Sustainable prevention of obesity through integrated strategies: The SPOTLIGHT project’s conceptual framework and design

BMC Public Health

Giel Nijpels⁶  Róza Ádány⁵  Jean-Michel Oppert^1,11  Tim Lobstein⁷  Aileen Robertson⁸  Patricia van Assema⁹  Ilse De Bourdeaudhuij²  Lynn Stockley^1,12  Oddrun Samdal¹  Euan Woodward³  Harry Rutter⁴  Pedro J Teixeira^1,10  Sandra Bot⁶  Johannes Brug⁶  Jeroen Lakerveld⁶ 

[1] Department of Health Promotion and Development, University of Bergen, PO Box 7808, NO-5020, Bergen, Norway;Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium;European Association for the Study of Obesity, 113-119 High Street, Hampton Hill, Middlesex, TW12 1NJ, UK;European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK;Department of Preventive Medicine, University of Debrecen, Medical and Health Science Center, Faculty of Public Health, Kassai Street 26, 4028, Debrecen, Hungary;The EMGO Institute for Health and Care Research and the departments of General Practice and Epidemiology & Biostatistics, VU University Medical Center, van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands;International Obesity TaskForce/International Association for the Study of Obesity, Charles Darwin House, 12 Roger Street, London, WC1N 2JU, UK;Metropolitan University College (Metropol), Pustervig 8, DK-1126, Copenhagen, Denmark;Department of Health Promotion, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands;Technical University of Lisbon, Faculty of Human Kinetics, FMH, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal;University of Paris 13 (UP13), UREN/Center for Human Nutrition Research (CRNH) Ile-de-France, SMBH, 75 avenue Marcel Cachin, 93017, Bobigny, France;BHF Health Promotion Research Group, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK

关键词: Lifestyle behaviour;    Environment;    Adults;    Prevention;    Obesity;   

Others  :  1163073
DOI  :  10.1186/1471-2458-12-793

 received in 2012-07-05, accepted in 2012-09-13,  发布年份 2012

【 摘 要 】

Background

The prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised that effective responses must go beyond interventions that only focus on a specific individual, social or environmental level and instead embrace system-based multi-level intervention approaches that address both the individual and environment. The EU-funded project “sustainable prevention of obesity through integrated strategies” (SPOTLIGHT) aims to increase and combine knowledge on the wide range of determinants of obesity in a systematic way, and to identify multi-level intervention approaches that are strong in terms of Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM).

Methods/Design

SPOTLIGHT comprises a series of systematic reviews on: individual-level predictors of success in behaviour change obesity interventions; social and physical environmental determinants of obesity; and on the RE-AIM of multi-level interventions. An interactive web-atlas of currently running multi-level interventions will be developed, and enhancing and impeding factors for implementation will be described. At the neighbourhood level, these elements will inform the development of methods to assess obesogenicity of diverse environments, using remote imaging techniques linked to geographic information systems. The validity of these methods will be evaluated using data from surveys of health and lifestyles of adults residing in the neighbourhoods surveyed. At both the micro- and macro-levels (national and international) the different physical, economical, political and socio-cultural elements will be assessed.

Discussion

SPOTLIGHT offers the potential to develop approaches that combine an understanding of the obesogenicity of environments in Europe, and thus how they can be improved, with an appreciation of the individual factors that explain why people respond differently to such environments. Its findings will inform governmental authorities and professionals, academics, NGOs and private sector stakeholders engaged in the development and implementation of policies to tackle the obesity epidemic in Europe.

