Good practice characteristics of diet and physical activity interventions and policies : an umbrella review

BACKGROUND: This umbrella review aimed at eliciting good practice characteristics of interventions and policies aiming at healthy diet, increasing physical activity, and lowering sedentary behaviors. Applying the World Health Organization's framework, we 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. This investigation was undertaken by the DEDPIAC Knowledge Hub (the Knowledge Hub on the DEterminants of DIet and Physical ACtivity), which is an action of the European Union's joint programming initiative. METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from 7 databases was analyzed (99 documents met inclusion criteria). Additionally, resources of 7 major stakeholders (e.g., World Health Organization) were systematically searched (10 documents met inclusion criteria). Overall, the review yielded 74 systematic reviews, 16 position review papers, and 19 stakeholders' documents. Across characteristics, 25% were supported by ≥ 4 systematic reviews. Further, 25% characteristics were supported by ≥ 3 stakeholders' documents. If identified characteristics were included in at least 4 systematic reviews or at least 3 stakeholders' documents, these good practice characteristics were classified as relevant. RESULTS: We derived a list of 149 potential good practice characteristics, of which 53 were classified as relevant. The main characteristics of intervention/policy (n = 18) fell into 6 categories: the use of theory, participants, target behavior, content development/management, multidimensionality, practitioners/settings. Monitoring and evaluation characteristics (n = 18) were 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 (n = 17) 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. CONCLUSIONS: 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

Maternal practices and perceptions of child body mass status explain child energy expenditure behaviors and body mass

This study investigated whether maternal perceptions of child body mass status would predict child body mass index (BMI) z-score via two sets of sequential mediators: (1) four maternal practices promoting child energy expenditure and (2) children’s energy expenditure behaviors. The data of N = 729 mother–child dyads were collected at baseline [T1; n = 495 at 7- to 8-month follow-up (T2)]. Mothers reported perceptions of child body mass status and maternal practices (T1); children reported sedentary screen use and physical activity (T1, T2). Child body mass was assessed objectively (T1, T2). Higher stimulation to be active (T1) was related to a lower child BMI z-score (T2) via higher levels of child physical activity (T2). Higher levels of monitoring of screen use (T1) were associated with higher child BMI z-score (T2) via lower levels of child physical activity (T2). Encouraging parents to stimulate their children to be active may be beneficial for children’s weight maintenance

Implementation conditions for diet and physical activity interventions and policies : an umbrella review

BACKGROUND: This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life. METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support. RESULTS: We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation. CONCLUSIONS: The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB

Self-efficacy, planning, or a combination of both? A longitudinal experimental study comparing effects of three interventions on adolescents' body fat

© 2016 Luszczynska et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: The superiority of an intervention combining two sets of theory-based behavior change techniques targeting planning and self-efficacy over an intervention targeting planning only or self-efficacy only has rarely been investigated. Purpose: We compared the influence of self-efficacy, planning, and self-efficacy+planning interventions with an education-based control condition on adolescents' body fat, assuming mediating effects of respective social cognitive variables and moderate-to-vigorous physical activity (MVPA). The moderating role of the built environment was examined. Methods: Participants (N = 1217, aged 14-18 years) were randomly assigned to four conditions: planning (n = 270), self-efficacy (n = 311), self-efficacy+planning (n = 351), and control (n = 285). The measurement was conducted at baseline (T1), two-month follow-up (T2), and fourteen-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. Percent of body fat tissue (measured at T1 and T3) was themain outcome. Social cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. The behavioralmediator (MVPA) and the presence of built MVPA facilities (the moderator) were evaluated at T1 and T3. Results: Similar small increases of body fat were found across the three intervention groups, but the increment of body fat was significantly larger in the control group. On average, differences between control and intervention groups translated to approximately 1% of body fat. Effects of the interventions on body fat were mediated by relevant social cognitive variables and MVPA. A lower increase of body fat was found among intervention group participants who had access to newly-built MVPA facilities. Conclusions: We found no superiority of an intervention targeting two social cognitive variables over the intervention targeting one cognition only

Intrinsic Motivation Predicting Performance Satisfaction in Athletes: Further Psychometric Evaluations of the Sport Motivation Scale-6

The study investigated psychometric properties of the Sport Motivation Scale-6 (SMS-6), assessing intrinsic regulation, four extrinsic regulation constructs, and amotivation among athletes competing at a regional and national level. In particular, we tested the factorial structure of SMS-6, its short-term stability, and the associations of SMS-6 constructs with self-efficacy, self-esteem, motivational climate, and satisfaction with sport performance. Participants were 197 athletes (57.4% women), representing team (54.7%) and individual disciplines. The measurement was repeated at the three-week follow-up (n = 107). Results yielded support for the six first-order factor structure (three second-order factors). More autonomous forms of motivation were related to higher levels of self-efficacy, performance satisfaction, and taskoriented motivational climate in sport organizations. Sequential multiple mediation analysis showed that the association between general self-efficacy and performance satisfaction at a follow-up was mediated by introjected regulation and personal-barrier self-efficacy

