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      The next step in health behavior research: the need for ecological moderation analyses - an application to diet and physical activity at childcare

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          Abstract

          Background

          The ecological perspective holds that human behavior depends on the interaction of different environmental factors and personal characteristics, but it lacks validation and operationalization. In the current paper, an ecological view was adopted to examine the interactive impact of several ecological systems on children’s dietary intake and physical activity at childcare or similar facilities. The ecological view was operationalized into three types of interaction: 1) interaction between types of childcare environment (physical, social, political, economic); 2) interaction between micro-systems (the childcare and home environment) in meso-systems; and 3) interaction between childcare environment and child characteristics. The predictive value of each of these interactions was tested based on a systematic review of the literature.

          Discussion

          Several studies support the hypothesis that the influence of the childcare environment on children’s physical activity and diet is moderated by child characteristics (age, gender), but interaction between environmental types as well as between micro-systems is hardly examined in the field of behavioral nutrition and physical activity. Qualitative studies and general child development research provide some valuable insights, but we advocate quantitative research adopting an ecological perspective on environmental influences.

          Summary

          Empirical studies operationalizing a true ecological view on diet and physical activity are scarce. Theorizing and assessment of interaction is advocated to become common practice rather than an exception in behavioral nutrition and physical activity research, in order to move the field forward.

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          Most cited references56

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          Environmental influences on energy balance-related behaviors: A dual-process view

          Background Studies on the impact of the 'obesogenic' environment have often used non-theoretical approaches. In this journal's debate and in other papers authors have argued the necessity of formulating conceptual models for differentiating the causal role of environmental influences on behavior. Discussion The present paper aims to contribute to the debate by presenting a dual-process view on the environment – behavior relationship. This view is conceptualized in the EnRG framework (Environmental Research framework for weight Gain prevention). In the framework, behavior is postulated to be the result of a simultaneous influence of conscious and unconscious processes. Environmental influences are hypothesized to influence behavior both indirectly and directly. The indirect causal mechanism reflects the mediating role of behavior-specific cognitions in the influence of the environment on behavior. A direct influence reflects the automatic, unconscious, influence of the environment on behavior. Specific personal and behavioral factors are postulated to moderate the causal path (i.e., inducing either the automatic or the cognitively mediated environment – behavior relation). In addition, the EnRG framework applies an energy balance-approach, stimulating the integrated study of determinants of diet and physical activity. Conclusion The application of a dual-process view may guide research towards causal mechanisms linking specific environmental features with energy balance-related behaviors in distinct populations. The present paper is hoped to contribute to the evolution of a paradigm that may help to disentangle the role of 'obesogenic' environmental factors.
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            Built environment, physical activity, and obesity: what have we learned from reviewing the literature?

            To evaluate the growing literature on the built environment and physical activity/obesity, we conducted a review of review papers. Through a systematic search, we identified 36 reviews that met the inclusion criteria and evaluated these reviews based on key information provided, review methodology, and specificity regarding measurement. We also analyzed research gaps and areas of improvement identified by previous reviews and propose a research agenda. Future studies should develop complex conceptual and statistical models that include moderators and mediators, improve objective and perceived measures of the built environment, and strengthen evidence of causality through better research designs. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Toward a comprehensive model of physical activity

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                Author and article information

                Contributors
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central
                1479-5868
                2014
                17 April 2014
                : 11
                : 52
                Affiliations
                [1 ]Department of Health Promotion, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
                [2 ]NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
                [3 ]Academic Collaborative Centre for Public Health Limburg, Regional Public Health Service, PO Box 2022, Geleen, HA, 6160, the Netherlands
                [4 ]Caphri, School of Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
                [5 ]Department of Epidemiology, Maastricht University, PO Box 616, Maastricht, MD, 6200, the Netherlands
                Article
                1479-5868-11-52
                10.1186/1479-5868-11-52
                4002539
                24742167
                98c90d1f-b61a-43eb-859c-ac87fdad2d07
                Copyright © 2014 Gubbels et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 September 2013
                : 9 April 2014
                Categories
                Debate

                Nutrition & Dietetics
                childcare,diet,ecological perspective,environment,interaction,meso-system,moderation,overweight,physical activity,preschoolers

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