Interventions to improve physical activity among socioeconomically disadvantaged groups: an umbrella review

Abstract Background: Across the world, the COVID-19 pandemic has disproportionately affected economically disadvantaged groups. This differential impact has numerous possible explanations, each with significantly different policy implications. We examine, for the first time in a low- or middle-income country, which mechanisms best explain the disproportionate impact of the virus on the poor. Methods: We use primary data from the CoVIDA project, including the results of 59,770 RT-PCR tests in Bogotá, targeted on a mostly asymptomatic adult population June 2020 to March 3rd, 2021. This is combined with administrative data that covers all reported cases in Bogotá. We estimate a number of parameters that are likely to drive inequality in COVID-19 infection rates across socioeconomic groups, then use these estimates in an individual-level branching process model of the epidemic. We use counterfactual scenarios to estimate the relative importance of different channels for explaining inequality in infection rates. Findings: Total infections and inequalities in infections are largely driven by inequalities in the ability to work remotely and in within-home secondary attack rates. Inequalities in isolation behavior are less important but non-negligible, while access to testing and contract-tracing plays practically no role. Interventions that mitigate transmission are found to be more effective when targeted on socioeconomically disadvantaged groups.Interpretation: Socioeconomically disadvantaged groups are particularly vulnerable to COVID-19 infections, and this appears to be primarily driven by the need to work out of home, higher transmission within home, and to some extent, the ability to isolate when needed. Policies that can successfully reduce these channels of transmission among the poor are likely to have large benefits.

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

10.21203/rs.3.rs-39460/v2 ◽

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.

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Dehumanization of Socioeconomically Disadvantaged Groups Decreases Support for Welfare Policies via Perceived Wastefulness

International Review of Social Psychology ◽

10.5334/irsp.414 ◽

2020 ◽

Vol 33 (1) ◽

pp. 12

Author(s):

Mario Sainz ◽

Steve Loughnan ◽

Rocío Martínez ◽

Miguel Moya ◽

Rosa Rodríguez-Bailón

Keyword(s):

Socioeconomically Disadvantaged ◽

Welfare Policies ◽

Disadvantaged Groups

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Tobacco Use and Socioeconomically Disadvantaged Groups

Nicotine & Tobacco Research ◽

10.1093/ntr/ntx199 ◽

2017 ◽

Vol 19 (12) ◽

pp. 1399-1400

Author(s):

Andrea H Weinberger

Keyword(s):

Tobacco Use ◽

Socioeconomically Disadvantaged ◽

Disadvantaged Groups

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Physical Activity and Exercise in Mild Cognitive Impairment and Dementia: An Umbrella Review of Intervention and Observational Studies

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2020.08.031 ◽

2020 ◽

Vol 21 (10) ◽

pp. 1415-1422.e6 ◽

Cited By ~ 1

Author(s):

Jacopo Demurtas ◽

Daniel Schoene ◽

Gabriel Torbahn ◽

Alessandra Marengoni ◽

Giulia Grande ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Observational Studies ◽

Umbrella Review ◽

Physical Activity And Exercise

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The effectiveness of sedentary behaviour interventions on sitting time and screen time in children and adults: an umbrella review of systematic reviews

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01009-3 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Phuong Nguyen ◽

Long Khanh-Dao Le ◽

Dieu Nguyen ◽

Lan Gao ◽

David W. Dunstan ◽

...

Keyword(s):

Physical Activity ◽

Children And Adolescents ◽

Sedentary Behaviour ◽

Systematic Reviews ◽

Screen Time ◽

Sitting Time ◽

Age Group ◽

Umbrella Review ◽

Occupational Sitting ◽

Meta Analyses

Abstract Background There is increasing concern about the time people spend in sedentary behaviour, including screen time, leisure and occupational sitting. The number of both primary research studies (published trials) and reviews has been growing rapidly in this research area. A summary of the highest level of evidence that provides a broader quantitative synthesis of diverse types of interventions is needed. This research is to articulate the evidence of efficacy of sedentary behaviour interventions to inform interventions to reduce sitting time. The umbrella review, therefore, synthesised systematic reviews that conducted meta-analyses of interventions aiming at reducing sedentary behaviour outcomes across all age group and settings. Method A systematic search was conducted on six databases (MEDLINE Complete, PsycINFO, CINAHL, Global Health via EBSCOhost platform, EMBASE, and Cochrane Central Register of Systematic Reviews). Included articles were systematic reviews with meta-analysis of interventions aiming at reducing sedentary behaviour (screen time, sitting time or sedentary time) in the general population across all age group. Results Seventeen reviews met the inclusion criteria (7 in children and adolescent, 10 in adults). All reviews of sedentary behaviour interventions in children and adolescents investigated intervention effectiveness in reducing screen time. Six out of 11 meta-analyses (reported in 7 reviews) showed small but significant changes in viewing time. All reviews of sedentary behaviour interventions in office workplaces indicated substantial reduction in occupational sitting time (range: 39.6 to 100 min per 8-h workday). Sub-group analyses reported a trend favouring environmental change components such as sit-stand desks, active permissive workstations etc. Meta-analyses indicated that sedentary behaviour interventions were superior to physical activity alone interventions or combined physical activity and sedentary behaviour interventions in reducing sitting time. Conclusion The current systematic reviews and meta-analyses supported sedentary behaviour interventions for reducing occupational sitting time in particular, with small changes seen in screen time in children and adolescents. Future research should explore approaches to maintaining behaviour change beyond the intervention period and investigate the potential of sedentary behaviour reduction interventions in older age groups in non-occupational settings.