Planning and self-efficacy interventions encouraging replacing energy-dense foods intake with fruit and vegetable: A longitudinal experimental study

OBJECTIVE This longitudinal experimental study compared effects of self-efficacy, planning and education-based conditions, encouraging adolescents to eat fruit and vegetable in place of energy-dense foods. DESIGN Data were collected among 506 adolescents (13-18 years old) who were randomly assigned to control (n = 181), planning (n = 153) or self-efficacy (n = 172) conditions. Measurements were taken at baseline (T1), at a 2-month follow-up (T2), and at a 14-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. OUTCOME MEASURES Self-reports of fruit and vegetable intake (FVI) and energy-dense foods intake were collected at three times. Cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. Body weight and height were objectively measured at T1 and T3. RESULTS AND CONCLUSIONS Similar significant increases of FVI were found for planning and self-efficacy interventions (T3). The planning intervention did not influence energy-dense food intake (T3), but the self-efficacy intervention tended to result in stabilising intake (compared to an increase found in the control group). There were no effects on body weight. Similar patterns were found for the total sample and for a subsample of adolescents with overweight/obesity. The effects of interventions on FVI were mediated by respective cognitions

Bi-directional associations between parental feeding practices and children's body mass in parent-child dyads

OBJECTIVE: This study investigated whether parental feeding practices, such as pressure to eat, permitting unhealthy food, and restriction of unhealthy food predict children's body mass index (BMI) percentile or if children's BMI percentiles predict parental feeding practices. DESIGN: Longitudinal data were collected among 526 dyads of children (6-11 years old) and one of their parents. Parents reported parental feeding practices, restriction of unhealthy food, permission of unhealthy food, and pressure to eat. Children's weight and height were assessed objectively. All measurements were conducted twice with a time lag of 10 months. RESULTS: Cross-lagged panel analyses demonstrated that low levels of children's BMI percentiles (measured at the baseline) predicted parental feeding practices (measured at the follow-up) but not vice versa. Only one effect suggesting bi-directionality was found, with parental restriction of unhealthy food preceding higher levels of children's BMI percentiles at the follow-up. CONCLUSIONS: Parental feeding practices seem to be a reaction to the levels of children's BMI percentiles

From enjoyment to physical activity or from physical activity to enjoyment? Longitudinal associations in parent-child dyads

BACKGROUND: This longitudinal dyadic study used cross-lagged analyses to examine reciprocal patterns of associations between physical activity (PA) enjoyment and moderate-to-vigorous PA (MVPA) among children and their parents. METHODS: At Time 1 (T1) 879 parent-child dyads provided their data. The follow-up (Time 2, T2) took place 7-8-months later. MVPA and PA enjoyment scales were filled out separately by parents and children at T1 and T2. FINDINGS: Child PA enjoyment (T1) predicted a higher level of child MVPA (T2), parental PA enjoyment (T1) explained a higher level of parental MVPA (T2), and parental MVPA (T1) predicted a higher level of parental PA enjoyment (T2). Furthermore, child PA enjoyment (T1) predicted a higher level of parental PA enjoyment (T2). CONCLUSIONS: Child PA enjoyment was the key variable predicting child and parental outcomes. In particular, it explained child MVPA, but also PA enjoyment among parents

What comes first, negative emotions, positive emotions, or moderate-to-vigorous physical activity?

Background: Although there is no doubt that indicators of physical activity (PA), negative and positive emotions are associated, the order in which they operate is not well-established. In this study, we investigated indirect associations between a negative emotions indicator (emotional symptoms of depression; henceforth: depression), a positive emotions indicator (physical activity [PA] liking), and moderate-to-vigorous physical activity (MVPA), in order to identify which one of the three variables is likely to precede the others. Methods: Data were collected twice, with a 7–8-month follow-up. 879 adults from the general population (N = 879 at Time 1, T1; N = 603 at Time 2, T2) filled in questionnaires measuring depression, PA liking and MVPA. Results: Mediation analyses showed that a higher level of depression (T1) predicted a lower level of PA liking (T2) which in turn explained a lower MVPA level (T2). Additionally, a higher level of PA liking (T1) predicted a lower level of depression (T2), which in turn was associated with a higher MVPA level at T2. Analyses with MVPA operating as the independent variable or the mediator were not significant. Conclusions: Results indicated that both negative and positive emotions precede rather than follow MVPA engagement