[Show abstract][Hide abstract] ABSTRACT: Knowledge about the relationships between micro-scale environmental factors and older adults’ walking for transport is limited and inconsistent. This is probably due to methodological limitations, such as absence of an accurate neighborhood definition, lack of environmental heterogeneity, environmental co-variation, and recall bias. Furthermore, most previous studies are observational in nature. We aimed to address these limitations by investigating the effects of manipulating photographs on micro-scale environmental factors on the appeal of a street for older adults’ transportation walking. Secondly, we used latent class analysis to examine whether subgroups could be identified that have different environmental preferences for transportation walking. Thirdly, we investigated whether these subgroups differed in socio-demographic, functional and psychosocial characteristics, current level of walking and environmental perceptions of their own street.
Data were collected among 1131 Flemish older adults through an online (n = 940) or an interview version of the questionnaire (n = 191). This questionnaire included a choice-based conjoint exercise with manipulated photographs of a street. These manipulated photographs originated from one panoramic photograph of an existing street that was manipulated on nine environmental attributes. Participants chose which of two presented streets they would prefer to walk for transport.
In the total sample, sidewalk evenness had by far the greatest appeal for transportation walking. The other environmental attributes were less important. Four subgroups that differed in their environmental preferences for transportation walking were identified. In the two largest subgroups (representing 86 % of the sample) sidewalk evenness was the most important environmental attribute. In the two smaller subgroups (each comprising 7 % of the sample), traffic volume and speed limit were the most important environmental attributes for one, and the presence of vegetation and a bench were the most important environmental attributes for the other. This latter subgroup included a higher percentage of service flat residents than the other subgroups.
Our results suggest that the provision of even sidewalks should be considered a priority when developing environmental interventions aiming to stimulate older adults’ transportation walking. Natural experiments are needed to confirm whether our findings can be translated to real environments and actual transportation walking behavior.
Preview · Article · Dec 2016 · International Journal of Behavioral Nutrition and Physical Activity
[Show abstract][Hide abstract] ABSTRACT: Background: In preschoolers, high levels of sedentary behaviour are associated with several adverse health outcomes. The purpose of this study is to report the effects of the ToyBox-intervention (a European 24-week cluster randomised controlled trial) on sedentary behaviour in preschoolers. Methods: In Belgium, 859 preschoolers from 27 kindergartens (15 intervention and 12 control) wore an accelerometer to objectively measure their sedentary time and 1715 parents/caregivers completed a questionnaire to assess sedentary activities in which preschoolers participate at home. Main outcomes were objectively measured sedentary time, time spent watching TV, using the computer and time spent in quiet play. Multilevel repeated measures analyses were conducted to take clustering into account. Intention to treat analysis was used to handle missing data. Results: A sample of 859 (29.5 % of all contacted children) preschoolers (4.4 ± 0.6 years, 54.4 % boys) provided valid accelerometer data at either baseline or follow-up and parents of 1715 (58.9 % of all contacted children) preschoolers (4.4 ± 0.5 years, 52.5 % boys) completed a questionnaire at either baseline or follow-up. No intervention effects were found on objectively and subjectively measured total sedentary time in the total sample. However, some effects on objectively and subjectively measured sedentary time were found in specific subgroups. Preschoolers from the intervention group from high SES kindergartens and preschoolers with high levels of sedentary time at baseline decreased their sedentary time, while preschoolers from the control group increased their sedentary time. Girls in the intervention group decreased their TV viewing time during weekend days (-5.83 min/day), while girls' &TV viewing in the control group increased (+4.15 min/day). In low SES kindergartens, a smaller increase for computer time during weekend days was found in preschoolers in intervention kindergartens (+6.06 min/day) than in control kindergartens (+12.49 min/day). Conclusion: While some small positive effects were found in some sub-groups, the ToyBox-intervention had no effect on objectively and subjectively measured sedentary time in the total sample. A longer period to implement the intervention and a more active involvement of parents/caregivers might enhance intervention effects.
