Günther Lüschen

Self-reported physical activity, public health and perceived environment: results from a comparative European study.

STUDY OBJECTIVE The focus of physical activity promotion is moving from methods for increasing health enhancing physical activity on the individual level to higher level strategies including environmental and policy approaches. Scientific inquiry, traditionally related to individual-based strategies, requires adaptation and refinement when environmental and policy changes become more relevant. The objective of this study is to investigate the significance for behaviour and health of community-based environments that encourage physical activity. DESIGN AND SETTING The article presents data and results from a cross sectional comparative survey of the general population in six European countries (Belgium, Finland, Germany (East and West), Netherlands, Spain, Switzerland). Specifically, the relation between perceived community-based opportunities for physical activity, self reported physical activity, and self rated health status is investigated. PARTICIPANTS Representative samples of general populations (adults 18 years or older). Overall response rate: 53.5%. Sample sizes realised: Belgium: nu2009=u2009389; Finland: nu2009=u2009400; Germany (East): n = 913; Germany (West): nu2009= 489; Netherlands: nu2009=u2009366; Spain: nu2009=u2009380; Switzerland: n =406. MAIN RESULTS Analyses show that best opportunities are reported by people who are lightly to moderately physically active. Peoples self rated health is moderately, but significantly associated with both perceived opportunities, and physical activity itself. These predictors interact in that especially for women, the health impact of physical activity is more pronounced in case of good opportunities. CONCLUSIONS The paper shows the potential of opportunities within residential and community environments with regard to physical activity, both for behaviour and health. Opportunities may enable the population, especially women, to develop an active lifestyle, and thus improve their health. Future studies with objective indicators for physical activity related environments should test the findings that are based on perceptions.

Determinants of health policy impact: a theoretical framework for policy analysis.

SummaryThis paper addresses the role of policy and evidencenin health promotion. The concept of von Wright’s “logic ofnevents” is introduced and applied to health policy impactnanalysis.According to von Wright (1976), human action can benexplained by a restricted number of determinants: wants,nabilities, duties, and opportunities. The dynamics of actionnresult from changes in opportunities (logic of events).nApplied to the policymaking process, the present model explainsnpersonal wants as subordinated to political goals. Abilitiesnof individual policy makers are part of organisational resources.nAlso, personal duties are subordinated to institutionalnobligations. Opportunities are mainly related to politicalncontext and public support. The present analysis suggestsnthat policy determinants such as concrete goals, sufficientnresources and public support may be crucial for achieving annintended behaviour change on the population level, while othernpolicy determinants, e.g., personal commitment and organisationalncapacities, may especially relate to the policy implementationnprocess. The paper concludes by indicating ways in which futurenresearch using this theoretical framework might contribute tonhealth promotion practice for improved health outcomes acrossnpopulations.

Determinants of health policy impact: comparative results of a European policymaker study.

SummaryObjectives: This article will use a new theoretical framework for the analysis of health policy impact introduced by Rütten et al. (2003). In particular, it will report on a comparative European study of policymakers’ perception and evaluation of specific determinants of the policy impact, both in terms of output (implemented measures) and outcome (health behaviour change). Policy determinants investigated are goals, resources, obligations and opportunities as related to the policymaking process.n Methods: Theory is applied to a comparative analysis of prevention and health promotion policy in Belgium, Finland, Germany, The Netherlands, Spain and Switzerland. The study is MED2-part of a project that has developed a Methodology for the Analysis of the Rationality and Effectiveness of Prevention and Health Promotion Strategies (MAREPS) within the EU-BIOprogram. A mail survey of 719 policymakers on the executive and administrative level selected by a focused sample procedure was conducted. This survey used policymakers’ experience and evaluative expertise to analyse determinants of policy output and outcome.n Results: Regression analyses reveal differential predictive power of policy goals, resources, obligations, as well as of political, organisational and public opportunities. For instance, whereas resources, concreteness of goals, and public opportunities have significant importance for health outcome of policy, obligations and organisational opportunities significantly predict policy output.n Conclusions: Results are discussed in terms of rationality and effectiveness of health policy. They indicate that six sensitising constructs derived from the theoretical framework represent equivalent structures across nations. They comprise a validated instrument that can be used for further comparative health policy research.

Research utilization and the impact of health promotion policy

SummaryObjectives:The conditions under which research utilization leads to policy impact are an important issue in health promotion. This analysis tests the assumption that utilization is positively associated with policy impact only if both political will (i.e., policy opportunities) and social strategies (in intervention and implementation) are present.nMethods:A survey of 719 policymakers involved in four poli-cies was conducted in six European countries. Policy impact (output, i.e., program implementation, and outcome, i.e., effects on behavior) and its proposed determinants were analyzed.nResults:Regression analyses reveal limited cross-national differences in research utilization, but show comparably high use in policies with a pathogenic focus. Utilization is associated with impact only if political will is lacking; for outcome, this tends to depend on social strategies. Political will is the strongest determinant of impact.nConclusions:Research utilization is not supporting health promotion policy impact if political will is favorable, but if it is poor; political will itself is the crucial determinant of impact. The study contributes to the “research utilization”-field by showing that research utilization may partially compensate for lack of, rather than depend on, political will.

