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Purpose. To examine the association between children's physical activity and factors of the built environment. Design. Cross-sectional study. Setting. Ten neighborhoods in six cities in the Netherlands. Subjects. Four hundred twenty-two children (age range, 6–11 years; 49% male). Measures. Physical activity diary, neighborhood observations, and anthropometric measures. Analysis. Univariate and multivariate linear regression analyses. Results. According to univariate analyses adjusted for age, sex, body mass index, and highest level of maternal education, physical activity (≥ 3 metabolic equivalents) was significantly (p < .05) associated with the proportion of green space, with the residential density, with the general impression of activity-friendliness of the neighborhood, and with the frequency of certain types of residences (e.g., terraced houses), sports fields, water, dog waste, heavy traffic, and safe walking and cycling conditions (e.g., cycle tracks and 30-km speed zones) in the neighborhood. According to adjusted multivariate analyses, physical activity was best predicted by the frequency of parallel parking spaces in the neighborhood and by the general impression of activity-friendliness of the neighborhood (R2 = 0.193). Conclusions. Children's physical activity is associated with certain modifiable factors of the built environment. Longitudinal studies should examine whether there is a causal relationship.

Abstract Background Eating patterns in Western industrialized countries are characterized by a high energy intake and an overconsumption of (saturated) fat, cholesterol, sugar and salt. Many chronic diseases are associated with unhealthy eating patterns. On the other hand, a healthy diet (low saturated fat intake and high fruit and vegetable intake) has been found important in the prevention of health problems, such as cancer and cardio-vascular disease (CVD). The worksite seems an ideal intervention setting to influence dietary behavior. The purpose of this study is to present the effects of a worksite environmental intervention on fruit, vegetable and fat intake and determinants of behavior. Methods A controlled trial that included two different governmental companies (n = 515): one intervention and one control company. Outcome measurements (short-fat list and fruit and vegetable questionnaire) took place at baseline and 3 and 12 months after baseline. The relatively modest environmental intervention consisted of product information to facilitate healthier food choices (i.e., the caloric (kcal) value of foods in groups of products was translated into the number of minutes to perform a certain (occupational) activity to burn these calories). Results Significant changes in psychosocial determinants of dietary behavior were found; subjects at the intervention worksite perceived more social support from their colleagues in eating less fat. But also counter intuitive effects were found: at 12 months the attitude and self-efficacy towards eating less fat became less positive in the intervention group. No effects were found on self-reported fat, fruit and vegetable intake. Conclusion This environmental intervention was modestly effective in changing behavioral determinant towards eating less fat (social support, self-efficacy and attitude), but ineffective in positively changing actual fat, fruit and vegetable intake of office workers.

The purpose of this study was to investigate the agreement between self-reported tobacco consumption and NicCheck 1^® (Dynagen Inc. Cambridge, Mass., USA) regarding smoking status and nicotine intake in a population of smokers (20.8%) and non-smokers. NicCheck 1 is a dipstick that changes colour in the presence of urinary nicotine metabolites. Smoking was assessed by self-report and NicCheck 1 in 169 males and 191 females (mean age 36.0 SD 0.7). Self-report and NicCheck 1 agreed highly on smoking status, especially in moderate to heavy smokers. With regard to nicotine intake, there was a large overlap in self-reported tobacco consumption between NicCheck 1 levels, despite a relatively high correlation coefficient between self-report and NicCheck 1 in smokers (i.e. 0.74). No effect modification by gender or BMI was found. When both methods were validated against two blood lipid parameters, self-report seemed to do equally well as NicCheck 1 in assessing nicotine intake.

Purpose. Evaluate counselors' adherence to an intervention protocol, counselors' competence, and the associations between three process indicators and body weight at follow-up in a 6-month individually based lifestyle intervention for construction workers. Design. Process evaluation with qualitative and quantitative data. Setting. Occupational health service. Subjects. A total of 408 male construction workers with an elevated risk of cardiovascular disease received the intervention, and 27 occupational health professionals delivered the intervention. Intervention. Seven counseling sessions, the first during which four prescribed items had to be discussed. Motivational interviewing (MI) was used as a counseling technique. Measures and Analysis. The number of sessions and the items discussed were registered by the counselors. Adherence to MI was determined by expert scoring of transcripts of random segments of 19 counseling sessions. Counselors' competence was rated by participants and counselors separately. Associations between three process indicators and body weight at follow-up were determined by linear and logistic regression analyses. Results. Two-thirds of all participants attended five or more sessions, and 38.5% attended all seven sessions. In 90.2% of all cases, the counselor discussed all obligatory items in the first session. MI adherence was reached in one audiotaped fragment. Most (86.3%) of all participants agreed with the counselor being competent. Neither counselors' competence nor number of sessions or items discussed was significantly associated with body weight loss. Conclusions. Performing five sessions and discussing four prescribed items was feasible for the counselors, whereas performing MI was not. Still, participants were positive about the counselors' competence and willing to attend the intervention sessions. Investigators are encouraged to report the evaluation of their intervention process to improve future lifestyle interventions in research or in practice.