Full-text · Article · Dec 2016 · International Journal of Behavioral Nutrition and Physical Activity
[Show abstract][Hide abstract] ABSTRACT: Positive bystander behavior in cyberbullying among adolescents may effectively mitigate cyberbullying and its harm for the victim. Limited, scattered, and sometimes only qualitative research is available on predictors of positive (e.g. defending, comforting or reporting) and negative (e.g. passive bystanding, joining, reinforcing) bystander behavior in cyberbullying. A multidimensional model and multilevel analysis were therefore applied in this study.
Full-text · Article · Apr 2016 · Computers in Human Behavior
[Show abstract][Hide abstract] ABSTRACT: Self-regulation tools are not always used optimally, and implementation intention plans often lack quality. Therefore, this study explored participants’ use and evaluation of self-regulation techniques and their impact on goal attainment.
Data were obtained from 452 adults in a proof of concept (POC) intervention of ‘MyPlan’, an eHealth intervention using self-regulation techniques to promote three healthy behaviours (physical activity (PA), fruit intake, or vegetable intake). Participants applied self-regulation techniques to a self-selected health behaviour, and evaluated the self-regulation techniques. The quality of implementation intentions was rated by the authors as a function of instrumentality (instrumental and non-instrumental) and specificity (non-specific and medium to highly specific). Logistic regression analyses were conducted to predict goal attainment.
Goal attainment was significantly predicted by the motivational value of the personal advice (OR:1.86), by the specificity of the implementation intentions (OR:3.5), by the motivational value of the action plan (OR:1.86), and by making a new action plan at follow-up (OR:4.10). Interaction-effects with behaviour showed that the specificity score of the implementation intention plans (OR:4.59), the motivational value of the personal advice (OR:2.38), selecting hindering factors and solutions(OR:2.00) and making a new action plan at follow-up (OR:7.54) were predictive of goal attainment only for fruit or vegetable intake. Also, when participants in the fruit and vegetable group made more than three plans, they were more likely to attain their goal (OR:1.73), whereas the reverse was the case in the PA group (OR:0.34).
The chance that adults reach fruit and vegetable goals can be increased by including motivating personal advice, self-formulated action plans, and instructions/strategies to make specific implementation intentions into eHealth interventions. To increase the chance that adults reach short-term PA goals, it is suggested to keep eHealth PA interventions simple and focus only on developing a few implementation intentions. However, more research is needed to identify behaviour change techniques that can increase health goal attainment at long-term.
[Show abstract][Hide abstract] ABSTRACT: We examined the mediating role of physical activity on the relationships of walkability with Flemish older adults' health outcomes. In low income neighborhoods, residents of high walkable neighborhoods had a 1.5kg/m2 lower BMI than low walkable residents. Of this difference 0.3kg/m2 (19%) and 0.2kg/m2 (12%) were explained through walking for transport and MVPA, respectively. Similar findings were observed for waist circumference. Walkability did not relate to functional performance or quality of life. Walkable neighborhoods may benefit older adults' health, especially in low income neighborhoods. More research in other contexts is warranted to confirm current findings.
[Show abstract][Hide abstract] ABSTRACT: Background:
Active transport is a convenient way to incorporate physical activity in adolescents' daily life. The present study aimed to investigate which psychosocial and environmental factors are associated with walking, cycling, public transport (train, tram, bus, metro) and passive transport (car, motorcycle, moped) over short distances (maximum eight kilometres) among older adolescents (17-18 years), to school and to other destinations.
562 older adolescents completed an online questionnaire assessing socio-demographic variables, psychosocial variables, environmental variables and transport to school/other destinations. Zero-inflated negative binomial regression models were performed.
More social modelling and a higher residential density were positively associated with walking to school and walking to other destinations, respectively. Regarding cycling, higher self-efficacy and a higher social norm were positively associated with cycling to school and to other destinations. Regarding public transport, a higher social norm, more social modelling of siblings and/or friends, more social support and a higher land use mix access were positively related to public transport to school and to other destinations, whereas a greater distance to school only related positively to public transport to school. Regarding passive transport, more social support and more perceived benefits were positively associated with passive transport to school and to other destinations. Perceiving less walking and cycling facilities at school was positively related to passive transport to school only, and more social modelling was positively related to passive transport to other destinations.
