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Purpose The aim of the present study was to investigate the effect of the JUMP-in programme on sports participation, overall physical activity (PA), shuttle run score and body composition in 6-12-year-old children. Methods JUMP-in is a school-based strategy combining environmental policy, neighbourhood, parents- and personal components. A controlled trial was carried out in 19 primary schools including 2848 children (50% boys). Measures were performed at the beginning of the first school year (T0: 2006) and repeated at the end of the first (T1: 2007) and second school year (T2: 2008). Results A significant beneficial intervention effect was found on organised sports participation (OR 2.8 (2.2 to 3.6)). Effects were stronger for girls (OR 3.6 (2.3 to 5.6)), and for Moroccan (OR 4.2 (3.6 to 5.7)) and Turkish children (OR 3.2 (1.9 to 5.2)). Participation in organised sports was associated with increased shuttle run score. No significant intervention effects on overall daily PA rates and body composition were observed. Conclusion The present study proves that a school-based strategy combining environmental and personal interventions was successful in improving structural sports participation among children. [ABSTRACT FROM AUTHOR]

Background: The Active Plus project is a systematically developed theory- and evidence-based, computer-tailored intervention, which was found to be effective in changing physical activity behavior in people aged over 50 years. The process and effect outcomes of the first version of the Active Plus project were translated into an adapted intervention using the RE-AIM framework. The RE-AIM model is often used to evaluate the potential public health impact of an intervention and distinguishes five dimensions: reach, effectiveness, adoption, implementation, and maintenance.Objective: To gain insight into the systematic translation of the first print-delivered version of the Active Plus project into an adapted (Web-based) follow-up project. The focus of this study was on the reach and effectiveness dimensions, since these dimensions are most influenced by the results from the original Active Plus project.Methods: We optimized the potential reach and effect of the interventions by extending the delivery mode of the print-delivered intervention into an additional Web-based intervention. The interventions were adapted based on results of the process evaluation, analyses of effects within subgroups, and evaluation of the working mechanisms of the original intervention. We pretested the new intervention materials and the Web-based versions of the interventions. Subsequently, the new intervention conditions were implemented in a clustered randomized controlled trial.Results: Adaptations resulted in four improved tailoring interventions: (1) a basic print-delivered intervention, (2) a basic Web-based intervention, (3) a print-delivered intervention with an additional environmental component, and (4) a Web-based version with an additional environmental component. Pretest results with participants showed that all new intervention materials had modest usability and relatively high appreciation, and that filling in an online questionnaire and performing the online tasks was not problematic. We used the pretest results to improve the usability of the different interventions. Implementation of the new interventions in a clustered randomized controlled trial showed that the print-delivered interventions had a higher response rate than the Web-based interventions. Participants of both low and high socioeconomic status were reached by both print-delivered and Web-based interventions.Conclusions: Translation of the (process) evaluation of an effective intervention into an adapted intervention is challenging and rarely reported. We discuss several major lessons learned from our experience.Trial Registration: Nederlands Trial Register (NTR): 2297; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2297 (Archived by WebCite at http://www.webcitation.org/65TkwoESp). [ABSTRACT FROM AUTHOR]

Background: Limited data are available on the development, implementation and evaluation processes of physical activity promotion programmes among older adults. More integrative insights into interventions describing the planned systematic development, implementation and evaluation are needed.Methods and Design: The purpose of this study is to give an integrative insight into the development of the Active plus programme applying the six-step Intervention Mapping protocol. The Active plus programme consisted of two theory- and evidence-based tailored physical activity promotion interventions, both comprising three tailored letters delivered over four months and aimed at raising awareness of insufficient physical activity, and stimulating physical activity initiation and maintenance among the over-fifties. The first intervention, the basic tailored intervention, provided tailored letters that intervened on the psychosocial determinants of physical activity. The second intervention, the intervention plus, provided the same tailored information but additionally provided tailored information about physical activity opportunities in the specific environment in which the older adults lived. This environment-based component also provided access to a forum and e-buddy system on a website. A plan for implementation and evaluation is also described.Discussion: The planned development of the Active plus programme resulted in two theory- and evidence-based tailored physical activity interventions targeted at the over-fifties.Trial Registration: Dutch Trial Register NTR 920. [ABSTRACT FROM AUTHOR]

Background: Healthy sleep is crucial for the physical and mental wellbeing of adolescents. However, many adolescents suffer from poor sleep health. Little is known about how to effectively improve adolescent sleep health as it is shaped by a complex adaptive system of many interacting factors. This study aims to provide insights into the system dynamics underlying adolescent sleep health and to identify impactful leverage points for sleep health promotion interventions., Methods: Three rounds of single-actor workshops, applying Group Model Building techniques, were held with adolescents (n = 23, 12-15 years), parents (n = 14) and relevant professionals (n = 26). The workshops resulted in a multi-actor Causal Loop Diagram (CLD) visualizing the system dynamics underlying adolescent sleep health. This CLD was supplemented with evidence from the literature. Subsystems, feedback loops and underlying causal mechanisms were identified to understand overarching system dynamics. Potential leverage points for action were identified applying the Action Scales Model (ASM)., Results: The resulting CLD comprised six subsystems around the following themes: (1) School environment; (2) Mental wellbeing; (3) Digital environment; (4) Family & Home environment; (5) Health behaviors & Leisure activities; (6) Personal system. Within and between these subsystems, 16 reinforcing and 7 balancing feedback loops were identified. Approximately 60 potential leverage points on different levels of the system were identified as well., Conclusions: The multi-actor CLD and identified system dynamics illustrate the complexity of adolescent sleep health and supports the need for developing a coherent package of activities targeting different leverage points at all system levels to induce system change., (© 2024. The Author(s).)

Objectives: To investigate the daily life experiences of sleep, mood, and pain in relation to appetite in community-dwelling older adults aged 75 years and older, stratified by sex., Design: Existing data from a daily experience study embedded in the Longitudinal Aging Study Amsterdam (LASA) among the oldest-old (≥75 years)., Setting: LASA is an ongoing cohort study of a nationally representative sample of older adults aged ≥55 years from three culturally distinct regions in the Netherlands., Participants: 434 community-dwelling older adults aged ≥75 years., Measurements: Participants filled-out a one-week diary on daily experience of pain, mood, last night sleep (10-point Likert scale), and appetite (5-point Likert scale) on five measurement occasions between 2016 and 2021. (Hybrid) linear mixed models were used to investigate overall, within-subject and between-subject association between mood, sleep, and pain (independent variables) and appetite (dependent variable), while correcting between-subject associations for season, age, educational level, partner status, body mass index, alcohol consumption, physical activity level, smoking status, chronic diseases and use of nervous system medication, stratified by sex., Results: Averaged over all days, males reported a poor appetite on 12% of the days and females on 19% of the days. Statistically significant between-subject associations with a poorer appetite were found for lower mood (unstandardized b = 0.084 [95% CI 0.043-0.126] (males), (b = 0.126 [95% CI 0.082-0.170] (females)), poorer sleep (b = 0.045 [95% CI 0.007-0.083] (males), (b = 0.51 [95% CI 0.017-0.085] (females)) and more severe pain in males only (b = 0.026 [95% CI 0.002-0.051]). Except for pain, within-subject associations were somewhat weaker: mood: b = 0.038 [95% CI 0.016-0.060] (males), (b = 0.082 [95% CI 0.061-0.104] (females)); sleep: b = 0.029 [95% CI 0.008-0.050] (males), (b = 0.15 [95% CI 0.005-0.025] (females)); and pain (b = 0.032 [95% CI 0.004-0.059] (males))., Conclusions: This study found that poor sleep, low mood (more strongly in females) and more severe pain (males only) are associated with poor appetite in older adults on a daily level both within and between persons. Sex differences in factors related to poor appetite should be considered in future research., (Copyright © 2023 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Objective: To investigate whether financial constraint and perceived stress modify the effects of food-related taxes on the healthiness of food purchases., Design: Moderation analyses were conducted with data from a trial where participants were randomly exposed to: a control condition with regular food prices, an sugar-sweetened beverage (SSB) tax condition with a two-tiered levy on the sugar content in SSB (5-8 g/100 ml: €0·21 per l and ≥ 8 g/100 ml: €0·28 per l) or a nutrient profiling tax condition where products with Nutri-Score D or E were taxed at a 20 percent level. Outcome measures were overall healthiness of food purchases (%), energy content (kcal) and SSB purchases (litres). Effect modification was analysed by adding interaction terms between conditions and self-reported financial constraint or perceived stress in regression models. Outcomes for each combination of condition and level of effect modifier were visualised., Setting: Virtual supermarket., Participants: Dutch adults ( n 386)., Results: Financial constraint or perceived stress did not significantly modify the effects of food-related taxes on the outcomes. Descriptive analyses suggest that in the control condition, the overall healthiness of food purchases was lowest, and SSB purchases were highest among those with moderate/high levels of financial constraint. Compared with the control condition, in a nutrient profiling tax condition, the overall healthiness of food purchases was higher and SSB purchases were lower, especially among those with moderate/high levels of financial constraint. Such patterns were not observed for perceived stress., Conclusion: Further studies with larger samples are recommended to assess whether food-related taxes differentially affect food purchases of subgroups.

