bluuebunny/crossref_metadata_2025 huggingface dataset:
37 Developing a practical tool for reaching consensus about shared outcome measurement in cross-sector health-enhancing physical activity partnerships
Authors: Kolovou Vasiliki , Crone Diane , Bolton Nicola
Published: September 2024

Purpose

To identify specific needs, priorities, and challenges to cross-sector partnerships, and to develop a practical tool for consensus-building on shared outcomes.

Methods

This work included a desk-based collation of case studies (cross-sector partnerships) and a Delphi study to seek input on the tool’s design, functionality, and usability. During Round 1, a survey was launched in the HEPA conference 2023 and conference participants were invited to complete a qualitative online survey, to define key terms and definitions across sectors, and for recommending desirable partnership outcomes. Open-ended questions were used to encourage diverse perspectives and a wider range of opinions. Inductive content analysis will be used to identify and inform the development of statements for Round 2. A stakeholder workshop may be planned to engage participants and a wider audience for using and refining the partnership tool.

Results

Case studies (N = 19) were identified as promoting or increasing physical activity and being driven by cross-sector partnership working. The relationships between the partners were reviewed and the process of developing and agreeing shared outcomes was collated to inform the Delphi study. Findings from the Delphi will be presented once it is completed but are anticipated to reflect the strength of agreement across the Delphi participants (N = 18, Round 1). Both case studies and Delphi surveys will lead to a partnership tool being developed to be used by real-world practitioners to develop shared partnership outcomes.

Conclusion

This study is unique in its scope and aims to develop a practical tool for guiding cross-sector partners in agreeing shared outcomes that recognise impact in the whole system. Widening criteria for success in cross-sector partnerships promotes inclusivity for stakeholders, recognises the complexity in changing health behaviours and a whole systems approach to resolving physical inactivity. Establishing a shared measurement of success in partnerships can promote diverse organisations and stakeholders to contribute to tackling physical inactivity, in line with the WHO’s Global Action Plan for Physical Activity.

Support/Funding source

This project was supported by the WHO Europe office for Noncommunicable diseases, as part of the lead investigator’s, Vasiliki Kolovou’s, participation in the HEPA Early Career Development Programme.
30 Dynapenia and risk factors in Immune-Mediated Rheumatic Diseases: A Systematic Review
Authors: Santo Rafaela Espírito , Melo Geiziane , Agostinis-Sobrinho Cesar
Published: September 2024

Dynapenia, the age-related decline in muscle strength, poses significant challenges to the quality of life, autonomy, and health of individuals, becoming a major public health concern. Immune-Mediated Rheumatic Diseases (IMRDs) patients often experience dynapenia, regardless of age. Therefore, our aims were to assess the association between changes in muscle strength and changes in clinical features in IMRDs. Additionally, to evaluate risk factors for adverse health outcomes in IMRDs. A systematic review of longitudinal studies published in English was conducted using PubMed, Embase, Web of Science and Scopus to November 2023. Search strategies were based on pre-defined keywords and medical subject headings. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale. Of 11.692 potential studies (5138 duplicate publication) screened for inclusion in the study, twenty-one were included. Of these 21 studies included, one study was with systematic sclerosis (Ss) patients, two studies were with systemic erythematosus lupus (SLE) patients and eighteen studies were with rheumatoid arthritis (RA) patients. The decrease in muscle strength was associated with worsening clinical features over time in both SLE and RA patients. Lastly, low muscle strength was linked to multiple falls and reduced 5-year survival in RA patients. Therefore, changes in muscle strength are associated with changes in clinical features over time, and low muscle strength is linked to adverse health outcomes. The study emphasizes the importance of targeted exercise interventions aimed at improving muscle strength to mitigate adverse health outcomes and enhance clinical features in IMRDs patients.
116 Expert Agreement on definitions for compensatory protective step strategies: Delphi method study
Authors: Melo-Alonso Maria , Murillo-Garcia Alvaro , Padilla-Moledo Carmen , Villafaina Santos , Carmen Gomez-Alvaro Maria , Morcillo-Parras Felipe Alejandro , Leon-Llamas Juan Luis , Gusi Narcis
Published: September 2024

Purpose

The older adults have a high probability of suffering an unexpected fall during activities of daily living, this can generate fear of fall, changes in gait patterns, decreased mobility, reduced social contact and impaired ability to perform different activities. Previous studies of gait in the presence of a perturbance identified and analyzed several protective gait strategies to prevent a fall. But there was a lack of common wording and definitions for the same strategy that limits the comparison and scientific synergic advance among researchers and professionals.

Objective

to elaborate and clarify the definitions of compensatory protective step strategies to create a single common terminology to be used by all related-professionals (e.g., physical educators, physiotherapists, occupational therapists, doctors and researchers).

