Recreational walking and the perceived local environment among socioeconomic disadvantaged adults

Abstract Background Insufficient physical activity (PA) is a risk factor for obesity and non-communicable diseases and seems more prevalent among socioeconomically disadvantaged (SED) adults. Recreational walking (RW) is an important type of leisure time PA which can be done for free and without specific equipment or facilities. Environmental factors influencing PA may be particularly important for SED adults who are more reliant on their direct environment. The objectively measured environment is not always congruent with the perception of residents, and this may differ by socioeconomic group. This study aims to identify the local environmental factors important for RW as perceived by SED adults. Methods This study is part of the CIVISANO project. Purposeful convenience sampling was used to recruit 38 SED adults (25-65 y/o) in two Flemish semi-urban municipalities. Individual walk-along interviews have been performed in the participants’ neighborhood. 20 participants joined the focus group discussion (n = 4) that were intended for member checking, to categorize identified environmental factors and to identify local actions to promote recreational walking. MaxQDA was used for content analysis. Results The way the environment is perceived by SED adults plays an important role in their RW behavior. Results demonstrate the interrelation of different environmental types (physical, sociocultural, economic, political and information) and sizes (micro, meso, macro). Improving communication and knowledge transfer, stimulation of physical, sociocultural, and economic accessibility, and promotion of physical and social safety are identified most important action points for the local government to facilitate RW. Conclusions Our findings indicate that the perceived local environment can play an important role in promoting RW among SED adults. Future studies should investigate if changes in these environments and in residents’ perception lead to changes in RW behavior of SED adults. Key messages The way the environment is perceived by socioeconomic disadvantaged adults plays an important role in their recreational walking behavior. Participation of community members allows to integrate novel and community-sourced ideas for practical intervention planning with high external validity.


Background:
Early childhood health interventions and educational programs are key to keeping children healthy and preventing disease during adulthood. Since several preventive strategies and campaigns targeting children have been proposed, the aim of this systematic review is to evaluate the effectiveness of digital-based interventions (e.g., cartoons, videos, video games, mobile apps, etc.) in promoting healthy behaviours in primary school-aged children.

Methods:
Following PRISMA guidelines, we searched three electronic databases (Medline, Embase, and Scopus) up to April 11, 2022. We included randomized and non-randomized experimental studies quantifying the effectiveness of digital or audio-visualbased health promotion interventions in childhood (up to 12 years of age).

Results:
The search strategy yielded a total of 1640 articles. Retrieved studies covered a wide range of health interventionsincluding a healthy diet, physical activity promotion, oral hygiene, skin cancer prevention, and different educational approaches (such as cartoons, interactive video games, etc.), mainly implemented in a school setting and comparing digital interventions to teacher-led interventions or no intervention at all. Data pooling suggests that digital and audio-visual-based health promotion interventions targeting children are effective in improving health literacy and healthy behaviours.

Conclusions:
This systematic review adds to the body of knowledge on health promotion in children and provides actionable measures to implement straightforward educational approaches in this specific population, empowering them to adopt preventive behaviours, and ultimately promoting health at the household and societal level.

Key messages:
Health promotion has to be delivered during childhood and evidence is needed to identify effective interventions in this population. Digital and audio-visual tools have great potential to convey effective health promotion interventions in children and adults to be.

Background:
Insufficient physical activity (PA) is a risk factor for obesity and non-communicable diseases and seems more prevalent among socioeconomically disadvantaged (SED) adults.
Recreational walking (RW) is an important type of leisure time PA which can be done for free and without specific equipment or facilities. Environmental factors influencing PA may be particularly important for SED adults who are more reliant on their direct environment. The objectively measured environment is not always congruent with the perception of residents, and this may differ by socioeconomic group. This study aims to identify the local environmental factors important for RW as perceived by SED adults.

Methods:
This study is part of the CIVISANO project. Purposeful convenience sampling was used to recruit 38 SED adults (25-65 y/o) in two Flemish semi-urban municipalities. Individual walk-along interviews have been performed in the participants' neighborhood. 20 participants joined the focus group discussion (n = 4) that were intended for member checking, to categorize identified environmental factors and to identify local actions to promote recreational walking. MaxQDA was used for content analysis.

Results:
The way the environment is perceived by SED adults plays an important role in their RW behavior. Results demonstrate the interrelation of different environmental types (physical, sociocultural, economic, political and information) and sizes (micro, meso, macro). Improving communication and knowledge transfer, stimulation of physical, sociocultural, and economic accessibility, and promotion of physical and social safety are identified most important action points for the local government to facilitate RW.

Conclusions:
Our findings indicate that the perceived local environment can play an important role in promoting RW among SED adults. Future studies should investigate if changes in these environments and in residents' perception lead to changes in RW behavior of SED adults.

Key messages:
The way the environment is perceived by socioeconomic disadvantaged adults plays an important role in their recreational walking behavior. Participation of community members allows to integrate novel and community-sourced ideas for practical intervention planning with high external validity.

Background:
The Portuguese National Health Plan (PNS) 2012-2016, extended to 2020, was the strategic health document shaping the direction of intervention within the Health System. The National Institute of Health Doutor Ricardo Jorge (INSA) is the institution responsible for carrying out its final evaluation. To underpin PNS final evaluation a multistep process was designed.

Methods:
A mixed methods study using a convenience sample was implemented to assess stakeholders' perception about five PNS dimensions: dissemination, communication, implementation, impact, and evaluation. For this purpose, two different tools were used. Semi-structured interviews with former health policy managers were conducted. In addition, an online survey was designed and widely distributed to additional stakeholders. From October 2019 to February 2020, data was collected using two separate instruments. Integral transcriptions of the interviews were made. Qualitative content analysis and quantitative descriptive analysis were used.

Results:
A total of 12 interviews and 179 valid surveys were obtained.
Regarding stakeholders' perception about PNS implementation process, there was an overall positive recognition about the strategic and operational relevance of the PNS, as a common dialogue platform and a tool for health improvements both for health status and health system function in Portugal. Among pointed implementation barriers, management was mentioned as the major constraint, mainly due to shortage of human and financial resources to carry out the recommended interventions within the PNS timeline.

Conclusions:
As part of the evaluation process the research team found relevant gain knowledge of the wider context in which PNS was developed and implemented, based on stakeholders' perception. Their considerations are important not only to support the definition of the questions and criteria for PNS final evaluation, but also to highlight key issues for the future policy cycle.

Background:
The COVID-19 pandemic has highlighted shortfalls in the delivery of vaccine programmes to older migrant groups. Guidelines exist, however, little is known around care pathways and engagement of these older cohorts in routine vaccinations in primary care, including catch-up programmes. We explored the views of primary care professionals around barriers and facilitators to catch-up vaccination in adult migrants (defined as foreign born; 18+ years) with incomplete or uncertain vaccination status.

Methods:
We did a qualitative interview study with purposive sampling and thematic analysis in UK primary care (50 practices included nationally; 1 hour qualitative interviews) with 64 15th European Public Health Conference 2022