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Socioeconomically disadvantaged groups and metabolic syndrome in European adolescents: The HELENA study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120002062 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Isabel Iguacel ◽

Claudia Börnhorst ◽

Nathalie Michels ◽

Christina Breidenassel ◽

Jean Dallongeville ◽

...

Keyword(s):

Smoking Status ◽

Tanner Stage ◽

Female Adolescents ◽

Z Score ◽

Response Relationship ◽

Socioeconomically Disadvantaged ◽

Dose Response Relationship ◽

Disadvantaged Groups ◽

Z Scores ◽

Low Educated

AbstractIntroduction:Psychosocial stressors deriving from socioeconomic disadvantages in adolescents can result in higher metabolic syndrome (MetS) risk. We aimed to examine whether socioeconomic disadvantages were associated with MetS independent of lifestyle and whether there was a dose response relationship between the number of cumulated socioeconomic disadvantages and the risk of MetS.Materials and Methods:The present study included 1,037 European adolescents (aged 12.5–17.5) of the 3,528 total HELENA participants. Sociodemographic variables and lifestyle were assessed through self-reported questionnaires. Disadvantaged groups included adolescents with low educated parents, low family affluence, migrant origin, unemployed parents, and from non-traditional families. MetS score was calculated as the sum of sex- and age-specific z-scores of waist circumference, HOMA-IR index, mean of z-scores of diastolic and systolic blood pressure and mean of z-score of HDL-C multiplied by -1 and z-score of TG. A higher score indicates poor metabolic health. Linear mixed-effects models were used to study the association between social disadvantages and MetS risk score. Models were adjusted for sex, age, pubertal status (Tanner stage) and lifestyle (diet quality, physical activity, alcohol consumption and smoking status).Results:Adolescents with low educated mothers showed a higher MetS score (0.54 [0.09–0.98]; β [99% confidence interval]) compared to high-educated mothers. Adolescents who accumulated more than three disadvantages (0.69 [0.08–1.31]) or with missing information on disadvantages (0.72 [0.04–1.40]) had a higher MetS risk compared to non-socioeconomically disadvantaged groups. Stronger associations between socioeconomic disadvantages and MetS were found in male in comparison with female adolescents.Discussion:Out of the studied socioeconomic disadvantages, maternal education is the most important determinant of adolescent's MetS risk independently of sex, age, Tanner stage, smoking status, alcohol consumption, diet quality and physical activity. Social vulnerabilities (migrant background, unemployment status and belonging to a non-traditional family) were not associated with a higher MetS risk in European adolescents. However, we found a dose-response relationship between the number of factors related to social disadvantage and adolescents’ MetS risk with adolescents accumulating three or more socioeconomic disadvantages showing the highest risk. Stronger associations between socioeconomic disadvantages and MetS were found in male compared to female adolescents. Policy makers should focus on low educated families to tackle health disparities.

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Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods

British Journal Of Nutrition ◽

10.1017/s0007114511003801 ◽

2011 ◽

Vol 107 (7) ◽

pp. 1028-1036 ◽

Cited By ~ 23

Author(s):

David A. Crawford ◽

Kylie Ball ◽

Verity J. Cleland ◽

Karen J. Campbell ◽

Anna F. Timperio ◽

...

Keyword(s):

Physical Activity ◽

Socioeconomically Disadvantaged ◽

Neighbourhood Environment ◽

Cross Sectional ◽

Low Socioeconomic ◽

Disadvantaged Communities ◽

Increased Risk ◽

Multivariable Analyses ◽

Disadvantaged Neighbourhoods ◽

Unhealthy Weight

A detailed understanding of the underlying drivers of obesity-risk behaviours is needed to inform prevention initiatives, particularly for individuals of low socioeconomic position who are at increased risk of unhealthy weight gain. However, few studies have concurrently considered factors in the home and local neighbourhood environments, and little research has examined determinants among children from low socioeconomic backgrounds. The present study examined home, social and neighbourhood correlates of BMI (kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional data were collected from 491 women with children aged 5–12 years living in forty urban and forty rural socioeconomically disadvantaged areas (suburbs) of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires about the home environment (maternal efficacy, perceived importance/beliefs, rewards, rules and access to equipment), social norms and perceived neighbourhood environment in relation to physical activity, healthy eating and sedentary behaviour. Children's height and weight were measured at school or home. Linear regression analyses controlled for child sex and age. In multivariable analyses, children whose mothers had higher efficacy for them doing physical activity tended to have lower BMI z scores (B = − 0·04, 95 % CI − 0·06, − 0·02), and children who had a television (TV) in their bedroom (B = 0·24, 95 % CI 0·04, 0·44) and whose mothers made greater use of food as a reward for good behaviour (B = 0·05, 95 % CI 0·01, 0·09) tended to have higher BMI z scores. Increasing efficacy among mothers to promote physical activity, limiting use of food as a reward and not placing TV in children's bedrooms may be important targets for future obesity prevention initiatives in disadvantaged communities.

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