【 授权许可】

   
2012 Lakerveld et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]OECD: Obesity update 2012. 2012. www.oecd.org/dataoecd/1/61/49716427.pdf webcite.
• [2]Pickett KE, Kelly S, Brunner E, Lobstein T, Wilkinson RG: Wider income gaps, wider waistbands? An ecological study of obesity and income inequality. J Epidemiol Community Health 2005, 59:670-674.
• [3]Roskam AJ, Kunst AE, Van OH, Demarest S, Klumbiene J, Regidor E, Helmert U, Jusot F, Dzurova D, Mackenbach JP: Comparative appraisal of educational inequalities in overweight and obesity among adults in 19 European countries. Int J Epidemiol 2010, 39:392-404.
• [4]World Health Organization: Obesity and overweight. WHO fact sheet 2012, N°311. 2012.
• [5]Swinburn B, Sacks G, Hall K, McPherson K, Finegood D, Moodie M, Gortmaker S: The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011, 378:804-814.
• [6]Brug J, Oenema A, Ferreira I: Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions. Int J Behav Nutr Phys Act 2005, 2:2. BioMed Central Full Text
• [7]Silva MN, Markland D, Minderico CS, Vieira PN, Castro MM, Coutinho SR, Santos TC, Matos MG, Sardinha LB, Teixeira PJ: A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: rationale and intervention description. BMC Public Health 2008, 8:234. BioMed Central Full Text
• [8]Silva MN, Markland D, Carraça EV, Vieira PN, Coutinho SR, Minderico CS, Matos MG, Sardinha LB, Teixeira PJ: Exercise autonomous motivation predicts 3-yr weight loss in women. Med Sci Sports Exerc 2011, 43:728-37.
• [9]Robertson A, Lobstein T, Knai C: Obesity and socio-economic groups in Europe: Evidence review and implications for action. 2007. http://ec.europa.eu/health/ph_determinants/life_style/nutrition/documents/ev20081028_rep_en.pdf webcite.
• [10]Canoy D, Buchan I: Challenges in obesity epidemiology. Obes Rev 2007, 8(Suppl 1):1-11.
• [11]Giskes K, Kamphuis CB, van Lenthe FJ, Kremers S, Droomers M, Brug J: A systematic review of associations between environmental factors, energy and fat intakes among adults: is there evidence for environments that encourage obesogenic dietary intakes? Public Health Nutr 2007, 10:1005-1017.
• [12]Hill JO, Wyatt HR, Reed GW, Peters JC: Obesity and the Environment: Where Do We Go from Here? Science 2003, 299:853-855.
• [13]Brug J, van Lenthe FJ, Kremers SP: Revisiting Kurt Lewin: how to gain insight into environmental correlates of obesogenic behaviors. Am J Prev Med 2006, 31:525-529.
• [14]Huang TT, Drewnosksi A, Kumanyika S, Glass TA: A systems-oriented multilevel framework for addressing obesity in the 21st century. Prev Chronic Dis 2009, 6:A82.
• [15]FORESIGHT: Tackling Obesities: Future Choices - Project Report. 2010.
• [16]Cavill N, Kahlmeier S, Racioppi F: Physical activity and health in Europe: evidence for action. Organization: World Health; 2006.
• [17]Stockley L: Toward public health nutrition strategies in the European Union to implement food based dietary guidelines and to enhance healthier lifestyles. Public Health Nutr 2001, 4:307-324.
• [18]Branca F, Nikogosian H, Lobstein T: The challenge of obesity in the WHO European Region and the strategies for response. Copenhagen: World Health Organization Regional Office for Europe; 2007. http://www.euro.who.int/__data/assets/pdf_file/0010/74746/E90711.pdf webcite.
• [19]Sassi F: Obesity and the Economics of Prevention: Fit not Fat. Paris: Organization for Economic Co-operation and Development (OECD); 2010.
• [20]Hawkes C, Blouin C, Henson S, Drager N, Dube L: Trade, Food, Diet and Health: Perspectives and Policy Options. Chichester: Wiley-Blackwell; 2010.
• [21]McLeroy K, Bibeau D, Steckler A, Glanz K: An ecological perspective on health promotion programs. Health Educ Q 1988, 15:351-377.
• [22]Swinburn B, Egger G, Raza F: Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med 1999, 29:563-570.
• [23]Swinburn B, Egger G: Preventive strategies against weight gain and obesity. Obes Rev 2002, 3:289-301.
