Biomedical subjects

J Brug

Publications and source records attributed to J Brug.

At least 19 recordsLinked to original sources

PubMed2006

Effects of tailoring health messages on physical activity.

Computer-tailored printed education can be a promising way of promoting physical activity. The present study tested whether computer-tailored feedback on physical activity is effective and whether there are differences between respondents with low and high motivation to change. Respondents (n = 487) were randomly assigned to a tailored intervention group or a no information control group. Physical activity and determinants were measured at baseline and after 3 months. At post-test, the motivated respondents in the control group were more likely not to meet the recommendation for physical activity than to meet it, and motivated respondents in the experimental group were more likely to engage in transport-related activities and showed more improvement over time for the total activity score than respondents in the control group (beta = 0.24, P = 0.02). Both groups improved their behaviour over time. No group differences in physical activity were found for the unmotivated respondents. The results showed that the effects of the tailored feedback were restricted to respondents who had a positive motivation to change at baseline. Possible explanations could be that unmotivated respondents were unwilling to read and process the information because they felt 'no need to change'. Alternatively, one tailored feedback letter may not have been sufficient for this unmotivated group.

Adolescent↗

PubMed2006

Effectiveness of an online computer-tailored physical activity intervention in a real-life setting.

The aim of this study was to evaluate the effectiveness of a computer-tailored physical activity intervention delivered through the Internet in a real-life setting. Healthy adults (n=526), recruited in six worksites, between 25 and 55 years of age were randomized to one of three conditions receiving, respectively, (i) online-tailored physical activity advice + stage-based reinforcement e-mails, (ii) online-tailored physical activity advice only, (iii) online non-tailored standard physical activity advice. At 6-month follow-up, no differences in physical activity between study conditions were found; total physical activity, physical activity at moderate intensity and physical activity in leisure time significantly increased in all study conditions between baseline and follow-up. Further evaluation of the intervention materials showed that the tailored advice was more read, printed and discussed with others than the standard advice. Most of the respondents in the e-mail group indicated to be satisfied about the number, frequency and usefulness of the stage-based e-mails. In conclusion, although tailored advice was appreciated more than standard advice, no evidence was found that an online-tailored physical activity intervention program outperformed online standard information.

Adult↗

PubMed2006

A systematic review of environmental correlates of obesity-related dietary behaviors in youth.

There is increasing interest in the role the environment plays in shaping the dietary behavior of youth, particularly in the context of obesity prevention. An overview of environmental factors associated with obesity-related dietary behaviors among youth is needed to inform the development of interventions. A systematic review of observational studies on environmental correlates of energy, fat, fruit/vegetable, snack/fast food and soft drink intakes in children (4-12 years) and adolescents (13-18 years) was conducted. The results were summarized using the analysis grid for environments linked to obesity. The 58 papers reviewed mostly focused on sociocultural and economical-environmental factors at the household level. The most consistent associations were found between parental intake and children's fat, fruit/vegetable intakes, parent and sibling intake with adolescent's energy and fat intakes and parental education with adolescent's fruit/vegetable intake. A less consistent but positive association was found for availability and accessibility on children's fruit/vegetable intake. Environmental factors are predominantly studied at the household level and focus on sociocultural and economic aspects. Most consistent associations were found for parental influences (parental intake and education). More studies examining environmental factors using longitudinal study designs and validated measures are needed for solid evidence to inform interventions.

Adolescent↗

PubMed2006

Differences in measured and self-reported height and weight in Dutch adolescents.

BACKGROUND/AIMS: Monitoring overweight prevalence and its trends in Dutch youth is frequently based on self-reported data. The validity of self-reported data especially in young adolescents is not sufficiently known. The purpose of this study is to study the validity of self-reported height and weight in 12- to 13-year-olds, to identify sociodemographic correlates and to explore whether correction factors can be developed to estimate the prevalence of overweight in youth. METHODS: 5,525 12- to 13-year-old pupils in the Rotterdam area filled in a confidential questionnaire on health topics, including their height and weight. In a sub-sample of 499 pupils both self-reported and measured height and weight were available. RESULTS: Self-reported data led to a considerable underestimation of Body Mass Index and consequently the prevalence of overweight. Underestimation was higher in pupils who regarded themselves as more fat, were of non-Dutch origin and in lower education levels. CONCLUSION: Self-reported height and weight appeared to be inappropriate to estimate the overweight prevalence in 12- to 13-year-olds, unless the figures were adjusted. Using adjusted self-reported BMI on an individual level is questionable. Actual measurements of height and weight are necessary to draw up valid correction formulas in new samples.

