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82 p. -- Bibliogr.: p. 43-51 [EUS] Aisian emakumeek gizonezkoek baino jarduera fisiko (JF) gutxiago egiten dutela jakinda eta emakume etorkinek are gutxiago, ikerketa honen helburua, Lasarte-Oriako emakume latinoamerikarrek aisian jarduera fisikoa egiteko dituzten oztopo eta arrazoiak ezagutzea izan zen, baita haien behar eta interesen inguruko informazio lortzea ere. Honetarako, ikuspegi feministak eta eredu sozioekologikoak oinarri hartuta metodologia kualitatiboa erabili zen. Elkarrizketa teknika bitartez, sakontzeko galdeketak eginez, parte-hartzaileen ahotsak, bizipen eta begirada ezagutzea lortu zen. Hauen ahotsetan JF egiteko oztopoak emakumea eta etorkina izateak dakarrenetik, zaintza ardurak dakarren denbora faltaraino. JF egiteko aukerei dagokienean, berriz, JF egiteko arrazoi nagusia askatasun unerako erabiltzen zutela izan zen. Emakumeek etorkizunera begira egindako proposamenen artean adierazi zuten, emakumeei bideratutako jardueren eskaintza zabalduko balute eta diru-sarrerak kontuan hartuko balituzte lagunduko lukeela euren bizi estiloa aldatzen eta JF egiteko aukerak zabaltzen. Ondorioz, emakume hauek emakume izateagatik dituzten zaintza ardurak eta gorputz irudiaren estereotipoen oztopoez gain, migrazio-politikek, besteen begiradek eta gutxiespenek hesi handiagoa sorrarazten dute, JF egiteko orduan eraginez. [ES] Se ha constatado que en su ocio las mujeres realizan menos actividad física que los hombres y las mujeres inmigrantes menos aún. El objetivo de este trabajo fue conocer los hábitos, obstáculos y razones de la actividad física en el tiempo libre de mujeres latinoamericanas de Lasarte-Oria para así, conocer sus necesidades e intereses. Para ello, mediante el método cualitativo, se ha usado como base la prespectiva feminista y el modelo socioecólogico. Mediante la técnica de entrevista se han logrado las voces, vivencias y la mirada de estas mujeres. En general, han destacado los obstáculos, desde lo que conlleva ser mujer e inmigrante hasta lo que suponen las responsabilidades de cuidado. La razón más importante para practicar actividad física fue tener un momento de desconexión. Las mujeres hicieron hincapié en propuestas de mejora para el futuro como ofrecer más actividades dirigidas a mujeres teniendo en cuenta sus ingresos. En consecuencia, además de las barreras asociadas a los estereotipos de la imagen corporal y de las responsabilidades de cuidado que tienen estas mujeres por el hecho de ser mujeres, las políticas migratorias, las miradas ajenas y los menosprecios han puesto de manifiesto una mayor barrera en la práctica de la actividad física. [EN] Women are less active in leisure than men, and more so in immigrant women. The purpose of this study was to recognize the difficulties and the reasons for doing physical activity of Latin women in leisure, and to obtain information about their needs and interests. A qualitative methodology was used based on feminist views and socioecological models. Through conversational techniques, deepening interrogations, the voices of participants became known for their experience and their gaze. The results underlined the inconvenience of being a woman and an immigrant in their voices as well as the lack of time due to caring responsibilities. The main reason to be physically active was that it was their moment of freedom. They pointed out among their proposals for the future, that if they were to extend the offer of activities aimed at women and take into account their income, it would help change their lifestyle and expand their chances of being physically active. Consequently, besides the obstacles such as stereotypes ans caring responsibilities, and stereotyopes related to the body image of these women for being women, they also answered that migration policies, the looks and the diminution of others create a greater barrier to physical activity.

The study aims were to 1) examine profiles of perception of motor competence (PMC) in relation to actual motor competence (AMC), i.e. under-estimators (UEs), realistic estimators (REs) and over-estimators (OEs) and 2) investigate associations between the profiles and selected socioecological factors at the individual, family and environmental levels. PMC (Pictorial Scale of Perceived Movement Skill Competence) and AMC (Test of Gross Motor Development-Third Edition) were administered to a representative sample of children from 37 childcare centres in Finland (n=441;6.2±0.6yrs;52% boys). Socioecological factors were investigated using a parental questionnaire. The three profiles were formed based on age- and gender-adjusted PMC and AMC z-scores. Multinomial logistic regression showed that OEs (n=81; p=0.04) tended to be younger than REs (n=306; p=0.04) and UEs (n=54; p=0.03). Parents of OEs reported more child health and developmental issues than parents of REs (p=0.03). Parents of UEs self-reported providing more support for physical activity than parents’ of REs (p=0.04). REs tended to live in denser population areas than UEs (n=54; p=0.03). Whilst PMC profiles revealed some socioecological differences, future research needs to focus on a broader range of potential correlates and untangle methodological analyses challenges to deepen the knowledge about PMC development in children.

The study aims were to 1) examine profiles of perception of motor competence (PMC) in relation to actual motor competence (AMC), i.e. under-estimators (UEs), realistic estimators (REs) and over-estimators (OEs) and 2) investigate associations between the profiles and selected socioecological factors at the individual, family and environmental levels. PMC (Pictorial Scale of Perceived Movement Skill Competence) and AMC (Test of Gross Motor Development-Third Edition) were administered to a representative sample of children from 37 childcare centres in Finland (n=441;6.2±0.6yrs;52% boys). Socioecological factors were investigated using a parental questionnaire. The three profiles were formed based on age- and gender-adjusted PMC and AMC z-scores. Multinomial logistic regression showed that OEs (n=81; p=0.04) tended to be younger than REs (n=306; p=0.04) and UEs (n=54; p=0.03). Parents of OEs reported more child health and developmental issues than parents of REs (p=0.03). Parents of UEs self-reported providing more support for physical activity than parents’ of REs (p=0.04). REs tended to live in denser population areas than UEs (n=54; p=0.03). Whilst PMC profiles revealed some socioecological differences, future research needs to focus on a broader range of potential correlates and untangle methodological analyses challenges to deepen the knowledge about PMC development in children.

(1) The harm-reduction benefits of opioid agonist treatment (OAT) are well-established; however, the UK government’s emphasis on “recovery” may be contributing to a high proportion of people leaving treatment and low retention rates. We wanted to develop a rich and nuanced understanding of the factors that might influence the treatment journeys of people who use OAT. (2) We explored factors at each level of the socioecological system and considered the ways these interact to influence treatment journeys in OAT. We carried out semi-structured interviews with people who use OAT (n = 12) and service providers (n = 13) and analysed data using reflexive thematic analysis. (3) We developed three themes representing participant perceptions of treatment journeys in OAT. These were: (1) The System is Broken; (2) Power Struggles; and (3) Filling the Void. (4) Conclusions: The data suggest that prioritisation of treatment retention is important to preserve the harm-reduction benefits of OAT. Stigma is a systemic issue which presents multiple barriers to people who use OAT living fulfilling lives. There is an urgent need to develop targeted interventions to address stigma towards people who use OAT.

With a stratified multi-stage sampling approach, 1361 male factory workers in the Longhua district of the Shenzhen Municipality of China were selected to investigate the multifaceted determinants of sexual intercourse with non-regular female sex partners (NRP) and female sex workers (FSW) among them. The results showed that 24.5% and 21.2% of participants had sexual intercourse with NRP and FSW in the past 6 months, respectively. More specifically, at the individual level, perceived higher job stress and maladaptive coping styles were linked with a higher likelihood of having sexual intercourse with NRP and FSW (adjusted odds ratios [AOR] ranged from 1.06 to 1.17). At the interpersonal level, those who had higher exposure to information related to sexual intercourse with NRP or FSW were more likely to have sex with these female sex partners (AOR: 1.08 & 1.11). At the social structural level, perceived social norms supporting multiple sex partnerships were linked with a higher likelihood of having sexual intercourse with NRP and FSW (AOR: 1.10 & 1.11). No interaction effects were found between the variables at different levels. Providing pre-employment training to clarify roles and job duties, introducing adaptive coping strategies, and addressing misconceptions of social norms are useful strategies to reduce sexual intercourse with NRP or FSW.

Despite the many benefits of club-organized sports participation for children, studies have shown that sports participation is lower among children from low-income families than among children from middle- or high-income families. Adopting a socioecological perspective, the main aim of our study was to identify and describe experiences of person-environment (PE) misfits in relation to parental facilitation of children's sports participation. We conducted 24 interviews with parents from low-income families. PE misfits were found in multiple behaviors related to the facilitation of children's sports participation: financing sports participation; planning and investing time; transporting children; acquiring, processing, and providing information; and arranging support. Across these PE misfits, influential attributes were found on the individual level (e.g., skills) as well as within the social, policy, physical, and information environment. In response to PE misfits experienced, parents deployed multiple strategies to reduce these PE misfits, aimed at enhancing either themselves (e.g., increasing financial capacities) or their environments (e.g., arranging social support). These results provide an insight into experienced PE misfits that took the form of multiple specific behaviors which parents found difficult while facilitating their children's sports participation. Furthermore, the results provide insight into the environmental and individual attributes that were involved in these PE misfits, and into how parents modified themselves or their environments in order to make their environments more supportive. The study contributes to future research on individual and environmental influences on parental facilitation of their children's sports participation, as well as on the development of multilevel interventions aimed at increasing sports participation among children from low-income families.

