scholarly journals Using theory of change to develop an intervention theory for designing and evaluating behavior change SDApps for healthy eating and physical exercise: the OCAPREV theory

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Olivier Aromatario ◽  
Aurélie Van Hoye ◽  
Anne Vuillemin ◽  
Aude-Marie Foucaut ◽  
Jeanine Pommier ◽  
...  
Keyword(s):  
Behavior Change ◽  
Health Inequalities ◽  
Healthy Eating ◽  
Theory Of Change ◽  
Social Health ◽  
Smart Devices ◽  
Intervention Theory ◽  
Causal Pathway ◽  
Social Health Inequalities ◽  
The Impact

Abstract Background Connected health devices and applications (referred to hereafter as “SDApps” - Smart devices and applications) are being portrayed as a new way for prevention, with the promise of accessibility, effectiveness and personalization. Many effectiveness evaluations (experimental designs) with strong internal validity exist. While effectiveness does appear to vary, the mechanisms used by these devices have not yet been thoroughly investigated. This article seeks to unpack this black box, and describes the process of elaboration of an intervention theory for healthy eating and physical activity SDApps. It includes a set of requirements relative to their impact on social health inequalities. Methods To build this theory, we drew on theory-driven approaches and in particular on the theory of change (ToC) method. To this end, we developed a cumulative and iterative process combining scientific data from the literature with knowledge from experts (researchers and practitioners) and from patients or users. It was a 3-step process, as follows: 1 - identifying the evidence base; 2 - developing the theory through design intervention and creating realistic expectations, including in our case specific work on social health inequalities (SHIs); 3 - modeling process and outcome. Results We produced an evidence-based theory according to the ToC model, based on scientific evidence and knowledge from experts and users. It sets out a causal pathway leveraging 11 key mechanisms - theoretical domains - with which 50 behavior change techniques can be used towards 3 ultimate goals: Capacity, Opportunity, Motivation – Behavior (COM-B). Furthermore, the theory specifically integrates requirements relative to the impact on SHIs. Conclusions This theory is an aid to SDAapp design and evaluation and it can be used to consider the question of the possible impact of SDApps on the increase in inequalities. Firstly, it enables developers to adopt a more overarching and thorough approach to supporting behavior change, and secondly it encourages comprehensive and contributive evaluations of existing SDApps. Lastly, it allows health inequalities to be fully considered.

scholarly journals Evaluating the effect of income support policies on social health inequalities (SHIs) at birth in Montreal and Brussels using a contextualised comparative approach and model family method: a study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e024015
Author(s):  
Mouctar Sow ◽  
Myriam De Spiegelaere ◽  
Marie-France Raynault
Keyword(s):  
Health Inequalities ◽  
Social Assistance ◽  
Social Health ◽  
Administrative Databases ◽  
Comparative Approach ◽  
Income Support ◽  
Poverty Level ◽  
Social Health Inequalities ◽  
The Impact ◽  
Model Family

IntroductionAssessing the effects of social policies on social health inequalities (SHIs) is a complex issue. Variations in social policy between countries or regions provide natural experiments in policy implementation to perform comparative research. Comparisons are most enlightening when: the object of the evaluation is well defined (types of policies, population groups); the context of policy is analysed (history, implementation); the impact of policy on household poverty is outlined in detail; the influence of various factors (other than poverty) on SHI is taken into consideration.Methods and analysisThis study aims to understand how income support policies (ISPs) in Brussels and Montreal influence the poverty level of households receiving social assistance, and how they are associated with SHI at birth. Two cases studies will be carried out from a comparative perspective. The analysis includes four stages : (1) The model family method will be used to compare ISPs and their impact on disposable income and poverty of households receiving social assistance in both regions. (2) Statistical analysis of administrative databases will enable the description and comparison of SHI in adverse pregnancy outcomes across the two regions. (3) Analysis of databases and documents will allow for description of various factors which are likely to interact with poverty and influence SHI at birth. (4) Based on the Diderichsen model, results from the previous stages will be used to formulate hypotheses about the mechanisms by which ISPs contribute to increasing or reducing SHI at birth in both regions.Ethics and disseminationThis research was approved by the Human Research Ethics Committee for Health research of Université de Montréal. In Belgium, the access to linked databases was approved by the Commission for the Protection of Privacy. Databases de-identified according to Belgian and Canadian legislation will be used. Results will be disseminated in scientific publications and will be shared with policy makers and field actors through collaborations with local organisations in Brussels and Montreal.

scholarly journals Unequal access to green space as a cause of a new category of health inequalities

