Implementation of interventions to maintain and promote the functional mobility of nursing home residents - a scoping review.

BACKGROUND: To provide an overview of the available evidence on the implementation of direct and capacity-building interventions to promote and maintain the functional mobility of nursing home residents. METHODS: We conducted a scoping review following the methodological guidance for the conduct of scoping reviews as described by the Joanna Briggs Institute. We searched for studies in MEDLINE (via PubMed) and CINAHL (via EBSCO). We conducted a qualitative content analysis of the included studies with deductive categories based on the Consolidated Framework for Implementation Research (CFIR). RESULTS: Ultimately, we included 8 studies on direct interventions, 6 studies on capacity-building interventions, and 2 studies on both types of interventions in our review. Seven studies provided evidence on implementation strategies comprising discrete as well as multifaceted, multilevel strategies. Most of the studies did not systematically evaluate the strategies but remained at a descriptive level. All 16 studies provided evidence of influencing factors. We identified 32 of the 37 influencing factors of the CFIR. The five most frequent influencing factors were available resources (n = 14), access to knowledge and information (n = 12), patient needs and resources (n = 10), knowledge and beliefs about the intervention (n = 10) and compatibility (n = 9). CONCLUSIONS: The available evidence on the implementation of functional mobility interventions in nursing homes is rather limited. This emphasizes the need for further research. Regarding implementation strategies, the systematic evaluation and further development of the reported promising approaches might be a starting point.

[Development of intervention databases to promote evidence-based prevention and health promotion-methodological considerations]. / Aufbau von Interventionsdatenbanken für mehr Evidenzbasierung in Prävention und Gesundheitsförderung ­ methodische Überlegungen.

Municipal actors do not experience sufficient scientific support in the development and selection of preventive and health promoting interventions. Intervention databases can remedy this by presenting scientifically validated and well-documented interventions. This allows local decisions to be informed by scientific evidence on the effectiveness of interventions. The databases can also be used to promote quality development of interventions.This paper explains methodological and conceptual considerations on how preventive and health-promoting interventions can be identified for databases and how they can be classified in terms of their effectiveness and prepared in a way that is appropriate for the target group. It is based on findings from the public health literature and the project "Ageing in Balance" ("Älter werden in Balance") of the Bundeszentrale für gesundheitliche Aufklärung (BZgA).Systematic reviews are of limited use in the search for suitable interventions for the database, partly because the types of interventions listed in them are limited and information relevant to implementation is often incompletely presented. However, it seems promising to include interventions from practice in the database if they are additionally classified with regard to their effectiveness or if consequences for further development and evaluation are formulated. In addition, as much information as possible should be provided on the practical implementation of interventions. A first suggestion shows what a description of the measures could look like. In addition, manuals for the implementation of measures should be available.

[Promotion of physical activity among the elderly as an example of knowledge translation: How do scientific findings enter community practice?] / Wissenstranslation am Beispiel Bewegungsförderung von älteren Menschen: Wie gelangen wissenschaftliche Erkenntnisse in die kommunale Praxis?

BACKGROUND: Scientific findings can be an important source of knowledge for public health stakeholders involved in promoting physical activity, but several barriers hinder their use. Knowledge translation can simplify this process, but it requires the understanding of the stakeholder's needs. OBJECTIVES: This qualitative study aims to describe how public health stakeholders access information and scientific findings, identify possible barriers, and highlight the needs of stakeholders in terms of presentation and processing. MATERIALS AND METHODS: Semi-structured interviews were conducted with twelve local- and state-level stakeholders from North Rhine-Westphalia, Saxony-Anhalt, and Thuringia working in the area of physical activity promotion. The interviewees were selected through purposive sampling. The interviews were evaluated using qualitative content analysis. RESULTS: The benefits of scientific findings are emphasized by the interviewees, but a lack of resources in combination with a flood of information, high complexity, and technical jargon complicate their application. There is a need for tailored preparation in the form of summaries, filter functions, elaboration of practice-relevant elements, and ways of provision. CONCLUSIONS: To achieve successful knowledge translation, collaboration and interactive exchange between researchers, policymakers, and practice as well as a demand-oriented processing of scientific findings are central. Networking and bundling of knowledge on a platform are important tasks for the future.

"It's like you are in the jungle": Using the draw-and-tell method to explore preschool children's play preferences and factors that shape their active play.