Background: When losing weight, most individuals find it difficult to maintain a healthy diet. Social environmental conditions are of pivotal importance in determining dietary behavior. To prevent individuals from lapsing, insight in social environmental predictors of lapse in dietary behavior is needed., Purpose: Identify social environmental predictors of lapse in dietary behavior, using ecological momentary assessment (EMA) amongst Dutch adults trying to lose weight., Methods: Adults (N = 81) participated in two 7-day EMA weeks. Six times a day semi-random prompts were sent. At each prompt, participants indicated whether a lapse had occurred and responded to questions assessing social support, descriptive norm, injunctive norm, social pressure, presence of others, and current location. Generalized estimating equations were used to examine associations with lapse., Results: Injunctive norm (OR = 1.07, 95% CI = 1.03-1.11), descriptive norm (OR = 1.04, 95% CI = 1.02-1.07), and social pressure (OR = 1.09, 95% CI = 1.05-1.14), all toward diverting from diet plans, predicted lapses. Social support toward sticking to diet plans and presence of others did not predict lapses. When controlling for a prior lapse, all other associations became nonsignificant. Lapses occurred most often at home and gradually occurred more often during the day., Conclusions: Traditional public health perspectives have mainly focused on individual choice and responsibility for overweight related unhealthy lifestyles. This study shows that there may be opportunities to enhance intervention programs by also focusing on social norms and social pressure. The involvement of partners or housemates may create more awareness of the impact of (unintentional) social pressure on risk of lapsing, and reduce the level of exerted social pressure., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Background: Multidisciplinary lifestyle interventions are recommended as a first step in treating weight recurrence after bariatric-metabolic surgery (BMS). However, little is known about the experience of patients and healthcare professionals (HCP) with these interventions and how they should be tailored to the patients' needs. The aim of this study was to gain more insight into the experiences and needs of patients and HCP regarding weight recurrence after BMS and an intervention to get Back on Track. In addition, attitudes towards integrating e-Health into the care program were explored., Methods: A qualitative process evaluation of an intervention for weight recurrence, the Back on Track (BoT), was conducted by means of in-depth interviews and focus groups with 19 stakeholders, including patients and HCP involved in BoT. Interviews were transcribed verbatim. Data were analyzed through thematic analysis., Results: Patients and HCP reported a wide array of causes of weight recurrence. Patients found it difficult to decide when weight recurrence is problematic and when they should ask for help. Patients reported feeling like the exception and ashamed, therefore experiencing a high threshold to seek help. E-Health was seen as a promising way to improve tailoring, screening, autonomy for the patient, and accessible contact., Conclusion: Patients should be adequately counselled on weight recurrence after BMS and the importance of intervening early. It is important to lower the threshold for seeking help. For example by offering more long-term standard care or by adding e-Health to the intervention., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: V. Voorwinde reports financial support was provided by De Nederlandse Obesitas Kliniek BV. V.M. Monpellier reports financial support was provided by De Nederlandse Obesitas Kliniek BV. I.M.C. Janssen reports financial support was provided by De Nederlandse Obesitas Kliniek BV. V. Voorwinde reports a relationship with De Nederlandse Obesitas Kliniek BV that includes: employment. V.M. Monpellier reports a relationship with De Nederlandse Obesitas Kliniek BV that includes: employment. I.M.C. Janssen reports a relationship with De Nederlandse Obesitas Kliniek BV that includes: board membership and consulting or advisory., (© 2023 The Authors.)

Insufficient sleep duration among adolescents is a widespread public health problem. Gaining better insight into social-cognitive determinants associated with adolescent sleep duration is necessary for developing effective preventive interventions to support healthy sleep. This study aimed to explore whether social-cognitive determinants regarding sufficient sleep duration were associated with sleep duration, and if these associations were mediated by collective sleep hygiene practices. Furthermore, we examined these associations for social-cognitive determinants related to not using media before bedtime and doing relaxing activities and considered whether these associations were mediated by specific sleep hygiene practices. Data were collected amongst second- and third-grade adolescents from 10 Dutch high schools. A total of 878 adolescents (mean [SD] age 13.3 [0.71] years) completed data on sleep duration, social-cognitive determinants of the Theory of Planned Behaviour (i.e., attitude, subjective norms from parents, subjective norms from peers, perceived behavioural control, intention), and sleep hygiene practices. Single- and multivariable path models were constructed and mediation by sleep hygiene practices was analysed by Monte Carlo simulation. All social-cognitive determinants except for subjective norms from peers were associated with longer sleep duration (p < 0.01). Sleep hygiene practices mediated all associations between social-cognitive determinants and sleep duration (mediation ranging from 16% to 72%). Although some of the significant associations and mediation disappeared in the multivariable model, behavioural arousal was the strongest mediator, but collective sleep hygiene practices and cognitive/emotional arousal also explained parts of the associations. The findings indicate that social-cognitive factors should not be overlooked when targeting adolescent sleep duration., (© 2022 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)

Objective: Behaviour change maintenance seems to be difficult for many people. To prevent people from relapsing, insight into determinants of relapse is needed. We synthesized the evidence on predictors of lapse and relapse in physical activity and dietary behaviour change., Design: Prospective studies in adults aged ≥18 years were identified from systematic searches in PsycINFO, PubMed and Cinahl. Methodological quality was analysed, and data were synthesized narratively., Main Outcome Measures: Lapse and relapse in physical activity and dietary behaviour., Results: 37 articles were included. For several predictors, evidence for an association was found, with self-efficacy as the only consistent predictor across the different outcomes, predicting both lapse and relapse in physical activity, and relapse in dietary behaviour. For most other variables, evidence for prospective relationships with lapse and relapse was insufficient., Conclusion: Most predictors on lapse and relapse were not examined frequently enough to draw conclusions from; many predictors were studied only once or had inconclusive evidence. To be able to provide more substantiated conclusions, more high-quality research is needed. Practitioners and intervention programs could focus on sustainability of behaviour change, by targeting the outcome of interest and its relevant predictors by using behaviour change techniques that have proven effective.

