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A scoping review of evaluation frameworks and their applicability to real-world physical activity and dietary change programme evaluation.
Fynn, JF, Hardeman, W, Milton, K, Jones, AP
BMC public health. 2020;(1):1000
Abstract
BACKGROUND Physical activity and dietary change programmes play a central role in addressing public health priorities. Programme evaluation contributes to the evidence-base about these programmes; and helps justify and inform policy, programme and funding decisions. A range of evaluation frameworks have been published, but there is uncertainty about their usability and applicability to different programmes and evaluation objectives, and the extent to which they are appropriate for practitioner-led or researcher-led evaluation. This review appraises the frameworks that may be applicable to evaluation of physical activity and/or dietary change programmes, and develops a typology of the frameworks to help guide decision making by practitioners, commissioners and evaluators. METHODS A scoping review approach was used. This included a systematic search and consultation with evaluation experts to identify evaluation frameworks and to develop a set of evaluation components to appraise them. Data related to each framework's general characteristics and components were extracted. This was used to construct a typology of the frameworks based on their intended programme type, evaluation objective and format. Each framework was then mapped against the evaluation components to generate an overview of the guidance included within each framework. RESULTS The review identified 71 frameworks. These were described variously in terms of purpose, content, or applicability to different programme contexts. The mapping of frameworks highlighted areas of overlap and strengths and limitations in the available guidance. Gaps within the frameworks which may warrant further development included guidance on participatory approaches, non-health and unanticipated outcomes, wider contextual and implementation factors, and sustainability. CONCLUSIONS Our typology and mapping signpost to frameworks where guidance on specific components can be found, where there is overlap, and where there are gaps in the guidance. Practitioners and evaluators can use these to identify, agree upon and apply appropriate frameworks. Researchers can use them to identify evaluation components where there is already guidance available and where further development may be useful. This should help focus research efforts where it is most needed and promote the uptake and use of evaluation frameworks in practice to improve the quality of evaluation and reporting.
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Weighing as a stand-alone intervention does not reduce excessive gestational weight gain compared to routine antenatal care: a systematic review and meta-analysis of randomised controlled trials.
Fealy, SM, Taylor, RM, Foureur, M, Attia, J, Ebert, L, Bisquera, A, Hure, AJ
BMC pregnancy and childbirth. 2017;(1):36
Abstract
BACKGROUND Excessive gestational weight gain is associated with short and long-term adverse maternal and infant health outcomes, independent of pre-pregnancy body mass index. Weighing pregnant women as a stand-alone intervention during antenatal visits is suggested to reduce pregnancy weight gain. In the absence of effective interventions to reduce excessive gestational gain within the real world setting, this study aims to test if routine weighing as a stand-alone intervention can reduce total pregnancy weight gain and, in particular, excessive gestational weight gain. METHODS A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted between November 2014 and January 2016, and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Seven databases were searched. A priori eligibility criteria were applied to published literature by at least two independent reviewers. Studies considered methodologically rigorous, as per the Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research, were included. Meta-analysis was conducted using fixed-effects models. RESULTS A total of 5223 (non-duplicated) records were screened, resulting in two RCTs that were pooled for meta-analysis (n = 1068 randomised participants; n = 538 intervention, n = 534 control). No difference in total weight gain per week was observed between intervention and control groups (weighted mean difference (WMD) -0.00 kg/week, 95% confidence interval (CI) -0.03 to 0.02). There was also no reduction in excessive gestational weight gain between intervention and control, according to pre-pregnancy body mass index (BMI). However, total weight gain was lower in underweight women (n = 23, BMI <18.5 kg/m2) in the intervention compared to control group (-0.12 kg/week, 95% CI -0.23 to -0.01). No significant differences were observed for other pregnancy, birth and infant outcomes. CONCLUSION Weighing as a stand-alone intervention is not worse nor better at reducing excessive gestational weight gain than routine antenatal care.
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Promoting healthy lifestyles in older cancer survivors to improve health and preserve function.
Demark-Wahnefried, W, Morey, MC, Sloane, R, Snyder, DC, Cohen, HJ
Journal of the American Geriatrics Society. 2009;(Suppl 2):S262-4
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Abstract
Currently, there are about 7 million cancer survivors in this country aged 65 and older, and this number is expected to increase rapidly, given trends toward aging and improvements in early detection and treatment. Unfortunately, cancer survivors are at risk for several comorbid conditions and accelerated functional decline. A previous cross-sectional study of 688 older breast and prostate cancer survivors found significant associations between lifestyle practices and levels of physical functioning, with positive associations noted for physical activity and fruit and vegetable consumption and negative associations observed for dietary fat. In a more-recent cross-sectional study of 753 older survivors of breast, prostate, and colorectal cancer, significant associations were also observed between physical function, and physical activity (rho=0.22, P<.001) and diet quality (rho=0.07, P=.046), and a significant negative association was also found between physical function and body mass index (rho=-0.29, P<.001). Therefore, lifestyle interventions may be helpful in positively reorienting the trajectory of functional decline in this vulnerable population, although there are substantial barriers, such as travel, that must be overcome in delivering behavioral interventions to older cancer survivors. Previously reported results from the Pepper Center-funded Leading the Way in Exercise and Diet Project intervention development study suggested that an exercise and diet intervention delivered using telephone counseling and mailed materials was readily accepted and appeared to be of benefit. Larger trials, such as Reach-out to ENhancE Wellness in Older Survivors, have recently produced compelling data.