Methods

the study followed the Conducting and Reporting of Delphi Studies guideline (CREDES) and a chronological order 1) review of the literature (scoping review), 2) step-by-step creating a quantitative questionnaire (Likert-type scale from 1 to 5) and qualitative assessment of degree the pertinence, wording and identification of each of the definitions (items=14), 3) same number of experts selection from different professional backgrounds (N = 14), 4) Aike's V coefficient was used to determine content validity.

Results

showed demanding levels of validity (V ≥ 0.68) and none of the strategy definitions were eliminated, all of them passed Aiken’s V critical value. Conclusion: the definitions of 14 compensatory protective step strategies (13 strategies mentioned in the scoping review and one added by the panel of experts) have been elaborated and clarified. The limb collisions were not included by the consensus of the panel of experts because it was considered as an isolated action and information about its protective function is lacking. These identifications could be used as innovative specific targets to include in health enhancing physical activity programs

Funding

The Spanish National R + D + i Plan co-funded by the Spanish Ministry of Sciences and Innovation (reference PID2019-107191RB I00/AEI/10.13039/501100011033). The author J.L.L.-L. was supported by a grant from the Spanish Ministry of Education, Culture and Sport (FPU18/05655).
98 Health care practitioners’ knowledge, use and confidence of PA guidelines and tools during pregnancy on the island of Ireland: a protocol and preliminary data
Authors: Deery Elizabeth , Faulkner Maria , Currie Sinead , Fitzpatrick Ben
Published: September 2024

Purpose

Regular physical activity (PA) during pregnancy is associated with benefits to maternal and foetal health, and the World Health Organisation recommend 150 minutes of weekly PA during pregnancy. Despite this, PA participation often decreases during pregnancy, and this may negatively impact mother-child PA participation later in life. Healthcare practitioners (HCPs) are considered well-placed to deliver health-behaviour messaging; however, little is known about the delivery of this in a maternity context. This study therefore aims to evaluate the delivery of PA guidance by HCPs during pregnancy, their knowledge of PA guidelines and resources, and their confidence in implementing these, across the island of Ireland.

Methods

Ethical approval will be sought from Ulster University research ethics committee. From June to September 2024, participants, who will be HCP involved in maternity care on the island of Ireland, will be invited to take part in an anonymous, online survey. Invitations will be circulated via professional bodies, networks, social media, and snowball sampling. The survey, which will be developed in conjunction with an expert advisory panel, will assess HCP knowledge, confidence, and delivery of PA guidelines and tools during pregnancy, and assess training received on PA guidance and PA tools during pregnancy. Statistical analysis will include independent t-tests, chi-squared, Pearson correlation, frequencies, and descriptive data. Content analysis will be used to analyse data produced from open-ended questions.

Results

Preliminary findings will include participant demographics and descriptive data regarding the knowledge, confidence, training in and prevalence of delivering PA guidance and PA tools during pregnancy. Statistical analysis will be subject to sample-size achievement at this preliminary stage.

Conclusions

The findings from this study have the potential to identify gaps in the knowledge and confidence of HCP delivering PA guidance during pregnancy. This will add knowledge to the extant literature and can provide a foundation to inform interventions and strategies aimed at enhancing the delivery of evidence-based practice regarding PA during pregnancy. This would have the potential to improve the quality of prenatal care, promote maternal and fetal health, and enhance health promoting health-enhancing PA in the prenatal population.

Funding Source

No funding to declare.
141 Implementation of exercise program after multidisciplinary treatment of chronic widespread musculoskeletal pain in the primary healthcare – study protocol
Authors: Pustivšek Suzana , Dakskobler Maja , Furlan Andraž
Published: September 2024

Purpose

Chronic musculoskeletal pain (CMS) is affecting approximately one third of the adult population. There is a lack of evidence in the literature for multicomponent exercise programmes for patients with CMS pain and adherence to these programmes is rarely reported. The main research question is: Does the supervised, individualised, patient-centered exercise programme implemented following a multidisciplinary programme for the treatment of CMS pain have an additional impact on patients’ perceptions of their own health and well-being and adherence to physical activity?

Methods

The study is a cohort study; the estimated sample size is 140 subjects. Participants will receive 16 supervised sessions. The first and last session will be individual, the other 14 will be group sessions with 8 participants led by a kinesiologist. Each session is divided in two parts: First includes warm-up and functional exercises, second includes breath-centered yoga practice with deep relaxation. Both, functional exercises and yoga practice will be graded through the sessions, with particular attention paid to the individualization of the participants. Outcome assessments will occur at baseline (1st session), end of intervention (16th session) and 8 weeks after the intervention. The main parameters will be patients’ perception of their own health and well-being (SF – 12 questionnaire), exercise adherence (ATEMPT questionnaire), physical fitness (senior fitness test battery) and pain level (numerical rating scale). Pre-specified analyses will evaluate the main effects of the treatment by comparing pre, post and follow-up results.

Results

The study will start in April 2024, with first preliminary results expected by the end of the year.