Background: To design a comprehensive approach to promote children's sleep health in Amsterdam, the Netherlands, we combined Intervention Mapping (IM) with the Health in All Policies (HiAP) perspective. We aimed to create an approach that fits local infrastructures and policy domains across sectors., Methods: First, a needs assessment was conducted, including a systematic review, two concept mapping studies, and one cross-sectional sleep diary study (IM step 1). Subsequently, semi-structured interviews with stakeholders from policy, practice and science provided information on potential assets from all relevant social policy sectors to take into account in the program design (HiAP and IM step 1). Next, program outcomes and objectives were specified (IM step 2), with specific objectives for policy stakeholders (HiAP). This was followed by the program design (IM step 3), where potential program actions were adapted to local policy sectors and stakeholders (HiAP). Lastly, program production (IM step 4) focused on creating a multi-sector program (HiAP). An advisory panel guided the research team by providing tailored advice during all steps throughout the project., Results: A blueprint was created for program development to promote children's sleep health, including a logic model of the problem, a logic model of change, an overview of the existing organizational structure of local policy and practice assets, and an overview of policy sectors, and related objectives and opportunities for promoting children's sleep health across these policy sectors. Furthermore, the program production resulted in a policy brief for the local government., Conclusions: Combining IM and HiAP proved valuable for designing a blueprint for the development of an integrated multi-sector program to promote children's sleep health. Health promotion professionals focusing on other (health) behaviors can use the blueprint to develop health promotion programs that fit the local public service infrastructures, culture, and incorporate relevant policy sectors outside the public health domain., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Belmon, Van Stralen, Harmsen, Den Hertog, Ruiter, Chinapaw and Busch.)

Study Objectives: This review aimed to summarize instruments that measure one or more domains of sleep health (i.e. duration, quality, efficiency, timing, daytime sleepiness and sleep-related behaviors) in a general population of 4-12-year old children, and to assess these instruments' content validity. Other measurement properties were evaluated for instruments with indications of sufficient content validity., Methods: A systematic literature search was performed in PubMed, PsycINFO, Web of Science, and EmBase. Methodological quality, content validity, and other measurement properties were assessed via the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. Instruments with indications of sufficient content validity (i.e. relevance, comprehensiveness and comprehensibility) were further evaluated on other measurement properties (i.e. other aspects of validity, reliability, responsiveness). A modified GRADE approach was applied to determine the quality of evidence., Results: Twenty instruments, containing 36 subscales, were included. None of the instruments measured all sleep health domains. For five (subscales of) instruments sufficient relevance and comprehensibility was found. The quality of evidence ranged from very low to moderate. For these five instruments all additional measurement properties were assessed. Sufficient results were found for structural validity (n = 1), internal consistency (n = 1), and construct validity (n = 1), with quality of evidence ranging from very low to high., Conclusions: Several (subscales of) instruments measuring domains of child sleep health showed good promise, demonstrating sufficient relevance, comprehensibility, and some also sufficient results on other measurement properties. However, more high quality studies on instrument development and the evaluation of measurement properties are required.PROSPERO registration number: CRD42021224109., (© Sleep Research Society 2022. Published by Oxford University Press on behalf of the Sleep Research Society.)

Purpose: Previous studies showed that patients with lower weight loss after bariatric surgery could be identified based on early postoperative weight loss. However, these studies had only 12-36-month follow-up. This study aimed to explore whether patients in the lowest weight loss quartile at 3 months had lower weight loss trajectories up to 5 years after Roux-en-Y gastric bypass (RYGB), banded Roux-en-Y gastric bypass (BRYGB), and sleeve gastrectomy (SG) surgery., Methods: Weight was assessed preoperatively, and 3, 6, 9, 12, 24, 36, 48, and 60 months postoperatively. Patients were grouped into four categories based on quartiles of percentage total weight loss (%TWL) at 3-month follow-up. Results were compared between the lowest %TWL quartile group and other quartile groups., Results: Patients underwent either RYGB (n=13,106; 72%), SG (n=3585; 20%), or BRYGB (n=1391, 8%) surgery. Weight loss trajectories of patients in the lowest %TWL quartile group remained lower than that of other quartile groups throughout a 5-year follow-up, for all three types of surgery. Patients in the lowest %TWL quartile group had higher age at surgery, higher baseline BMI, and were more likely to be male (in the SG group), and to suffer from diabetes, hypertension, dyslipidemia, and osteoarthritis., Conclusion: This study showed a positive association between weight loss at 3 and 12 to 60 months after bariatric surgery. Weight loss at 3 months after surgery could be used to identify patients whose anticipated weight loss trajectories are below average, to potentially improve their outcomes through early behavioral or medical interventions., (© 2022. The Author(s).)

Background: Little research has taken individual variability in weight loss into account. Furthermore, physical activity (PA) and eating style (ES) have been linked only sporadically to weight loss longitudinally., Objectives: Identify and describe latent classes of weight loss, change of PA, and change of ES up to 5 years after surgery and investigate whether these trajectories are interrelated., Setting: Multicenter outpatient clinic., Methods: This is a retrospective study of data collected during standard treatment before and up to 5 years after surgery. Latent class growth analysis was used to identify trajectories of weight loss (percent total weight loss), PA (Baecke questionnaire), and ES (Dutch Eating Behavior Questionnaire)., Results: A total of 2785 patients were included. Follow-up rate was 84% at 1 year and 34% at 5 years. Analyses revealed 5 weight loss trajectories. Most patients followed an average, fairly stable weight loss trajectory (48%) or an above-average partial-regain trajectory (36%). Other patients followed a low-responder trajectory (9%), a rapid weight loss and weight regain trajectory (6%), or a continued weight loss trajectory (2%). Patients in the most favorable weight loss trajectory were more likely to also follow the most favorable ES trajectories. Patients following the most unfavorable weight loss trajectory were never also in the PA trajectory with an initial great increase in PA., Conclusion: This study distinguishes demographic and behavioral factors that may influence long-term weight loss trajectories after bariatric surgery. Trajectories varied mainly in magnitude and less in the pattern of weight loss over time, suggesting that very deviant patterns are rare., (Copyright © 2022 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Background: This study evaluated the effect of the school-based intervention Charge Your Brainzzz on adolescents' social-cognitive determinants, sleep hygiene and sleep duration and quality., Methods: A cluster-randomized controlled trial was conducted with 972 students from 10 Dutch high schools. Schools were randomly allocated to the intervention (N = 5) or control condition (N = 5). Outcomes were measured with the digital Consensus Sleep Diary and via a digital questionnaire, based on valid measures. Data were collected at baseline (T0), ±1.5 weeks post-intervention (T1) and ±3 months post-intervention (T2). Mixed model analyses were performed to estimate the effects on social-cognitive determinants, sleep hygiene, and sleep outcomes., Results: The intervention increased sleep knowledge post-intervention (b = 1.91; 95%CI: 1.22-2.60) and at follow up (b = 1.40; 95%CI: 0.70-2.10). The intervention was also effective in changing adolescents' attitudes (b = 0.10; 95%CI: 0.01-0.19) and perceived behavioral control (b = 0.11; 95%CI: 0.01-0.22) post-intervention. No positive changes were found regarding subjective norms, behavioral intentions, sleep hygiene, or sleep outcomes., Conclusions: The intervention improved adolescents' sleep knowledge, attitude, and perceived behavioral control. To significantly impact sleep health, theoretically sound and systematically developed interventions are needed which take into account the interplay between sleep, sleep-related behaviors, and adolescents' social and physical environment., Clinical Trial Registration: Trial name: Evaluation of the school-based intervention Charge Your Brainzzz promoting sleep in adolescents; URL: https://doi.org/10.1186/ISRCTN36701918; ID: ISRCTN36701918., (© 2022 The Authors. Journal of School Health published by Wiley Periodicals LLC on behalf of American School Health Association.)

