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ISBNPA 2007: Marketing, serious games and nanny states. Observations from the sixth annual meeting of the International Society of Behavioral Nutrition and Physical Activity, Oslo 2007
Johannes Brug
International Journal of Behavioral Nutrition and Physical Activity , 2007, DOI: 10.1186/1479-5868-4-37
Abstract: The sixth annual meeting of the International Society of Behavioral Nutrition and Physical Activity was held in Oslo June 22 to 24, 2007. As president-elect I was responsible for the program and therefore busy with organizational issues during the conference, and I could not attend as many sessions as I wanted. This paper is therefore not based on a representative, but rather on a highly selective sample of keynotes, symposiums, oral papers and posters presented at the conference [1]. Nevertheless, even this narrow selection of presentations that I was able to attend, indicates that our annual meeting covered what ISBNPA is all about: International focus, a Society of researchers, with a focus on Behavioral research, related to Nutrition and Physical Activity.The sixth ISBNPA annual meeting reflected the growing internationality of the society. Scientists from more than 30 countries presented their research. However, the vast majority of presentations were from a more selective number of countries and regions, North America, Australia and North-Western Europe in particular. Many countries outside these regions are confronted with similar important behavioral nutrition and physical activity issues and it is a challenge for ISBNPA to create even better opportunities to share our research with colleagues from other countries and to learn from their studies. The fact that some colleagues from Latin America were present at the conference is an important step towards a broader international focus. In other parts of the world issues such as the fast changing nutrition and physical activity patterns, introduction of processed foods, and remaining high prevalence of under-nutrition, combined with a fast growing obesity problem require high quality behavioral research and researchers to monitor and explain behavioral patterns, and inform intervention and policy development. In this respect, it was promising to meet researchers from Africa at the conference, facilitated by a s
Order is needed to promote linear or quantum changes in nutrition and physical activity behaviors: a reaction to 'A chaotic view of behavior change' by Resnicow and Vaughan
Johannes Brug
International Journal of Behavioral Nutrition and Physical Activity , 2006, DOI: 10.1186/1479-5868-3-29
Abstract: From the very start of the International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) the journal has recognized the limited success of the prevailing health behavior theories in explaining and predicting nutrition and physical activity behaviors and behavior change. The IJBNPA therefore encouraged a theory debate to promote a discussion on the limitations of common behavioral theories, and ways to improve the theories and how the theories are used. This in order to better inform behavioral nutrition and physical activity interventions. Four theory debate papers had been published so far. Dr. Robert Jeffery did the kick-off with a straightforward critique of the social cognition theories that are most often used to explain and predict nutrition and physical activity behaviors, such as the Theory of Planned Behavior, Health Belief Model, protection Motivation Theory and Social Cognitive Theory [1]. Jeffery argued that these theories focus primarily on psychological variables as predictors of people's motivation to change, but often fail to address people's abilities and opportunities to change. He further described a number of projects to promote weight loss he was professionally involved in, to show that using these theories to inform behavioral nutrition and physical activity interventions did not improve the chances of success. Jeffery further argued that a focus on the interface between the person and the environment as well as a return to the more classic learning theories might better inform weight loss interventions.In the second theory debate paper [2], Dr. Rothman also concluded that the prevailing theories have limited success in explaining behavior change. Although he recognizes the importance of structured protocols to better apply theoretical constructs in intervention development, he argued that such protocol may only help to provide better guidance as to how existing theories should be applied, while more effort is necessary to refine
The European charter for counteracting obesity: A late but important step towards action. Observations on the WHO-Europe ministerial conference, Istanbul, November 15–17, 2006
Johannes Brug
International Journal of Behavioral Nutrition and Physical Activity , 2007, DOI: 10.1186/1479-5868-4-11
