Evaluating physical activity interventions for socioeconomically disadvantaged adults through the RE-AIM framework: A systematic review of experimental and non-/quasi-experimental trials.

The promotion of physical activity in people from lower social strata is a public health priority. Previous reviews of physical activity interventions among socioeconomically disadvantaged adults have focused on intervention effectiveness without considering their translation into practice. This review utilised the RE-AIM framework (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance) to (1) evaluate the extent to which experimental and non-/quasi-experimental trials of interventions to promote physical activity among socioeconomically disadvantaged adults report on issues of internal and external validity and (2) to provide recommendations for future intervention studies. Four databases were searched through June 2021. We included studies published in English or German since 2000 that tested physical activity interventions for socioeconomically disadvantaged adults. Two researchers coded all studies using a validated RE-AIM data extraction tool with 61 indicators referring to internal and external validity. Binary coding (yes = 1/no = 0) was applied to calculate the number and percentage of studies reporting each of the indicators. We included 39 studies of which 22 were non-/quasi-experimental trials. Indicators of reach were most frequently reported (59.2%), followed by implementation (38.9%) and efficacy/effectiveness (28.9%). Dimensions related to external validity were least frequently reported (adoption: 21.9%, maintenance: 17.8%). Few differences were found between experimental and non-/quasi-experimental trials. Analysis showed overall poor reporting of components related to internal and external validity. We recommend that future research should increase attention on reporting indicators of internal and external validity to facilitate their translation and implementation into real world settings. Trial registration: The review was registered with PROSPERO (CRD42021283688).

Implementing the capability approach in health promotion projects: Recommendations for implementation based on empirical evidence.

OBJECTIVE: The aim of this paper was to develop a framework for the use of the capability approach in health promotion projects, which could guide future projects as well as improve the comparability of the projects' effectiveness. METHOD: The study involved a three-stage process comprising a total of six steps. We first developed a theoretical model and then analyzed data from four empirical studies that had implemented projects using the capability approach between 2015 and 2018 in the settings of kindergartens, schools, vocational training, and communities to promote an active lifestyle. Finally, we developed a framework for the use of the capability approach in health promotion projects based on the analysis of the data. RESULTS: We developed a theoretical model of the "capability cycle," which was used for further analysis. There were divergent understandings of the capability approach due to existing theoretical constructs that are commonly used by the scientific teams of the projects. Further, the conceptualization, implementation, and evaluation of the capability approach within the four settings showed discrepancies, which inhibited a comparison of their effectiveness. The developed framework comprises recommendations regarding the planning of a project, its implementation, and especially its evaluation in future comparisons of project effectiveness. CONCLUSION: This paper provides a comprehensive analysis of four projects for which we developed a framework using a participatory approach. The findings can help research teams in the conceptualization, implementation, and evaluation of future projects that focus on improving capabilities in the field of health promotion. Further, the established framework will help facilitate comparisons of capability-oriented health promotion projects in terms of their effectiveness.

Exploring Well-Being and Its Correlates among Young Men Using Sen's Capability Approach: Results from the Young Adults Survey, Switzerland (YASS).

BACKGROUND: The range of options people have to do the things they value in life may have strong effects on their well-being. This is especially true for young adults, as their opportunities and choices may affect both their current and future lives. This study follows Sen's capability approach (CA) to assess young people's well-being in terms of capabilities and functionings. METHODS: Repeated cross-sectional data from the Young Adult Survey Switzerland were used for the analysis (N = 58,615). Descriptive statistics were applied to analyze the distribution of capabilities and functionings according to individuals' capital equipment. Finally, multivariate regression analyses were conducted to investigate associations between social, cultural, and economic capital; overall capabilities; and functionings. RESULTS: Young men with lower capital equipment rated their capabilities and functionings lower than others. Capabilities and corresponding functionings differed in the domains of health, happiness, and intellectual stimulation. Multivariate analysis confirmed the effects of social, economic, and cultural capital on both overall capabilities and functionings. CONCLUSIONS: Young men differ in their perceived capabilities and functionings in different life domains according to their equipment with different forms of capital. To better understand the mechanisms underlying the transformation of capabilities into functionings, future studies should analyze issues of choice and adaptation to restricted living conditions.