An increasing number of governments worldwide have introduced a tax on sugar-sweetened beverages (SSB) for public health. However, the adoption of such a policy is still debated in many other countries, such as in the Netherlands. We investigated Dutch stakeholder views on taxation of SSB and perceived barriers and facilitators to its adoption in the Netherlands. Semi-structured interviews were conducted in 2019 with 27 stakeholders from health and consumer organizations, health professional associations, trade associations, academia, advisory bodies, ministries and parliamentary parties. Data were analysed using a thematic content approach. The findings reveal that, between and within sectors, stakeholders expressed contradictory views on the effectiveness, appropriateness and (socio)economic effects of an SSB tax. Perceived barriers to the adoption of an SSB tax in the Netherlands included an unfavourable political context, limited advocacy for an SSB tax, a strong lobby against an SSB tax, perceived public opposition, administrative load and difficulties in defining SSB. Perceived facilitators to its adoption included an increasing prevalence of overweight, disappointing results from voluntary industry actions, a change of government, state budget deficits, a shift in public opinion, international recommendations and a solid legal basis. In conclusion, this study shows that several challenges remain to be overcome for the adoption of an SSB tax in the Netherlands. Similar research on stakeholder views in other countries may further inform SSB tax policy processes., (© The Author(s) 2021. Published by Oxford University Press.)

Objective: To investigate the effects of a sugar-sweetened beverage (SSB) tax and a nutrient profiling tax on consumer food purchases in a virtual supermarket., Design: A randomised controlled trial was conducted with a control condition with regular food prices (n 152), an SSB tax condition (n 130) and a nutrient profiling tax condition based on Nutri-Score (n 112). Participants completed a weekly grocery shop for their household. Primary outcome measures were SSB purchases (ordinal variable) and the overall healthiness of the total shopping basket (proportion of total unit food items classified as healthy). The secondary outcome measure was the energy (kcal) content of the total shopping basket. Data were analysed using regression analyses., Setting: Three-dimensional virtual supermarket., Participants: Dutch adults aged ≥18 years are being responsible for grocery shopping in their household (n 394)., Results: The SSB tax (OR = 1·62, (95 % CI 1·03, 2·54)) and the nutrient profiling tax (OR = 1·88, (95 %CI 1·17, 3·02)) increased the likelihood of being in a lower-level category of SSB purchases. The overall healthiness of the total shopping basket was higher (+2·7 percent point, (95 % CI 0·1, 5·3)), and the energy content was lower (-3301 kcal, (95 % CI -6425, -177)) for participants in the nutrient profiling tax condition than for those in the control condition. The SSB tax did not affect the overall healthiness and energy content of the total shopping basket (P > 0·05)., Conclusions: A nutrient profiling tax targeting a wide range of foods and beverages with a low nutritional quality seems to have larger beneficial effects on consumer food purchases than taxation of SSB alone.

The aim of the present study was to explore potential factors of inadequate sleep health (i.e. sleep duration, quality, and timing) of school-aged children. Data were collected among 382 primary school children (aged 4-13 years) and their parents. Personal characteristics (i.e. age, sex), individual lifestyle behaviours (i.e. screen use, sleep hygiene behaviour), social and community factors (i.e. parental sleep-related practices, parental barriers, perceived ethnicity), and living conditions (i.e. parental educational level, sleep environment) were assessed with a parental questionnaire. Sleep duration, quality, and timing were assessed with a sleep diary. Associations were analysed using linear mixed models and logistic regression analyses. In total, 332 children, with a mean (range) age of 7.5 (4-13) years, were included in the analyses. The mean sleep duration was 632 min/night, the mean sleep quality score was 40, on a scale from 10 to 50, and 25% had a bedtime that varied >40 min between weekdays. Factors negatively associated with children's sleep health included older age, perceived non-Dutch cultural background, lower parental pre-sleep emotional support, the parental barrier to get their child to bed on time when siblings have a later bedtime, high parental educational level, sleeping in a darkened bedroom, and being brought to bed after falling asleep. On average, children in the present study had adequate sleep health. The factors found to be associated with children's sleep health are useful for future healthy sleep research and intervention development., (© 2021 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.)

Introduction: Not all patients with suboptimal weight loss after bariatric surgery are willing to participate in postoperative behavioral intervention to improve their weight loss. The objective of this study was to explore barriers to and facilitators of participation in postoperative behavioral intervention., Methods: Thirty semi-structured interviews were conducted with patients (18), physicians (6), and therapists (6) (i.e., psychologists, dieticians, or physiotherapists). A thematic analysis approach was used., Results: Emotional responses caused by confrontation with suboptimal weight loss hampered patients' deliberation about participation; insufficient exploration of their need for help limited patients' ability to make informed decisions; patients were receptive to their physician's advice when their physician respected their autonomy; using visual weight loss graphs helped to explain suboptimal weight loss to patients; and financial costs and time constraints obstructed participation., Conclusions: To improve adequate intervention participation, healthcare providers should focus on emotion regulation, support patients in exploring their own need for help, and respect patients' autonomy., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

Background: Preventing people from relapsing into unhealthy habits requires insight into predictors of relapse in weight loss maintenance behaviors. We aimed to explore predictors of relapse in physical activity and dietary behavior from the perspectives of health practitioners and persons who regained weight, and identify new predictors of relapse beyond existing knowledge., Methods: We used concept mapping to collect data, by organizing eight concept mapping sessions among health practitioners (N=39, five groups) and persons who regained weight (N=21, three groups). At the start of each session, we collected participants' ideas on potential predictors. Subsequently, participants individually sorted these ideas by relatedness and rated them on importance. We created concept maps using principal component analysis and cluster analysis., Results: 43 predictors were identified, of which the majority belonged to the individual domain rather than the environmental domain. Although the majority of predictors were mentioned by both stakeholder groups, both groups had different opinions regarding their importance. Also, some predictors were mentioned by only one of the two stakeholder groups. Practitioners indicated change in daily structure, stress, maladaptive coping skills, habitual behavior, and lack of self-efficacy regarding weight loss maintenance as most important recurrent (mentioned in all groups) predictors. Persons who regained weight indicated lifestyle imbalance or experiencing a life event, lack of perseverance, negative emotional state, abstinence violation effect, decrease in motivation and indulgence as most important recurrent predictors., Conclusions: For several predictors associations with relapse were shown in prior research; additionally, some new predictors were identified that have not been directly associated with relapse in weight loss maintenance behaviors. Our finding that both groups differed in opinion regarding the importance of predictors or identified different predictors, may provide an opportunity to enhance lifestyle coaching by creating more awareness of these possible discrepancies and including both points of view during coaching., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Objective: To investigate the level of public acceptability of a sugar-sweetened beverage (SSB) tax and its associated factors., Design: Participants completed an online self-administered questionnaire. Acceptability of an SSB tax was measured on a seven-point Likert scale (strongly disagree to strongly agree). Associations between acceptability and sociodemographic factors, weight status, SSB consumption and beliefs about effectiveness (e.g., 'An SSB tax would reduce people's SSB consumption'), appropriateness, socioeconomic and economic benefit, implementation and trust were assessed using multivariable linear regression analyses., Setting: The Netherlands., Participants: Dutch adults aged ≥18 years representative of the Dutch population for age, sex, education level and location (n 500)., Results: Of the participants, 40 % supported and 43 % opposed an SSB tax in general. Moreover, 42 % supported (43 % opposed) an SSB tax as a strategy to reduce overweight, and 55 % supported (32 % opposed) an SSB tax if revenue is used for health initiatives. Participants with a low education level (B = -0·82, 95 % CI -1·31, -0·32), overweight (B = -0·49, 95 % CI -0·89, -0·09), moderate or high SSB consumption (B = -0·86, 95 % CI -1·30, -0·43 and B = -1·01, 95 % CI -1·47, -0·56, respectively) and households with adolescents (B = -0·57, 95 % CI -1·09, -0·05) reported a lower acceptability of an SSB tax than their counterparts. Beliefs about effectiveness, appropriateness, socioeconomic and economic benefit, implementation and trust were associated with acceptability (P < 0·001)., Conclusions: Public acceptability of an SSB tax tends to be higher if revenue is used for health initiatives. The factors associated with acceptability should be taken into consideration.

