Promoting physical activity and healthful diets: should we pursue more practice-based evidence in order to get to more evidence-based practice?

The obesity epidemic, sedentary lifestyles and lack of fitness, and the burden of disease related to vascular problems, asks for effective promotion of physical activity and healthful nutrition. I spite of the growing and very substantial number of behavioural nutrition and physical activity interventions that are being implemented in the Netherlands, only very few of these are evidence-based. Today, the Netherlands Organisation for Health Research and Development (ZonMW) hosted a workshop on this gap between practice and research, that I was asked to chair. On the one hand, quite a few interventions are being tested, initiated by academic researchers, while on the other hand schools, municipal health services, and national health promotion institutes are developing and implementing a range of interventions that have not been tested. Academia seems to fail to study the interventions that policy makers and practioners like, while policy and practice appear to fail to adopt the interventions that academia have tested and approved.
Prof. Larry Green, Adjunct Professor of Epidemiology and Biostatistics at the University of California at San Francisco, and, I believe, the godfather of planned health promotion, and author of the text book on this topic (Health promotion planning: an educational and ecological approach), gave an introductory lecture on the issues, after which two example projects were presented. The first one, the Krachtvoer (power food) project, initiated in academia, developed and tested according to the text books, but taking very long to get into the hearts and minds of practice. The second one, BigMove, developed and initiated in practice settings, but failing to get any funding for formal evaluation.
These presentations were followed by a general discussion and two workshops. The results and conclusions will help ZonMW to further improve their grant allocation procedures, to put what is being done in practice more in the lead to define what needs to be researched, and hopefully giving scientists the responsibility to define and develop the right methods and designs to do that. We should move from finding the appropriate research questions to the well-controlled research designs that the scientific community prefers, to finding and developing the right research designs to the research questions derived from what is going on in health promotion practice.