Objective: Sleeping less or more than the 7-8 h has been associated with mortality in the general population, which encompasses diversity in employment status, age and community settings. Since sleep patterns of employed individuals may differ to those of their unemployed counterparts, the nature of their sleep-mortality relationship may vary. We therefore investigated the association between self-reported sleep duration and all-cause mortality (ACM) or cardiovascular disease mortality (CVDM) in employed individuals. Data sources: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, searches between January 1990 and May 2020 were conducted in PubMed, Web of Science and Scopus. Inclusion/exclusion criteria: Included were prospective cohort studies of 18–64-year-old disease-free employed persons with sleep duration measured at baseline, and cause of death recorded prospectively as the outcome. Gray literature, case-control or intervention design studies were excluded. Data Extraction: Characteristics of the studies, participants, and study outcomes were extracted. The quality and risk of bias were assessed using the Newcastle-Ottawa Scale. Data synthesis: The pooled relative risks (RR) with 95% confidence intervals (CI) were obtained with a random-effects model and results presented as forest plots. Heterogeneity and sensitivity analysis were assessed. Results: Shorter sleep duration (≤6 h) was associated with a higher risk for (ACM) (RR: 1.16, 95% CI: 1.11 -1.22) and CVDM (RR: 1.26, 95% CI: 1.12 -1.41) compared to 7-8 h of sleep, with no significant heterogeneity. The association between longer sleep (≥8 h) and ACM (RR: 1.18, 95% CI:1.12 -1.23, P < 0.001) needs to be interpreted cautiously owing to high heterogeneity (I2 = 86.0%, P < 0.001). Conclusion: Interventions and education programs targeting sleep health in the workplace may be warranted, based on our findings that employed individuals who report shorter sleep appear to have a higher risk for ACM and CVDM.

Introduction Socioeconomic health differences have often been described, but remain insufficiently understood. Recent evidence suggests that workers who are high (compared with low) physically active at work are less healthy. Moreover, workers who are highly physically active at work are predominantly physically inactive during leisure time. These observations suggest that workers with a lower socioeconomic status may be exposed to negative health consequences of occupational physical activity and may only benefit to a limited extent from health benefits of leisure-time physical activity. Physical activity may therefore be an important driver of socioeconomic health differences. We describe the rationale and protocol of the active worker study, an individual participant data meta-analysis aimed at exploring socioeconomic health differences by differential doses of physical activity at work and leisure time. Methods and analysis Using database and scoping searches (we searched in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews from database inception to 14 September 2017), we have identified 49 published and unpublished prospective studies in which the association of occupational and leisure-time physical activity with cardiovascular or all-cause mortality was assessed. Principal investigators of these studies will be invited to participate in the active worker consortium, after which data will be retrieved. After data merging and harmonising, we will perform multilevel survival analysis assessing the combined association of occupational and leisure-time physical activity with mortality. We will also test the mediating effect of physical activity on the association of socioeconomic status and mortality (ie, socioeconomic health differences). Discussion The Medical Ethical Committee of the VU University Medical Center has declared, according to Dutch legislation, that the 'Dutch Medical Research Involving Human Subjects Act' does not apply to the current study. As such, no ethics approval is required. We intent to publish outcomes of the active worker Study in scientific peer-reviewed journals.

This cross-sectional study investigated whether physical activity, social cohesion, and loneliness mediate the association between time spent visiting green spaces and perceived mental health and vitality. Questionnaire data were collected from 3,948 residents from 124 neighborhoods across four European cities. Multilevel linear regression analysis revealed positive, but weak, associations between time spent visiting green space and Medical Outcome Study Short Form (SF-36) mental health and vitality score, which suggest small mental health benefits. Single mediation analyses showed that different indicators of physical activity (total, during leisure time, and walking during leisure time), social cohesion, and loneliness were mediators. Multiple mediation analyses showed that physical activity during leisure time and loneliness may explain about 25% of the relationship. The unmediated part of the association suggests that other mediators may explain the association.

Purpose.To determine the effects of the physical activity promotion programs Rehabilitation & Sports (R&S) and Active after Rehabilitation (AaR) on sport and daily physical activity 1 year after in- or outpatient rehabilitation.Design.Subjects in intervention rehabilitation centers were randomized into a group receiving R&S only (n = 315) and a group receiving R&S and AaR (n = 284). Subjects in six control centers (n = 603) received usual care.Setting.Ten Dutch rehabilitation centers.Subjects.Subjects consisted of 1202 rehabilitation patients. Most frequent diagnoses were stroke, neurological disorders, and back disorders.Intervention.Both the sport stimulation program (R&S) and the daily physical activity promotion program (AaR) consisted of personalized tailored counseling.Measures.Two sport outcomes and two daily physical activity outcomes were assessed with questionnaires at baseline and 1 year after rehabilitation.Analysis.Multilevel analyses comparing both intervention groups to the control group.Results.The R&S program showed no significant effects. Intention-to-treat analyses in the R&S + AaR group showed borderline significant improvements in one sport (odds ratio [OR] = 1.66, p = .02) and both physical activity outcomes (OR = 1.68, p = .01 and regression coefficient = 10.78, p = .05). On-treatment analyses in the R&S + AaR group showed similar but stronger effects.Conclusions.The combination of the R&S and AaR programs improved physical activity behavior and sport participation 1 year after in- or outpatient rehabilitation. The R&S program alone did not have any effects.