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      Bewegungsförderung bei sozial benachteiligten Frauen : Erkenntnisse zur Zielgruppenerreichung, Kursbindung und Wirkung des BIG-Projekts als Fallstudie für partizipative Interventionen im kommunalen Setting Findings on target group outreach, course retention, and impact of the BIG project as a case study for participatory interventions in community settings

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          Zusammenfassung

          Hintergrund

          Das Projekt „Bewegung als Investition in Gesundheit“ (BIG) – ein partizipatives Projekt im kommunalen Setting – wurde 2005 entwickelt, um benachteiligten Frauen den Zugang zu körperlich-sportlicher Aktivität zu erleichtern. Seitdem wurde BIG deutschlandweit auf 17 Kommunen übertragen.

          Ziel

          Es wird untersucht, ob im BIG-Projekt sozial benachteiligte Frauen erreicht und an Bewegungskurse gebunden werden können. Zudem werden die Angaben der Frauen zu deren Gesundheitszustand und Sporttreiben berichtet. Zuletzt wird geprüft, ob 5 Risikofaktoren einer sozialen Benachteiligung sowie das Sporttreiben mit dem Gesundheitszustand assoziiert sind.

          Methode

          Quantitative Querschnittsdaten aus 6 Erhebungswellen (2006–2013) zweier Projektstandorte (Erlangen, Regensburg) wurden aggregiert. Zur Analyse der Zielgruppenerreichung wurden die Charakteristika der Teilnehmerinnen ( N = 430) mit Bevölkerungsdaten der Standorte verglichen. Zielgruppenerreichung, Kursbindung und Angaben zu Gesundheitszustand und Sporttreiben wurden darüber hinaus deskriptiv analysiert. Der Einfluss der Risikofaktoren und des Sporttreibens wurde durch multivariate Regressionsanalyen untersucht.

          Ergebnisse

          Von den Teilnehmerinnen wiesen 67 % mindestens einen Risikofaktor auf. Die Frauen nahmen im Mittel 2,4 Jahre an den BIG-Kursen teil. Über 50 % der Frauen berichteten einen verbesserten Gesundheitszustand, über 60 % trieben im Vergleich zu der Zeit vor BIG mehr Sport. Die Anzahl vorliegender Risikofaktoren war mit dem Gesundheitszustand im Vergleich zur Zeit vor BIG ( p < 0,001) assoziiert. Mangelnde Deutschkenntnisse zeigten einen signifikanten Zusammenhang mit dem aktuellen Gesundheitszustand.

          Schlussfolgerung

          Das BIG-Projekt erreicht sozial benachteiligte Frauen. Insbesondere Frauen mit wenig Risikofaktoren berichten positive Veränderung des Gesundheitszustands und Sporttreibens verglichen zur Zeit vor der BIG-Teilnahme. Hier scheinen die Anzahl vorliegender Risikofaktoren, sowie mangelnde Deutschkenntnisse von Bedeutung zu sein.

          Abstract

          Background

          The BIG project—a participatory project in a community setting (“Bewegung als Investition in Gesundheit”)—was developed in 2005 to facilitate access to physical activity for disadvantaged women. Since then, BIG has been transferred to 17 municipalities.

          Aim

          To investigate whether socially disadvantaged women can be reached and retained in exercise classes in the BIG project. In addition, the information provided by the women on their state of health and exercise is reported. Finally, we will examine whether five risk factors associated with social disadvantages are associated with health status and physical activity.

          Methods

          Quantitative cross-sectional data from six survey waves (2006–2013) from two project sites (Erlangen, Regensburg) were summarized. To analyze the reach of the target group, participant characteristics ( N = 430) were compared with population data from the sites. The reach of the target group, course retention, and data on health status and physical activity were also descriptively analyzed. The influence of risk factors and physical activity on health status was examined by multivariate regression analyses.

          Results

          Of the participants, 67% had at least one risk factor. Women participated in the BIG courses for a mean of 2.4 years. Over 50% of women reported improved health, and over 60% exercised more compared with before BIG. The number of risk factors present was associated with the health status compared to the time before BIG ( p < 0.001). Lack of German language skills showed a significant association with current health status.

          Conclusions

          The BIG project reaches socially disadvantaged women. In particular, women with few risk factors report positive change in health status and physical activity compared to the time before BIG participation. Here, the number of risk factors present and lack of German language skills seem to be important.

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          Most cited references40

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          Correlates of physical activity: why are some people physically active and others not?

          Physical inactivity is an important contributor to non-communicable diseases in countries of high income, and increasingly so in those of low and middle income. Understanding why people are physically active or inactive contributes to evidence-based planning of public health interventions, because effective programmes will target factors known to cause inactivity. Research into correlates (factors associated with activity) or determinants (those with a causal relationship) has burgeoned in the past two decades, but has mostly focused on individual-level factors in high-income countries. It has shown that age, sex, health status, self-efficacy, and motivation are associated with physical activity. Ecological models take a broad view of health behaviour causation, with the social and physical environment included as contributors to physical inactivity, particularly those outside the health sector, such as urban planning, transportation systems, and parks and trails. New areas of determinants research have identified genetic factors contributing to the propensity to be physically active, and evolutionary factors and obesity that might predispose to inactivity, and have explored the longitudinal tracking of physical activity throughout life. An understanding of correlates and determinants, especially in countries of low and middle income, could reduce the eff ect of future epidemics of inactivity and contribute to effective global prevention of non-communicable diseases.
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              Is Open Access

              Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes

              Background Community participation is widely believed to be beneficial to the development, implementation and evaluation of health services. However, many challenges to successful and sustainable community involvement remain. Importantly, there is little evidence on the effect of community participation in terms of outcomes at both the community and individual level. Our systematic review seeks to examine the evidence on outcomes of community participation in high and upper-middle income countries. Methods and findings This review was developed according to PRISMA guidelines. Eligible studies included those that involved the community, service users, consumers, households, patients, public and their representatives in the development, implementation, and evaluation of health services, policy or interventions. We searched the following databases from January 2000 to September 2016: Medline, Embase, Global Health, Scopus, and LILACs. We independently screened articles for inclusion, conducted data extraction, and assessed studies for risk of bias. No language restrictions were made. 27,232 records were identified, with 23,468 after removal of duplicates. Following titles and abstracts screening, 49 met the inclusion criteria for this review. A narrative synthesis of the findings was conducted. Outcomes were categorised as process outcomes, community outcomes, health outcomes, empowerment and stakeholder perspectives. Our review reports a breadth of evidence that community involvement has a positive impact on health, particularly when substantiated by strong organisational and community processes. This is in line with the notion that participatory approaches and positive outcomes including community empowerment and health improvements do not occur in a linear progression, but instead consists of complex processes influenced by an array of social and cultural factors. Conclusion This review adds to the evidence base supporting the effectiveness of community participation in yielding positive outcomes at the organizational, community and individual level. Trial registration Prospero record number: CRD42016048244.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                German Journal of Exercise and Sport Research
                Ger J Exerc Sport Res
                Springer Science and Business Media LLC
                2509-3142
                2509-3150
                June 09 2023
                Article
                10.1007/s12662-023-00893-8
                7cba0adc-2b1c-4340-bbee-67292afeaa68
                © 2023

                https://creativecommons.org/licenses/by/4.0

                https://creativecommons.org/licenses/by/4.0

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