Promoting active transport in rural communities through infrastructural modifications: the PABEM needs assessment tool

The design of the built environment in communities influences active transport and physical activity levels of citizens. Existing instruments for quantitatively assessing built environments were developed for use in urban areas and mainly by experts. Participative assessment of built environment modifications (PABEM) is a needs assessment tool that involves citizens and community decision-makers within a structured process for identifying needed changes to promote walking and cycling in rural areas. This article describes the development of the PABEM process and evaluates its initial use in three rural towns in Austria. PABEM consists of the following seven steps: (i) qualitative interviews; (ii) expert assessment of the built environment; (iii) citizen assessment of the built environment; (iv) social media interaction; (v) household questionnaire; (vi) participatory workshop; and (vii) evaluation and scoring workshop. The main modifications identified as necessary in rural towns were the revitalization of existing walking and cycling facilities and the construction of new barrier-free and safe sidewalks. In addition cycling routes to schools, to public transport facilities and to central public places as well as cleaner and inviting seating, a car-free school environment, speed reduction in town centres, more crosswalks and improved cleanliness in public places were also deemed necessary modifications. PABEM's provisions to ensure collaborative participation of citizens and local decision-makers fostered a continuous dialogue about the requirements of the built environment, user needs and opportunities for realization throughout the whole process.

Online-Training to strengthen Health Literacy in Austrian Companies

Background

The HL-Survey-EU-2011 showed limited health literacy [HL] among the European population especially within Austria. In fact, every second Austrian is affected by limited health literacy [51,6%]. Approaches to strengthen HL in organisations are lacking in Austria.

Objectives

A Massive-Open-Online-Coors (MOOC) was developed in a four-step-approach to strengthen HL in Austrian companies: step 1) Literature review; step 2) Development workshops [n = 3]; step 3) National and international expert feedbacks [n = 8]; step 4) In-person pilot testing [n = 10 companies]. The MOOC took place in autumn 2020.

Results

In total, n = 81 people within service and production sectors were registered for the training. The final training concept covered six modules and was carried out in a four-week online training. Modules were: M1) Concepts of health; M2) Individual HL and HL in organisations M3) Health information search and critical assessment; M4) HL Communication [and how to make information available for workforce & costumers]; M5) Project management for practical implementation; M6) Development of HL initiatives for each company (mutual exchange of ideas). The four-week MOOC was free of charge. Participants spent 3-4 hours per week. Each week had a focus and was led by an expert. Contents were provided through learning videos, literature and exercise materials. Participants were encouraged to discuss the given forum and upload completed tasks based on provided templates. Participants graduated with a certificate.

Conclusions

This is the first virtual HL training programme for companies in Austria. HL is a new and complex topic for service and production sectors. Trainers need comprehensive competences in order to transform the topic into operational practice. Mutual exchange among participants and course instructors seem crucial for HL online trainings. It is important to advertise HL-MOOCs intensively right before the start. The online course provides reusable content.

Key messages

Mutual exchange and interactive discussions between participants and course instructors (e.g. in discussion forums) strengthen the online learning success. Trainers and course instructors need comprehensive competences in order to transform the topic into operational practice.

Factors influencing (health-promoting) telework during COVID-19: A company sample in Austria

Background

Many companies had to switch to teleworking (TW) due to COVID-19 pandemic in spring 2020. However, TW conditions (home office) are not always health promoting. The question was: To what extent companies enabled TW before, during and after the first lockdown (time points t1-t3) and what is the role of workplace health promotion (WHP) in the establishment of health-promoting TW?

Methods

Using TAM, hypotheses were operationalised using a standardised questionnaire. At the beginning of 2020, a selection of 1858 Austrian companies were asked to participate in an online survey. The n = 192 responses from company representatives cover a broad mix of different sectors, industries, company sizes and regions in Austria. The analysis was carried out using structural equation models.

Results

Both the extent of TW implemented (means: mt1=3.7, mt2=18.4, mt3=8.6 days per month/employee) and the proportion of the workforce that could make use of TW (mt1=17.3%, mt2=58.6%, mt3=40.1%) increased significantly during the 1st lockdown and did not return to the pre-lockdown level afterwards. The degree of TW depended on how well the companies were prepared for it (β = 0.271). The (a) experience with TW and the (b) willingness to continue offering TW depended on the preparation (a: 0.243; b: 0.453) and on the actual degree of implementation of TW (a: 0.228; b: 0.193). For the intention to implement health-promoting TW in the company, the general willingness for TW (0.415) but also the existing WHP structures are central requirements (0.446; all p < 0.050).

Conclusions

Far more than before COVID-19, TW is of central interest for public health and WHP. In terms of a holistic health understanding of TW, companies have to adapt to the changing conditions (eg technical, communication) and to establish comprehensive WHP structures and processes. Support for companies can come from training or further education to raise awareness and develop an appropriate health-promoting company culture.

Key messages

Health promoting telework conditions need to be assessed and developed further. Companies need to be supported when implementing health-promoting telework, eg with guidelines, further education.

Strategy for Deployment of Integrated Healthy Aging Regions Based Upon an Evidence-Based Regional Ecosystem-The Styria Model

In 2013, the European Commission founded the platform European Innovation Partnership on Active and Healthy Aging as a communication and innovation network in this domain. The goal of the current study was the development of an integrated regional ecosystem for active and healthy aging for the region of Styria via a step-by-step co-creation process. A mixed model approach was used to establish an ecosystem for active and healthy aging, which includes macro-, meso- and micro-level stakeholders in the province of Styria, Austria. Based on the results, eight recommendations for the deployment of a healthy aging region were developed. The visibility and accessibility of healthy aging products and services were evaluated as key factors for innovation in active and healthy aging in the region. Health professionals were identified as major drivers of innovation related to active and healthy aging in Styria. The study presented in this article assessed the capacities for healthy aging in the Styria region and identified the need to improve communication pathways between all levels of the public health system and market.