Background: Healthy sleep duration is essential to health and well-being in childhood and later life. Unfortunately, recent evidence shows a decline in sleep duration among children. Although effective interventions promoting healthy sleep duration require insight into its predictors, data on these factors are scarce. This study therefore investigated (i) which individual (lifestyle), social and cultural factors, and living conditions and (ii) which changes in these factors might be associated with the changes in sleep duration of Dutch primary schoolchildren observed over time., Method: Data from the ChecKid study was used, a dynamic cohort study among 4-13-year-old children living in the city of Zwolle, the Netherlands. Associations between changes in sleep duration and individual (lifestyle) factors (i.e., age, sex, physical activity behavior, sugar-sweetened beverage consumption, screen behavior), social and cultural factors (i.e., parental rules, ethnicity), and living conditions (i.e., parental education, presence of screens in the bedroom, household size) were analyzed using multivariable linear regression., Results: A total of 1180 children participated, aged 6.6 ± 1.4 years in 2009. Mean sleep duration decreased from 11.4 ± 0.5 h/night in 2009 to 11.0 ± 0.5 h/night in 2012. Older children, boys, children who used screens after dinner, children with greater computer/game console use, and children whose parents had low levels of education had a greater decrease in sleep duration., Conclusions: This article reports on one of the first large, longitudinal cohort studies on predictors of child sleep duration. The results of the study can inform future interventions aimed at promoting healthy sleep in primary schoolchildren.

Background: Socioeconomic inequalities in overweight and obesity exist in many European countries. A sugar-sweetened beverages (SSB) tax may contribute to a reduction of these inequalities. However, in the Netherlands, the government decided to not (yet) introduce an SSB tax, although the government has acknowledged its potential to be pro-equity. Understanding how various stakeholder groups perceive the potential effects of an SSB tax on different socioeconomic groups may provide useful insights into equity-related considerations in the debate whether or not to implement an SSB tax. This study aims to gain insight into the perceptions of stakeholder groups in the Netherlands on (1) the effects of an SSB tax on the budgets of lower and higher socioeconomic groups and (2) the impact of an SSB tax on socioeconomic inequalities in dietary intake and health., Methods: Semi-structured interviews were conducted in 2019 with 27 participants from various stakeholder groups in the Netherlands (i.e. health and consumer organizations, health professional associations, trade associations, academia, advisory bodies, ministries and parliamentary parties). Data were analyzed using a thematic content approach., Results: Participants from all stakeholder groups indicated that an SSB tax would have a larger impact on the budgets of lower socioeconomic groups. Participants from nearly all stakeholder groups (except trade associations) mentioned that an SSB tax could have greater health benefits among lower socioeconomic groups as these often have a higher SSB consumption and are more likely to be overweight or obese. Some participants mentioned that an SSB tax may have no or adverse health effects among lower socioeconomic groups (e.g. compensation of lower SSB consumption with other unhealthy behaviours). Some participants emphasised that an SSB tax should only be introduced when accompanied by other interventions (e.g. offering healthy alternatives), to make it easier for lower socioeconomic groups to lower their SSB consumption in response to an SSB tax, and to prevent adverse health effects., Conclusions: Participants believed an SSB tax could contribute to a reduction in socioeconomic inequalities in dietary intake and health. However, additional interventions facilitating the reduction of SSB consumption in lower socioeconomic groups were recommended.

An increasing number of children experience inadequate sleep, which negatively effects their health. To promote healthy sleep among children, it is essential to understand the underlying determinants. This online concept mapping study therefore explores potential determinants of children's inadequate sleep as perceived by professionals with expertise in the sleep health of children aged 4-12 years. Participants ( n = 27) were divided in three groups: (1) doctors ( n = 9); (2) nurses ( n = 11); (3) sleep experts ( n = 7). Participants generated potential determinants (i.e., ideas) of children's inadequate sleep. Subsequently, they sorted all ideas by relatedness and rated their importance. These data were analysed using multidimensional scaling and hierarchical cluster analysis. The results of all three groups were combined and validated by an additional group of professionals ( n = 16). A large variety of perceived determinants were identified. The most important determinants perceived by all groups belonged to the categories psychosocial determinants (i.e., worrying, a change in daily life), daytime and evening activities (i.e., screen use before bedtime, stimulating game play before bedtime, inadequate amount of daytime physical activity), and pedagogical determinants (i.e., inconsistent sleep schedule, lack of a bedtime routine). These perspectives are valuable for future longitudinal studies on the determinants of children's sleep and the development of future healthy sleep interventions.

Objective: To provide insight into the motivational working mechanisms (i.e. mediators) of an effective physical activity (PA) intervention for adults aged over fifty. Design: The mediation model ( N  = 822) was investigated in an RCT for the total intervention population, participants who were not norm-active at baseline (targeting PA initiation) and norm-active participants (targeting PA maintenance) separately. Main Outcome Measures: Potential mediators (attitude, self-efficacy, intention, action planning and coping planning) of the effect on PA (6-months) were assessed at baseline, 3 and/or 6 months. Results: The intervention resulted in a decrease in intention ( B = -.209; p =.017), and an increase in action planning ( B =.214; p =.018) and PA ( B =.220; p =.002). Intention and action planning did not mediate the effect on PA. Self-efficacy, although not significantly influenced by the intervention, was found to be the only motivational variable that predicted change in PA ( B =.164; p =.007). These results were confirmed among participants initiating PA. Among norm-active participants no significant intervention effects were identified. Conclusion: The motivational factors cannot explain the intervention effect on PA. Most likely, the effect can be explained by an interaction between the motivational factors together. Differences between participants initiating versus maintaining PA, highlight the importance of performing mediation analyses per subgroup.

Purpose: Sleeve gastrectomy (SG) is the most popular type of bariatric surgery. It has often been compared to Roux-en-Y gastric bypass (RYGB) in terms of clinical outcomes. However, health-related quality of life (HRQoL) has been sparsely studied after SG. The goal was to study HRQoL after SG using a generic (RAND-36) and an obesity-specific (impact of weight on quality of life-lite, IWQOL-lite) questionnaire and to compare the results with RYGB., Methods: HRQoL and weight were measured before and 9, 15, and 24 months after surgery. RAND-36 physical health summary (PHS) and mental health summary (MHS), and IWQOL-lite total score were calculated. A mixed model analysis was conducted to study the change in HRQoL and compare SG with RYGB., Results: A total of 219 patients (8.7%) underwent a SG and 2309 patients (91.3%) a RYGB. PHS, MHS, and IWQOL-lite significantly improved after SG when comparing baseline to all follow-up moments (p < 0.001 in all). There were no significant differences when comparing SG with RYGB: change in PHS (β - 0.10, 95% CI - 1.24 to 1.04, p = 0.861), MHS (β - 0.51, 95% CI - 1.56 to 0.52, p = 0.330), and IWQOL-lite (β 0.310, 95% CI - 0.85 to 1.47, p = 0.601)., Conclusion: HRQoL significantly improved after SG. In the included populations, weight loss was comparable and the extent to which HRQoL improved did not differ between SG and RYGB, when measured with the RAND-36 or IWQOL-lite. This might be partly caused by the fact that these questionnaires do not assess specific bariatric HRQoL and/or complaints.

