From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis
Abstract
:1. Introduction
2. Methods
2.1. Literature Scoping and Initial Programme Theory Development
2.2. Searching Process
2.3. Selection and Appraisal of Documents
3. Results
3.1. Step 1: Emersion of Scientific Evidence and Definition of an Agenda Setting
3.1.1. Sub-Question
- How and Through which Mechanism of Advocacy did PA enter onto the Agenda Setting?
3.2. Step 2: Formulation and Dissemination of PA Guidelines
3.2.1. Sub-Questions
- Are PA guidelines developed synthesising data meaningful for different policy sectors?
- Is there coherence among PA guidelines delivered by different authorities?
3.2.2. The Source of Evidence
3.2.3. Proliferation of Guidance and Contrasting Evidence
3.3. Step 3: Adoption of PA Guidelines within National PA Plans and Regulatory Measures at Local Level
3.3.1. Sub-Questions
- Are PA guidelines coherently integrated within national/regional plans for PA, physical education at school and sports promotion?
- Which are the determinants of effective PA guidelines adoption in the health sector at local government level?
- Is the perception of PA as a policy priority influenced by policy sectors different from health (transport, urban planning)?
- Did medical schools adopt curricula coherently with PA guidelines?
3.3.2. Adoption of PA Guidelines within the Education and Sport Sectors
3.3.3. Adoption of PA Guidelines in the Health Sector and Differences among Jurisdictional Levels
3.3.4. Adoption of PA Guidelines in the Transport and Urban Planning Sectors
3.3.5. Medical School Curricula and PA Guidelines Contents
3.4. Step 4: Implementation of Interventions for PA Promotion and Compliance by Actors in Different Sectors
3.4.1. Sub-Questions
- Do school principals’ beliefs about compatibility of PA and academic achievement matter?
- Do medical doctors’ attitudes influence PA prescription?
- Do urban planners’ and administrators’ attitudes influence PA promotion interventions?
3.4.2. School Principals’ Beliefs about Compatibility of PA and Academic Achievement Goals
3.4.3. Attitude toward PA Prescription by General Practitioners and Clinicians
3.4.4. Attitude toward PA Promotion Interventions by Urban Planners and Administrators
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
- World Health Organization. Global Status Report on Noncommunicable Diseases. Available online: http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf?ua=1 (accessed on 2 October 2017).
- World Health Organization. Draft WHO Global Action Plan on Physical Activity 2018–2030. Available online: http://www.who.int/ncds/governance/gappa_version_4August2017.pdf (accessed on 2 October 2017).
- Council of the European Union. Council Recommendation of 26 November 2013 on Promoting Health-Enhancing Physical Activity across Sectors. Official Journal of the European Union. 2013/C 354/01. Available online: http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=OJ:C:2013:354:FULL&from=EN (accessed on 2 October 2017).
- Bauman, A.E.; Reis, R.S.; Sallis, J.F.; Wells, J.C.; Loos, R.J.; Martin, B.W. Correlates of physical activity: Why are some people physically active and others not? Lancet Physical Activity Series Working Group. Lancet 2012, 380, 258–271. [Google Scholar] [CrossRef]
- Ding, D. Ecological models: Application to physical activity. In Encyclopedia of Behavioral Medicine; Gellman, L.D., Turner, J.R., Eds.; Springer-Verlag: New York, NY, USA, 2013; pp. 251–282. [Google Scholar]
- Condello, G.; Ling, F.C.M.; Bianco, A.; Chastin, S.; Cardon, G.; Ciarapica, D.; Conte, D.; Cortis, C.; De Craemer, M.; Di Blasio, A.; et al. Using concept mapping in the development of the EU-PAD framework (EUropean-Physical Activity Determinants across the life course): A DEDIPAC-study. BMC Public Health 2016, 16, 1145. [Google Scholar] [CrossRef] [PubMed]
- Ding, D.; Gebel, K. Built environment, physical activity, and obesity: What have we learned from reviewing the literature? Health Place 2012, 18, 100–105. [Google Scholar] [CrossRef] [PubMed]
- Bauman, A.E.; Sallis, J.F.; Dzewaltowski, D.A.; Owen, N. Toward a better understanding of the influences on physical activity: The role of determinants, correlates, causal variables, mediators, moderators, and confounders. Am. J. Prev. Med. 2002, 23, 5–14. [Google Scholar] [CrossRef]
- Sallis, J.F.; Myron, F.F.; Rodríguez, D.A.; Saelens, B.E. Role of built environments in physical activity, obesity and cardiovascular disease. Circulation 2012, 125, 729–737. [Google Scholar] [CrossRef] [PubMed]
- European Commission. White Paper on a Strategy for Europe on Nutrition, Overweight and Obesity Related Health Issues . 2007. Available online: http://ec.europa.eu/health/ph_determinants/life_style/nutrition/documents/nutrition_wp_en.pdf (accessed on 30 August 2017).