Conclusion

This research will use a novel approach to treating CMS pain, as a programme combining graded functional exercises and breath-centered yoga practice will be an extension of multidisciplinary CMS pain management. If the programme shows significant benefits for users, it can be used as a maintenance programme for an active lifestyle for people with CMS pain. In this way, the burden of CMS pain on the healthcare sector can be reduced.

Fundings

The project “Upgrading treatment of musculoskeletal pain at the primary level” is being implemented within the framework of the Recovery and Resilience Plan.
109 Optimising Community-Based Physical Activity for Chronic Condition Management in Ireland: A Comprehensive Systems Analysis guided by RE-AIM
Authors: O’Connor Rachael , McGrath Aisling , Lodge Clare , Murphy Niamh
Published: September 2024

Purpose

The prevalence of chronic conditions (CC) is rising rapidly and coupled with an aging demographic, poses a significant threat to the well-being of populations and overburdened healthcare systems. The negative impact of CC on physical, mental, and social well-being requires innovative approaches to combat decline in quality of life (QOL). The concept of “exercise as medicine” demonstrates the value of physical activity (PA) in treating CCs. Community-based PA initiatives are accessible solutions to improve QOL and prevent disease progression in CC populations, yet contextual factors impacting implementation are not widely understood. Therefore, as part of a broader study, this research will provide a comprehensive qualitative systems analysis of community-based PA interventions for populations with CC in Ireland.

Methods

This study will employ a qualitative data approach guided by systems approaches and implementation science. Following a desk-based review, semi-structured interviews guided by the RE-AIM framework will be conducted with multiple stakeholders to inform a comprehensive understanding of the landscape (intricacies and contextual factors) of community-based PA for populations with CC. Purposive and snowball sampling will recruit diverse stakeholders (providers, referrers, policymakers, funders) across sites. A hybrid coding approach of inductive and deductive coding guided by implementation science frameworks will be used for analysis of qualitative data.

Results

This study aims to understand the key components and interconnections within the current system of community-based PA for CC in Ireland. This study will provide insights into barriers and facilitators influencing effectiveness and sustainability of community-based PA initiatives and aid in identifying implementation strategies to enhance the pathway of care into such initiatives for individuals with CC in Ireland.

Conclusions

To ensure effective implementation of community-based PA programmes, a clear understanding of the overall landscape, relationships, interdependencies is required. Implications of this study will inform the broader project through identifying barriers influencing effective implementation of community-based programmes. This process will contribute to identifying a suitable delivery model for these programmes, leading to scale-up of facilities, enhancing QOL of individuals.

Funding source

Funded by SETU Co-fund programme and Carlow Sports Partnership.
102 Parous women perform less moderate to vigorous physical activity than their nulliparous peers: a population-based study in Denmark
Authors: Bueno Solvej Videbæk , Nielsen Rasmus Oestergaard , Kallestrup Per , Ryom Knud , Morgan Kelly , Elsborg Peter , Petersen Christina Bjørk , Jacobsen Julie Sandell
Published: September 2024

Purpose

The World Health Organisation (WHO) highlights parous women as a key population for monitoring trends of physical activity (PA). We aimed to estimate the proportion of Danish women non-adhering to WHO PA guidelines in parous women compared with nulliparous women, and to describe leisure-time PA intensity in each of these groups.

Methods

This population-based study builds on a sample of 27,668 women aged 16-40 years from the Danish National Health Survey 2021. These data were linked with childbirth data from the Danish National Birth Registry. The primary outcome was self-reported weekly hours of moderate to vigorous leisure-time PA (MVPA) dichotomized into: (i) Adhering to WHO guidelines for MVPA, or (ii) Not adhering to WHO guidelines for MVPA. Binomial regression analysis was used to calculate prevalence proportions (PP) and prevalence proportion ratios (PPR).

Results

Of the 27,668 women, a total of 20,022 were included; 9,338 (46.6%) parous women and 10,684 (53.4%) nulliparous women. The PP of women non-adhering to WHO PA guidelines was 63.8% (95% CI 62.9-64.8) for parous and 51.3% (95% CI 50.4-52.3) for nulliparous women, corresponding to a PPR of 1.24 (95% CI 1.21;1.27).

Conclusions

The proportion of parous women who did not adhere to WHO PA guidelines for MVPA was 24% higher than that of nulliparous women. This highlights parous women as a subgroup of the adult population at increased risk of non-adherence to WHO PA guidelines. These findings call for future research to inform new strategies aiming to promote PA in parous women.

