Malte Bödeker

Qualitätssicherung in der Gesundheitsförderung in Settings

ZusammenfassungHintergrundZiel des Projekts war es, eine kriterienbasierte Übersicht über Instrumente und Verfahren der Qualitätssicherung in der Gesundheitsförderung bereit zu stellen.Material und MethodenEin Überblick über generische und settingspezifische Instrumente stellte die Basis der Analyse da. Eine literaturgestützte Kriterienliste wurde erstellt, a) um zu entscheiden, welche Instrumente und Verfahren eingeschlossen werden und b) um eine Stärken-Schwächen-Betrachtung durchführen zu können.ErgebnisseMittlerweile stehen zahlreiche Qualitätsinstrumente zur Verfügung. Der Aufwand der Einarbeitung kann nur selten abgeschätzt werden. Nur wenige Instrumente und Verfahren sind evidenzbasiert und nur selten werden Informationen über die Nutzung und den Nutzen zur Verfügung gestellt.SchlussfolgerungEs sollten Wirksamkeitsstudien durchgeführt werden. Beratung und Training sollten etabliert werden, um Nutzern die Auswahl und Anwendung zu erleichtern.AbstractBackgroundIt is the aim of the project to give a criterion-guided overview of instruments that can be used to enhance quality of projects and programmes.MethodsA review of generic instruments as well as of instruments for health promotion in settings homes served as the basis for the analysis. A list of criteria, based on scientific literature, was created a) to decide which instruments should be included in the analysis and b) to provide a grid to elaborate on the strength and weaknesses.ResultsA variety of different instruments is available to enhance quality in health promotion. Information about the time and costs that are needed to become familiar with the instruments are given rarely. The minority of instruments is evidence based and only some provide information about the use and usability.ConclusionFurther research is needed, especially on the effectiveness and efficacy of instruments. Counselling and training should be established to facilitate choice and application of instruments.

Self-reported physical activity within and outside the neighborhood: Criterion-related validity of the Neighborhood Physical Activity Questionnaire in German older adults

ABSTRACT The Neighborhood Physical Activity Questionnaire allows to assess physical activity within and outside the neighborhood. Study objectives were to examine the criterion-related validity and health/functioning associations of Neighborhood Physical Activity Questionnaire-derived physical activity in German older adults. A total of 107 adults aged ≥60 years completed the Neighborhood Physical Activity Questionnaire and Short Form 12 Health Survey. A subsample of 58 participants wore piezoelectric pedometers for 7 consecutive days. Rank correlation coefficients (ρ) along with 95% confidence intervals (CIs) were computed for the criterion-related validity and health/functioning associations of single Neighborhood Physical Activity Questionnaire modules and total physical activity. Criterion-related validity was moderate (ρ ≤ .60) for total physical activity, total walking, and neighborhood walking, but low (ρ ≤ .40) for walking outside the neighborhood. Health/functioning associations were moderate for recreation walking and low for total physical activity, total walking, and walking within as well as outside the neighborhood. The study provides low-to-moderate validity evidence of Neighborhood Physical Activity Questionnaire-derived physical activity in older adults.

Walking and Walkability in Pre-Set and Self-Defined Neighborhoods: A Mental Mapping Study in Older Adults

Neighborhood walkability contributes to older adults’ walking. However, associations vary depending on the neighborhood definition applied as well as between objective and perceived walkability measures. Therefore, this study aimed to comparatively assess walkability indices for commonly used pedestrian network buffers and perceived neighborhood areas. A total of 97 adults aged ≥65 years answered a written physical activity questionnaire and 69 respondents participated in face-to-face interviews that involved mental mapping, i.e., to draw perceived neighborhood delineations on paper maps. Hierarchical regression analyses were used to compare the contribution of walkability indices for pre-set buffers and self-defined neighborhoods to older adults’ walking after adjusting for covariates. Results show that older adults’ self-defined neighborhoods are significantly larger, less home-centered, and more walkable than commonly used buffers. Furthermore, the variance accounted for in neighborhood walking increased from 35.9% to 40.4% (ΔR2 = 0.046; p = 0.029), when the walkability index was calculated for self-defined neighborhoods rather than pre-set buffers. Therefore, the study supports that geometric differences between pre-set buffers and older adults’ spatial ideas of perceived neighborhoods have a significant influence on estimated walkability effects and that exposure areas should be matched with the spatial dimension of outcome variables in future research.

Gesundheitsregionenplus in Bayern: Synergien im regionalen Gesundheitsmanagement

Die gesundheitliche Versorgung weist durch historische Entwicklungen grose regionale Unterschiede auf. In diesen gewachsenen Strukturen stellt die Sicherung der bedarfsgerechten Versorgung auf regionaler Ebene in Folge des demographischen Wandels und der hohen Komplexitat des deutschen Gesundheitssystems eine grose Herausforderung dar (SVR 2014).