- European Union. Physical Activity Guidelines. Recommended Policy Actions in Support of Health-Enhancing Physical Activity. Available online: http://ec.europa.eu/assets/eac/sport/library/policy_documents/eu-physical-activity-guidelines-2008_en.pdf (accessed on 30 August 2017).
- World Health Organization. Steps to Health. A European Framework to Promote Physical Activity for Health. Available online: http://www.euro.who.int/__data/assets/pdf_file/0020/101684/E90191.pdf (accessed on 30 August 2017).
- American College of Sports Medicine; Chodzko-Zajko, W.J.; Proctor, D.N.; Fiatarone, S.M.A.; Minson, C.T.; Nigg, C.R.; Salem, G.J.; Skinner, J.S. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med. Sci. Sports Exerc. 2009, 41, 1510–1530. [Google Scholar] [CrossRef] [PubMed]
- Canadian Society for Exercise Physiology. Canadian Physical Activity and Sedentary Behaviour Guidelines. Available online: http://www.csep.ca/cmfiles/guidelines/csep_guidelines_handbook.pdf (accessed on 30 August 2017).
- O’Donovan, G.; Blazevich, A.J.; Boreham, C.; Cooper, A.R.; Crank, H.; Ekelund, U.; Fox, K.R.; Gately, P.; Giles-Corti, B.; Gill, J.M.; et al. The ABC of physical activity for health: A consensus statement from the British Association of Sport and Exercise Sciences. J. Sports Sci. 2010, 28, 573–591. [Google Scholar] [CrossRef] [PubMed]
- National Institute for Health and Clinical Excellence (NICE). Walking and Cycling. Public Health Guidance PH41. Available online: https://www.nice.org.uk/guidance/ph41 (accessed on 30 August 2017). (Article included in the realist review).
- Centers for Disease Control and Prevention (CDC). School Health Guidelines to Promote Healthy Eating and Physical Activity; 2011. Available online: https://www.cdc.gov/mmwr/pdf/rr/rr6005.pdf (accessed on 30 August 2017).
- National Institute for Health and Clinical Excellence (NICE). Physical Activity in the Workplace. Public Health Guidance PH13. 2008. Available online: https://www.nice.org.uk/guidance/ph13 (accessed on 30 August 2017).
- Edwards, P.; Tsouros, T. Promoting Physical Activity and Active Living in Urban Environments; World Health Organization, Regional Office for Europe: Copenhagen, Denmark, 2006; Available online: http://www.euro.who.int/__data/assets/pdf_file/0009/98424/E89498.pdf (accessed on 30 August 2017).
- Transportation Research Board. Does the Built Environment Influence Physical Activity? Examining the Evidence. 2005. Available online: http://onlinepubs.trb.org/onlinepubs/sr/sr282.pdf (accessed on 30 August 2017).