• [24]Kremers SP, de Bruijn GJ, Visscher TL, van Mechelen W, de Vries NK, Brug J: Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act 2006, 3:9. BioMed Central Full Text
• [25]Sallis J, Floyd M, Rodriguez D, Saelens B: Role of built environments in physical activity, obesity, and cardiovascular disease. Circulation 2012, 125:729-737.
• [26]Baker P, Francis D, Soares J, Weightman A, Foster C: Community wide interventions for increasing physical activity. Cochrane Database Syst Rev 2011, CD008366.
• [27]Clarke P, Ailshire J, Melendez R, Bader M, Morenoff J: Using Google Earth to conduct a neighborhood audit: reliability of a virtual audit instrument. Health Place 2010, 16:1224-1229.
• [28]Rundle A, Bader MD, Richards C, Neckerman K, Teitler J: Using Google Street View to audit neighborhood environments. Am J Prev Med 2011, 40:94-100.
• [29]Wilson J, Kelly C, Schootman M, Baker E, Banerjee A, Clennin M, Miller D: Assessing the built environment using omnidirectional imagery. Am J Prev Med 2012, 42:193-199.
• [30]Brug J, Lien N, Klepp KI, van Lenthe F: Exploring overweight, obesity and their behavioural correlates among children and adolescents: results from the Health-promotion through Obesity Prevention across Europe project. Public Health Nutr 2010, 13:1676-1679.
• [31]Prevention of Obesity in Europe: Consortium for the prevention of obesity through effective nutrition and physicial activity action--EURO-PREVOB. EURO-PREVOB Summary Report 2010. http://prevob.lshtm.ac.uk/EURO-PREVOB%20Project%20summary%20Eng.pdf webcite.
• [32]Handy SL, Boarnet MG, Ewing R, Killingsworth RE: How the built environment affects physical activity: views from urban planning. Am J Prev Med 2002, 23:64-73.
• [33]King AC, Jeffery RW, Fridinger F, Dusenbury L, Provence S, Hedlund SA, Spangler K: Environmental and policy approaches to cardiovascular disease prevention through physical activity: issues and opportunities. Health Educ Q 1995, 22:499-511.
• [34]King AC, Sallis JF: Why and how to improve physical activity promotion: lessons from behavioral science and related fields. Prev Med 2009, 49:286-288.
• [35]Sallis JF, Owen N: Ecological models. In Health behavior and health education: Theory, research, and practice. Edited by Glanz K, Lewis FM, Rimer BK. San Francisco: Jossey-Bass; 1997:403-424.
• [36]Sallis JF, Story M, Lou D: Study designs and analytic strategies for environmental and policy research on obesity, physical activity, and diet: recommendations from a meeting of experts. Am J Prev Med 2009, 36:S72-S77.
• [37]McKinnon RA, Reedy J, Handy SL, Rodgers AB: Measuring the Food and Physical Activity Environments: Shaping the Research Agenda. Am J Prev Med 2009, 36:S81-S85.
• [38]RE-AIM 2012. http://cancercontrol.cancer.gov/IS/reaim/index.html webcite.
• [39]Glasgow R, Vogt T, Boles S: Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health 1999, 89:1322-1327.
• [40]Higgins JPT GS: Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Available from www.cochrane-handbook.org webcite.
• [41]Chow CK, Lock K, Madhavan M, Corsi DJ, Gilmore AB, Subramanian SV, Li W, Swaminathan S, Lopez-Jaramillo P, Avezum A, et al.: Environmental Profile of a Community's Health (EPOCH): An Instrument to Measure Environmental Determinants of Cardiovascular Health in Five Countries. PLoS One 2010, 5:e14294.
• [42]Glasgow RE, Lichtenstein E, Marcus AC: Why Don't We See More Translation of Health Promotion Research to Practice? Rethinking the Efficacy-to-Effectiveness Transition. Am J Public Health 2003, 93:1261-1267.
• [43]Woolf SH: The Meaning of Translational Research and Why It Matters. JAMA 2008, 299:211-213.
• [44]Salmon J, King AC: Population approaches to increasing physical activity and reducing sedentary behaviour among children and adults. In Obesity Epidemiology. 2nd edition. Edited by Crawford D, Jeffery RW, Brug J. Oxford: Oxford University Press; 2010:186-207.