Adolescent↗

PubMed2006

Feasibility, acceptability, and quality of Internet-administered adolescent health promotion in a preventive-care setting.

An Internet tool for monitoring, personalized feedback and referral was developed to support routine adolescent preventive care and was compared with usual practice using paper and pencil (P&P). A total of 1071 students (average age 15 years) from seven secondary schools were randomly assigned to the Internet or P&P group. The Internet group received a health and health-behavior assessment, tailored feedback on health and health behavior (specifically fruit consumption), and an online referral to see a physician/nurse if necessary. The P&P group received the same assessment, preprinted generic advice on fruit consumption and a mailed referral (where applicable). Students and physicians/nurses completed evaluation forms to assess indicators of feasibility, acceptability (i.e. satisfaction) and quality of each administration mode. Student participation rate was 87%. The electronic health feedback was positively evaluated. Students perceived the Internet-tailored fruit advice as more pleasant, more personally targeted and more enjoyable, but less credible than the generic preprinted advice (P < 0.01). No differences in indicators of acceptability and quality of consultation were found (P > or = 0.05). Thus, the Internet can be a valuable tool to support physicians/nurses in the field of preventive care. It is recommended to further optimize and evaluate the Internet as a tool.

Adolescent↗

PubMed2006

Parent and child reports of fruit and vegetable intakes and related family environmental factors show low levels of agreement.

OBJECTIVE: The purpose of the present study was to determine the level of agreement between child and parent reports of 9- to 10-year-old children's consumption of fruit and vegetables and potential family-environmental determinants. METHODS: Schoolchildren and their parents completed parallel questionnaires at baseline and at follow-up (1 year later) about usual fruit and vegetable consumption of the child, potential determinants and general demographics. Matched child-parent couples were included in the analyses (baseline = 380; follow-up = 307). To assess the level of agreement between child and parent reports at both points in time, dependent-sample t-test, correlation coefficients, weighted Cohen's kappa coefficients and Bland-Altman plots including limits of agreement were used. RESULTS: Both at baseline and at follow-up, the mean intake of fruit and vegetable reported by the children were significantly higher than reported by their parents, but differences were smaller at follow-up. Correlation coefficients between child and parent reports (0.28-0.43) and weighted Cohen's kappa coefficients (0.25-0.28) were weak to moderate. Limits of agreement were wide. CONCLUSION: The agreement between parent and child reports is weak to moderate and may depend on the age of the child. Fourth graders may overestimate their own intake of fruit and vegetables.

Adult↗

PubMed2006

Underestimation and overestimation of personal weight status: associations with socio-demographic characteristics and weight maintenance intentions.

OBJECTIVE: Unwarranted underestimation and overestimation of personal weight status may prevent weight maintenance behaviour. The present study reports on correlates of under- and overestimation of personal weight status and the association with weight maintenance intentions and self-reported action. DESIGN: Comparison of three cross-sectional surveys, representing different population groups. SUBJECTS: Survey 1: 1694 adolescents 13-19 years of age; survey 2: 979 nonobese adults 25-35 years of age; survey 3: 617 adults 21-62 years of age. MEASUREMENTS: Self-administered written questionnaires (surveys 1 and 3) and telephone-administered questionnaires (survey 2); self-reported BMI, self-rated weight status, intentions and self-reported actions to avoid weight gain or to lose weight, sex, age, education and ethnic background. Respondents were classified as people who are realistic about personal body weight status or people who under- and overestimate their body weight status, based on BMI and self-rated weight status. RESULTS: Most respondents in the three survey populations were realistic about their weight status. Overestimation of weight status was consistently more likely among women, whereas underestimation was more likely among men, older respondents and respondents from ethnic minorities. Self-rated weight status was a stronger correlate of intentions and self-report actions to avoid weight gain than weight status based on Body Mass Index. CONCLUSIONS: Relevant proportions of the study populations underestimated or overestimated their bodyweight status. Overestimation of personal weight status may lead to unwarranted weight maintenance actions, whereas underestimation may result in lack of motivation to avoid further weight gain.

Adolescent↗

PubMed2005

Participation rates in worksite-based intervention studies: health promotion context as a crucial quality criterion.

Recently, a set of specific quality evaluation criteria for health promotion research has been proposed in this journal. One of the quality criteria identified is the 'health promotion context'. With this paper we would like to contribute to the dialogue by specifying the importance of this criterion on the basis of our on experience with worksite-based obesity prevention interventions. We advocate the reporting of participation rates among approached worksites in publications on worksite intervention effects. Such information will help to draw conclusions on the practical relevance of the shown effectiveness of the intervention. Health promotion practice is advised to adopt and disseminate evidence-based interventions, accompanied by a diffusion study with a minimal research burden for participants.

