Effectiveness of interventions to promote physical activity among socioeconomically disadvantaged women : a systematic review and meta-analysis

Physical activity is important for preventing weight gain and obesity, but women experiencing socioeconomic disadvantage are at high risk of inactivity. This study aimed to determine the effectiveness of interventions to increase physical activity among women experiencing disadvantage, and the intervention factors (i.e. physical activity measure, delivery mode, delivery channel, setting, duration, use of theory, behavioural techniques, participant age, risk of bias) associated with effectiveness. We conducted a meta-analysis of controlled trials using random-effects models and meta-regression. Seven databases were searched for trials among healthy women (18–64 years), which included a physical activity intervention, any control group, and statistical analyses of a physical activity outcome at baseline and post-intervention. Nineteen studies were included (n = 6,339). Because of substantial statistical heterogeneity (χ2 = 53.61, df = 18, P < 0.0001, I2 = 66%), an overall pooled effect is not reported. In subgroup analyses, between-group differences were evident for delivery mode, which modestly reduced heterogeneity (to 54%). Studies with a group delivery component had a standardized mean difference of 0.38 greater than either individual or community-based delivery. Programs with a group delivery mode significantly increase physical activity among women experiencing disadvantage, and group delivery should be considered an essential element of physical activity promotion programs targeting this population group.

The cost-effectiveness of a successful community-based obesity prevention program: the Be Active Eat Well program

Objective: 

Cost-effectiveness of fiscal policies to prevent obesity

Cost-effective, sustainable strategies are urgently required to curb the global obesity epidemic. To date, fiscal policies such as taxes and subsidies have been driven largely by imperatives to raise revenue or increase supply, rather than to change population behaviours. This paper reviews the economic evaluation literature around the use of fiscal policies to prevent obesity. The cost-effectiveness literature is limited, and more robust economic evaluation studies are required. However, uncertainty and gaps in the effectiveness evidence base need to be addressed first: more studies are needed that collect ‘real-world’ empirical data, and larger studies with more robust designs and longer follow-up timeframes are required. Reliability of cross-price elasticity data needs to be investigated, and greater consideration given to moderators of intervention effects and the sustainability of outcomes. Economic evaluations should adopt a societal perspective, incorporate a broader spectrum of economic costs and consider other factors likely to affect the implementation of fiscal measures. The paucity of recent cost-effectiveness studies means that definitive conclusions about the value for money of fiscal policies for obesity prevention cannot yet be drawn. However, as in other public health areas such as alcohol and tobacco, early indications are that population-level fiscal policies are likely to be potentially effective and cost-saving.

Introducing the D4 Diagnostic Quadrant as a targeting tool: developing a framework for the effectiveness of HIV/AIDS interventions in Tanzania and beyond

The current study develops and evaluates a tool to distinguish four different categories of educators for the effective delivery of HIV/AIDS health education using data from 548 randomly selected participants aged 16 years. The D4 Diagnostic Quadrant is based on HIV knowledge and sexual practice behaviours and indicates four distinct typologies of educator. The discerning educator has high HIV/AIDS knowledge and healthy sexual practices. The dissolute educator has high HIV/AIDS knowledge but employs unhealthy or risky sexual practices. The decorous educator has low HIV/AIDS knowledge but practices healthy sexual practices. The disempowered educator has low HIV/AIDS knowledge and employs unhealthy or risky sexual practices. The study found that the two categories that will result in the most effective behaviour-change interventions are those that target ‘discerning’ and ‘decorous’ individuals as the educators. Both these categories have underlying healthy practices that minimise the risk of HIV transmission. The D4 Diagnostic Quadrant tool provides information as to existing knowledge and beliefs about HIV/AIDS that can inform decisions relating to the allocation of scarce resources. The tool will be very useful in the selection process of would-be educators particularly in health-promotion interventions.

Investigating the effectiveness of teacher education for early career teachers in diverse settings: analysis of large-scale survey data

‘As researchers and practitioners in the field of teacher education, we seem ill prepared to respond to critics who question the value of professional education for teachers with evidence of our effectiveness’ (Grossman, 2008, p.13). While there are many small-scale, nuanced case studies that speak about the particularities of specific teacher education practices, large scale, systematic, longitudinal studies that can provide rich and comprehensive data about the effectiveness of teacher education are limited (Cochran-Smith & Zeichner, 2005). In Australia, the Studying the Effectiveness of Teacher Education (SETE) project is addressing this gap by investigating the effectiveness of teacher education programs in preparing teachers for the variety of school settings in which they begin their careers. This three-year study utilises large-scale surveys and case studies to construct a deeper understanding of early career teachers’ experiences. It tracks all 2010/2011 teacher education graduates in Queensland and Victoria to investigate the effectiveness of particular characteristics of their teacher education programs in equipping them with the capacity to meet the learning needs of young people in a diverse range of Australian school settings.

This paper will discuss findings from the first of a series of online surveys completed by teacher education graduates in Queensland and Victoria (March-April 2012). Survey data includes teacher demographic information which form independent variables to inform inferential statistical analysis. Beginning teacher responses are mapped against key characteristics of participants' pre-service programs and framed in relation to the key themes of curriculum, pedagogy, assessment, behaviour management, and engagement with school stakeholders and local community. The findings will assist teacher educators design teacher education programs for effective beginning teaching in diverse settings and will also provide an evidentiary basis for policy decisions regarding teacher education and beginning teaching.