Partizipative Entwicklung und Durchführung von Interventionsprogrammen zur Veränderung des Ernährungs- und Bewegungsverhaltens

Participation and empowerment are important components in intervention studies, in order to establish participant satisfaction and to strengthen sustainability. These important aspects were already mentioned in the Ottawa Charter (ratified in 1986). So far, participatory research methods are widely used especially in Anglo-American and Scandinavian countries. Thus, the transfer of scientifically proven participatory research methods to the German setting is recommended. In addition, the adaptation of evidence-based, theory-driven and quality-ensured projects is requested for local settings. The main scientific theme of this cumulative thesis is the analysis and evaluation of participation as a core element in prevention and health promotion studies. The thesis is based on two studies, IDEFICS and OptimaHl 60plus â in both the intervention was developed and implemented in a participatory way. An important aspect of both interventions is the change of dietary and physical activity behaviour through a structural and behavioural prevention. Diet and physical activity in children (IDEFICS-study) and older adults (OptimaHl 60plus) play a vital role to be healthy and active and to ultimately stay autonomous. A balanced diet and sufficient physical activity give the opportunity to reduce risk factors and prevent diseases. The background and findings of this research are presented in five chapters. After a short introduction and the description of the scientific background (Chapter 1), the following two chapters present the participatory development and implementation of interventions to change the health behaviour (Chapter 2) and the participatory recruitment to interventions (Chapter 3). Chapter 4 comprises two articles on the evaluation of interventions that were developed in a participatory way. Chapter 5 discusses the findings and draws conclusions. The findings of this thesis show that scientifically proven participatory aspects can successfully be transferred to the German setting. Participatory research methods (such as focus groups) were applied in both studies (Chapter 2). An intervention mapping protocol was used to ensure that the two interventions were developed using a theory-driven and participatory approach (Chapter 2). The evidence-base of both studies as well as of the given intervention recommendations is ensured (Chapters 1, 5). Furthermore, participation is an important aspect in the recruitment and compliance of study participants â as described in detail in Chapter 3. It is also possible to evaluate interventions applying participatory measures. However, in both studies a participatory evaluation was not aimed for because this could possibly have jeopardised the scientific objectivity and publication of results (Chapter 5). Participation in intervention development and implementation is desirable. However, as part of the evaluation it bears potential hazards. Going beyond this general conclusion, some recommendations for future studies as well as implications for research, practice and politics are outlined in Chapter 5

Using the intervention mapping protocol to develop a community-based intervention for the prevention of childhood obesity in a multi-centre European project: the IDEFICS intervention

Background: The prevalence of childhood obesity has increased during the past decades and is now considered an urgent public health problem. Although stabilizing trends in obesity prevalence have been identified in parts of Europe, preventive efforts in children are still needed. Using the socio-ecological approach as the underlying theoretical perspective, the IDEFICS project aimed to develop, implement and evaluate a community-based intervention for the prevention of childhood obesity in eight European countries. The aim of the present manuscript was to describe the content and developmental process of the IDEFICS intervention. Methods: The intervention mapping protocol (IMP) was used to develop the community-based intervention for the prevention of childhood obesity in 3 to 10 years old children. It is a theory-and evidence-based tool for the structured planning and development of health promotion programs that requires the completion of six different steps. These steps were elaborated by two coordinating centers and discussed with the other participating centers until agreement was reached. Focus group research was performed in all participating centers to provide an informed basis for intervention development. Results: The application of the IMP resulted in an overall intervention framework with ten intervention modules targeting environmental and personal factors through the family, the school and the community. The summary results of the focus group research were used to inform the development of the overall intervention. The cultural adaptation of the overall intervention was realised by using country specific focus group results. The need for cultural adaptation was considered during the entire process to improve program adoption and implementation. A plan was developed to evaluate program effectiveness and quality of implementation. Conclusions: The IDEFICS project developed a community-based intervention for the prevention of childhood obesity by using to the intervention mapping heuristic. The IDEFICS intervention consists of a general and standardized intervention framework that allows for cultural adaptation to make the intervention feasible and to enhance deliverability in all participating countries. The present manuscript demonstrates that the development of an intervention is a long process that needs to be done systematically. Time, human resources and finances need to be planned beforehand to make interventions evidence-based and culturally relevant

