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HINTERGRUND: Regelmäßige körperliche Aktivität ist von zentraler Bedeutung für gesundes Altern. Allerdings halten in Deutschland weniger als ein Viertel der ab 65-Jährigen die Aktivitätsempfehlungen der Weltgesundheitsorganisation ein. ZIEL DER ARBEIT: In zwei Studienphasen (PROMOTE I und II) wurden web- und print-basierte Programme zur Förderung körperlicher Aktivität älterer Erwachsener ab 60 Jahren entwickelt und mittels randomisierter Interventionsstudien analysiert und evaluiert. Ziel dieses Beitrags ist es, die daraus resultierenden Empfehlungen und Materialien, die im Rahmen einer Toolbox für Anbieter:innen von Bewegungsprogrammen im kommunalen Setting angeboten werden, vorzustellen. MATERIAL UND METHODEN: Insgesamt erhielten 651 Personen über 10 Wochen Zugang zu der web- oder print-basierten „Fit im Nordwesten“-Bewegungsintervention. In der zweiten Studienphase (PROMOTE II) wurde das Programm mithilfe eines partizipativen Ansatzes an bisher inaktive Ältere angepasst. Die Zufriedenheit mit der Intervention und die Effektivität hinsichtlich des Bewegungsverhaltens wurden wissenschaftlich evaluiert. ERGEBNISSE: Die „Fit im Nordwesten“-Toolbox umfasst theoriebasierte, praxisrelevante und wissenschaftlich evaluierte Handlungsempfehlungen für die Förderung der körperlichen Aktivität älterer Erwachsener ab 60 Jahren. Die bereitgestellten Dokumentensets enthalten Materialien für 1) die Vor- und Nachbereitung, 2) die Durchführung eines zehnwöchigen Bewegungsprogramms, 3) die langfristige Aufrechterhaltung des Bewegungsverhaltens und 4) die Begleitung für Theorie und Praxis. SCHLUSSFOLGERUNG: Bisher existierten kaum wissenschaftlich evaluierte Materialien für die praktische Nutzung in der Bewegungsförderung. Die „Fit im Nordwesten“-Toolbox kann die zukünftige Anwendung in Bewegungsprogrammen für ältere Erwachsene unterstützen. BACKGROUND: Regular physical activity is central to healthy ageing. However, less than 25% of German older adults aged 65 years or older currently reach the World Health Organization’s recommendations. OBJECTIVES: In two study phases (PROMOTE I and II), web- and print-based programs to promote physical activity in older adults aged 60 years and older were developed. Intervention effectiveness was evaluated in randomized intervention trials. The goal is to present the recommendations and materials that emerged and were summarized in a toolbox for use in intervention planning and implementation in the community setting. MATERIALS AND METHODS: A total of 651 individuals received access to the web- or print-based “Fit im Nordwesten” physical activity intervention for 10 weeks. As part of the PROMOTE II study, the program was adapted to initially inactive older adults using a participatory approach. Acceptance and intervention effectiveness regarding physical activity behavior were scientifically evaluated. RESULTS: The “Fit im Nordwesten” toolbox includes theory-based, practice-relevant, and scientifically evaluated recommendations for the promotion of physical activity among older adults aged 60 years and older. The provided document sets include materials for (1) the preparation and postprocessing, (2) the implementation of the 10-week physical activity program, (3) supporting long-term maintenance of physical activity behavior, and (4) supporting materials for theory and practice. CONCLUSIONS: Thus far, the provision of scientifically evaluated materials for practical use in the promotion of physical activity was limited. The findings and recommendations presented here as part of the “Fit im Nordwesten” toolbox can support future application in physical activity programs targeting older adults.