Despite the many benefits of club-organized sports participation for children, studies have shown that sports participation is lower among children from low-income families than among children from middle- or high-income families. Adopting a socioecological perspective, the main aim of our study was to identify and describe experiences of person–environment (PE) misfits in relation to parental facilitation of children’s sports participation. We conducted 24 interviews with parents from low-income families. PE misfits were found in multiple behaviors related to the facilitation of children’s sports participation: financing sports participation; planning and investing time; transporting children; acquiring, processing, and providing information; and arranging support. Across these PE misfits, influential attributes were found on the individual level (e.g., skills) as well as within the social, policy, physical, and information environment. In response to PE misfits experienced, parents deployed multiple strategies to reduce these PE misfits, aimed at enhancing either themselves (e.g., increasing financial capacities) or their environments (e.g., arranging social support). These results provide an insight into experienced PE misfits that took the form of multiple specific behaviors which parents found difficult while facilitating their children’s sports participation. Furthermore, the results provide insight into the environmental and individual attributes that were involved in these PE misfits, and into how parents modified themselves or their environments in order to make their environments more supportive. The study contributes to future research on individual and environmental influences on parental facilitation of their children’s sports participation, as well as on the development of multilevel interventions aimed at increasing sports participation among children from low-income families.

This rapid qualitative exploratory study focused on perceptions of adopting risk-reduction measures, such as face masks, on campuses within institutions of higher education in the United States. It was intended to identify safety measures to reduce virus spread and develop community-informed public health messaging to promote COVID-19 risk-reduction strategies within campus communities. This study was approved by the institutional review board where the study took place. A total of 113 stakeholders, including students, staff, and faculty attended one of nine focus groups. We use the socioecological model to illustrate the use of COVID-19 public health measures in private and public spaces and how macro-level processes, specifically sociocultural values of personal freedom and social responsibility shape the meaning and interpretation of COVID-19 public health measures. A rapid qualitative data analysis was conducted. This analysis was characterized by three steps: (1) transcription of the interviews, (2) completion of a summary template per focus group analysis (data reduction strategy), and (3) matrix analyses involving a cross-case analysis of the nine focus groups conducted. Based on study findings, we offer community-centered recommendations for safe and healthy reopening of large public research institutions. This article contributes to the foundation of scientific literature that qualitatively describes evidence-based strategies for safe reopening of places of education and employment in the COVID-19 pandemic.

In the last few years, the World Health Organization has highlighted that physical inactivity is a global issue affecting women to a greater extent than men. Faced with this, different nation states have developed public policies to reduce physical inactivity at school; however, the biomedical and individualistic models used have generated widespread criticism, as figures remain the same. In the context of failed interventions on increasing levels of physical activity, this study utilizes a socioecological model to analyze and understand how physical inactivity is reproduced in girls in the Chilean education system. A qualitative study was implemented, as it allows a focus on the entailed meanings, context, and processes. Active semi-structured interviews were conducted with 40 groups comprising headmasters, teachers, non-teachers, students, and families. The results show that physical inactivity is linked to factors that go beyond the individualistic model; that is, consideration must include intrapersonal, interpersonal, organizational, community, and public policy dimensions. Furthermore, gender stereotypes gain relevance in physical education classes, in addition to friendships and family, teaching, and administrative work, access to safe play areas, use of spaces, and widespread cultural factors associated with men and women. This study concludes that the assessed gender differences should be approached from a pedagogical perspective beyond common sense, further reporting that the individualized explanation for physical inactivity is irrelevant to answer why women are more inactive than men.

Purpose: This qualitative study explores the barriers and facilitators to health care from the perspective of providers who care for patients without documentation status in the San Francisco Bay Area. Methods: Twenty-four direct providers were interviewed using semi-structured in-depth interviews. Participants included health care providers and community-based organization leaders. Interviews were independently coded using grounded theory analysis. The socioecological framework was used to develop the interview guide, analyze findings, and guide the discussion. Results: Participants identified fear as a barrier that transcended multiple levels of influence. At the public policy level, national policies, such as public charge and anti-immigration rhetoric, limited access to services. Local expansion of health care coverage, such as Healthy San Francisco, facilitated access to care. At the organizational level, law enforcement presence generated fear. This was countered by a welcoming environment, described as culturally concordant clinical sites, representation of the community in the provider pool, and resources to address social needs. Individual-level fear, rooted in trauma and economic insecurity, was eased by trauma-informed care and health navigators. Community engagement and sustained partnerships built trust and credibility to transcend the fear that hindered access to care. Conclusion: In a region with expansive policies for improved health care access, barriers are rooted in fear and span individual, organizational, and public policy levels of access to care. Richer community engagement may lessen the national and systemic barriers that this vulnerable population continues to face. Developing an understanding of this topic improves health care providers' ability to meet the needs of this growing and vulnerable population.

Background Nigeria is one of the ten countries globally that account for 62% of under- and unvaccinated children worldwide. Despite several governmental and non-governmental agencies’ interventions, Nigeria has yet to achieve significant gains in childhood immunization coverage. This study identifies intrapersonal, interpersonal, organizational, community, and policy-level factors that influence childhood immunization uptake from various stakeholders’ perspectives using the Socioecological Model (SEM). Methods Using the Socioecological Model as a guiding framework, we conducted ten focus group sessions with mothers/caregivers and community leaders residing in Lagos state and nine semi-structured interviews with healthcare workers who provide routine immunization services in Lagos state primary healthcare facilities. We performed a qualitative analysis of focus groups and semi-structured interviews using deductive coding methods. Results The study sample included 44 mothers/caregivers and 24 community leaders residing in Lagos State, Nigeria, and 19 healthcare workers (routine immunization focal persons) working in the primary healthcare setting in Lagos state. Study participants discussed factors at each level of the SEM that influence childhood immunization uptake, including intrapersonal (caregivers’ immunization knowledge, caregivers’ welfare and love of child/ren), interpersonal (role of individual relationships and social networks), organizational (geographical and financial access to health facilities, health facilities attributes, staff coverage, and healthcare worker attributes), community (community outreaches and community resources), and policy-level (free immunization services and provision of child immunization cards). Several factors were intertwined, such as healthcare workers’ education of caregivers on immunization and caregivers’ knowledge of vaccination. Conclusions The reciprocity of the findings across the Socioecological Model levels emphasizes the importance of developing multi-pronged interventions that operate at multiple levels of the SEM. Our results can inform the design of culturally appropriate and effective interventions to address Nigeria’s suboptimal immunization coverage.

Joukkoliikenne on tärkeä palvelu, joka mahdollistaa lasten ja nuorten arkisen paikasta toiseen liikkumisen lähiympäristöään kauemmas. Sen käyttö on kuitenkin suhteellisen vähäistä. Mikkelin kaupunki on tarjonnut maksuttomat bussimatkat kaikille peruskoululaisille vuodesta 2017 lähtien. Tässä tutkimuksessa selvitetään lasten bussin käyttöä edesauttavia ja vaikeuttavia tekijöitä hyödyntäen teoreettisena ja analyyttisena työkaluna sosioekologista mallia. Aineisto koostuu Mikkelissä ja Kouvolassa asuvien 10-12-vuotiaiden lasten osallistava paikkatieto (PPGIS) -kyselyn avovastauksista (n=157 ja n=295), mikkeliläishuoltajien PPGIS-kyselyn avovastauksista (n=27) sekä 11 lapsen ja 11 huoltajan laadullista haastatteluista. Aineisto analysoitiin luokittelevan ja teoriaohjaavan sisällönanalyysin keinoin. Lasten PPGIS-kyselyn avovastauksissa yleisin sosioekologisen mallin taso oli fyysinen ympäristö: Bussilla liikutaan pitkillä matkoilla ja mikäli aikuisilta ei saada kyytiä. Pyörää ja autoa pidettiin bussia nopeampina ja helpompina kulkumuotoina. Haastatteluaineistossa puolestaan esiintyi tasaisemmin mallin eri tasoja sekä poliittisen päätöksentekoon liittyviä teemoja, kuten bussin käyttöä vaikeuttavana tekijänä harvoin liikennöinti sekä tutkittavien kannalta toimimattomat reitit, mutta myös bussin käytön merkitys lasten itsenäistä liikkumista edesauttavana tekijänä. Tulokset ovat hyödynnettävissä joukkoliikenteen kehittämiseen kunnissa., Public transport is an important service which enables the mobility of children and young people. However, the use of public transport remains relatively low. Since 2017, the city of Mikkeli has offered free bus to students in comprehensive school. In this study, we examine the factors which promote or complicate children’s bus use. As a theoretic and analytic tool, we utilize a socio-ecological model. The data consists of an open-end Public Participatory GIS (PPGIS) survey of 10–12-year-old children (n=157 and n=295) and their guardians (n=27), and the qualitative interviews of 11 children and 11 parents living in Mikkeli or Kouvola. The data was analyzed using theory-based content analysis. In the socio-ecological model, the most common level in the children’s open-end survey answers was their physical environment: buses are used for long journeys, if it is not possible to get a ride from adults. Additionally, using the bus was seen to be more difficult when buses operated infrequently, or the routes were impractical for the interviewees. Bicycles and cars were considered faster and easier modes of transport than buses. However, buses were seen as beneficial and to facilitate children’s independent traveling. The results of this study are topical and can be...

