Assessing community readiness for overweight and obesity prevention in pre-adolescent girls:a case study

BACKGROUND: Childhood overweight and obesity is a global public health concern. For girls in particular, being overweight or obese during pre-adolescence (aged 7–11 years) has intergenerational implications for both the mother and her future offspring. In the United Kingdom (UK) there is increasing interest in community targeted interventions but less is known about how to tailor these approaches to the needs of the community. This study applied the Community Readiness Model (CRM), for the first time in the UK, to demonstrate its applicability in designing tailored interventions. METHODS: Community readiness assessment was conducted using semi-structured key informant interviews. The community’s key informants were identified through focus groups with pre-adolescent girls. The interviews addressed the community’s efforts; community knowledge of the efforts; leadership; community climate; community knowledge of the issue and resources available to support the issue. Interviews were conducted until the point of theoretical saturation and questions were asked separately regarding physical activity (PA) and healthy eating and drinking (HED) behaviours. The interviews were transcribed verbatim and were firstly analysed thematically and then scored using the assessment guidelines produced by the CRM authors. RESULTS: Readiness in this community was higher for PA than for HED behaviours. The lowest scores related to the community’s ’resources’ and the ’community knowledge of the issue’; affirming these two issues as the most appropriate initial targets for intervention. In terms of resources, there is also a need for resources to support the development of HED efforts beyond the school. Investment in greater physical education training for primary school teachers was also identified as an intervention priority. To address the community’s knowledge of the issue, raising the awareness of the prevalence of pre-adolescent girls’ health behaviours is a priority at the local community level. Inconsistent school approaches contributed to tensions between schools and parents regarding school food policies. CONCLUSIONS: This study has identified the readiness level within a UK community to address the behaviours related to overweight and obesity prevention in pre-adolescent girls. The focus of an intervention in this community should initially be resources and raising awareness of the issue within the community

How many days of pedometer monitoring predict monthly ambulatory activity in adults?

PURPOSE: To determine how many days of pedometer monitoring are necessary to estimate monthly ambulatory activity in adults. METHODS: 212 adults (64% female, age=38.3±13.3 years, BMI=27.9±5.3 kg/m2) wore a pedometer (SW-200) for 28 consecutive days. 76.4% were randomly allocated to a reliability group while the remainder (n = 50) comprised a confirmation group. Mean step counts calculated over the 28-day period served as the criterion. Using the reliability group, intra-class correlations (ICCs) were computed for the entire 4 week period, for 3, 2 and 1 weeks, and for different combinations of any 6, 5, 4, 3 and 2 days. The reliability of the recommended time frame was tested in the confirmation group using regression analysis. RESULTS: In the reliability group, the ICC for any single given day was 0.41. All combinations including 6 days or more had ICCs above 0.80. The inclusion of participant characteristics into a regression, alongside mean steps reported during 1 week of monitoring, failed to strengthen the prediction. When tested in the confirmation group, there was a significant relationship between mean step counts calculated from the first week of monitoring and the criterion (adjusted R2 =0.91, CONCLUSION: It is recommended that researchers collect pedometer data over a 7-day period for a reliable estimate of monthly activity in adults. A 7-day period is recommended, as opposed to 6 days (where ICCs were >0.80) because: 1) step counts are characteristically lower on a Sunday, thus for a reliable estimate of habitual activity, Sunday activity should always be included, and 2) in the event of missing data (1 day), data collected on six days will remain sufficiently reliable to estimate mean monthly activity

Research with and for Older People at Loughborough University

Our Dementia research is part of Loughborough University Health and Wellbeing (HWB) Global Challenge http://www.lboro.ac.uk/research/excellence/challenges/health-wellbeing/). This strategic approach supports multi-disciplinary research in bringing complex real world solutions to promote health and wellbeing across the life course. Other research priorities within HWB include Planetary Health and Anti-Microbial Resistance. Research with and for older people in Loughborough University is carried out by a number of multi-disciplinary research units/groups with different specialist interests for example: - Dementia research for design, diagnostics and interventions http://www.lboro.ac.uk/research/dementia/ - Centre for Research in Social Policy (http://www.lboro.ac.uk/research/crsp/) - Healthcare Ergonomics & Patient Safety (http://www.lboro.ac.uk/departments/design-school/research/environmentalergonomics/) - Life Long determinants of health and wellbeing (http://www.lboro.ac.uk/departments/ssehs/research/lifestyle-healthwellbeing/life-course-determinants-health-wellbeing/) We describe our research in these five overlapping and closely-related topic areas: (1) New Dynamics of Ageing; (2) Dementia: Diagnosis, Design and Interventions; (3) Getting out and about (Transport ); (4) Working Later; (5) Health, Wellbeing and Safety for Older Peopl

