Center for Translational Research in Public Health

Newcastle upon Tyne, United Kingdom

Center for Translational Research in Public Health

Newcastle upon Tyne, United Kingdom
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Penn L.,Northumbria University | Penn L.,Center for Translational Research in Public Health | Dombrowski S.U.,University of Stirling | Sniehotta F.F.,Northumbria University | And 3 more authors.
BMJ Open | Year: 2014

Background: Type 2 diabetes (T2D) is a debilitating disease, highly prevalent in UK South Asians, and preventable by lifestyle intervention. The 'New life, New you' (NLNY) physical activity (PA) and dietary intervention for T2D prevention was culturally adapted to better engage minority ethnic populations and tested for feasibility. Objectives: To investigate Pakistani female participants' perspectives of their behaviour change and of salient intervention features. Setting: A community-based 8-week programme of group delivered PA sessions with behavioural counselling and dietary advice, culturally adapted for ethnic minority populations, in an area of socioeconomic deprivation. Participants to NLNY were recruited through screening events in community venues across the town. Participants: Interviews were conducted with 20 Pakistani female NLNY participants, aged 26-45 (mean 33.5) years, from different parts of town. Results: Within the a priori Theoretical Domains Framework (intentions and goals, reinforcement, knowledge, nature of the activity, social role and identity, social influences, capabilities and skills, regulation and decision, emotion and environment), we identified the importance of social factors relating to participants' own PA and dietary behaviour change. We also identified cross-cutting themes as collateral benefits of the intervention including participants' 'psychological health'; 'responsibility' (for others' health, especially family members included in the new PA and diet regimes) and 'inclusion' (an ethos of accommodating differences). Conclusions: Our findings suggest that culturally adapted interventions for Pakistani women at risk of T2D, delivered via group PA sessions with counselling and dietary advice, may encourage their PA and dietary behaviour change, and have collateral health and social benefits. The NLNY intervention appeared to be acceptable. We plan to evaluate recruitment, retention and likely effect of the intervention on participant behaviour prior to definitive evaluation.

Dombrowski S.U.,Newcastle University | Sniehotta F.F.,Newcastle University | Sniehotta F.F.,Center for Translational Research in Public Health | Johnston M.,University of Aberdeen | And 5 more authors.
Patient Education and Counseling | Year: 2012

Objective: To test and optimize the feasibility and acceptability of a physical activity (PA) and healthy eating behavior change intervention for obese adults with obesity-related co-morbidities or additional risk factors for co-morbidities. Methods: Open-pilot intervention study using an uncontrolled pre and post design with ongoing measures on intervention acceptability and feasibility. Participants received 5 weekly nurse-led one-hour long group sessions. Acceptability and feasibility were assessed throughout. PA, dietary behavior and weight were measured before and after the intervention. Results: Of 74 consenting participants, 61 (82%) received and 47 (64%) completed the intervention. Average ratings of intervention materials and components by participants ranged between 4.1 and 4.9 out of 5. Average facilitator satisfaction rating was 90% (range 75-100%). The intervention delivery was feasible as indicated by ratings and comments from participants and the facilitator. Participants lost -0.86. kg of weight t(45) = 3.84, p= 0.0001, and increased PA by an additional 1.6 (SD= 2.7) sessions/week, t(31) = -3.3, p= 0.002. No significant dietary differences emerged. Conclusion: The intervention was acceptable to the facilitator and participants and feasible for delivery. Several intervention aspects were further optimized. Practice implications: The current study outlines a PA and dietary behavior change pilot intervention coupled with a systematic and transparent process of intervention optimization. © 2011 Elsevier Ireland Ltd.