Background Preschool-aged children’s physical activity (PA) and screen time (ST) are important health-related behaviours likely influenced by PA opportunities, parental perceptions of neighbourhood safety and parenting practices pertaining to PA and ST. How these factors interact to impact on young children’s PA and ST, and whether their effects are generalisable across cultures and geographical location is not known. This study addressed these knowledge gaps by conducting pooled analyses of comparable data from two culturally and geographically diverse samples – Chinese parent-child dyads from an ultra-dense city (Hong Kong, China) and Latino parent-child dyads from a low-density city (Houston, USA). Methods The analytical sample consisted of 164 Hong Kong Chinese and 84 US Latino parent-child dyads with data on socio-demographic characteristics, parent-perceived neighbourhood destinations and facilities for children’s PA, physical and social safety-related neighbourhood attributes, PA-related parenting practices and child’s ST and accelerometer-assessed PA. Generalised linear models with robust standard errors accounting for neighbourhood-level clustering were used to estimate associations and interaction effects. Results Hong Kong Chinese children accumulated less PA than US Latino children, although the latter had more ST. Hong Kong Chinese parents reported more parenting practices promoting inactivity. Neighbourhood PA opportunities were positively related to children’s PA only if parental perceptions of neighbourhood safety were favourable, and the associations of physical neighbourhood environment characteristics with children’s PA and ST depended on PA-related parenting practices. Community cohesion was positively related to children’s PA and negatively related to ST, while parental promotion of ST was positively associated with children’s ST. Correlates of children’s PA and ST did not differ by city. Conclusions The substantial differences in activity patterns between Hong Kong Chinese and US Latino preschool-aged children observed in this study are likely due to a combination of cultural and built environmental factors. However, the fact that no between-city differences in correlates of PA and ST were detected indicates that both populations of children are equally affected by parent-perceived neighbourhood environmental characteristics and parenting practices. Overall, this study highlights the importance of considering how various individual-, home- and neighbourhood physical and social factors interact to influence young children’s health-promoting activity levels.

SOCIOECOLOGICAL MODEL APPROACH TO IMPROVE POSBINDU CADRE COMPETENCE IN PROLANIS PROGRAM MANAGEMENT IN THE WORK AREA OF PUSKESMAS PADASUKA, BANDUNG CITY, WEST JAVA. Socioecological models include promotive and preventive efforts, the government launched PROLANIS as an effort carried out by BPJS Health in the JKN era. The number of elderly people is always increasing and it is known that about 12% of the population in Indonesia is elderly, becoming one of the factors increasing the number of chronic degenerative diseases such as type II diabetes mellitus and hypertension. Coverage of health services for the elderly is still very low at 30.72%. Public awareness needs to be increased to control risk factors that might arise, through the chronic health care program that often occurs in the elderly should be prevented by promotive and preventive efforts. Posbindu Cadre Empowerment through increased competence with the socio ecological model approach, namely prevention programs and promoting the resolution of health problems can be done together. The purpose of the program is to develop and implement a program to develop Posbindu cadres in the Prolanis program. In carrying out this activity, Posbindu cadres. The program began with the identification of problems with prolanis, posbindu cadre health programs, health promotion, cadre training, and posbindu grouping. The method used is descriptive quantitative. The results obtained that there is an increase in the competence of cadres in the postbindu knowledge about PROLANIS.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) The elderly population is increasing in Brazil and worldwide, highlighting the need for cities to prepare to welcome this population, guaranteeing them the quality of their mobility in a safe and autonomously way. This research aims to study the active mobility of the elderly in a medium-sized city based on a socioecological approach. This approach suggests verifying multiple levels of influence in the individual's relationship with the environment they are living in. For this study, four levels of influence were selected: individual, social, physical environment, and public policies. In other words, this study aims to identify factors that influence the active mobility of the elderly and to assess the perception of these individuals regarding each one of these factors. Furthermore, the study aims to analyze the importance of socioecological levels in the active mobility of the elderly. To achieve this, the most cited factors in the literature were selected and classified according to their respective socioecological level. After this stage, a questionnaire was developed and later applied in the city of São Carlos – SP, to assess the perception of the elderly to these selected factors. As a result, it was observed that at the individual level most of the elderly showed a positive attitude towards walking, demonstrating affinity with the practice. However, effectively, most of the elderly were classified as non-active individuals (walking less than 150 minutes a week). The social level indicated, in general, that support received from family and friends is neutral to encourage walking. Considering each factor in the social levels individually, family tends to encourage the elderly to walk more than encouragement from friends. The level of the physical environment of the neighborhood was also evaluated as neutral. Although factors such as the quality of sidewalks, aesthetics (eg. no weeds, garbage, etc.), and safety (eg. fear of being robbed or assaulted) were evaluated as bad, discouraging walking, factors such as mixed land-use and alternative paths acted as practice motivators. Regarding the political level, the elderly believe that public administration does not adequately maintain sidewalks and public spaces planned for pedestrians. Lastly, after evaluating the perception of the respondents, the binary logistic regression model was calibrated to verify which levels were most relevant for the elderly to be active, and from their results, a sensitivity analysis was performed to graphically represent the results obtained. It was observed that the most relevant level was the physical environment, followed by the individual level (represented by attitude) and social support level. The political level was not statistically significant in the regression model. In conclusion, understanding influence levels and verifying their importance is a starting point that allows city managers to plan their cities with a macro view. They can initially focus where intervention is most needed and, considering the elderly perception about factors corresponding to each level, it is possible to individually verify which one’s act as a barrier or stimulus, fostering information that makes it possible to create measures to encourage the active mobility of the elderly. O aumento da população de idosos, no Brasil e no mundo, evidencia a necessidade das cidades se prepararem para acolher esta população, garantindo a estes a qualidade de seu deslocamento de forma segura e autônoma. Neste contexto, esta pesquisa busca realizar um estudo sobre a mobilidade ativa de idosos em uma cidade de porte médio a partir da abordagem socioecológica. Esta abordagem propõe verificar múltiplos níveis de influência na relação do indivíduo com o ambiente, sendo estabelecidos para o estudo, o nível individual, social, de ambiente físico e políticas públicas. Sendo assim, a pesquisa tem como objetivo identificar fatores que influenciam na mobilidade ativa de idosos e avaliar a percepção destes indivíduos em relação aos fatores, além de analisar a importância dos níveis socioecológicos na mobilidade ativa de idosos. Para isto, foram selecionados os fatores mais citados na literatura sendo classificados de acordo com seu respectivo nível socioecológico. Após esta etapa, foi elaborado um instrumento de pesquisa, aplicado na cidade de São Calos (SP), para avaliar a percepção dos idosos em relação aos fatores. Como resultado, observou-se que em relação ao nível individual, a maior parte dos idosos apresentou uma atitude positiva em relação à caminhada, mostrando afinidade com a prática. No entanto, de forma efetiva, a maior parte foi classificada como indivíduos não ativos (caminham menos de 150 minutos na semana). O nível social indicou, de forma geral, que o apoio recebido de familiares e amigos foi neutro para o incentivo a caminhada. Avaliando os fatores individualmente deste nível, foi observado que a família tende a incentivar mais os idosos a caminharem do que amigos. O nível de ambiente físico do bairro, também foi avaliado como neutro. Apesar de fatores como a qualidade de calçadas, estética (sem mato, lixo, entre outros) e seguridade (medo a assalto e agressões) terem sido avaliados como ruins, desestimulando a caminhada, fatores como mistura de usos do solo e caminhos alternativos atuaram como incentivadores para a prática. Em relação ao nível político, para os idosos a administração pública não cuida adequadamente de calçadas e espaços destinados aos pedestres. Por fim, após avaliar a percepção dos respondentes, foi calibrado o modelo de regressão logística binária para verificar qual ou quais níveis foram mais relevantes para que os idosos sejam ativos, e a partir de seus resultados, foi realizada uma análise de sensibilidade para representar de forma gráfica os resultados obtidos. Verificou-se que o nível mais relevante foi o ambiente físico, seguido do nível individual (representado pela atitude) e o apoio social. O nível político não se mostrou estatisticamente significativo no modelo de regressão. Compreender esses níveis e verificar sua importância são um ponto de partida que permite aos gestores planejarem suas cidades com uma visão macro, atuando inicialmente onde mais é necessário e, ao observar a avaliação da percepção dos idosos sobre os fatores correspondentes a cada nível, é possível verificar individualmente quais atuam como barreira ou estímulo, fomentando informações que possibilitem que sejam criadas medidas de incentivo a mobilidade ativa de idosos. 88882.426610/2019-01