Aim: Weight loss success is highly variable among individuals. Cluster analysis contributes to future intervention development by recognising this individual variability and identifying different weight loss patterns. Identifying determinants that differentiate between these patterns would explain the source of variability. Thus, we aimed to identify weight loss patterns and their determinants in adults with overweight and obesity., Methods: The present study is a secondary analysis of data from the PortionControl@HOME study. The weight of 175 adults was measured at 0, 3 and 12 months and potential determinants were self-reported using validated questionnaires at 0 and 3 months. Weight loss patterns were identified based on percent weight change during Phase 1 (0-3 months) and Phase 2 (3-12 months) using cluster analysis. Determinants were assessed using multinomial logistic regression., Results: We identified three weight loss patterns: (i) low success, demonstrating low weight loss achievement, (ii) moderate success, demonstrating successful weight loss in Phase 1 followed by partial regain in Phase 2 and (iii) high success, demonstrating weight loss in Phase 1 followed by continued weight loss in Phase 2. Compared to the moderate success pattern, the low success pattern was negatively associated with power of food at baseline (i.e. the appetitive drive to consume highly palatable food) (odds ratio, OR = 0.42, 95% CI = 0.21-0.86) and change in portion control behaviour (i.e. the use of behavioural strategies to control the amount of food consumed) (OR = 0.28, 95% CI = 0.10-0.78)., Conclusions: Three weight loss patterns were identified in adults with overweight and obesity. Adults with greater power of food and increased portion control behaviour were less likely to exhibit an unsuccessful weight loss pattern., (© 2020 Dietitians Association of Australia.)

Many children do not meet the recommendations for healthy sleep, which is concerning given the potential negative effects on children's health. To promote healthy sleep, it is crucial to understand its determinants. This concept mapping study therefore explores perspectives of children and parents on potential determinants of children's inadequate sleep. The focus lies on 9-12 year old children ( n = 45), and their parents ( n = 33), from low socioeconomic neighbourhoods, as these children run a higher risk of living in a sleep-disturbing environment (e.g., worries, noise). All participants generated potential reasons (i.e., ideas) for children's inadequate sleep. Next, participants sorted all ideas by relatedness and rated their importance. Subsequently, multidimensional scaling and hierarchical cluster analyses were performed to create clusters of ideas for children and parents separately. Children and parents both identified psychological (i.e., fear, affective state, stressful situation), social environmental (i.e., sleep schedule, family sleep habits), behavioural (i.e., screen behaviour, physical activity, diet), physical environmental (i.e., sleep environment such as temperature, noise, light), and physiological (i.e., physical well-being) determinants. These insights may be valuable for the development of future healthy sleep interventions.

Introduction: The prevalence and clinical significance of weight regain after bariatric surgery remains largely unclear due to the lack of a standardized definition of significant weight regain. The development of a clinically relevant definition of weight regain requires a better understanding of its clinical significance., Objectives: To assess rates of weight regain 5 years after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), applying six definitions and investigating their association with clinical outcomes., Methods: Patients were followed up until 5 years after surgery and weight regain was calculated. Regression techniques were used to assess the association of weight regain with health-related quality of life (HRQoL) and the presence of comorbidities., Results: A total of 868 patients participated in the study, with a mean age of 46.6 (± 10.4) years, of which 79% were female. The average preoperative BMI was 44.8 (± 5.9) kg/m 2 and the total maximum weight loss was 32% (± 8%). Eighty-seven percent experienced any regain. Significant weight regain rates ranged from 16 to 37% depending on the definition. Three weight regain definitions were associated with deterioration in physical HRQoL (p < 0.05), while associations between definitions of weight regain and the presence of comorbidities 5 years after surgery were not significant., Conclusion: These results indicate that identifying one single categorical definition of clinically significant weight regain is difficult. Additional research into the clinical significance of weight regain is needed to inform the development of a standardized definition that includes all dimensions of surgery success: weight, HRQoL, and comorbidity remission.

Background: Nicotine dependence during adolescence increases the risk of continuing smoking into adulthood. The magnitude of nicotine dependence among adolescents in the European Union (EU) has not been established. We aimed to estimate the number of nicotine dependent 15-year-old adolescents in the EU, and identify high-risk groups., Methods: The number of nicotine dependent 15-year-olds in the EU was derived combining: (i) total number of 15-year-olds in the EU (2013 Eurostat), (ii) smoking prevalence among 15-year-olds (2013/2014 HBSC survey) and (iii) proportion of nicotine dependent 15-year-olds in six EU countries (2013 SILNE survey). Logistic regression analyses identified high-risk groups in the SILNE dataset., Results: We estimated 172 636 15-year-olds were moderately to highly nicotine dependent (3.2% of all 15 years old; 35.3% of daily smokers). In the total population, risk of nicotine dependence was higher in males, adolescents with poor academic achievement, and those with smoking parents or friends. Among daily smokers, only lower academic achievement and younger age of smoking onset were associated with nicotine dependence., Conclusion: According to our conservative estimates, more than 172 000 15-year-old EU adolescents were nicotine dependent in 2013. Prevention of smoking initiation, especially among adolescents with poor academic performance, is necessary to prevent a similar number of adolescents getting addicted to nicotine each consecutive year., (© The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Taxation of sugar-sweetened beverages (SSBs), as a component of a comprehensive strategy, has emerged as an apparent effective intervention to counteract the rising prevalence of overweight and obesity. Insight into the political and public acceptability may help adoption and implementation in countries with governments that are considering an SSBs tax. Hence, we aimed to conduct a systematic review and meta-analysis to synthesize the existing qualitative and quantitative literature on political and public acceptability of an SSBs tax., Methods: Four electronic databases (PubMed, Embase, Scopus, Web of Science) were searched until November 2018. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Qualitative studies were analyzed using a thematic synthesis. Quantitative studies were analyzed using a random-effects meta-analysis for the pooling of proportions., Results: Thirty-seven articles reporting on forty studies were eligible for inclusion. Five themes derived from the thematic synthesis: (i) beliefs about effectiveness and cost-effectiveness, (ii) appropriateness, (iii) economic and socioeconomic benefit, (iv) policy adoption and implementation, and (v) public mistrust of the industry, government and public health experts. Results of the meta-analysis indicated that of the public 42% (95% CI = 0.38-0.47) supports an SSBs tax, 39% (0.29-0.50) supports an SSBs tax as a strategy to reduce obesity, and 66% (0.60-0.72) supports an SSBs tax if revenue is used for health initiatives., Conclusions: Beliefs about effectiveness and cost-effectiveness, appropriateness, economic and socioeconomic benefit, policy adoption and implementation, and public mistrust of the industry, government and public health experts have important implications for the political and public acceptability of an SSBs tax. We provide recommendations to increase acceptability and enhance successful adoption and implementation of an SSBs tax: (i) address inconsistencies between identified beliefs and scientific literature, (ii) use raised revenue for health initiatives, (iii) communicate transparently about the true purpose of the tax, and (iv) generate political priority for solutions to the challenges to implementation.