Physical Activity as a Human Right?

Public awareness of the importance of physical activity has increased due to the many lockdowns imposed during the COVID-19 pandemic. This has brought more widespread attention to a question previously confined primarily to parts of the physical activity promotion community: Do humans have a right to be active? While the public health benefits of physical activity are undisputed, up to now no clear understanding has emerged as to whether physical activity represents a human right. Even though the right to physical activity is not explicitly recognized in international human rights treaties, it seems possible to derive it from well-established human rights such as the right to health, the right to rest and leisure, the right to education, and the principle of nondiscrimination. This paper shows how a right to physical activity could be derived from international human rights treaties, how the attributes of such a right could be defined, and which state obligations would be associated with it. Given that the current human rights discourse in this field focuses mainly on the interconnections between sport and human rights, we would like to argue that there is added value in a debate about physical activity as a human right.

Scientific Cooperation and the Co-production of Scientific Outcomes for Physical Activity Promotion: Results From a Transdisciplinary Research Consortium.

Background: To tackle complex societal challenges such as the high prevalence of physical inactivity, research funding is increasingly channeled toward cross-disciplinary research consortia. This study focused on exchange and cooperation (E&C) among the scientists of a 5-year transdisciplinary research initiative in Germany. Researchers' perceptions of E&C were combined with numbers of collaborative products during the project's life to make the developments of E&C and the quality of collaborative products visible. Methods: We applied a mixed-methods design including a qualitative content analysis of pre-interviews, focus-group interviews, and documents as well as a quantitative analysis of research (scientific publications, books, conference participations) and training outcomes (supervised bachelor's, master's, and Ph.D. theses). Inductive and deductive approaches were combined to analyze factors of collaborative readiness and to identify perceptions of E&C among project teams. Based on Hall et al.'s "Conceptual Model for Evaluation of Collaborative Initiatives," the project period was separated into phases of "collaborative readiness," "collaborative capacity," and "collaborative products." Results: Our findings revealed a discrepancy between the objectively assessed concepts of collaborative readiness and researchers' reported perceptions of E&C during the early project stage. A set of E&C hindering factors identified during the initial project phase remained present until the final project stage. Further, E&C among scientists increased over time, as reflected by researchers' perceptions. Reports of scientists also showed that outcomes were co-produced at the final project stage for the first time, while knowledge integration had not yet been achieved. Generally, the number of collaborative products (particularly scientific publications) also substantially increased over time. E&C was supported and promoted by the efforts of the coordinating sub-project. Conclusion: Scientific E&C is a learning process and needs time to develop. A participatory research approach taking into account the perspectives on and requirements for E&C during the project's design might lay the ground for suitable, supportive, and transparent conditions for effective and successful E&C. Despite their time- and resource-consuming nature, cross-disciplinary research initiatives provide a fertile context in which to generate new solutions for pressing societal issues given that long-term funding and the establishment of an overarching coordination organ is assured.

Development of national physical activity recommendations in 18 EU member states: a comparison of methodologies and the use of evidence.

OBJECTIVES: The aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were chosen for detailed case study analysis of development processes. DESIGN: Cross-sectional survey. PARTICIPANTS: The representatives of the 28 EU member state governments to the EU physical activity Focal Point Network. OUTCOME MEASURES: From national documents we extracted data on (1) the participants of the development process, (2) the different methods used during development, and (3) on which sources national PA recommendations were based. An additional survey for case study countries provided details on (1) anonymised information on the participants of development process, (2) methods employed and rationale for choosing them, (3) development process and timeline, and (4) main source documents used for recommendation development. RESULTS: Eighteen national documents on PA recommendations contained information about development process. The results showed that countries used different approaches to develop national recommendations. The main strategies were (1) adoption of WHO 2010 recommendations or (2) a combination of analysis and adoption of other national and international recommendations and literature review. All of the five case study countries relied on review processes rather than directly adopting WHO recommendations. CONCLUSIONS: While there are arguments for the use of particular strategies for PA recommendation development, there is currently no evidence for the general superiority of a specific approach. Instead, our findings highlight the broad spectrum of potential development methods, resources utilisation and final recommendations design currently available to national governments. These results may be a source of inspiration for other countries currently planning the development or update of national PA recommendations.