Overall, psychosocial variables seemed to be more important than environmental variables across the four transport modes. Social norm, social modelling and social support were the most consistent psychosocial factors which indicates that it is important to target both older adolescents and their social environment in interventions promoting active transport. Walking or cycling together with siblings or friends has the potential to increase social norm, social modelling and social support towards active transport.
[Show abstract][Hide abstract] ABSTRACT: This study aimed to examine the mediating effects of energy-balance related behaviors on the association of neighborhood socio-economic status (SES) and neighborhood residential area density (RAD) with body mass index (BMI). In total, 6037 adults from four neighborhood types (high SES/high RAD, high SES/low RAD, low SES/high RAD, and low SES/low RAD) in five Mid-European urban regions completed an online survey asking about their energy-balance related behaviors (physical activity [PA], sedentary behavior, and dietary behavior), determinants of these behaviors and their body weight and height. MacKinnon's product-of-coefficients test was used to assess mediating effects. Both transport-related PA, leisure-time PA and vegetable intake seemed to mediate the association between neighborhood type and BMI. Residents from low SES/low RAD neighborhoods reported less transport-related PA, less leisure-time PA and less vegetable intake than high SES/high RAD residents, and these behaviors (i.e. transport-related PA, leisure-time PA and vegetable intake) were related to having a higher BMI.
No preview · Article · Jan 2016 · Preventive Medicine
[Show abstract][Hide abstract] ABSTRACT: Background: In Self-Determination Theory (SDT), a well-validated macro-theory on human motivation, a distinction is made between internally controlling teaching practices (e.g., guilt-induction and shaming) and externally controlling practices (e.g., threats and punishments, commands). While both practices are said to undermine students’ motivation, they would do so through somewhat differential motivational processes. Unfortunately, the relevance of the conceptual distinction between internally and externally controlling strategies has not been examined systematically. In the context of sport and physical education (PE), most studies on controlling teaching have either measured controlling teaching in an undifferentiated way or have focused on one particular feature of controlling teaching.
Purpose: The purpose of this study was to provide a more fine-grained picture on the differential de-motivational effects of internally and externally controlling teaching strategies in the domain of PE.
Participants: A total of 925 students with an average age of 15.80 years (+1.99) coming out of 92 classes taught by 22 different PE teachers participated in the present study.
Data analysis: Data on perceived controlling teaching style and students’ motivation were analyzed within a multilevel framework from both a variable-centered (regression analyses) and person-centered approach (cluster analyses).
Results: We found evidence for a distinction between perceived internally and externally controlling teaching. Both teaching styles were strongly related to each other (r = .54). At the level of zero-order correlations, both internally and externally controlling teaching related negatively to students’ intrinsic motivation and identified regulation and related positively to introjected regulation, external regulation, and amotivation. However, when both teaching styles were included simultaneously as predictors of motivation in the regression-analyses, only internally controlling teaching predicted poor quality and low quantity of motivation. A cluster analysis revealed different profiles of perceived controlling teaching style, with two profiles being characterized by either high or low levels of the two types of controlling teaching and other profiles displaying elevated or reduced levels of one of the types of controlling teaching. This person-centered analysis confirmed that particularly students who perceive their PE teacher as internally controlling are likely to report poor quality motivation.
Conclusion: Controlling teaching (and internally controlling teaching in particular) is related to maladaptive motivational outcomes. As such, it can be advise to PE-practitioners to refrain from using controlling strategies when teaching students. More research is needed to identify the conditions under which teachers’ behavior is perceived as (externally and/or internally) controlling.