McDonald S.,Newcastle University | O'Brien N.,Newcastle University | White M.,Newcastle University | White M.,Center for Translational Research in Public Health | And 2 more authors.
International Journal of Behavioral Nutrition and Physical Activity | Year: 2015

Background: There are considerable inter-individual differences in the direction and degree of change in physical activity (PA) levels during the retirement transition. There is currently a limited theoretical understanding of how these differences can be explained. This study aimed to explore and compare perceptions about how theory-based factors influence PA change during the transition from employment to retirement among individuals approaching retirement and recently retired. Methods: Theory-based, one-to-one, semi-structured interviews were conducted with a purposive sample of 28 adults (15 retired) within 24 months of retirement. Participants were sampled to reflect a diverse range of socio-economic and occupational backgrounds. The interview was based on the 12 domains within the Theory Domain Framework and designed to elicit anticipated or experienced retirement-related changes in PA behaviour and perceived determinants. Interview transcripts were analysed using Framework analysis to explore intra- and inter-individual perceptions of how PA changes after retirement and the factors which may influence this change. Results: The majority of participants perceived retirement to be related to an increase in PA levels. Four themes emerged from the data regarding factors perceived to influence changes in PA behaviour after retirement: (1) resources for PA; (2) structure of daily life in retirement; (3) opportunities for PA; and (4) transitional PA phases after retirement. Retirement is associated with a number of inter-related changes and opportunities which can have a positive or negative impact on PA behaviour. The influence of these factors does not appear to be static and may change over time. A number of different transitional phases may be experienced after leaving work and each phase may have a differential impact on PA behaviour. Conclusions: The findings of this qualitative study contribute to the theoretical understanding of PA change during the retirement transition. Each post-retirement PA trajectory is highly individual and personalised intervention approaches to increase PA during the retirement transition may be most successful. Future research should focus on the maintenance of PA change during the retirement transition and should develop and evaluate interventions to promote and maintain PA during retirement. © 2015 McDonald et al.

Heaven B.,Northumbria University | Brown L.J.E.,Manchester Metropolitan University | White M.,Northumbria University | White M.,Center for Translational Research in Public Health | And 3 more authors.
Milbank Quarterly | Year: 2013

Context The marked demographic change toward greater proportions of older people in developed nations poses significant challenges for health and social care. Several studies have demonstrated an association between social roles in later life and positive health and well-being outcomes. After retiring from work, people may lose roles that provide purpose and social contacts. The outcomes of interventions to promote social roles in retirement have not been systematically reviewed. Methods We examined three research questions: (1) What kinds of intervention have been developed to promote social roles in retirement? (2) How much have they improved perceived roles? (3) Have these roles improved health or well-being? We included those studies that evaluated the provision of social roles; used a control or comparison group; targeted healthy retirement-transition adults who were living in the community; provided an abstract written in English; took place in a highly developed nation; and reported social role, health, or well-being outcomes. We searched eight electronic databases and combined the results with hand searches. Findings Through our searches, we identified 9,062 unique publications and eleven evaluative studies of acceptable quality, which reported seven interventions that met our inclusion criteria. These interventions varied in year of inception and scope, but only two were based outside North America. The studies rarely reported the quality or meaning of roles. Only three studies used random allocation, thus limiting inferences of causality from these studies. Interventions providing explicit roles and using supportive group structures were somewhat effective in improving one or more of the following: life satisfaction, social support and activity, physical health and activity, functional health, and cognition. Conclusions Social role interventions may improve health and well-being for people in retirement transition. Future research should improve the quality of intervention and assessment and look at which interventions are most effective and acceptable in facilitating social roles for diverse older populations. © 2013 Milbank Memorial Fund.

Lara J.,Northumbria University | Hobbs N.,Northumbria University | Moynihan P.J.,Northumbria University | Meyer T.D.,Northumbria University | And 9 more authors.
BMC Medicine | Year: 2014

Background: Retirement from work involves significant lifestyle changes and may represent an opportunity to promote healthier eating patterns in later life. However, the effectiveness of dietary interventions during this period has not been evaluated. Methods: We undertook a systematic review of dietary interventions among adults of retirement transition age (54 to 70 years). Twelve electronic databases were searched for randomized controlled trials evaluating the promotion of a healthy dietary pattern, or its constituent food groups, with three or more months of follow-up and reporting intake of specific food groups. Random-effects models were used to determine the pooled effect sizes. Subgroup analysis and meta-regression were used to assess sources of heterogeneity. Results: Out of 9,048 publications identified, 68 publications reporting 24 studies fulfilled inclusion criteria. Twenty-two studies, characterized by predominantly overweight and obese participants, were included in the meta-analysis. Overall, interventions increased fruit and vegetable (F&V) intake by 87.5 g/day (P <0.00001), with similar results in the short-to-medium (that is, 4 to 12 months; 85.6 g/day) and long-term (that is, 13 to 58 months; 87.0 g/day) and for body mass index (BMI) stratification. Interventions produced slightly higher intakes of fruit (mean 54.0 g/day) than of vegetables (mean 44.6 g/day), and significant increases in fish (7 g/day, P = 0.03) and decreases in meat intake (9 g/day, P <0.00001). Conclusions: Increases in F&V intakes were positively associated with the number of participant intervention contacts. Dietary interventions delivered during the retirement transition are therefore effective, sustainable in the longer term and likely to be of public health significance. © 2014 Lara et al.; licensee BioMed Central Ltd.

