The physical therapist's role in physical activity promotion

Clinicians are increasingly confronted with the diseases of physical inactivity. Paradoxically, a promising strategy to motivate sedentary individuals to become more active is the opportunity to encourage physical activity related behavioural change when individuals encounter health professionals. Although health care professionals trained in exercise prescription are recognised as having the potential to play an important role in promoting regular physical activity, their role has been minimal in multi-disciplinary approaches to date. Even so, the role of physical therapists has gone largely unrecognised. Nevertheless, because of their training and experience, physical therapists are ideally placed to promote the health and well being of individuals and the general public through physical activity and exercise prescription. Therefore, physical therapists, general practitioners and other caregivers alike should become aware of the physical therapist's potential in promoting safe and healthy physical activity

FoodSteps : The effects of a worksite environmental intervention on cardiovascular risk indicators

This dissertation describes the results of the FoodSteps project. The purpose of this project is to evaluate the effects of a relatively modest worksite environmental intervention on physical activity, food habits and biological cardiovascular risk indicators. The effects of FoodSteps study are evaluated using controlled quasi-experimental design, in which two comparable governmental companies in The Hague (The Netherlands) were used, each comprised of multi-story office building: one intervention and one control building. A worksite intervention solely based on environmental changes is relatively new. Therefore, the first chapter gives a systematic literature review to gain insight in how many and what kind of environmental worksite interventions have been performed so far. The main purpose of this review is, however, to systematically assess the effectiveness of such worksite health promotion programs on physical activity, dietary intake and health risk indicators. The FoodSteps intervention was developed and implemented, among other things based on the knowledge obtained from this review. The intervention consisted of two parts focusing on both sides of the energy balance: one part on ‘Food’ to stimulate healthy food choices and the other on ‘Steps’ (i.e., physical activity) to stimulate stair use. As there is substantial amount of scientific evidence suggesting that even small amounts or bouts of physical activity accumulated during the day can have health benefits (e.g., favorable effects on cardiovascular disease risk factors), it is essential that a simple daily physical activity like stair use is stimulated. However, it is very difficult to measure a physical activity such as stair use objectively. Moreover, no research has been performed to date to develop and validate different methods of stair use measurement. Therefore, the study as described in the second chapter has the purpose to gain insight in the comparability of self-reported stair use versus objectively measured stair use using a newly developed measuring system. The third chapter describes the short and long term effects of the ‘Steps’ intervention on stair use behavior also using this objective measuring system in a worksite environment. In the fourth chapter the effects of the combined FoodSteps intervention on biological cardiovascular disease risk indicators (i.e., BMI, blood pressure, skinfold thickness and serum cholesterol levels) are described. The fifth and the sixth chapter describe the results of FoodSteps concerning self-reported behavior regarding food habits (i.e., fruit, vegetable and fat intake) and physical activity. In the final chapter (8) the results and methods used in the FoodSteps trial are discussed and recommendations for future research and practice are made.Mechelen, W. van [Promotor]Poppel, M.N.M. van [Copromotor

The design of a real-time formative evaluation of the implementation process of lifestyle interventions at two worksites using a 7-step strategy (BRAVO@Work)

<p>Abstract</p> <p>Background</p> <p>Worksite health promotion programs (WHPPs) offer an attractive opportunity to improve the lifestyle of employees. Nevertheless, broad scale and successful implementation of WHPPs in daily practice often fails. In the present study, called BRAVO@Work, a 7-step implementation strategy was used to develop, implement and embed a WHPP in two different worksites with a focus on multiple lifestyle interventions.</p> <p>This article describes the design and framework for the formative evaluation of this 7-step strategy under real-time conditions by an embedded scientist with the purpose to gain insight into whether this this 7-step strategy is a useful and effective implementation strategy. Furthermore, we aim to gain insight into factors that either facilitate or hamper the implementation process, the quality of the implemented lifestyle interventions and the degree of adoption, implementation and continuation of these interventions.</p> <p>Methods and design</p> <p>This study is a formative evaluation within two different worksites with an embedded scientist on site to continuously monitor the implementation process. Each worksite (i.e. a University of Applied Sciences and an Academic Hospital) will assign a participating faculty or a department, to implement a WHPP focusing on lifestyle interventions using the 7-step strategy. The primary focus will be to describe the natural course of development, implementation and maintenance of a WHPP by studying [a] the use and adherence to the 7-step strategy, [b] barriers and facilitators that influence the natural course of adoption, implementation and maintenance, and [c] the implementation process of the lifestyle interventions. All data will be collected using qualitative (i.e. real-time monitoring and semi-structured interviews) and quantitative methods (i.e. process evaluation questionnaires) applying data triangulation. Except for the real-time monitoring, the data collection will take place at baseline and after 6, 12 and 18 months.</p> <p>Discussion</p> <p>This is one of the few studies to extensively and continuously monitor the natural course of the implementation process of a WHPP by a formative evaluation using a mix of quantitative and qualitative methods on different organizational levels (i.e. management, project group, employees) with an embedded scientist on site.</p> <p>Trial Registration</p> <p>NTR2861</p

