Effects of Interventions Promoting Active Travel to Work on Driving and Worker Health: Formative Research and Tests of Workplace Travel Plans

Travel to work by walking, cycling and public transport is healthier than driving and is promoted as active travel. Workplace travel plans that aim to promote active travel as an alternative to driving are a site-based delivery mechanism for transport management options. In some jurisdictions they can be required through land use planning and approvals processes. Research on the effect of workplace travel plans for increasing active travel to work shows they are promising but their effect is not conclusive. Data on their impacts on active travel and physical activity are weak and scarce. Using a translation research approach this thesis conducts formative research to assess appropriate study designs for the present stage of evidence generation, including a systematic review of the literature. A travel plan is developed, then a study assesses validity of the main outcome measure at baseline whilst gathering objective data on physical activity associated with different transport modes. The effectiveness research stage includes two pragmatic studies of the effectiveness of workplace travel plans for decreasing driving and increasing active travel to work - a three-year time-series study and a retrospective controlled before-after study. In-depth interviews with 20 transport and health practitioners involved in the effectiveness studies, and others who have implemented travel plans are conducted to determine key factors for successful travel plan implementation. Finally, lessons from the formative research and effectiveness studies are applied to develop two ideal studies for assessing the effectiveness of workplace travel plans for decreasing driving and increasing active travel – a cluster-randomised controlled trial and a quasi-experiment. Rigor versus pragmatism in evaluation is considered, and criteria for assessing causality are applied to ensure the research plans address all major research gaps

"Treats, sometimes food, junk.”: Exploring "extra‟ food with parents of young children

This report presents the findings from an exploratory qualitative study which investigates parents‟ understanding and approaches to providing energy-dense and nutrient-poor “extra foods‟ to their preschool aged children. The study also explores the extent to which there is variation between parents of low and high socio-economic status (SES) in relation to these issues. The study involved 13 focus groups with 88 parents of 3-5-year-old children in distinctly socially disadvantaged and socially advantaged areas. Data from transcripts were analysed using framework analysis, which is an approach to qualitative thematic analysis that explicitly aims to generate practice and policy relevant findings

\u27Treats\u27, \u27sometimes foods\u27, \u27junk\u27: A qualitative study exploring \u27extra foods\u27 with parents of young children

Objective The present study investigated parents\u27 understanding and approaches to providing energy-dense and nutrient-poor \u27extra foods\u27 to pre-school children and explored variation between parents of low and high socio-economic status in relation to these issues. Design We conducted thirteen focus groups. Data were subject to framework analysis. Setting Child-care centres in distinctly socially disadvantaged and socially advantaged areas. Subjects Eighty-eight parents of children aged 3-5 years. Results The three most common terms parents identified to describe foods that are not \u27everyday foods\u27 were \u27treats\u27, \u27sometimes foods\u27 and \u27junk\u27. Parents\u27 perceptions regarding what influences them in providing food to their children included seven sub-themes: (i) the influence of the child; (ii) food-related parenting practices; (iii) health considerations; (iv) food costs and convenience; (v) external factors perceived as influencing their child; (vi) factors related to child care; and (vii) social influences and occasions. Parents\u27 decision-making processes regarding provision of \u27extra foods\u27 related to moderation and balance. Parents generally expressed the position that as long as a child is eating healthy foods, then treats are appropriate; and for many parents, this might apply frequently. All groups described the health of their child as an influence, but parents in low socio-economic groups were more likely to describe immediate concerns (dental health, behaviour) in relation to avoiding sugar-dense food or drink. Conclusions The belief that provision of \u27extra foods\u27 can be frequent as long as children are eating a healthy balance of foods is factored into parents\u27 decision making. Challenging this belief may be important for reducing the consumption of \u27extra foods\u27 by young children

Parents' views on food study: Feedback to participating centres

The Parents’ Views on Food Study aimed to explore parents’ understanding and approaches to giving ‘extra’ foods to their 3-5 year old children. This study was conducted to gain insights into the views of parents’ with children attending pre-school and long day care in NSW on the topic of energy-dense and nutrient-poor ‘extra foods’. This report was created as feedback to the 13 early centre-based child care services that took part in the study during October 2009. Therefore, it summarises the study and focuses on providing practical information in relation to the issues parents raised

Young Adults’ Use of Mobile Food Delivery Apps and the Potential Impacts on Diet During the COVID-19 Pandemic: Mixed Methods Study