Educational program for multipliers to promote health literacy

The HL-Survey-EU-2011 showed limited health literacy (HL) among the Austrian population (51,6%). “On health course - health literacy in Feldbach” focuses on individual and organizational HL. As a part of the project, an education program for multipliers from 11 companies to promote health literacy of employees and customers took place in autumn 2019. Basic knowledge on 'finding, understanding, evaluating and applying of health information' and 'health communication' represented the basic structure of the training and supported the participants in the implementation.

The training for the multipliers (n = 12) was divided into 3 focus areas, each was structured in 2 modules. Individual health literacy, organizational health literacy and special approaches to promoting health literacy were important components of the program. In this context, the quality criteria of health information were content of the training. Subsequently, there were inputs concerning health communication. In order to be able to evaluate health information critically, the multipliers learned how they recognize good and reputable health information and where they can find it. The participants studied how they could prepare and provide good health information for their employees and customers. The participants implemented projects to increase health literacy in their companies.

The evaluation showed that the structure and content of the education program was appropriate. The attendees were able to put what they had learned into practice. The difficulty lay in conveying numerous contents in a very short time (3 days/8 ours). The different industries and company sizes of the participating companies and the resulting different needs also presented a major challenge during the training.

With the content of the training and the experience of project implementation, a massive open online course (MOOC) is being created, which will be offered to all companies and interested parties in autumn 2020.

Key messages

It is important to train multipliers in order to increase the organization-related health literacy. The provision of practical examples for the implementation of measures to promote HL is crucial for the success of an HL education program.

Improving Health Literacy in Austrian Companies: Results from a Systematic Company Recruitment

Issue

The HL-Survey-EU-2011 showed limited health literacy (HL) among the Austrian population (51,6%), especially in the federal state of Styria (63,1%). The project “Auf Gesundheitskurs - gesundheitskompetent in Feldbach” focuses on individual and organizational HL by training and educating production and service company workforce in a rural region in Austria.

Description

The population in the target region is especially disadvantaged regarding HL due to the parameters of age, gender, education, income and ethnicity. There are several small and medium-sized businesses within this area. This project (2018-2020) aims to improve knowledge, competences and skills of multipliers from different companies concerning organizational and individual HL, based on an in-person training programme. However, in order to recruit participants for this research project, a systematic recruitment approach was used.

Results

A total of 783 companies, listed in the community database, were contacted via email in order to inform about the project and to invite for an interview. After the initial email, 40 companies were selected, based on four characteristics: industry sector, company size, distance to town centre, relevance to HL, and contacted via phone as well. However, 7 companies out of 783 confirmed the first interview and 6 out of 7 signed the project cooperation. 18 out of 40 phone contacts led to personal meetings, 9 resulted in signing the cooperation. In total, 15 companies have decided to participate in the project.

Lessons

Overall, telephone contact led to much higher response rates than email alone. The parameters which effected positive outcomes during the interaction by phone and in-person were demonstrating benefits (healthy workplace, motivated staff, positive atmosphere, new customers), explaining the practical value, clarifying costs, expenditures and time effort. Although the topic of workplace health promotion is popular in this rural region, the focus on HL is new.

Key messages

Key factors in company recruitment for HL initiatives in rural regions are telephone and personal contact. Pointing out specific benefits for companies within the recruiting process seems also crucial.

Holistic physical exercise training improves physical literacy among physically inactive adults: a pilot intervention study

BACKGROUND

Physical literacy (PL), given as a multidimensional construct, is considered a person's capacity and commitment to a physically active lifestyle. We investigated the effect of a holistic physical exercise training on PL among physically inactive adults.

METHODS

A non-randomised controlled study was conducted. Thirty-one physically inactive adults in the intervention group (IG; 81% females, 44 ± 16 years) participated in a holistic physical exercise training intervention once weekly for 15 weeks. A matched, non-exercising control group (CG) consisted of 30 physically inactive adults (80% female, 45 ± 11 years). PL, compliance and sociodemographic parameters were measured. PL was evaluated by a questionnaire, covering five domains: physical activity behaviour, attitude towards a physically active lifestyle, exercise motivation, knowledge and self-confidence/self-efficacy. Data were analysed using ANCOVA models, adjusted for age, gender and BMI at baseline.

RESULTS

At post-training intervention, the IG showed significant improvements in PL (p = 0.001) and in the domains physical activity behaviour (p = 0.02) and exercise self-confidence/self-efficacy (p = 0.001), with no changes overserved for the CG regarding PL and those domains. No intervention effect were found for the other three domains, i.e. attitude, knowledge and motivation. Additionally, for the IG baseline BMI was identified to be positively correlated with physical exercise-induced improvements in PL (β = 0.51, p = 0.01).

CONCLUSIONS

The results from this study are very useful for further public health activities, which aim at helping physically inactive adults to adopt a physically active lifestyle as well as for the development of further PL intervention strategies. This pilot-study was a first attempt to measure PL in inactive adults. Yet, a validated measurement tool is still not available. Further research is necessary to determine the psychometric properties for this PL questionnaire.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS), DRKS00013991 , date of registration: 09.02.2018, retrospectively registered.