Public health approaches to tackling obesity in the UK

2019 ◽  
Vol 30 (6) ◽  
pp. 294-298
Author(s):  
Hilda Mulrooney
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Behaviour Change ◽  
Population Based ◽  
Dietary Intakes ◽  
Obesogenic Environment ◽  
Individual Behaviour ◽  
Adults And Children ◽  
The Uk ◽  
Individual Behaviour Change

Being obese and overweight affects an increasing number of adults and children in the UK. Hilda Mulrooney presents an overview of the population-based approaches to improving public health and enabling more people to lose weight Obesity is a serious condition that is highly prevalent in UK adults and children. A number of population-based approaches to improve the ‘obesogenic’ environment have been put into place while more are being proposed. Many of these approaches have the advantage of potentially altering dietary intakes without individual behaviour change, and they are taking place in a wider context that encourages physical activity and partnership working. Approaches to obesity and progress made towards targets will be discussed.

scholarly journals The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development

2017 ◽  
Vol 21 (5) ◽  
pp. 1-164 ◽  
Author(s):  
Paul Flowers ◽  
Olivia Wu ◽  
Karen Lorimer ◽  
Bipasha Ahmed ◽  
Hannah Hesselgreaves ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Behaviour Change ◽  
Hiv Transmission ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Individual Behaviour ◽  
Behaviour Change Interventions ◽  
Individual Level ◽  
The Uk ◽  
Individual Behaviour Change

AbstractBackgroundMen who have sex with men (MSM) experience significant inequalities in health and well-being. They are the group in the UK at the highest risk of acquiring a human immunodeficiency virus (HIV) infection. Guidance relating to both HIV infection prevention, in general, and individual-level behaviour change interventions, in particular, is very limited.ObjectivesTo conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate intervention.Data sourcesAll major electronic databases (British Education Index, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Educational Resource Index and Abstracts, Health and Medical Complete, MEDLINE, PsycARTICLES, PsycINFO, PubMed and Social Science Citation Index) were searched between January 2000 and December 2014.Review methodsA systematic review of the clinical effectiveness of individual behaviour change interventions was conducted. Interventions were examined using the behaviour change technique (BCT) taxonomy, theory coding assessment, mode of delivery and proximity to HIV infection testing. Data were summarised in narrative review and, when appropriate, meta-analysis was carried out. Supplemental analyses for the development of the candidate intervention focused on post hoc realist review method, the assessment of the sequential delivery and content of intervention components, and the social and historical context of primary studies. Expert panels reviewed the candidate intervention for issues of implementation and optimisation.ResultsOverall, trials included in this review (n = 10) demonstrated that individual-level behaviour change interventions are effective in reducing key HIV infection risk-related behaviours. However, there was considerable clinical and methodological heterogeneity among the trials. Exploratory meta-analysis showed a statistically significant reduction in behaviours associated with high risk of HIV transmission (risk ratio 0.75, 95% confidence interval 0.62 to 0.91). Additional stratified analyses suggested that effectiveness may be enhanced through face-to-face contact immediately after testing, and that theory-based content and BCTs drawn from ‘goals and planning’ and ‘identity’ groups are important. All evidence collated in the review was synthesised to develop a candidate intervention. Experts highlighted overall acceptability of the intervention and outlined key ways that the candidate intervention could be optimised to enhance UK implementation.LimitationsThere was a limited number of primary studies. All were from outside the UK and were subject to considerable clinical, methodological and statistical heterogeneity. The findings of the meta-analysis must therefore be treated with caution. The lack of detailed intervention manuals limited the assessment of intervention content, delivery and fidelity.ConclusionsEvidence regarding the effectiveness of behaviour change interventions suggests that they are effective in changing behaviour associated with HIV transmission. Exploratory stratified meta-analyses suggested that interventions should be delivered face to face and immediately after testing. There are uncertainties around the generalisability of these findings to the UK setting. However, UK experts found the intervention acceptable and provided ways of optimising the candidate intervention.Future workThere is a need for well-designed, UK-based trials of individual behaviour change interventions that clearly articulate intervention content and demonstrate intervention fidelity.Study registrationThe study is registered as PROSPERO CRD42014009500.FundingThe National Institute for Health Research Health Technology Assessment programme.

