AbstractThis study assessed the efficacy of a co-designed, school-based intervention meant to promote physical activityand fitness among Dutch prevocational secondary students. In a two-year clustered randomized controlled trial,students’ physical activity and fitness was measured by indirect and direct methods. In the intervention group,we used the triple-I procedure, a participatory action research method, to co-design the intervention together withthe students and schools. This procedure involved focus group discussions by interviewing and imagingtechniques, followed by a co-design process to align the intervention content and implementation processes withstudents’ preferences. The study involved 22 Dutch schools, with a total of 2685 13-to-14-year-old prevocationalsecondary students. Schools were randomly assigned to either intervention (11 schools, 1446 students) or controlgroup (11 schools, 1239 students).There were no significant intervention differences between students’ overallphysical activity behavior on intervention versus control schools. However, with regards to various specificphysical fitness indicators, such as the long jump, handgrip strength, shuttle run test, and the sum of skinfolds,intervention school students performed significantly better than the control group students. Furthermore, whentaking into account student participation, i.e. the success of the co-design process, schools with higher levels ofstudent participation showed higher shuttle run scores. However, such graded effects were not similarly apparentwith regards to students’ physical fitness indicators. This study showed that co-designing a comprehensivephysical activity intervention on numerous Dutch high schools via the Triple-I Interactive Method was feasible.Moreover, results showed that certain aspects of physical fitness were improved after two years of intervention,although taken together with the lack of effects on physical activity, results were mixed.
Amsterdam is een superdiverse stad met belangrijke uitdagingen op het gebied van gezondheid. Overgewicht, eenzaamheid en de gezondheidskloof tussen de gevestigde bovenlaag en groepen die het minder goed getroffen hebben zijn daar enkele van. De wijk als omgeving waar mensen wonen,werken, spelen en leren biedt kansen maar ook belemmeringen voor de gezondheid. Een integrale, ‘Whole-ofsociety’- benadering – dat is een aanpak met alle partijen inclusief bewoners –biedt aanknopingspunten om de gezondheid in grootstedelijke wijken te bevorderen. Lector Gezondheiden Omgeving Lea den Broeder gaat in haar rede in op de achtergronden en oplossingsrichtingen van de uitdagende gezondheidsvraagstukken in de stad. Het bijzonder lectoraat Gezondheid en Omgeving is ingesteld in samenwerking met het Rijksinstituut voor Volksgezondheid en Milieu.
Ageing potentially poses a threat to independent functioning of older adults. Although clinicians commonly focus on physical factors limiting Functional Independence (FI), it is likely that personal and environmental interactions also seem important to maintain FI. Herewith, FI exceeds several professional borders and calls for a uniform, multidisciplinary interdisciplinary supported definition of FI. This study aims to provide such a definition of FI in community dwelling older people. A scoping review was performed. Pubmed/Medline, Psychinfo and CINAHL were searched for studies describing aspects of FI. A literature-based definition of FI was discussed by experts (n = 7), resulting in a formulated final definition of FI and insight into contributing factors to FI. A multidisciplinairy focusgroup a stakeholder consultation (n = 15) ensured clinical relevance for daily practice. Data from the focusgroup stakeholder consultation were analyzed by using Atlas.ti (version 8). Based on the literature search, 25 studies were included. FI was finally defined as “Functioning physically safely and independent from another person, within one’s own context”. The contributing factors of FI comprised physical capacity combined with coping, empowerment and health literacy. Moreover, the level of FI is influenced by someone’s own context. This study confirms the relevance of the physical aspect of FI, but additionally stresses the importance of psychological factors. In addition, this study shows that one’s context may affect the level of FI as well. This underlines the importance of a holistic view and calls for multidisciplinary interdisciplinary collaboration in community-dwelling older people.
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