The study aims were to 1) examine profiles of perception of motor competence (PMC) in relation to actual motor competence (AMC), i.e. under-estimators (UEs), realistic estimators (REs) and over-estimators (OEs) and 2) investigate associations between the profiles and selected socioecological factors at the individual, family and environmental levels. PMC (Pictorial Scale of Perceived Movement Skill Competence) and AMC (Test of Gross Motor Development-Third Edition) were administered to a representative sample of children from 37 childcare centres in Finland (n=441;6.2±0.6yrs;52% boys). Socioecological factors were investigated using a parental questionnaire. The three profiles were formed based on age- and gender-adjusted PMC and AMC z-scores. Multinomial logistic regression showed that OEs (n=81; p=0.04) tended to be younger than REs (n=306; p=0.04) and UEs (n=54; p=0.03). Parents of OEs reported more child health and developmental issues than parents of REs (p=0.03). Parents of UEs self-reported providing more support for physical activity than parents’ of REs (p=0.04). REs tended to live in denser population areas than UEs (n=54; p=0.03). Whilst PMC profiles revealed some socioecological differences, future research needs to focus on a broader range of potential correlates and untangle methodological analyses challenges to deepen the knowledge about PMC development in children. peerReviewed

The aim of our study was to explore the barriers and facilitators that teachers, principals, and parents face when adapting to COVID-19 pandemic scenario in terms of promoting toddlers’ physical activity (PA). Thirty-four (20 teachers and principals, and 14 parents) semi-structured qualitative interviews were conducted from October 2020 to March 2021. The socioecological model has enabled the identification of barriers and facilitators, some of which are related to the pandemic and others which are not. The main results suggest that upon reopening the ECEC institutions, regarding environmental barriers, educators mentioned the impact on the use of space, and parents, the modification of daily activities generated by COVID-19. However, educators also considered that the presence of suitable spaces in the school for practicing PA was a facilitator. At the intra- and interpersonal level, facilitators of PA that were unrelated to the pandemic included, for parents, the predisposition of children to be physically active and their own function as role models, and for educators, the curricular practices themselves. At an environmental level, the risk of danger in the traditional classroom plus bad weather were considered barriers by educators, while parents mentioned difficulties accessing outdoor space and the poor suitability of indoor spaces. Our results suggest the simultaneous analysis of the perceptions of different actors in the educational environments offers a broad vision of the ecological alternatives for offering children opportunities for PA in these difficult times.

This study uses a meaningful case study sample to investigate the self-esteem of pre-adolescent girls and the contributing factors. I studied three pre-adolescent girls in rural Hawaii who all participated in the same homeschooling community. In this paper, I offer a socioecological model of the perceived support of self-esteem of the girls. This model addresses the following questions: How do the three girls in the study demonstrate confidence? Are they perceived as confident by themselves, and the others in the study? What aspects of the educational community context are considered salient by educators, parents, and students? My findings draw on the following data sources: Informal observations over nine sessions and interviews with students, parents and teachers (N= 13). Following a thematic analysis, thirteen salient themes were identified which speak to different aspects of the educational context which are perceived to foster self-esteem. From an educational and psychological perspective, my findings emphasize the nested and interconnected influences within an educational environment that should be considered regarding self-esteem in pre-adolescent females.

The Russian Federation is a major immigrant-receiving nation and hosts large immigrant populations from post-Soviet countries including Central Asia. However, there is yet little research on their health needs, and especially on mental health of immigrant women. This study uses qualitative data from 72 interviews with women from Kyrgyzstan, Tajikistan, and Uzbekistan conducted in two large cities in Central Russia, Kazan and Nizhny Novgorod, from April 2014 to February 2017. This study examines psychological distress among immigrant women and applies a gendered socioecological lens to understand its causes. We have identified intersecting factors that operate at different levels and cause distress in Central Asian immigrant women in Russia. Gendered vulnerabilities, persistent worry about their families' well-being, separation from loved ones, and limited sources of social support are key individual and interpersonal level of distress factors. Poor working and housing conditions along with economic hardships and concerns over their ability to reach the goals that guided their decisions to move to Russia reinforce experienced distress among immigrant women. Discrimination against Central Asian nationals and structural racism amplify challenges for immigrants' psychological well-being and mental health in Russia. By investigating underlying factors of psychological distress among an understudied immigrant population, this study defines configurations of Russia's risk environment and contributes to an understanding of migration as an important determinant of mental health.

Although public engagement in research is increasingly popular, the involvement of citizens living in vulnerable circumstances is rarely realized. This narrative review aims to describe and critically analyse concerns and corresponding strategies, tools, and methods that could support the inclusion of these citizens in health research. The 40 studies that are included were thematically analysed using the socioecological model. Concerns originate most often on the intrapersonal level of the socioecological model, but concerns were also identified at institutional, community, and policy levels. It is thought-provoking that there is a lack of attention for the research and policy structure in which engagement practices are designed, implemented and evaluated. More research is needed to explore how these cultures could be changed in a way that promotes rather than restrains the engagement of citizens living in vulnerable circumstances in research and policymaking.

Purpose: In 2014, the Danish Government introduced a new public school reform, which included implementation of 45 min of daily physical activity (PA) within the academic classroom curriculum. The purpose of the present study was to explore school staff’s perceived barriers to implementation of a national PA policy. Method: A mixed-methods approach using a questionnaire and semistructured interviews was conducted. A total of 198 teachers and 26 school management team members (principals, deputy principals, and leading teachers) from 31 schools completed a questionnaire, and 11 school management team members were interviewed. The socioecological model was used as a theoretical framework to examine the results. Results: A total of 15 different barriers were identified and reflected within all levels of the socioecological model. Facilities, motivation, and time were the most prominent barriers identified. Conclusion: Development and deployment of a national PA policy needs to be done in cooperation with consumers from all levels within the socioecological model to ensure successful implementation. Purpose: In 2014, the Danish Government introduced a new public school reform, which included implementation of 45 min of daily physical activity (PA) within the academic classroom curriculum. The purpose of the present study was to explore school staff’s perceived barriers to implementation of a national PA policy. Method: A mixed-methods approach using a questionnaire and semistructured interviews was conducted. A total of 198 teachers and 26 school management team members (principals, deputy principals, and leading teachers) from 31 schools completed a questionnaire, and 11 school management team members were interviewed. The socioecological model was used as a theoretical framework to examine the results. Results: A total of 15 different barriers were identified and reflected within all levels of the socioecological model. Facilities, motivation, and time were the most prominent barriers identified. Conclusion: Development and deployment of a national PA policy needs to be done in cooperation with consumers from all levels within the socioecological model to ensure successful implementation.

International audience; Energy balance-related behaviors (EBRBs), i.e., diet, sedentary behavior, physical activity, and sleep, combine into lifestyle patterns, which we aim to identify in French preschoolers and analyze their family correlates within the framework of a comprehensive socioecological model. Parental questionnaires provided information about family characteristics and children's EBRBs for 978 5-year-olds of the EDEN cohort. We used principal component analysis to derive lifestyle patterns from EBRBs and hierarchical multivariable linear regressions to assess their associations with family socio-demographics, parent health/behaviors, and parent-child interactions. Analyses were stratified by sex. Of the three lifestyle patterns identified (unhealthy, healthy, and mixed), the mixed pattern differed the most between sexes. Lower parental education, suboptimal maternal diet, TV during meals, and later bedtime were associated with higher adherence to unhealthy patterns. Children cognitively stimulated at home and boys of mothers not employed adhered more to the healthy pattern. Older siblings (for girls) and higher engagement of parents in leisure-time physical activity (for boys) were related to greater adherence to mixed patterns. The identification of various correlates from multiple socioecological levels suggests that tackling the potentially synergistic effect of lifestyle patterns on health requires addressing processes relevant to the parent-child dimension and structural barriers parents may encounter.

Although public engagement in research is increasingly popular, the involvement of citizens living in vulnerable circumstances is rarely realized. This narrative review aims to describe and critically analyse concerns and corresponding strategies, tools, and methods that could support the inclusion of these citizens in health research. The 40 studies that are included were thematically analysed using the socioecological model. Concerns originate most often on the intrapersonal level of the socioecological model, but concerns were also identified at institutional, community, and policy levels. It is thought-provoking that there is a lack of attention for the research and policy structure in which engagement practices are designed, implemented and evaluated. More research is needed to explore how these cultures could be changed in a way that promotes rather than restrains the engagement of citizens living in vulnerable circumstances in research and policymaking. Supplementary Information The online version contains supplementary material available at 10.1186/s40900-021-00306-w., Plain English summary Unfortunately, citizens living in vulnerable circumstances are seldom engaged in research or policymaking. Think of, citizens living in poverty, those with an ethnic minority background or citizens with mental health issues are often excluded. Their involvement is, however, crucial to prevent growing (health) inequalities. To support the engagement of people living in vulnerable circumstances we conducted a literature review. We looked for strategies, tools, and methods that could support the inclusion of these citizens in research or policymaking. In total, 40 studies were identified and analysed. The main finding is that strategies tools, and methods are always context depended. Researchers should always ask: What works for whom in which context? We, therefore, stress the importance of close collaboration with experienced owners and community based organisations from the start. Also, more attention should be paid to how engagement practices are designed, implemented and evaluated. Think of, strict deadlines which limit the time to build trust. Or low budgets that limit the options to create the right preconditions, think of recruitment and data collection in multiple languages. To make sure that not only the ‘usual suspects’ but also citizens living in vulnerable circumstance will be engaged attention is needed from advocacy groups, research funders and researchers. All these actors need to reflect more often on the question what they can do to change the current research and policymaking culture in such a way that it will support the engagement of citizens living in vulnerable circumstances. Supplementary Information The online version contains supplementary material available at 10.1186/s40900-021-00306-w.