Support/Funding

This work was supported by the Health Foundation (20-B-0260).
225 Perceptions of Physical Activity and Structured Exercise in South Carolinian Adult Native Americans
Authors: Cavallini Maria Felicia , Dyck David J
Published: September 2024

Due to the current developments of obesity, diabetes, cardiovascular diseases, alcoholism, hypertension and high suicide rates, the overall health of Indigenous citizens is of considerable concern. Physical activity (PA) plays a key role in overall health and well-being. However, appropriate strategies for PA connection, preferences, motivation, and promotion levels for Natives is lacking and in dire need. The purpose of this study is to examine the adult relationship with PA as well as to investigate the perceived influence of PA not only on physical health but mental, emotional, social, and psychological health among adult Native Americans in South Carolina. Fifteen key informant interviews were conducted with diverse adult Native Americans including four Chiefs. Questions pertaining to beliefs, outlook, preferences, attitude, barriers, gym perception, and motivators towards lifestyle PA versus structured exercise were explored and discussed, as well as PA’s relationship to overall wellness. Qualitative methods with phenomenological underpinnings were used. Using the note transcriptions from the non-taped interviews, we concluded lifestyle physical activity (LPA) was overwhelmingly preferred over structured exercise. Natives found LPA to be an essential part of their culture and way of life. In addition to signifying that the U.S. PA guidelines could be met through LPA, the Native American participants indicated that lack of time was their number one barrier (whether real or psychological), and that being outdoors and engaging in LPA was preferred over the gym environment. Health and feeling good, and being happier afterwards were the main motivators to engaging in LPA. Furthermore, South Carolinian Natives felt that regular participation in LPA would positively affect and directly improve mental, emotional, social, and psychological health. A second more quantitative phase (questionnaire) will follow, with a recruitment of as many Native Americans from South Carlina as possible i.e. 300+. Ultimately, the goal is to develop new and innovative culturally based PA intervention strategies and customized programs for the Native American community through a heritage, health, and cultural center to address the PA and wellness needs of Indigenous people while promoting Native need for community involvement, a wholistic approach to life, and connection to land and the environment.
47 Physical activity, sedentary behavior, and sleep across lifespan in adults across European countries: Background and Design
Authors: Shiran Roksana , Nigg Claudio R
Published: September 2024

Introduction

Regular physical activity (PA) has benefits for health throughout the lifespan. In adults, PA benefits musculoskeletal, cardiometabolic health, and overall well-being (Dale et al., 2019). To promote health and well-being, the World Health Organization (WHO) recommends at least 150 minutes of moderate to vigorous (MV)PA or 75 min of vigorous-intensity PA (Bull et al., 2020). However, about 40 – 60% of the EU adults population is leading a predominantly sedentary lifestyle (Nikitara et al., 2021).

Sedentary behavior (SB) includes activities such as watching television, playing computer games, and browsing the Internet (Wang et al., 2019). High levels of SB have been associated with decline of PA which, in turn, is associated with negative health outcomes, including obesity. Furthermore, there has been a growing focus on exploring the relationship between SB and sleep duration. This relation between SB and sleep duration is noteworthy, especially when considering that sleep duration guidelines recommend 7-9 hours of sleep for adults in the EU. In 2018, a systematic review synthesized findings from 56 studies that employed iso-temporal substitution models in PA, SB and sleep. Research has shown that changes in the time spent on these movement-related behaviors that make up a 24-h day can interact to influence health outcomes (Trembley et al., 2016). However, to -date, there are no specific recommendations on SB, and sleep is often not included. Therefore, this project will present the background, methods and design of a 24 hour movement summary of behaviors (PA, SB, sleep) for Europe.

Methods

Utilizing a cross-sectional design we will analyze existing data for PA, SB, and sleep from the Eurostat Organization on European adults 18 to 65+. Descriptive analysis using mean, median, and 95% Confidence Intervals, will be complemented by frequency distributions and histograms.

Results

The findings from this research have the potential to inform surveillance efforts, public health strategies, evidence-based guidelines, and possibly improve overall well-being.

Conclusion

Implications of this research may inform researchers on further questions to pursue, policy makers in resource allocation, and practitioners on where to focus intervention efforts.
90 The association between risk of depression and combined vigorous physical activity and screen time behaviours in French-speaking Belgian adolescents
Authors: Assakali Wassila , Castetbon Katia , Eggen Morgane , Holmberg Emma , Mertens Caroline
Published: September 2024

Purpose

While there is a clear consensus on the positive effect of physical activity on reducing the risk of depression, the literature on the association between screen time and risk of depression is rather conflicting. Also, no clear consensus has been reached on whether being sufficiently active could alleviate the negative effects of being sedentary on mental health. The purpose of this study was to investigate the association of combined vigorous physical activity (VPA) and screen time (ST) behaviours with the risk of depression (RD) in Belgian adolescents.

Methods

The analysis used data collected through self-reported questionnaires from 8412 adolescents aged 10 to 20 included in the 2022 “Health Behaviour in School-aged Children” (HBSC) study in French-speaking schools. RD was measured using the World Health Organisation Five Well-being Index (WHO-5), with scores ≤28/100 indicating RD. VPA and ST behaviours were identified by combining data on ST (TV, video games and internet use) and VPA in three categories: (1) low ST (total weekly ST < 4hours/day), independently of VPA; (2) high VPA-high ST (VPA≥3 times/week and total weekly ST ≥ 4hours/day) and (3) low VPA-high ST (VPA<3 times/week and total weekly ST ≥ 4hours/day). The association between RD and VPA-ST behaviours was measured using adjusted binary logistic regression.

