Final children Flashcards
define metabolic syndrome
clustering of RFs for CVD and T2DM including…
IDF management of metabolic
moderate calorie restriction (5-10% loss of body weight)
Moderate increase in PA
Change in dietary composition
Relationship between PA/ SB and cognition
Depends on construct measured
Single bout can benefit cognition
Evidence for daily PA and cognition relationship is still equivocal
Relationship between PA/SB and AA
Classroom PA does no harm
Classroom PA can improve achievement in certain subjects
Emerging evidence inverse relationship between TV viewing and AA
Evidence for daily PA on AA is still equivocal
Why should we care about the young athlete or sports participation?
Large % of MVPA
Associated with other benefits ouside of EE
Harmful for growing child
Sport and talent ID causing dropout/ harm?
How does maturity timing impact sports participation?
Talent ID and athlete selection
Self selection and drop out
DEsign of training and conditioning programs and potential for injury
Grouping of athletes for comp and practice
Difference between talent selection and ID
Selection = best players now in children
ID = training large numbers of players instead of cutting all but elite
Tips for coaches
Aware of whos the oldest Focus on participation and experimentation Dont cut people Gift is in despire Use motor skills to monitor not select
Ash’s current evidence summary for PAL
• Physically active lessons do not:
– lead to increased overall daily physical activity
– lead to reduced overall daily sedentary time
• Physically active lessons may:
– lead to increased physical activity in the classroom
– lead to decreased sedentary time in the classroom
– increase attention to tasks in the classroom
– increase academic achievement in some subjects
– increase pupil’s enjoyment of learning
• Physically active breaks can lead to increased physical activity in the classroom
Current evidence (PAL) limitations
Short duration interventions
• Lack of (long) follow-up
– What happens when the intervention finishes?
• Small sample size
• Few studies have developed interventions using behavioural theory
• Few studies utilise inclinometers to measure sitting time
• Lack of assessment on out of school physical activity/sedentary
• Lack of generalisability, most studies based in USA + Australasia
• Lack of implementation data
Aim of the behaviour change wheel
•
The BCW provides a systematic way of identifying relevant intervention functions and policy categories based on what is understood about the target behaviour
how many intervention functions/ policy categories?
9 intervention
7 policy
What is motivation?
The sum total of internal influences that energise and directs behaviour: a moment-by-moment property which is shaped by different systems of influence: physiological, impulses and inhibitions, motives, beliefs and identitys
Reflective
People’s values and beliefs about what is important (good and bad), conscious intentions, decisions and plans
Autonomic
Emotional responses, desires and habits resulting from associative learning and physiological stress e.g. make somehing fun/ rewarding
What is capaciticy
an individual’s psychological and physical capacity to engage in the activity concerned
Psychological capability
Any mental process or skill that is required for the person to perform the behaviour
Physical capability
Any set of physical actions that requires an ability or proficiency learned through practice e.g. motor skill, fitness level
What is opportunity
The external social & physical factors that make wanted behaviours more likely to happen & the unwanted behaviours less likely to happen
Physical
Anything in the physical environment that discourages or encourages the performance of the behavior
e.g. stair use prompts, availability of standing desks, size of classroom
Social
Influences that come from friends, family, colleagues & other influential people that support the doing or not doing of a behaviour either by provision of direct support or by influencing the way people think or feel about a behaviour
Transform us aims
Determine whether an 18-month, behavioural and environmental intervention in the school and family setting results in a higher level of PA and lower rates of SB among 8-9 year olds children
Determine independent and combined effects of PA and SB on children’s cardiometabolic health
Identify factors that mediate the success of the intervention
Determine if the intervention is cost-effective
Categories of components of interventions in transform us
Curriculum component Class strategies Physical environment Homework tasks Newsletters (Teacher proffesional development, lesson plans)
What type of economic evaluation
x
Tranform us mid intervention 5-9 month results
SB+PA group spent 13.3 min/day less SED compared to control
SB group had higher enjoyment of standing
PA+SB and PA groups had more positive perceptions of standing opportunities
No mediating effects were observed
Why no sig mediators in transform us?