From 2014 to 2022, the BMBF has funded five research networks in prevention research and health promotion that are also jointly coordinated (Research Network Primary Prevention and Health Promotion, www.fp2g.net). The researchers have produced a large number of relevant research outputs with insights gained into essential aspects of prevention research and health promotion. The networks research focused on basic principles, application-relevant findings, and implementation conditions of long-term prevention and health promotion for non-communicable diseases (NCDs). The constraints imposed by the pandemic from 2020 onwards were partly addressed by integrating Corona-related research and transfer activities. The importance of resilience for dealing with multiple health and social challenges got increased attention and was analyzed and discussed during the pandemic. For prevention research, research questions such as how to better implement prevention measures through digital tools are gaining additional importance. Together, the research networks have presented achievements and desiderata for future research. This perspective paper with its nine theses formulated in conclusion is intended as a stimulus for discussion among funders as well as the communty of researchers on the subject of successful prevention and health promotion. It is explicitly part of the continuity of the memoranda on prevention research developed in 2012.Von 2014 bis 2022 fördert das BMBF fünf Forschungsverbünde der Präventionsforschung und Gesundheitsförderung, die ebenfalls über eine gemeinsame Koordination verfügen (Forschungsnetzwerk Primärprävention und Gesundheitsförderung, www.fp2g.net). Die Forschenden haben eine Vielzahl relevanter Forschungsergebnisse erarbeitet und Erkenntnisse über wesentliche Aspekte der Präventionsforschung und Gesundheitsförderung gewonnen. Die Forschung der Verbünde konzentrierte sich auf Grundlagen, anwendungsrelevante Erkenntnisse und Umsetzungsbedingungen einer langfristig angelegten Prävention und Gesundheitsförderung für nicht-übertragbare Erkrankungen (NCD). Den Einschränkungen durch die Pandemie ab 2020 konnte z.T. durch Integration von Corona-bezogenen Forschungs- und Transferaktivitäten begegnet werden. Die Bedeutung von Resilienz für den Umgang mit den vielfältigen gesundheitlichen und sozialen Herausforderungen wird in Zeiten der Pandemie verstärkt analysiert und diskutiert. Für die Präventionsforschung gewinnen Forschungsfragen etwa zur besseren Implementierung von Präventionsmaßnahmen durch digitale Werkzeuge zusätzliche Bedeutung. Gemeinsam stellen die Verbünde Erreichtes und Desiderate zukünftiger Forschung dar. Dieses Perspektivpapier mit den abschließend formulierten neun Thesen ist für eine erfolgreiche Prävention und Gesundheitsförderung als Diskussionsanregung für Förderer wie auch für die Gemeinschaft der Forschenden gedacht. Es stellt sich explizit in die Kontinuität der schon im Jahr 2012 erarbeiteten Memoranden zur Präventionsforschung.

Background Reducing inequalities in physical activity (PA) and PA-associated health outcomes is a priority for public health. Interventions to promote PA may reduce inequalities, but may also unintentionally increase them. Thus, there is a need to analyze equity-specific intervention effects. However, the potential for analyzing equity-specific effects of PA interventions has not yet been sufficiently exploited. The aim of this study was to set out a novel equity-specific re-analysis strategy tried out in an international interdisciplinary collaboration. Methods The re-analysis strategy comprised harmonizing choice and definition of outcomes, exposures, socio-demographic indicators, and statistical analysis strategies across studies, as well as synthesizing results. It was applied in a collaboration of a convenience sample of eight European PA intervention studies in adults aged ≥45 years. Weekly minutes of moderate-to-vigorous PA was harmonized as outcome. Any versus no intervention was harmonized as exposure. Gender, education, income, area deprivation, and marital status were harmonized as socio-demographic indicators. Interactions between the intervention and socio-demographic indicators on moderate-to-vigorous PA were analyzed using multivariable linear regression and random-effects meta-analysis. Results The collaborative experience shows that the novel re-analysis strategy can be applied to investigate equity-specific effects of existing PA interventions. Across our convenience sample of studies, no consistent pattern of equity-specific intervention effects was found. Pooled estimates suggested that intervention effects did not differ by gender, education, income, area deprivation, and marital status. Conclusions To exploit the potential for equity-specific effect analysis, we encourage future studies to apply the strategy to representative samples of existing study data. Ensuring sufficient representation of ‘hard to reach’ groups such as the most disadvantaged in study samples is of particular importance. This will help to extend the limited evidence required for the design and prioritization of future interventions that are most likely to reduce health inequalities.

BackgroundBehavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities by education and gender among older adults in Germany.MethodsWe created six intervention scenarios targeting the elderly population: Scenarios #1–#4 applied realistic intervention effects that varied by education (low, medium high). Under scenario #5, all older adults adapted the physical activity pattern of those with a high education. Under scenario #6, all increased their physical activity level to the recommended 300 min weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes under each of these six intervention scenarios was simulated for males and females over a 10-year projection period using the DYNAMO-HIA tool. Results were compared against a reference-scenario with unchanged physical activity.ResultsUnder scenarios #1–#4, approximately 3589–5829 incident disease cases and 6248–10,320 deaths could be avoided among males over a 10-year projection period, as well as 4381–7163 disease cases and 6914–12,605 deaths among females. The highest reduction for males would be achieved under scenario #4, under which the intervention is most effective for those with a high education level. Scenario #4 realizes 2.7 and 2.4% of the prevented disease cases and deaths observed under scenario #6, while increasing inequalities between education groups. In females, the highest reduction would be achieved under scenario #3, under which the intervention is most effective amongst those with low levels of education. This scenario realizes 2.7 and 2.9% of the prevented disease cases and deaths under scenario #6, while decreasing inequalities between education groups. Under scenario #5, approximately 31,687 incident disease cases and 59,068 deaths could be prevented among males over a 10-year projection period, as well as 59,173 incident disease cases and 121,689 deaths among females. This translates to 14.4 and 22.2% of the prevented diseases cases among males and females under scenario #6, and 13.7 and 27.7% of the prevented deaths under scenario #6.ConclusionsThis study shows how the overall population health impact varies depending on how the intervention-induced physical activity change differs across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities.

Objective Selective study dropout limits manifestation and detection of intervention effects and is a major challenge in behavioral intervention studies. Engaging in health-risk behaviors might make individuals especially dropout-vulnerable. Thus, this theory-based study's aim was to identify health-related lifestyle profiles affecting dropout in a web-based physical activity intervention trial targeting older adults. Method The 12-week intervention trial was conducted between 2016 and 2018 in Germany. Baseline lifestyle profiles consisting of self-reported physical activity, sedentary behavior, alcohol consumption, fruit and vegetable intake, nocturnal sleep, and social activity were assessed with questionnaires and investigated in 589 individuals. The risk of study dropout related to health-related lifestyle profile was tested with Poisson regression in 571 individuals (96.9%). Results Latent profile analysis identified four latent health-related lifestyle profiles: socially inactive (n = 23, 3.9%), slightly unhealthy (n = 449, 75.2%), health-promoting (n = 81, 13.8%), and highly physically active lifestyle (n = 36, 6.1%). Profiles differed significantly by sex, stage of behavior change, and subjective health. Compared with the average of all profiles, statistically significant study dropout adjusted risk ratios (aRR) were 1.91 for the socially inactive lifestyle, and aRR = 0.73 for the slightly unhealthy lifestyle. There were no statistically significant effects for the highly physically active lifestyle (aRR = 0.94) and the health-promoting lifestyle (aRR = 0.76) on study dropout. Conclusions This study highlights the relevance of accounting for the correlation between health-related lifestyle profiles and study participation of older adults in physical activity interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective Communities are important settings for health promotion and prevention. The community readiness assessment offers a structured approach to assess resources and opportunities to tackle a health problem within a community. The assessment relies on semi-structured interviews with key informants from the communities. A number of 4–6 key informant interviews are recommended in the literature. However, it is unclear whether this is sufficient to obtain a valid representation of the respective community. This study analysed whether increasing the number of key informants from 4–6 to 12–15 alters the results of the community readiness assessment. Results A total of 55 community readiness interviews were carried out in 4 communities. Overall, the community readiness scores showed little variation after having interviewed 10 key informants in a community. However, even after completing 10 interviews in a community, key informants were still able to identify up to 6 new information items regarding community efforts for physical activity promotion among the elderly, contact and communication channel for informing or approaching the target group, or barriers to participation.