2016 ◽  
Vol 20 ◽  
pp. 25-36
Author(s):  
Agnieszka Makarewicz-Marcinkiewicz
Keyword(s):  
Development Strategy ◽  
Health Inequalities ◽  
Green Space ◽  
Social Health ◽  
Legal Regulations ◽  
Direct Link ◽  
Green Areas ◽  
Social Health Inequalities ◽  
Unequal Access ◽  
The Impact

Unequal access to green space as a cause of a new categoryof health inequalitiesThe article presents the influence of unequal access to green space on human health, resulting in the formation of health inequalities. The work is based on the hypothesis that unequal access to green areas in the place of residence and leisure, largely determined by the level of income and the scope of implementation of sustainable development strategy by the state, contributes to deepening social health inequalities. The article analyses the attitude towards the impact of access to green space on health present in official documents and related researchIt also identifies a direct link between limited access to green space and social health inequalities. In the last part of the article, legal regulations concerning access to greenery in Poland are presented.

scholarly journals The choice of a diet quality indicator to evaluate the nutritional health of populations

2000 ◽  
Vol 3 (3) ◽  
pp. 357-365 ◽  
Author(s):  
Lise Dubois ◽  
Manon Girard ◽  
Nathalie Bergeron
Keyword(s):  
Health Inequalities ◽  
Diet Quality ◽  
Eating Habits ◽  
Social Health ◽  
Dietary Recommendations ◽  
Nutrition Survey ◽  
Nutritional Health ◽  
The Usa ◽  
Social Health Inequalities ◽  
The Impact

AbstractBackgroundThe USA and Canada both want to reduce social health inequalities in their population. These two countries have recently begun a process of harmonization of their nutrient recommendations.ObjectiveTo develop a standardized indicator to measure the impact of these recommendations on the health of different social groups in North America. The authors have compared three of the methods currently used for measuring overall diet quality for a population.Design and settingThe three methods, adjusted to the 1990 Canadian nutrition recommendations, were used to analyse the Québec Nutrition Survey data collected by Santé Québec in 1990.ResultsThe authors found that the indicator developed by Kennedy and collaborators works best for analysing the Québec data. Moreover, it allows comparisons with the USA. Some questions, such as whether or not to add calories from alcohol consumption to the model and whether the indicators should be adjusted to the different cultures and specific population groups remain unanswered.ConclusionsIn order to determine the role of nutrition in social health inequalities, it is important to develop standard indicators that are suitable for monitoring the relationship between dietary recommendations and eating habits.

scholarly journals Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – An umbrella review

2020 ◽  
Author(s):  
Janis Fiedler ◽  
Tobias Eckert ◽  
Kathrin Wunsch ◽  
Alexander Woll
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Sedentary Behavior ◽  
Healthy Eating ◽  
Social Contexts ◽  
Just In Time ◽  
Umbrella Review ◽  
Behavior Change Techniques ◽  
Adaptive Interventions ◽  
The Impact

Abstract Background: Electronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology.Methods: PubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects (i.e. subjects without physical or physiological morbidities which would influence the realization of behaviors targeted by the respective interventions) were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized.Results: The systematic search reveled eleven systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions.Conclusion: Findings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions.Trial registration: The protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.

scholarly journals Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – an umbrella review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Janis Fiedler ◽  
Tobias Eckert ◽  
Kathrin Wunsch ◽  
Alexander Woll
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Sedentary Behavior ◽  
Healthy Eating ◽  
Social Contexts ◽  
Just In Time ◽  
Umbrella Review ◽  
Behavior Change Techniques ◽  
Adaptive Interventions ◽  
The Impact

Abstract Background Electronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology. Methods PubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects (i.e. subjects without physical or physiological morbidities which would influence the realization of behaviors targeted by the respective interventions) were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized. Results The systematic search revealed 11 systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions. Conclusion Findings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions. Trial registration The protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.

Social Health Inequalities in the Czech Republic

Epidemiology ◽  
2006 ◽  
Vol 17 (Suppl) ◽  
pp. S386-S387
Author(s):  
H Slachtova ◽  
H Tomaskova ◽  
D Skybova ◽  
P Polaufova ◽  
I Tomasek ◽  
...  
Keyword(s):  
Czech Republic ◽  
Health Inequalities ◽  
Social Health ◽  
The Czech Republic ◽  
Social Health Inequalities

scholarly journals Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors

2016 ◽  
Vol 12 (3) ◽  
pp. 184-199 ◽  
Author(s):  
Steve Amireault ◽  
Angela J. Fong ◽  
Catherine M. Sabiston
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Cancer Survivors ◽  
Healthy Eating ◽  
Health Behavior Change ◽  
Cochrane Library ◽  
Multiple Health Behavior Change ◽  
The Impact ◽  
Multiple Health

Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.

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