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Background
The interconnectedness of physical inactivity and sedentarism, obesity, non-communicable disease (NCD) prevalence, and socio-economic costs, are well known. There is also strong research evidence regarding the mutuality between well-being outcomes and the neighbourhood environment. However, much of this evidence relates to urban contexts...
Citations
... Numerous studies have demonstrated the effectiveness of educating women on physical activity as a means of increasing their own levels of engagement (25)(26)(27)(28)(29)(30). Nevertheless, it is imperative to identify the various factors that influence women's participation in physical activities due to their complex intersection with financial circumstances, employment status, environmental conditions, family dynamics, cultural norms and sub-culture values, systems, religious practices, educational background, and socio-demographic traits (17,26,(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). ...
... The study findings are also in line with the results of studies conducted on rural women in the United States (54), diabetic individuals in Spain (40), adults in Australia (31), Korean-American women residing in the United States (34), and men and women aged between thirty and fifty years old from Rourkela, India (55). Further, it extends to encompass those over eighteen years of age from Tasmania, Australia (36) and urban adults between twenty and sixty years old based in Sri Lanka (51). Last but not least, when accounting for depressed individuals combined with type 2 diabetics aged anywhere from eighteen to sixty-five residing within Pakistan (49), and ultimately considering adults ranging from eighteen to eighty years old living within Lagos, Nigeria (50), family problems and lack of support were identified as significant barriers. ...
Background: The female population above the age of 50 exhibits a higher inclination toward sedentary lifestyles compared to their counterparts. Moreover, physiological factors, such as breastfeeding, pregnancy, and menopause, render women more susceptible to ailments and disabilities. This study was conducted in an attempt to discern various elements contributing to women’s physical activity levels in Ilam town. Methods: A targeted sampling approach was employed for this qualitative investigation. The data collection involved conducting individual interviews with 16 females who fell within the middle-aged bracket of 30–59 years in the year 2019 in Ilam town, Iran. These interviews followed a semi-structured format wherein open-ended questions were asked that aimed at gaining clear and comprehensive insights without any biasing influence. To derive patterns from these interviews, the content analysis method was utilized by identifying differences and similarities among codes, along with repetitions of semantic units. For this purpose, MAXQDA software (version 10) facilitated effective analysis. Results: Upon analyzing the obtained information from participants aged around 40, primarily homemakers; several categories emerged pertaining to advantages associated with regular physical activity, as cited by the respondents themselves. The overall outcome thus encompassed four distinct categories, disclosing beneficence related to consistent exercise engagement among them. The findings of the study were divided into three primary classifications, including comprehending the advantages of physical activity, explanatory factors, and persuasive factors. Additionally, there were barriers to regular physical activity that fell into seven major categories, including family, social, customary, economic, environmental, and cultural spheres. Each barrier encompassed both tangible and intangible aspects. Conclusion: The participants provided accounts of various individual, socioeconomic, political, and environmental elements that fostered consistent engagement in physical activity. Moreover, the study subjects reported encountering a range of barriers and facilitators with respect to cultural and economic influences on their physical activity levels. Therefore, strategies devised to encourage women’s involvement in physical activity should primarily focus on bolstering social support knowledge and self-efficacy while concurrently minimizing or eliminating cultural and economic hindrances. These socio-cultural factors should also be considered when formulating future initiatives by communities, organizations, and policymakers so as to develop interventions that more effectively align with the needs and perspectives of women.
... Much of the existing evidence base being underpinned by linear models of cause and effect is also exacerbating this issue. The whole-of-systems approach of the CAPITOL Project, along with 3 years of preliminary work [58][59][60] and early and frequent engagement of stakeholders in all aspects of project planning, is expected to elicit maximal translatory potential of the current SP initiative. Further, community-wide, representative consultation and equity in decision-making and agenda setting is also considered best practice in this line of intervention [53]. ...
Background:
Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The rampant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional "biomedical approach of care" to a "biopsychosocial model" required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level.
Objective:
The proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases; (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion; and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation.
Methods:
This paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated "navigator" will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives.
Results:
A multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on individuals, community groups, and the health care system will be implemented within the initial pilot phase of the project.
Conclusions:
Literature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life examples of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The diverse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap.
International registered report identifier (irrid):
PRR1-10.2196/41280.
Background
It is widely recognised that complex public health interventions roll out in distinct phases, within which external contextual factors influence implementation. Less is known about relationships with external contextual factors identified a priori in the pre-implementation phase. We investigated which external contextual factors, prior to the implementation of a community-centred approach to reducing alcohol harm called ‘Communities in Charge of Alcohol’ (CICA), were related to one of the process indicators: numbers of Alcohol Health Champions (AHCs) trained.
Methods
A mixed methods design was used in the pre-implementation phase of CICA. We studied ten geographic communities experiencing both high levels of deprivation and alcohol-related harm in the North West of England. Qualitative secondary data were extracted from pre-implementation meeting notes, recorded two to three months before roll-out. Items were coded into 12 content categories using content analysis. To create a baseline ‘infrastructure score’, the number of external contextual factors documented was counted per area to a maximum score of 12. Descriptive data were collected from training registers detailing training numbers in the first 12 months. The relationship between the baseline infrastructure score, external contextual factors, and the number of AHCs trained was assessed using non-parametric univariable statistics.
Results
There was a positive correlation between baseline infrastructure score and total numbers of AHCs trained (Rs = 0.77, p = 0.01). Four external contextual factors were associated with significantly higher numbers of lay people recruited and trained: having a health care provider to coordinate the intervention (p = 0.02); a pool of other volunteers to recruit from (p = 0.02); a contract in place with a commissioned service (p = 0.02), and; formal volunteer arrangements (p = 0.03).
Conclusions
Data suggest that there were four key components that significantly influenced establishing an Alcohol Health Champion programme in areas experiencing both high levels of deprivation and alcohol-related harm. There is added value of capturing external contextual factors a priori and then testing relationships with process indicators to inform the effective roll-out of complex interventions. Future research could explore a wider range of process indicators and outcomes, incorporating methods to rate individual factors to derive a mean score.
Trial registration
ISRCTN81942890, date of registration 12/09/2017.