Participatie bedrijfsbewegingsprogramma's : wie doet er mee, hoe frequent en hoe lang?

In dit literatuur- en veldonderzoek is in kaart gebracht hoe groot de deelname is aan bedrijfsbewegingsprogramma’s in het algemeen en uitgesplitst naar diverse risico- en doelgroepen. De studie beoogt de geconstateerde kennislacunes hierover op te vullen om bedrijven meer handvaten te geven om een verantwoorde keuze te kunnen maken uit het aanbod van bedrijfsbewegingsprogramma’s. Twee aanbieders van incompany bedrijfsfitness en twee aanbieders van ex-company bedrijfsfitness hebben ieder participatiegegevens aangeleverd. De resultaten laten o.m. zien dat de participatiegraad en gemiddelde trainingsfrequentie niet systematisch verschilden tussen bedrijven met in-company bedrijfsfitness en bedrijven met ex-company bedrijfsfitness. Het percentage daadwerkelijke en regelmatige deelnemers en de gemiddelde trainingsfrequentie in sommige risicogroepen (voorheen inactieve medewerkers en werknemers met lagere inkomens) blijven iets achter bij de niet-risicogroepen. De belangrijkste succesfactoren van deelname aan bedrijfsfitness die door aanbieders genoemd werden, zijn persoonlijke aandacht, goede begeleiding, ondersteuning vanuit het bedrijf, het stellen van eisen en het bieden van financiële prikkels. De belangrijkste succesfactoren die door personeelsmanagers genoemd werden, zijn een goede toegankelijkheid, een vernieuwend en verrassend aanbod en het creëren van draagvlak en voldoende publiciteit

Verkenning risicobranches voor beweegarmoede en overgewicht

In deze verkennende studie is gekeken in welke branches en beroepstakken werknemers met een lage sociaal economische status en oudere werknemers (50+) met de kenmerken beweegarmoede en/of overgewicht het meeste voorkomen en wat er binnen deze branches en beroepstakken aan bewegingsstimulering wordt gedaan. Voor het onderzoek is gebruik gemaakt van het OBiN (Ongevallen en Bewegen in Nederland) bestand van TNO waarin gegevens zitten van ± 65.000 personen die representatief zijn voor de Nederlandse bevolking. Daarnaast is een enquêteonderzoek gebruikt dat TNO in 2006 heeft uitgevoerd bij 916 werkgevers. Op basis van de resultaten uit dit verkennend onderzoek zijn de vervoersbranche, de voedings- en genotmiddelenindustrie en de papier en kartonindustrie en drukkerijen door het Nederlands Instituut voor Sport en Bewegen (NISB) als risicobranches aangewezen. Binnen deze drie risicobranches is vervolgens behoeftepeiling uitgezet onder werkgevers (inclusief HRM en P&O medewerkers) en de bovengenoemde werknemersgroepen. Verder is in kaart gebracht welke netwerken en randvoorwaarden van belang zijn bij de implementatie van de beweeginterventies. De conclusie is o.a. dat alle drie de branches het probleem van overgewicht en beweegarmoede erkennen en openstaan voor bewegingsstimulering vanuit brancheorganisaties. Maar dat vooral binnen de papier- en kartonindustrie de mogelijkheden voor NISB het grootste lijken om bewegen op de agenda te krijgen. De branche is goed georganiseerd