How many key informants are enough? Analysing the validity of the community readiness assessment

OBJECTIVE: Communities are important settings for health promotion and prevention. The community readiness assessment offers a structured approach to assess resources and opportunities to tackle a health problem within a community. The assessment relies on semi-structured interviews with key informants from the communities. A number of 4–6 key informant interviews are recommended in the literature. However, it is unclear whether this is sufficient to obtain a valid representation of the respective community. This study analysed whether increasing the number of key informants from 4–6 to 12–15 alters the results of the community readiness assessment. RESULTS: A total of 55 community readiness interviews were carried out in 4 communities. Overall, the community readiness scores showed little variation after having interviewed 10 key informants in a community. However, even after completing 10 interviews in a community, key informants were still able to identify up to 6 new information items regarding community efforts for physical activity promotion among the elderly, contact and communication channel for informing or approaching the target group, or barriers to participation

Development and evaluation of the efficacy of a web-based ‘social norms’-intervention for the prevention and reduction of substance use in a cluster-controlled trial conducted at eight German universities

Abstract Background Previous research suggests that perceptions of peer substance use are associated with personal use. Specifically, overestimating use in the peer group is predictive of higher rates of personal substance use. ‘Social norms’-interventions are based on the premise that changing these misperceived social norms regarding substance use by providing feedback on actual norms is associated with a reduction in personal substance use. Studies conducted in the U.S.A. suggest that ‘social norms’-feedback is an effective strategy for reducing substance use among university students. It is unknown whether the effects of a ‘social norms’-feedback on substance use can be replicated in a sample of German university students. The objective of this article is to describe the study design and aims of the ‘INternet-based Social norms-Intervention for the prevention of substance use among Students’ (INSIST)-study, a cluster-controlled trial examining the effects of a web-based ‘social norms’- intervention in students enrolled at four intervention universities with those enrolled at four delayed intervention control universities. The INSIST-study is funded by the German Federal Ministry of Health. Methods/Design Eight universities in four regions in Germany will take part in the study, four serving as intervention and four as delayed intervention control universities (randomly selected within a geographic region). Six hundred students will be recruited at each university and will be asked to complete a web-based survey assessing personal and perceived substance use/attitudes towards substance use at baseline. These data will be used to develop the web-based ‘social norms’-feedback tailored to gender and university. Three months after the baseline survey, students at intervention universities will receive the intervention. Two months after the launch of the intervention, students of all eight universities will be asked to complete the follow-up questionnaires to assess changes in perceptions of/attitudes toward peer substance use and rates of personal substance use. Discussion This study is the first German cluster-controlled trial investigating the influence of a web-based ‘social norms’-intervention on perceptions of/attitudes towards substance use and substance use behavior in a large university student sample. This study will provide new information on the efficacy of this intervention strategy in the German university context. Trial registration DRKS00007635 at the ‘German Clinical Trials Register’ (17.12.2014)

Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review protocol

BACKGROUND: It is known that regular physical activity (PA) is associated with improvements in physical, psychological, cognitive, and functional health outcomes. The World Health Organization recommends 150 min of moderate exercise per week for older adults to achieve these health benefits. However, only 20–60 % of adults aged 60 years and above currently meet these recommendations for exercise. The widespread use of the internet and mobile phones among older adults may open new opportunities to promote PA in this population. Findings of previous reviews suggest that eHealth interventions are effective in promoting PA in adults of various ages. However, to date, none of these reviews have provided a differentiated picture of engagement in such interventions and effects on PA among older adults. Also, we are unaware of any studies comparing effects of participation in eHealth vs. traditional paper-and-pencil interventions on PA in this population. The aim of this systematic review and meta-analysis is to compare the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with either a non-eHealth PA intervention or a group that is not exposed to any intervention. METHODS: Eight electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, PEI, PsycINFO, Web of Science, and OpenGrey) will be searched to identify experimental and quasi-experimental studies examining the effectiveness of eHealth interventions for PA promotion in adults aged 55 years and above. Two authors will independently select and review references, extract data, and assess the quality of the included studies by using the Cochrane Collaboration’s risk of bias tool. Disagreements between authors will be resolved by discussion involving a third author. If feasible, a meta-analysis will be conducted. Narrative synthesis using harvest plots will be performed, should a meta-analysis not be feasible. DISCUSSION: The proposed systematic review will be the first review that compares the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with control groups exposed to a non-eHealth intervention or to no intervention. The results of this review will provide new information regarding the question whether eHealth interventions are an effective intervention vehicle for PA promotion in this population