Abstract: The fact that all member states of WHO-Europe have now explicitly agreed on an ecological approach to fighting the obesity epidemic with a timeline for visible results is important. However, the charter does not explicate specific enough and measurable objectives for improvement, nor the means needed to reach these.The fact that all WHO-Europe member states have agreed on a charter that recognizes that counteracting obesity requires a multidisciplinary and ecological approach, with a timeline for improvements, is a late but important step forward for public health policy and practice across Europe. However, more specific tangible goals should now be set, the required means should be allocated, coordinated and immediate action should be implemented, and research to identify effective strategies should be encouraged and facilitated.After several years of careful preparation, a ministerial conference on counteracting obesity was organized from November 15–17, 2006, by the World Health Organization regional Office for Europe (WHO-Europe). This conference brought together ministerial delegations from 48 countries in the European region. The conference was held in the European part of the city of Istanbul, Turkey, with Asia only a crossing of the Bosporus away. This was an appropriate place for a conference specifically aimed at the European region, but with outcomes that are also relevant for other regions of the world.The conference aimed to put obesity on the political and policy agendas, to come to some sort of consensus about the appropriate way and realistic timeline to reverse the obesity trends, and to encourage international and intersectoral collaboration for concrete action. Apart from the ministerial delegations, the approximately 600 attendees included representatives of various (international) nongovernmental organisations (NGOs) and mass media, as well as a number of key experts who were appointed as temporary advisors.The preparation of the conference was
Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions
Johannes Brug, Anke Oenema, Isabel Ferreira
International Journal of Behavioral Nutrition and Physical Activity , 2005, DOI: 10.1186/1479-5868-2-2
Abstract: Since behavior theory is a reflection of the compiled evidence of behavior research, theory is the only foothold we have for the development of behavioral nutrition and physical activity interventions. Application of theory should improve the effectiveness of interventions. However, some of the theories we use lack a strong empirical foundation, and the available theories are not always used in the most effective way. Furthermore, many of the commonly-used theories provide at best information on what needs to be changed to promote healthy behavior, but not on how changes can be induced. Finally, many theories explain behavioral intentions or motivation rather well, but are less well-suited to explaining or predicting actual behavior or behavior change.For more effective interventions, behavior change theory needs to be further developed in stronger research designs and such change-theory should especially focus on how to promote action rather than mere motivation. Since voluntary behavior change requires motivation, ability as well as the opportunity to change, further development of behavior change theory should incorporate environmental change strategies.Intervention Mapping may help to further improve the application of theories in nutrition and physical activity behavior change.Is there "nothing more practical than a good theory" in improving behavioral nutrition and physical activity interventions? And which theories are indeed good enough to help us improve the practice of encouraging people to adopt healthier diets and physical activity patterns? The International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) recognized the importance of this issue and encouraged a 'theory debate' [1]. Jeffery started the debate by sharing his experiences with and views on applying theories in weight management and weight loss interventions [2]. His conclusion is that we focussed too much on social cognition models and that these models proved to be not very
The past, present and future of the International Journal of Behavioral Nutrition and Physical Activity
Johannes Brug, Simone French, Bente Wold
International Journal of Behavioral Nutrition and Physical Activity , 2006, DOI: 10.1186/1479-5868-3-6
Abstract: The journal is now in its fourth year. There is a steady growth in the number of papers that are submitted to the journal (2003: 29; 2004: 66; 2005: 97). The journal is dedicated to only publish high-quality papers on innovative research on physical activity and eating behaviors. The number of papers that meet our strict quality and innovation criteria is limited, which is reflected by the number of papers that actually gets published (2004: 17; 2005:18).Because IJBNPA is an electronic journal, authors learn very quickly whether their paper will be published in the IJBNPA, and this swift review and publication process means that important research results, new theoretical insights, or important commentaries on emerging behavioral nutrition and physical activity issues can be shared with the relevant scientific and practice communities in a timely manner. The average time from initial submission to publication is 161 days.The papers that are published by the IJBNPA garner attention. According to the tracking information that is provided by the IJBNPA publisher, BioMed Central, in January 2006 ten of the 35 papers published in the IJBNPA were 'highly accessed' (accessed more than 1,000 times per month). Nine papers have been accessed more than 4,000 times, and the most frequently accessed paper was accessed more than 30,000 times over all [1]. These impressive data illustrate the importance of IJBNPA being an 'open access' journal. Despite IJBNPA's recent inception, papers published in IJBNPA are already beginning to be cited in other journals.The papers published by the IJBNPA are mainly original empirical studies on important behavioral nutrition and physical activity issues. However, commentary papers are also published. For example, three ' theory debate' papers were recently published that discussed the strengths and weaknesses of behavioral theories applied in behavioral nutrition and physical activity research and practice [2-4].In 2005, the IJBNPA editorial bo