One strategy to promote physical activity (PA) is for health care providers to give exercise prescriptions (ExRx) that refer to community-based facilities. However, facilitators and barriers specific to urban programs in the US for under-resourced women are unknown. Thus the purpose of this formative research was to explore ExRx barriers and facilitators specific to US under-resourced women to inform future intervention targets and strategies. This mixed-methods community-engaged research was conducted in partnership with an urban women’s only wellness center that exchanged ExRx for free access (1–3 months). Qualitative semi-structured interviews and validated quantitative questionnaires (SF-12, International Physical Activity Questionnaire, Physical Activity Self-Efficacy, Physical Activity Stage of Change, and Barriers to Physical Activity, Social Support for Exercise, and Confusion, Hubbub, and Order Scale) were administered by phone and guided by the socio-ecological model. ExRx utilization was defined as number visits/week divided by membership duration. Means and percentages were compared between ≥1 visit/week vs. &lt, 1 visit/week with t-tests and chi-square, respectively. Women (n = 30) were 74% Black, 21–78 years of age, 50% had ≤ high school diploma, and 69% had household incomes ≤45,000/year. Women with ≥1 visit/week (n = 10, 33%) reported more education and higher daily activity, motivation, number of family CVD risk factors and family history of dyslipidemia compared with &lt, 1 visit/week. Facilitators among women with ≥1 visit/week were “readiness” and “right timing” for ExRx utilization. Barriers among women with &lt, 1 visit/week (n = 20, 67%) were “mismatched expectations” and “competing priorities”. Common themes among all women were “sense of community” and “ease of location”. ExRx utilization at an US urban wellness center may be dependent on a combination of multi-level factors including motivation, confidence, peer support, location and ease of access in under-sourced women. Additional resources may be needed to address mental and/or physical health status in additional to physical activity specific programming.

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five focus groups with elected community leaders, community residents, members, and key stakeholders to assess perspectives on physical activity barriers and resources within the county. The cohort survey sample (N = 152) reported a median of 6 barriers (range 0–13) to participating in at least 30 min of physical activity daily. The qualitative analysis yielded three overarching themes related to physical activity participation: lack of motivation, physical environment, and cultural barriers. This mixed-methods study revealed the challenges and perceptions among rural residents across the socioecological model when assessing physical inactivity. Findings can be used to tailor future interventions focused on expanding social support, designing infrastructure, and creating policies that promote physical activity.

Background The COVID-19 pandemic continues to have a disproportionate effect on ethnic minorities. Across countries, greater vaccine hesitancy has been observed among ethnic minorities. After excluding foreign domestic helpers, South Asians make up the largest proportion of ethnic minorities in Hong Kong. It is necessary to plan for COVID-19 vaccination promotional strategies that cater to the unique needs of South Asians in Hong Kong. Objective This study investigated the prevalence of COVID-19 vaccine uptake among a sample of South Asians in Hong Kong. We examined the effects of sociodemographic data and factors at individual level (perceptions), interpersonal level (information exposure on social media), and sociostructural level (cultural) based on the socioecological model. Methods A cross-sectional web-based survey was conducted on May 1-31, 2021. Participants were South Asian people aged 18 years or older living in Hong Kong; able to comprehend English, Hindi, Nepali, or Urdu; and having access to a smartphone. Three community-based organizations providing services to South Asians in Hong Kong facilitated the data collection. The staff of the community-based organizations posted the study information in WhatsApp groups involving South Asian clients and invited them to participate in a web-based survey. Logistic regression models were fit for data analysis. Results Among 245 participants, 81 (33.1%) had taken at least one dose of the COVID-19 vaccine (one dose, 62/245, 25.2%; and both doses, 19/245, 7.9%). After adjusting for significant background characteristics, cultural and religious reasons for COVID-19 vaccine hesitancy were associated with lower COVID-19 vaccine uptake (adjusted odds ratio [AOR] 0.83, 95% CI 0.71-0.97; P=.02). At the individual level, having more positive attitudes toward COVID-19 vaccination (AOR 1.31, 95% CI 1.10-1.55; P=.002), perceived support from significant others (AOR 1.29, 95% CI 1.03-1.60; P=.03), and perceived higher behavioral control to receive COVID-19 vaccination (AOR 2.63, 95% CI 1.65-4.19; P Conclusions In this study, one-third (81/245) of our participants received at least one dose of the COVID-19 vaccine. Cultural or religious reasons, perceptions, information exposure on social media, and influence of peers were found to be the determinants of COVID-19 vaccine uptake among South Asians. Future programs should engage community groups, champions, and faith leaders, and develop culturally competent interventions.

We investigated child, family, and environmental factors associated with young children's perceptions of locomotor (LM) and object control (OC) skills. The participants comprised 472 children (6.22 ± 0.63) and their parents. The children were assessed for their perception of motor competence in LM and OC skills (using the pictorial scale of Perceived Movement Skill Competence for young children), and actual motor competence (Test of Gross Motor Development 3rd edition and Körperkoordinationstest Für Kinder). Anthropometrics were calculated using the children's body mass index standard deviation scores. A parent questionnaire included questions about child factors (sex, child's independent walking age, time spent sedentary and outdoors, participation in organized sport activities, and access to electronic devices), family factors (parent educational level, physical activity frequency, and sedentary behavior), and environmental factors (access to sport facilities). Variance analysis sought to identify age-related differences, and a linear regression model examined correlates of children's perception of LM and OC skills. The children's movement skill perceptions were found to be generally high. Four factors explained 5.7% of the variance in perceptions of LM skills and 7.5% of the variance in perceptions of OC skills. Two factors, lower age and higher actual motor competence, explained most of the children's skill perceptions. Access to electronic devices (less) and Body mass index (BMI) (higher) were associated with perceptions of LM skills. Participation in organized sport activities (higher) and parental education (lower) were associated with perceptions of OC skills. When promoting children's physical activity and motor competence, perceptions of motor competence are an important consideration.

The study objective was to determine prevalence of food insecurity and its associations with socioecological model (SEM) characteristics for undergraduate and graduate students. An online questionnaire was distributed to a convenience sample of students aged 18–34 at a Midwestern university. Of the 938 responses, 675 were complete for analysis. Outcome measures included demographics, food security level, housing, food access barriers, coping strategies, and food assistance program usage. Results found that predictors associated with undergraduate food insecurity included non-White race, receipt of financial aid, lower self-reported health status, living off-campus, employment, and food cost (p &lt, 0.001). Graduate student food insecurity was associated with Asian self-identification, employment, food cost, no time to prepare foods, and lack of foods for dietary needs (p &lt, 0.001). Students with food insecurity were more likely to buy cheap food (p &lt, 0.001). Almost 50% of food-insecure undergraduates asked friends or family to help buy food. Food-insecure students were more likely to want information on meal preparation and budgeting. More graduate students were likely to know of and use food pantries. Overall, food insecurity was higher among undergraduate than graduate students. Universities should consider institutional and policy changes tailored to the separate populations to mitigate the prevalence of campus food insecurity.

Background Handwashing with soap is a cost-effective, efficient health behavior to prevent various diseases. Despite its immense health benefits, the lowest prevalence of handwashing is found in low-income countries. Here, its practice is not only determined by individual behavior, but also heavily shaped by deprivations in the social and structural ecology. Moreover, handwashing barriers are not equally experienced as overlapping social identities (e.g., age and gender) intersect and create inequities between members of different social groups. To embrace the complexities of handwashing beyond individual-level behavior and singular social identities, a combined socioecological and intersectional perspective is employed. This multi-level approach with regards to intersecting privileges and disadvantages serves as a basis to promote this highly important health behavior. Methods This study used a qualitative, theory-based approach and combined data from two samples: experts in health promotion (n = 22) and local citizens stratified by gender and rural/urban location (n = 56). Data was collected in face-to-face interviews in Sierra Leone between November 2018 and January 2019 and analyzed using thematic analysis and typology of the qualitative data. Results The conceptualization of multi-level determinants of handwashing within a socioecological model showed the high relevance of inhibiting social and structural factors for handwashing practice. By establishing seven distinguishing social identity dimensions, data demonstrates that individuals within the same social setting yet with distinct social identities experience strikingly differing degrees of power and privileges to enact handwashing. While a local leader is influential and may also change structural-level determinants, a young, rural wife experiences multiple social and structural constraints to perform handwashing with soap, even if she has high handwashing intentions. Conclusion This study provides a holistic analytical framework for the identification of determinants on multiple levels and accumulating intersections of socially produced inequalities for handwashing and is applicable to other health topics. As the exploration of handwashing was approached from a solution-focused instead of a problem-focused perspective, the analysis can guide multi-level intervention approaches (e.g., using low-cost, participatory activities at the community level to make use of the available social capital). Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11923-1.

