BackgroundClearly stated national recommendations for physical activity (PA) are available in many nations. Yet, their impact on national level policy-making might be considered modest at best. This paper analyses the approach selected to curtail this problem in Germany.Main textAcademics, government institutions and relevant stakeholders worked in collaboration to produce a series of national recommendations for PA and PA promotion published in 2016. Since their publication, these recommendations have achieved a measurable political impact through a systematic approach focused on dissemination and implementation strategies. For example, the German Conference of Health Ministers has acknowledged the national recommendations, endorsed their dissemination and proposed that they are included in measures within the Federal Prevention Act.ConclusionSince their publication, the national recommendations have yielded satisfactory political impact. The contributing aspects might partially be explained by the Multiple Streams Approach.
Background: Existing physical activity guidelines predominantly focus on healthy age-stratified target groups. The objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18-65 years) with noncommunicable diseases (NCDs). Methods: The PA recommendations were developed based on existing PA recommendations. In phase 1, systematic literature searches were conducted for current PA recommendations for seven chronic conditions (osteoarthrosis of the hip and knee, chronic obstructive pulmonary disease, stable ischemic heart disease, stroke, clinical depression, and chronic non-specific back pain). In phase 2, the PA recommendations were evaluated on the basis of 28 quality criteria, and high-quality recommendations were analysed. In phase 3, PA recommendations for seven chronic conditions were deducted and then synthesised to generate generic German PA recommendations for adults with NCDs. In relation to the recommendations for PA promotion, a systematic literature review was conducted on papers that reviewed the efficacy/effectiveness of interventions for PA promotion in adults with NCDs. Results: The German recommendations for physical activity state that adults with NCDs should, over the course of a week, do at least 150 min of moderate-intensity aerobic PA, or 75 min of vigorous-intensity aerobic PA, or a combination of both. Furthermore, muscle-strengthening activities should be performed at least twice a week. The promotion of PA among adults with NCDs should be theory-based, specifically target PA behaviour, and be tailored to the respective target group. In this context, and as an intervention method, exercise referral schemes are one of the more promising methods of promoting PA in adults with NCDs. Conclusion: The development of evidence-based recommendations for PA and PA promotion is an important step in terms of the initiation and implementation of actions for PA-related health promotion in Germany. The German recommendations for PA and PA promotion inform adults affected by NCDs and health professionals on how much PA would be optimal for adults with NCDs. Additionally, the recommendations provide professionals entrusted in PA promotion the best strategies and interventions to raise low PA levels in adults with NCDs. The formulation of specific PA recommendations for adults with NCDs and their combination with recommendations on PA promotion is a unique characteristic of the German recommendations.
Background: The objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18-65 years) with noncommunicable diseases (NCDs). Methods: The PA recommendations were developed based on existing PA recommendations and using a three-phased process. In phase 1, systematic literature searches were conducted for current PA recommendations for seven chronic conditions (osteoarthrosis of the hip and knee, chronic obstructive pulmonary disease, stable ischemic heart disease, stroke, clinical depression, and chronic non-specific back pain). In phase 2, the PA recommendations were evaluated on the basis of 28 quality criteria. High-quality recommendations were identified, and a content analysis was conducted on these recommendations. In phase 3, the findings of the content analysis were summarised, and PA recommendations for seven chronic conditions were deducted. The seven recommendations were then synthesised to generate generic German PA recommendations for adults with noncommunicable diseases (NCDs). In relation to the recommendations for PA promotion, a systematic literature review was conducted on papers that reviewed the efficacy/effectiveness of interventions for PA promotion in adults with NCDs. Results: The German Recommendations for Physical Activity state that adults with NCDs should, over the course of a week, should do at least 150 minutes of moderate-intensity aerobic PA, or 75 minutes of vigorous-intensity aerobic PA, or a combination of both. Furthermore, muscle-strengthening activities should be performed at least twice a week. The promotion of PA among adults with NCDs should be theory-based, specifically target PA behaviour, and be tailored to the respective target group. In this context, and as an intervention method, exercise referral schemes are one of the more promising methods of promoting PA in adults with NCDs. Conclusion: The development of evidence-based recommendations for PA and PA promotion is an important step in terms of the initiation and implementation of actions for PA-related health promotion in Germany. The German Recommendations for PA and PA promotion inform adults affected by NCDs and health professionals on how much PA would be optimal for adults with NCDs. Additionally, the recommendations provide professionals entrusted in PA promotion the best strategies and interventions to raise low PA levels in adults with NCDs. The formulation of specific PA recommendations for adults with NCDs and their combination with recommendations on PA promotion is a unique characteristic of the German recommendations.
ZusammenfassungDie flächendeckende Verbreitung erfolgreicher Interventionen der Gesundheitsförderung ist eine wichtige Voraussetzung, um messbare und nachhaltige Gesundheitswirkungen auf Bevölkerungsebene zu erzielen. Das Konzept des Scaling-Up bietet Ansätze, um Pilotinterventionen auf andere Standorte oder ganze Systeme zu übertragen und sie so einer Vielzahl von Menschen zugänglich zu machen. Dieser Beitrag möchte für den deutschsprachigen Raum auf Basis einer Literatur-Review einen ersten Überblick über einige theoretische Scaling-Up-Modelle sowie praktische Leitlinien für ein erfolgreiches Scaling-Up geben. Der Blick in die aktuelle Forschung liefert wichtige Erkenntnisse zur Definition von Scaling-Up und von damit verbundenen Konzepten, den verschiedenen Typen von Scaling-Up, zu zentralen Akteuren und ihren spezifischen Rollen, zum Ablauf von Scaling-Up-Prozessen sowie zu begünstigenden und hinderlichen Kontextfaktoren für erfolgreiches Scaling-Up. Damit kann dieser Artikel einerseits die Planung und praktische Umsetzung konkreter Scaling-Up-Vorhaben unterstützen und andererseits Anregungen für die weitere Forschung auf diesem Gebiet bieten.
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