Results

In 2022, 15.4% had low ST, 40.6% high VPA-high ST, and 44.0% low VPA-high ST behaviours. Moreover, 13.2% were at risk of depression. This prevalence was eight times higher in low VPA-high ST (62.9%) and four times higher in high VPA-high ST (29.5%) than in low ST (7.6%) adolescents. After adjusting for sociodemographic characteristics, body mass index and sleep duration, adolescents with low VPA-high ST behaviours were more likely to be at risk of depression (aOR=1.17, 95%CI: 1.31-2.35) compared to those with low ST, but this was not the case for those who had high VPA-high ST (aOR=1.18, 95%CI: 0.81-1.71).

Conclusion

These findings suggest that having either low ST or sufficient VPA may be protective for RD in adolescents. With ST increasing and PA remaining low in French-speaking Belgian adolescents, health promotion initiatives should continue to promote both PA and the reduction of sedentary behaviours in adolescents.
172 The Effects of Antenatal Behaviour-Change Lifestyle Interventions on Improving Maternal and Foetal Health Outcomes: A Systematic Review and Meta-Analysis Protocol
Authors: O’Keeffe Abbey , Deery Elizabeth , Currie Sinéad , McMonagle Gemma , Faulkner Maria
Published: September 2024

Purpose

The purpose of this systematic review is to examine the effects of antenatal behaviour-change lifestyle interventions that focus on physical activity (PA) and evidence-based nutritional practices (NP) to improve maternal and foetal outcomes, and pregnant individuals’ adherence to lifestyle interventions.

Methods

The following databases will be searched from their inception using a detailed search strategy, MEDLINE; CINAHL; PsycINFO; Embase; AMED; WHOLiS, Web of Science; ScieLo and ASSIA. A Population, Intervention, Comparator, Outcome and Study-Design framework will guide the selection process. The review will be restricted to Randomised Controlled Trials that compared the effects of nonpharmacological, antenatal behaviour-change PA and NP lifestyle interventions. The review will utilise the FITT (Frequency, Intensity, Time/Duration and Type) principle of PA and an adapted-NP classification table to categorise interventions. Interventions will be evaluated using the ‘Framework for Developing and Evaluating Complex Interventions’.

Primary outcomes will include maternal and foetal health outcomes, including: maternal mental health-status; gestational weight-gain; gestational diabetes mellitus diagnosis; mode of delivery; birthweight; gestational age and perinatal mortality. Secondary outcomes will include adherence to interventions. Authors will independently screen titles, abstracts, and full-text articles according to inclusion/exclusion criteria. A standardised data extraction tool will be developed based on the Cochrane Handbook of Systematic Reviews of Interventions. The Cochrane Collaboration’s Risk of Bias Assessment tool will assess methodological quality of studies and GRADEpro criteria will evaluate the quality of the evidence.

Results

Meta-analysis will be employed to synthesise the results on the effects of the interventions on maternal and foetal outcomes. Primary outcomes will be pooled using a random-effects model. Subgroup analyses will explore variations across participant characteristics or intervention types. Sensitivity analyses will assess the impact of missing data. Heterogeneity among studies will be assessed quantitatively using statistical tests and the I2 statistic, with planned exploration of potential sources of heterogeneity through subgroup analyses, followed by meta-regression.

Conclusions

This review will synthesise available evidence on the effectiveness of antenatal behaviour-change lifestyle interventions to provide valuable information for clinicians and health policymakers to improve policy and practice.

Support/Funding Source

Atlantic Technological University, Donegal Research Bursaries and The Health Research Board’s SPHeRE PhD Programme.
S02 Exploring equity and social inclusion in national PA policy documents and policy monitoring
Authors: Kahlmeier Sonja
Published: September 2024

Equity and social inclusion are prerequisites for ethical public health services provision. In the field of physical activity promotion, ensuring wide and equitable access to PA infrastructure and services has been recognized as a modality to address social inequities in health.

However, it is still not clear how these desiderates translate in national PA policies.

This symposium aims to cover this gap by presenting aspects related to equity and social inclusion in national and transnational policy documents and policy monitoring and evaluation frameworks.

Systematic literature review, thematic policy documents analysis, stakeholders' consultations and other quantitative and qualitative methods are employed in the four studies presented in the symposium.
S02-1: Improving Physical Activity policies and their impact on health Equity: An overview of the IMPAQT project
Authors: Woods Catherine , Volf Kevin , van Hoye Aurelie , Gelius Peter , Messing Sven , Forberger Sarah , Zukowska Joanna , Okraszewska Romanika , den Braver Nicole , Lakerveld Jeroen , Heuvelman Fleur , Sandu Petru , Messing Sven , Baceviciene Migle , Jankauskiene Rasa
Published: September 2024

Purpose

The growing burden of non-communicable diseases (NCDs) requires effective public policy to change systems instead of individuals and create supportive contexts that reduce NCDs and health inequity. A major determinant of disease reduction is physical activity (PA). Many countries have policies in place, but the implementation of those policies is unknown. This presentation will show how Germany, Ireland, Lithuania, Netherlands, Poland and Romania are collaborating to gather data to benchmark the extent of implementation of their PA policies and their health equity impact.