DEVASYS – Entwicklung eines Online-Tools zur Unterstützung der systematischen Evaluation von Interventionsprojekten der Prävention und Gesundheitsförderung

ZIELE DER ARBEIT: Das Wissen über Wirkungen und Umsetzungsqualität in praxisbezogenen Projekten der Prävention und Gesundheitsförderung in Deutschland ist aktuell sehr begrenzt. Für die Evaluation solcher Projekte gibt es derzeit kaum strukturierte Evaluationssysteme, die leicht und mit wenig Aufwand, auch im Rahmen von Selbstevaluationen, genutzt werden können. Das Ziel der vorliegenden Arbeit war die wissenschaftsbasierte Entwicklung und Pilotierung eines Online-Tools zur Unterstützung einer strukturierten Dokumentation und Selbstevaluation von Interventionsprojekten der Prävention und Gesundheitsförderung, das zu einer zyklischen Projektentwicklung beiträgt. METHODIK: Der multimethodische Ansatz beinhaltete 2 Abschnitte, eine Literatur- und Datenbankrecherche zur Erstellung eines Rahmenmodells sowie eine Praxisanpassung, einschließlich einer Fokusgruppe und einem Anwendungstest mit Stakeholdern aus unterschiedlichen Praxisbereichen der Prävention und Gesundheitsförderung (N=12). ERGEBNISSE: Das Dokumentations- und Evaluationssystem (DEVASYS) unterscheidet die Bereiche „Planung“, „Dokumentation“ und „Evaluation“, die jeweils auch unabhängig voneinander bearbeitet werden können. Konzeptionelle Grundlage des Tools bildet das RE-AIM Framework. Zur Bestimmung der Projektqualität können sowohl Dimensionen der Output-Ebene (Reichweite, Akzeptanz, Implementierung) als auch der Outcome-Ebene (Wirksamkeit, Aufrechterhaltung) erfasst werden. SCHLUSSFOLGERUNG: DEVASYS ist ein praxiserprobtes Werkzeug, das zu einer verbesserten Evaluation existierender praxisbezogener Interventionsprojekte und zu einer Qualitätsentwicklung zukünftiger Projekte in der Prävention und Gesundheitsförderung beiträgt. Nächste Schritte sind die systematische Dissemination und Implementierung.OBJECTIVES: To date, knowledge about the effects and implementation quality of disease prevention and health promotion projects in Germany is limited. Only a few structured evaluation systems exist that can be easily used and which include features for evaluating research and practice projects. The aim of the current project was to develop and carry out a pilot study of an online evaluation tool that enables structured self-evaluation of projects in disease prevention and health promotion practice and contributes to an improved documentation and cyclical development of projects. METHODS: The mixed-methods approach taken in this project included 2 steps: a) search of literature and database to develop a theoretical framework for the tool and b) adaptation process to test the fit of the tool for practice, including a focus group discussion and a usability test with different disease prevention and health promotion stakeholders (N=12). RESULTS: The resulting documentation and evaluation system (DEVASYS) is comprised of the components “planning”, “documentation”, and “evaluation” which can be used independently of one another. The conceptual basis of the tool is the RE-AIM framework. To determine the quality of an individual project, dimensions of both the output (reach, acceptance, implementation) and the outcome levels (effectiveness, maintenance) can be documented with the tool. CONCLUSION: DEVASYS is a practice-oriented tool contributing to an improved evaluation of existing practice-related intervention projects and the overall quality of future projects in the area of disease prevention and health promotion. Systematic dissemination and implementation of the tool are the next steps to be taken

Additional file 1: of Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review protocol

PRISMA-P 2015 checklist: recommended items to address in a systematic review protocol. (PDF 212 kb

Equity impacts of interventions to increase physical activity among older adults: a quantitative health impact assessment

