Multicomponent Health Promotion Research Articles

Affective Experiences of Older Adults Enrolled in a Multi-Component Health Promotion Program: A Focu-Group Study

The purpose of this qualitative study using focus groups was to explore the affective experiences of older adults enrolled in Bingocize®, a health promotion program that combines bingo and exercise after program facili-tators received a supplemental training developed by a recreational therapist titled, FUNctional Movement. The training emphasized participant enjoyment and autono-my support utilizing The Self-Determination Enjoyment Enhancement Service Delivery Model. Focus groups, comprised of 17 participants across three sessions, re-vealed that while the supplemental training may have improved engagement, many were unaware of the fall prevention components of Bingocize®. Focus group themes included autonomy sup-port, enjoyment, future desired activities, and barriers to physical activity. This may highlight a need to explicitly incorporate fall prevention and functional movement into Bingocize® training for facilitators. Additionally, integrating health education topics like sexual health and incontinence into Bingocize® could address participant needs and enhance program offerings. These findings may provide insights for refining Bin-gocize® training, aligning it more closely with participant expectations through a rec-reational therapy approach to physical activity in long-term care settings. The authors provide practice recommendations.

Home Together: A Multi-Level Community-Based Health Promotion Program Supporting Families Experiencing Homelessness

Abstract: Home Together (HT) is a multi-level multi-component health promotion program, co-led by academic and non-profit partners in Arkansas that sought (1) to improve access to and family acceptance of social services and health care among women experiencing homelessness who have a diagnosed mental health condition and a child younger than six years and (2) to increase service provider capacity to engage with this population. A socioecological perspective was used to detail program components and lessons learned. Home Together enrolled 345 women representing unduplicated families. Of these, 214 completed six-month reassessments and 111 completed discharge assessments. Representative of the area and population served, most self-identified as belonging to racial minorities (87.0%), being younger than 35 years (80.1%), experiencing violence (76%), and being heterosexual (82%). Pre-post testing indicated positive changes for HT families, including improvements in mental health, health care access, and housing. Yet, even the most coordinated comprehensive programs are no substitute for policy-level changes that help families reach stability.

Evaluating Multidisciplinary Approaches within an Integrated Framework for Human Health Risk Assessment

This study explores the multifaceted realm of human health risk assessment, emphasizing the pivotal role of integrated frameworks and multidisciplinary approaches. As environmental challenges and their associated health risks become increasingly complex, traditional, single-discipline methods are often inadequate. A holistic perspective that integrates knowledge and methodologies from various disciplines is essential for comprehensive human health risk assessment. It serves as the initial phase in multicomponent health promotion initiatives. The Human Health Risk Assessment (HHRA) encompasses five crucial components: hazard identification, risk assessment, risk control, documentation of findings, and control review. Ultimately, scientific risk assessment provides valuable insights to guide decisionmaking related to risk. Establishing comprehensive and robust principles is essential to underpin the risk management framework. These guiding principles provide an ethical foundation for evaluating various factors relevant to risk management decisions. Nevertheless, their practical application requires both flexibility and practical judgment. The study is based on a thorough review of existing global literature.

Fit Around the Farm: A holistic approach to health promotion for elders

As a consequence of historical and contemporary structural racism, people from minoritized communities are burdened with higher incidence, more severe morbidity, and earlier mortality from chronic diseases, including diabetes, heart disease, and hypertension. To advance health equity, public health policies and programs must address racialized inequities in the social and environmental determinants of health and support individuals in making the behavioral changes that can prevent the onset of chronic disease and intervene in its progression. Based on analysis of in-depth, qualitative interviews with elder Black women (n = 13), this article examines the experiences and perspectives of participants in Fit Around the Farm, an innovative, farm-based, multicomponent health promotion program in Boston, MA. Drawing on their narratives, we describe how the program supports participants’ health and well-being by improving food access and nutrition, increasing physical activity (and capacity for physical activity), creating a supportive community oriented to wellness, and providing access to safe and culturally resonant green space. This analysis suggests that community based urban farms offer a compelling site for multicomponent health promotion programs for Black elders in urban communities, a structurally disadvantaged population at risk for chronic disease.

