Ilse De Bourdeaudhuij

Ghent University, Gand, Flanders, Belgium

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Publications (380)866.83 Total impact

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    ABSTRACT: This observational study aimed to adapt a computer-tailored step advice for the general population into a feasible advice for breast cancer survivors and to test its usability. First, several adaptations were made to the original design (adding cancer-related physical activity (PA) barriers and beliefs, and self-management strategies to improve survivors' personal control). Second, the adapted advice was evaluated in two phases: (1) a usability testing in healthy women (n = 3) and survivors (n = 6); and (2) a process evaluation during 3 weeks in breast cancer survivors (n = 8). Preliminary usability testing revealed no problems during logging-in; however, three survivors misinterpreted some questions. After refining the questionnaire and advice, survivors evaluated the advice as interesting, attractive to read, comprehensible and credible. Inactive survivors found the advice novel, but too long. The process evaluation indicated that the majority of the women (n = 5/8) reported increased steps. Monitoring step counts by using a pedometer was perceived as an important motivator to be more active. To conclude, this study provides initial support for the usability and acceptability of a computer-tailored pedometer-based PA advice for breast cancer survivors. After testing efficacy and effectiveness of this intervention, this tool can broaden the reach of PA promotion in breast cancer survivors.
    European Journal of Cancer Care 09/2014; · 1.31 Impact Factor
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    ABSTRACT: Background Adequate knowledge on environmental correlates of physical activity (PA) in older adults is needed to develop effective health promotion initiatives. However, research in this age group is scarce and most existing studies were conducted in North America. The present study aimed to examine relationships between GIS-based neighborhood walkability and objective and self-reported PA in community-dwelling Belgian older adults. Furthermore, moderating effects of neighborhood income levels were investigated.Methods The Belgian Environmental Physical Activity Study (BEPAS) for Seniors is a cross-sectional study in older adults (¿65 yrs) and was conducted between October 2010 and September 2012. Data from 438 older adults living in 20 neighborhoods across Ghent (Belgium) were analyzed. Stratification of selected neighborhoods was based upon objective walkability and neighborhood income. Participants wore an accelerometer during seven consecutive days to obtain objective levels of moderate-to-vigorous physical activity (MVPA). Self-reported levels of transportation walking/cycling and recreational walking/cycling were assessed using the International Physical Activity Questionnaire (long, last 7 days version) adapted for the elderly. Multi-level regression analyses were conducted.ResultsFindings showed a positive relationship between neighborhood walkability and weekly minutes of older adults¿ self-reported walking for transportation (B = 4.63 ± 1.05;p < 0.001) and a negative relationship between walkability and accelerometer-derived low-light PA (B = ¿1.38 ± 0.62;p = 0.025). Walkability was not related to any measure of recreational PA. A walkability x income interaction was found for accelerometer-derived MVPA (B = -1.826 ± 1.03;p = 0.075), showing only a positive association between walkability and MVPA in low-income neighborhood residents.Conclusions This was the first European study to examine walkability-PA relationships in older adults. These Belgian findings suggest that a high neighborhood walkability relates to higher levels of older adults¿ transport-related walking. As transport-related walking is an accessible activity for older adults and easy to integrate in their daily routine, policy makers and health promoters are advised to provide sufficient destinations and pedestrian-friendly facilities in the close vicinity of older adults¿ residences, so short trips can be made by foot. Neighborhood income moderated the relationship between walkability and objectively-measured MVPA. Increasing total MVPA levels in older adults should be a key topic in development of promotion initiatives and special attention should be paid to low-income neighborhood residents.