Full-text · Article · Jan 2016 · Physical Education and Sport Pedagogy
[Show abstract][Hide abstract] ABSTRACT: Background. Serious digital games can be effective at changing healthy lifestyles, but large differences in their effectiveness exist. The extent of user-involvement in game design may contribute to game effectiveness by creating a better fit with user preferences. Participatory design (PD), which represents active user involvement as informant (users are asked for input and feedback) or co-designer (users as equal partners in the design) early on and throughout the game development, may be associated with higher game effectiveness, as opposed to no user involvement or limited user involvement. Objective. This paper reports the results of a meta-analysis examining the moderating role of PD in the effectiveness of serious digital games for healthy lifestyle promotion Methods. Four databases were searched for peer-reviewed papers, in English, published or in press before October 2014, and using a (group-) randomized controlled trial design. Effectiveness data were derived from another meta-analysis assessing the role of behavior change techniques and game features in serious game effectiveness. Results. Fifty-eight games evaluated in 61 studies were included. As previously reported, serious digital games had positive effects on healthy lifestyles and their determinants. Unexpectedly, PD (g=0.075; 95% CI 0.017; 0.133) throughout game development was related to lower game effectiveness on behavior (Q=6.74, P<.05) than when users were only involved as testers (g=0.520, 95% CI 0.150; 0.890, P<.01). Games developed with PD (g=0.171; 95% CI 0.061; 0.281, P<.01) also related to lower game effectiveness on self-efficacy (Q=7.83, P<.05) than when users were not involved in game design (g=0.384, 95% CI 0.283;0.485, P<.001). Some differences were noted depending on age group, publication year of the study, and on the specific role in PD (informant, co-design), and depending on the game design element. Games developed with PD were more effective in changing behavioral determinants when they included users in design elements on game dynamics (β=0.215, 95% CI 0.075; 0.356, p<.01), and more specifically, as an informant (β=0.235, 95% CI 0.079; 0.329, p<.01). Involving users as informants in PD to create game levels also related to higher game effectiveness (Q=7.02, P<.01). Co-design related to higher effectiveness when used to create the game challenge (Q=11.23, P<.01), but to lower game effectiveness when used to create characters (Q=4.36, P<.05) and the game world (Q=3.99, P<.05). Conclusions. The findings do not support higher effectiveness of games developed with PD. However, significant differences existed among PD games. More support was found for informant roles than for co-design roles. When PD was applied to game dynamics, levels and game challenge, this was associated with higher effectiveness than when it was applied to game aesthetics. Since user involvement may be important influence on reach, adoption and implementation of the intervention, further research and design efforts are needed to enhance effectiveness of serious games developed with PD.
No preview · Article · Jan 2016 · Journal of Medical Internet Research
[Show abstract][Hide abstract] ABSTRACT: This chapter describes the current research on the negative outcomes of traditional and cyberbullying concerning psychological health, physical health, social functioning, and behaviour problems. They explore these problems from the perspective of bullies, victims, bully/victims, and bystanders, and discuss whether the impact of cyberbullying compared to traditional bullying on the outcomes is equal, less, or more severe. Furthermore, they discuss the interrelatedness between (cyber-)bullying and negative (health) outcomes.
[Show abstract][Hide abstract] ABSTRACT: Background:
Chronic diseases are the principal cause of morbidity and mortality worldwide. An increased consumption of vegetables and fruit reduces the risk of hypertension, coronary heart disease, stroke, and cancer. An increased fruit and vegetable (FV) intake may also prevent body weight gain, and therefore indirectly affect type 2 diabetes mellitus. Insufficient physical activity (PA) has been identified as the fourth leading risk factor for global mortality. Consequently, effective interventions that promote PA and FV intake in a large number of people are required.
To describe the systematic development of an eHealth intervention, MyPlan 1.0, for increasing FV intake and PA.
The intervention was developed following the six steps of the intervention mapping (IM) protocol. Decisions during steps were based upon available literature, focus group interviews, and pilot studies.
Based on needs assessment (Step 1), it was decided to focus on fruit and vegetable intake and physical activity levels of adults. Based on self-regulation and the health action process approach model, motivational (eg, risk awareness) and volitional (eg, action planning) determinants were selected and crossed with performance objectives into a matrix with change objectives (Step 2). Behavioral change strategies (eg, goal setting, problem solving, and implementation intentions) were selected (Step 3). Tablet computers were chosen for delivery of the eHealth program in general practice (Step 4). To facilitate implementation of the intervention in general practice, GPs were involved in focus group interviews (Step 5). Finally, the planning of the evaluation of the intervention (Step 6) is briefly described.
Using the IM protocol ensures that a theory- and evidence-based intervention protocol is developed. If the intervention is found to be effective, a dynamic eHealth program for the promotion of healthy lifestyles could be available for use in general practice.
[Show abstract][Hide abstract] ABSTRACT: Objective:
To study the quantity and quality of water intake from beverages among pre-schoolers and investigate associations with gender and socio-economic status (SES).
