Partizipative Entwicklung und Durchführung von Interventionsprogrammen zur Veränderung des Ernährungs- und Bewegungsverhaltens

Abstract

Participation and empowerment are important components in intervention studies, in order to establish participant satisfaction and to strengthen sustainability. These important aspects were already mentioned in the Ottawa Charter (ratified in 1986). So far, participatory research methods are widely used especially in Anglo-American and Scandinavian countries. Thus, the transfer of scientifically proven participatory research methods to the German setting is recommended. In addition, the adaptation of evidence-based, theory-driven and quality-ensured projects is requested for local settings. The main scientific theme of this cumulative thesis is the analysis and evaluation of participation as a core element in prevention and health promotion studies. The thesis is based on two studies, IDEFICS and OptimaHl 60plus in both the intervention was developed and implemented in a participatory way. An important aspect of both interventions is the change of dietary and physical activity behaviour through a structural and behavioural prevention. Diet and physical activity in children (IDEFICS-study) and older adults (OptimaHl 60plus) play a vital role to be healthy and active and to ultimately stay autonomous. A balanced diet and sufficient physical activity give the opportunity to reduce risk factors and prevent diseases. The background and findings of this research are presented in five chapters. After a short introduction and the description of the scientific background (Chapter 1), the following two chapters present the participatory development and implementation of interventions to change the health behaviour (Chapter 2) and the participatory recruitment to interventions (Chapter 3). Chapter 4 comprises two articles on the evaluation of interventions that were developed in a participatory way. Chapter 5 discusses the findings and draws conclusions. The findings of this thesis show that scientifically proven participatory aspects can successfully be transferred to the German setting. Participatory research methods (such as focus groups) were applied in both studies (Chapter 2). An intervention mapping protocol was used to ensure that the two interventions were developed using a theory-driven and participatory approach (Chapter 2). The evidence-base of both studies as well as of the given intervention recommendations is ensured (Chapters 1, 5). Furthermore, participation is an important aspect in the recruitment and compliance of study participants as described in detail in Chapter 3. It is also possible to evaluate interventions applying participatory measures. However, in both studies a participatory evaluation was not aimed for because this could possibly have jeopardised the scientific objectivity and publication of results (Chapter 5). Participation in intervention development and implementation is desirable. However, as part of the evaluation it bears potential hazards. Going beyond this general conclusion, some recommendations for future studies as well as implications for research, practice and politics are outlined in Chapter 5.