- Michie, S.; Pilling, S.; Garety, P.; Whitty, P.; Eccles, M.P.; Johnston, M.; Simmons, J. Difficulties implementing a mental health guideline: An exploratory investigation using psychological theory. Implement. Sci. 2007, 2, 8. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kastner, M.; Bhattacharyya, O.; Hayden, L.; Makarski, J.; Estey, E.; Durocher, L.; Chatterjee, A.; Perrier, L.; Graham, I.D.; Straus, S.E.; et al. Guideline uptake is influenced by six implementability domains for creating and communicating guidelines: A realist review. J. Clin. Epidemiol. 2015, 68, 498–509. [Google Scholar] [CrossRef] [PubMed]
- Fischer, F.; Lange, K.; Klose, K.; Greiner, W.; Kraemer, A. Barriers and strategies in guideline implementation-A scoping review. Healthcare 2016, 29, 36. [Google Scholar] [CrossRef] [PubMed]
- Rycroft-Malone, J.; Harvey, G.; Kitson, A.; McCormack, B.; Seers, K.; Titchen, A. Getting evidence into practice: Ingredients for change. Nurs. Stand. 2002, 16, 38–43. [Google Scholar] [CrossRef] [PubMed]
- Brownson, R.C.; Ballew, P.; Brown, K.L.; Elliott, M.B.; Haire-Joshu, D.; Heath, G.W.; Kreuter, M.W. The Effect of Disseminating Evidence-Based Interventions That Promote Physical Activity to Health Departments. Am. J. Public Health 2007, 97, 1900–1907. [Google Scholar] [CrossRef] [PubMed]
- Glasgow, R.E.; Emmons, K.M. How Can We Increase Translation of Research into Practice? Types of Evidence Needed. Annu. Rev. Public Health 2007, 28, 413–433. [Google Scholar] [CrossRef] [PubMed]
- Hellénius, M.; Sundberg, C.J. Editorials: Physical activity as medicine: Time to translate evidence into clinical practice. Br. J. Sports Med. 2011, 45, 158. [Google Scholar] [CrossRef] [PubMed]
- Murphy, K.; Fafard, P.; O’Campo, P. Introduction-knowledge translation and urban health equity: Advancing the agenda. J. Urban Health 2012, 89, 875–880. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Bridging the “Know-Do” Gap: Meeting on Knowledge Translation in Global Health. Available online: http://www.who.int/kms/WHO_EIP_KMS_2006_2.pdf (accessed on 30 August 2017).
- Greenhalgh, T.; Wieringa, S. Is it time to drop the ‘knowledge translation’ metaphor? A critical literature review. J. R. Soc. Med. 2011, 104, 501–509. [Google Scholar] [CrossRef] [PubMed]
- Gelius, P.; Rütten, A.; Goodwin, L.; Marin, M.; Abu-Omar, K.; Kahlmeier, S.; Martin-Diener, E.; Murphy, M.H.; Ferguson, K.; Cavill, N. Study on the Implementation of Physical Activity Guidelines. Final Progress Report of Tender EAC 2014-0574; European Union: Brussels, Belgium, 2016. [Google Scholar] [CrossRef]
- MacDonald, M.; Pauly, B.; Wong, G.; Schick-Makaroff, K.; van Roode, T.; Strosher, H.W.; Kothari, A.; Valaitis, R.; Manson, H.; O’Briain, W.; et al. Supporting successful implementation of public health interventions: Protocol for a realist synthesis. Syst. Rev. 2016, 5, 54. [Google Scholar] [CrossRef] [PubMed]
- Gabbay, J.; Le May, A. Evidence based guidelines or collectively constructed “mindlines?” Ethnographic study of knowledge management in primary care. BMJ 2004, 329, 1013. [Google Scholar] [CrossRef] [PubMed]
- Grimshaw, J.; Eccles, M.; Thomas, R.; MacLennan, G.; Ramsay, C.; Fraser, C.; Vale, L. Toward evidence-based quality improvement evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966–1998. J. Gen. Intern. Med. 2006, 21, S14–S20. [Google Scholar] [CrossRef] [PubMed]
- Huijg, J.M.; Van der Zouwe, N.; Crone, M.R.; Verheijden, M.W.; Middelkoop, B.J.C.; Gebhardt, W.A. Factors influencing the introduction of physical activity interventions in primary health care: A qualitative study. Int. J. Behav. Med. 2015, 22, 404–414. [Google Scholar] [CrossRef] [PubMed]
- Allender, S.; Cavill, N.; Parker, M.; Foster, C. ‘Tell us something we don’t already know or do!’ The response of planning and transport professionals to public health guidance on the built environment and physical activity. J. Public Health Policy 2009, 30, 102–116, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Pawson, R. Evidence-Based Policy: A Realist Perspective; SAGE Publications Ltd.: London, UK, 2006. [Google Scholar]