Health Promotion↗

PubMed2005

The Dutch heart health community intervention 'Hartslag Limburg': results of an effect study at organizational level.

BACKGROUND: 'Hartslag Limburg', a cardiovascular diseases (CVD) prevention programme, integrates a community strategy and a high-risk strategy to reduce CVD risk behaviours. This article presents the results of the effect evaluation study of the community intervention at the organizational level. Organizational changes were an intermediate goal of the Hartslag Limburg community intervention, as these are assumed to be a prerequisite for changes at the individual level. METHODS: A baseline-post-test control group design was used. The baseline measurement was conducted in 1998 and the post-test measurement in 2001. At baseline, 700 organizations were selected in the Maastricht region, and 577 in a control region. All organizations that were potentially significant agents in health-promoting activities were included. Data on organizational involvement in health-promoting activities were gathered by means of structured questionnaires, and sent to organization representatives by mail. RESULTS: The overall post-test percentage of organizations involved in at least one activity relating to physical activity was higher in the Maastricht region than in the control region. Furthermore, the number of activities per organization involved in activities relating to healthy eating, smoking behaviour or physical activity was higher in the Maastricht region than in the control region at post-test. CONCLUSIONS: This study provided valuable information about organizational involvement in health-promoting activities, as well as important information to consider in future research in this area. Due to the limitations of the study, the importance of measuring change at different social levels in community-based programmes, and the scarcity of effect studies of community interventions at the organizational level, further research on this subject is warranted.

Cardiovascular Diseases↗

PubMed2005

Neighbourhood inequalities in physical inactivity: the role of neighbourhood attractiveness, proximity to local facilities and safety in the Netherlands.

We investigated the association between the neighbourhood socioeconomic environment and physical inactivity, and explored the contribution of neighbourhood characteristics to this association. Data were analysed of 20-69 years old participants of the Dutch GLOBE study who lived in 78 neighbourhoods of Eindhoven (n = 8.767). The neighbourhood socioeconomic environment was assessed from aggregated self-reported information of participants' education and occupation level, and employment status. Aspects of physical inactivity investigated were based on the time spent on (a) walking and cycling to shops or work, (b) walking, cycling and gardening in leisure time, and (c) participation in sports activities. Characteristics of neighbourhoods included the proximity to food shops, general physical design of neighbourhoods, quality of green facilities, noise pollution from traffic and required police attention as evaluated by municipal services (professionals) responsible for these characteristics. Compared to those living in the most advantaged neighbourhoods, residents living in the quartile of socio-economically most disadvantaged neighbourhoods were more likely to walk or cycle to shops or work, but less likely to walk, cycle or garden in leisure time and less likely to participate in sports activities (adjusted for age, sex and individual educational level). Neighbourhood inequalities in walking or cycling to shops or work were not mediated by specific neighbourhood characteristics included in our analyses. The increased probability of almost never walking, cycling and gardening in leisure time in the most disadvantaged neighbourhoods was partly mediated by a poorer general physical design in these neighbourhoods. Similarly, the increased probability of almost never participating in sports activities in the most disadvantaged neighbourhoods was partly mediated by larger amounts of required police attention. The direction of neighbourhood inequalities differs for aspects of physical inactivity. Neighbourhood characteristics are related to physical inactivity and contribute to neighbourhood socioeconomic inequalities in physical inactivity.

Adult↗

PubMed2005

The impact of an organ donation registration information program for high school students in the Netherlands.

In 1998, a new organ donor registration system was implemented in the Netherlands to increase the number of potential donors. A high school education program was developed to prepare adolescents to make an informed decision about organ donation. A post-test only randomised controlled trial was conducted in 39 high schools including 2868 students. Students within schools were randomly allocated to either attend the organ donation education program or not. The impact of the program on students' intention to register their organ donation preference (and determinants thereof) were analysed using multivariate multileveling modelling (MlwiN). The results show that students who were exposed to the education program had more favourable registration intentions (B = .40), were more often willing to be donors (OR = 1.45), and had greater knowledge about (B = 3.84) and more positive social outcome expectations (B = .09) and self-efficacy regarding organ donation registration (B=.22). Lastly, they experienced significantly less negative outcome expectations related to organ donation registration (B = -.15). Students' evaluation of the school-based education program was favourable. The present organ donation registration program proved to be effective in changing determinants of organ donation registration, and a large-scale implementation in the Dutch high school curriculum is planned.