School-Based Cardiovascular Health Promotion in Adolescents

School-based interventions offer an opportunity for health promotion in adolescence. To assess the effect of 2 multicomponent educational health promotion strategies of differing duration and intensity on adolescents' cardiovascular health (CVH). The SI! Program for Secondary Schools is a 4-year cluster randomized clinical intervention trial conducted in 24 secondary schools from Barcelona and Madrid, Spain, from September 7, 2017, to July 31, 2021. Eligible participants were adolescents enrolled in the first grade of secondary school. Schools and their participants were randomized to receive a health promotion intervention (SI! Program) over 4 school years (long-term intervention [LTI], 8 schools, 412 adolescents) or 2 school years (short-term intervention [STI], 8 schools, 504 adolescents) or to receive the standard curriculum (control, 8 schools, 441 adolescents). The primary end point was the between-group difference at 2 and 4 years in the change from baseline of the overall CVH score, as defined by the American Heart Association (range, 0-14 points, with a higher score indicating a healthier CVH profile). Intervention effects were tested with multilevel mixed-effects models. A complete-case intention-to-treat analysis was performed as the primary analysis. Of the randomized students, the study enrolled 1326 adolescents (684 [51.6%] boys, mean [SD] age, 12.5 [0.4] years at recruitment) with a study completion rate of 86.0%. Baseline overall CVH scores were 10.3 points in the LTI group, 10.6 points in the STI group, and 10.5 points in the control group. After 2 years, at halfway through the LTI and at the end of the STI, the difference in the CVH score change was 0.44 points (95% CI, 0.01-0.87; P = .04) between the LTI group and the control group and 0.18 points (95% CI, -0.25 to 0.61; P = .39) between the STI group and the control group. At 4 years, differences for the LTI and STI groups vs control were 0.12 points (LTI: 95% CI, -0.19 to 0.43; P = .42) and 0.13 points (STI: 95% CI, -0.17 to 0.44; P = .38). No adverse events were reported. Overall, the tested school-based health promotion strategies in this randomized clinical trial had a neutral effect on the CVH of the adolescents. Although there was evidence of a marginal beneficial effect at a point halfway through implementation in the LTI group, such a benefit was not noted at 4 years. Further research is warranted into the efficacy of school-based health promotion programs. ClinicalTrials.gov Identifier: NCT03504059.

ITHRIVE 365: A Community-Led, Multicomponent Health Promotion Intervention for Black Same Gender Loving Men.

Although health inequities among Black same gender loving men (SGLM) are well documented (e.g., chronic psychological disorders, HIV, suicide), there are few accessible, culturally affirming, and community-led interventions designed to reduce these inequities. The present manuscript describes the process through which we developed iTHRIVE 365, a multicomponent health-promotion intervention designed by Black SGLM for Black SGLM. We utilized a community-based participatory research approach (CBPR) that included collaboration between THRIVE SS, a Black SGLM-run community-based organization, and a multisectoral team of public health, research, and digital design professionals to develop the intervention. A five-phase development process included four phases of focus groups and a technical pilot to assess community priorities and incorporate input on each feature of the intervention. Directed content analysis indicated that participants wanted a multicomponent and technology-mediated intervention that promotes health knowledge and motivation, Black SGLM social support, access to affirming healthcare, and housing and economic resources. iTHRIVE 365 combines multilevel and culturally affirming intervention features to combat the effects of oppression and ultimately promote Black SGLM's biopsychosocial health.

Process evaluation of workplace health promotion in a sheltered workplace: a care ethics perspective.