Participatory development and implementation of intervention programmes to change the nutrition- and physical activity behaviour

Participation and empowerment are important components in intervention studies, in order to establish participant satisfaction and to strengthen sustainability. These important aspects were already mentioned in the Ottawa Charter (ratified in 1986). So far, participatory research methods are widely used especially in Anglo-American and Scandinavian countries. Thus, the transfer of scientifically proven participatory research methods to the German setting is recommended. In addition, the adaptation of evidence-based, theory-driven and quality-ensured projects is requested for local settings. The main scientific theme of this cumulative thesis is the analysis and evaluation of participation as a core element in prevention and health promotion studies. The thesis is based on two studies, IDEFICS and OptimaHl 60plus in both the intervention was developed and implemented in a participatory way. An important aspect of both interventions is the change of dietary and physical activity behaviour through a structural and behavioural prevention. Diet and physical activity in children (IDEFICS-study) and older adults (OptimaHl 60plus) play a vital role to be healthy and active and to ultimately stay autonomous. A balanced diet and sufficient physical activity give the opportunity to reduce risk factors and prevent diseases. The background and findings of this research are presented in five chapters. After a short introduction and the description of the scientific background (Chapter 1), the following two chapters present the participatory development and implementation of interventions to change the health behaviour (Chapter 2) and the participatory recruitment to interventions (Chapter 3). Chapter 4 comprises two articles on the evaluation of interventions that were developed in a participatory way. Chapter 5 discusses the findings and draws conclusions. The findings of this thesis show that scientifically proven participatory aspects can successfully be transferred to the German setting. Participatory research methods (such as focus groups) were applied in both studies (Chapter 2). An intervention mapping protocol was used to ensure that the two interventions were developed using a theory-driven and participatory approach (Chapter 2). The evidence-base of both studies as well as of the given intervention recommendations is ensured (Chapters 1, 5). Furthermore, participation is an important aspect in the recruitment and compliance of study participants as described in detail in Chapter 3. It is also possible to evaluate interventions applying participatory measures. However, in both studies a participatory evaluation was not aimed for because this could possibly have jeopardised the scientific objectivity and publication of results (Chapter 5). Participation in intervention development and implementation is desirable. However, as part of the evaluation it bears potential hazards. Going beyond this general conclusion, some recommendations for future studies as well as implications for research, practice and politics are outlined in Chapter 5

JAGGED controls Arabidopsis petal growth and shape by interacting with a divergent polarity field

A flowering plant generates many different organs such as leaves, petals, and stamens, each with a particular function and shape. These types of organ are thought to represent variations on a common underlying developmental program. However, it is unclear how this program is modulated under different selective constraints to generate the diversity of forms observed. Here we address this problem by analysing the development of Arabidopsis petals and comparing the results to models of leaf development. We show that petal development involves a divergent polarity field with growth rates perpendicular to local polarity increasing towards the distal end of the petal. The hypothesis is supported by the observed pattern of clones induced at various stages of development and by analysis of polarity markers, which show a divergent pattern. We also show that JAGGED (JAG) has a key role in promoting distal enhancement of growth rates and influences the extent of the divergent polarity field. Furthermore, we reveal links between the polarity field and auxin function: auxin-responsive markers such as DR5 have a broader distribution along the distal petal margin, consistent with the broad distal organiser of polarity, and PETAL LOSS (PTL), which has been implicated in the control of auxin dynamics during petal initiation, is directly repressed by JAG. By comparing these results with those from studies on leaf development, we show how simple modifications of an underlying developmental system may generate distinct forms, providing flexibility for the evolution of different organ functions