ALZHEIMER’S ASSOCIATION: INITIATIVES & PUBLIC HEALTH PERSPECTIVE

2016 ◽  
pp. 1-3
Author(s):  
H.M. Snyder ◽  
M.C. Carrillo
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Risk Factors ◽  
Cognitive Decline ◽  
Population Based ◽  
Current Evidence ◽  
Public Health Perspective ◽  
Reduce Risk ◽  
Number Of Individuals ◽  
Do So

An estimated 47 million people worldwide are living with dementia in 2015 and this number is expected to triple by 2050. There is a clear urgency for therapies and / or interventions to slow, stop or prevent dementia. Amounting evidence suggests strategies to reduce risk of development dementia may be of growing import for reducing the number of individuals affected. The Alzheimer’s Association believes, from a population based perspective that: (1) Regular physical activity and management of cardiovascular risk factors (e.g. diabetes, obesity, smoking and hypertension) have been shown to reduce the risk of cognitive decline and may reduce the risk of dementia; (2) A healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline. The current evidence underscores the need to communicate to the broader population what the science indicates and to do so with diverse stakeholders and consistent messaging. There has never been a better time to define and distribute global messaging on public health for dementia.

scholarly journals A modified Delphi study to gain consensus for a taxonomy to report and classify physical activity referral schemes (PARS)

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Coral L. Hanson ◽  
Emily J. Oliver ◽  
Caroline J. Dodd-Reynolds ◽  
Alice Pearsons ◽  
Paul Kelly
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Delphi Study ◽  
Policy Research ◽  
Monitoring And Evaluation ◽  
Health Improvement ◽  
Behaviour Change Techniques ◽  
Policy And Practice ◽  
Modified Delphi ◽  
The Uk

Abstract Background Physical Activity Referral Schemes (PARS), including exercise referral schemes, are a popular approach to health improvement, but understanding of effectiveness is limited by considerable heterogeneity in reporting and evaluation. We aimed to gain consensus for a PARS taxonomy as a comprehensive method for reporting and recording of such schemes. Methods We invited 62 experts from PARS policy, research and practice to complete a modified Delphi study. In round one, participants rated the need for a PARS taxonomy, the suitability of three proposed classification levels and commented on proposed elements. In round two, participants rated proposed taxonomy elements on an 11-point Likert scale. Elements scoring a median of ≥7, indicating high agreement, were included in the final taxonomy. Results Of those invited, 47 (75.8%) participated in round one, with high retention in round two (n = 43; 91.5%). 42 were UK-based, meaning the resultant taxonomy has been scrutinised for fit to the UK context only. The study gained consensus for a three-level taxonomy: Level 1: PARS classification (primary classification, provider, setting, conditions accepted [have or at risk of], activity type and funding). Level 2: scheme characteristics (staff structure, staff qualifications, behaviour change theories, behaviour change techniques, referral source, referrers, referral process, scheme duration, session frequency, session length, session times, session type, exit routes, action in case of non-attendance, baseline assessment, exit assessment, feedback to referrer and exclusion criteria) and Level 3: participant measures (demographics, monitoring and evaluation, and measures of change). Conclusion Using a modified Delphi method, this study developed UK-based consensus on a PARS classification taxonomy. We encourage PARS practitioners and public health colleagues, especially those working with similar service models internationally, to test, refine and use this taxonomy to inform policy and practice.

scholarly journals Get A Move On: Using intelligent personal systems to promote behaviour change within the home setting – A process evaluation

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Caomhan Logue ◽  
Jonathan Flynn ◽  
Alison Gallagher ◽  
Marie Murphy ◽  
Angela Carlin
Keyword(s):  
Physical Activity ◽  
Process Evaluation ◽  
Behaviour Change ◽  
Feasibility Study ◽  
Dietary Habits ◽  
Secondary Outcome ◽  
Health Promotion Programme ◽  
Home Setting ◽  
Adults And Children ◽  
Recommended Level

AbstractApproximately one quarter of children living in Northern Ireland are overweight or obese. Intelligent personal systems (IPS) such as Amazon Echo and Google Home have become increasingly integrated into the home setting and therefore, may facilitate behaviour change via novel interactions or as an adjunct to conventional interventions. However, little is currently known about their potential role in this context; therefore, the aim of this feasibility study is to assess the effect of a home-based technology intervention (delivered using Amazon Echo) on physical activity (PA) and dietary habits in families attending the Safe Wellbeing Eating & Exercise Together (SWEET) project, a community-based health promotion programme. Recruitment to the study is ongoing with the aim of recruiting up to 16 families. Families are randomly assigned to receive an IPS (n = 8) or assigned to control (n = 8) i.e. attend the SWEET project as usual, for 12 weeks. Individualised prompts and reminders, aligned with the content of the SWEET project, are regularly delivered to families via the IPS and normal interaction with the device is also encouraged. The primary outcome measure is PA, which will be objectively measured using an Actigraph accelerometer, and secondary outcome measures include body mass index (BMI) and family eating and activity habits. Process evaluation data from focus groups and device interaction will be used to determine the feasibility of using IPS to promote healthy behaviours within the home setting. To date, 11 families have been recruited (11 adults, 90.9% F; 16 children, 56.3% F), mean age 40.4 ± 5.5 years and BMI 34.9 ± 6.7 kg/m2 for adults and 8.9 ± 2.1 years and BMI z-score 2.61 ± 1.23 for children. Average moderate-to-vigorous intensity physical activity (MVPA) was dichotomised to determine the percentage of adults and children meeting the UK (2011) PA guidelines for health. In total, 62.5% of adults reached the recommended level of 150 minutes MVPA per week before the intervention (n = 8;191.50 ± 81.10 minutes), with 40% of children reaching the recommended level of 60 minutes MVPA each day of the week (n = 10; M = 52.83 ± 31.07 minutes). Follow-up measurements will be taken at the end of the intervention and acceptability and usability of such devices within the context of promoting healthy behaviours will be assessed. The findings from this feasibility study will demonstrate whether the use of IPS can increase PA in adults and children, as well as provide novel insights into the feasibility of using these devices to facilitate behaviour change.