Despite the potential health benefits of workplace health promotion for employees in sheltered workplaces, participation is often limited. The aim of this study was (i) to understand this limited participation, and (ii) to find opportunities for adapting workplace health promotion, such that it better meets the needs of the target population. A responsive process evaluation of an extensive multi-component workplace health promotion program targeting lifestyle behaviors, financial behaviors, literacy and citizenship, was performed in a large, sheltered workplace in the Netherlands (>3500 employees). To understand the limited participation, interviews with employees (n = 8), supervisors (n = 7) and managers (n = 2), and 10 participant observations were performed. To find opportunities for improving workplace health promotion in the sheltered workplace, 7 dialogs with employees were performed (n = 30). The interview data on the barriers for participation were evaluated through the lens of care ethics, as this allowed to understand the role of various stakeholders in the limited participation, as well as the indirect role of the institutional context. Findings showed that participation in workplace health promotion could increase if it is organized in a way that it encourages employees to work on health together, allow to tailor activities to different needs and capabilities of employees, and connects activities to employees' daily lives. A strength of this study is that the responsive process evaluation focused both on barriers for participation, as well as on opportunities to increase participation.

A Creative Concept to empower office workers addressing work-related health risks.

Among office workers, the sedentary work-related health challenges are mainly associated with the fact that they often sit for up to 10 hr a working day. Members of the Research Group conducted a research program to assist the office workers of an international telecommunication company's affiliate in Budapest to enhance comfort levels in the office work environment. The data collection included a Comfort Survey to reveal employees' sense of comfort related to Indoor Environmental Quality (IEQ) components and the characteristics of employees' feelings and behavior during working hours. Moreover, a measurement of IEQ components was carried out and focused on air quality, lighting, sound exposure and thermal comfort parameters. Based on the survey's results, a Creative Concept was developed to empower office workers to address work-related health risks, notably sedentary work risks. The Creative Concept consists of five elements: a Comfort Map as an IEQ-related application to select a suitable workplace, redesigning concepts to increase the use of lounges, a newly developed work pad to improve personal hygiene in an office environment, recommendations for creating a health-enabling work environment and a workplace training program to raise health awareness. After validation, our Creative Concept can function as a multi-component workplace health promotion method to offer assistance for a wide variety of offices to create a health-enabling working environment.

Three-year follow-up of a multi-component community-driven health promotion intervention in Denmark.

The article presents a follow-up study of a multi-component community-driven health promotion intervention in Denmark. The study examines the perceptions and actions of professional stakeholders 3 years after completion of a 19 months intervention period addressing healthy living, well-being and social engagement among families with young children living in three rural communities on the Danish island of Bornholm. The intervention was implemented within the framework of Project Health and Local Community, also referred to as Project SoL. Qualitative in-depth interviews were conducted with diverse professional stakeholders of the project. They represented local government, public institutions, private enterprises, civil society organizations and local mass media. The interviews addressed the extent to which the project had sustained its influence on professional stakeholders' perceptions and actions following project completion. Efforts were made to understand if persisting influences were value-based and/or manifested as concrete community-driven actions. The study showed that the project had succeeded in sustaining a positive long-term post-intervention influence among informants regarding the values and principles of the project. Despite their sustained motivation and preparedness to continue implementing coordinated community-driven actions this was severely hampered by lack of coordination after project completion. Instead, some of the stakeholders continued developing and implementing actions based on the values and principles of the project within the framework of their own professional networks. The article discusses the structural factors that are required to sustain complex community-driven interventions and the need to reconsider the nature of external support to community development from being project-based to integrated, strategic and long term.

The Danish SoL Project: Effects of a Multi-Component Community-Based Health Promotion Intervention on Prevention of Overweight among 3-8-Year-Old Children.

The aim of the study was to determine the effects of a multi-component community-based health promotion intervention on body mass index (BMI) z-scores and waist circumference (WC) in three- to eight-year-old children. A quasi-experimental design was adopted to evaluate the effects of the SoL intervention involving three intervention and three control communities. The 19-month intervention was based on the supersetting approach and was designed to promote healthier eating and physical activity among children and their families. BMI z-scores and WC were measured at baseline and follow-up. At baseline, 238 (54%) and 214 (51%) of all eligible children were measured from intervention and control, respectively. The change over time in the BMI z-scores of children from the intervention group was significantly different from that of the control group (p = 0.001). BMI z-scores increased over time in the intervention group in contrast to the control group, whose BMI z-scores decreased (difference in change between groups 0.19 z-scores 95% CI 0.08, 0.30). No significant differences were observed for WC. The results showed no favourable effects of the intervention of Project SoL on BMI z-scores and WC in children. Further studies based on a larger sample size and a longer intervention duration are needed.