Background Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities among older adults in Germany. Methods We created six hypothetical intervention scenarios targeting adults aged 55 years and above: Scenarios #1 to #4 applied realistic intervention effects that varied by education. Under scenario #5, the lower and medium educated group adapted the physical activity pattern of the higher educated. Under scenario #6, all persons increased their physical activity level to the recommended 300 minutes weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes was simulated under each of these six intervention scenarios for males and females over a 10-year projection period using the DYNAMO-HIA tool, and compared against a reference scenario with unchanged physical activity pattern. Results For males, the highest reduction of disease cases and deaths would be achieved under scenario #4 (most effective in higher educated persons), while increasing inequalities between education groups. For females, the highest reduction would be achieved under scenario #3 (most effective in lower educated persons), while decreasing inequalities between education groups. Scenarios #1 to #4 would prevent only a fraction of the disease cases and deaths that would be avoided under scenario #5 or scenario #6. Conclusions This modelling study shows how the overall population health impact varies, depending on how intervention-induced physical activity changes differ across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant, as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities. Key messages Health impact assessments with a focus on equity are essential for decision-makers. In order to correctly project population health effects, and choose between options of intervention types from a public health perspective, data on subgroup-specific intervention effects are needed.

BackgroundA supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence.MethodsA systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≥ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided.ResultsOf the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified.ConclusionsThe strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored.

Background It remains unclear how physical activity (PA) interventions need to be designed to reach older adults and to be widely accepted in this target group. The aim of this study was to assess the acceptance of a web-based PA program, including individual intervention components as well as relevant contextual factors, and to specify requirements for future interventions. Methods Two hundred sixty-six participants of a PA intervention completed a questionnaire covering individual program components (content, structure, and context). Further, 25 episodic guided interviews focusing on reasons for (non-) participation were conducted with 8 participants and 17 non-participants. Following qualitative content analysis, different requirements were identified and organized based on the social-ecological model, resulting in a profile of requirements. Results Based on the participants’ and non-participants’ statements, six different levels of requirements affecting acceptance of and successful participation in a web-based PA intervention were identified. The individual fit was influenced by an interaction of different factors at the intrapersonal, sociocultural, content, spatial, digital and organizational levels. Several age- and gender-specific requirements were noted in the interviewed older adults. Men and women, as well as younger (

To date, knowledge about the effects and implementation quality of disease prevention and health promotion projects in Germany is limited. Only a few structured evaluation systems exist that can be easily used and which include features for evaluating research and practice projects. The aim of the current project was to develop and carry out a pilot study of an online evaluation tool that enables structured self-evaluation of projects in disease prevention and health promotion practice and contributes to an improved documentation and cyclical development of projects.The mixed-methods approach taken in this project included 2 steps: a) search of literature and database to develop a theoretical framework for the tool and b) adaptation process to test the fit of the tool for practice, including a focus group discussion and a usability test with different disease prevention and health promotion stakeholders (N=12).The resulting documentation and evaluation system (DEVASYS) is comprised of the components "planning", "documentation", and "evaluation" which can be used independently of one another. The conceptual basis of the tool is the RE-AIM framework. To determine the quality of an individual project, dimensions of both the output (reach, acceptance, implementation) and the outcome levels (effectiveness, maintenance) can be documented with the tool.DEVASYS is a practice-oriented tool contributing to an improved evaluation of existing practice-related intervention projects and the overall quality of future projects in the area of disease prevention and health promotion. Systematic dissemination and implementation of the tool are the next steps to be taken.Das Wissen über Wirkungen und Umsetzungsqualität in praxisbezogenen Projekten der Prävention und Gesundheitsförderung in Deutschland ist aktuell sehr begrenzt. Für die Evaluation solcher Projekte gibt es derzeit kaum strukturierte Evaluationssysteme, die leicht und mit wenig Aufwand, auch im Rahmen von Selbstevaluationen, genutzt werden können. Das Ziel der vorliegenden Arbeit war die wissenschaftsbasierte Entwicklung und Pilotierung eines Online-Tools zur Unterstützung einer strukturierten Dokumentation und Selbstevaluation von Interventionsprojekten der Prävention und Gesundheitsförderung, das zu einer zyklischen Projektentwicklung beiträgt.Der multimethodische Ansatz beinhaltete 2 Abschnitte, eine Literatur- und Datenbankrecherche zur Erstellung eines Rahmenmodells sowie eine Praxisanpassung, einschließlich einer Fokusgruppe und einem Anwendungstest mit Stakeholdern aus unterschiedlichen Praxisbereichen der Prävention und Gesundheitsförderung (N=12).Das Dokumentations- und Evaluationssystem (DEVASYS) unterscheidet die Bereiche „Planung“, „Dokumentation“ und „Evaluation“, die jeweils auch unabhängig voneinander bearbeitet werden können. Konzeptionelle Grundlage des Tools bildet das RE-AIM Framework. Zur Bestimmung der Projektqualität können sowohl Dimensionen der Output-Ebene (Reichweite, Akzeptanz, Implementierung) als auch der Outcome-Ebene (Wirksamkeit, Aufrechterhaltung) erfasst werden.DEVASYS ist ein praxiserprobtes Werkzeug, das zu einer verbesserten Evaluation existierender praxisbezogener Interventionsprojekte und zu einer Qualitätsentwicklung zukünftiger Projekte in der Prävention und Gesundheitsförderung beiträgt. Nächste Schritte sind die systematische Dissemination und Implementierung.