- Wong, G.; Greenhalgh, T.; Westhorp, G.; Buckingam, J.; Pawson, R. RAMESES publication standards: Realist syntheses. BMC Med. 2013, 11. [Google Scholar] [CrossRef]
- Rycroft-Malone, J.; McCormack, B.; Hutchinson, A.M.; DeCorby, K.; Bucknall, T.K.; Kent, B.; Schultz, A.; Snelgrove-Clarke, E.; Stetler, C.B.; Titler, M.; et al. Realist synthesis: Illustrating the method for implementation research. Implement. Sci. 2012, 7, 33. [Google Scholar] [CrossRef] [PubMed]
- Brown, H.E.; Atkin, A.J.; Panter, J.; Corder, K.; Wong, G.; Chinapaw, M.J.M.; van Sluijs, E. Family-based interventions to increase physical activity in children: A meta-analysis and realist synthesis protocol. BMJ Open 2014, 4, e005439. [Google Scholar] [CrossRef] [PubMed]
- Stame, N. Theory-based evaluation and types of complexity. Evaluation 2004, 10, 58–76. [Google Scholar] [CrossRef]
- Pawson, R.; Greenhalgh, T.; Harvey, G.; Walshe, K. Realist Synthesis: An Introduction; ESRC Research Methods Programme RMP Methods Paper 2/2004; University of Manchester: Manchester, UK, 2004; Available online: http://www.betterevaluation.org/sites/default/files/RMPmethods2.pdf (accessed on 4 October 2017).
- Davies, P.; Walker, A.E.; Grimshaw, J.M. A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. Implement. Sci. 2010, 5, 14. [Google Scholar] [CrossRef] [PubMed]
- Pawson, R.; Owen, L.; Wong, G. Legislating for health: Locating the evidence. J. Public Health Policy 2010, 31, 164–177. [Google Scholar] [CrossRef] [PubMed]
- Oliver, K.; Lorenc, T.; Innvær, S. New directions in evidence-based policy research: A critical analysis of the literature. Health Res. Policy Syst. 2014, 12, 34. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cavill, N.; Kahlmeier, S.; Racioppi, F. Physical Activity and Health in Europe: Evidence for Action; World Health Organisation Regional Office for Europe: Copenhagen, Denmark, 2006; Available online: http://www.euro.who.int/__data/assets/pdf_file/0011/87545/E89490.pdf (accessed on 30 August 2017).
- Kitto, S.C.; Sargeant, J.; Reeves, S.; Silver, I. Towards a sociology of knowledge translation: The importance of being dis-interested in knowledge translation. Adv. Health Sci. Educ. Theory Pract. 2012, 17, 289–299. [Google Scholar] [CrossRef] [PubMed]
- Shilton, T. Advocacy for physical activity—From evidence to influence. Promot. Educ. 2006, 13, 118–126, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Intersectoral Action on Health. A Path for Policy-Makers to Implement Effective and Sustainable Action on Health. Available online: http://www.who.int/kobe_centre/publications/ISA-booklet_WKC-AUG2011.pdf (accessed on 30 August 2017).
- World Health Organization. The Ottawa Charter for Health Promotion. First International Conference on Health Promotion, Ottawa, ON, Canada, 21 November 1986; Available online: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html (accessed on 30 August 2017).
- World Health Organization. Advocacy Strategies for Health and Development: Development Communication in Action. Report of the Inter-Agency Meeting on Advocacy. Available online: http://apps.who.int/iris/bitstream/10665/70051/1/HED_92.4_eng.pdf (accessed on 30 August 2017).
- Princen, S. Agenda-Setting in the European Union; Macmillan: Basingstoke, UK, 2009; (Article included in the realist review). [Google Scholar]
- Kurzer, P.; Cooper, A. Hold the croissant! The European Union declares war on obesity. J. Eur. Soc. Policy 2011, 21, 107–119, (Article included in the realist review). [Google Scholar] [CrossRef]
- Lelieveldt, H.; Princen, S. (Eds.) The Politics of the European Union; University Press: Cambridge, UK, 2011; (Article included in the realist review). [Google Scholar]
- Hallsworth, M.; Krapels, J.; Ling, T. The EU Platform on Diet, Physical Activity and Health. Third Monitoring Progress Report; RAND Corporation: Santa Monica, CA, USA, 2008; Available online: http://www.rand.org/content/dam/rand/pubs/technical_reports/2008/RAND_TR609.pdf (accessed on 30 August 2017)(Article included in the realist review).