Family-based intervention to prevent childhood obesity among school-age children of low socioeconomic status: study protocol of the FIVALIN project

BackgroundChildhood obesity represents a global public health crisis: the number of obese children and adolescents (aged 5–19 years) worldwide has risen tenfold in the past four decades. The vast majority of overweight and obese children live in high-income countries, and low socio-economic status (SES) is a significant risk factor. Family Based Interventions (FBI) have demonstrated positive results in preventing obesity, although these results are strongly influenced by SES. Moreover, we still poorly understand how FBI can determine a positive trend in weight status in low-income communities. Therefore, there is an urgent need to define and evaluate innovative and multi-target projects to reduce obesity risk behaviors and health inequalities and the present study aims to present the study protocol of FIVALIN a FBI that pretends to achieve this goal.MethodsWe will conduct a quasi-experimental design within 60 Community Child Centers (CCC) in Barcelona metropolitan area. Each cluster (CCC) will be assigned by convenience to the intervention and control groups. For the whole study, a total of 810 children aged 8–12 years and 600 parents will be recruited during 3 consecutive editions (1st – 2019/2020; 2nd – 2020/2021; 3rd – 2021/2022) of 10 months each. The action is a regular multicomponent health-promotion intervention targeting children, families, and CCC. All activities are based on the Motivational Interviewing (MI) approach and will focus on promoting good dietary habits, physical activity, appropriate screen time and sleep duration, and psychological well-being. The control group participate in a unique workshop on general awareness of healthy lifestyles for families. We will perform a comparative analysis of the evolution of weight status, healthy lifestyles, and socioeconomic variables, between the intervention and control groups.DiscussionThere is a need for more evidence on how to target and evaluate holistic interventions in low SES families. Our multi-targeting intervention for obesity prevention tackles risky behaviors that go beyond diet and physical activity (PA). Therefore, future interventions can effectively promote all the behavioral domains that determine trends in the weight status.Trial registrationISRCTN Registry: ISRCRN12682870. Registered 9 July 2020. Retrospectively registered.Protocol version: 30 April 2021, version 5.

Weight loss, hypertension and mental well-being improvements during COVID-19 with a multicomponent health promotion programme on Zoom: a service evaluation in primary care

BackgroundObesity is a risk factor for complications from SARS-CoV-2 infection, increasing the need for effective weight management measures in primary care. However, in the UK, COVID-19 restrictions have hampered primary...

Step on up! A multi-component health promotion intervention to promote stair climbing

Objectives: To study the influence of a multi-component poster-based intervention to promote stair climbing in a library on a Canadian university campus. Participants: Adults who ascended to upper levels via staircase/elevator. Methods: Individuals who used the staircase/elevators were counted by observers for 28 days, while either in the absence/presence of a poster-based intervention. Chi-square tests were used to compare staircase versus elevator use before, during and after the poster-based intervention. Data from weekdays and weekends were analysed separately. Results: A total of 7,663 stair climbers and elevator users were observed. Compared to the baseline period, the frequency of staircase use on weekdays was significantly higher during the intervention and follow-up periods. This effect was not found at weekends. Conclusion: This study provides evidence that a multi-component poster-based intervention can result in increased staircase use. The increase observed in this study is similar to that in previous research using point-of-choice prompts only.

Bingocize® beyond the numbers: Motivations and perceptions of a multicomponent health promotion program among older adults living in long-term care

Physical activity (PA) participation among older adults remains the lowest of any demographic, with even lower participation rates in long-term care facilities (LTCFs). While fall risk decreases when individuals engage in PA programs focused on fall prevention, enrollment in such programs remains low. The purpose of this feasibility study was to pilot questions for development of a participant survey used to explore the perceptions and motivations of older adults currently enrolled in a health promotion program called Bingocize®. The program combines fall prevention exercises with the familiar game of bingo. Study participants included a convenience sample of four older adults currently residing in a LTCF. A phenomenological qualitative research approach using video recorded interviews was chosen for the exploratory study. Results revealed that older adults viewed the overall program as enjoyable, identifying social aspects such as intergenerational connection with program facilitators as motivation for participation. Focusing attention on these factors may assist future implementation of the intervention and to promote higher levels of participation in fall prevention programs centered on PA.