Spence S.,Northumbria University | Delve J.,Northumbria University | Stamp E.,Northumbria University | Matthews J.N.S.,Northumbria University | And 4 more authors.
PLoS ONE | Year: 2013

In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9). We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change 2128 mg, 95% CI: 2183 to 273 mg) in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (21.8%, 22.8 to 20.9) and saturated fat (21.0%; 21.6 to 20.5) than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6), protein (3.6 g, 1.1 to 6.0), non-starch polysaccharides (1.5 g, 0.5 to 1.9), vitamin C (0.7 mg, 0.6 to 0.8), and folate (12.3 fig, 9.7 to 20.4) in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet. © 2013 Spence et al.

Spence S.,Northumbria University | White M.,Northumbria University | White M.,Center for Translational Research in Public Health | Adamson A.J.,Northumbria University | And 2 more authors.
BMJ Open | Year: 2015

Objectives: An expectation of research is that participants should give fully informed consent. However, there is also a need to maximise recruitment to ensure representativeness. We explored the impact of passive or active parental consent on consent, completion rates and on dietary data quality in a survey among children aged 11-12 years. Setting: Six middle schools in North-East England. Participants: All children aged 11-12 years attending the six middle schools were eligible to participate (n=1141). Main outcomes: Primary outcomes: whether or not each eligible child's parent gave consent and provided a complete dietary diary; whether or not a child completed their dietary diary but only among children who agreed to participate, and whether or not children providing diaries were classified as an under-reporter or not. Results: Parents were more likely to consent passively than actively. This difference was greater among the more deprived: OR 16.9 (95% CI 5.7 to 50.2) in the least and 129.6 (95% CI 39.9 to 420.6) in the most deprived quintile (test for interaction: method of consent by level of deprivation, p=0.02). For all children eligible, completion was more likely if passive consent was used (OR 2.8, 95% CI 2.2 to 3.7). When only children who gave consent are considered, completion was less likely when passive rather than active consent was used (OR 0.6, 95% CI 0.4 to 0.9). Completion rate decreased as level of deprivation increased; we found no evidence that the OR for the method of consent varied by level of deprivation. There was no evidence that the quality of dietary data, as measured by an assessment of under-reporting, differed by method of consent (OR 0.8, 95% CI 0.5 to 1.2). Conclusions: Passive consent led to a higher participation rate and a more representative sample without compromising data quality. © 2014, BMJ Publishing Group. All rights reserved.

Kwasnicka D.,Northumbria University | Kwasnicka D.,Center for Translational Research in Public Health | Presseau J.,Northumbria University | Presseau J.,Center for Translational Research in Public Health | And 4 more authors.
Health Psychology Review | Year: 2013

Health-related interventions often prompt participants to plan how to cope with anticipated barriers to behaviour change, a technique known as coping planning. The purpose of this study was to review the evidence of the efficacy of prompting individuals to form coping plans as a technique for promoting health-related behaviour change. Electronic databases (MEDLINE, Embase and PsycInfo) and unpublished literature were searched for randomised controlled trials that allocated participants to the study conditions with and without prompts to form coping plans. Evidence was assessed for quality and narratively synthesised. Full text papers of 65 articles were assessed for eligibility and 11 papers were included in the review. Coping planning interventions appear to be efficacious when participants are supported in the process of forming coping plans. Combining action plans with coping plans seems to be more efficacious than using action plans only. The overall efficacy of coping planning is variable. Future interventions should consider potential moderators of the efficacy of such plans. © 2013 © 2013 Taylor & Francis.

