Physical activity: Health outcomes and importance for public health policy

Information is considered the currency within health systems. Numerous reorganisations and restructuring, coupled with many buzz words (e.g. evidence-based practice) and the various advancements in ICT (information and communication technology) are apparently designed to improve the utilisation of this currency. However, what constitutes information appears to vary between health professionals. For some, only the data derived from RCTs (randomized control trials) is considered evidence, for others it is the conclusions drawn from focus groups, whilst for others, finding information goes well beyond subjectivity and experimental design and comes from understanding human behaviour and other processes.Although advancements in ICT have greatly improved access to information (currency), the data often disguised as information appears only as small change. Restructuring and reorganizing have been used to inflate the value of this currency (information) leading to the replacement of information departments by the Public Health Intelligence Units or Observatories. However, a change in behaviour is difficult to bring about and manage, while it is easier to change the tools with which the tasks are carried out. It is all too easy to fall into the trap of reproducing what has been produced before by information departments only under a different guise, as well as using different configurations, software or updated hardware and ICT (e.g. the Internet). These units hardly concern themselves with exploring the underlying message of the data. A quick trawl of the web pages of these entities can be testimony to this fact. The process so far has been, in effect, one of test-tubing health outcomes and then extracting the data from the test tubes. Although we have been eager to embrace technological advancements and change, we have failed to monitor the impact and consequences of change on our behaviour and thus on health outcomes. This chapter will delve into the current availability of information for public health policy purposes and will argue its ineffectiveness as information/evidence in the context of human behaviour and social processes. Behaviour and processes are by nature dynamic. Specifically, the feedback effect, a feature of dynamic process, can have a profound attenuating effect on data that was once important, thereby affecting not only the shelf life of a policy but also its intended outcomes. Examples from published reports by public health intelligence units/observatories in New Zealand and the UK, plus references to teenage smoking and suicide, will be used to illustrate these concepts and issues. A conceptual but pragmatic model of data collection based on current health care data management systems will be argued as a way forward for translating data into information and tangible evidence with a view to informing the process of public health policy formation. This chapter discusses a holistic approach to identifying data needed as evidence to inform the process of policy formation/decision making as a conceptual model.

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Diet and physical activity as determinants of weight gain, overweight and obesity: The WCRF/AICR evidence and policy implications

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001561 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Isobel Bandurek ◽

Emily Almond ◽

Susannah Brown ◽

Giota Mitrou ◽

Ifigeneia Bourgiezi ◽

...

Keyword(s):

Public Health ◽

Physical Activity ◽

Health Policy ◽

Weight Gain ◽

Public Health Policy ◽

Screen Time ◽

Overweight And Obesity ◽

Evidence Based ◽

Diet And Physical Activity ◽

Adults And Children

AbstractIntroductionGlobally, over 1.97 billion adults and 338 million children and adolescents are living with overweight and obesity, increasing the risk of numerous co-morbidities, including at least 12 cancers(1). WCRF/AICR conducted a literature review of diet and physical activity as determinants of weight gain, overweight and obesity in adults and children. We also introduce a novel evidence-based policy framework for promoting physical activity, and linked database, currently in development as part of the EU-funded CO-CREATE project on child and adolescent obesity prevention.Materials and MethodsEvidence on diet and physical activity as determinants and risk of weight gain, overweight and obesity was systematically extracted from existing reviews and a systematic search for recent meta-analyses, then collated and analysed. The WCRF Continuous Update Project Expert Panel drew conclusions about which exposures influence risk of weight gain, overweight and obesity, using pre-defined criteria that included evidence of biological plausibility.ResultsThe Panel identified strong evidence that several diet and physical activity related exposures influence the risk of weight gain, overweight and obesity in adults and children (see table 1). Separate conclusions were drawn for adults and children in relation to screen time, considered a marker of sedentary time.However, the Panel noted that as exposures tend to cluster, physiologically interact and share common biological mechanisms, they should not be regarded as absolutely ‘singular'but an integrated concept of interrelated exposures within a pattern of lifestyle. Table 1.Risk of weight gain, overweight and obesitySTRONG EVIDENCEDECREASES RISKINCREASES RISKCONVINCINGWalkingScreen time (children)Sugar sweetened drinksPROBABLEAerobic physical activityFoods containing dietary fibre‘Mediterranean type’ dietary patternHaving been breastfedScreen time (adults)‘Fast foods’‘Western type’ dietFor full list of footnotes, see Energy Balance and Body Fatness report(1).DiscussionHealthy dietary patterns help prevent excess weight gain. Achieving such patterns requires attention to the broader economic, environmental and social factors that influence and constrain people's behaviour. The findings of this report support the need for evidence-based public health policy to help create health-enabling environments, particularly for children and adolescents. The WCRF International MOVING framework(2) presents a package of policies to promote physical activity, which alongside wider public health policy can help address the multiple drivers of overweight and obesity.