Impact of "JolinchenKids-Fit and Healthy in Daycare" on Children's Objectively Measured Physical Activity: A Cluster-Controlled Study.

To evaluate a multicomponent health promotion program targeting preschoolers' physical activity (PA). PA of children from 23 German daycare facilities (DFs; 13 interventionDFs, 10 controlDFs) was measured via accelerometry at baseline and after 12months. Children's sedentary time, light PA, and moderate to vigorous PA were estimated. Adherence was tracked with paper-and-pencil calendars. Mixed-model regression analyses were used to assess intervention effects. PA data were analyzed from 183 (4.2 [0.8]y, 48.1% boys) children. At follow-up, children in DF groups with more than 50% adherence to PA intervention components showed an increase of 9 minutes of moderate to vigorous PA per day (β = 9.28; 95% confidence interval [CI], -0.16 to 18.72) and a 19-minute decrease in sedentary time (β = -19.25; 95% CI, -43.66 to 5.16) compared with the control group, whereas children's PA of those who were exposed to no or less than 50% adherence remained unchanged (moderate to vigorous PA: β = 0.34; 95% CI, -13.73 to 14.41; sedentary time: β = 1.78; 95% CI, -26.54 to 30.09). Notable effects were found in children with migration background. Only small benefits in PA outcomes were observed after 1year. A minimum of 50% adherence to the intervention seems to be crucial for facilitating intervention effects.

Workplace pedometer interventions for increasing physical activity.

Workplace pedometer interventions for increasing physical activity.

Examining Implementation Feasibility of a Multicomponent Parenting and Health Promotion Program for Military Families

Promoting military child well-being is imperative for enhancing resiliency and public health within military families and the United States. Providing military families with parent-focused interventions (PFIs) is one, potentially beneficial technique for fostering favorable health outcomes in military children. This study presents implementation feasibility, fidelity, and initial post-program findings from a pilot study of Grow, a PFI that enhances positive parenting, stress management, and physical health promotion skills in military parents of children 5- to 10-year-old. Results indicate that Grow is highly acceptable, feasible to implement with fidelity, and shows promising post-program health outcomes. Study limitations and future directions are discussed.

Improving the Lifestyle of Adolescents Through Peer Education and Support in Vietnam: Protocol for a Pilot Cluster Randomized Controlled Trial.

BackgroundIn Ho Chi Minh City, Vietnam, recent studies found a rapid increase in overweight and obesity in adolescents. There is a need for effective health promotion interventions to support healthy diets and encourage a physically active lifestyle. This study will help fill an evidence gap on effective interventions to prevent excess weight gain in adolescents and generate new insights about peer-led education to promote healthy lifestyles.ObjectiveWe aim to assess the feasibility and acceptability of a combined peer-led and peer support intervention among junior high school students in Ho Chi Minh City. Additionally, the efficacy of the intervention on adolescents’ dietary practices and time spent on physical activity will also be measured in this pilot study.MethodsThe Peer Education and Peer Support (PEPS) project is a pilot cluster randomized controlled trial with 2 intervention and 2 control schools. The intervention consists of 4 weekly education sessions of why and how to choose healthy food and drinks and how to be more physically active. Additionally, the intervention includes a school-based and online support system to help maintain student engagement during the intervention. We will use in-depth interviews with students, peer leaders, teachers, and parents; focus group discussions with peer educators; and direct observation of the school environment and peer leaders’ interactions with the students. Acceptability and feasibility of the intervention will be assessed. We will also quantitatively assess limited efficacy by measuring changes in student’ physical activity levels and dietary behaviors.ResultsWe delivered the peer education intervention at the start of each school year over 3 months for all new grade 6 adolescents in the selected schools, followed by peer support and home engagement activities over 6 months until the end of the school year. There was a baseline assessment and 2 post-intervention assessments: the first immediately after the intervention to assess the short-term impact and the second at the end of the school year to assess the sustained impact on changes in adiposity, diet, and physical activity.ConclusionsThe findings of this study will be used to develop a larger-scale cluster randomized controlled trial to examine the impact of a multicomponent, school- and home-based health promotion intervention. The trial will use innovative peer education methods to reduce overweight and obesity and improve dietary choices and physical activity levels in Vietnamese adolescents.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12619000421134; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376690&isReview=trueInternational Registered Report Identifier (IRRID)DERR1-10.2196/15930