Background Web-based, theory-driven interventions effectively promote older adults' physical activity. Social-cognitive mechanisms of their effect on stage of change need to be further researched. Methods Older adults were randomly allocated to intervention group 1 (10-week online physical activity program), intervention group 2 (same program plus activity tracker), or delayed intervention control group; n = 351 were analyzed (59.6% of originally allocated individuals). Stages of change for recommended endurance and strength training and social-cognitive predictors of physical activity were assessed using questionnaires at baseline and follow-up. Intervention effects and mediation were investigated using mixed-effects ANOVA and ordinal least squares regression. Results Direct effects on stage of change were found for intervention group 1 regarding endurance training (bintervention group 1 = 0.44, 95% confidence interval [0.15, 0.73]), and both groups regarding strength training (bintervention group 1 = 1.02, [0.71, 1.33], bintervention group 2 = 1.24, [0.92, 1.56]). Social-cognitive predictor changes in task self-efficacy, intention, and action planning explained intervention effect on stage of change, but not to the full extent. Conclusions The results indicate significant web-based intervention effects on physical activity stage, partly mediated by changes in task self-efficacy, intention, and action planning.

ZIELE DER ARBEIT: Das Wissen über Wirkungen und Umsetzungsqualität in praxisbezogenen Projekten der Prävention und Gesundheitsförderung in Deutschland ist aktuell sehr begrenzt. Für die Evaluation solcher Projekte gibt es derzeit kaum strukturierte Evaluationssysteme, die leicht und mit wenig Aufwand, auch im Rahmen von Selbstevaluationen, genutzt werden können. Das Ziel der vorliegenden Arbeit war die wissenschaftsbasierte Entwicklung und Pilotierung eines Online-Tools zur Unterstützung einer strukturierten Dokumentation und Selbstevaluation von Interventionsprojekten der Prävention und Gesundheitsförderung, das zu einer zyklischen Projektentwicklung beiträgt. METHODIK: Der multimethodische Ansatz beinhaltete 2 Abschnitte, eine Literatur- und Datenbankrecherche zur Erstellung eines Rahmenmodells sowie eine Praxisanpassung, einschließlich einer Fokusgruppe und einem Anwendungstest mit Stakeholdern aus unterschiedlichen Praxisbereichen der Prävention und Gesundheitsförderung (N=12). ERGEBNISSE: Das Dokumentations- und Evaluationssystem (DEVASYS) unterscheidet die Bereiche „Planung“, „Dokumentation“ und „Evaluation“, die jeweils auch unabhängig voneinander bearbeitet werden können. Konzeptionelle Grundlage des Tools bildet das RE-AIM Framework. Zur Bestimmung der Projektqualität können sowohl Dimensionen der Output-Ebene (Reichweite, Akzeptanz, Implementierung) als auch der Outcome-Ebene (Wirksamkeit, Aufrechterhaltung) erfasst werden. SCHLUSSFOLGERUNG: DEVASYS ist ein praxiserprobtes Werkzeug, das zu einer verbesserten Evaluation existierender praxisbezogener Interventionsprojekte und zu einer Qualitätsentwicklung zukünftiger Projekte in der Prävention und Gesundheitsförderung beiträgt. Nächste Schritte sind die systematische Dissemination und Implementierung. OBJECTIVES: To date, knowledge about the effects and implementation quality of disease prevention and health promotion projects in Germany is limited. Only a few structured evaluation systems exist that can be easily used and which include features for evaluating research and practice projects. The aim of the current project was to develop and carry out a pilot study of an online evaluation tool that enables structured self-evaluation of projects in disease prevention and health promotion practice and contributes to an improved documentation and cyclical development of projects. METHODS: The mixed-methods approach taken in this project included 2 steps: a) search of literature and database to develop a theoretical framework for the tool and b) adaptation process to test the fit of the tool for practice, including a focus group discussion and a usability test with different disease prevention and health promotion stakeholders (N=12). RESULTS: The resulting documentation and evaluation system (DEVASYS) is comprised of the components “planning”, “documentation”, and “evaluation” which can be used independently of one another. The conceptual basis of the tool is the RE-AIM framework. To determine the quality of an individual project, dimensions of both the output (reach, acceptance, implementation) and the outcome levels (effectiveness, maintenance) can be documented with the tool. CONCLUSION: DEVASYS is a practice-oriented tool contributing to an improved evaluation of existing practice-related intervention projects and the overall quality of future projects in the area of disease prevention and health promotion. Systematic dissemination and implementation of the tool are the next steps to be taken.