Sport und körperliche Aktivität im Alter: sozialstruktureller Kontext und die Beziehung zur Gesundheit

SummaryObjectivesThe following contribution analyses the sociostructural context of sport as well as the relationship between sport/physical activity and health among older people (≥60 years).MethodsThe data are part of a telephone-survey by random sample with 436 realised cases in the independent cities of the Western Ruhr-District and thus represent a situation in highly urbanised areas.ResultsIn the cardinal question concerning the meaning of sport and physical activity for health a positive relationship was found, in particular between sport intensity and health measured by Advanced Activities of Daily Living (AADL) as well as for sport as hobby, which showed a highly significant relationship with subjective health. With regard to sociodemographic variables results show that sport and physical activity vary with gender and age. Apart from that attitudes like low external control for ones health as well as the value of appearance show strong relationships with sport participation. Stratification variables with the exception of income only show weak effects.ConclusionsThe results, which are partly not congruent, indicate that further research is needed in the field of sport and health among the aged.ZusammenfassungFragestellungIm folgenden Beitrag wird zum einen der sozialstrukturelle Kontext von sportlichen und körperlichen Aktivitäten im Alter analysiert; zum anderen wird die Beziehung des Sports und nicht-utilitärer körperlicher Aktivität zur Gesundheit bei alten Menschen (60 Jahre und älter) untersucht.MethodenDie Daten stammen aus einer Telefon-Umfrage basierend auf einem Zufalls-Sample von 436 realisierten Fällen in den kreisfreien Städten des westlichen Ruhrgebiets und repräsentieren damit Verhältnisse in hoch-urbanisierten Gebieten.ErgebnisseIn der Hauptfrage um die gesundheitliche Bedeutung des Sports und körperlicher Aktivität im Alter ergeben sich positive Zusammenhänge zwischen Sportintensität und dem durch “Fortgeschrittene Aktivitäten des täglichen Lebens” gemessenen funktionalen Status sowie zwischen Sport als Lieblingsbeschäftigung und der subjektiven Gesundheit. Im Hinblick auf soziodemographische Variablen zeigt sich, dass Sport und körperliche Aktivität mit dem Alter und dem Geschlecht variieren. Einstellungen wie geringere externale gesundheitliche Kontrollüberzeugungen und auch die positive Bewertung äusserer Erscheinung weisen darüber hinaus starke Beziehungen zur Beteiligung am Sport im Alter auf. Die sozialstrukturellen Variablen sind demgegenüber mit Ausnahme des Einkommens weitgehend unbedeutend.SchlussfolgerungenDie z.T. nich kongruenten Befunde machen einen weiteren Forschungsbedarf hinsichtlich der Beziehung zwischen Sport und Gesundheit im Alter deutlich.RésuméObjectifsUtilisant une méthode socio-épidémiologique et les données dune enquête, la contribution suivante analyse le contexte socio-structurel ainsi que la relation du sport et lactivité physique à la santé des gens âgés de 60 ans ou plus.MéthodesLes données sont part dune interview au téléphone par sondage au hasard de 436 cas dans les villes urbaines de louest du district du Ruhr. Lenquête fut dirigée, en premier lieu, vers la relation de la santé au statut social; elle a aussi mesuré un nombre dindicateurs de la santé et variables de sport et activité physique. Ainsi, les données permettent lanalyse du contexte socio-structurel et la relation sport/activité physique avec la santé physique et psychique.RésultatsDans la cardinale question concernant la signifiance du sport et activité physique pour la santé objective une positive relation fut trouvée, en particulier pour lintensité du sport et la santé objective-mesurée par AADL-ainsi que pour sport hobby qui a montré une relation très signifiante avec la santé subjective. En ce qui concerne le contexte socio-structurel, le sport et lactivité physique des gens âgés sont determinés par âge et genre. En outre attitudes comme peu du control externe pour la santé et la valeur de lapparition expliquent lintensité de la participation au sport. Une remarquable rejection du control externe est liée à ceux utilisant sport pour leur santé. Les variables de la stratification ne sont pas important, à lexception du revenu.ConclusionsLes résultats sont partiellement non coïncidents et indiquent évidemment le besoin en recherche par rapport à la relation du sport et santé dans le vieil âge.

Klassen-, Status-, Rangkristallisation und ihre Exploration im Sport

Probleme der Konsistenz und Inkonsistenz sind allgemein und am Beispiel des Sports uber Dimensionen des individuellen Status (Statuskristallisation), der sozialen Schichten (Klassenkristallisation) und der Strukturebenen in Gruppen (Rangkristallisation) zu diskutieren. Ausgehend von Lenskis Ansatz und den Anregungen von Landecker hinsichtlich struktureller Interdependenzen soll schlieslich eine Erweiterung solcher Forschungs- und Erklarungsansatze fur den Bereich der Gruppe uber die Analyse von Sportgruppen erreicht werden. Der vorliegende Beitrag referiert daruber hinaus erste Ergebnisse einer 1985/86 durchgefuhrten empirischen Untersuchung.

Sport als Explorationsfeld Soziologischer Kristallisationsforschung

Die von Gerhard E. Lenski (1954, 1956, 1967) unter dem Konzept der Statuskristallisation aktualisierte Diskussion uber das Problem der Inkonsistenz zur Erklarung namentlich politischen Verhaltens hat inzwischen zu einer Fulle von Beitragen und Diskussionen gefuhrt. Einerseits ergaben sich dabei nach ersten vermeintlich gultigen Ergebnissen zum politischen Verhalten und zur sozialen Teilnahme (Lenski 1954, 1956) eine ganze Reihe von Widerspruchen (Geschwender 1970), andererseits fuhrten Lenskis Ansatze zu einer Erweiterung gerade struktureller Ansatze, die die ursprunglich vor allem aus sozialpsychologischer Sicht reflektierende Theorie in den Zusammenhang makrosoziologischer Einsichten (Konzept der Klassenkristallisation. Landecker 1963, 1970, 1981) oder interaktionistisch-situativen Verstandnisses (Malewski 1963) stellten. Auch die Teilnahme am Sport sowie die im Sport zu erkennende Leistungshohe schienen in einer Leitstudie durch die Statuskristallisationstheorie einen neuen Erklarungsansatz zu finden (Luschen 1984, Butten 1985).