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Aletta Jacobs School of Public Health

Together for more healthy years
Agenda Junior Research Meet-up

Parallel session 2C: Lifestyle in public health

Carel-Peter van Erpecum - Are changes in the fast-food and physical activity environment associated with changes in weight status? A natural experiment in Lifelines

Background
Evidence on the association between fast-food and physical activity environments and weight status remains inconclusive due to a paucity of natural experiments.

Aim
We investigated associations between changes in the residential fast-food and physical activity environment and changes in objectively measured Body Mass Index (BMI).

Methods
We linked geo-coded residential addresses from Lifelines adults (18+) of the first and second assessment (N=90,549; mean(SD) follow-up: 3.9(1.2) years) to fast-food outlet and physical activity facility locations. Changes in the fast-food and physical activity environment were computed in terms of proximity and 1-kilometer(km) density. We performed multilevel linear regression analysis, and adjusted for age, sex, education, household size, healthy food outlet exposure, neighbourhood deprivation, and address density. Analyses were stratified for participants who stayed at the same address (‘stayers’) and participants who moved houses (‘movers’).

Preliminary results
Stayers who saw the nearest fast-food outlet getting closer to home experienced a stronger BMI increase than stayers who kept living equally far from the nearest fast-food outlet (B=0.49, 95% CI: 0.37, 0.61). Remarkably, however, stayers who saw the nearest fast-food outlet getting further away from home also experienced a stronger BMI increase than stayers who kept living equally far from the nearest fast-food outlet (B=0.73, 95% CI: 0.47, 1.00). Stayers who saw the nearest physical activity facility getting further away and stayers who saw the nearest physical activity facility getting closer both experienced a stronger BMI increase than stayers who kept living equally far from the nearest physical activity facility (further away: B=0.69, 95% CI: 0.43, 0.95; closer: B=0.53, 95% CI: 0.27, 0.80). Results were similar for movers.

Preliminiary conclusion
Changes in the fast-food and physical activity environment were associated with weight status changes, but the direction of associations was sometimes opposite from expected. More natural experiments are needed to further unravel these associations.

Key words: Fast-food outlets, physical activity facilities, Body Mass Index

Renske van Lonkhuijzen - Developing, implementing and evaluating an integral strategy that empowers low SES pregnant women to have a healthier dietary intake

Background
A healthy diet is important for everyone, but crucial during pregnancy for the health of both mother and child. However, pregnant women, especially those with lower socioeconomic status (SES), often fail to meet the nutritional requirements. Healthy nutrition promotion by midwives is very promising, but midwives find it difficult to contribute to a healthier dietary intake for pregnant women.

Aim
This research has three main aims. The first is to determine which set of actions, methods and tools are needed in an integral strategy, aimed at empowering low SES pregnant women to have a healthier dietary intake. The second aim is to assess the impact of the developed strategy on low SES pregnant women’s empowerment, dietary intake and pregnancy-related outcomes The third aim regards the evaluation of the strategy by midwives and dieticians in terms of impact, multidisciplinary collaboration, facilitators and barriers.

Method
The first aim will be achieved by various literature studies, focus groups with midwives and dieticians, expert meetings, interviews with pregnant women, midwives and dieticians and pressure cooker sessions. To reach the second aim, a repeated, questionnaire will be distributed among participating pregnant women prior and after exposure to the strategy. Additionally, participants will be asked to participate in focus groups and interviews. To reach the third aim, involved midwives and dieticians will be asked to participate in a questionnaire, in focus groups and/or in an interview.

Expected results
This research will implement, evaluate and optimize an integral strategy, developed with the different stakeholders, that empowers low SES pregnant women to have a healthier dietary intake. Insights will be gained into the impact of the proposed integral strategy on pregnant women, their experiences with the strategy and the evaluation of the strategy by midwives and dieticians in terms of benefits and barriers, impact, and multidisciplinary collaboration.

Key words: empowerment, healthy dietary intake, low SES pregnant women

Last modified:14 January 2021 7.36 p.m.