Good practice characteristics of diet and physical activity interventions and policies

Diet, physical activity and sedentary behaviour are main determinants of avoidable burden of disease. To promote health healthy lifestyles, public policies that promote or endorse such lifestyles are of crucial importance. Within the DEDIPAC (Determinants of Diet and Physical Activity) joint action of the Healthy Diet for a Healthy Life European Joint Programming initiative, we conducted an umbrella review -i.e. a systematic reviews of existing reviews- aimed at eliciting good practice characteristics of interventions and policies aiming at healthy diet, increasing physical activity, and lowering sedentary behaviours. This umbrella review was just published in the journal BMC Public Health.
We applied the World Health Organization’s framework, and sought for 3 types of characteristics, reflecting: (1) main intervention/policy characteristics, referring to the design, targets, and participants, (2) monitoring and evaluation processes, and (3) implementation issues.
We derived a list of 149 potential good practice characteristics, of which 53 were classified as relevant. The main characteristics of intervention/policy fell into 6 categories: the use of intervention theory, participants, target behavior, content development/management, multidimensionality, practitioners/settings. Monitoring and evaluation characteristics were also grouped into 6 categories: costs/funding, outcomes, evaluation of effects, time/effect size, reach, the evaluation of participation and generalizability, active components/underlying processes. Implementation characteristics were grouped into eight categories: participation processes, training for practitioners, the use/integration of existing resources, feasibility, maintenance/sustainability, implementation partnerships, implementation consistency/adaptation processes, transferability.
The use of the proposed list of 53 good practice characteristics may foster further development of health promotion sciences, as it would allow for identification of success vectors in the domains of main characteristics of interventions/policies, their implementation, evaluation and monitoring processes.

A virtual audit tool to assess obesogenicity of the build environment in neighbourhoods

A lack of physical activity and overconsumption of energy dense food is associated with overweight and obesity. The neighbourhood environment may stimulate or hinder the development and/or maintenance of a healthy lifestyle. To improve research on the obesogenicity of neighbourhood environments, reliable, valid and convenient assessment methods of potential obesogenic characteristics of neighbourhood environments are needed. In a study just published in pre-pub in the International Journal of Health Geographics -as part of the Spotlight project- we examined the reliability and validity of the SPOTLIGHT-Virtual Audit Tool (S- VAT), which uses remote sensing techniques (Street View feature in Google Earth) for desk- based assessment of environmental obesogenicity.
A total of 128 street segments in four Dutch urban neighbourhoods – heterogeneous in socio- economic status and residential density – were assessed using the S-VAT. Environmental characteristics were categorised as walking related items, cycling related items, public transport, aesthetics, land use-mix, grocery stores, food outlets and physical activity facilities. To assess concordance of inter- and intra-observer reliability of the Street View feature in Google Earth, and validity scores with real life audits, percentage agreement and Cohen's Kappa (k) were calculated.

The results suggest that the S-VAT is a reliable and valid remote sensing tool to assess potential obesogenic environmental characteristics.

Implementation evaluation of school-based obesity prevention programmes in youth; how, what and why?

In an ideal world, one combats public health problems with theory- and evidence-based programmes. In the real world, evidence-based programmes are often lacking and programmes that are developed and implemented are mainly practice-based. Furthermore, if evidence-based programs are available, these are often not implemented as intended, making the effectiveness in real life settings often much lower than ideal.
Three important generic implementation research questions in the context of programme evaluation are: (i) how to promote implementation as intended; (ii) what happens during implementation; and (iii) why did my programme (not) work? In an invited commentary just published in the journal Public Health Nutrition we -with soon-to-be Dr. Femke van Nassau as first author- discuss
these three questions, enriched by our experiences with the school-based obesity prevention programme DOiT(Dutch Obesity Intervention in Teenagers).

Parental modelling mediates parental education differences in children's TV time

Children from lower educated parents tend to have less positive health behaviours than kids from higher educated parents. Children's sport participation is a health behaviour, associated with positive health outcomes, while children's TV time -a sedentary behaviour- is associated with higher likelihood for overweight and obesity and lower cardiometabolic health. In a paper just published online in Preventive Medicine, we assessed whether differences in children's sport participation and TV time according to parental education were mediated by parental modelling, i.e. by 'example behaviour' of the parents. In other words: we wanted to explore if lower educated parents are less likely to participate in sports and watch more TV themselves and if these behaviours help explain the less positive health behaviours in their children. We used the data of the cross European ENERGY study. We found evidence that parental modelling was important for differences in children's health behaviours according to the level of education of their parents, especially regarding children's TV time.