BackgroundIn the U.S., strong ethnic/racial, socioeconomic, demographic, and geographic breastfeeding (BF) inequities persist, and African American and Hispanic women are less likely to meet their breastfeeding goals compared to White women. This systematic review (SR) was designed to answer the question: What is the impact of breastfeeding interventions targeting ethnic/racial minority women in the U.S. on improving BF initiation, duration and exclusivity rates?MethodsThe SR was conducted following the Institute of Medicine Guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The study protocol was developed and registered a priori in PROSPERO (ID#CRD42020177764). The electronical databases searched was MEDLINE All (Ovid). Search strategies were led by the team’s expert public health librarian using both controlled vocabulary and free text queries and were tested against a validated set of relevant papers included in existing reviews. The GRADE methodology was used to assess the quality of the studies.ResultsWe included 60 studies that had randomized (n = 25), observational (n = 24), quasi-experimental (n = 9), or cross-sectional (n = 2) designs. The studies focused on populations that were multi-ethnic/racial (n = 22), only Hispanic (n = 24), only Black (n = 13), and only American Indian (n = 1). The study interventions were classified following the socioecological model: macrosystem/policy level (n = 6); community level (n=51), which included healthcare organizations (n = 34), The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (n = 9), and community organizations/public health institutions (n = 8); and interpersonal level (n = 3).ConclusionsPolicy and community level interventions delivered through WIC, healthcare facilities, and community agencies) are likely to improve BF outcomes among women of color. The combination of interventions at different levels of the socioecological model has not been studied among minority women in the U.S. Implementation science research is needed to learn how best to scale up and sustain effective BF interventions, taking into account the needs and wants of minority women. Thus, it is strongly recommended to conduct large scale implementation research studies addressesing how to strengthen the different health and social environments surrounding women of color in the U.S. to improving their BF outcomes.

Language focused on individual dietary behaviors, or alternatively, lifestyle choices or decisions, suggests that what people eat and drink is primarily a choice that comes down to free will. Referring to and intervening upon food consumption as though it were a freely chosen behavior has an inherently logical appeal due to its simplicity and easily defined targets of intervention. However, despite decades of behavioral interventions, population-level patterns of food consumption remain suboptimal. This debate paper interrogates the manner in which language frames how problems related to poor diet quality are understood and addressed within society. We argue that referring to food consumption as a behavior conveys the idea that it is primarily a freely chosen act that can be ameliorated through imploring and educating individuals to make better selections. Leveraging practice theory, we subsequently propose that using the alternative language of eating practices and patterns better conveys the socially situated nature of food consumption. This language may therefore point to novel avenues for intervention beyond educating and motivating individuals to eat more healthfully, to instead focus on creating supportive contexts that enable sustained positive dietary change. Clearly, shifting discourse will not on its own transform the science and practice of nutrition. Nevertheless, the seeds of change may lie in aligning our terminology, and thus, our framing, with desired solutions.

Migrant health has been identified as one of the most pressing issues of the 21st century. Migration experiences are influenced by gender and gender norms and have important implications for the sexual health of migrant women. This systematic review explored socioecological factors influencing sexual health experiences and health outcomes of migrant Asian women living in “Western” high-income countries. PRISMA guidelines were followed and this study was registered with PROSPERO. Five academic databases were searched for peer-reviewed articles published between 2000 and 2019. Of 2415 studies retrieved, 17 met the selection criteria: 12 qualitative, 4 quantitative, and 1 mixed-methods study. The four levels of Bronfenbrenner’s socioecological model were applied to examine the individual, interpersonal, institutional, and societal factors of influence. Most studies (n = 13) reported individual level factors, focusing on knowledge and use of contraceptives. At a societal level, host country sociocultural factors, including gender and cultural norms, influenced knowledge, ability to access and utilise contraceptives, and access to health services. Findings suggest that the public health policy, practice, and research to improve the sexual health of migrant women requires greater consideration of the intersecting factors of gender, culture, and the migration process.

Background. Adolescent girls are less active than boys, with approximately 10% of girls in Ireland and the United Kingdom meeting the minimum recommended daily physical activity (PA) guidelines. This study investigated factors perceived to influence PA among adolescent girls from low socioeconomic areas in order to inform the design of a future intervention (The HERizon Project). Methods. A total of 48 adolescent girls (13&ndash, 18 years) from low socioeconomic areas of the United Kingdom and Ireland participated in focus groups (n = 8), to explore perspectives of physical activity and the influence of gender within this. Focus groups were thematically analyzed and interpreted within a socioecological framework. Results. Most girls enjoyed PA and were aware of its benefits. They identified both barriers and facilitators to PA at intrapersonal (fear of judgement and changing priorities WITH age), interpersonal (changing social pressures and support from others) and organizational (delivery of PE) levels. Gender inequality was a multilevel factor, crossing all socioecological levels. Conclusion. Although many adolescent girls enjoy PA, their experiences appear to be limited by a fear of judgement and an overarching sense of gender inequality. Future interventions, such as the HERizon Project, should address influences at intrapersonal, interpersonal and organizational levels to promote positive PA experiences for adolescent girls.

Background: Precursors driving leisure-time sedentary behaviors remain poorly investigated, despite their detrimental consequences. This study aimed to investigate the predictive validity of controlled and automatic motivational precursors toward reducing sedentary behaviors and being physically active on leisure-time sedentary behaviors. The influence of demographic, physical, socio-professional, interpersonal, and environmental variables was also examined and compared with the associations of motivational precursors. Methods: 125 adults completed questionnaires measuring controlled motivational precursors (i.e., intentions, perceived competence), demographical (i.e., sex and age), physical (i.e., body mass index), and interpersonal (i.e., number of children) variables. Regarding automatic motivational precursors, habit strength and approach-avoidance tendencies were captured using the Self-Report Behavioral Automaticity Index and a manikin task. Time at work was computed as a socio-professional variable, days of the week and weather conditions were recorded as environmental precursors. Participants wore an accelerometer for 7 days and leisure time was identified using notebooks. Associations between the different precursors and the leisure-time sedentary behaviors were examined in linear mixed effect models. Results: Intention to be physically active and habit strength toward physical activity were negatively associated with leisure-time sedentary behaviors. Sex, body mass index, time at work, number of children, day of the week, and weather conditions were more strongly associated with leisure-time sedentary behaviors. Conclusion: Our findings show that, in comparison with other variables, the influence of motivational precursors on leisure-time sedentary behaviors is limited. This study supports the adoption of a broad-spectrum of precursors when predicting sedentary behaviors.

Socioecological theories predict that, in mammals, feeding and mating competitions affect male and female energetic conditions differently but energetic studies investigating both sexes simultaneously are rare. We investigated the effect of socioecological factors on the energetic conditions of male and female western chimpanzees, a long-lived species with high degrees of male-male competition. We used behavioural data collected on one chimpanzee community in the Taï National Park over 12 months, phenological data and urinary c-peptide (UCP) measures, a marker of energy balance. We found a positive effect of food availability on UCP levels in both sexes. Dominance rank also affected chimpanzee UCP levels. High-ranking females had higher UCP levels than low-ranking ones but only in periods when no oestrus females were present in the community. In contrast, high-ranking males had higher UCP levels than low-ranking males in the presence of oestrus females but lower UCP levels in their absence. Our results suggest that oestrus female presence lessened the competitive advantages of high-ranking females in feeding competition and that low-ranking males bore higher energetic costs related to mating competition than high-ranking ones. Yet caution should apply in interpreting these results since the statistical model was only close to significance. High-ranking male and female chimpanzees spent significantly less energy. Furthermore, all chimpanzees significantly spent less time feeding and spent more energy when food availability was high. Finally, our behavioural measure of energy intake and expenditure did not correlate with UCP levels highlighting the value of non-invasive hormonal markers for field studies.Significance statementGeneral socioecological theories hypothesize that the social grouping dynamic and energetics of females are highly influenced by food competition, whereas in males, competition for sexual partners is more influential for these factors. Recent studies in the non-invasive physiological assessment of energy balance in primates have begun to test the implied relationship between chimpanzee socioecology and individual energetic condition, with inconsistent results. However, only a few studies have investigated this relationship concurrently for both sexes. Here, using non-invasive measures of energy balance in wild western chimpanzees, we found that the energetics of both males and females are related to ecological factors, such as food availability. However, female energy balance appears also to be related to increased male mating competition, as this can result in increased aggression directed from males to females, with apparent energetic costs for females.

