Background There are gaps in the research regarding the implementation and evidence of overall strategies for municipal health promotion addressing communities. The aim of this scoping review is to gain initial findings concerning theoretical models, approaches and evidence on strategies of municipal health promotion, which include self-care, mutual aid and healthy environments. The findings can enrich the development of health promotion services. Methods A systematic scoping literature analysis was conducted in the databases PubMed, Web of Science, SAGE-Journals, Wiley-Online, ScienceDirect, LIVIVO and WiSo database as well as in a German project database. Evaluation studies and research reports on strategies in municipal health promotion were included and analysed qualitatively. Results According to our predefined inclusion and exclusion criteria, 15 hits were included. Capacity building, planning and the establishment of structures for health promotion were identified as theory-based models and approaches. None of the publications included showed clear evidence of the effects of municipal health promotion measures in terms of classically medically defined evidence. Conclusions The use of evidence-based theoretical models and approaches is no guarantee for the success of strategies for municipal health promotion. Challenges with regard to evidence are the execution of study designs corresponding to higher evidence classes and the isolation of effects of health promotion measures in complex environments. Trial registration This scoping review was not registered beforehand.

Background Combining smartphone-assisted group activities in the neighbourhood and training in physical and cognitive skills may offer the potential to promote social participation and connectedness of older adults. This non-controlled proof-of-concept, retrospectively registered study aimed to determine the feasibility of such an intervention approach, including its evaluation. Methods In two consecutive six-month intervention cycles, 39 community-dwelling adults were provided with weekly smartphone, physical and cognitive training by two tutors. Using a specifically designed app, the participants were also encouraged to join and later self-organise physically and cognitively stimulating activities related to hot spots in their Bochum neighbourhood. Indicators of feasibility were documented. Results The recruitment and assessments took 3 hours per participant. Excluding smartphone support, the preparation and the implementation of the intervention amounted to nine person-hours per week. Six participants dropped out, and 13 did not complete one or more assessments. The participants attended 76 ± 15% of the weekly training sessions. The instructors deemed the programme feasible, but familiarisation with the smartphone and the app was very time-consuming. Twenty-seven of 29 participants reported high overall satisfaction, and 22 agreed that the programme helped them to establish social contacts. The smartphones attracted substantial interest and were used frequently, despite mixed satisfaction with the project-specific app. From baseline to follow-up, the six-minute walking distance, lower extremity strength and moderate to vigorous physical activity, as well as quality of life, were preserved at a high level, while balance performance was significantly improved. Of the 11 tests related to cognitive functioning, 4 tests (a memory test, the Stroop test and 2 tests of verbal fluency) indicated significant improvement. No moderate or serious adverse events occurred in relation to the assessments or the intervention. Conclusions The multimodal approach seems safe and feasible and offers the potential to promote social connectedness, bonds in the residential neighbourhood and smartphone competency, as well as to preserve or improve physical and cognitive functions. Adaptations of the intervention and of the outcome assessments may contribute to better assessment and exploitation of the potential of this approach in a future study involving socially, physically and cognitively less active elderly persons.

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(1) In the field of health promotion, municipalities offer opportunities to reduce SES-based health inequalities by addressing vulnerable communities. This research project aims to identify facilitating and inhibiting factors for the creation of healthy living environments. (2) After preliminary literature and qualitative research work, an online-based Delphi survey was conducted (December 2020–March 2021). This included the rating and commentating of 22 theses at two times, whereby the results of the first round of rating were visible to the participants the second time. (3) Twelve experts from seven European countries participated in the Delphi survey across both rounds (1st round: n = 37; 12 countries). The consensus was particularly clear with regard to providing resources, which, in turn, are especially necessary for involving target groups in health promotion. (4) The results illustrate the relevance of further cross-national exchange. Certain aspects however, such as the HiAP approach or strategies to reach disadvantaged groups, are still challenging in practice. In order to develop concrete recommendations, the theses need to be further operationalised. The Delphi method offers a suitable possibility to map international expertise in this field and with a focus on health equity.

Zusammenfassung Einführung Das Potenzial einer Verschränkung technikgestützten Trainings körperlicher und kognitiver Fähigkeiten zur Förderung der sozialen Teilhabe und Gemeinschaft Älterer im Wohnquartier erscheint beträchtlich. Derartige Ansätze sind aber in der Praxis selten und kaum wissenschaftlich erprobt. Im BMBF-Projekt Quartier Agil – aktiv vor Ort wird ein solches Programm entwickelt und seine Machbarkeit überprüft. Methoden Vorgestellt werden die Ergebnisse aus dem ersten von 2 6-monatigen Interventionszyklen einer explorativen, nicht-kontrollierten Studie. Unterstützt von 2 Teilhabementorinnen, nahmen n = 19 selbstständig im gleichen Ortsteil Bochums lebende ältere Menschen wöchentlich für 90 Minuten an Smartphone-Schulungen, körperlichem und kognitiven Training teil. Teilnehmer wurden mittels Smartphone und spezieller Apps angeregt, weitere individuelle Trainingseinheiten sowie körperlich und geistig aktivierende Angebote mit Bezug zu Identifikationspunkten („hot spots“) im Quartier zu nutzen oder diese selbst zu organisieren. Diverse Indikatoren der Machbarkeit wurden erhoben. Pre / Post-Erhebungen körperlicher und kognitiver Variablen und der Lebensqualität ergänzt durch Selbstbewertungen der sozialen Teilhabe dienten der ersten Einschätzung möglicher Effekte. Ergebnisse Die Teilhabementorinnen investierten wöchentlich ca. 6 Stunden Zeit und schätzten das Programm als gut machbar ein, wenngleich die App / Smartphone-Einweisung mehr Zeit als erwartet in Anspruch nahm. Die durchschnittliche Anwesenheit in den Veranstaltungen lag bei 76 ± 15 %. Insgesamt traten keine adversen Ereignisse auf. Allerdings brachen 2 Teilnehmer / innen die Studie ab, weitere 4 waren bei den Posttests verhindert. Alle Befragten (n = 13) waren mit dem Programm zufrieden, und 9 von 13 sagten, dass Quartier Agil ihre soziale Vernetzung gefördert habe. Die Smartphones generierten großes Interesse und wurden regelmäßig genutzt, trotz durchwachsener Zufriedenheit mit der projekteigenen App. Vom Pre- zum Posttest verbesserten sich Balance (Berg Balance Scale) und 6 Minuten Gehstrecke tendenziell. Die Kraft der unteren Extremität und körperliche Aktivität blieben auf hohem Niveau erhalten. Eine tendenziell effizientere kognitive Verarbeitung zeigte sich bspw. im Bereich der Wortflüssigkeit. Fazit Der Quartier Agil-Ansatz erscheint machbar und bietet Potenzial zur Förderung von sozialer Teilhabe inklusive verbesserter Bindung an das Wohnquartier und Smartphone-Kompetenz sowie zur Aufrechterhaltung körperlicher und kognitiver Funktionen. Organisatorische und methodisch-didaktische Erkenntnisse flossen in die Anpassung des Programms für einen 2. Interventionszyklus ein. In künftigen Studien sollten körperlich und kognitiv weniger inaktive Teilnehmer adressiert werden. Erhebungen des Aktionsradius und der Dual-Task-Fähigkeiten könnten zukünftig eine spezifischere Quantifizierung möglicher Effekte gestatten.