Methods

An innovative tool, the PA-Environment Policy Index for Equity (PA-EPIQ) will be developed and used to test and promote policy benchmarking as a tool to improve policy implementation in six countries. This will involve mixed methods including evidence synthesis, document analysis and case reports to ‘evidence ground’ countries’ policy implementation status in relevant domains, e.g. health, sport, education, transport. Quantitative and qualitative evidence validation with policymakers will ensure the comprehensive representation of government action. While engagement with stakeholders – both experts and citizens – from each country will independently assess the evidence on their governments’ action, comparing it to international best practice.

Results

IMPAQT will generate six country-specific policy index scores, which will be translated into report cards containing critical implementation gaps and policy recommendations for each country. It will also bring the individual country reports together and create a unified report for citizens, scientific communities, and policymakers.

Conclusions

IMPAQT is based on scientific research as well as the involvement of policymakers, experts and citizens through a co-production approach in 6 EU countries. Transnational comparisons will provide international benchmarks to support policymakers in enhancing health equity in PA policy development.

Support/Funding Source

ERA4Health, GA N° 101095426 of the EU Horizon Europe Research and Innovation Programme
S04-2: Government-driven physical activity policy monitoring across 27 countries: The EU HEPA Monitoring Framework
Authors: Wendel-Vos Wanda
Published: September 2024

Purpose

National policy action is essential to increase population-level physical activity. To support these activities, the European Commission published Physical Activity Guidelines in 2008. In 2013, a Recommendation by the Council of the EU endorsed their implementation across Member States and called on governments to monitor their progress using a joint framework.

Methods

The Council Recommendation established 23 indicators based on the categories of the EU Physical Activity Guidelines. A survey tool was developed with support from WHO Europe, accompanied by a Staff Working Document with background information and detailed instructions. An EU Physical Activity Focal Points Network was established in 2014 to support governments and ensure harmonized data collection across countries.

Results

Supported by the European Commission and WHO Europe, EU Member States have conducted three rounds of data collection for the Monitoring Framework since 2015, with a fourth round in 2024. Results were published in summary documents and individual Country Factsheets in 2015, 2018 and 2021, as well as thematic factsheets and scientific publications. In a 2020 survey, a broad majority of Focal Points stated that the information was useful for national policy development, e.g. to gain insights from other countries, to communicate with national policymakers, and to exchange with other sectors.

Conclusions

With 23 indicators for 27 countries, the EU HEPA Monitoring Framework is arguably the most comprehensive dataset currently available comparing national physical activity policy in a harmonized way. It is also one of the few examples for government-driven physical activity policy monitoring. The framework has proven to be an important tool for policy development in the EU and inspired data collection in several other countries. Future challenges include further developing the Framework to account for global challenges like climate change and for glass ceiling effects as national physical activity policies continue to evolve.

Support/Funding Source

Data are collected by EU Member States. The WHO Regional Office for Europe provides support for data collection and analysis as via grant from the European Commission.
S04-3: Reflexive feedback on the use of a local health-enhancing policy audit tool: the CAPLA-santé
Authors: Racine Antoine Noël , Van Hoye Aurélie , Vuillemin Anne
Published: September 2024

Purpose

The implementation of effective intersectoral policies is a key issue in developing an upstream approach to the promotion of health-enhancing physical activity (HEPA). In the last few years, comprehensive frameworks and tools for the analysis of HEPA policies have been developed. In 2018, a local policy audit analysis tool “CAPLA-Santé” was developed by the French Public Health Society with a research team and policy makers from different sectors. Since then, this tool has been used for practical and research purposes. The aim of this project is to collect and analyze feedback on the use of CAPLA-Santé from policy-makers.

Methods

This project involves the capitalization of the experience of CAPLA-Santé users in order to analyze their experiential knowledge in practical application. The users were contacted from the database of the French Public Health Society, which manages the tool. All known users were contacted and invited to take part in an interview. General information about the type of user and the context of use of the tool were collected, and participants were asked to give their reflective feedback on their experience of using the tool.

Results

Elected officials (n = 4) and department heads (n = 4) from two mid-sized French municipalities (n = 2) were interviewed to provide reflective feedback on their experience using CAPLA-Santé. According to the department heads, the tool was useful in promoting discussion and collaboration among different sectors, particularly in achieving better alignment of policies to reach a common goal or shared population target. According to elected officials, CAPLA-Santé was particularly useful for taking stock and formulating a more comprehensive and coherent policy, especially in preparation of a new political mandate. However, the use of the tool required expertise and was seen as time-consuming, which could be a barrier for its use among other municipalities.

