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Since the Lalonde report, contemporary public-health theory has given steadily more attention to the role of environments in influencing health status. Environments, both social and physical, influence health directly or through complex interactions with behavior, genetics and health-care systems. They are also important for public-health because e...
Contexts in source publication
Context 1
... is ample evidence that environmental conditions have an influence on human health by means of at least four pathways. Figure 1 represents these pathways graphically. Our dis- cussion below follows the numerical represen- tations of each pathway in Figure ...
Citations
... This for example by increasing opportunities for social interactions in the physical environment or through organized activities. Commers et al. [82] proposed an analytical instrument to use for strategies to influence various aspects of physical and social environments for health. Included in this instrument is the role of the public health professional when empowering groups or individuals to gain ability to undertake suitable environmental actions. ...
Background
The aim of the present study was to examine to what extent observed gender differences in mental health are associated with the protective factors social support, sense of coherence and participation in regular physical activity and more generally, engagement in organized or unorganized activity with other people.
Methods
This study was based upon a cross-sectional regional health survey in Norway, conducted during the winter of 2015–2016, in three southern counties; Aust-Agder, Vest-Agder and Vestfold. The study focused on young adults, comparing three age groups; 18–24 years old ( n = 624), 25–31 ( n = 582), and 32–38 years old ( n = 795).
Results
Sense of coherence was strongly associated with low mental distress in all age groups and for both genders, while the association between low social support and mental distress was significant for young women only. Regular physical activity was not positively associated with low mental distress when sense of coherence and social support were included in the analysis.
Conclusion
Social support appears to have a stronger role as a protective factor for mental distress among young women, compared to young men and older persons. This has implications for health promoting activities that target young women. Sense of coherence showed a strong association with low mental distress scores for all ages studied.
... This for example by increasing opportunities for social interactions in the physical environment or through organized activities. Commers et al. [80] proposed an analytical instrument to use for strategies to in uence various aspects of physical and social environments for health. Included in this instrument is the role of the public health professional when empowering groups or individuals to gain ability to undertake suitable environmental actions. ...
Background: The aim of the present study was to examine to what extent observed gender differences in mental health are associated with the protective factors social support, sense of coherence and participation in regular physical activity and more generally, engagement in organized or unorganized activity with other people.
Methods: This study was based upon a cross-sectional regional health survey in Norway, conducted during the winter 2015-2016, in three southern counties; Aust-Agder, Vest-Agder and Vestfold. The study focused on young adults, comparing three age groups; 18-24 years old (n=624), 25-31 (n=582), and 32-38 years old (n=795).
Results: Sense of coherence was strongly associated with low mental distress in all age groups and for both genders, while the association with social support was highly significant for young women only. Regular physical activity was not positively associated with low mental distress when sense of coherence and social support were included in the analysis.
Conclusion: Social support appears to have a stronger role as a protective factor for mental distress among young women, compared to young men and older persons. This has implications for health promoting activities that target young women. Sense of coherence showed a strong association with low mental distress scores for all ages studied.
... It was important to consider individual and intrapersonal factors, in addition to a range of interpersonal factors including social support, institutional and community environments and broader social, economic and political influences. These emphasise the complex environment in which the causes and conditions of individual health behaviour are determined (Best et al. 2003;Commers, Gottlieb, and Kok 2007;Green et al. 2015) and in so doing elevate the importance not only of engaging with individuals and groups but also exploring the linkages between individuals and groups who affect, and are affected by, efforts to improve health. This is highly consistent with an approach that seeks to understand sport's role in facilitating community health development (Edwards 2015). ...
Ecological approaches to health promotion have been increasingly adopted to address the complexities of increasing population level physical activity. These approaches understand individual behaviour in terms of the outcome of interactions between multiple biological, psycho-sociological and environmental factors which require complex and multilevel interventions. However, the health promotion field has been hampered by a lack of evaluation frameworks that provide sufficient flexibility to accommodate the complexity of ‘real world’ settings which lie at the heart of ecological approaches. In order to evaluate a small grants community health promotion programme this study deployed a social-ecological evaluation framework operationalised through a Social Return on Investment (SROI) methodology. This sought to understand and assess the broader social outcomes relating to the implementation of range of local physical activity and sport projects, and to maintain stakeholder engagement throughout. The formative and summative components of the evaluation are described before results are presented, which include qualitative findings and outcome indicator values. Findings highlight a diverse range of societal outcomes at the individual level for example, improved physical and mental health, and community level for example, community connectedness, which reflect a range of social, personal and interpersonal, and economic benefits. The SROI methodology not only provides social enterprises with a framework for measuring performance and impact, but is also shown to be a valuable management and stakeholder engagement tool for those commissioning local physical activity and sport programmes of this type.
... At the same time, the BE can affect health in a less direct, and perhaps more complex, manner by influencing individuals' lifestyles and shaping their behaviors in the space (Commers, Gottlieb, & Kok, 2007). This line of research builds upon the findings by environmental psychologists that behaviors may be predicted more accurately from the situations people are in than from their individual characteristics (Wicker, 1984). ...
