Health and Society Group, Wageningen University & Research, P.O. Box 8130, 6700, EW, Wageningen, the Netherlands.
Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Centre for Quality of Healthcare, IQ healthcare, P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands.
BMC Public Health. 2022 Aug 10;22(1):1522. doi: 10.1186/s12889-022-13936-w.
Overweight and obesity rates are increasing worldwide, particularly among people with a low socioeconomic status (SES). Care-physical activity (care-PA) initiatives may improve participants' lifestyles and thereby lower overweight and obesity rates. A two-year care-PA initiative specifically developed for citizens with a low SES, X-Fittt 2.0, was offered free of charge to participants, and included 12 weeks of intensive guidance and sports sessions, and 21 months of aftercare. Here, we study the impact of X-Fittt 2.0 on health, quality of life (QoL) and societal participation using a mixed-methods design.
Questionnaires and body measurements were taken from 208 participants at the start of X-Fittt 2.0 (t) and after 12 weeks (t), one year (t) and two to three years (t). We also held 17 group discussions (t, n = 71) and 68 semi-structured interviews (t and t). Continuous variables were analysed using a linear mixed-model analysis (corrected for gender, age at t, height, education level and employment status at the different time points), while we used descriptive statistics for the categorical variables. Qualitative data were analysed using a thematic analysis.
Body weight was significantly lower at all three post-initiative time points compared with the baseline, with a maximum of 3.8 kg difference at t. Body Mass Index, waist circumference, blood pressure and self-perceived health only significantly improved during the first 12 weeks. A positive trend regarding paid work was observed, while social visits decreased. The latter might be explained by the COVID-19 pandemic, as lockdowns limited social life. Furthermore, participants reported increased PA (including sports) and a few stopped smoking or drinking alcohol. Participants mentioned feeling healthier, fitter and more energetic. Additionally, participants' self-esteem and stress levels improved, stimulating them to become more socially active. However, the participants also mentioned barriers to being physically active, such as a lack of money or time, or physical or mental health problems.
X-Fittt 2.0 improved the health, QoL and societal participation of the participants. Future initiatives should take into account the aforementioned barriers, and consider a longer intervention period for more sustainable results. More complete data are needed to confirm the findings.
超重和肥胖率在全球范围内呈上升趋势，尤其是在社会经济地位较低的人群中。关爱型体力活动（care-PA）计划可能会改善参与者的生活方式，从而降低超重和肥胖率。一项专门为社会经济地位较低的公民开发的为期两年的关爱型体力活动计划 X-Fittt 2.0，免费向参与者提供，包括 12 周的强化指导和运动课程，以及 21 个月的后续护理。在这里，我们使用混合方法设计研究了 X-Fittt 2.0 对健康、生活质量（QoL）和社会参与的影响。
从 208 名参与者在 X-Fittt 2.0 开始时（t）和 12 周后（t）、1 年后（t）和 2 到 3 年后（t）时收集问卷和身体测量数据。我们还进行了 17 次小组讨论（t，n=71）和 68 次半结构化访谈（t 和 t）。连续变量使用线性混合模型分析进行分析（校正性别、t 时的年龄、身高、不同时间点的教育水平和就业状况），而分类变量则使用描述性统计。定性数据使用主题分析进行分析。
与基线相比，所有三个倡议后时间点的体重均显著降低，最大差异为 3.8kg。体重指数、腰围、血压和自我感知健康仅在最初的 12 周内显著改善。有偿工作呈积极趋势，而社会访问减少。后者可能是由于 COVID-19 大流行，因为封锁限制了社交生活。此外，参与者报告增加了体力活动（包括运动），一些人停止吸烟或饮酒。参与者表示感觉更健康、更健康、更有活力。此外，参与者的自尊心和压力水平有所提高，促使他们更加活跃。然而，参与者还提到了身体活动的障碍，例如缺乏金钱或时间，或身体或心理健康问题。
X-Fittt 2.0 改善了参与者的健康、生活质量和社会参与度。未来的计划应考虑到上述障碍，并考虑更长的干预期以获得更可持续的结果。需要更完整的数据来证实这些发现。