BackgroundA poor diet contributes substantially to the development of noncommunicable diseases. In Singapore, it is recommended to consume at least 2 servings of fruits and vegetables daily to reduce the risk of developing noncommunicable diseases. However, the adherence rate among young adults is low. The COVID-19 pandemic has led to frequent users of mobile food delivery apps (MFDAs) adopting unhealthy eating habits, including high consumption of sugar-sweetened beverages, making it crucial to gain a deeper understanding of the underlying factors driving their use patterns. ObjectiveWe aimed to examine the use patterns of MFDAs among young adults during the COVID-19 pandemic; investigate the association between MFDA use and sociodemographic factors, dietary factors, and BMI; identify the underlying reasons for the observed use patterns of MFDAs among users; and compare the influences of MFDA use between frequent and infrequent users. MethodsA sequential mixed methods design was used involving a web-based survey and in-depth interviews with a subset of respondents. Poisson regression and thematic analysis were used to analyze the quantitative and qualitative data, respectively. ResultsThe quantitative results revealed that 41.7% (150/360) of participants reported using MFDAs frequently, defined as at least once a week. Although not substantial, the study found that frequent users were less likely to consume 2 servings of vegetables per day and more likely to drink sugar-sweetened beverages. Nineteen individuals who had participated in the quantitative component were selected for and completed the interviews. Qualitative analysis identified 4 primary themes: deliberations about other sources of meals versus meals purchased via MFDAs, convenience is vital, preference for unhealthy meals ordered from MFDAs most of the time, and cost is king. Before making any purchase, MFDA users consider all these themes at the same time, with cost being the most important influential factor. A conceptual framework based on these themes was presented. Lack of culinary skills and COVID-19 restrictions were also found to influence frequent use. ConclusionsThis study suggests that interventions should focus on promoting healthy dietary patterns in young adults who frequently use MFDAs. Teaching cooking skills, especially among young male individuals, and time management skills could be useful to reduce reliance on MFDAs. This study highlights the need for public health policies that make healthy food options more affordable and accessible. Given the unintended changes in behavior during the pandemic, such as reduced physical activity, sedentary behavior, and altered eating patterns, it is essential to consider behavior change in interventions aimed at promoting healthy lifestyles among young adults who frequently use MFDAs. Further research is needed to evaluate the effectiveness of interventions during COVID-19 restrictions and assess the impact of the post–COVID-19 new normal on dietary patterns and physical activity levels

Measuring Workplace Travel Behaviour: Validity and Reliability of Survey Questions

Background. The purpose of this study was to assess the (previously untested) reliability and validity of survey questions commonly used to assess travel mode and travel time. Methods. Sixty-five respondents from a staff survey of travel behaviour conducted in a south-western Sydney hospital agreed to complete a travel diary for a week, wear an accelerometer over the same period, and twice complete an online travel survey an average of 21 days apart. The agreement in travel modes between the self-reported online survey and travel diary was examined with the kappa statistic. Spearman’s correlation coefficient was used to examine agreement of travel time from home to workplace measured between the self-reported online survey and four-day travel diary. Moderate-to-vigorous physical activity (MVPA) time of active and nonactive travellers was compared by t-test. Results. There was substantial agreement between travel modes (K=0.62, P<0.0001) and a moderate correlation for travel time (ρ=0.75, P<0.0001) reported in the travel diary and online survey. There was a high level of agreement for travel mode (K=0.82, P<0.0001) and travel time (ρ=0.83, P<0.0001) between the two travel surveys. Accelerometer data indicated that for active travellers, 16% of the journey-to-work time is MVPA, compared with 6% for car drivers. Active travellers were significantly more active across the whole workday. Conclusions. The survey question “How did you travel to work this week? If you used more than one transport mode specify the one you used for the longest (distance) portion of your journey” is reliable over 21 days and agrees well with a travel diary

Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods approach

BMJ Open1041-12United Kingdo

Understanding and Influencing Occupational Sedentary Behavior: A Mixed-Methods Approach in a Multiethnic Asian Population

10.1177/1090198119885431Health Education & Behavior109019811988543-10901981198854

Effectiveness of prescribing physical activity in parks to improve health and wellbeing - the park prescription randomized controlled trial

10.1186/s12966-020-00941-8International Journal of Behavioral Nutrition and Physical Activity17

Activity in nature mediates a park prescription intervention's effects on physical activity, park use and quality of life: a mixed-methods process evaluation.

10.1186/s12889-021-10177-1BMC Public Health211204