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

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

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

Association between Children's Physical Activity and Parental Practices Enhancing Children's Physical Activity: The Moderating Effects of Children's BMI z-Score

Parental practices that aim at increasing children's physical activity were found to be related to children's physical activity. So far, however, the association between these two sets of variables was studied without considering the moderating role of children's BMI z-score, which may determine the effectiveness of parental practices. The present study aims at filling this void. Longitudinal data were collected among 879 dyads of children (6-11 years old) and their parents. Seven parental physical activity practices were assessed at baseline. Physical activity, body mass, and height (measured among children) were assessed twice (at baseline and 7-month follow-up). Body mass and height were measured objectively. Seven moderation analyses were conducted. Six parental practices emerged to predict physical activity of children: collaborative social control, overall support, stimulation to be active, general encouragement for physical activity, positive social control, and modeling. Children's BMI z-score moderated three associations. The relationships between parental positive social control, overall parental support, and general parental encouragement for physical activity (at baseline), and children's physical activity (at follow-up) were significant only among children with low and medium BMI z-score. In turn, collaborative social control and modeling predicted children's physical activity at the follow-up regardless child's BMI z-score. Parental positive social control or overall parental support may be ineffective in children with higher body mass who are in need to increase their physical activity

Cooking together: The IKEA effect on family vegetable intake

Objective: Based on the idea of the 'IKEA effect', assuming that individuals like self-created objects more than objects created by someone else, this study hypothesizes that parents' involvement of their children in meal planning and preparation is positively related to vegetable intake, mediated via liking vegetables. Design: Longitudinal observational study with two time points (10-month interval). Method: Nine hundred and twenty-four parent-child dyads filled out questionnaires measuring involvement, vegetable liking, vegetable intake, and further environmental and food-related determinants of vegetable intake. On average, parents were M = 36.10 (SD = 5.43) and children (54.3% girls) M = 8.24 (SD = 1.44; range 6-11) years old. Hypotheses were tested with path analyses, accounting for intra-dyadic associations among respective constructs (e.g., parents' and children's liking vegetables). Results: Two direct effects were found: (1) parents' involvement of their children in cooking activities impacted children's liking of vegetables and vegetable intake, and (2) liking vegetables impacted vegetable intake. The effect of involvement on vegetable intake was mediated via liking vegetables, but only for children and not for parents. Conclusions: The findings emphasize the importance of parents' encouragement for involving children in the preparation of healthy meals, as this improves liking of vegetables and, thereby, increases their vegetable intake. Statement of contribution What is already known on this subject? Processes behind the effectiveness of shared cooking activities to increase vegetable intake are unclear. Previous research suggests the IKEA effect as an explanation. It assumes a higher consumption of self-created products due to a higher liking compared to third-party products. What does this study add? First test of the IKEA effect for joint cooking activities under consideration of spillover effects in families. Affirmation of the IKEA effect was found for children, not for parents. Interventions should focus on the involvement of children in cooking activities to improve vegetable intake