What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults – a qualitative focus group study

Background During geriatric rehabilitation, attempts are made to increase the patients’ health and functional capacity. In order to maintain these improvements in the medium- and long-term, behavioural changes regarding mobility and nutrition are also targeted, but these are often not sustainable. International studies show positive effects on the sustainability of the improvement of physical activity behaviour in healthy seniors through the use of electronic devices and software applications. Comparable approaches that include nutrition topics or combine them and were additionally developed for geriatric rehabilitation patients (≥70 years) to date are not known. The aim of this study was to identify what geriatric rehabilitation patients require from an electronic coaching system (e-coach) to support them in improving their nutritional and physical activity behaviour, and what content and features physiotherapists and dieticians consider relevant. Method Focus group interviews (09–11/2019) were conducted in a geriatric rehabilitation centre in Germany with patients aged 70 years and older, relatives and experts (physiotherapists and nutritionists). The focus groups were recorded, transcribed verbatim and analysed using content analysis. Results Three focus groups with patients and relatives (n = 17, 65% female, 16 (94%) in age category 70–99 years) and one focus group with experts (2 dieticians and 1 physiotherapist) were conducted. Relevant contents and feedback elements for nutrition and physical activity in old age were identified. The patients’ comments show that an e-coach must offer obvious benefits for the older persons and promote motivation in order to be used. The willingness to change nutrition and physical activity behaviour and the previous experiences in these areas are very heterogeneous, therefore content should be adaptable to different requirements. Conclusion Experts and patients identified quite similar contents, barriers and facilitators for a nutrition and physical activity e-coach. The e-coach needs to be able to address different points of behaviour change, enable adaptations to the individual patient and convince the older person that using it will help them to improve their nutrition and physical activity. It is also important that the e-coach is easy to use and can be easily integrated into the patient’s everyday life after rehabilitation.

The Effect of Health Promotion Educational Interventions on Self-Care Behaviors of Nutrition and Physical Activity Among Universities Staff in Southeastern Iran

Background: A workplace has an important role in staff health. Besides, it is a suitable place for performing interventions to reduce the risk of suffering from health problems associated with physical inactivity and overweight, and to reduce risks of cardiovascular and non-communicable diseases. Objectives: This study aims to investigate the effects of health promotion educational interventions on self-care behaviors of nutrition and physical activity among the selected university staff in Zahedan during the COVID-19 pandemic. Methods: The present quasi-experimental research was conducted in 2020-2021 in Zahedan, southeastern Iran. The control and intervention groups included a random selectionof 110 and 144 non-academic staff members of Zahedan University of Medical Sciences (ZAUMS) as well as Sistan and Baluchestan University (SBU), respectively. At the beginning of the COVID-19 pandemic, an online researcher-made questionnaire (Porsline, https://survey.porsline.ir) (CVR: 92%; CVI: 90%; reliability: 85%) was uploaded, which had been already approved. Besides, educational booklets were provided to the intervention group via WhatsApp and Soroush messengers, through which the participants were allowed to ask their questions after every session. One month after the intervention, the online questionnaires were re-uploaded on Porsline and recompleted by the participants. The results were analyzed using SPSS V21.0. Results: The results indicated that the self-care behaviors of nutrition and physical activity increased significantly in terms of awareness, attitude, and performance among the intervention group participants after conducting the educational intervention (P-value < 0.05). Accordingly, the educational intervention resulted in an increase in the level of awareness, attitude, and performance of nutrition and physical activity among the university staff of the intervention group. Besides, the performance of physical activity was significantly affected not only by the intervention (P < 0.001) but also by work experience (P < 0.001). In addition, nutrition behavior was significantly better in female staff than male staff (P = 0.048), but there was no significant correlation between gender and the intervention (P = 0.266). Conclusions: The educational program executed in the present study was shown to be effective in promoting self-care behaviors of nutrition and physical activity among the university staff. Thus, health programmers and policymakers can have a significant role in promoting staff health by executing interventional educational programs. Accordingly, the efficiency of the whole system will improve by adopting these strategies and programs.

Diet Quality of Australian Children and Adolescents on Weekdays versus Weekend Days: A Secondary Analysis of the National Nutrition and Physical Activity Survey 2011–2012

Daily routines may influence children and adolescents’ eating patterns, however the influence of days of the week on dietary intake has rarely been explored. This study aimed to examine discretionary choices intake in the context of diet quality on weekdays versus weekends. A secondary analysis was conducted using the Australian National Nutrition and Physical Activity Survey 2011–2012. Differences in discretionary choices intake and diet quality on weekdays versus weekends, were examined using ANCOVA analyses. Associations between child and parent-proxy characteristics and weekday/weekend discretionary choices intake were examined using multivariable regression models. Primary analyses included 2584 Australian 2–17-year-olds. There were small differences in discretionary choices intake and diet quality between weekdays and weekends in all age subgroups. Compared to weekdays, intakes on weekends were characterized by a higher intake of discretionary choices, and lower total Dietary Guidelines Index for Children and Adolescents (DGI-CA) scores across the age subgroups (all p < 0.01). Parent-proxy discretionary choices intake and child age were predictors of weekday and weekend discretionary choices intake. Parent-proxy obesity weight status compared with healthy weight status was a predictor of weekend intake, while parent-proxy education level was a predictor of weekday discretionary choices intake. Future intervention strategies should target discretionary choices intake on both weekdays and weekends.