Needs and Challenges Related to Multilevel Interventions: Physical Activity Examples

Sallis, James F.

doi:10.1177/1090198118796458

Cited by 52 publications

(56 citation statements)

References 23 publications

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“…On the other hand, the study might provide a base for developing interventions that address both behavioral context and intrapersonal factors. Such so-called multilevel interventions could be more effective than interventions focusing only on one of these two levels [7,31,77].…”

Section: Discussionmentioning

confidence: 99%

“…However, in order to foster adolescents' exercise and sport behavior, it is important to more deeply understand the interplay of influencing factors from different levels [7,10,12]. Multilevel studies regarding specific interacting mechanisms are of practical use as they generate knowledge for designing more effective interventions [12,31]. In fact, a basic tenet of the socialecological framework [12] is that factors from multiple levels, such as behavioral context and intrapersonal factors, interact with each other.…”

Section: Introductionmentioning

confidence: 99%

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The interaction of behavioral context and motivational-volitional factors for exercise and sport in adolescence: patterns matter

2020

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Background: In order to generate more effective interventions to promote exercise and sport in adolescence, a better understanding of the interaction of influencing factors across different levels is needed. In particular, motivation and volition for exercise and sport, as well as the context in which adolescents are doing exercise and sport, have been identified as important factors. Behavioral context refers to both the organizational setting, e.g., doing exercise and sport in a club, and the social setting, e.g., doing exercise and sport with friends. Extending previous research, the present study applies a person-oriented approach and aims to identify typical behavioral context patterns and motivational-volitional patterns. To validate the patterns, it was examined whether they differ concerning the exercise and sport activity level. Furthermore, the study investigated how behavioral context patterns and motivational-volitional patterns interact. Method: A cross-sectional design with 1155 adolescents (M age = 15.29; 53% female) was applied. A latent profile analysis was used twice to identify typical patterns: once with eight organizational and social setting factors to examine behavioral context patterns, and once with five motivational-volitional factors to examine motivationalvolitional patterns. To validate the patterns identified, the exercise and sport activity level were compared across the patterns using Wald-tests. Finally, transition probabilities and odds ratios were calculated in order to investigate the interaction of the behavioral context and motivational-volitional patterns. Results: Four behavioral context patterns − differing in activity level − were identified: Mostly inactive, non-cluborganized individualists, self-organized individualists and family sportspersons, and traditional competitive club athletes with friends. Furthermore, five motivational-volitional patterns emerged with differing activity levels: three level patterns with overall low, moderate or high motivation and volition, and two shape patterns called the intention-and plan-less and the plan-less motivated. Regarding interaction, the results indicate that one behavioral context pattern is not solely responsible for moderate to high motivation and volition in adolescents. Conclusion: Applying a person-oriented approach allows a more differentiated view of how behavioral context and motivational-volitional factors interact within homogenous subgroups. This, in turn, provides a basis to design tailored multilevel interventions which account for the interaction of influencing factors across different levels.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The interaction of behavioral context and motivational-volitional factors for exercise and sport in adolescence: patterns matter

2020

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“…To increase PA and reduce SB needs multilevel interventions. Any interventions involve multiple levels of factors are more effective than single-level interventions [ 52 ]. Medical schools should focus on multilevel interventions to fight the low levels of PA and high levels of sedentariness of medical students as a whole system.…”

Section: Discussionmentioning

confidence: 99%

Results from the Medical School Physical Activity Report Card (MSPARC) for a Thai Medical School: a mixed methods study

