platform.
A total of 114 unique datasets were found for inclusion within the DEDIPAC compendium. Of these datasets, 14 were eventually obtained and reused to address 10 exemplar research questions. The DEDIPAC data harmonisation platform proved to be useful for pooling, but in general, harmonisation was often restricted to just a few core (crude) outcome variables and some individual-level sociodemographic correlates of these behaviours.
Obtaining, pooling and harmonising data for secondary data analyses proved to be difficult and sometimes even impossible. Compliance to FAIR data management and stewardship principles currently appears to be limited for research in the field of physical activity and sedentary behaviour. In the paper in BMJ Open we discuss some of the reasons why this might be the case and present recommendations based on our experience.

Tuesday, October 3, 2017

Lessons learned from process evaluation of an exercise intervention among cancer patients

In a paper just published in European Journal of Cancer Care -with Saskia Persoon as first author, and as part of the Alpe D'HuZes Cancer Rehabilitation research program (A-CaRe)-, we describe the process evaluation of an 18-week supervised exercise programme in 50 patients treated with high-dose chemotherapy followed by autologous stem cell transplantation. The intervention included 30 exercise sessions with six resistance exercises and interval training. We evaluated the context, dose delivered and received, and patients' and physiotherapists' satisfaction with the intervention. Ninety-two per cent of the patients trained within 15 km of their home address, with an average session attendance of 86%. Most patients trained at the prescribed intensity for four of the six resistance exercises, but the dose delivered and received of the two remaining resistance exercises and interval training could not be determined. Both patients and physiotherapists highly appreciated the program (score of 8.3 and 7.9 out of 10 respectively).

Monday, October 2, 2017

Which exercise prescriptions improve quality of life and physical function in patients with cancer?

Certain exercise prescriptions for patients with cancer may improve quality of life (QoL) and self-reported physical function (PF). In a systematic review and meta-analysis of the scientific literature, we investigated the effects of exercise on QoL and PF in patients with cancer and studied differences in effects between different intervention-related and exercise-related characteristics. This investigation has just been published online in the British Journal of Sports Medicine, with Maike Sweegers as first author, and as part of the POLARIS (Predicting OptimaL cAncer RehabIlitation and Supportive care) study
We searched four electronic databases to identify randomised controlled trials investigating exercise effects on QoL and PF in patients with cancer. Subgroup analyses were conducted based on intervention dimensions, including timing, duration and delivery mode, and exercise dimensions, including frequency, intensity, type and time (FITT factors).
Patients in exercise interventions had significantly improved QoL and PF compared with patients in control groups. Especially supervised exercise interventions were effective. No significant differences in intervention effects were found for variations in intervention timing, duration or exercise FITT factors. Unsupervised exercise with higher weekly energy expenditure was more effective than unsupervised exercise with lower energy expenditure.
Our conclusion is that exercise interventions, especially when supervised, have statistically significant and small clinical benefit on self-reported QoL and PF in patients with cancer. Unsupervised exercise intervention effects on PF were larger when prescribed at a higher weekly energy expenditure.

Monday, September 25, 2017

Social disparities in food preparation behaviours

Socio-economic differences in nutrition and eating behaviors are important for socio-economic health disparities, and differences in food preparation practices may partly explain such differences in nutrition and eating behaviors. In a study just published in Nutrition Journal (with Dr. Caroline Méjean as first author) we investigated whether there was an independent association of socio-economic indicators (education, occupation, income) with food preparation behaviors.
A total of 62,373 adults participating in the web-based NutriNet-Santé cohort study were included in the analyses. The study was part of the Determinants of Diet and Physical Activity (DEDIPAC) joint action. Cooking skills, preparation from scratch and kitchen equipment were assessed as well as frequency of meal preparation, enjoyment of cooking and willingness to cook better/more frequently.
Participants with the lowest education, the lowest income group and female manual and office workers spent more time preparing food daily than participants with the highest education, those with the highest income and managerial staff. The lowest educated individuals were more likely to be non-cooks than those with the highest education level, while female manual and office workers and the never-employed were less likely to be non-cooks. Female manual and office workers had lower scores of preparation from scratch and were less likely to want to cook more frequently than managerial staff. Women belonging to the lowest income group had less kitchen equipment and were less likely to enjoy cooking meal daily than those with the highest income.
Lower socio-economic groups, particularly women, spend more time preparing food than high socioeconomic groups, but were less likely to prepare meals from scratch with fresh ingredients and enjoy cooking less.

Saturday, August 5, 2017

Objectively measured sedentary time among five ethnic groups in Amsterdam

Sedentary behaviour is increasingly recognised as a health risk behaviour, partly independent of moderate to vigorous physical activity. An increasing number of studies focus on sedentary behaviour, but  studies on sedentary behaviour among ethnic minority groups are scarce. In a a study just published in Plos ONE -with Dr. Anne Loyen as first authors- we compared levels and socio-demographic and lifestyle-related correlates of objectively measured sedentary time in five ethnic groups in Amsterdam, the Netherlands.
Data were collected as part of the HELIUS study, a cohort study conducted in Amsterdam. The sample consisted of adults from a Dutch, Moroccan, African Surinamese, South-Asian Surinamese and Turkish ethnic origin. Data were collected by questionnaire, physical examination, and a combined heart rate and accelerometry monitor (Actiheart). Sedentary time was defined as waking time spent on activities of <1 .5="" a="" href="" target="_blank">metabolic equivalents
. All analyses were adjusted for gender and age.Sedentary time ranged from 569 minutes/day (9.5 hours/day) for participants with a Moroccan and Turkish origin to 621 minutes/day (10.3 hours/day) in African Surinamese participants. There were no statistically significant differences in the levels or correlates of sedentary time between the ethnic groups. Meeting the physical activity recommendations (150 minutes/week) was consistently inversely associated with sedentary time across all ethnic groups, while age was positively associated with sedentary time in most groups.