Summer to winter variability in the step counts of normal weight and overweight adults living in the UK

BACKGROUND: This study investigated whether pedometer-determined activity varies between summer and winter in normal-weight and overweight adults. METHODS: Forty-five normal-weight (58% female, age = 39.1 ± 12.4 years, BMI = 22.2 ± 2.1 kg/m2) and 51 overweight (49% female, age = 42.1 ± 12.5 years, BMI = 29.3 ± 4.5 kg/m2) participants completed a within-subject biseasonal pedometer study. All participants completed 2 4-week monitoring periods; 1 period in the summer and 1 period the following winter. Changes in step counts across seasons were calculated and compared for the 2 BMI groups. RESULTS: Both BMI groups reported significant summer to winter reductions in step counts, with the magnitude of change being significantly greater in the normal-weight group (–1737 ± 2201 versus –781 ± 1673 steps/day, P = .02). Winter step counts did not differ significantly between the 2 groups (9250 ± 2845 versus 8974 ± 2709 steps/day, P = .63), whereas the normal-weight group reported a significantly higher mean daily step count in the summer (10986 ± 2858 versus 9755 ± 2874 steps/day, P = .04). CONCLUSION: Both normal-weight and overweight individuals experienced a reduction in step counts between summer and winter; however, normal-weight individuals appear more susceptible to winter decreases in ambulatory activity, with the greatest seasonal change occurring on Sundays. Effective physical activity policies should be seasonally tailored to provide opportunities to encourage individuals to be more active during the winter, particularly on weekends

A critical discussion of the Community Readiness Model using a case study of childhood obesity prevention in England

Recent reforms to the public health system in England aim to generate co-ordinated action between local authorities, healthcare systems and communities to target local health priorities. To support this effort, researchers must contribute and evaluate appropriate strategies for designing interventions tailored to community-specific needs. One strategy is to apply the Community Readiness Model (CRM), which uses key informant interviews to assess a community's readiness to address local issues. This article presents a critical discussion of the CRM developed from a case study of obesity prevention in pre-adolescent girls within a community in the United Kingdom. Data were collected between February and November 2011. We offer lessons learnt and recommendations relating to (i) modifications to the interview guide; (ii) key informant identification; (iii) conducting interviews to theoretical saturation; (iv) using key informants to define their community; (v) key informant's ability to respond on behalf of the community; (vi) using a qualitative model with a quantitative scoring system; and (vii) the optimum application of transcript scoring. In conclusion, the CRM can help researchers, health professionals and local authorities identify the priorities of a community. It is recommended that users of the model be careful to identify and recruit suitable key informants with the help of the community under study, select an appropriate ‘community’ and utilise the qualitative findings to strengthen the interpretation of the readiness score

UK adults exhibit higher step counts in summer compared to winter months

Background: Seasonal differences in step counts have been observed in a limited number of studies conducted on US adults. Due to the diverse global climate, assessment and interpretation of seasonal patterns in ambulatory activity may vary between countries, and regionally specific studies are necessary to understand global patterns. Currently, no studies have assessed whether a seasonal trend is present when ambulatory activity is measured objectively in adults living in the UK. Aim: To investigate whether pedometer-determined step counts of adults living in the UK vary between summer and winter. Subjects and methods: Ninety-six adults (52% male, age = 41.0 ± 12.3 years, BMI = 26.1 ± 5.1 kg/m2) completed a within-subject bi-seasonal pedometer study. All participants completed two four-week monitoring periods; one during the summer and one the following winter. The same Yamax SW-200 pedometer was worn throughout waking hours during both seasons, and daily step counts were recorded in an activity log. Intra-individual seasonal changes in mean daily steps were analysed using a paired samples t-test. Results: Summer mean daily step counts (10417 ± 3055 steps/day) were significantly higher than those reported during the winter (9132 ± 2841 steps/day) (p < 0.001). A follow-up study conducted the subsequent summer in a sub-sample (n = 28) reinforced this trend. Summer step counts were significantly higher than winter step counts on all days of the week (p ≤ 0.001). A significant day of the week effect was present in both seasons, with step counts reported on a Sunday being on average 1,500 steps/day lower than those reported Monday through to Saturday. Conclusion: Step counts in the sample of UK adults surveyed decreased significantly in the winter compared to the summer, suggesting future pedometer surveillance studies should capture step counts throughout the year for a non-biased reflection of habitual ambulatory activity. Public health initiatives should target these seasonal differences and opportunities should be provided which encourage individuals to increase their activity levels during the colder, darker months of the year