Co-producing active lifestyles as whole-system-approach: theory, intervention and knowledge-to-action implications

Abstract

Population health interventions tend to lack links to the emerging discourse on interactive knowledge production and exchange. This situation may limit both a better understanding of mechanisms that impact health lifestyles and the development of strategies for population level change. This paper introduces an integrated approach based on structure-agency theory in the context of 'social practice'. It investigates the mechanisms of co-production of active lifestyles by population groups, professionals, policymakers and researchers. It combines a whole system approach with an interactive knowledge-to-action strategy for developing and implementing active lifestyle interventions. A system model is outlined to describe and explain how social practices of selected groups co-produce active lifestyles. Four intervention models for promoting the co-production of active lifestyles through an interactive-knowledge-to-action approach are discussed. Examples from case studies of the German research network Capital4Health are used to illustrate, how intervention models might be operationalized in a real-world intervention. Five subprojects develop, implement and evaluate interventions across the life-course. Although subprojects differ with regard to settings and population groups involved, they all focus on the four key components of the system model. The paper contributes new strategies to address the intervention research challenge of sustainable change of inactive lifestyles. The interactive approach presented allows consideration of the specificities of settings and scientific contexts for manifold purposes. Further research remains needed on what a co-produced knowledge-to-action agenda would look like and what impact it might have for whole system change.

Using a multi-stakeholder experience-based design process to co-develop the Creating Active Schools Framework

“…The CAS framework provides researchers with an understanding of the multiple components that need to be addressed to create and evaluate whole-school physical activity interventions. It emphasises the need for researchers to move beyond push approaches and codevelop interventions with multiple stakeholders within the school setting from conception [16]. The challenge for researchers resides in creating programmes that create systems-level change within schools.…”

“…[13][14][15]. These findings have been attributed to 'top-down' approaches where researchers and external stakeholders drive intervention design with limited input from school stakeholders [16]. Co-production of interventions by all stakeholders is therefore essential, galvanising both bottom-up and topdown approaches to create 'systems change' [5,17].…”

“…New integrated approaches have emerged that enable the identification and combination of the expertise of multiple stakeholders in the development of systems approaches [16]. Yet, to date, these have not been applied within the school setting, nor to design a comprehensive whole-school physical activity framework.…”

How Health Promoters Can Assess Capacity Building Processes in Setting-Based Approaches—Development and Testing of a Monitoring Instrument

“…Capital4Health is a German research network (FKZ01EL1421A) which focuses on active lifestyles within different settings (kindergardens, schools, workplaces, communities, residential homes) [30]. Five empirical subprojects established participatory group processes aimed at planning and implementing interventions to promote physical activity in the respective setting (Table 1).…”

Reflective Praxis: accelerating knowledge generation through reflecting on our research and practice

“…By contrast, health promotion theory and practice must draw upon community members' understandings and local information in order to develop a responsive and locally appropriate agenda for promoting health in urban communities (Bryant et al 2007). Knowledge interaction and co-production that considers the specificities of settings, as well as scientific contexts, is urgently needed (Rütten et al 2019).…”