Effectiveness of YouRAction, an Intervention to Promote Adolescent Physical Activity Using Personal and Environmental Feedback: A Cluster RCT
Richard Geuchien Prins, Johannes Brug, Pepijn van Empelen, Anke Oenema
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0032682
Abstract: Background In this study the one and six months effects of the computer-tailored YouRAction (targeting individual level determinants) and YouRAction+e (targeting in addition perceived environmental determinants) on compliance with the moderate-to-vigorous physical activity (MVPA) guideline and weight status are examined. In addition the use and appreciation of both interventions are studied. Methods A three-armed cluster randomized trial was conducted in 2009–2010 with measurements at baseline, one and six months post intervention. School classes were assigned to one of the study arms (YouRaction, YouRAction+e and Generic Information (GI) control group). MVPA was derived from self-reports at baseline, one and six months post intervention. Body Mass Index and waist circumference were measured at baseline and six months post intervention in a random sub-sample of the population. Use of the interventions was measured by webserver logs and appreciation by self-reports. Multilevel regression analyses were conducted to study the effects of the intervention against the GI control group. ANOVA's and chi-square tests were used to describe differences in use and appreciation between study arms. Results There were no statistically significant intervention effects on compliance with the MVPA guideline, overweight or WC. Access to the full intervention was significantly lower for YouRAction (24.0%) and YouRAction+e (21.7%) compared to the GI (54.4%). Conclusion This study could not demonstrate that the YouRAction and YouRAction+e interventions were effective in promoting MVPA or improve anthropometric outcomes among adolescents, compared to generic information. Insufficient use and exposure to the intervention content may be an explanation for the lack of effects. Trial Registration TrialRegister.nl NTR1923
The ENDORSE study: Research into environmental determinants of obesity related behaviors in Rotterdam schoolchildren
Klazine Horst, Anke Oenema, Petra Looij-Jansen, Johannes Brug
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-142
Abstract: The ENDORSE study is a longitudinal study with a two-year follow-up of a cohort of adolescents aged 12–15 years. Data will be collected at baseline (2005/2006) and at two years follow-up (2007/2008). Outcome measures are body mass index (BMI), waist circumference, time spent in physical activity and sedentary behaviors, and soft drink, snack and breakfast consumption. The ENDORSE study consists of two phases, first employing qualitative research methods to inform the development of a theoretical framework to examine important energy balance related behaviors and their determinants, and to inform questionnaire development. Subsequently, the hypothetical relationships between behavioral determinants, energy balance related behaviors and BMI will be tested in a quantitative study combining school-based surveys and measurements of anthropometrical characteristics at baseline and two-year follow-up.The ENDORSE project is a comprehensive longitudinal study that enables investigation of specific environmental and individual determinants of overweight and obesity among younger adolescents. The project will result in specific recommendations for obesity prevention interventions among younger adolescents.Adolescent overweight and obesity are important public health concerns in the Netherlands as well as in other western countries, due to the increasing proportion of adolescents classified as overweight or obese [1]. Children and adolescents are an important target group for intervention activities aimed at the prevention of overweight. Overweight and obesity often manifest early in life [2,3] and is associated with an increased the risk of serious diseases during childhood and adolescence [4]. Furthermore, obese children and adolescents are likely to become obese adults, who have an increased risk for various chronic diseases and premature death [5]. Therefore, it is important to develop interventions that prevent children and adolescents from gaining excess weight. Preventio
Monitoring of risk perceptions and correlates of precautionary behaviour related to human avian influenza during 2006 - 2007 in the Netherlands: results of seven consecutive surveys
Onno de Zwart, Irene K Veldhuijzen, Jan Richardus, Johannes Brug
BMC Infectious Diseases , 2010, DOI: 10.1186/1471-2334-10-114
Abstract: Seven web-based surveys were conducted including 3,840 respondents over a one-year period. Time trends were analyzed with linear regression analyses. Multivariate analysis was used to study determinants of precautionary behaviour.While infection with AI was considered a very severe health problem with mean score of 4.57 (scale 1 - 5); perceived vulnerability was much lower, with a mean score of 1.69. While perceived severity remained high, perceived vulnerability decreased slightly during a one-year period covering part of 2006 and 2007. Almost half of the respondents (46%) reported taking one or more preventive measures, with 36% reporting to have stayed away from (wild) birds or poultry. In multivariate logistic regression analysis the following factors were significantly associated with taking preventive measures: time of the survey, higher age, lower level of education, non-Dutch ethnicity, vaccinated against influenza, higher perceived severity, higher perceived vulnerability, higher