Regular physical activity (PA) is of central importance for healthy ageing. However, in Germany, only 42% of older adults currently reach the PA recommendations of the World Health Organization. The aim of this study was to examine the effects of two web-based interventions on PA in adults aged 65–75 years living in Northwestern Germany compared to a delayed intervention control group (CG). 589 older adults were randomized to one of the three groups. Participants in intervention group 1 (IG1) received access to a web-based intervention for ten weeks assisting them in self-tracking PA behavior. Participants in IG2 received the intervention of IG1 and additionally an activity tracker to objectively track PA behavior. To analyze differences in objectively measured moderate-to-vigorous PA and sedentary time between baseline and follow-up (12 weeks after baseline), linear mixed models were used. The interaction effects revealed a decrease in minutes spent on moderate-to-vigorous PA in bouts of 10 min by 11 min per week in IG1 participants (β = −11.08, 95% CI: (−35.03; 12.87)). In comparison, IG2 participants were 7 min more physically active at follow-up (β = 7.48, 95% CI: (−17.64; 32.60)). Sedentary time in bouts of 30 min per week increased in IG1 participants (β = 106.77, 95% CI: (−47.69; 261.23)) and decreased in IG2 participants at follow-up (β = −16.45, 95% CI: (−178.83; 145.94)). Participation in the two web-based interventions did not lead to significant increases in moderate-to-vigorous PA or significant decreases in sedentary time compared to the CG. The study was registered at the German Clinical Trials Register (DRKS00010052, 07-11-2016)., Highlights • Regular physical activity (PA) is central to healthy ageing. • In Germany, only 42% of older adults currently meet the WHO-recommended PA levels. • PROMOTE examined the effectiveness of web-based PA interventions in older adults. • Two ten week web-based PA interventions were compared to a control group. • We found no increases in moderate-to-vigorous PA or decreases in sedentary time.

To date, conditions for successfully implementing and maintaining multi-level interventions and policies for the promotion of a balanced diet and physical activity are not well understood from the perspective of stakeholders.The aim of this article is to examine which factors are regarded as facilitating or impeding introduction, implementation and maintenance of multi-level interventions and policies from the standpoint of stakeholders.Semi-structured face-to-face interviews with stakeholders of one multi-level intervention (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS [IDEFICS] for the prevention of childhood obesity, n = 4) and one policy (Federal state offices coordinating networks for the provision of healthy food options in schools, n = 3) were analysed using qualitative content analysis.In both cases, the use of existing structures facilitated introduction, implementation and maintenance. Additionally, training of staff for implementation according to standardised protocols or concepts and taking structures and work conditions of settings into account during implementation were considered essential. In both cases, conflicting interests in interdisciplinary stakeholder teams regarding intervention content and implementation were identified as a barrier. A lack of political support and insecure long-term funding only played a role in regard to the implementation and maintenance of policies. On the other hand, target groups of the multi-level intervention were not sufficiently involved in the development of intervention materials which resulted in a lack of tailoring and acceptance in the target groups.The results provide important insights into the long-term implementation of multi-level interventions and policies in different settings.