Kindergarten-based cross-sectional survey within the large-scale European ToyBox-study. A standardized protocol was used and parents/caregivers filled in sociodemographic data and a semi-quantitative FFQ.
Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain).
European pre-schoolers (aged 3·5-5·5 years) and their parents/caregivers (n 7051).
Mean water intake was 1051 ml/d; plain water, 547 ml/d; plain milk, 241 ml/d; other fruit juice, 104 ml/d; pure fruit juice, 59 ml/d; soft drinks, 55 ml/d; tea, 45 ml/d; sugared and chocolate milk, 37 ml/d; smoothies, 15 ml/d; and light soft drinks, 6 ml/d. Boys had a higher water intake than girls due to a higher consumption of plain water, but more importantly to the consumption of beverages of less quality. Lower-SES pre-schoolers scored better on quantity than high-SES pre-schoolers, but as a consequence of consumption of sugared beverages. Nevertheless, the associations differed by country.
The water intake from beverages did not meet the European Food Safety Authority standard of 1280 ml/d; especially in Western European countries water intake from beverages was low. The most important water sources were plain water, milk and fruit juices. Interventions aiming at a proper and sufficient water intake should focus on both quantity and quality. Messages about water and water sources should be clear for everyone and interventions should be sufficiently tailored.
Full-text · Article · Dec 2015 · Public Health Nutrition
[Show abstract][Hide abstract] ABSTRACT: This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life.
METHODS: A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support.
RESULTS: We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation.
CONCLUSIONS: The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB.
Full-text · Article · Dec 2015 · BMC Public Health
[Show abstract][Hide abstract] ABSTRACT: Introduction: From April 2008 to August 2010 the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) intervention aimed to encourage healthier diets, higher physical activity levels and lower stress levels among European children and their families. While the intervention was intended to improve children’s health, we also wished to assess whether there were unwelcome aspects or negative side-effects. Therefore all parents of children who participated in the IDEFICS intervention were asked for their views on different aspects of the intervention.
Methods: A total of 10,016 parents of children who participated in the IDEFICS survey and who were involved in the intervention were invited to complete a questionnaire on positive and negative impacts of the intervention. Responses to each of the statements were coded on a four point Likert-type scale. Demographic data were collected as part of the baseline (T0) and first follow-up (T1) surveys; intervention exposure data was also collected in the T1 follow-up survey. Anthropometric data was collected in the same surveys, and child’s weight status was assessed according to Cole and Lobstein. After initial review of the univariate statistics multi-level logistic regression was conducted to analyse the influence of socio-economic factors, child’s weight status and intervention exposure on parental responses.
Results: In total 4,997 responses were received. Approval rates were high, and few parents reported negative effects. Parents who reported higher levels of exposure to the intervention were more likely to approve of it and were also no more likely to notice negative aspects. Less-educated and lower income parents were more likely to report that the intervention would make a lasting positive difference, but also more likely to report that the intervention had had negative effects. Parents of overweight and obese children were more likely to report negative effects – above all, that ‘the intervention had made their child feel as if he/she was “fat” or “overweight.”’
Conclusion: While the results represent a broad endorsement of the IDEFICS intervention, they also suggest the importance of vigilance concerning the psychological effects of obesity interventions on overweight and obese children.
[Show abstract][Hide abstract] ABSTRACT: The global increase of cardiovascular diseases is linked to the shift towards unbalanced diets with increasing salt and fat intake. This has led to a growing consumers’ interest in more balanced food products, which explains the growing number of health-related claims on food products (e.g., “low in salt” or “light”). Based on a within-subjects design, consumers (n = 129) evaluated the same cheese product with different labels. Participants rated liking, saltiness and fat flavor intensity before and after consuming four labeled cheeses. Even though the cheese products were identical, inclusion of health labels influenced consumer perceptions. Cheese with a “light”
label had a lower overall expected and perceived liking compared to regular cheese. Although cheese with a “salt reduced” label had a lower expected liking compared to regular cheese, no lower liking was found when consumers actually consumed the labeled cheese. All labels also influenced the perceived intensities of the attributes related to these labels, e.g., for example salt intensity for reduced salt label. While emotional profiles of the labeled cheeses differed before tasting, little differences were found when actual tasting these cheeses. In conclusion, this study shows that health-related labels might influence the perceived flavor and emotional profiles of cheese products.
