Systematic realist synthesis of health-related and lifestyle interventions designed to decrease overweight, obesity and unemployment in adults

Abstract

Background Obesity and unemployment are complex social and health issues with underlying causes that are interconnected. While a clear link has been established, there is lack of evidence on the underlying causal pathways and how health-related interventions could reduce obesity and unemployment using a holistic approach. Objectives The aim of this realist synthesis was to identify the common strategies used by health-related interventions to reduce obesity, overweight and unemployment and to determine for whom and under what circumstances these interventions were successful or unsuccessful and why. Methods A realist synthesis approach was used. Systematic literature searches were conducted in Cochrane library, Medline, SocIndex, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PsychInfo. The evidence from included studies were synthesised into Context-Mechanism-Outcome configurations (CMOcs) to better understand when and how programmes work, for which participants and to refine the final programme theory. Results A total of 83 articles met the inclusion criteria. 8 CMOcs elucidating the contexts of the health-related interventions, underlying mechanisms and outcomes were identified. Interventions that were tailored to the target population using multiple strategies, addressing different aspects of individual and external environments led to positive outcomes for reemployment and reduction of obesity. Conclusion This realist synthesis presents a broad array of contexts, mechanisms underlying the success of health-related interventions to reduce obesity and unemployment. It provides novel insights and key factors that influence the success of such interventions and highlights a need for participatory and holistic approaches to maximise the effectiveness of programmes designed to reduce obesity and unemployment. Trial registration PROSPERO 2020 CRD42020219897.

Der Teufelskreis zwischen Arbeitslosigkeit und Substanzgebrauchsstörungen

“…Studien über den Zusammenhang von Arbeitslosigkeit und körperlichen Erkrankungen sind zahlreich [13][14][15][16][17]. Auch ist die Korrelation mit psychischen Erkrankungen belegt, in dem Arbeitslose ein signifikant schlechteres psychisches Wohlbefinden als Erwerbstätige aufweisen; nachgewiesen anhand von Depressionen, Angststörungen oder psychosomatischen Symptomen bzw.…”

Body composition and motivations for accessing an innovative, digital community health engagement tool in socially deprived areas

“…Limited research has explored the motivations of individuals living with obesity to engage with community health and engagement services as an alternative to general practice services. The aim of this study is to assess the associations between body composition and the use of a novel community health engagement tool in socially deprived communities.Data for this study was collected as part of the larger Adding to Social capital and individual Potential In disadvantaged Regions (ASPIRE) study (2) using the Interactive Health Kiosk (2) . The Health Kiosk is an interactive health and wellbeing engagement tool based on validated measures which allows users to do a health MOT, by measuring body composition and other health and wellbeing metrics.…”

“…Data for this study was collected as part of the larger Adding to Social capital and individual Potential In disadvantaged Regions (ASPIRE) study (2) using the Interactive Health Kiosk (2) . The Health Kiosk is an interactive health and wellbeing engagement tool based on validated measures which allows users to do a health MOT, by measuring body composition and other health and wellbeing metrics.…”

Self-efficacy of participants in a holistic intervention to reduce unemployment and obesity in France and England

“…Data were collected at baseline as part of The Adding to Social capital and individual Potential In disadvantaged Regions (ASPIRE) project which is a novel and innovative, programme developed to improve weight, wellbeing, self-efficacy, and employment in individuals who were living with obesity or unemployed in England and France (3) . In addition to demographic variables, data on self-efficacy was collected using a validated self-administered digital version of the General Self-Efficacy Scale (GSE).…”

“…This highlights the need for interventions using a holistic approach to address common modifiable determinants of obesity and unemployment including self-efficacy. The aim of this study was to assess perceived selfefficacy in a sample of individuals living with obesity and/or unemployed.Data were collected at baseline as part of The Adding to Social capital and individual Potential In disadvantaged Regions (ASPIRE) project which is a novel and innovative, programme developed to improve weight, wellbeing, self-efficacy, and employment in individuals who were living with obesity or unemployed in England and France (3) . In addition to demographic variables, data on self-efficacy was collected using a validated self-administered digital version of the General Self-Efficacy Scale (GSE).…”