    International Journal of Behavioral Nutrition and Physical Activity 08/2014; 11(1):110. · 3.58 Impact Factor
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    ABSTRACT: Background Objective walkability is an important correlate of adults¿ physical activity. Studies investigating the relation between walkability and children¿s physical activity are scarce. However, in order to develop effective environmental interventions, a profound investigation of this relation is needed in all age groups. The aim of this study was to investigate the association between objective walkability and different domains of children¿s physical activity, and to investigate the moderating effect of neighborhood socio-economic status in this relation.Methods Data were collected between December 2011 and May 2013 as part of the Belgian Environmental Physical Activity Study in children. Children (9¿12 years old; n¿=¿606) were recruited from 18 elementary schools in Ghent (Belgium). Children together with one of their parents completed the Flemish Physical Activity Questionnaire and wore an accelerometer for 7 consecutive days. Children¿s neighborhood walkability was calculated using geographical information systems. Multilevel cross-classified modeling was used to determine the relationship between children¿s PA and objectively measured walkability and the moderating effect of neighborhood SES in this relation.ResultsIn low SES neighborhoods walkability was positively related to walking for transportation during leisure time (ß¿=¿0.381¿±¿0.124; 95% CI¿=¿0.138, 0.624) and was negatively related to sports during leisure time (ß¿=¿¿0.245¿±¿0.121; 95% CI¿=¿¿0.482, ¿0.008). In high socio-economic status neighborhoods, walkability was unrelated to children¿s physical activity. No relations of neighborhood walkability and neighborhood socio-economic status with cycling during leisure time, active commuting to school and objectively measured moderate- to vigorous-intensity physical activity were found.Conclusions No univocal relation between neighborhood walkability and physical activity was found in 9¿12 year old children. Results from international adult studies cannot be generalized to children. There is a need in future research to determine the key environmental correlates of children¿s physical activity.
    International Journal of Behavioral Nutrition and Physical Activity 08/2014; 11(1):104. · 3.58 Impact Factor
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    ABSTRACT: Previous studies have shown convincing evidence for positive relationships between transportation cycling in adults and macro-scale physical environmental factors. In contrast, relationships are less consistent for more changeable, micro-scale environmental factors. The majority of existing studies used observational study designs, which cannot determine causality. The present mixed-methods study used manipulated photographs to determine causal relationships between micro-scale environmental factors and the environment¿s invitingness for transportation cycling. Further, interactions among environmental factors and moderating effects of gender, age and educational level were investigated. For this study a panoramic photograph of a street was manipulated on eight environmental factors: traffic, speed bump, general upkeep, evenness of the cycle path, vegetation, separation of motorized traffic, separation with sidewalk and cycle path width. Sixty-six middle-aged adults participated in the study and sorted the manipulated panoramic photographs from least to most inviting to cycle for transportation. Participants also provided qualitative data on how they sorted the streets. Multilevel cross-classified modelling was used to analyse the relationships between the environmental manipulations and the invitingness-scores. The qualitative data were deductively categorized according to the environmental factors. All environmental factors, except for separation with sidewalk, proved to have a significant main effect on the invitingness-score for transportation cycling. Cycle path evenness appeared to have the strongest effect on the invitingness. This effect was even stronger in an environment with good compared to poorly overall upkeep. Another significant interaction effect showed that the invitingness decreased when both separations along the cycle path were present compared to only a separation with traffic. No moderating effects of the demographic factors on these relationships were found. Qualitative data confirmed the observed quantitative relationships and added depth and understanding. Current study shows that the use of manipulated photographs can be an effective way to examine environment-physical activity relationships. Our findings indicate that evenness of the cycle path may be a crucial environmental factor when aiming to increase a street¿s invitingness for transportation cycling among middle-aged adults. The findings of our exploratory study could be used to develop an environmental intervention to determine if our findings are applicable to real changes in cycling behavior.
    International Journal of Behavioral Nutrition and Physical Activity 08/2014; 11(1):88. · 3.58 Impact Factor
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    ABSTRACT: Screen-related behaviours are highly prevalent in schoolchildren. Considering the adverse health effects and the relation of obesity and screen time in childhood, efforts to affect screen use in children are warranted. Parents have been identified as an important influence on children's screen time and therefore should be involved in prevention programmes. The aim was to examine the mediating role of family-related factors on the effects of the school-based family-focused UP4FUN intervention aimed at screen time in 10- to 12-year-old European children (n child-parent dyads = 1940).
    BMC Public Health 08/2014; 14(1):857. · 2.08 Impact Factor
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    ABSTRACT: Reliable assessments of health-related behaviours are necessary for accurate evaluation on the efficiency of public health interventions. The aim of the current study was to examine the reliability of a self-administered primary caregivers questionnaire (PCQ) used in the ToyBox-intervention. The questionnaire consisted of six sections addressing sociodemographic and perinatal factors, water and beverages consumption, physical activity, snacking and sedentary behaviours. Parents/caregivers from six countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain) were asked to complete the questionnaire twice within a 2-week interval. A total of 93 questionnaires were collected. Test-retest reliability was assessed using intra-class correlation coefficient (ICC). Reliability of the six questionnaire sections was assessed. A stronger agreement was observed in the questions addressing sociodemographic and perinatal factors as opposed to questions addressing behaviours. Findings showed that 92% of the ToyBox PCQ had a moderate-to-excellent test-retest reliability (defined as ICC values from 0.41 to 1) and less than 8% poor test-retest reliability (ICC < 0.40). Out of the total ICC values, 67% showed good-to-excellent reliability (ICC from 0.61 to 1). We conclude that the PCQ is a reliable tool to assess sociodemographic characteristics, perinatal factors and lifestyle behaviours of pre-school children and their families participating in the ToyBox-intervention.