Impact of the intervention program \u201cJolinchenKids \u2013 fit and healthy in daycare\u201d on energy balance related-behaviors: results of a cluster controlled trial

BackgroundThe purpose of this study was to evaluate the multi-component health promotion program, JolinchenKids – fit and healthy in daycare, designed to promote physical activity (PA), healthy eating, and mental wellbeing among 3- to 6-year-old preschoolers.MethodsFor this cluster controlled trial, 62 daycare facilities (DFs) from thirteen different federal states in Germany were recruited (31 intervention, 31 control DFs). Outcome measures were children’s habitual PA, fruits and vegetable consumption, consumption of unsweetened beverages and snacks with parents as raters. Study nurses assessed children’s body composition and motor skills. Data was collected at baseline and 12 months later. To track adherence to the implementation of intervention modules at individual DF groups, an implementation calendar was used from baseline to follow-up. Linear mixed models were used to investigate effects for survey, group and their interaction at the individual level while accounting for clustering.ResultsSamples of 831 (baseline) and 641 (follow-up) children aged 4.3 ± 0.8 and 5.2 ± 0.8 years were analysed. More than half of the intervention DFs chose the nutrition or PA module for the first year of implementation while an implementation level of > 50% was only achieved in less than a third. A significant intervention effect (survey × group interaction) was found for the standing long jump favouring children at intervention DFs (β = 3.08; 95% Confidence interval [CI]: (0.09; 6.07)). No significant intervention effects were found for time spent on PA, total screen time, dietary habits, and body composition, i.e. body-mass-index and percentage of body fat.ConclusionsParticipation in JolinchenKids – fit and healthy in daycare led to improvements in some indicators for motor skills. However, other health outcomes and behaviours were not affected by program participation over the course of 1 year.Trial registrationGerman Clinical Trials Register DRKS00011065 (Date of registration 16-09-2016).

Effects of a multi-behavioral health promotion program at worksite on smoking patterns and quit behavior.

Tobacco use is associated with various severe health risks. Therefore, the need to decrease smoking rates is a great public health concern. The workplace has capability as a setting through which large groups of smokers can be reached to encourage smoking cessation. The aim of the present study was to evaluate effects of a multi behavioral worksite health promotion intervention. The primary outcome was the change of smoking rate. Secondary outcomes were changes in smoking attitudes and readiness to stop smoking among employees over an intervention period of 12 months. 112 and 110 employees were enrolled in the intervention and control arm respectively. The intervention group received a 12-month multicomponent health promotion intervention. One of the main elements of the multicomponent intervention was a smoking cessation and counseling program. During the pilot year, participants completed a self-evaluation questionnaire at baseline and again after 12 months to related outcomes and changes. Results showed that participants' quit behavior and smoking behavior changed over time in the intervention group (IG). Readiness to quit smoking also increased in the IG compared to the comparison group (CG). Some positive intervention effects were observed for cognitive factors (e.g., changes attitudes towards smoking). Baseline willingness to change smoking behavior was significantly improved over time. This study showed initial results of a long-term multicomponent worksite health promotion program with regard to changes in smoking behavior, attitudes towards smoking and readiness to quit smoking. The evaluation suggests that a worksite health promotion program may lead to improvements in smoking behavior for a number of workers.