Conclusions

A reflexive analysis of the use of the CAPLA-Santé tool, based on the experiences of policy makers and researchers in practice, could help to provide a more comprehensive overview of the needs and perspectives in this field.

Funding Source

No funding
S04-5: Lessons learned from the results of policy audits of multiple local governments
Authors: Takeda Noriko , Oida Yukio , Inoue Shigeru , Miyachi Motohiko
Published: September 2024

Purpose

To promote health-enhancing physical activity (HEPA), it is essential to evaluate physical activity policies not only at the national level but also the local level. We have conducted research on physical activity policies in multiple local governments across Japan.

Methods

Japan has 47 prefectures and 1,718 municipalities. We first developed a Local Policy Audit Tool (L-PAT) for prefectures, comprising 11 items based on WHO’s HEPA Policy Audit Tool (PAT) that cover key policy areas. We then developed a City PAT (C-PAT) with six questions based on the HEPA PAT. All 47 prefectures were targeted for the L-PAT study, and 272 municipalities were targeted with the C-PAT, randomly selected by municipality size. For both tools, we asked key government departments (e.g. health, sports, urban planning and transport) for their responses.

Results

The response rate to the L-PAT was 71.6%. Results indicate that health and sports are the most active departments in promoting HEPA at a prefecture level. Some prefectures also reported actions by the urban planning and transport departments. The response to the C-PAT was 37.7%. The rate of policy formulation was extremely high in the health and sports departments, with slight variation by population size. By contrast, policy formulation rates were generally low in the urban planning, transport and environment departments, especially in smaller municipalities.

Conclusions

The advantage of the L-PAT and C-PAT is that they can quantitatively assess the status of local government HEPA policies. This allows for comparisons by state, by population size, and between countries. The assessment at the municipal level showed the impact of the size of the municipality. This may help us to provide better support to these local governments from the national government. The next steps could be to revise the questionnaires to increase their usefulness, to consider ways to increase the response rate, and to use them for continuously monitoring local HEPA policies.
S04-6: INTEGRATE-PA-Pol: A Tool for Assessing Cross-Level Collaboration in HEPA Policies
Authors: Resendiz Eugen , Salvo Deborah , Ramírez-Varela Andrea , Mejía-Grueso Juliana , Moon Jane , Pratt Michael , Mitáš Josef , Brownson Ross C
Published: September 2024

Purpose

The Physical Activity Policy at the National and City Levels Project aimed to develop and test a tool to assess how national and subnational (city and region) governments collaborate to develop and implement health-enhancing physical activity (HEPA) policies.

Project Description

The development of the “Interaction between National and Local Government Levels in Development and Implementation of Physical Activity Policies Tool” (INTEGRATE-PA-Pol) took place in three phases: 1) scoping review to identify local government physical activity promotion policies and instruments for assessing them, 2) questionnaires development, and 3) cognitive response testing (validity testing and item modification) with local physical activity experts. The final tool comprises six questionnaires assessing how national and subnational governments (city and region) collaborate to develop and implement HEPA policies. An observational cross-sectional study was conducted in four Latin American countries and eight of their cities to test the feasibility of the tool used for global surveillance. GoPA! Country Contacts from each country were invited to serve as their country’s principal investigators. Country Contacts identified the main sectors, key actors, and policymakers from each sector involved in HEPA policy development and implementation at the national level, the capital city, and an additional city for participant recruitment. Between August 2022 and February 2023, online snowball sampling surveys collected data on national and subnational government informants' perspectives on the development and implementation stages of national and local HEPA policies. The pilot study demonstrated the feasibility of collecting national and subnational HEPA policy data across countries with the active collaboration of GoPA! Country Contacts. We also successfully identified governmental interactions throughout the PA policy process, suggesting suboptimal engagement between national and subnational levels.

Conclusions

This tool can assist in better understanding how government levels and sectors collaborate during the HEPA policy process and will help uncover policy gaps and improve policy translation between national and subnational (city and region) governments. Our tool will contribute to developing and implementing a global public policy monitoring system to enable benchmarking and priority setting for HEPA policies.
S05-1: Dutch national fall prevention program - implementation challenges
Authors: Preller Liesbeth
Published: September 2024

Purpose

In the Netherlands, an ambitious national multi-domain fall prevention program for older people is being implemented starting in 2023 as part of a broader prevention plan. This is done because of the high burden of falls for healthcare capacity and costs. Large responsibility is given to municipalities for implementation at the local level, and to regional public health services at a higher level.

Project description

The program is developed based on existing evidence and by consulting a wide range of stakeholders. This led to a chain approach including description of screening, fall prevention physical activity programs (FPPs), Physical Activities (PA) outside these FPPs for people with no or limited fall risk and as follow up after participation to FPPs. Each year 3% of people over 65 should attend an FPP VeiligheidNL is responsible for coordinating development and subsequent implementation.

