Determinants of exercise adherence and maintenance among cancer survivors: a systematic review

There is better and better evidence that exercise and physical activity is of utmost importance for health and quality of life for cancer survivors. Special exercise and physical activity-based cancer rehabilitation programs are therefore developed, tested and implemented. For such an exercise intervention to be successful, it is -evidently- important that cancer survivors adhere to the prescribed program. To be able to improve adherence and thus the effects of cancer rehabilitation, insights into the factors that may determine adherence to such programs is important. In a paper just published in the International Journal of Behavioral Nutrition and Physical Activity -with Caroline Kampshoff as first author- we aimed to systematically review determinants of exercise adherence and maintenance in cancer survivors. This review was part of the A-CaRe (Alpe D'Huzes Cancer Rehabilitation) research program Eighteen studies were reviewed in which a range of potential determinants of adherence were studied, but only very few of these potential determinants were supported by the available evidence. We found moderate evidence for a positive association between exercise history and exercise adherence, i.e. that patients who already were physically active before becoming a cancer patient, were more likely to adhere to exercise programs. Inconsistent findings were found for age, gender and education as well as for psychological factors such as stage of change, perceived behavioral control, self-efficacy, extraversion, attitude, intention, fatigue, and quality of life, and physical factors including cardiovascular fitness, body mass index, and baseline physical activity.

Interactive-Technology Health Behavior Promotion Program for Heart Failure Patients

In a paper just published in Journal of Medical Internet Research -Research Protocols- (with Rony Calo as first author), we describe a pilot study to explore the use of interactive technology to promote heart failure (HF) patients’ engagement in physical activity (PA) and adherence to medication. This IT-based interventions, called Motivate4Change, is a program for delivery in the hospital setting, and the development was guided by the Intervention Mapping protocol. The study is a collaboration between researchers from the EMGO Institute for Health & Care Research and Philips Research.

We used observations at a hospital in the United Kingdom and semistructured interviews with hospitalized HF patients and HF nurses following their completion of Motivate4Change. Results demonstrated that patient needs included empathic and contextual content, interactive learning, and support from others, including nurses and family members. The nurse needs included integration in current educational practices and finding opportunities for provision of the program.

Schoolchildren from lower educated parents and minority groups have less positive home environments and believes regarding energy balance behaviours

To explore differences in personal and home environmental factors that are regarded as determinants of energy balance-related behaviours (i.e. physical activity, sedentary and dietary behaviours; EBRBs) according to parental education and ethnic background among 10-12 year old schoolchildren across Europe, the data from the cross sectional study of the ENERGY project were analysed (also see the ENERGY website). The results of these analyses were just published in BMC Public Health.
A school-based survey among 10-12 year olds was conducted in eight countries across Europe. A range of personal and home environment variables relevant for soft drink consumption, daily breakfast, sport participation and TV time was assessed by means of child report. Personal factors included attitude, health beliefs, and preference/liking. Home environment factors included parental subjective norm, modeling, support, practices and home availability. Children were classified based on parental education (i.e., low vs. high) and ethnic background (i.e., native vs. non-native). Data from 6018 children in the eight countries were included in the analyses.
Our analyses analyses showed that the majority of the variables tested -and especially home environment variables- were more favorable among children from higher educated parents and from native ethnicity. None of the personal and home environment factors was found to be more favorable among children from lower educated parents or non-native ethnicity.

hand hygiene promotion contributes to a reduced infection rate among very low-birth weight infants

Hand hygiene in hospital settings is needed to reduce hospital infections. Adequate hand hygiene is seen as the most important intervention to prevent nosocomial infections. Compliance with hand hygiene protocols needs continuous promotion and facilitation. In a paper just published in the American Journal of Infection Control, with Dr. Onno Helder as first author, we describe a study of the effectiveness of sequential hand hygiene promotion among hospital workers in an intensive care unit in a children's hospital.
We conducted an observational study with an interrupted time series analysis of the occurrence of nosocomial bloodstream infections (NBSIs) among very low-birth weight (VLBW) infants. Interventions consisted of an education program, gain-framed (i.e. the positive effects of hand hygiene was communicated) screen saver messages, and an infection prevention week with an introduction on consistent glove use.
Almost 2,000 VLBW infants were studied admitted between 2002 and  2011. The proportion of infants with ≥1 NBSI decreased from 47.6%-21.2%; the number of NBSIs per 1,000 patient days decreased from 16.8-8.9. Pre-
intervention, the number of NBSIs significantly increased, while after the first intervention a significantly declining trend in NBSIs was observed, which stayed at this lower level during the sequential interventions.
We concluded that continuous sequential hand hygiene promotion contributes to a sustained low NBSI rate.

Successful DEDIPAC full consortium meeting

Yesterday and today the first full consortium meeting of the determinants of diet and physical activity knowledge hub (DEDIPAC) was held. On Thursday a plenary program informed the 175 DEDIPAC partners who had come to Amsterdam for this meeting about the progress made so far and were further inspired by short keynote speeches on ambulatory assessment of physical activity, sedentary and dietary behaviour and their determinants by Ulrich Ebner-Priemer, the president of the society for ambulatory assessment, on a paradigm shift in research on determinants towards systems-models of health behaviour change, by Stef Kremers, and on the INFORMAS framework for food environment and policy monitoring and benchmarking by Stefanie Vandervijvere. On the Thursday afternoon and Friday a series of workshops were conducted to further the work on DEDIPAC's three thematic areas, i.e. harmonisation of measurement and monitoring of diet, physical activity, sedentary behaviour and their determinants, gaining further insights in multilevel determinants of these behaviours, and evaluation of multilevel interventions and policies to promote and facilitate healthier diets, more physical activity and less sedentariness.

DEDIPAC website launched

The DEterminants of DIet and Physical Activity knowledge hub is the first joint action of the European Joint Programming Initiative for a Healthy Diet for a Healthy Life in Europe. The DEDIPAC KH is a multidisciplinary consortium of scientists from 46 research centres in 12 countries across Europe. The main objective of DEDIPAC is to understand the determinants of dietary, physical activity and sedentary behaviours and to translate this knowledge into a more effective promotion of a healthy diet and physical activity. DEDIPAC is now underway for a few months, and next week the firts full consortium meeting will be held in Amsterdam, at the EMGO Institute for Health and Care Research of the VU University and its medical center. The website for DEDIPAC was launched this week in preparation of the meeting.

Correlates of Active and Non-Active Gaming Among Dutch Adolescents

Playing video games contributes substantially to sedentary behavior in youth. A new generation of video games—active games—may be an alternative to such sedentary games to promote physical activity and reduce sedentary behavior. In order to promote active gaming, insight is needed in the correlates and potential determinants of such active gaming. In a paper just published in the e-journal JMIR serious games, with Monique Simons as first author, we reported the results of a survey among Dutch 12-16 y old youth to examine personal, social, and game-related correlates of both active and non-active gaming in adolescents.
Active gaming was significantly associated with a more positive attitude toward active gaming , a less positive attitude toward non-active games, more habitual gaming and having siblings and friends  who spend more time on active gaming, and a somewhat lower game engagement. Non-active gaming  was significantly associated with a more positive attitude toward non-active gaming, a stronger habit regarding gaming , having friends who spend more time on non-active gaming , and a more positive image of a non-active gamer.