DEDIPAC: Determinants of diet and physical activity Knowledge Hub

To address major societal challenges and enhance cooperation in research across Europe, the European Commission has initiated and facilitated ‘joint programming’. Joint programming is a process by which Member States engage in defining, developing and implementing a common strategic research agenda, based on a shared vision of how to address major societal challenges that no Member State is capable of resolving independently. Setting up a Joint Programming Initiative (JPI) should also contribute to avoiding unnecessary overlap and repetition of research, and enable and enhance the development and use of standardised research methods, procedures and data management. The Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub (KH) is the first joint action of the European JPI ‘A Healthy Diet for a Healthy Life’. A paper describing the rationale, organisation and potential added value of DEDIPAC was just published in the International Journal of Behavioral Nutrition and Physical Activity. The objective of DEDIPAC is to contribute to improving understanding of the determinants of dietary, physical activity and sedentary behaviours. DEDIPAC KH is a multi-disciplinary consortium of 46 consortia and organisations supported by joint programming grants from 12 countries across Europe. The work is divided into three thematic areas: (I) assessment and harmonisation of methods for future research, surveillance and monitoring, and for evaluation of interventions and policies; (II) determinants of dietary, physical activity and sedentary behaviours across the life course and in vulnerable groups; and (III) evaluation and benchmarking of public health and policy interventions aimed at improving dietary, physical activity and sedentary behaviours. In the first three years, DEDIPAC KH will organise, develop, share and harmonise expertise, methods, measures, data and other infrastructure. This should further European research and improve the broad multi-disciplinary approach needed to study the interactions between multilevel determinants in influencing dietary, physical activity and sedentary behaviours. Insights will be translated into more effective interventions and policies for the promotion of healthier behaviours and more effective monitoring and evaluation of the impacts of such interventions.

An intervention aimed at interrupting sitting time in schoolchildren

Sedentary behaviour, especially prolonged uninterrupted sitting, may be bad for cardiometabolic health. Breaking up sitting time may be more effective for health promotion than reducing total sitting time. However, there are currently no studies available reporting intervention effects on breaking up children's sedentary time. In a study just published online in the journal Pediatric Exercise Science we report on a study in which we examined intervention effect on objectively measured number of breaks in sedentary time, number of sedentary bouts (≥10 mins) and total and average amount of time spent in those sedentary bouts among 10- to 12- year-old Belgian children. The total sample included 354 children aged 10-11 with valid ActiGraph accelerometer data at pre- and post-test. Only few and small intervention effects were found, namely on total time spent in sedentary bouts immediately after school hours and on average time spent in sedentary bouts before school hours  and immediately after school hours in favour of children from intervention schools. Unexpectedly, girls from intervention schools decreased the number of breaks during school hours
and increased the number of sedentary bouts on a weekend day, whereas girls in control schools showed an increase in number of breaks and a decrease in number of bouts. In conclusion, UP4FUN did not have a consistent or substantial effect on breaking up children's sedentary time and these data suggest that more intensive and longer lasting interventions are needed, if interrupting sitting time is to be further pursued.

Sedentary behaviour and health in children: Evaluating the evidence

There is much to do about sedentary behaviour -too much (prolonged) sitting, for example by means of TV watching, computer and other IT activities, long school or office days et cetera- as a possible risk factor for cardiometabolic health. Scientists have claimed that sedentary time is a risk factor for cardiometabolic health partly or largely independent of physical activity. I.e. even if you do enough exercise, if you sit most of the rest of the day, your cardiometablic health may be at unnecessary risk. Some countries have already proposed recommendations for maximum sedentary time and interventions to reduce or interrupt sedentary time have been developed and are being tested or implemented.
In a commentary just published in the journal Preventive Medicine, with Prof. Mai Chin A Paw as first author, we argue that the evidence for sedentary behaviour as an independent cardiometabolic risk factor for children and adolescents is certainly not yet convincing, and propose research that should be conducted first to see if a stronger case can be build for treating sedentary behaviour as a separate risk factor, before we start using the meagre means for preventative interventions on sedentary behaviour instead of promoting physical activity and healthy eating.