Penn L.,Northumbria University | Penn L.,Center for Translational Research in Public Health | Dombrowski S.U.,Northumbria University | Sniehotta F.F.,Northumbria University | And 3 more authors.
BMJ Open | Year: 2013

Objectives: In a qualitative substudy, we sought to elicit participants' perspectives of their behavioural change and maintenance of new behaviours towards intervention optimisation. Setting: The intervention was delivered in leisure and community settings in a local authority, which according to the UK government statistics ranks as 1 of the 10 most socioeconomically deprived areas in England. Participants: We recruited 218 adults aged 40-65 years at elevated risk of type 2 diabetes (Finnish Diabetes Risk Score≥11) to the intervention. Follow-up at 12 months was completed by 134 (62%). We recruited 15 participants, purposively sampled for physical activity increase, to the qualitative substudy. Intervention: Lifestyle intervention can prevent type 2 diabetes, but translation to service provision remains challenging. The 'New life, New you' intervention aimed to promote physical activity, healthy eating and weight loss, and included supervised group physical activity sessions. Behavioural change and weight loss at 12-month follow-up were encouraging. Design: We conducted 15 individual semistructured interviews. The Framework approach, with a comparison of emerging themes, was used in analysis of the transcribed data and complemented by the Theory Domains Framework. Results: Themes emerging from the data were grouped as perceptions that promoted initiating, enacting and maintaining behavioural change. The data were then categorised in accordance with the Theory Domains Framework: intentions and goals; reinforcement; knowledge; social role and identity; social influences; skills and beliefs about capabilities; behavioural regulation, memory, emotion, attention and decision processes and environmental context and resources. Participant perceptions of intervention features that facilitated behavioural change processes were then similarly analysed. Conclusions: Social influences, reference to social role and identity (eg, peer support), and intentions and goals (eg, to lose weight) were dominant themes across the three phases of behavioural change.

Penn L.,Northumbria University | Penn L.,Center for Translational Research in Public Health | Ryan V.,Northumbria University | White M.,Northumbria University | White M.,Center for Translational Research in Public Health
BMJ Open | Year: 2013

Objectives and design: Lifestyle interventions can prevent type 2 diabetes (T2D) in adults with impaired glucose tolerance. In a mixed methods pilot study, we aimed to assess the feasibility, acceptability and outcomes at a 12-month follow-up of a behavioural intervention for adults at risk of T2D. Participants: Adults aged 45-65 years with a Finnish Diabetes Risk Score (FINDRISC) ≥11. Setting: The intervention was delivered in leisure and community settings in a local authority that ranks in the 10 most socioeconomically deprived in England. Intervention: A 10-week supported programme to promote increased physical activity (PA), healthy eating and weight loss was delivered by fitness trainers as twice-weekly group PA or cookery sessions, each followed by behavioural counselling with support to 12 months. Outcome measures: We assessed feasibility and acceptability of the intervention, and change in behavioural and health-related outcomes at 6 and 12 months. Results: From 367 registers of interest, 218 participants were recruited to the programme with baseline mean (SD): age 53.6 (6) years, FINDRISC 13.9 (3.1), body mass index 33.5 (5.9) kg/m2, waist circumference 108.1 (13.7) cm, PA levels (self-report): daily total 49.1 (5.9) metabolic-equivalent (MET) h/day. Follow-up at 12 months was completed by 134 (61%) participants, with an estimated mean (95% CI) change from baseline in weight -5.7 (-7.8 to -2.8); -2.8 (-3.8 to -1.9) kg, waist circumference -7.2 (-9.2 to -5.2); -6.0 (-7.1 to -5.0) cm, and PA level 7.9 (5.8 to 10.1); 6.7 (5.2 to 8.2) MET h/day equivalent, for men and women, respectively (from covariance pattern mixed models). Participants reported an enjoyable, sociable and supportive intervention experience. Conclusions: Participants' views indicated a high level of intervention acceptability. High retention and positive outcomes at 12 months provide encouraging indications of the feasibility and potential effectiveness of the intervention. A definitive trial of this intervention is warranted.

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