A growing body of evidence from environmental health promotion research shows that the physical environment can affect health directly or through complex interactions with people’s behavior. A holistic understanding of these effects requires that we study individuals’ behavior in space. Nonetheless, finding the right geographical context and translating it into a working spatial unit of analysis is far from easy. As a result, researchers have used a variety of spatial units in empirical research. Among these units, activity spaces have been especially gaining interest.
Activity space models have been implemented in different ways to represent the area within which individuals travel during the course of their daily activities. Nonetheless, despite the fundamental role of activity spaces in empirical analysis, they have rarely been at the center of scholarly focus. This has contributed to a lack of conceptual and methodological consensus related to how activity spaces are defined and used in environmental health research. Recent evidence suggests that this might have resulted in uncertainties that negatively affect the validity of empirical findings. However, little is known about the involved mechanisms, their implications, and how they should be addressed in research. This dissertation takes steps toward filling these gaps.
Initially, this dissertation aims to disambiguate the concept of activity space through a literature review. Following this conceptual clarification, the dissertation pursues its methodological objectives by implementing two novel individual-based activity space models. The first model, dynamic home range, is a versatile polygon representing an improved estimation of individual residential area. The second, individualized residential exposure model (IREM), is a more advanced model of activity space that incorporates a place-based estimation of exposure to provide a more refined picture of individuals’ spatial behavior.
This dissertation goes further by presenting an empirical framework for the measurement and use of activity space in research. While this framework shows how the relationships between activity space and personal and environmental characteristics can be multidimensionally examined, it also reveals interesting empirical findings from the Helsinki metropolitan area. These studies are based on data collected though online public participation geographical information system (PPGIS) surveys.
Another contribution of this dissertation is to provide empirical evidence on how the choice of spatial units can considerably affect the results regarding the associations between the environment and health. The findings elucidate the implicit mechanisms that can affect the results and help provide guidelines for the choice of spatial units in research. Finally, this dissertation presents a set of practical geographical information system (GIS) tools that can facilitate use of advanced activity space models in environmental health research.
... This reflects the ecological model's emphasis on multiple, overlapping and interacting influences on health (Golden and Earp, 2012;Jolley, 2014). Thinking expansively in this way emphasizes health and the complex environment in which the causes and conditions of individual health behaviour are determined (Best et al., 2003;Commers et al., 2007;Green and Tones, 2010). In doing so, it elevates the importance not only of engaging with individuals and groups, but also of exploring the linkages between individuals and groups who affect, and are affected by, efforts to improve health. ...
... Carpini, Cook, and Jacobs (2004) have expanded the understanding of democracy, in contrast to voting-centric views, by positing the term public deliberation. Although they maintain that deliberative democracy focuses on communicative processes and the discussion of opinions, it remains unclear how politicians and stakeholders can involve citizens in those processes and in local planning in order to provide them with real opportunities to influence the future of their communities (Carpini et al., 2004;Commers, Gottlieb, & Kok, 2007). ...
... The results of the study presented here offer some examples about what citizens' participation can be, partly in response to Crawford et al.'s (2008) call to concretize and contribute to more empowering municipalities. Experience bears out that citizens are seldom asked to be involved in health promoting policy planning (Commers et al., 2007;Fransen et al., 2015;Lillefjell et al., 2013;Lillefjell et al., 2017). The study has concretized bottomup strategies that are lacking from most public health works. ...
Health promotion has generally relied on traditional forms of community planning without including citizens, despite their occupation-based experiences and knowledge about the society in which they live. Acknowledging that it is a challenge for stakeholders to involve citizens in public health planning, this study explores why and how stakeholders might facilitate the involvement of citizens in public health planning as a part of a municipality's health promotion work. Data were obtained through interviews with six key stakeholders (f=4, m=2) working in the local community. Qualitative analysis generated two themes and six subthemes: I) Involving whom and why, with four subthemes of i) Addressing justice, ii) Generating ownership, iii) Developing trust and a feeling of togetherness, and iv) Concretizing the history, values, uniqueness, and identity of the city; as well as II) Considering differences, with two subthemes of i) Accommodating creativity and ii) Building confidence. The discussion highlights how occupation-based knowledge from citizens can strengthen the quality of public health planning and the successful local implementation of health promotion policy.
... It also organized the comprehensive evaluation plan (Cooksy, Gill, & Kelly, 2001; Figure 1). Intervention staff worked with preschool teachers, who in turn operated as organizational change agents (Commers, Gottlieb, & Kok, 2007) and carried out the intervention (Pfeiffer et al., 2013). As recommended (Durlak & DuPre, 2008), interventionists provided training, site visits, ongoing technical assistance, and resource materials (Howie et al., 2014). ...
