Establishing and maintaining healthy environments: Toward a social ecology of health promotion.

Stokols, Daniel

doi:10.1037/0003-066x.47.1.6

Cited by 1,547 publications

(1,130 citation statements)

References 83 publications

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“…In the field of health promotion we would argue that these (lay) interpretations resonate far more closely to what have been called social ecological models of health promotion (Sallis and Owen, 1997;Stokols, 1992) than they do to social cognition models. Indeed, as Burke, Joseph, Pasick et al, (2009) argue, social cognition models often regard the things that are highlighted by our respondents as merely 'contextual' and important only in so far as they have an effect on the attitudes and motives of individuals.…”

Section: And I Know It's Not Your (Ie the Moderator's) Remit But Imentioning

confidence: 83%

“…Although the residents of the intervention area were approached without any theoretical pre-conceptions as to what influenced health behaviour and PA, we found that lay thinking about health and wellbeing and the role of activity resonated particularly strongly with many assumptions of a social ecology perspective on health promotion (Ding, Sallis, Conway et al, 2012;Sallis and Owen, 1997;Stokols, 1992). That was especially so in so far as our respondents focussed attention on structures (material, social, cultural and political) and processes more than on personal motives or motivation; and on groups and communities rather than individuals.…”

Section: Getting Folks Activementioning

confidence: 93%

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Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Prior¹,

Scott²,

Hunter³

et al. 2014

Social Science & Medicine

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It is now recognised that inactive lifestyles underpin much of the disease burden evident in the richer nations of the world. Indeed, the WHO has identified physical inactivity as a 'global public health problem' and has established minimum physical activity (PA) targets for people at different stages of the life-course. Yet, according to WHO, just under 1/3 of working age adults across the globe meet those targets and it is not at all clear how the disjunction between the recommendations of policy makers and the behaviour of ordinary people might be surmounted. Using an opportunity to examine the impact of an urban regeneration project on community residents in East Belfast (Northern Ireland) this paper examines the views of some 113 people on how to increase rates of PA in an area of multiple deprivation. The results of the analysis suggest that lay people rarely consider PA as a discrete issue, or one that centres on individuals and their motivation, but rather as one component in a complex web of concerns, processes and events that include such things as the actions of neighbours and relatives, material and political environments, vandalism, violence, and the weather. We explore and unravel the nature of those concerns using novel methods of content analysis that generate 'issue webs'. Particular attention is paid to the ways in which lay people conceptualize 'activity' and to the manner in which they point to ways of encouraging activity that are rooted in everyday life rather than in the corpocentric, agent-centred, and sport dominated strategies favoured by local policy makers. Our results support those who argue that interventions to increase rates of PA need to move beyond behavioural approaches that focus on individuals and consider the social, political and material contexts in which 'activity' occurs. Research Highlights. Challenges the dominance of behavioural approaches to public health interventions. Supports a social ecology perspective on policy relating to physical activity. Introduces the notion of 'issue webs' as a focus for qualitative research. Explores the complexity of public health problems in a conflict zone.

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Section: And I Know It's Not Your (Ie the Moderator's) Remit But Imentioning

confidence: 83%

Section: Getting Folks Activementioning

confidence: 93%

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Prior¹,

Scott²,

Hunter³

et al. 2014

Social Science & Medicine

View full text Add to dashboard Cite

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“…1. Using social cognitive theory [10] and the social ecological model [11,12] as a guide, the framework emphasizes that the successful translation of evidence-based behavioral interventions requires understanding factors specific to the real world settings and populations to which they are being translated. Population characteristics, which include knowledge, attitudes, and behavioral practices as well as surface (observable behavior) and deep (shared belief system) cultural structures [13], guide message framing, and intervention format.…”

Section: Methodsmentioning

confidence: 99%

Translation of the diabetes prevention program lifestyle intervention for promoting postpartum weight loss among low-income women

Rosal¹,

Lemon²,

Nguyen³

et al. 2011

Behav. Med. Pract. Policy Res.

