Jan Vinck

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: n = 389; Finland: n = 400; Germany (East): n = 913; Germany (West): n = 489; Netherlands: n = 366; Spain: n = 380; 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.

The differential role of pain, work characteristics and pain-related fear in explaining back pain and sick leave in occupational settings.

&NA; This cross‐sectional questionnaire study investigated the role of pain (pain severity, radiating pain), work characteristics (physical workload, job stressors, job satisfaction), negative affect and pain‐related fear in accounting for low back pain (LBP) and sick leave (SL) in 1294 employees from 10 companies in Belgium and the Netherlands. An increased risk for short‐term LBP (1–30 days during the last year) was observed for workers reporting high physical workload (OR=2.39), high task exertion (OR=1.63) and high negative affect (OR=1.03). For prolonged LBP (>30 days during the last year) severe pain (OR=13.03), radiating pain (OR=2.37) and fear of work‐related activities (OR=3.17) were significant risk factors. A lack of decision latitude decreased the risk of long‐term LBP (OR=0.39). Short‐term SL (1–30 days during the last year) was associated with severe pain (OR=2.83), high physical workload (OR=2.99) and high fear of movement/(re)injury (OR=1.88). A lack of decision latitude increased the risk of short‐term SL (OR=1.92). Long‐term SL (>30 days during the last year) was associated with radiating pain (OR=3.80) and high fear of movement/(re)injury (OR=6.35). A lack of co‐worker support reduced the risk of long‐term SL (OR=0.27). These results suggest that physical load factors are relatively more important in the process leading to short‐term LBP and short‐term SL, whereas job stressors, severe pain, radiation, and pain‐related fear are more important in determining the further course and maintenance of the inability to work. The potential implications of these findings for primary and secondary prevention, and occupational rehabilitation are discussed.

Development of and recovery from short- and long-term low back pain in occupational settings: A prospective cohort study

Using the data of the EuroBack Unit prospective cohort study, this paper investigated the role of work‐related physical factors and psychological variables in predicting the development of and recovery from short‐term and long‐term LBP. At baseline, 1294 predominantly male industrial workers from 10 companies in Belgium and the Netherlands filled in questionnaires. At follow‐up, data from 812 employees were available. Odds ratios (ORs) were calculated using simple and multiple logistic regression analyses. For those workers reporting 0 days LBP in the year prior to baseline, negative affectivity (OR 1.06, 95% CI 1.01–1.11) was a risk factor for the development of short‐term LBP (=1–30 days total of LBP in the year prior to follow‐up). For those who reported 1–30 days total of LBP in the year prior to baseline, only high fear of (re)injury due to movement (OR 1.07, 95% CI 1.02–1.12) increased the risk for failure to recovery from short‐term LBP. For the development of long‐term LBP (=more than 30 days total of LBP in the year prior to follow‐up), a significant increased risk was observed among workers with high pain severity (OR 1.19, 95% CI 1.01–1.40) and with pain referred to the ankles or feet (OR 2.92, 95% CI 1.09–7.83). The risk was reduced by social support of co‐workers (OR 0.73, 95% CI 0.59–0.92) and by manual handling of materials (OR 0.63, 95% CI 0.46–0.85). For those who reported more than 30 days total of LBP in the year prior to baseline, high pain severity (OR 1.18, 95% CI 1.04–1.34) increased the risk for failure to recovery from long‐term LBP. Results are compared to the baseline study ( Gheldof et al., 2005 ) and discussed in relation with prospective studies.

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

SummaryThis paper addresses the role of policy and evidence in health promotion. The concept of von Wright’s “logic of events” is introduced and applied to health policy impact analysis.According to von Wright (1976), human action can be explained by a restricted number of determinants: wants, abilities, duties, and opportunities. The dynamics of action result from changes in opportunities (logic of events). Applied to the policymaking process, the present model explains personal wants as subordinated to political goals. Abilities of individual policy makers are part of organisational resources. Also, personal duties are subordinated to institutional obligations. Opportunities are mainly related to political context and public support. The present analysis suggests that policy determinants such as concrete goals, sufficient resources and public support may be crucial for achieving an intended behaviour change on the population level, while other policy determinants, e.g., personal commitment and organisational capacities, may especially relate to the policy implementation process. The paper concludes by indicating ways in which future research using this theoretical framework might contribute to health promotion practice for improved health outcomes across populations.

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. 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. 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. 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. Methods: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. Results: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. Conclusions: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.

Editorial: Health psychology and public health--bridging the gap.

Limburgs Univ Ctr, Diepenbeek, Belgium. Queensland Univ Technol, Brisbane, Qld, Australia. GSF, Natl Res Ctr Environm & Hlth, Neuherberg, Germany.Vinck, J, Limburgs Univ Ctr, Univ Campus, Diepenbeek, Belgium.

Health policy perception and health behaviours: a multilevel analysis and implications for public health psychology.

Associations of health policy perception with health behaviours are analysed. Policy perception is differentiated in information about programmes and appraisal of health policy’s contribution to policy goals, and conceptualized on the level of: (1) individuals; and (2) populations (as a social climate indicator). Survey data from the Biomed2-Project MAREPS gathered in Belgium, Finland, Germany, The Netherlands, Spain and Switzerland (N= 3343) show that at the individual level, only policy information is associated with utilizing mammography, quitting smoking, physical activity and political participation in creating healthy environments. In contrast, multilevel regression analyses show that policy appraisal is related to physical activity and political participation as a social climate factor. Implications for integrating health psychology and public health within public health psychology are discussed.

Downward trends in the prevalence of childhood overweight in two pilot towns taking part in the VIASANO community-based programme in Belgium: data from a national school health monitoring system

Multilevel approaches involving environmental strategies are considered to be good practice to help reduce the prevalence of childhood overweight.

Hydration and Obesity Prevention

The easy access to an abundance of sugar-sweetened beverages (SSB) is of major concern now that compelling evidence has linked high intakes of these drinks to childhood obesity. Recently, two independent trials showed increased weight in children consuming SSB compared with a control group who received water or drinks with artificial sweeteners [1, 2] . Therefore, the high availability and intense marketing of SSB combined with the high rates of childhood obesity worldwide should raise concern among public health professionals as well as politicians [3, 4] . In this article, we elaborate on the evidence for the association between SSB and adverse health effects, and propose a multiple-setting behavioral intervention in the community that promotes water and discourages SSB after breast and/or bottle feeding in children between the ages of 0 and 4 years. Published online: April 4, 2014 www.karger.com/ofa DOI: 10.1159/000360748