self efficacy, lower level of knowledge, more information about AI, and thinking more about AI. Self efficacy was a stronger predictor of precautionary behaviour for those who never or seldom think about AI (OR 2.3, 95% CI 1.9 - 2.7), compared to those who think about AI more often (OR 1.5, 95% CI 1.2 - 1.9).The fact that perceived severity of AI appears to be high and remains so over time offers a good point of departure for more specific risk communications to promote precautionary actions. Such communications should aim at improving knowledge about the disease and preventive actions, and focus on perceived personal vulnerability and self efficacy in taking preventive measures.Infectious diseases are once again among the major public health challenges. The SARS epidemic of 2003 showed not only that there are new unknown viruses which can have severe health consequences, but also made clear how fast a disease can spread globally, what the societal and economic impact can be, as we
Correlates of motivation to prevent weight gain: a cross sectional survey
Birgitte Wammes, Stef Kremers, Boudewijn Breedveld, Johannes Brug
International Journal of Behavioral Nutrition and Physical Activity , 2005, DOI: 10.1186/1479-5868-2-1
Abstract: A cross-sectional survey among 979 non-obese Dutch adults aged 25–35 years was conducted. Multiple binary logistic regression analysis was conducted to assess the associations of Body Mass Index (BMI), demographic factors and psychosocial variables from the TPB with the intention to prevent weight gain. Differences in BMI, demographic and psychosocial factors between PAPM-stages were explored using one-way analysis of variance and chi-square tests.Eighty-five percent of respondents intended to prevent weight gain. Age, attitudes and risk perceptions related to weight gain were the strongest correlates of intention (age: OR = 1.12, 95%CI: 1.04–1.20; attitude OR = 7.91, 95%CI: 5.33–11.74; risk perception OR = 1.24, 95%CI: 1.11–1.38). Significant differences were detected between the PAPM-stages in almost all variables. Notably, perceived behavioural control was lowest among people who had decided to prevent weight gain.Messages to influence attitudes towards the prevention of weight gain and risk perception may affect people who are not yet motivated to prevent weight gain. Interventions increasing people's perceived behavioural control in overcoming barriers to prevent weight gain may help people to act on their intentions.Prevalence of overweight and obesity in Western societies has increased rapidly [1]. This is a threat for public health by its link to chronic illness and disabilities and impaired quality of life [2-4]. Overweight is a result of a long-term positive imbalance between energy intake and energy expenditure produced by a relative excess in energy input (diet) and/or a deficit in energy output (physical activity) [5].In The Netherlands, the prevalence of obesity has approximately doubled over the past 20 years [1]. The prevalence of overweight and obesity is about 45% for men and 35% for women, while 11% of the men and 12% of the women are obese [5,6]. To stop the increase in the prevalence of overweight and obesity, effective strategies for the manage
Are positive changes in potential determinants associated with increased fruit and vegetable intakes among primary schoolchildren? Results of two intervention studies in the Netherlands: The Schoolgruiten Project and the Pro Children Study
Nannah I Tak, Saskia J te Velde, Johannes Brug
International Journal of Behavioral Nutrition and Physical Activity , 2008, DOI: 10.1186/1479-5868-5-21
Abstract: A design with baseline and two follow-up measurements. 344 children of the Dutch Schoolgruiten Project and 258 children of the Pro Children Study completed questionnaires, including questions on general demographics, usual F&V intake frequency, important potential determinants of F&V intake, such as taste preferences of F&V, availability of F&V, knowledge of recommended intake levels of F&V, self-efficacy for eating F&V, and parental influences for eating F&V. Three different associations between changes in determinants of F&V intake and changes in F&V intake frequency were assessed by multilevel multinomial regression analyses.Results of one of the investigated associations indicated that in both studies behavior change (increase in F&V intake frequency) was preceded by changes in the following variables; liking of fruit, parental facilitation of vegetables, family rules for eating vegetables and availability at home of vegetables. Furthermore, changes in F&V intake frequency preceded changes in liking of F&V later in time.In accordance with behavior change theories, the present study provides some evidence that behavior change was preceded by changes in certain potential determinants of F&V intake. Potential determinants of F&V intake that appear to be important to induce behavior change were liking of fruit, parental facilitation of vegetables, family rules for eating vegetables and availability at home of vegetables. Some evidence was also found that behavior changes may precede changes in presumed determinants of F&V intake, such as liking of F&V.Ample intake of fruit and vegetables (F&V) is part of dietary recommendations in many countries. However, among schoolchildren across Europe, the reported intake of F&V is lower than recommended [1]. The Dutch recommendations for F&V intake for 10–12-year-old children are to eat at least two pieces of fruit (about 200–250 grams) and 150–200 grams vegetables per day [2].According to health behavior change theories such
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