Local implementation is generally done or under supervision of the local policy department of Sport. This is supported by involving several national and regional stakeholders on public health and local policy. Additionally, national and regional sports organisations fill gaps experienced by municipalities and other stakeholders.

Preliminary evaluation shows that local implementation largely varies depending on the role taken by municipalities and local sports and healthcare organisations, and by regional health service organisations.

Dissemination to all municipalities is guaranteed because of designated funding in combination with obligations for health insurance companies to reimburse the costs of participation to FPP for the (estimated 1% of 65) people with the highest fall risk.

Conclusions

The national program leads to broader knowledge about and attention to PA for older people, development of supportive tools and a slowly increasing number of people attending FPP. Still many challenges have to be overcome, such as reach of the target group, local intersectoral collaboration, and scaling up to obtain sufficient qualified trainers for FPP and sufficient structural PA at local sports and PA providers.
S06-2: Moving Cancer Care: The importance of exercise during and after a cancer treatment
Authors: Crabbe Marie , Vrancken Dimitri , Van Stappen Vicky , Declerck Ine
Published: September 2024

Purpose

Literature is recognizing exercise in cancer as a promising therapeutic tool. Authors have shown that exercise could prevent health deterioration, reduce the risk of comorbidities, and improve overall quality of life. Despite this, few cancer patients participate in exercise programs. In this study, we identify barriers and solutions for cancer patients and professionals in promoting exercise. We investigate patient motivations, enhance professional roles (assess, motivate, refer) and identify optimal exercise programs.

Methods

We used a human-centred design research, an iterative approach that focuses on understanding and addressing the needs of the field. For this, we first reviewed the international literature and specifically mapped the situation in Flanders (Belgium). We used qualitative (face-to-face interviews, focus groups, online survey) and quantitative (parameter registration) methods among cancer patients (39) and health/exercise professionals (36). In the second phase, our goal was to address the issue through collaborative feedback and partnership with the professional field. This resulted in the creation of practical tools, allowing professionals to assist cancer patients more effectively in their exercise routines.

Results

Patients and professionals commonly face barriers related to exercise resistance (e.g. lack of motivation) and limited referral pathways.

Patients also express concerns about the location of exercise programs and susceptibility to external factors (e.g. weather conditions). While health and exercise professionals contend with challenges such as limited professional knowledge and organizational barriers, including an overloaded workload.

When developing exercise programs, it is important to incorporate proven design criteria from previous research. These include the use of behaviour change models, adherence to evidence-based exercise standards, and the provision of guidance and follow-up throughout the program.

Conclusions

This research highlights the urgent need for a paradigm shift in cancer care, advocating not only more appropriate exercise programs, but also the integration of exercise coaching into the standard care pathway for all cancer patients.

The inspirational book and practical guidelines elaborated serves as valuable resources for health and exercise professionals and aims to promote physical activity during cancer treatment. This project aims to contribute to the future of care, envisioning sustainable physical rehabilitation beyond the traditional hospital setting
S07-2: Principles for quality design of green spaces to ensure equal hepa opportunities for all – experience from Slovenia
Authors: Erjavec Ina Šuklje , Kozamernik Jana , Žlender Vita
Published: September 2024

Purpose

Numerous studies have shown that green spaces are an important determinant of HEPA, in terms of promoting daily PA as well as of the greater health benefits of outdoor PA in contact with nature. However, people do not have same opportunities for PA nor the same access to green spaces. There are wide disparities between countries, cities, neighbourhoods, urban and rural environments and between different population groups. Vulnerable groups are particularly disadvantaged in this respect. In addition, not all green spaces are suitable or attractive for PA but must meet several conditions related to the type of PA and the needs and abilities of the users. For that comprehensive, inclusive, and long-term spatial planning is needed.

Project description

In line with WHO recommendations and guidelines, the Ministry of Health of the Republic of Slovenia has taken a step towards cross-sectoral integration of HEPA and green space planning and in 2017 started co-funding a three-year programme entitled Expert basis for designing green spaces to promote physical activity – Going Out for Health. Currently, the Urban Planning Institute of the Republic of Slovenia, is implementing the third program: Green Spaces for Active Lifestyles, Healthy Cities, and Municipalities (https://venzazdravje.uirs.si/en-us/) , focusing mainly on practical support to local communities in the form of consultancy workshops to assess and improve the condition of their green spaces for HEPA and their accessibility for people of all ages with the special focus on vulnerable groups.

Conclusions

To improve the cross-sectoral understanding of the importance of and approach to ensuring appropriate, inclusive spatial conditions for HEPA in the context of green spaces, we will present some of the results of all three programmes relating to aspects of the quality of planning and design of green spaces in relation to equitable accessibility and usability for all. We will present in more detail our eight HEPA Green Space Design Quality Principles and the methodology of the Municipal Consultations on the topic, with a particular focus on the inclusion of people with disabilities.

Funding

Ministry of Health of the Republic of Slovenia, Slovenian Research and Innovation Agency, grant. no. V5-2232.