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Cited by 109Health Policy Implementation SciencePhysical Activity and HealthCommunity Health and Development

Co-producing active lifestyles as whole-system-approach: theory, intervention and knowledge-to-action implications

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Rütten, Alfred, Frahsa, Annika, Abel, Thomas, Bergmann, Matthias, de Leeuw, Evelyne, Hunter, David, Jansen, Maria, King, Abby +1 more·2019·Health Promotion International
DOI 10.1093/heapro/dax053
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Abstract

Population health interventions tend to lack links to the emerging discourse on interactive knowledge production and exchange. This situation may limit both a better understanding of mechanisms that impact health lifestyles and the development of strategies for population level change. This paper introduces an integrated approach based on structure-agency theory in the context of 'social practice'. It investigates the mechanisms of co-production of active lifestyles by population groups, professionals, policymakers and researchers. It combines a whole system approach with an interactive knowledge-to-action strategy for developing and implementing active lifestyle interventions. A system model is outlined to describe and explain how social practices of selected groups co-produce active lifestyles. Four intervention models for promoting the co-production of active lifestyles through an interactive-knowledge-to-action approach are discussed. Examples from case studies of the German research network Capital4Health are used to illustrate, how intervention models might be operationalized in a real-world intervention. Five subprojects develop, implement and evaluate interventions across the life-course. Although subprojects differ with regard to settings and population groups involved, they all focus on the four key components of the system model. The paper contributes new strategies to address the intervention research challenge of sustainable change of inactive lifestyles. The interactive approach presented allows consideration of the specificities of settings and scientific contexts for manifold purposes. Further research remains needed on what a co-produced knowledge-to-action agenda would look like and what impact it might have for whole system change.

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  • Evidence reviewing effective health-based interventions emphasizes the need for greater engagement with participants in design and delivery as well as understanding how participant expectations and individual needs measure against actual outcomes.

    “Evidence reviewing effective health-based interventions emphasizes the need for greater engagement with participants in the design and delivery as well as an understanding of how participant expectations and individual needs measure against actual outcomes (Poland et al., 2009; Rütten et al., 2019).”

    From Blue care: a systematic review of blue space interventions for health and wellbeing (2020) · cites this paper as Rütten et al., 2019

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  • RCTs pose a challenge in the context of public health as they are often difficult to apply in 'real world situations'.

    “However, RCTs pose a challenge in the context of public health as they are often difficult to apply in ‘real world situations’ [(Rütten et al., 2019), p. 4], an issue the authors return to in the discussion.”

    From Blue care: a systematic review of blue space interventions for health and wellbeing (2020) · cites this paper as Rütten et al., 2019

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  1. Brownson, R. C., Dreisinger, M., Colditz, G. A. and Proctor, E. K. (2012a) The path forward in dissemination and imple- mentation research. In Brownson, R. C., Colditz, G. A. and Proctor, E. K. (eds), Dissemination and Implementation Research in Health, Oxford University Press, Oxford.

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Authors
Rütten, A., Frahsa, A., Abel, T., Bergmann, M., de Leeuw, E., Hunter, D., Jansen, M., King, A., & Potvin, L.
Affiliations
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • University of Bern (CH)
  • Institute for Social-Ecological Research (DE)
  • Centre for Health Equity Training Research and Evaluation (CHETRE), University of New South Wales, Sydney, Australia
  • Durham University (GB)
  • Maastricht University (NL)
  • Stanford University (US)
  • Université de Montréal (CA)
Corresponding author
Frahsa, Annika
ORCID
Venue
Health Promotion International
Publisher
Oxford University Press (OUP)
Published
2017-09-08
Volume
34
Issue
1
Pages
47-59
ISSN
  • 0957-4824 (ISSN-L)
  • 1460-2245
DOI
10.1093/heapro/dax053
OpenAlex
W2752663490
Cited by
109
References
65
Citations by year
2026: 12 · 2025: 8 · 2024: 8 · 2023: 14 · 2022: 23 · 2021: 18 · 2020: 15 · 2019: 8 · 2018: 3
FWCI
11.41
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • Health Promotion International (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (submittedVersion, cc-by-nc-nd)
  • UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
  • BORIS (University Library Bern) (submittedVersion, other-oa)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • Research Publications (Maastricht University) (submittedVersion)
Funders
Medical Research Council (MR/K02325X/1)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Health Professions › General Health Professions › Community Health and Development
Keywords
active lifestyle, co-production, knowledge to action, whole systems approach, social practices, population health interventions, intervention model, life course, sustainable lifestyle change
MeSH terms
Healthy Lifestyle, Population Health, Delivery of Health Care, Humans, Health Knowledge, Attitudes, Practice, Health Behavior, Exercise, Organizational Case Studies

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