BACKGROUND: Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities by education and gender among older adults in Germany. METHODS: We created six intervention scenarios targeting the elderly population: Scenarios #1–#4 applied realistic intervention effects that varied by education (low, medium high). Under scenario #5, all older adults adapted the physical activity pattern of those with a high education. Under scenario #6, all increased their physical activity level to the recommended 300 min weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes under each of these six intervention scenarios was simulated for males and females over a 10-year projection period using the DYNAMO-HIA tool. Results were compared against a reference-scenario with unchanged physical activity. RESULTS: Under scenarios #1–#4, approximately 3589–5829 incident disease cases and 6248–10,320 deaths could be avoided among males over a 10-year projection period, as well as 4381–7163 disease cases and 6914–12,605 deaths among females. The highest reduction for males would be achieved under scenario #4, under which the intervention is most effective for those with a high education level. Scenario #4 realizes 2.7 and 2.4% of the prevented disease cases and deaths observed under scenario #6, while increasing inequalities between education groups. In females, the highest reduction would be achieved under scenario #3, under which the intervention is most effective amongst those with low levels of education. This scenario realizes 2.7 and 2.9% of the prevented disease cases and deaths under scenario #6, while decreasing inequalities between education groups. Under scenario #5, approximately 31,687 incident disease cases and 59,068 deaths could be prevented among males over a 10-year projection period, as well as 59,173 incident disease cases and 121,689 deaths among females. This translates to 14.4 and 22.2% of the prevented diseases cases among males and females under scenario #6, and 13.7 and 27.7% of the prevented deaths under scenario #6. CONCLUSION: This study shows how the overall population health impact varies depending on how the intervention-induced physical activity change differs across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities

Effects of two web-based interventions promoting physical activity among older adults compared to a delayed intervention control group in Northwestern Germany: Results of the PROMOTE community-based intervention trial

Regular physical activity (PA) is of central importance for healthy ageing. However, in Germany, only 42% of older adults currently reach the PA recommendations of the World Health Organization. The aim of this study was to examine the effects of two web-based interventions on PA in adults aged 65–75 years living in Northwestern Germany compared to a delayed intervention control group (CG). 589 older adults were randomized to one of the three groups. Participants in intervention group 1 (IG1) received access to a web-based intervention for ten weeks assisting them in self-tracking PA behavior. Participants in IG2 received the intervention of IG1 and additionally an activity tracker to objectively track PA behavior. To analyze differences in objectively measured moderate-to-vigorous PA and sedentary time between baseline and follow-up (12 weeks after baseline), linear mixed models were used. The interaction effects revealed a decrease in minutes spent on moderate-to-vigorous PA in bouts of 10 min by 11 min per week in IG1 participants (β = −11.08, 95% CI: (−35.03; 12.87)). In comparison, IG2 participants were 7 min more physically active at follow-up (β = 7.48, 95% CI: (−17.64; 32.60)). Sedentary time in bouts of 30 min per week increased in IG1 participants (β = 106.77, 95% CI: (−47.69; 261.23)) and decreased in IG2 participants at follow-up (β = −16.45, 95% CI: (−178.83; 145.94)). Participation in the two web-based interventions did not lead to significant increases in moderate-to-vigorous PA or significant decreases in sedentary time compared to the CG

Additional file 2: of Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review protocol

MEDLINE search. (PDF 193 kb

Evidence-based primary prevention and health promotion : methods and procedures in 5 research consortia