Physical activity (PA) and the reduction of sedentary behavior positively influence healthy aging. PA results in increases in aerobic capacity and strength and is associated with less age-related cognitive decline. Further, a pronounced sedentary behavior, i.e. prolonged periods of sitting or overall inactivity, increases mortality risk regardless of PA level [1]. The interaction between sedentary behavior, dedicated exercise and PA level, and their effects on physical and mental fitness has not yet been fully elucidated.

Regular physical activity (PA) is central to healthy ageing. However, only a minority of older adults currently meet the WHO-recommended PA levels. The aim of this systematic review is to compare the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with either no intervention or a non-eHealth intervention (review registration: PROSPERO CRD42015023875). Eight electronic databases were searched to identify experimental and quasi-experimental studies examining the effectiveness of eHealth interventions for PA promotion in adults aged 55 years and above. Two authors independently selected and reviewed references, extracted data, and assessed study quality. In the search, 5771 records were retrieved, 20 studies met all inclusion criteria. Studies varied greatly in intervention mode, content, duration and assessed outcomes. Study quality ranged from poor to moderate. All interventions comprised tailored PA advice and the majority of interventions included goal setting and feedback, as well as PA tracking. Participation in eHealth interventions to promote PA led to increased levels of PA in adults aged 55 years and above when compared to no intervention control groups, at least in the short term. However, the results were inconclusive regarding the question of whether eHealth interventions have a greater impact on PA behavior among older adults than non-eHealth interventions (e.g., print interventions). eHealth interventions can effectively promote PA in older adults aged 55 years and above in the short-term, while evidence regarding long-term effects and the added benefit of eHealth compared to non-eHealth intervention components is still lacking.

Background Previous research suggests that perceptions of peer substance use are associated with personal use. Specifically, overestimating use in the peer group is predictive of higher rates of personal substance use. ‘Social norms’-interventions are based on the premise that changing these misperceived social norms regarding substance use by providing feedback on actual norms is associated with a reduction in personal substance use. Studies conducted in the U.S.A. suggest that ‘social norms’-feedback is an effective strategy for reducing substance use among university students. It is unknown whether the effects of a ‘social norms’-feedback on substance use can be replicated in a sample of German university students. The objective of this article is to describe the study design and aims of the ‘INternet-based Social norms-Intervention for the prevention of substance use among Students’ (INSIST)-study, a cluster-controlled trial examining the effects of a web-based ‘social norms’- intervention in students enrolled at four intervention universities with those enrolled at four delayed intervention control universities. The INSIST-study is funded by the German Federal Ministry of Health. Methods/Design Eight universities in four regions in Germany will take part in the study, four serving as intervention and four as delayed intervention control universities (randomly selected within a geographic region). Six hundred students will be recruited at each university and will be asked to complete a web-based survey assessing personal and perceived substance use/attitudes towards substance use at baseline. These data will be used to develop the web-based ‘social norms’-feedback tailored to gender and university. Three months after the baseline survey, students at intervention universities will receive the intervention. Two months after the launch of the intervention, students of all eight universities will be asked to complete the follow-up questionnaires to assess changes in perceptions of/attitudes toward peer substance use and rates of personal substance use. Discussion This study is the first German cluster-controlled trial investigating the influence of a web-based ‘social norms’-intervention on perceptions of/attitudes towards substance use and substance use behavior in a large university student sample. This study will provide new information on the efficacy of this intervention strategy in the German university context. Trial registration DRKS00007635 at the ‘German Clinical Trials Register’ (17.12.2014).