Measurement quality of self-reported mediators
Failure to capture the relevant mechanisms that explain the association between intervention and PA or SB
Time lag between change in mediators and change in behaviour
Unpublished end of intervention results for transform us
After 2.5 years children significantly:
Increased their PA at recess and lunchtime by 33 minutes per week
Reduced their sitting time by 196 minutes per week
Preliminary cost analysis shows that Transform-Us! cost ~ $30.08 per child per year ($0.08 per child per day).
Approach to ADG
Multi agency and sector
Evidence based approach (stars)
Urban planners, designers, architects, policy makers, government agencies
Basic concepts ADG`
Active transport
Active Buildings
Active recreation
Healthy eating
ADG survey domains assessed
Knowledge of evidence linking the built environment and health
Confidence to implement ADG strategies
Implementation of ADG strategies (i.e., self‐reported practice)
Perceptions of clients’ attitudes toward active design
What does FLAIR stand for
Family lifestyle intervention of future risk.
Results of FLAIR evaluation
Parents expressed a desire to change behaviours to achieve healthier families
They believed that doctors should increase their focus on healthy habits during visits
Parents were more accepting of nutrition discussions than increasing activity (citing a lack of safe outdoor space) or decreasing sedentary behaviours (citing many benefits of television viewing)
Parents expressed frustration with physicians for offering advice about changing behaviour but not how to achieve it
Also focus groups
what is social marketing?
Application of commercial marketing technologies to the analysis, planning, execution, and evaluation of programs designed to influence the voluntary behaviour of target audiences in order to improve their personal welfare
Initial aim of C4L
drive, coax, encourage and support people . . . [to] eat well, move more and live longer
What does C4L involve?
Advertising
Sponsership of The Simpsons
Direct and relationship marketing
Digital communications e.g. Website and emails
Public relations
Partnership marketing
Communications aimed at stakeholders e.g. Health adn teachers
independent evaluation
cluster RCT - just questionnaire - baseline and follow up No change in TV viewing No change in PA importance Increased awareness of campaign Little impact on attitude or behaviour Low engagement a key issue (Obesity mention?)
Reach
• The absolute number, proportion, and representativeness
of individuals who are willing to participate in a given
initiative
Efficacy/ Effectiveness
The impact of an intervention on important outcomes, including potential negative effects, QoL and economic outcomes
Efficacy = best case scenario in controlled session e.g. Ideal delivery
Effectiveness = real world e.g. Train teachers, absent children
Adoption
• The absolute number, proportion, and
representativeness of settings and intervention
agents (modalities) who are willing to initiate a
program.
Do differences exist between participating sites
or agents
Implementation
At the setting level, implementation refers to the
intervention agents’ fidelity to the various
elements of an intervention’s protocol.
This includes consistency of delivery as intended
and the time and cost of the intervention.
Maintainence
The extent to which a program or policy becomes
institutionalized or part of the routine organizational practices
and policies.
• Within the RE-AIM framework, maintenance also applies at
the individual level.
• At the individual level, maintenance has been defined as the
long-term effects of a program on outcomes after 6 or more
months after the most recent intervention contact.
Study overview reporting
Rationale: – Why was the study conducted? – What was the gap in the research area? • Measurement: – How were the primary and secondary outcomes collected? – What were the advantages and disadvantages? • Target: – Who was the intervention aimed at? – How representative was the sample? – Was the sample fit for purpose? • Intervention and Resources: – What was the intervention? – How long did it last? – What was the participant burden?
Why disconnect between research and practice?
Research • Homogenous, highly motivated children/setting • Intensive, clinic-based intervention • Relatively brief and lack of follow-up • Implemented by research staff • Funded study – Dedicated staff – Cost effectiveness Practice • Diverse population level • ‘Real world’ setting • Implementation by nonresearch staff • Competes with other areas for funding and focus • Subject to whims of policymakers • Relies on ‘champions’