Background: Discerning the determinants of weight loss maintenance is important in the planning of future interventions and policies regarding overweight and obesity. We have therefore systematically synthesized recent literature on determinants of weight loss maintenance for individuals with overweight and obesity., Methods: With the use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, prospective studies were identified from searches in PubMed and PsycINFO from 2006 to 2016. We included articles investigating adults with overweight and obesity undergoing weight loss without surgery or medication. Included articles were scored on their methodological quality, and a best-evidence synthesis was applied to summarize the results., Results: Our search resulted in 8,222 articles of which 67 articles were selected. In total, 124 determinants were identified of which 5 were demographic, 59 were behavioural, 51 were psychological/cognitive and 9 were social and physical environmental determinants. We found consistent evidence that demographic determinants were not predictive of weight loss maintenance. Behavioural and cognitive determinants that promote a reduction in energy intake, an increase in energy expenditure and monitoring of this balance are predictive determinants., Conclusion: This review identifies key determinants in weight loss maintenance. However, more research regarding cognitive and environmental determinants of weight loss maintenance is needed to advance our knowledge on determinants of weight loss maintenance., (© 2018 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

To develop evidence-based healthy sleep interventions for children, this review provides insight into the behavioral determinants of sleep behavior. Hence, the objective of this review is to systematically review the longitudinal evidence on determinants of children's sleep behavior. Studies were identified from searches in PubMed, PsycINFO, and Web of Science, until January 2017. Longitudinal studies investigating the association between potential determinants and sleep behavior (duration, quality and timing) in healthy children aged 4-12 years were included. The methodological quality was scored and the results were summarized using a best-evidence synthesis. We followed the PRISMA statement guidelines in order to summarize the evidence accurately and reliably. Twelve of the 45 included studies were rated as 'high quality'. We found strong evidence for child age and moderate evidence for screen time, past sleep behavior, and a difficult temperament as determinant of sleep duration. For determinants of sleep quality, evidence was either insufficient or inconsistent. We found moderate evidence for week schedule as a determinant of sleep timing, with later bed- and wake times in weekends. More high quality studies, which are extensive, collaborative, and multidisciplinary, are needed into the determinants of all dimensions of sleep behavior., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: The present study aimed to explore the mediating role of family-related determinants on the effects of the ToyBox-intervention on pre-school children's consumption of healthy and unhealthy snacks., Design: The ToyBox-intervention was a kindergarten-based, family-involved intervention with a cluster-randomized design, aiming to promote healthy lifestyle behaviours to prevent obesity at pre-school age., Setting: Kindergartens (n 309) in six European countries., Subjects: A total of 6290 pre-schoolers and their families participated in the ToyBox-intervention in 2012-2013 and data from 5212 pre-schoolers/families were included in the current analyses., Results: Even though the total effect of the ToyBox-intervention on healthy and unhealthy snacking was not significant, the ToyBox-intervention significantly improved parental rule setting on children's unhealthy snack consumption (i.e. restriction of snacking while watching television and permission only at certain occasions) and parental consumption of unhealthy snacks, while it increased parental knowledge on snacking recommendations. Regarding healthy snacking, the ToyBox-intervention improved children's attitude towards fruit and vegetables (F&V). All previously mentioned family-related determinants mediated the intervention effects on pre-schoolers' consumption of healthy and unhealthy snacks. Almost all family-related determinants examined in the study were independently associated with pre-schoolers' consumption of healthy and unhealthy snacks., Conclusions: The intervention was effective in improving relevant family-related determinants. Interventions aiming to promote F&V consumption and limit the consumption of unhealthy snacks in pre-schoolers should target on these mediators, but also identify new family-, school- or peer-related determinants, to enhance their effectiveness.

Background: The ToyBox-intervention has increased preschool children's water consumption. This study aimed to examine if family-related determinants mediate the effects of the ToyBox-intervention on preschoolers' water consumption., Methods: Overall, 6290 preschoolers and their families from 6 European countries participated in the ToyBox-intervention and returned parental questionnaires in May/June 2012 and 2013. This study included the 3725 preschoolers/families who had complete data on water consumption, all mediators, and confounders. Mediation effects were assessed with bootstrapping procedure., Results: Regarding the intervention effects on family-related determinants, the ToyBox-intervention significantly increased water availability during meals, parental water consumption, parental encouragement to their children to drink water, and parental knowledge on water recommendations. In the multiple mediator model, all factors were independently associated with preschoolers' water consumption and mediated the intervention effect on preschoolers' water consumption (total mediation effect = 40%). After including all mediators into the model, the direct intervention effect remained significant., Conclusions: The effect of the ToyBox-intervention on preschool children's water consumption was mediated by most family-related determinants examined in this study (ie, availability, parental modeling, parental encouragement, and parental knowledge). Interventions aiming to promote water in preschoolers should target these mediators to enhance their effectiveness., (© 2018, American School Health Association.)

These longitudinal studies in older adults targeted mediated relationships between habit and physical activity (PA). In The Netherlands two independent studies were conducted among 1976 (Study 1: Mage = 63.63, SD = 8.66, 30% functional limitations) and 2140 (Study 2: Mage = 62.75, SD = 8.57, 45% functional limitations) adults aged 50 years or older. Cross-lagged panel designs were applied to examine whether habit mediates the relationship between prior and later PA and whether PA simultaneously mediates the relationship between prior and later habit. Data on habit and PA were collected by means of questionnaires at baseline (t0) and at 6 (t1) and 12 (t2) months after baseline measurement. Results of structural equation modeling analyses were not unambiguous. Indications for the existence of both hypothesized mediation effects were found, but no clear, unequivocal pattern appeared. Somewhat more support was found for the PA-habit-PA path than for the habit-PA-habit path. More research is needed to draw more definitive conclusions.

Purpose: To gain more insight into the optimal strategy to achieve weight loss and weight loss maintenance in overweight and obese cancer survivors after completion of initial treatment, this systematic review aimed to provide an overview of the literature on intervention effects on weight, to describe intervention components used in effective interventions, to identify and synthesize behaviour change techniques (BCTs) and to assess the frequency with which these BCTs were used in effective interventions., Methods: Six databases were searched for original research articles describing weight changes in adult overweight cancer survivors after participation in a lifestyle intervention initiated after completion of initial treatment. Two researchers independently screened the retrieved papers and extracted BCTs using the BCT Taxonomy version 1., Results: Thirty-two papers describing 27 interventions were included. Interventions that were evaluated with a robust study design (n = 8) generally showed <5% weight loss and did not evaluate effects at ≥12 months after intervention completion. Effective interventions promoted both diet and physical activity and used the BCTs 'goal setting (behaviour)', 'action planning', 'social support (unspecified)' and 'instruction on how to perform the behaviour'., Conclusions: The results of this first review on intervention components of effective interventions could be used to inform intervention development and showed a need for future publications to report long-term effects, a detailed intervention description and an extensive process evaluation., Implications for Cancer Survivors: This study contributed to increasing knowledge on the optimal strategy to achieve weight loss, which is recommended for overweight cancer survivors to improve health outcomes.

Lack of physical activity (PA) and high levels of sedentary behaviour (SB) have been associated with health problems. This systematic review evaluates the effectiveness of school-based interventions to increase PA and decrease SB among 15-19-year-old adolescents, and examines whether intervention characteristics (intervention length, delivery mode and intervention provider) and intervention content (i.e. behaviour change techniques, BCTs) are related to intervention effectiveness. A systematic search of randomised or cluster randomised controlled trials with outcome measures of PA and/or SB rendered 10 results. Risk of bias was assessed using the Cochrane risk of bias tool. Intervention content was coded using Behaviour Change Technique Taxonomy v1. Seven out of 10 studies reported significant increases in PA. Effects were generally small and short-term (Cohen's d ranged from 0.132 to 0.659). Two out of four studies that measured SB reported significant reductions in SB. Interventions that increased PA included a higher number of BCTs, specific BCTs (e.g., goal setting, action planning and self-monitoring), and were delivered by research staff. Intervention length and mode of delivery were unrelated to effectiveness. More studies are needed that evaluate long-term intervention effectiveness and target SBs among older adolescents.

Objective: We aimed to identify barriers for meeting the fruit, vegetable and fish guidelines in older Dutch adults and to investigate socio-economic status (SES) differences in these barriers. Furthermore, we examined the mediating role of these barriers in the association between SES and adherence to these guidelines., Design: Cross-sectional., Setting: Longitudinal Aging Study Amsterdam (LASA), the Netherlands., Subjects: We used data from 1057 community-dwelling adults, aged 55-85 years. SES was measured by level of education and household income. An FFQ was used to assess dietary intake and barriers were measured with a self-reported lifestyle questionnaire., Results: Overall, 48.9 % of the respondents perceived a barrier to adhere to the fruit guideline, 40.0 % for the vegetable and 51.1 % for the fish guideline. The most frequently perceived barriers to meet the guidelines were the high price of fruit and fish and a poor appetite for vegetables. Lower-SES groups met the guidelines less often and perceived more barriers. The association between income and adherence to the fruit guideline was mediated by 'perceiving any barrier to meet the fruit guideline' and the barrier 'dislike fruit'. The association between income and adherence to the fish guideline was mediated by 'perceiving any barrier to meet the fish guideline' and the barrier 'fish is expensive'., Conclusions: Perceived barriers for meeting the dietary guidelines are common in older adults, especially in lower-SES groups. These barriers and in particular disliking and cost concerns explained the lower adherence to the guidelines for fruit and fish in lower-income groups in older adults.