Adolescent↗

PubMed2005

Netherlands research programme weight gain prevention (NHF-NRG): rationale, objectives and strategies.

OBJECTIVE: To outline the rationale, objectives and strategies used in a systematically designed research programmme to study specific weight gain-inducing behaviours, their social-psychological as well as environmental determinants, and the effects of interventions aimed at the prevention of weight gain. DESIGN: The evidence for potential behavioural determinants and strategies to prevent weight gain was reviewed, and the methods applied within the Netherlands Research programme weight gain prevention (NHF-NRG) project were described. The project is designed according to the Intervention Mapping protocol. SETTING: The Netherlands. SUBJECTS: The main target groups are (a) adolescents (12-16 y) in secondary school, (b) young adults (20-40 y) at the workplace and (c) recently retired people (55-65 y) at home. INTERVENTIONS: Each intervention includes an individual component, in which computer-tailored information is provided. Additionally, interventions are aimed at changing environmental components. RESULTS: The short-term results of this project can be expected by the beginning of 2005. Guidelines for nationwide weight gain prevention, based on this research programme, will become available in 2007. CONCLUSIONS: Based on the few interventions that were evaluated to date, no robust conclusions can be drawn regarding the effectiveness of obesity prevention. The systematic and multidisciplinary design of the NHF-NRG programme enables the identification of potentially effective methods and strategies for the prevention of weight gain.

Adolescent↗

PubMed2005

The internet and nutrition education: challenges and opportunities.

OBJECTIVE: To review the possibilities of using the Internet and especially the World Wide Web (WWW) in nutrition education. RESULTS: A healthy existence is partly dependent on dietary behaviours. One way to promote health-promoting dietary habits is nutrition education. In the last decades several potentially important new channels for health communication and nutrition education have emerged, with the Internet and its WWW as the most striking example. The introduction and growth of the WWW has enabled swift and inexpensive distribution of nutrition education expertise and materials. Furthermore, the WWW has also been used for tailoring nutrition education to the personal characteristics of the user. Only few studies have investigated the effects of generic web-based nutrition education, while web-based computer-tailored nutrition education has been studied in randomised controlled trials, with promising but mixed results. Two important challenges for web-based nutrition education interventions are to realise sufficient exposure and to ensure sufficient source reliability and credibility. CONCLUSIONS: Next to the great opportunities, there are many challenges for web-based nutrition education. Some evidence for effects of web-based computer-tailored nutrition education has been reported, but more research is needed to obtain evidence for the effectiveness in real-life situations.

Computer-Assisted Instruction↗

PubMed2005

Reliability and validity of a questionnaire to measure personal, social and environmental correlates of fruit and vegetable intake in 10-11-year-old children in five European countries.

OBJECTIVES: To investigate the internal consistency of the scales and the test-retest reliability and predictive validity of behaviour theory-based constructs measuring personal, social and environmental correlates of fruit and vegetable intake in 10-11-year-old children. DESIGN: Test-retest with one-week interval. SETTING: Five European countries: Norway, Spain, Denmark, Portugal, Belgium. SUBJECTS: Three hundred and twenty-six children completed the questionnaire during class hours. RESULTS: For the total sample across all countries, the test-retest reliability was good to very good (intra-class correlation coefficient (ICC) >0.60) for 12 out of the 15 fruit constructs and also for 12 out of the 15 vegetable constructs. Acceptable ICCs, ranging between 0.50 and 0.59, were found for the remaining constructs. Test-retest reliability was comparable across countries. Only in Portugal were some significantly lower ICCs found for some constructs (knowledge and barriers related to fruit, general self-efficacy related to fruit and vegetables) compared with the other countries. Cronbach's alpha values were moderate to high (range 0.52 to 0.89) with the exception of the general self-efficacy scale, which had a value below 0.50 for both fruit (alpha=0.42) and vegetables (alpha=0.49). Spearman correlations with intake ranged between -0.16 and 0.54 for personal determinants and between 0.05 and 0.38 for environmental determinants. Compared with other studies, predictive validity can be considered moderate to good. CONCLUSIONS: The questionnaire provides a reliable, valid and easy-to-administer tool for assessing personal, social and environmental factors of potential influence on fruit and vegetable intake in 10-11-year-olds.

Attitude to Health↗

PubMed2005

Why do adolescents eat what they eat? Personal and social environmental predictors of fruit, snack and breakfast consumption among 12-14-year-old Dutch students.