scholarly journals Cognitive and environmental interventions to encourage healthy eating: evidence-based recommendations for public health policy

2019 ◽  
Vol 6 (10) ◽  
pp. 190624 ◽  
Author(s):  
Lindsay A. Walker ◽  
Christopher D. Chambers ◽  
Harm Veling ◽  
Natalia S. Lawrence
Keyword(s):  
Public Health ◽  
Behaviour Change ◽  
Cognitive Training ◽  
Evidence Based ◽  
Environmental Interventions ◽  
Average Percentage ◽  
Public Health Burden ◽  
The Public ◽  
The Uk ◽  
Do So

Policymakers are focused on reducing the public health burden of obesity. The UK average percentage of adults classified as obese is 26%, which is double that of the global average. Over a third of UK adults report using at least one weight management aid. Yet, many people still struggle to change their diet-related behaviour, despite having the awareness, intention and capability to do so. This ‘intention–behaviour gap’ may be because most existing dietary-choice interventions focus on individual decision-making, ignoring the effects of environmental cues on human behaviour. Behaviour change interventions that ‘nudge’ people into making healthier choices by modifying the food environment have been shown to be effective. However, this type of intervention is typically challenging for policymakers to implement for economic, ethical and public accessibility reasons. To overcome these concerns, policymakers should consider ‘boosting’ interventions. Boosting involves enhancing competences that help people make decisions consistent with their goals. Here, we outline cognitive training as a boosting intervention to tackle obesity. We synthesize the evidence for one type of cognitive training (go/no-go training) that may be effective at modifying food-related decisions and reducing body weight. We offer evidence-based recommendations for an obesity-focused Public Health Wales behaviour change programme.

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

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.

scholarly journals Emerging Adults and Social Distancing During COVID-19: Who Was More Likely to Follow Guidelines and What Were the Correlates With Well-Being and Weight-Related Behaviors?

2021 ◽  
pp. 216769682110514
Author(s):  
Jerica M. Berge ◽  
Nicole Larson ◽  
Dianne Neumark-Sztainer
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Emerging Adults ◽  
Healthy Eating ◽  
Social Distance ◽  
Eating Behaviors ◽  
Emerging Adult ◽  
Well Being ◽  
Population Based ◽  
Social Distancing

The aim of this study is to identify the prevalence, predictors, and psychosocial well-being (depressive symptoms, stress) and weight-related behavior (eating behaviors, physical activity, and sedentary behavior) correlates of social distancing during COVID-19 among emerging adults. A rapid-response survey was sent to participants ( n=720; mean age=24.7 ± 2.0 years, 62% female) in a population-based cohort study in Minnesota during April–October 2020. Half of emerging adults reported fully social distancing. Emerging adults from White backgrounds were least likely to social distance while those from Asian backgrounds were most likely to social distance, in addition to those living with a parent. Females who partially/did not social distance reported less healthy eating behaviors, while males and “essential workers” reported higher levels of psychosocial distress. Public health messaging and practical supports for social distancing may need to be made more relevant to emerging adults during public health crises. Resources may need to differ depending on sex of emerging adult.

The principles of a national diabetic eye screening programme

2020 ◽  
pp. 111-122
Author(s):  
Paul Galsworthy
Keyword(s):  
Public Health ◽  
Young Person ◽  
Population Based ◽  
National Standards ◽  
Evidence Based ◽  
Independent Evidence ◽  
Eye Screening ◽  
Increased Risk ◽  
Diabetic Eye Screening ◽  
The Uk

Screening identifies apparently healthy people who may be at increased risk of a disease or condition, enabling earlier treatment or better-informed decisions. The NHS diabetic eye screening (DES) programme is one of the young person and adult NHS population screening programmes in the UK. The UK National Screening Committee (UK NSC), which makes independent, evidence-based recommendations to ministers in the four UK nations about the 11 population-based screening programmes. Public Health England (PHE)—Screening Quality Assurance Service (SQAS) ensures programmes are safe and effective by ensuring national standards are met.

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