- World Health Organization. Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. Available online: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf (accessed on 30 August 2017). (Article included in the realist review).
- Metcalf, B.S.; Hosking, J.; Jeffery, A.N.; Voss, L.D.; Henley, W.; Wilkin, T.J. Fatness leads to inactivity, but inactivity does not lead to fatness: A longitudinal study in children (EarlyBird 45). Arch. Dis. Child. 2011, 96, 942–947, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Council of the European Union. Council Conclusions on the Launching of Joint Programming Initiatives on “Agriculture, Food Security and Climate Change”, Cultural Heritage and Global Change: A New Challenge for Europe, and “A Healthy Diet for a Healthy Life”, n. 14976/10. 2010. Available online: http://data.consilium.europa.eu/doc/document/ST-14976-2010-INIT/en/pdf (accessed on 30 August 2017).
- Ogilvie, D.; Egan, M.; Hamilton, V.; Petticrew, M. Theory and methods of systematic reviews of health effects of social interventions: 2. Best available evidence: How low should you go? J. Epidemiol. Community Health 2005, 59, 886–892, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Weaver, N.; Williams, J.L.; Weightman, A.L.; Kitcher, H.N.; Temple, J.M.; Jones, P.; Palmer, S. Taking STOX: Developing a cross disciplinary methodology for systematic reviews of research on the built environment and the health of the public. J. Epidemiol. Community Health 2002, 56, 48–55, (Article included in the realist review). [Google Scholar] [CrossRef]
- Piątkowska, M.; Ružbarská, I. The evolution of physical activity guidelines. Balt. J. Health Phys. Act. 2011, 3, 299–310, (Article included in the realist review). [Google Scholar] [CrossRef]
- National Institute for Health and Clinical Excellence (NICE). Implementation Advice: Four Commonly Used Methods to Increase Physical Activity. Public Health Intervention Guidance PH2; NICE: London, UK, 2006. [Google Scholar]
- Foster, C. Developing and Transferring Evidence into Practice: NICE or Nasty? Reflections on Working with NICE to Develop and Implement Public Health Guidance. Available online: https://www.ndph.ox.ac.uk/cpnp/publications/400685 (accessed on 30 August 2017). (Article included in the realist review).
- Sowden, S.; Raine, R. Running along parallel lines: How political reality impedes the evaluation of public health interventions. A case study of exercise referral schemes in England. J. Epidemiol. Community Health 2008, 62, 835–841, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Promoting Sport and Enhancing Health in European Union Countries: A Policy Content Analysis to Support Action. 2011. Available online: http://www.euro.who.int/__data/assets/pdf_file/0006/147237/e95168.pdf (accessed on 30 August 2017).
- Daugbjerg, S.B.; Kahlmeier, S.; Racioppi, F.; Martin-Diener, E.; Martin, B.; Oja, P.; Bull, F. Promotion of physical activity in the European region: Content analysis of 27 national policy documents. J. Phys. Act. Health 2009, 6, 805–817, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Eyler, A.A.; Brownson, R.C.; Aytur, S.A.; Cradock, A.; Doescher, M.; Evenson, K.R.; Kerr, J.; Maddock, J.; Pluto, D.L.; Steinman, L.; et al. Examination of trends and evidence-based elements in state physical education legislation: A content analysis. J. Sch. Health 2010, 80, 326–332, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Sanchez-Vaznaugh, E.V.; Sánchez, B.N.; Rosas, L.G.; Baek, J.; Egerter, S. Physical education policy compliance and children’s physical fitness. Am. J. Prev. Med. 2012, 42, 452–459, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Cradock, A.L.; O’Donnell, E.M.; Benjamin, S.E.; Walker, E.; Slining, M.A. A review of state regulations to promote physical activity and safety on playgrounds in child care centers and family child care homes. J. Phys. Activ. Health 2010, 7, 108–119, (Article included in the realist review). [Google Scholar] [CrossRef]