This study investigated the utility of the Study of Health and Activity in Preschool Environments (SHAPES) conceptual model, which targeted physical activity (PA) behavior in preschool children, by examining the relationship between implementation monitoring data and child PA during the school day. We monitored implementation completeness and fidelity based on multiple elements identified in the conceptual model. Comparing high-implementing, low-implementing, and control groups revealed no association between implementation and outcomes. We performed post hoc analyses, using process data, to refine our conceptual model's depiction of an effective preschool PA-promoting environment. Results suggest that a single component of the original four-component conceptual model, providing opportunities for moderate-to-vigorous physical activity through recess for 4-year-old children in preschool settings, may be a good starting place for increasing moderate-to-vigorous physical activity. Interventions that are implemented with optimal levels of completeness and fidelity are more likely to achieve behavior change if they are based on accurate conceptual models. Examining the mechanisms through which an intervention produces its effects, as articulated in the conceptual model that guides it, is particularly important for environmentally focused interventions because they are guided by emerging frameworks. The results of this study underscore the utility of using implementation monitoring data to examine the conceptual model on which the intervention is based.
... As previously stated, enabling people to use their GRRs to deal with stressors may lead to increased levels of SOC. In addition, health can be positively affected when people behave more adaptive in stressful situations, for example by seeking help from the social environment to overcome certain problems (Commers et al., 2007). As Antonovsky (Antonovsky, 1979) puts forward, having plenty of GRR's available does not necessarily produce health, people actively have to use the GRRs to deal with the stressors. ...
Sense of coherence (SOC) reflects a coping capacity of people to deal with everyday life stressors and consists of three elements: comprehensibility, manageability and meaningfulness. SOC is often considered to be a stable entity that is developed in young adulthood and stabilizes around the age of 30. Recent studies have questioned this stability of SOC and some studies report on interventions that have been successful in strengthening SOC in adult populations. Currently, however, there is no clear understanding of the mechanisms underlying SOC. As a consequence, it is a challenge to determine what is needed in health promotion activities to strengthen SOC. This article aims to explore the mechanisms underlying SOC as these insights may underpin future health promotion efforts. An exploration of the salutogenic model suggests two important mechanisms: the behavioural and the perceptual. The behavioural mechanism highlights the possibility to empower people to use their resources in stressful situations. The perceptual mechanism suggests that, in order for people to deal with life stressors, it is essential that they are able to reflect on their understanding of the stressful situation and the resources that are available. Based on these mechanisms, we suggest that both empowerment and reflection processes, which are interdependent, may be relevant for health promotion activities that aim to strengthen SOC. The successful application of resources to deal with stressors is not only likely to have a positive influence on health, but also creates consistent and meaningful life experiences that can positively reinforce SOC levels.
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... The ENRICH intervention entailed developing working relationships with RCH staff to achieve the mutually agreed-upon goal of enhancing RCH social and physical environments to promote PA for children residing in the homes. Adult staff formed small working groups, Wellness Teams (WT) which served as organizational change agents (Commers, Gottlieb, & Kok, 2007) by developing and carrying out plans to create RCH environments that supported PA. Project staff provided two annual regional WT trainings between 2004 and 2006 (Early Group) and 2006-2008 Delayed Group. ...
... Each church formed a FAN committee and attended a training that focused on assessing current church activities to promote physical activity and healthy eating and then ways to add, enhance, or expand them. The FAN committee thus served as organizational change agents (Commers, Gottlieb, & Kok, 2007). Churches were asked to implement physical activity and healthy eating activities that targeted each of the four structural factors within the structural ecologic model (Cohen et al., 2000): availability and accessibility, physical structures, social structures, and cultural and media messages. ...
... The results presented here underscore the importance of clearly defining what constitutes implementation by operationalizing the program elements necessary to produce change (Bartholomew, Parcel, Kok, & Gottlieb, 2006;Harachi, Abbott, Catalano, Haggerty, & Fleming, 1999;Lillehoj, Griffin, & Spoth, 2004;Scheirer et al., 1995). This may be particularly important when the intervention components are defined at the organizational level (i.e., the Health-Promoting Church) and are implemented by existing church personnel who receive staff development and on-going consultation, as recommended for environmental change (Commers et al., 2007). Due to the complexity of the FAN intervention and settings, it was essential that we monitor implementation and examine the chain of events or causal pathway from implementation to outcomes guided by the FAN logic model. ...
Faith, Activity and Nutrition (FAN), a community-based participatory research project in African American churches, aimed to increase congregant physical activity and healthy eating. The Health-Promoting Church framework, developed collaboratively with faith-based partners, guided the intervention and a comprehensive process evaluation. The Health-Promoting Church components related to healthy eating and physical activity were getting the message out, opportunities, pastor support, and organizational policy. There was no evidence for sequential mediation for any of the healthy eating components. These results illustrate the complexity of systems change within organizational settings and the importance of conducting process evaluation. The FAN intervention resulted in increased implementation for all physical activity and most healthy eating components. Mediation analyses revealed no direct association between implementation and increased physical activity; rather, sequential mediation analysis showed that implementation of physical activity messages was associated with improved self-efficacy at the church level, which was associated with increased physical activity.