Background: The transition from adolescence to early adulthood is a critical period in which there is a decline in physical activity (PA). College and university students make up a large segment of this age group. Smartphones may be used to promote and support PA. The purpose of this qualitative study was to explore Dutch students' preferences regarding a PA application (PA app) for smartphones., Methods: Thirty Dutch students (aged 18-25 years) used a PA app for three weeks and subsequently attended a focus group discussion (k = 5). To streamline the discussion, a discussion guide was developed covering seven main topics, including general app usage, usage and appreciation of the PA app, appreciation of and preferences for its features and the sharing of PA accomplishments through social media. The discussions were audio and video recorded, transcribed and analysed according to conventional content analysis., Results: The participants, aged 21 ± 2 years, were primarily female (67%). Several themes emerged: app usage, technical aspects, PA assessment, coaching aspects and sharing through social media. Participants most often used social networking apps (e.g., Facebook or Twitter), communication apps (e.g., WhatsApp) and content apps (e.g., news reports or weather forecasts). They preferred a simple and structured layout without unnecessary features. Ideally, the PA app should enable users to tailor it to their personal preferences by including the ability to hide features. Participants preferred a companion website for detailed information about their accomplishments and progress, and they liked tracking their workout using GPS. They preferred PA apps that coached and motivated them and provided tailored feedback toward personally set goals. They appreciated PA apps that enabled competition with friends by ranking or earning rewards, but only if the reward system was transparent. They were not willing to share their regular PA accomplishments through social media unless they were exceptionally positive., Conclusions: Participants prefer PA apps that coach and motivate them, that provide tailored feedback toward personally set goals and that allow competition with friends.

Objective: To explore the influences of migration to a Western country on obesity and related risk factors by comparing measures of body composition and energy balance-related behaviours between Turkish adolescents in Turkey (TR-TR) and adolescents from Turkish immigrant ethnicity in the Netherlands (TR-NL)., Design: Cross-sectional survey or baseline intervention data from six Dutch school-based studies and one Turkish study., Setting: Primary and secondary schools., Subjects: A total of 915 (49 % girls; mean age 13·1 (sd 0·8) years) TR-TR adolescents and 433 (51 % girls; mean age 11·7 (sd 1·3) years) TR-NL adolescents were included. Outcome measures were self-reported sugar-containing beverage consumption, fruit and vegetable intake, screen time, physical activity, measured body height and weight, BMI, waist and hip circumferences, and skinfold thicknesses., Results: Our data showed that more TR-NL adolescents were overweight (31 % v. 26 %) and obese (9 % v. 6 %) and had significantly higher mean BMI (21·1 v. 20·0 kg/m2), waist circumference (72·2 v. 71·3 cm) and suprailiac skinfold thickness (19·8 v. 13·1 mm) than TR-TR adolescents. TR-NL adolescents reported significantly higher sugar-containing beverage consumption (1173 v. 115 ml/d), less fruit and vegetable intake (295 v. 647 g/d), less screen time (253 v. 467 min/d) and higher physical activity levels (61 v. 27 min/d) than TR-TR adolescents., Conclusions: Immigrant adolescents in the Netherlands were more often overweight and had a less favourable dietary pattern than their peers in Turkey, while their physical activity and screen time patterns were more favourable. These results suggest that adolescents from Turkish immigrant ethnicity in the Netherlands have adopted lifestyles towards the host culture.

The school is an important setting for promoting healthy eating especially at the transition from childhood to adolescence. This study contributes to the literature by describing practices within physical, political and sociocultural aspects of the school nutrition environment in seven countries across Europe based on questionnaires to the school management, and exploring their associations with soft drink consumption reported on questionnaires by 10-12 year olds. Several of the commonly self-reported practices could be supportive of a healthy diet (time to eat, access to water, restriction on marketing), but some practices were underutilized (i.e. discussion with stakeholders, healthy foods at events). Only a few associations of practices with the pupils׳ soft drink consumption were found., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

This study provides insight in the effectiveness of a print-delivered and a Web-based physical activity (PA) intervention (with or without additional environmental information on local PA possibilities) among people aged over 50. Intervention groups (print-delivered basic [PB; n = 439], print-delivered environmental [PE; n = 435], Web-based basic [WB; n = 423], Web-based environmental [WE; n = 432]) and a control group (n = 411) were studied in a clustered randomized controlled trial. Participants received three times tailored advice within four months, targeting the psychosocial determinants of PA, and additional environmental information (in two conditions). Outcome measures include weekly minutes and days of sufficient PA 6 months after the start, considering age, gender, educational level, body mass index, the presence of a chronic physical limitation and PA intentions as possible effect moderators. The results showed that the PB (B = 192.47; 95% CI = 75.24-309.71; P = 0.003), the PE (B = 229.31; 95% CI = 108.73-349.89; P = 0.001) and the WB-intervention condition (B = 214.25; 95% CI 88.65-339.85; P = 0.002) resulted in significantly increased weekly minutes of PA. Only the printed conditions resulted in increased days of sufficient PA (PB: B = 0.63; 95% CI = 0.35-0.92; P < 0.001; PE: B = 0.55; 95% CI = 0.26-0.85; P = 0.001). Additional environmental information did not increase intervention effects. Differences in effect were found between age and gender subgroups. In conclusion, both printed and Web-based interventions can be effective in increasing PA in adults aged over 50., (© Crown copyright 2014.)

Background: Parents and their parenting practices play an important role in shaping their children's environment and energy-balance related behaviours (EBRBs). Measurement of parenting practices can be parent- or child-informed, however not much is known about agreement between parent and child perspectives. This study aimed to assess agreement between parent and child reports on parental practices regarding EBRBs across different countries in Europe and to identify correlates of agreement., Methods: Within the ENERGY-project, a cross-sectional survey was conducted among 10-12 year old children and their parents in eight European countries. Both children and parents filled in a questionnaire on 14 parental practices regarding five different EBRBs (i.e. soft drink, fruit juice and breakfast consumption, sports activity and watching TV) and socio-demographic characteristics. Children's anthropometric measurements were taken at school. We calculated percentages of agreement between children and their parents and weighted kappa statistics (for ordinal variables) per practice and country and assessed factors associated with agreement using multilevel linear regression., Results: Reports of 6425 children and their parents were available for analysis. Overall mean agreement between parent and child reports was 43% and varied little among countries. The lowest agreement was found for questions assessing joint parent-child activities, such as sports (27%; Kappa (κ) = 0.14) or watching TV (30%; κ = 0.17), and for parental allowance of the child to have soft drinks (32%; κ = 0.24) or fruit juices (32%; κ = 0.19), or to watch TV (27%; κ = 0.17). Having breakfast products available at home or having a TV in the child's bedroom were the only practices with moderate to good agreement (>60%; κ = 0.06 and 0.77, respectively). In general, agreement was lower for boys, younger children, younger parents, parents with less than 14 years of education, single parents, parents with a higher self-reported body mass index and parents who perceived their child to be underweight., Conclusions: Parents and children perceive parental practices regarding dietary, physical activity and sedentary behaviours differently in all parts of Europe, with considerable variation across specific practices and countries. Therefore, future studies should assess both, parents and children's view on parental practices.