[Show abstract][Hide abstract] ABSTRACT: Occupational sitting can be the largest contributor to overall daily sitting time in white-collar workers. With adverse health effects in adults, intervention strategies to influence sedentary time on a working day are needed. Therefore, the present aim was to examine employees' and executives' reflections on occupational sitting and to examine the potential acceptability and feasibility of intervention strategies to reduce and interrupt sedentary time on a working day.
Seven focus groups (four among employees, n = 34; three among executives, n = 21) were conducted in a convenience sample of three different companies in Flanders (Belgium), using a semi-structured questioning route in five themes [personal sitting patterns; intervention strategies during working hours, (lunch) breaks, commuting; and intervention approach]. The audiotaped interviews were verbatim transcribed, followed by a qualitative inductive content analysis in NVivo 10.
The majority of participants recognized they spend their working day mostly sitting and associated this mainly with musculoskeletal health problems. Participants suggested a variety of possible strategies, primarily for working hours (standing during phone calls/meetings, PC reminders, increasing bathroom use by drinking more water, active sitting furniture, standing desks, rearranging the office) and (lunch) breaks (physical activity, movement breaks, standing tables). However, several barriers were reported, including productivity concerns, impracticality, awkwardness of standing, and the habitual nature of sitting. Facilitating factors were raising awareness, providing alternatives for simply standing, making some strategies obligatory and workers taking some personal responsibility.
There are some strategies targeting sedentary time on a working day that are perceived to be realistic and useful. However several barriers emerged, which future trials and practical initiatives should take into account.
Full-text · Article · Dec 2015 · International Journal of Behavioral Nutrition and Physical Activity
[Show abstract][Hide abstract] ABSTRACT: Background:
The aim of this study was to explore whether the IDEFICS intervention had a differential effect on 11,041 children's weight trajectories depending on their baseline body mass index status.
Two subgroups of children are considered in the present analysis: those who were overweight or obese prior to the intervention and those who were neither overweight nor obese.
Among children in all eight countries who did not have prevalent overweight or obesity (OWOB) at baseline, 2 years later, there was no significant difference between intervention and control groups in risk of having developed OWOB. However, we observed a strong regional heterogeneity, which could be attributed to the presence of one distinctly outlying country, Belgium, where the intervention group had increased risk for becoming overweight. In contrast, among the sample of children with prevalent OWOB at baseline, we observed a significantly greater probability of normalized weight status after 2 years. In other words, a protective effect against persistent OWOB was observed in children in intervention regions compared with controls, which corresponded to an adjusted odds ratio of 0.76 (95% confidence interval: 0.58, 0.98).
This analysis thus provided evidence of a differential effect of the IDEFICS intervention, in which children with overweight may have benefited without having been specifically targeted. However, no overall primary preventive effect could be observed in children without initial overweight or obesity.
[Show abstract][Hide abstract] ABSTRACT: Background Recent research has illustrated the need for cross-sector partnerships to tackle multidimensional problems such as health inequalities and sport and physical activity promotion. Capacity building is based on partnerships and has demonstrated effectiveness in tackling these multidimensional problems. This study aims to explain how cross-sector partnerships build capacity at the practitioner, organisational and partnership levels. The subject of this study is a community sport program (CSP) that aims to increase sport participation rates and physical activity levels. Methods The study examined multiple cases in four disadvantaged communities in Antwerp, Belgium where the CSP was implemented. Forty-four face-to-face interviews were held with leaders from sport, social, health, culture and youth organisations that collaborated with the CSP. Results Thirteen elements of cross-sector partnerships were identified as critical to building capacity at each of the different levels. These include: process evaluation, trust, mutuality, policy support, partner complementarity and fit, diversity of activities and period of collaboration-time. Trust in turn was fostered by a longer period of collaboration-time, better personal contact, clearer coordination and an external focus. Policy support was developed by support of partners and establishing clear metrics of success. Conclusion Insight into the key elements of cross-sector partnerships that build capacity is given and several practical recommendations are suggested for practitioners and policy makers.
Full-text · Article · Dec 2015 · BMC Public Health