Meta-analysis of physical activity interventions in school settings have revealed low efficacy and that there is a need to explore implementation fidelity. The aim of this rapid realist review was to determine, what physical activity interventions in school settings for children aged 7- to 11-years-old works, for whom, and in what circumstances. The realist synthesis was conducted following RAMESES guidelines. Relevant studies were identified following a systematic search process and data from 28 studies was extracted for evidence to form context-mechanism-outcome configurations that were clustered and refined. Using the five-level socioecological model, the program theories were classified into the levels of intrapersonal (child), interpersonal (teachers), institutional (program content, school administration, and school environment), community (home and neighborhood), and policy. The school level led to most context-mechanism-outcome configurations related to school leadership and policy, workforce structure, program characteristics, and school environment. At each level, we identified features of interventions, alongside implementation considerations that might work to promote efficacy and sustainability. The need to recognize the school environment as part of a complex system with multi-level interaction and influences was a key finding. In line with realist philosophy, the researchers encouraged primary research to confirm, refute, and refine the program theories presented.

Fathers of refugee background with young children can experience significant mental health difficulties, with the potential for intergenerational impacts. This study aimed to explore how fathers of refugee background experience risk and protective factors for their own health and wellbeing during the early years of parenting. Semi-structured interviews and one semi-structured focus group were conducted with fathers of refugee background, with young children (0–5 years), who had settled in Australia. Transcribed interviews were analysed using thematic analysis, informed by the socioecological model of health. A total of 21 fathers participated in the study. Risk factors experienced included: prior experiences of trauma, reduced access to family support in Australia, adjustments in parenting roles, and the challenges of learning a new language and securing employment. Fathers drew on a number of sources of strength, including a sense of joy from fatherhood and support from partners, families, and communities. While most fathers regularly accompanied their partners and children to healthcare appointments, they were rarely asked by healthcare professionals about their own needs. Our findings support the idea that there is a need for greater assistance for fathers, particularly for navigating issues arising from the settlement process. Healthcare services working with families of refugee background must adopt a father-inclusive, trauma-informed approach that is responsive to fathers’ needs.

The transition from solitary life to sociality is considered one of the major transitions in evolution. In primates, this transition is currently not well understood. Traditional verbal models appear insufficient to unravel the complex interplay of environmental and demographic factors involved in the evolution of primate sociality, and recent phylogenetic reconstructions have produced conflicting results. We therefore analyze a theoretical model for the evolution of female social philopatry that sheds new light on the question why most primates live in groups. In individual-based simulations, we study the evolution of dispersal strategies of both resident females and their offspring. The model reveals that social philopatry can evolve through kin selection, even if retention of offspring is costly in terms of within-group resource competition and provides no direct benefits. Our model supports the role of predator avoidance as a selective pressure for group-living in primates, but it also suggests that a second benefit of group-living, communal resource defense, might be required to trigger the evolution of sizable groups. Lastly, our model reveals that seemingly small differences in demographic parameters can have profound effects on primate social evolution.

Sedentary behavior is associated with poor physical and mental health. Targeting sedentary behavior is a simple strategy that may help counter physical and mental health concerns associated with COVID-19-related social restrictions. Of course, traditional strategies such as achieving optimal exercise and physical activity levels are also important and should be recommended. However, even under normal circumstances, the difficulty in promoting lasting exercise habits at multiple levels (e.g. individual, environment, policy) are well documented, and chances of maintaining or improving these factors is now even lower. Thus, relative to other lifestyle behaviors – sedentary behavior may be more amenable to change. Moreover, reducing sedentary behavior may be less susceptible to influence from factors associated with health disparities such as age, race, and socio-economic status compared to exercise or physical activity. Sedentary behavior is a feasible health strategy that should be targeted during COVID-19.

Most public health issues in Kuwait are related to unhealthy behaviours. Research shows that behaviours are the result not only exclusively of personal choices but also of myriads of other social and environmental factors. Kuwait is one of the leading countries in obesity and tobacco use in the world. Cardiovascular diseases stemming from complications related to these and other risk factors are important health issues based on their morbidity and mortality implications. These risks are spread across society and affect the old as well as young boys. The serious gaps between Kuwait’s health-related needs and the existing policies to reduce public health risks in Kuwait create a significant obstacle to healthy behaviour change. Kuwait requires adequate laws, policies, regulations, activities, and programs to promote people’s health. The Socio-Ecological Model (SEM) has been used successfully in health promotion in various behavioural settings, including obesity, physical inactivity, and smoking. We propose the use of SEM as a planning framework in building sustainable health promotion programs in Kuwait while paying attention to other concepts such as systems thinking, authentic community participation, community capacity, policy development, public health infrastructure enhancement, health coaching, and equity.

Physical activity and motor competence (MC) have been considered to be closely related and prevent childhood obesity. The aim of the study was two-fold: to examine MC measured with two different tools in relation to individual, family, and environmental correlates and to investigate gender differences in MC. The Test of Gross Motor Development-Third Edition (TGMD-3) was administered to three- to seven-year-old children (n = 945), while the K&ouml, rperkoordinationstest f&uuml, r Kinder (KTK) was also used for five- to seven-year-old children (n = 444). The parent questionnaire (n = 936) included questions about individual (e.g., participation in organized sports), family (e.g., parents&rsquo, education level), and environmental (e.g., access to sports facilities) correlates. The children&rsquo, s temperament was assessed using the Colorado Childhood Temperament Inventory (CCTI) questionnaire. Data were analyzed using one-way analysis of variance and linear mixed-effects regression models. The regression models explained 57% and 38% of the variance in TGMD-3 and KTK, respectively. Individual correlates, including older age, more frequent participation in sports, and specific temperament traits of activity and attention span-persistence, were the strongest predictors for better MC. Small gender differences were found in both assessment tools, albeit in a different manner. In conclusion, socioecological correlates of MC in young children are multidimensional, and individual correlates appear to be the most important predictors of MC. Importantly, the correlates can differ according to the MC assessment tools.

Physical activity and motor competence (MC) have been considered to be closely related and prevent childhood obesity. The aim of the study was two-fold: to examine MC measured with two different tools in relation to individual, family, and environmental correlates and to investigate gender differences in MC. The Test of Gross Motor Development-Third Edition (TGMD-3) was administered to three- to seven-year-old children (n = 945), while the Körperkoordinationstest für Kinder (KTK) was also used for five- to seven-year-old children (n = 444). The parent questionnaire (n = 936) included questions about individual (e.g., participation in organized sports), family (e.g., parents’ education level), and environmental (e.g., access to sports facilities) correlates. The children’s temperament was assessed using the Colorado Childhood Temperament Inventory (CCTI) questionnaire. Data were analyzed using one-way analysis of variance and linear mixed-effects regression models. The regression models explained 57% and 38% of the variance in TGMD-3 and KTK, respectively. Individual correlates, including older age, more frequent participation in sports, and specific temperament traits of activity and attention span-persistence, were the strongest predictors for better MC. Small gender differences were found in both assessment tools, albeit in a different manner. In conclusion, socioecological correlates of MC in young children are multidimensional, and individual correlates appear to be the most important predictors of MC. Importantly, the correlates can differ according to the MC assessment tools.

Physical activity and motor competence (MC) have been considered to be closely related and prevent childhood obesity. The aim of the study was two-fold: to examine MC measured with two different tools in relation to individual, family, and environmental correlates and to investigate gender differences in MC. The Test of Gross Motor Development-Third Edition (TGMD-3) was administered to three- to seven-year-old children (n = 945), while the Körperkoordinationstest für Kinder (KTK) was also used for five- to seven-year-old children (n = 444). The parent questionnaire (n = 936) included questions about individual (e.g., participation in organized sports), family (e.g., parents’ education level), and environmental (e.g., access to sports facilities) correlates. The children’s temperament was assessed using the Colorado Childhood Temperament Inventory (CCTI) questionnaire. Data were analyzed using one-way analysis of variance and linear mixed-effects regression models. The regression models explained 57% and 38% of the variance in TGMD-3 and KTK, respectively. Individual correlates, including older age, more frequent participation in sports, and specific temperament traits of activity and attention span-persistence, were the strongest predictors for better MC. Small gender differences were found in both assessment tools, albeit in a different manner. In conclusion, socioecological correlates of MC in young children are multidimensional, and individual correlates appear to be the most important predictors of MC. Importantly, the correlates can differ according to the MC assessment tools.

Background Identifying risk factors of incomplete immunization among children is crucial to developing relevant policies to improve immunization coverage. In this study, we investigated factors associated with incomplete immunization among children in Indonesia and elucidated differences in risk factors between urban and rural areas. Methods The data came from a national-wide survey, the 2017 Indonesia Demographic Health Surveys. In total, 3,264 children aged 12∼23 months were included in the study. An incomplete immunization status was defined as a child who did not complete the ten doses of basic vaccinations, consisting of one dose of bacille Calmette-Guerin, one dose of hepatitis B, three doses of pentavalent vaccine (diphtheria, pertussis, tetanus, hemophilus influenza type B, and hepatitis B vaccine), four doses of polio vaccine, and one dose of measles vaccine. Generalized linear mixed models were constructed to examine the effects of different levels of risk factors on the incomplete immunization status. We further conducted stratified analyses by urban and rural areas. Results About 40% of the 3,264 children were incompletely immunized, among whom 45.3% were in urban areas and 54.7% were in rural areas. Eight of the 34 provinces had incomplete immunization rates exceeding 50%, and the Papua and Maluku regions had the highest rates of incomplete child immunization. The multivariate analyses showed that when women attended fewer than four antenatal care sessions and resided outside the Nusa Tenggara region, their children were more likely to have incomplete immunization in both urban and rural areas. On the other hand, having no health insurance was positively associated with incomplete immunization in urban areas, whereas having received a tetanus vaccination during pregnancy was negatively associated with incomplete immunization in rural areas. Conclusions Results of this study suggest that tailored interventions should be developed to address significant risk factors in rural and urban areas.