OBJECTIVE: To summarize the current evidence on the effectiveness of school-based interventions for the maintenance of mental health and the prevention of psychosocial problems among pupils. METHODS: A systematic literature search of reviews published between 2007 and 2015 was carried out. Databases searched included Medline, PsycINFO, Campbell Library, Cochrane Library, NICE, ERIC, and Web of Science. Study selection, data extraction, and quality assessment (using AMSTAR criteria) were performed by 2 independent reviewers. RESULTS: 6 reviews covering 331 primary studies were included in this review of reviews. Findings of three reviews with a focus on the maintenance and/or promotion of mental health and general well-being suggested that interventions aimed at changes in the social and the school environment were more effective than those that only targeted individual behavior change among pupils. Interventions for the reduction of mobbing/bullying were most effective if they comprised organizational changes at schools, such as playground and schoolyard supervision, and disciplinary measures. One review suggested strong evidence for the effectiveness of classroom management to reduce violent behavior among pupils. CONCLUSIONS: Participation in interventions promoting changes in the school environment, in addition to individual behavior change, appears to be associated with improved mental health among pupils and reductions in mobbing/bullying and violent behavior at schools. ZIEL DER STUDIE: Zusammenfassung der aktuellen Evidenz zur Wirksamkeit von schulbasierten Interventionen zur Aufrechterhaltung von psychischer Gesundheit und zur Prävention psychosozialer Probleme. METHODIK: Eine systematische Literaturrecherche zu zwischen 2007 und 2015 publizierten Übersichtsarbeiten wurde in den Datenbanken Medline, PsycINFO, Campbell Library, Cochrane Library, NICE, ERIC und Web of Science durchgeführt. Die Studienauswahl, Datenextraktion und Qualitätsbewertung (nach AMSTAR-Kriterien) erfolgte durch 2 unabhängige Reviewerinnen. ERGEBNISSE: 6 Übersichtsarbeiten zu insgesamt 331 Primärstudien wurden in dieses Review von Reviews eingeschlossen. Bei Interventionen zur Förderung der psychischen Gesundheit bzw. des allgemeinen Wohlbefindens erzielten diejenigen, die die soziale Umgebung und Schulumwelt einbezogen, eine größere Wirkung als Interventionen, die nur auf Änderungen im individuellen Verhalten abzielten. Bei Interventionen zur Reduktion von Mobbing/Bullying erwiesen sich organisationale Änderungen, wie die Einführung einer Pausenaufsicht oder Disziplinarmaßnahmen, als wirksam. Zur Reduktion von Gewalt in Schulen zeigte eine Übersichtsarbeit starke Evidenz für die Wirksamkeit von Klassenraummanagement. SCHLUSSFOLGERUNG: Interventionen, die über das Individualverhalten hinaus auch Aspekte der Schulumwelt adressieren, scheinen zur Förderung von psychischer Gesundheit bei Schülern/-innen beizutragen und Mobbing/Bullying sowie Gewalt an Schulen zu reduzieren.

Background It is known that regular physical activity (PA) is associated with improvements in physical, psychological, cognitive, and functional health outcomes. The World Health Organization recommends 150 min of moderate exercise per week for older adults to achieve these health benefits. However, only 20–60 % of adults aged 60 years and above currently meet these recommendations for exercise. The widespread use of the internet and mobile phones among older adults may open new opportunities to promote PA in this population. Findings of previous reviews suggest that eHealth interventions are effective in promoting PA in adults of various ages. However, to date, none of these reviews have provided a differentiated picture of engagement in such interventions and effects on PA among older adults. Also, we are unaware of any studies comparing effects of participation in eHealth vs. traditional paper-and-pencil interventions on PA in this population. The aim of this systematic review and meta-analysis is to compare the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with either a non-eHealth PA intervention or a group that is not exposed to any intervention. Methods Eight electronic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, PEI, PsycINFO, Web of Science, and OpenGrey) will be searched to identify experimental and quasi-experimental studies examining the effectiveness of eHealth interventions for PA promotion in adults aged 55 years and above. Two authors will independently select and review references, extract data, and assess the quality of the included studies by using the Cochrane Collaboration’s risk of bias tool. Disagreements between authors will be resolved by discussion involving a third author. If feasible, a meta-analysis will be conducted. Narrative synthesis using harvest plots will be performed, should a meta-analysis not be feasible. Discussion The proposed systematic review will be the first review that compares the effectiveness of eHealth interventions promoting PA in older adults aged 55 years and above with control groups exposed to a non-eHealth intervention or to no intervention. The results of this review will provide new information regarding the question whether eHealth interventions are an effective intervention vehicle for PA promotion in this population. Systematic review registration PROSPERO CRD42015023875 Electronic supplementary material The online version of this article (doi:10.1186/s13643-016-0223-7) contains supplementary material, which is available to authorized users.