OBJECTIVE: The aim of the study was to investigate the relative importance of personal and social environmental predictors of the consumption of fruit, high-fat snacks and breakfast. DESIGN: A school-based cross-sectional survey. Data were collected through written questionnaires. SETTING: Students from eight schools in the southern part of The Netherlands. SUBJECTS: Six hundred and one students from preparatory secondary vocational education schools. RESULTS: About a quarter of the variation in actual behaviours and intentions to change the behaviours could be explained. Stepwise multiple regression analysis revealed that, for all three behaviours, higher intention to change was especially associated with a more positive attitude and subjective norm, and higher intentions to increase fruit intake with more positive self-efficacy expectations. With regard to actual consumption, a more positive attitude towards eating fruit was the only significant correlate of a higher consumption of fruit. A more positive attitude towards eating high-fat snacks, perceived lower intake of the mother, and higher food availability and accessibility were associated with consumption of high-fat snacks, and a more positive attitude to breakfast more frequently was associated with more frequent breakfast consumption. CONCLUSION: The results indicate that adolescents' attitudes are the most important determinants of different health-related eating behaviours and intentions to change. Interventions promoting a healthy diet for adolescents should include creative strategies to achieve positive associations with healthy dietary changes.

Adolescent↗

PubMed2005

The impact of a nutrition education intervention on main meal quality and fruit intake in people with financial problems.

BACKGROUND: As part of a course teaching household budgeting, a nutrition education intervention was provided to people with financial problems. The present study aimed at assess the effects of this intervention on the nutritional quality of their main meal and fruit intake, and to collect process information on intervention participation, reactions and opinions. METHODS: For the effect study, a quasi-experimental multiple pre and post-test control group design was used. Telephone dietary recalls were conducted with 35 people in the intervention group and 39 people in the control group. Observations, personal interviews and written questionnaires were used to collect the process data. RESULTS: A significant reduction in saturated fat intake during the mail meal was found. Also, an intervention effect was found for fruit juice consumption, but not for daily fruit intake or vegetable intake during main meal occasions. CONCLUSIONS: The process data revealed some improvements that should be made to the intervention, such as providing more individualized information and tailored recipes.

Adult↗

PubMed2005

Determinants of fruit and vegetable consumption among 6-12-year-old children and effective interventions to increase consumption.

PURPOSE: To review the current literature about potential determinants of fruit and vegetable intakes and effective intervention strategies to increase the consumption of fruits and vegetables among 6-12-year-old children. METHODS: A structured review of literature located in PubMed and Psychinfo electronic literature databases. RESULTS: Of all determinants, the availability and accessibility of fruit and vegetables and taste preferences were most consistently and most positively related to consumption. There was some evidence that parental fruit and vegetable intakes, knowledge of intake recommendations and skills had a positive association with children's intakes, whereas television viewing, exposure to television advertisement, and having a snack bar at school were associated with lower intakes of fruit and vegetables. Multi-component school-based interventions that combined classroom curriculum, parent and food service components showed the greatest promise for fruit and vegetable promotion among children. School fruit and vegetable subscription programmes, scout-based interventions, and fruit and vegetables education via computer multi-media channels also appear promising. CONCLUSIONS: Interventions should improve the availability and accessibility of fruit and vegetables to children, and should aim to improve their taste preferences for them. Such interventions should be of a multi-component nature, school-based or use other social channels and may include multi-media channels.

Child↗

PubMed2005

Why don't young people volunteer to give blood? An investigation of the correlates of donation intentions among young nondonors.

BACKGROUND: In the past decade, the number of blood donors has steadily declined in the Netherlands, and young adults are underrepresented among registered donors. An understanding of the correlates of donation intentions among nondonors could facilitate targeting psychological prerequisites of donation decisions in recruitment campaigns. STUDY DESIGN AND METHODS. A cross-sectional study with self-administered questionnaires based on an extension of the Theory of Planned Behavior (TPB; a social cognition model to study the determinants of volitional behavior) was conducted to assess potential cognitive determinants of willingness to donate blood in a student sample. A response rate of 50.5 percent yielded a sample of 311. RESULTS: Just over 7 percent of participants were registered blood donors but most (61.7%) had never seriously considered becoming donors. Self-efficacy (confidence in performing the behavior), attitude (the overall evaluation of the behavior), and personal moral norm (the perceived personal responsibility to perform the behavior) regarding blood donation were the most important correlates of the intention to become a blood donor. In total, 43 percent of the variance in the intentions toward blood donation could be explained by a TPB-based model. CONCLUSION: Among students, determinants of the intention to become a blood donor include self-efficacy, attitude, personal moral norm regarding blood donation, and subjective norm (perceived social support). Future research could establish whether campaigns targeting these psychological prerequisites would be more effective than current strategies.

Adolescent↗