ISSUE ADDRESSED: A child's preference for active or sedentary play is a key proximal indicator of a child's physical activity behaviour. There is a need to understand children's physical activity preferences in order to make physical play more enjoyable to them, and this may encourage participation and a more positive relationship with physical activity. To date, little research has incorporated the perspectives of young children on this topic. This study specifically examines (a) what activities preschool children prefer; and (b) what children consider to be barriers and facilitators to participating in their preferred activity. METHODS: The authors employed visual methodologies to explore the activity preferences of 29 preschool children. Children were asked to draw their preferred activities and answer a series of open and closed questions about their drawing and what they think are the barriers and facilitators to participating in this activity. RESULTS: Participants expressed a desire to play unstructured activities with friends or family, to engage in imaginative, challenging play, as well as the opportunity to have control over the activity they engage in. Children reported that rules at home and at preschool, the availability of toys, friends and family and having access to a natural environment served as both barriers and facilitators to participating in their favourite activity. CONCLUSIONS: Listening to children's voices about their play preferences and the barriers and facilitators to engaging in these activities provides important insight into children's play behaviour and the promotion of active play in early childhood. Participants' desire for more natural features within their play environment and for challenging, unstructured and imaginative play may be considered as facilitators of their engagement in physical activity. SO WHAT?: The current findings suggest the incorporation of unstructured playtime within natural environments could support young children's participation in and increased enjoyment of physical activity.

Development and reliability testing of an audit toolbox for the assessment of the physical activity friendliness of urban and rural environments in Germany.

Background: According to socio-ecological theories, physical activity behaviors are linked to the physical and social neighborhood environment. Reliable and contextually adapted instruments are needed to assess environmental characteristics related to physical activity. This work aims to develop an audit toolbox adapted to the German context, to urban and rural settings, for different population groups, and different types of physical activity; and to evaluate its inter-rater reliability. Methods: We conducted a systematic literature search to collect existing audit tools and to identify the latest evidence of environmental factors influencing physical activity in general, as well as in German populations. The results guided the construction of a category system for the toolbox. Items were assigned to the categories based on their relevance to physical activity and to the German context as well as their comprehensibility. We piloted the toolbox in different urban and rural areas (100 street segments, 15 parks, and 21 playgrounds) and calculated inter-rater reliability by Cohen's Kappa. Results: The audit toolbox comprises a basic streetscape audit with seven categories (land use and destinations, traffic safety, pedestrian infrastructure, cycling infrastructure, attractiveness, social environment, and subjective assessment), as well as supplementary tools for children and adolescents, seniors and people with impaired mobility, parks and public open spaces, playgrounds, and rural areas. 76 % of all included items had moderate, substantial, or almost perfect inter-rater reliability (κ > 0.4). Conclusions: The audit toolbox is an innovative and reliable instrument for the assessment of the physical activity friendliness of urban and rural environments in Germany.

Health promotion and disease prevention registries in the EU: a cross country comparison.

BACKGROUND: Health promotion and disease prevention programme registries (HPPRs), also called 'best practice portals', serve as entry points and practical repositories that provide decision-makers with easy access to (evidence-based) practices. However, there is limited knowledge of differences or overlaps of howe current national HPPRs in Europe function, the context and circumstances in which these HPPRs were developed, and the mechanisms utilised by each HPPR for the assessment, classification and quality improvement of the included practices. This study prepared an overview of different approaches in several national HPPRs and the EU Best Practice Portal (EU BPP) as well as identified commonalities and differences among the core characteristics of the HPPRs. METHODS: We conducted a descriptive comparison - that focused on six European countries with existing or recently developed/implemented national HPPR and the EU BPP -to create a comparative overview. We used coding mechanisms to identify commonalities and differences; we performed data management, collection and building consensus during EuroHealthNet Thematic Working Group meetings. RESULTS: All HPPRs offer a broad range of health promotion and disease-prevention practices and serve to support practitioners, policymakers and researchers in selecting practices. Almost all HPPRs have an assessment process in place or planned, requiring the application of assessment criteria that differ among the HPPRs. While all HPPRs collect and share recommendable practices, others have implemented further measures to improve the quality of the submitted practices. Different dissemination tools and strategies are employed to promote the use of the HPPRs, including social media, newsletters and publications as well as capacity building workshops for practice owners or technical options to connect citizens/patients with local practices. CONCLUSIONS: Collaboration between HPPRs (at national and EU level) is appreciated, especially regarding the use consistent terminology to avoid misinterpretation, facilitate cross-country comparison and enable discussions on the adaption of assessment criteria by national HPPRs. Greater efforts are needed to promote the actual implementation and transfer of practices at the national level to address public health challenges with proven and effective practices.

Interventions simultaneously promoting social participation and physical activity in community living older adults: A systematic review.