- Taber, D.R.; Chriqui, J.F.; Chaloupka, F.J. Association and diffusion of nutrition and physical activity policies on the state and district level. J. Sch. Health 2012, 82, 201–209, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Lindsay, I. Tackling the dangers of inactivity through sport. Int. Centre Sport Secur. J. 2013, 1, 99–101, (Article included in the realist review). [Google Scholar]
- Mahtani, K.R.; Protheroe, J.; Slight, S.P.; Demarzo, M.M.; Blakeman, T.; Barton, C.A.; Brijnath, B.; Roberts, N. Can the London 2012 Olympic ‘inspire a generation’ to do more physical or sporting activities? An overview of systematic reviews. BMJ Open 2013, 3, 1–8, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Weed, M. How will we know if the London 2012 Olympics and Paralympics benefit health? BMJ 2010, 340, c2202, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Hoeijmakers, M.; De Leeuw, E.; Keni, P.; De Vries, N.K. Local health policy development processes in the Netherlands: An expanded toolbox for health promotion. Health Promot. Int. 2007, 22, 112–121, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Fosse, E.; Helgesen, M. Advocating for health promotion policy in norway: The role of the county municipalities. Societies 2017, 7, 5, (Article included in the realist review). [Google Scholar] [CrossRef]
- Rütten, A.; Abu-Omar, K.; Gelius, P.; Dinan-Young, S.; Frändin, K.; Hopman-Rock, M.; Young, A. Policy assessment and policy development for physical activity promotion: Results of an exploratory intervention study in 15 European Nations. Health Res. Policy Syst. 2012, 10, 14, (Article included in the realist review). [Google Scholar] [CrossRef] [Green Version]
- Dill, J.; Howe, D. The role of health and physical activity in the adoption of innovative land use policy: Findings. J. Phys. Activ. Health 2011, 8, S116–S124, (Article included in the realist review). [Google Scholar] [CrossRef]
- Allender, S.; Gleeson, E.; Crammond, B.; Sacks, G.; Lawrence, M.; Peeters, A.; Loff, B.; Swinburn, B. Policy change to create supportive environments for physical activity and healthy eating: Which options are the most realistic for local government? Health Promot. Int. 2011, 7, 261–274, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Nguyen, S.; Häcker, A.L.; Henderson, M.; Barnett, T.; Mathieu, M.E.; Pagani, L.; Bigras, J.L. Physical activity programs with post-intervention follow-up in children: A comprehensive review according to categories of intervention. Int. J. Environ. Res. Public Health 2016, 13, 664, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Chau, J.; Bonfiglioli, C.; Chey, T.; Bauman, A. The Cinderella of public health news: Physical activity coverage in Australian newspapers, 1986–2006. J. Public Health 2009, 33, 189–192. [Google Scholar] [CrossRef] [PubMed]
- Weiler, R.; Chew, S.; Coombs, N.; Hamer, M.; Stamatakis, E. Physical activity education in the undergraduate curricula of all UK medical schools Are tomorrow’s doctors equipped to follow clinical guidelines? Br. J. Sports Med. 2012, 46, 1024–1026, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mathews, A.E.; Pluto, D.; Ogoussan, O.; Banda, J. Active travel to school: Policies and attitudes of school and district leaders. J. Phys. Act. Health 2010, 7, S13–S19, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Centers for Disease Control and Prevention. The Association between School-Based Physical Activity, Including Physical Education, and Academic Performance. Available online: http://www.cdc.gov/healthyschools/health_and_academics/pdf/pa-pe_paper.pdf (accessed on 30 August 2017).
