Community-based dietary and physical activity interventions in low socioeconomic groups in the UK: A mixed methods systematic review

Everson-Hock, Emma; Johnson, Maxine; Jones, Ray V. H.; Woods, Helen Buckley; Goyder, Elizabeth; Payne, Nick; Chilcott, Jim

doi:10.1016/j.ypmed.2013.02.023

Cited by 49 publications

(54 citation statements)

References 59 publications

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“…Previous reviews have focussed on diabetes prevention programs [27, 28, 78], but have not specifically examined experiences within a primary care context. Thus, this review has provided a clearer understanding of the factors impacting on the delivery and uptake of preventative services to fill an evidence gap.…”

Section: Discussionmentioning

confidence: 99%

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A narrative systematic review of factors affecting diabetes prevention in primary care settings

et al. 2017

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BackgroundType 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient’s primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults.AimTo understand the factors related to the delivery and uptake of type 2 diabetes prevention interventions within primary care in higher income countries.MethodsFor this narrative systematic review, we combined qualitative and quantitative studies of diabetes prevention within a primary care setting for patients at-risk of developing the condition. We used an iterative approach for evidence collection, which included using several databases (MEDLINE, Embase, Pysch info, BNI, SSCI, CINAHL, ASSIA), where we combined diabetes terms with primary care terms. Narrative and thematic synthesis were utilised to identify the prominent themes emerging from the data.ResultsA database of 6646 records was screened by the research team, and 18 papers were included. Three major themes were identified in this review. The first theme of context and setting of diabetes progression includes the risk and progression of diabetes, primary care as a setting, and where the responsibility for change is thought to lie. This review also found mixed views on the value of preventative services within primary care. The second theme focused on the various patient factors associated with diabetes prevention such as a patient’s motivation to modify their current lifestyle, perceptions and knowledge (or lack thereof) of the impacts of diabetes, lack of follow-up in healthcare settings, and trust in healthcare professionals. The third theme was centred on professional factors impacting on diabetes prevention which included workload, time constraints, resources, self-efficacy and knowledge as well as professionals’ perception of patient motivations towards change.ConclusionThis review explored the factors influencing diabetes prevention in primary care, and identified the context of prevention, as well as patient and professional factors related to preventative services being offered in primary care. This systematic review complements previous reviews of real-world settings by exploring the significant factors in prevention, and the findings are relevant to academics, policymakers, patients and practitioners interested in understanding the factors associated with the delivery and uptake of diabetes prevention interventions.

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Section: Discussionmentioning

confidence: 99%

“…Little is known about how health practitioners discuss lifestyle modifications with patients in primary care. Previous reviews have not focused exclusively on primary care [27–28], and those that have a primary care emphasis have focused on effectiveness of interventions [14]. …”

Section: Introductionmentioning

confidence: 99%

A narrative systematic review of factors affecting diabetes prevention in primary care settings

et al. 2017

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“…There is also a need to revise the content and delivery of PA public health messages, to assure disadvantaged communities of their personal relevance for them. PA information delivered to SED groups should be ‘clear and consistent’, enhancing confidence and beliefs [6]. Sharing community leaders’ and lay residents’ knowledge with those who plan PA interventions should optimise opportunities, ensure safety and provide appropriate facilities for all.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple factors influence physical inactivity [6,7]. However, research into its determinants has focused mainly at an individual level [8].…”

Section: Introductionmentioning

confidence: 99%

Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study

Cleland

Hunter

Tully

et al. 2014

Int J Behav Nutr Phys Act

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BackgroundThere is an urgent need to increase population levels of physical activity, particularly amongst those who are socio-economically disadvantaged. Multiple factors influence physical activity behaviour but the generalisability of current evidence to such ‘hard-to-reach’ population subgroups is limited by difficulties in recruiting them into studies. Also, rigorous qualitative studies of lay perceptions and perceptions of community leaders about public health efforts to increase physical activity are sparse. We sought to explore, within a socio-economically disadvantaged community, residents’ and community leaders’ perceptions of physical activity (PA) interventions and issues regarding their implementation, in order to improve understanding of needs, expectations, and social/environmental factors relevant to future interventions.MethodsWithin an ongoing regeneration project (Connswater Community Greenway), in a socio-economically disadvantaged community in Belfast, we collaborated with a Community Development Agency to purposively sample leaders from public- and voluntary-sector community groups and residents. Individual semi-structured interviews were conducted with 12 leaders. Residents (n = 113), of both genders and a range of ages (14 to 86 years) participated in focus groups (n = 14) in local facilities. Interviews and focus groups were recorded, transcribed verbatim and analysed using a thematic framework.ResultsThree main themes were identified: awareness of PA interventions; factors contributing to intervention effectiveness; and barriers to participation in PA interventions. Participants reported awareness only of interventions in which they were involved directly, highlighting a need for better communications, both inter- and intra-sectoral, and with residents. Meaningful engagement of residents in planning/organisation, tailoring to local context, supporting volunteers, providing relevant resources and an ‘exit strategy’ were perceived as important factors related to intervention effectiveness. Negative attitudes such as apathy, disappointing experiences, information with no perceived personal relevance and limited access to facilities were barriers to people participating in interventions.ConclusionsThese findings illustrate the complexity of influences on a community’s participation in PA interventions and support a social-ecological approach to promoting PA. They highlight the need for cross-sector working, effective information exchange, involving residents in bottom-up planning and providing adequate financial and social support. An in-depth understanding of a target population’s perspectives is of key importance in translating PA behaviour change theories into practice.

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“…Cleland et al, 2013). However, the evidence of best approaches to increase physical activity in disadvantaged populations remains limited (Everson-Hock et al, 2013).…”

Section: Evidence-based Approaches To Increase Physical Activity In Amentioning

confidence: 99%

The influence of child physical activity programs on parent physical activity in a rural community.

Leslie

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Community-based dietary and physical activity interventions in low socioeconomic groups in the UK: A mixed methods systematic review

Abstract: Evidence on the effectiveness of community-based dietary and physical activity interventions is inconclusive. A range of barriers and facilitators exist, some of which were addressed by interventions but some of which require consideration in future research.

Cited by 49 publications

References 59 publications

A narrative systematic review of factors affecting diabetes prevention in primary care settings

A narrative systematic review of factors affecting diabetes prevention in primary care settings

Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: a qualitative study

The influence of child physical activity programs on parent physical activity in a rural community.

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