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Sport, physical activity and public health policy

Sport and Health ◽

10.4324/9781315266459-9 ◽

2017 ◽

pp. 164-178

Author(s):

Bob Snape ◽

Kathryn Curran

Keyword(s):

Public Health ◽

Physical Activity ◽

Health Policy ◽

Public Health Policy

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Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review (Preprint)

10.2196/preprints.17274 ◽

2019 ◽

Author(s):

Alison Brown ◽

Courtney Barnes ◽

Judith Byaruhanga ◽

Matthew McLaughlin ◽

Rebecca K Hodder ◽

...

Keyword(s):

Public Health ◽

Decision Making ◽

Health Policy ◽

Knowledge Translation ◽

Health Outcomes ◽

Health Professionals ◽

Public Health Policy ◽

Randomized Trials ◽

Policy Makers ◽

Or Practice

BACKGROUND Knowledge translation (KT) aims to facilitate the use of research evidence in decision making. Changes in technology have provided considerable opportunities for KT strategies to improve access and use of evidence in decision making by public health policy makers and practitioners. Despite this opportunity, there have been no reviews that have assessed the effects of digital technology-enabled KT (TEKT) in the field of public health. OBJECTIVE This study aims to examine the effectiveness of digital TEKT strategies in (1) improving the capacity for evidence-based decision making by public health policy makers and practitioners, (2) changing public health policy or practice, and (3) changes in individual or population health outcomes. METHODS A search strategy was developed to identify randomized trials assessing the effectiveness of digital TEKT strategies in public health. Any primary research study with a randomized trial design was eligible. Searches for eligible studies were undertaken in multiple electronic bibliographic databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus) and the reference lists of included studies. A hand search of 2 journals (Implementation Science and Journal of Medical Internet Research) and a gray literature search were also conducted. Pairs of independent review authors screened studies, assessed the risk of bias, and extracted data from relevant studies. RESULTS Of the 6819 citations screened, 8 eligible randomized trials were included in the review. The studies examined the impact of digital TEKT strategies on health professionals, including nurses, child care health consultants, physiotherapists, primary health care workers, and public health practitioners. Overall, 5 of the interventions were web-training programs. The remaining 3 interventions included simulation games, access to digital resource materials and the use of tailored messaging, and a web-based registry. The findings suggest that digital TEKT interventions may be effective in improving the knowledge of public health professionals, relative to control, and may be as effective as a face-to-face KT approach. The effectiveness of digital TEKT strategies relative to a control or other digital KT interventions on measures of health professional self-efficacy to use evidence to enhance practice behavior or behavioral intention outcomes was mixed. The evidence regarding the effects on changes to health policy or practice following exposure to digital TEKT was mixed. No trials assessed the effects on individual or population-level health outcomes. CONCLUSIONS This review is the first to synthesize the effectiveness of digital TEKT interventions in a public health setting. Despite its potential, relatively few trials have been undertaken to investigate the impacts of digital TEKT interventions. The findings suggest that although a digital TEKT intervention may improve knowledge, the effects of such interventions on other outcomes are equivocal.

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Housing and Healthy Child Development: Known and Potential Impacts of Interventions

Annual Review of Public Health ◽

10.1146/annurev-publhealth-040119-094050 ◽

2020 ◽

Vol 41 (1) ◽

pp. 381-396

Author(s):

James R. Dunn

Keyword(s):

Public Health ◽

Health Policy ◽

Child Development ◽

Child Health ◽

Health Outcomes ◽

Conceptual Framework ◽

Healthy Child ◽

Public Health Policy ◽

Important Determinant ◽

Child Health Outcomes

Housing is often described as an important determinant of health, but less commonly of child health. Despite acknowledgment of the importance of housing to health, however, there are relatively few studies of the effects of housing interventions on health, and again even fewer on child health. This article argues that a broad focus on healthy child development—as opposed to just physical health—coupled with a conceptual framework outlining specific attributes of housing with the potential to influence child health, should be adopted to guide a comprehensive approach to public health policy for healthy child development. Most housing interventions address direct pathways linking in-home hazard exposures to child health outcomes, with promising but mixed results. But few housing interventions address the broader aspects of healthy child development. This review addresses potential housing interventions that could impact the broader determinants of healthy child development and accompanying methodological challenges.

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