    Obesity reviews : an official journal of the International Association for the Study of Obesity. 08/2014; 15 Suppl S3:61-66.
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    ABSTRACT: The ToyBox-study aims to develop and test an innovative and evidence-based obesity prevention programme for preschoolers in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. In multicentre studies, anthropometric measurements using standardized procedures that minimize errors in the data collection are essential to maximize reliability of measurements. The aim of this paper is to describe the standardization process and reliability (intra- and inter-observer) of height, weight and waist circumference (WC) measurements in preschoolers. All technical procedures and devices were standardized and centralized training was given to the fieldworkers. At least seven children per country participated in the intra- and inter-observer reliability testing. Intra-observer technical error ranged from 0.00 to 0.03 kg for weight and from 0.07 to 0.20 cm for height, with the overall reliability being above 99%. A second training was organized for WC due to low reliability observed in the first training. Intra-observer technical error for WC ranged from 0.12 to 0.71 cm during the first training and from 0.05 to 1.11 cm during the second training, and reliability above 92% was achieved. Epidemiological surveys need standardized procedures and training of researchers to reduce measurement error. In the ToyBox-study, very good intra- and-inter-observer agreement was achieved for all anthropometric measurements performed.
    Obesity reviews : an official journal of the International Association for the Study of Obesity. 08/2014; 15 Suppl S3:67-73.
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    ABSTRACT: Process evaluation (PE) is used for the in-depth evaluation of the implementation process of health promotion programmes. The aim of the current paper was to present the PE design and tools used in the ToyBox-intervention. The PE design was based on a three-step approach, including the identification of ToyBox-specific PE elements (step 1), the development of PE tools and harmonization of procedures (step 2), and the implementation of PE using standardized protocol and tools across the intervention countries (step 3). Specifically, to evaluate the implementation of the intervention, teachers' monthly logbooks were recorded (dose delivered, fidelity, dose received); post-intervention questionnaires were completed by parents/caregivers and teachers (dose received); participation and attrition rates were recorded (recruitment, reach); and audit questionnaires and retrospective information on weather conditions were collected (physical and social environment within which the intervention was implemented). Regarding the teachers' training sessions, the researchers who performed the trainings completed evaluation forms and documented teachers' attendance after each training (dose delivered, fidelity, dose received) and teachers completed evaluation forms after each training (dose received). The PE performed in the ToyBox-intervention may contribute in the evaluation of its effectiveness, guide the revision of the intervention material and provide insights for future health promotion programmes and public health policy.
    Obesity reviews : an official journal of the International Association for the Study of Obesity. 08/2014; 15 Suppl S3:74-80.
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    ABSTRACT: The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox-study, aiming to identify young children's key behaviours and their determinants related to early childhood obesity. The ToyBox-intervention is a multi-component, kindergarten-based, family-involved intervention with a cluster-randomized design, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families. The intervention was implemented during the academic year 2012-2013 in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. Standardized protocols, methods, tools and material were used in all countries for the implementation of the intervention, as well as for the process, impact, outcome evaluation and the assessment of its cost-effectiveness. A total sample of 7,056 preschool children and their parents/caregivers, stratified by socioeconomic level, provided data during baseline measurements and participated in the intervention. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline, prior to the implementation of the intervention.
    Obesity reviews : an official journal of the International Association for the Study of Obesity. 08/2014; 15 Suppl S3:5-13.
