No abstract

Health problems such as obesity are increasingly addressed by complex intervention programmes which operate at multiple levels of influence (e.g. families, schools, neighbourhoods) involving partners from various academic, professional and cultural backgrounds. Following a complex participatory health promotion approach is challenging, because conflicting interests as well as contextual constraints may occur which are rarely discussed empirically. Process evaluations of some programmes investigate factors influencing the implementation process. However, researchers' perspectives on inter- and transdisciplinary work are mostly neglected. This paper aims at illustrating and critically analysing challenges that arose in the planning and implementation of a health promotion project in a socially deprived neighbourhood in Germany. Drawing on minutes, email conversations, and research diary entries we reflect on discrepancies and difficult interactions within the research team, with collaborating (academic) institutions (interdisciplinary work) and with the community partners (transdisciplinary work) respectively. Differences in language, interests, success criteria, professional preferences and habits as well as contextual factors are worked out and coping strategies or solutions are proposed. According to our experiences, bringing to light researchers' positions, preferences and interactions with the community is necessary to find a balance between research and practice, to develop adequate solutions for challenging situations and to evaluate the process, effectiveness and transferability of a programme. Health promotion research should report not only on the effectiveness of interventions but also on struggles, unsuccessful attempts and useful (or useless) strategies to fuel discourse on opportunities in and the efficacy and transferability of health promotion projects.

ZusammenfassungAuf Grundlage der Erkenntnis, dass die Prävention von Adipositas im Kindesalter komplexe Interventionen unter Berücksichtigung individueller und umweltbezogener Faktoren benötigt, werden im Projekt „GRÜNAU BEWEGT sich” über einen par-tizipativen, gemeinwesenorientierten Ansatz gesundheitsförderliche Verhältnisse geschaffen, die die Entstehung von Adipositas bei Kindern verhindern sollen. Mittels der Planungsmodelle PRECEDE-PROCEED und dem Intervention Mapping Ansatz (IMA) werden systematisch und theoriegeleitet Interventionen in den Bereichen Ernährung, Bewegung und Kapazitätsentwicklung entwickelt. Sie berücksichtigen lokale Gegebenheiten und setzen auf verschiedenen Ebenen (Kind, Familie, Institution, Quartier) an. Die Umsetzung der entwickelten Interventionen erfolgt seit 2016. Die Maßnahmen adressieren pädagogische Fachkräfte aus Kitas und Schulen, Kinder und Eltern und beziehen verschiedene Akteure (Verwaltung, Vereine, Krankenkassen, Handel) ein. Im Spannungsfeld von medizinischem und sozialem Problemverständnis werden auch die begrenzte Handlungsfähigkeit und Wirksamkeit von Interventionen auf gesellschaftlich bedingte Problemlagen sichtbar.

The greater availability of unhealthy food may contribute to the development of obesity. Preventive measures should consider the physical and social environment.

Despite the beneficial effects of physical activity (PA), only 26% of children in Germany meet the WHO’s recommendations. Because active play contributes to PA and is accepted by families, the creation of “playable” environments could promote PA. This study is a natural experiment that was conducted to investigate whether slight changes in the physical environment can increase PA in children. In autumn 2016, 140 students from two primary schools located in a deprived district of Leipzig (Germany) gathered ideas on PA-promoting street designs. After protracted negotiations with the city administration, two footpaths were decorated with colored markings (hopscotch grids, labyrinths, “mirror me”) in September 2019. 48 observations were made before (August 2019) and after (September/October 2019) the implementation using the System for Observing Play and Recreation in Communities (SOPARC). Age, gender, activity level, bike use, and interactions with the colored markings were recorded. A total of 5455 individuals (including 1099 cyclists) were observed. Almost one fifth of the observed children (0 to 12 years) interacted with the markings. There was a slight increase in vigorous activity in all observed individuals after the implementation (2.9% vs. 6.4%, p < 0.001). The chance for vigorous activity was higher on decorated footpaths (OR 2.45, CI 1.54–3.89, p < 0.001), for children (OR 19.32, CI 13.07–28.56, p < 0.001), and on Sundays (OR 3.39, CI 2.33–4.94, p < 0.001). The participatory development and design of footpaths that support spontaneous active play “on the way” might be one component that can be used to support changes in children’s PA behaviors and social interactions.