et al. 2018

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BackgroundData systems for surveillance and monitoring are essential to develop understanding of the levels of physical activity (PA) occurring at the population levels. To comprehensively understand PA in medical schools, a suitable surveillance tool might be useful to present and monitor key PA-related metrics. This study investigated PA-related metrics in a Thai medical school and summarised the findings using a newly developed tool-the Medical School Physical Activity Report Card (MSPARC).MethodsA mixed methods study was carried out at three campuses of a medical school in Southern Thailand. Data analysis included descriptive statistics and qualitative reviews. All 285 medical students from a medical school were the target population. The prevalence of PA (≥ 150 min/week of moderate- to vigorous-intensity PA) and sedentary behaviours (SB) (≥ 8 h/day of sedentary time) among medical students were analysed using data from a self-administered questionnaire. Usage patterns, quality, and accessibility of walkable neighbourhoods; bicycle facilities; and recreational areas were assessed. PA promotion programmes, education, and investment related to PA promotion were reviewed from the school documents.ResultsOf 279 participants, 138 (49.5%) met PA recommendation, but 71.7% met criteria for SB. Male students were more active (61.8 vs. 42.4%) and less sedentary (65.7 vs. 75.1%) than female students. Bicycle facilities were rated as having the lowest quality and accessibility among PA-related facilities. Most PA promotion programmes were sports clubs and sport competitions. A total of 25 h of PA education was taught throughout the entire curriculum, which provided minimal PA counselling training. The school invested 2136.14 Baht/student/year (US $64.34) in PA promotion, or 2.4% of the annual tuition. The MSPARC presented the summary of the findings by using simple symbols, infographics, and short texts.ConclusionsTo increase PA and decrease SB among medical students, there is a need to improve the quality and accessibility of the built environment as well as the natural environment, so as to establish health promoting policies. PA counselling training is required to develop the medical students’ essential skills and awareness for future practices. Monitoring and subsequent surveillance of PA in medical school are needed.

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“…Health behaviors, including physical activity, are critical for reducing the development of MetS and related diseases [ 31 , 42 ], but most people don't achieve recommended activity levels [ 23 ]. Multiple factors influence physical activity, from individual to communities [ 47 , 49 ]. Intervening on physical activity at multiple levels can reduce morbidity, mortality, and health care costs [ 22 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

A community-based positive psychology group intervention to promote physical activity among people with metabolic syndrome: Proof of concept results to inform a pilot randomized controlled trial protocol

Millstein¹,

Thorndike²,

Kim³

et al. 2020

Contemporary Clinical Trials Communications

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Background Community-based physical activity interventions can offset the burden of developing chronic diseases. Positive psychology (PP) interventions may improve health behaviors, but little is known about their effectiveness in community-based prevention settings. A multilevel PP-based intervention has never been studied in people at risk for chronic diseases. Purpose The aim of the trial is to demonstrate feasibility, acceptability, and improve physical activity. The purpose is to describe the theory, design, and rationale of the randomized controlled trial (RCT) phase of an iteratively developed physical activity intervention for metabolic syndrome. The feasibility results of the proof-of-concept phase are presented. Methods Participants are adult primary care patients at community health centers with metabolic syndrome and low physical activity (target n = 64). The 8-week group intervention consists of weekly physical activity goal-setting and self-monitoring, positive psychology activities, and neighborhood walks. Participants rate feasibility and acceptability of sessions. Pre-post-intervention, and 24 weeks later, participants complete accelerometers, questionnaires, and biometrics. Feasibility results Eight participants enrolled and seven completed. The median number of group sessions attended was 7 out of 8. Average ease and usefulness of sessions were rated as 7.0 (±0.5)/10 and 8.1 (±1.0)/10, respectively, indicating feasibility and acceptability. Average pre-post physical activity increased by 2152 steps and 29.25 min of MVPA/week. Discussion This proof-of-concept trial demonstrated high feasibility and acceptability, with increased physical activity. These positive findings suggest that the RCT phase will show high feasibility, acceptability, and initial impact on physical activity.

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Needs and Challenges Related to Multilevel Interventions: Physical Activity Examples

Cited by 52 publications

References 23 publications

The interaction of behavioral context and motivational-volitional factors for exercise and sport in adolescence: patterns matter

The interaction of behavioral context and motivational-volitional factors for exercise and sport in adolescence: patterns matter

Results from the Medical School Physical Activity Report Card (MSPARC) for a Thai Medical School: a mixed methods study

A community-based positive psychology group intervention to promote physical activity among people with metabolic syndrome: Proof of concept results to inform a pilot randomized controlled trial protocol

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