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The Women Infants and Children (WIC) program is a promising venue in which to implement weight loss interventions for low-income postpartum women. The goals of this study were to describe formative steps to translate the DPP lifestyle intervention to be delivered to diverse low-income postpartum women who are served by the WIC program, and to present the results of a pilot trial of the intervention. The steps of intervention translation involved were the following: (1) building partnerships, (2) understanding the target setting, (3) understanding the target population, (4) re-designing the intervention, and (5) refining the intervention. The pilot trial was a single group pre/post test comparison among 27 overweight/obese postpartum WIC clients. The intervention resulted in an average weight loss of 4.6lb at a 4-month follow-up (p=0.004). A dose-response association between intervention attendance and weight loss was observed. This translation of the DPP for diverse low-income postpartum women has potential for widespread implementation. KEYWORDS Weight loss, Health disparities, Intervention, Translational researchThe postpartum period is a critical time for targeting weight loss, as on average, women retain approximately 3 kg per pregnancy over the life course [1]. Low SES and minority women are at greatest risk of postpartum weight retention, and these populations also experience significant weight gain after the first few postpartum weeks [2]. The Women Infants and Children (WIC) program is a promising setting in which to implement evidence-based weight loss interventions for low SES women. WIC is a federaland state-funded program with a mission to promote health of low-income women, infants, and children up to age 5 who are at nutritional risk. WIC serves approximately 18 million individuals a year via 9,000 clinics across the country. The program does not systematically provide weight loss services per se, but addressing weight loss among its participants is within the mission of WIC.Only a few interventions have aimed to promote postpartum weight loss among WIC clients and have had minimal or no success [2][3][4]. These interventions have not used or translated existing evidence-based programs or strategies [5,6] (i.e., limited focus on creating an energy deficit; nonsystematic use of self-monitoring, goal-setting and problem-solving, and limited hands-on opportunities and support to develop healthy cooking skills and physical activity behaviors). In addition, studies reported poor attendance and high attrition rates.Despite the promise of efficacious weight loss interventions such as the Diabetes Prevention Program (DPP) Lifestyle Intervention [5,7], to date only a few studies have demonstrated a positive effect of using the DPP intervention in real world settings and populations [8]. There are sizeable barriers to widespread implementation and dissemination of efficacious weight loss interventions like the DPP to real world settings and populations, such as WIC clinics and the low SES postpartum ...

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“…education plus environmental change). The latter is an important issue to consider in future studies as some strategies, such as education, maybe more effective when other elements are in place, as consistent with social-ecological theory (Stokols, 1992). For example, educating children about the benefits of walking to school can only be helpful if the local environment near the school is relatively traffic-free, or there are attractive and safe routes to walk to school.…”

Section: Insert Table 2 About Here Discussionmentioning

confidence: 99%

The effectiveness of interventions to increase physical activity among young girls: A meta-analysis

Biddle

Braithwaite

Pearson

2014

Preventive Medicine

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Context. Pre-adolescent girls are an important target population for physical activity behaviour change as it may enhance tracking into the crucial period of adolescence. The quantification of intervention effectiveness for this age group of girls has not been previously reported.Evidence acquisition. Studies published in English up to and including August 2013 were located from computerised (MedLine, PsychInfo, Science Direct, Web of Science, EPPI centre databases, and Cochrane Library database) and manual searches. Intervention studies aimed at promoting physical activity, that included pre-adolescent girls aged 5-11 years, and a non-physical activity control/comparison group, were included.Evidence synthesis. A random-effects meta-analysis was conducted. The average treatment effect for pre-adolescent girls involved in physical activity interventions was significant but small (g = 0.314, p < .001). Moderator analyses showed larger effects for interventions that catered for girls-only and used educational and multicomponent strategies.Conclusions. Interventions to increase physical activity in pre-adolescent girls show small but significant effects, suggesting that behaviour change may be challenging, but results suggest some strategies that could be successful.

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Establishing and maintaining healthy environments: Toward a social ecology of health promotion.

Cited by 1,547 publications

References 83 publications

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

Translation of the diabetes prevention program lifestyle intervention for promoting postpartum weight loss among low-income women

The effectiveness of interventions to increase physical activity among young girls: A meta-analysis

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