Bakgrund: Samhälls-och hälsoorienteringen till nyanlända är en av de hälsofrämjande insatserna som bedrivs över hela landet och är även lagstadgad. Trots det etableras det inte på samma sätt eller nivå i varje län och forskning visar för att de nyanlända ska kunna finna möjligheterna att etablera sig bör det finnas ett arbete som förhåller sig till den nivån av behov som krävs. Syfte: Syftet med studien är att undersöka hur aktörer arbetar och upplever samhälls-och hälsoinformation för nyanlända och personer med utomnordiskt påbrå samt vilka förutsättningar finns för att genomföra samhälls-och hälsoinformation på modersmål. Metod: En kvalitativ metod användes för att besvara studiens syfte och frågeställning. Kvalitativa semi-strukturerade intervjuer var studiedesignen som valdes för att smala in data. Urvalet bestod av tio intervjupersoner och alla intervjupersoner är aktörer med olika yrken, som är kopplade till integration och nyanlända. Resultat: Studiens resultat påvisade att befintliga samhälls-och hälsoorienteringen upplevs ge både möjligheter och svårigheter när det gäller aktörerna som arbetar med det och deras upplevelse av nyanlända som deltar. En ständig utveckling, ökade resurser och behovsanpassade insatser krävs för en lyckad samhälls-och hälsoorientering som hjälper till att främja hälsan. Slutsats: Resultatet redogjorde att den befintliga samhälls-och hälsoorienterings insatsen har två olika upplevda perspektiv. Det studerade perspektivet som var aktörerna och det andra var mottagarna av insatsen vilket är de nyanlända. Aktörerna upplevdes ha olika behov, upplevelser och uppfattningar av samhälls-och hälsoorienterings insatsen. Studiens fynd redovisade att samhälls-och hälsoorientering på modersmål kommer att gynna och påverka samhället på ett främjande sätt lika mycket som individen själv, samt att förutsättningarna är positiva trots de olika nivåerna av utmaningar som kan påträffa insatsen. Background: Community and health orientation to immigrants is one of the health promotion efforts conducted across the country and is also statutory. Despite this, they do not hold the same quality in each county, which is required to give immigrants the same opportunities to integrate themselves in the new contest. Aim: The purpose of the study is to examine how sectors experience social and health information for immigrants and people with non-Nordic ancestry and the conditions for implementation of social and health information in the native language. Method: A qualitative method was used to answer the questions of the study. Qualitative semi-structured interviews were used. The sample consisted of ten interviewees and all respondents are sectors with different professions, that work with immigrant integration. Results: The results of the study show that existing social and health orientation is perceived to provide both opportunities and difficulties in terms of both perspectives, the actors working with it and immigrants participating. Continuous development, increased resources and needs-based efforts are needed for a successful community and health orientation that helps to promote health. Conclusion: The existing social and health orientation has two different perceived perspectives. The studied perspective was the sectors working with the orientation. Each perspective has different needs, experiences, and perceptions of the orientation. The study's findings showed that orientation in the native language will benefit and influence society as much as the individual, and that the conditions are positive despite the different levels of challenges that may be encountered.

Worldwide, the overwhelming majority of parents initiate chest/breastfeeding at birth. Human milk is regarded as optimal nutrition for infants and the perfect version of milk for the first years of life; lactation also prevents disease in chest/breastfeeders. Most birth parents want to chest/breastfeed and it is seen as central to motherhood. Chest/breastfeeding is often challenging, resulting in early cessation. Exclusive pumping—that is, only expressing/pumping milk rather than nursing directly at the breast/chest—provides an alternative for those who cannot or do not want to nurse, while retaining most chest/breastfeeding benefits. Existing literature on EPing predominantly focuses on neonatal intensive care unit settings, milk composition, and quantitative data, such as secondary analyses of nationwide surveys. Despite the growing numbers of exclusive pumpers, there is little-to-no data concerning the lived experiences of exclusive pumpers, particularly pertaining to support needs and information provision. Through a retrospective, cross-sectional survey of over 2,000 exclusive pumpers and longitudinal follow-up with over 300 participants, the Breastfeeding Without Nursing study collected qualitative and quantitative data to explore their lived experiences, including: why some chest/breastfeeding exclusively pump; how they feel about it; and what information and support they need and where they find it. Themes within four domains—the circumstances surrounding exclusive pumping, affective experiences, information, and support—were identified through inductive thematic analysis. The findings of this analysis, combined with descriptive and statistical analysis of quantitative data, demonstrate that exclusive pumpers, in general, wanted to nurse at the breast, but as a result of a variety of socioecological influences, were unable to. This led to feelings of loss, grief, and anger, but also determination and pride. Participants needed earlier and better information, many having been incognizant of exclusive pumping despite receiving chest/breastfeeding education. Online support groups were vital sources of information and support; lactation consultants were often not regarded supportive or providing useful information. Having identified gaps in exclusive pumping information, education, and support, I suggest best practices and future research. Contributions to information science include recognizing the importance of education in overcoming incognizance and using a socioecological perspective to analyze the influences on information experience.

In this chapter, we will explore a case involving an outbreak of tuberculosis that occurred among men living in a homeless shelter. The case delves into both the public health challenges involved in investigating a disease outbreak in a vulnerable population and the delicate balance of protecting individuals’ autonomy and confidentiality while protecting the public’s health. By the conclusion of the case, learners will be able to apply the socioecological model to tuberculosis, analyze an outbreak of disease using epidemiologic tools, and identify conflicts in balancing autonomy and justice while managing potential public health threats.

Introduction Cigarette smoking can have negative consequences in military populations including injury, reduced physical endurance, higher frequency of sick days, and reduced combat readiness. This study used the socioecological model to understand individual, interpersonal, and organizational influences on cigarette smoking among military members. Materials and Methods The sample for this secondary analysis was drawn from personnel at 24 large U.S. military installations, six from each service branch. Analyses included 4,728 personnel who were classified as current cigarette smokers. Generalized linear mixed models were used to estimate the associations among risk and protective factors from multiple ecological levels for smoking intensity and nicotine dependence. Results Smoking to fit in with one’s unit, being in the Army, smoking as a reaction to stress, and work-related stressors were all related to increased intensity of smoking and nicotine dependence. More active coping was associated with lower nicotine dependence and reduced smoking intensity. Conclusion Results based on the socioecological model identify influencing factors and suggest possible interventions for smoking cessation. Reducing tobacco use in the military will require coordinated interventions that address multilevel determinants of use and improve military health. This is important to the strategic alignment of policy and services across the continuum of health care needs.

Primates spend a considerable amount of time grooming each other. Grooming is regularly found to be traded reciprocally (for grooming) or for rank-related benefits in the presence of food competition. It has been suggested that if food sources are clustered and monopolizable, then lower-ranked individuals will groom higher-ranked ones in order to be tolerated on food patches. This leads to grooming being directed up the hierarchy. However, the conditions where this is expected to occur are based on verbal reasoning alone, and no quantitative analysis of the conditions favouring grooming up the hierarchy appear in the literature. Here, we develop a quantitative model investigating when food competition can result in grooming up the hierarchy. Individuals are assumed to take actions pertaining to whom to groom, where to feed and whom to tolerate on food patches. By allowing individuals to choose actions according to reinforcement learning, we delineate conditions where groups of individuals will express reciprocal grooming and grooming up the hierarchy depending on environmental conditions (e.g. quality, number of food patches). In particular, we show that conditions of intense food competition may lead to less grooming up the hierarchy. The predictions of our model could guide future comparative studies and meta-analyses investigating social relationships in primates.

Summary Sedentary behaviour tracks from early to middle childhood, suggesting the need to intervene early. The aim of this systematic review was to identify determinants of change in accelerometer‐assessed sedentary behaviour in young children, with a view to informing interventions. Ten electronic databases were searched. Longitudinal and intervention studies were included if they (a) targeted sedentary behaviour in young children (less than of equal to 6 years), (b) assessed change in accelerometer‐assessed sedentary behaviour, and (c) reported on at least one determinant of change in sedentary behaviour. Intervention components were coded according to clusters of behaviour change technique (BCT) (ie, grouping similar BCTs components). Data synthesis was guided by the socioecological model. Sixteen studies (four longitudinal; 12 intervention) met the inclusion criteria. Two (out of five identified determinants) were associated with an increase in sedentary behaviour in longitudinal studies: the after childcare/school period and transition from childcare to school. Three (out of 21 identified determinants) were associated with a decrease in sedentary behaviour in intervention studies: “goals and planning” (ie, “behavioural contract”), “repetition and substitution” (ie, “graded tasks”), and “reward and treat” (ie, “incentives”). The environmental and interpersonal determinants identified in this review may help to inform behavioural strategies, timing, and settings for future interventions.