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    ABSTRACT: Overweight and obesity in children are recognized as a major health problem. The ToyBox-intervention was developed with the aim of preventing obesity in pre-schoolers. Because it is increasingly important to inform policy makers not only on the effects of prevention interventions, but also on their costs and cost-effectiveness, our purpose was to establish a method to estimate the cost-effectiveness of the ToyBox-intervention. In order to estimate the long-term impact of the ToyBox-intervention on health and societal costs, extrapolations of the intervention effect will be conducted to predict children's weight status (based on the body mass index) at adult age. Effects of the adult weight status on the prevalence of obesity-related complications will be modelled through a Markov model, with a total time horizon of 70 years and a cycle length of 1 year. The model will be conducted in six European countries participating in the ToyBox-intervention, based on country-specific economic and epidemiological data. This study describes the methodological rationale and implementation of an analytic model to examine the cost-effectiveness of the ToyBox-intervention for six European countries, in order to inform decision-makers on the value for money of this intervention in the prevention of obesity in pre-schoolers.
    Obesity reviews : an official journal of the International Association for the Study of Obesity. 08/2014; 15 Suppl S3:81-89.
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    ABSTRACT: The ToyBox-intervention is a kindergarten-based, family-involved intervention targeting multiple lifestyle behaviours in preschool children, their teachers and their families. This intervention was conducted in six European countries, namely Belgium, Bulgaria, Germany, Greece, Poland and Spain. The aim of this paper is to provide a descriptive overview of the harmonization and standardization procedures of the baseline and follow-up evaluation of the study (and substudies). Steps related to the study's operational, standardization and harmonization procedures as well as the impact and outcome evaluation assessment tools used are presented. Experiences from the project highlight the importance of safeguarding the measurement process to minimize data heterogeneity derived from potential measurement error and country-by-country differences. In addition, it was made clear that continuing quality control and support is an important component of such studies. For this reason, well-supported communication channels, such as regular email updates and teleconferences, and regular internal and external meetings to ensure smooth and accurate implementation were in place during the study. The ToyBox-intervention and its harmonized and standardized procedures can serve as a successful case study for future studies evaluating the efficacy of similar interventions.
    Obesity reviews : an official journal of the International Association for the Study of Obesity. 08/2014; 15 Suppl S3:53-60.
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    ABSTRACT: Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers.
    Obesity Reviews 07/2014; 15(Suppl 3):14-26. · 6.87 Impact Factor
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    ABSTRACT: Previous questionnaires targeting older adults' sedentary time have underestimated total sedentary time, possibly by not including all relevant specific sedentary behaviors. The current study aimed to investigate the criterion validity and test-retest reliability of a new questionnaire assessing a comprehensive set of sedentary behaviors. Additionally, we examined whether the criterion validity of the questionnaire differed according to age, gender and educational level.
    BMC Public Health 07/2014; 14(1):734. · 2.08 Impact Factor
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    ABSTRACT: When students make the transition from high school to college or university, their physical activity (PA) levels decrease strongly. Consequently, it is of crucial importance to identify the determinants of this decline in PA.
    International Journal of Behavioral Medicine 07/2014; · 2.63 Impact Factor
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    ABSTRACT: The purpose of the present study was to investigate the associations of family sociodemographic characteristics with children's weight status and whether these potential associations are mediated by children's breakfast habits.
    Public health nutrition. 07/2014;
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    ABSTRACT: The family, and parents in particular, are considered the most important influencers regarding children's energy-balance related behaviours (EBRBs). When children become older and gain more behavioural autonomy regarding different behaviours, the parental influences may become less important and peer influences may gain importance. Therefore the current study aims to investigate simultaneous and interactive associations of family rules, parent and friend norms and modelling with soft drink intake, TV viewing, daily breakfast consumption and sport participation among schoolchildren across Europe.