Background: In recent years, there has been a global trend toward an increase in life expectancy and the proportion of elderly people among the population. In this regard, it becomes important to promote active and healthy aging. Physical inactivity and social isolation are both risk factors of many chronic illnesses and highly prevalent in older adults. This challenges communities to develop interventions that reduce these risk factors among elderly populations. The main aims of this study were to summarize community-based interventions that aim to simultaneously promote social participation and physical activity in older adults and to examine their effects. Methods: We performed a systematic review based on the PRISMA standards. Literature searches were conducted in six scientific databases in July 2021. Articles were included if they had an interventional design, focused on older adults living in the community and measured social participation and physical activity as an outcome. The data were summarized narratively due to the heterogeneity of studies and the variety of outcome measures. Results: Overall, 46 articles published in English were included. The studies were grouped in (1) interventions with main focus on physical activity promotion; (2) social activities that included a physical activity component; (3) health behavior interventions/ health education interventions; (4) multicomponent interventions; (5) environmental interventions. The majority of the reviewed studies reported positive effects of interventions on physical activity and/or social participation. No study reported negative effects. Analysis of quantitative studies showed that multicomponent interventions have great positive effects on both outcomes. In qualitative studies positive effects were found regardless of intervention type. Conclusion: This review summarizes the evidence about the effects of community-based interventions that aim to promote social participation and physical activity in older adults. Multicomponent interventions seem to be most suitable for simultaneous promotion of physical activity and social participation. However, high variability in measurement methods used to assess both social participation and physical activity in the included studies made it difficult to compare studies and to indicate the most effective. Systematic review registration: www.crd.york.ac.uk, identifier: PROSPERO [CRD42021268270].

Organizational Capacity Building in Nursing Facilities to Promote Resident Mobility: A Systematic Review.

OBJECTIVES: The objective of the present systematic review was to investigate the effects of organizational capacity building interventions on the environment, nursing staff capacity, and mobility of residents in nursing facilities. DESIGN: Systematic review. SETTING AND PARTICIPANTS: Nursing facilities, staff, and residents. METHODS: We conducted a systematic review according to the methods of the Cochrane Collaboration. The systematic review was prospectively registered in the PROSPERO database of systematic reviews (registration number CRD42020202996). We searched for studies in MEDLINE (via PubMed), CINAHL (via EBSCO), the Physiotherapy Evidence Database (PEDro), and the Cochrane Library (07/20). A narrative synthesis was conducted because of the high heterogeneity of the included studies. RESULTS: We identified 6747 records and included 14 studies in our review. We clustered the 14 interventions into 3 different categories (environmental modification, nursing staff capacity, and multifactorial interventions). Three studies assessed outcomes at the nursing staff level, and all studies reported outcomes at the resident level. We found highly heterogeneous and inconsistent effects of organizational capacity building on increasing nursing staff capacity and/or resident mobility. CONCLUSIONS AND IMPLICATIONS: The findings emphasize the need for further research focusing on an international understanding and definition of organizational capacity building. Additionally, research and intervention development for organizational capacity building interventions to promote resident mobility are needed while applying the framework of the Medical Research Council. Furthermore, studies should assess outcomes regarding the environment and nursing staff to better understand if and how environmental structures and nursing staff capacity effect resident mobility.

A Systematic Review of Data Collection Techniques Used to Measure Preschool Children's Knowledge of and Preference for Physical Activity.

BACKGROUND: Early childhood has been identified as a crucial period in which children develop physical activity preferences and behaviors. Both the knowledge of and preferences for physical activity are key proximal indicators of activity choices in children. Thus, accurate data collection tools are required to measure these variables. This review evaluates the data collection techniques that have been utilised to assess preschool children's knowledge of and preference for physical activity, and examines the validity and reliability of existing techniques. METHODS: A systematic search for relevant studies published from 1980 through to December 2017 was conducted via ProQuest, CINAHL, Embase, Scopus, ERIC, PubMed, MEDLINE, and ScienceDirect. RESULTS: Fourteen studies were eligible for inclusion in the review. The identified studies employed a limited but disparate range of techniques to assess children's physical activity knowledge and preferences. Findings reveal that four techniques were consistently used across the reviewed studies, including: interviews, structured play-based activities, questionnaires, and observations. Only four out of 14 included studies reported the assessment of the validity of the data collection tool used, and six reported testing the measures for at least one type of reliability. CONCLUSION: There is a need for validated and reliable measures to assess children's knowledge of and preference for physical activity. Greater consideration is required to align data collection techniques with the characteristics, needs and abilities of this study population.