Von 2014 bis 2022 erforschen die 5 deutschen Forschungsverbünde AEQUIPA, CAPITAL4HEALTH, HLCA, PartKommPlus und SMARTACT Themen der Primärprävention und Gesundheitsförderung mit dem Ziel, die Evidenzgrundlagen in diesen Bereichen weiterzuentwickeln. In diesem Beitrag wird die Arbeit der 5 Forschungsverbünde für Primärprävention und Gesundheitsförderung unter dem Aspekt der Evidenzbasierung aus der internen Perspektive vorgestellt, analysiert und diskutiert. Als orientierender Rahmen dient ein Modell der evidenzbasierten Public Health.Die 5 Forschungsverbünde nutzen für die Evidenzgenerierung vielfältige Zugangswege bzgl. der Beteiligung nichtakademischer, zivilgesellschaftlicher Akteur*innen und Nutzer*innen. Es finden sich vielfältige Studiendesigns, die von randomisiert kontrollierten Studien und systematischen Reviews zu diversen qualitativen Designs reichen. Die Nutzung von Modellen und Theorien unterstützt die Evidenzbasierung. Über die Evidenzentwicklung hinaus legen alle Verbünde einen Schwerpunkt auf die zumindest exemplarische Implementierung des neuen Wissens.Durch die Methodenvielfalt kann eine breit gefächerte Evidenzbasierung unter Berücksichtigung verbundspezifischer Aspekte realisiert werden. Grenzen für eine weitere systematische Stärkung der Evidenzbasierung liegen in strukturellen Rahmenbedingungen. Insbesondere die Einbindung von nichtakademischen, zivilgesellschaftlichen Akteur*innen und Nutzer*innen für die Arbeit mit schwer erreichbaren Zielgruppen kann oft nicht ausfinanziert bzw. zeitlich berücksichtigt werden. Die COVID-19-Pandemie verdeutlicht die Wichtigkeit eines flexiblen Methodenspektrums, in dem ein sinnvolles Zusammenspiel von digitalen und analogen Methoden anzustreben ist.publishe

Perspective Paper "Future Prevention Research" - Current and Future Coordinated Research on Prevention and Health Promotion

Zeeb H, Brandes M, Bauer U, et al. Perspektivpapier „Zukunft Präventionsforschung“: Koordinierte Forschung zu Prävention und Gesundheitsförderung – aktuell und in der Zukunft. Gesundheitswesen. 2022.From 2014 to 2022, the BMBF has funded five research networks in prevention research and health promotion that are also jointly coordinated (Research Network Primary Prevention and Health Promotion, www.fp2g.net). The researchers have produced a large number of relevant research outputs with insights gained into essential aspects of prevention research and health promotion. The networks research focused on basic principles, application-relevant findings, and implementation conditions of long-term prevention and health promotion for non-communicable diseases (NCDs). The constraints imposed by the pandemic from 2020 onwards were partly addressed by integrating Corona-related research and transfer activities. The importance of resilience for dealing with multiple health and social challenges got increased attention and was analyzed and discussed during the pandemic. For prevention research, research questions such as how to better implement prevention measures through digital tools are gaining additional importance. Together, the research networks have presented achievements and desiderata for future research. This perspective paper with its nine theses formulated in conclusion is intended as a stimulus for discussion among funders as well as the communty of researchers on the subject of successful prevention and health promotion. It is explicitly part of the continuity of the memoranda on prevention research developed in 2012. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).Von 2014 bis 2022 fördert das BMBF fünf Forschungsverbünde der Präventionsforschung und Gesundheitsförderung, die ebenfalls über eine gemeinsame Koordination verfügen (Forschungsnetzwerk Primärprävention und Gesundheitsförderung, www.fp2g.net). Die Forschenden haben eine Vielzahl relevanter Forschungsergebnisse erarbeitet und Erkenntnisse über wesentliche Aspekte der Präventionsforschung und Gesundheitsförderung gewonnen. Die Forschung der Verbünde konzentrierte sich auf Grundlagen, anwendungsrelevante Erkenntnisse und Umsetzungsbedingungen einer langfristig angelegten Prävention und Gesundheitsförderung für nicht-übertragbare Erkrankungen (NCD). Den Einschränkungen durch die Pandemie ab 2020 konnte z.T. durch Integration von Corona-bezogenen Forschungs- und Transferaktivitäten begegnet werden. Die Bedeutung von Resilienz für den Umgang mit den vielfältigen gesundheitlichen und sozialen Herausforderungen wird in Zeiten der Pandemie verstärkt analysiert und diskutiert. Für die Präventionsforschung gewinnen Forschungsfragen etwa zur besseren Implementierung von Präventionsmaßnahmen durch digitale Werkzeuge zusätzliche Bedeutung. Gemeinsam stellen die Verbünde Erreichtes und Desiderate zukünftiger Forschung dar. Dieses Perspektivpapier mit den abschließend formulierten neun Thesen ist für eine erfolgreiche Prävention und Gesundheitsförderung als Diskussionsanregung für Förderer wie auch für die Gemeinschaft der Forschenden gedacht. Es stellt sich explizit in die Kontinuität der schon im Jahr 2012 erarbeiteten Memoranden zur Präventionsforschung