    International Journal of Behavioral Nutrition and Physical Activity 07/2014; 11(1):82. · 3.58 Impact Factor
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    ABSTRACT: Background:Physical activity (PA) has been consistently implicated in the etiology of obesity, while recent evidence on the importance of sedentary time remains inconsistent. Understanding of dose-response associations of PA and sedentary time with overweight and obesity in adults can be improved with large-scale studies using objective measures of PA and sedentary time. The purpose of this study was to examine the strength, direction and shape of dose-response associations of accelerometer-based PA and sedentary time with BMI and weight status in 10 countries, and the moderating effects of study site and gender.Methods:Data from the International Physical activity and the Environment Network (IPEN) Adult study were used. IPEN Adult is an observational multi-country cross-sectional study, and 12 sites in 10 countries are included. Participants wore an accelerometer for seven consecutive days, completed a socio-demographic questionnaire and reported height and weight. In total, 5712 adults (18-65 years) were included in the analyses. Generalized additive mixed models, conducted in R, were used to estimate the strength and shape of the associations.Results:A curvilinear relationship of accelerometer-based moderate-to-vigorous PA and total counts/minute with BMI and the probability of being overweight/obese was identified. The associations were negative, but weakened at higher levels of moderate-to-vigorous PA (>50 min/day) and higher counts/minute. No associations between sedentary time and weight outcomes were found. Complex site- and gender-specific findings were revealed for BMI, but not for weight status.Conclusions:Based on these results, the current Institute of Medicine recommendation of 60 minutes/day of moderate-to-vigorous PA to prevent weight gain in normal-weight adults was supported. No relationship between sedentary time and the weight outcomes was present, calling for further examination. If moderator findings are confirmed, the relationship between PA and BMI may be country- and gender-dependent, which could have important implications for country-specific health guidelines.International Journal of Obesity accepted article preview online, 02 July 2014; doi:10.1038/ijo.2014.115.
    International journal of obesity (2005) 07/2014; · 5.22 Impact Factor
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    ABSTRACT: During the last decades, the use of active travel modes declined in all age groups. Childhood is a critical time to establish lifelong healthy patterns. To develop effective interventions in this age group, insight in the correlates of health behaviors and the possible mediating factors is necessary. Among children, the role of parents may not be overlooked. Therefore, this study aimed to examine the associations of parental perceptions of neighborhood environmental attributes with active transport and total physical activity in 10-12 year old Belgian boys and girls. Furthermore, this study examined the potential mediating effect of independent mobility on these associations.
    BMC Public Health 06/2014; 14(1):631. · 2.08 Impact Factor
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    ABSTRACT: To explore differences in personal and home environmental factors that are regarded as determinants of energy balance-related behaviors (EBRBs) according to parental education and ethnic background among 10-12 year old schoolchildren across Europe.
    BMC Public Health 06/2014; 14(1):610. · 2.08 Impact Factor
  • D Van Dyck, G Cardon, B Deforche, I De Bourdeaudhuij
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    ABSTRACT: This study aimed to assess convergent validity of IPAQ interview (long form, last seven days), and to examine differences in reported physical activity and sedentary time between the self-administered and interview versions of the long IPAQ (last seven days); and whether these differences depend on gender, age, educational level and weight status.
    The Journal of sports medicine and physical fitness. 06/2014;

Publication Stats

5k Citations
866.83 Total Impact Points


  • 1994–2014
    • Ghent University
      • Department of Movement and Sports Sciences
      Gand, Flanders, Belgium
  • 2012–2013
    • Harokopion University of Athens
      • Department of Nutrition and Dietetics
      Athens, Attiki, Greece
    • University of Maiduguri
      • Department of Physiotherapy
      Maidugari, Borno, Nigeria
  • 2010–2013
    • University of Zaragoza
      Caesaraugusta, Aragon, Spain
  • 2009–2013
    • Free University of Brussels
      • • Faculty of Physical Education and Physiotherapy
      • • Biomechanics and Human Biometry (BIOM)
      Brussels, BRU, Belgium
  • 2011–2012
    • Open Universiteit Nederland
      • M.A. Program in Health Psychology
      Heerlen, Limburg, Netherlands
  • 2010–2011
    • Universiteit Hasselt
      • Faculty of Business Economics (BEW)
      Flanders, Belgium
    • University of Granada
      Granata, Andalusia, Spain
  • 2008–2011
    • VU University Medical Center
      • • Department of Public and Occupational Health
      • • Department of Epidemiology and Biostatistics
      Amsterdam, North Holland, Netherlands
  • 2007–2008
    • University of Queensland 
      • Cancer Prevention Research Centre
      Brisbane, Queensland, Australia
    • Erasmus Universiteit Rotterdam
      • Department of Public Health (MGZ)
      Rotterdam, South Holland, Netherlands
  • 2003–2008
    • University of Leuven
      • • Department of Human Kinesiology
      • • Department of Biomedical Kinesiology
      Louvain, Flanders, Belgium
  • 2005–2007
    • University of Oslo
      • Department of Nutrition
      Oslo, Oslo, Norway
  • 2006
    • University of Iceland
      Reikiavik, Capital Region, Iceland
  • 2005–2006
    • Erasmus MC
      • Research Group for Public Health
      Rotterdam, South Holland, Netherlands