- Howie, E.K.; Pate, R.R. Physical activity and academic achievement in children: A historical perspective. J. Sport Health Sci. 2012, 1, 160–169, (Article included in the realist review). [Google Scholar] [CrossRef]
- Hillman, C.H. Conclusions and future directions of the research on physical activity and childhood cognitive and brain health. Monographs Soc. Res. Child. Dev. 2014, 79, 149–152. [Google Scholar] [CrossRef] [PubMed]
- Donnelly, J.E.; Hillman, C.H.; Castelli, D.; Etnier, J.L.; Lee, S.; Tomporowski, P.; Szabo-Reed, A.N. Physical activity, fitness, cognitive function, and academic achievement in children: A systematic review. Med. Sci. Sports Exerc. 2016, 48, 1197–1222. [Google Scholar] [CrossRef] [PubMed]
- Pesce, C.; Ben-Soussan, D. “Cogito ergo sum” or “ambulo ergo sum”? New perspectives in developmental exercise and cognition research. In Exercise-Cognition Interaction: Neuroscience Perspectives; McMorris, T., Ed.; Elsevier: London, UK, 2016; pp. 251–282. [Google Scholar]
- Kohl, H.W.; Cook, D. Educating the student body. Taking physical activity and physical education to school. In The Committee on Physical Activity and Physical Education in the School Environment; Academic Press: Washington, DC, USA, 2013. [Google Scholar]
- Bailey, R.; Hillman, C.; Arent, S.; Petitpas, A. Physical activity as an investment in personal and social change: The Human Capital Model. J. Phys. Activ. Health 2013, 9, 1053–1055, (Article included in the realist review). [Google Scholar] [CrossRef]
- Attalin, V.; Romain, A.J.; Avignon, A. Physical-activity prescription for obesity management in primary care: Attitudes and practices of GPs in a southern French city. Diabetes Metab. 2012, 38, 243–249, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Fantini, A.C.; Compagni, A.; Rucci, P.; Mimmi, S.; Longo, F. General practitioners’ adherence to evidence-based guidelines: A multilevel analysis. Health Care Manag. Rev. 2012, 37, 67–76, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Zhu, D.; Norman, I.J.; While, A.E. The relationship between health professionals’ weight status and attitudes towards weight management: A systematic review. Obes. Rev. 2011, 12, e324–e337, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Huijg, J.M.; Gebhardt, W.A.; Verheijden, M.W.; van der Zouwe, N.; De Vries, J.; Middlekoop, B.J.C.; Cron, M.R. Factors influencing primary health care professionals’ physical activity promotion behaviors: A systematic review. Int. J. Behav. Med. 2014, 22, 32–50, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Godin, G.; Bélanger-Gravel, A.; Eccles, M.; Grimshaw, J. Healthcare professionals’ intentions and behaviours: A systematic review of studies based on social cognitive theories. Implement. Sci. 2008, 3, 36. [Google Scholar] [CrossRef] [PubMed]
- Aarts, M.J.; Schuit, A.J.; Van de Goor, I.A.M.; van Hpers, H.A.M. Feasibility of multi-sector policy measures that create activity-friendly environments for children: Results of a Delphi study. Implement. Sci. 2011, 6, 128, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Koohsari, M.J.; Mavoa, S.; Villanueva, S.; Sugiyama, T.; Badland, H.; Kaczynski, A.T.; Owen, N.; Giles-Corti, B. Public open space, physical activity, urban design and public health: Concepts, methods and research agenda. Health Place 2015, 33, 75–82. [Google Scholar] [CrossRef] [PubMed]
- Lee, K. Developing and implementing the Active Design Guidelines in New York City. Health Place 2012, 18, 5–7, (Article included in the realist review). [Google Scholar] [CrossRef] [PubMed]
- Adams, E.J.; Cavill, N.; Sherar, L.B. Evaluation of the implementation of an intervention to improve the street environment and promote walking for transport in deprived neighbourhoods. BMC Public Health 2017, 17, 655. [Google Scholar] [CrossRef] [PubMed]
- Latimer-Cheung, A.E.; Rhodes, A.E.; Kho, M.E.; Tomasone, J.R.; Gainforth, H.L.; Kowalski, K.; Nasuti, G.; Perrier, M.-J.; Duggan, M. Evidence-informed recommendations for constructing and disseminating messages supplementing the new Canadian physical activity guidelines. BioMed Central Public Health 2013, 13, 419. [Google Scholar] [CrossRef] [PubMed]
- Nutley, S.; Davies, H.; Walter, I. Evidence Based Policy and Practice: Cross Sector Lessons from the UK. WP 9; Centre for Evidence Based Policy and Practice ESRC: London, UK, 2002. [Google Scholar]
- Leone, L. Review sistematiche, sintesi theory-driven e utilizzazione delle evidenze. IL caso dei programmi di prevenzione [Systematic reviews, theory-driven synthesis and evidence utilization. The case of prevention programmes]. Rassegna Italiana di Valutazione RIV 2006, 35, 55–85. [Google Scholar]
- McCormack, B.; Rycroft-Malone, J.; DeCorby, K.; Hutchinson, A.M.; Bucknall, T.; Kent, B.; Schultz, A.; Snelgrove-Clarke, E.; Stetler, C.; Titler, M.; et al. A realist review of interventions and strategies to promote evidence-informed healthcare: A focus on change agency. Implement. Sci. 2013, 8, 107. [Google Scholar] [CrossRef] [PubMed]
Step | Context | Mechanism | Outcome |
---|---|---|---|
I° Agenda setting and advocacy | Supranational health body advocating for PA within an “obesity fight” framework | Scientific legitimation | + Shift of relevant PA interest groups to supranational level |
Lacking pressure by other public bodies and NGOs | Advocacy | − PA introduction into EU agenda driven by nutrition policy. | |
“Cascade” effect | |||
II° PA guidelines delivery | Health sector delivering PA guidelines addressed to several policy sectors | Scientific legitimation | + Role of public health authorities as credible sources |
Self-referential concept of knowledge | − Bias in evidence gathering (solely from health databases) and lack of consultation with other policy sectors | ||
III° PA guidelines adoption | Scholastic districts with strong state policies for child health care | Advocacy | + Adoption of PA guidelines by the education sector |
Enforcement | + Enhanced PE at school | ||
Sport strategies and plans at national level | Lacking advocacy | + Partial adoption of PA guidelines within national sport plans | |
Competition for attracting resources | − Investments for elite sport facilities at the expense of PA/sport for all | ||
Health authorities at state level | Enforcement due to higher authority | + Dissemination of PA guidelines resulting in increased adoption and implementation at state level | |
Health authorities at local level | Lacking enforcement | − No pivotal role due to the dominance of a medical approach to health | |
Transport and urban planning sectors at local government level | Knowledge translation | + Reframing of PA goals within each policy sector | |
+ Promotion of urban environments supportive for PA with a pivotal role of urban planners as innovators | |||
Enforcement | − Perception of recommendations as “statements of the obvious” without link to legislation. | ||
Medical schools | Knowledge gap | − Lacking or limited introduction of PA subject in medical curricula | |
Lacking advocacy | |||
IV° Implementation | School principals’ believes about compatibility of PA and academic achievement. | Enforcement | + Support for PA in in-school and out-of-school settings |
Positive expectations | |||
General practitioners’ habits to practice PA | Perception of being a faithful model | + High adherence to PA guidelines, frequent PA prescription to patients | |
Lacking PA skills and habits | − Low adherence to PA guidelines, seldom PA prescription to patients | ||
Urban planners’ and administrators’ attitudes towards PA promotion interventions | Perception of feasibility | + Implementation of policy measures for active-friendly environments for children | |
Familiarity with concepts |
Confirmation of the Initial Programme Theory | Refinements or Threats of the Initial Programme Theory |
---|---|
STEP 1: Agenda Setting | PA introduction into the EU policy agenda with a strong delay and driven by obesity epidemic. |
STEP 2: Guidelines Delivery | Gaps due to gathering data limited to health databases. Methodological concerns and lack of consultation. Possible conflicting advice in some PA guidelines. |
STEP 3: Guidelines Adoption | Non-synergic relations in EU PA plans among health, education and sport sectors. Prioritization of elite sport facilities. Weak role played by local health agencies. Risk of absence of added value in PA guidelines for urban planners. |
STEP 4: Evidence-based Implementation | Role of personal lifestyle and believes on PA counselling and prescription by health care professionals. Role of active-friendly environments concepts among administrators and urban planners. |
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Leone, L.; Pesce, C. From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis. Int. J. Environ. Res. Public Health 2017, 14, 1193. https://doi.org/10.3390/ijerph14101193
Leone L, Pesce C. From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis. International Journal of Environmental Research and Public Health. 2017; 14(10):1193. https://doi.org/10.3390/ijerph14101193
Chicago/Turabian StyleLeone, Liliana, and Caterina Pesce. 2017. "From Delivery to Adoption of Physical Activity Guidelines: Realist Synthesis" International Journal of Environmental Research and Public Health 14, no. 10: 1193. https://doi.org/10.3390/ijerph14101193