Background: Playgrounds are a central resource when it comes to physical activity among minors. This study assesses the association between area deprivation and the quality of playgrounds. Methods: All playgrounds in the city of Mannheim, Germany (145 km2, 311,000 inhabitants) were visited between July 2016 and January 2017 as part of a systematic audit. Each playground’s amenities, attractiveness, cleanliness, and safety were operationalized using well-established, validated instruments. Global and geographically weighted regression models were fitted to investigate the association of the amenities, attractively, cleanliness, and safety of playgrounds with sociodemographic indicators on the social area level. Results: A total of 271 playgrounds were identified. Overall, population density showed the strongest association with all quality variables in the global models, followed by the central official poverty indicator. Significant spatial variation in parameter estimates was found for most of the deprivation indicators with regard to attractiveness, cleanliness, and safety of playgrounds indicating locally negative associations between area-level deprivation and quality. Conclusion: Our findings illustrate the importance of a qualitative approach by analyzing physical activity resources. Concerning the quality of playgrounds, the data from this study support the deprivation amplification hypothesis, meaning that children who are already socially disadvantaged might experience a further contextual disadvantage.
Christoph Buck, Anca Bolbos and Sven Schneider
Katharina Diehl, Manfred Mayer, Frank Mayer, Tatiana Görig, Christina Bock, Raphael M. Herr and Sven Schneider
In physical activity (PA) counseling, primary care physicians (PCPs) play a key role because they are in regular contact with large sections of the population and are important contact people in all health-related issues. However, little is known about their attitudes, knowledge, and perceived success, as well as about factors associated with the implementation of PA counseling.
We collected data from 4074 PCPs including information on physician and practice characteristics, attitudes toward cardiovascular disease (CVD) prevention, and measures used during routine practice to prevent CVD. Here, we followed widely the established 5 A’s strategy (Assess, Advise, Agree, Assist, Arrange).
The majority (87.2%) of PCPs rated their own level of competence in PA counseling as ‘high,’ while 52.3% rated their own capability to motivate patients to increase PA as ‘not good.’ Nine of ten PCPs routinely provided at least 1 measure of the modified 5 A’s strategy, while 9.5% routinely used all 5 intervention strategies.
The positive attitude toward PA counseling among PCPs should be supported by other stakeholders in the field of prevention and health promotion. An example would be the reimbursement of health counseling services by compulsory health insurance, which would enable PCPs to invest more time in individualized health promotion.
Katharina Diehl, Ansgar Thiel, Stephan Zipfel, Jochen Mayer, Alexia Schnell and Sven Schneider
The authors’ aim was to examine the prevalence of (daily) dietary-supplement (DS) use among elite adolescent athletes and to differentiate use by different types of DS according to their function. Data were analyzed for associations between users of these DS types, sociodemographic, sport-specific characteristics, and opinion on the need for DS. In addition, sources of supply and information were examined. In the framework of the GOAL Study, 1,138 German elite adolescent athletes (14–18 yr) answered questions about DS. The data were analyzed to identify groups at risk for using DS after a classification by supplemental function. Of the young athletes, 91.1% reported DS use during the previous month. (Daily) DS use was significantly associated with sex, kind of sport, and the weekly duration of sporting activity. Furthermore, some athletes were required to use DS by their sporting organization. DS use was more likely in these athletes than in those whose sporting organizations had no such requirement. Overall, DS with short- and long-term supplemental function were mostly associated with the use of magnesium. However, DS with medium-term muscle-building function played an important role among daily users. The main source of information about DS was coaches; main source of supply was parents. Professional education is urgently needed, as 9 out of 10 athletes used DS, and strong positive opinions toward the use of DS were present, particularly in the DS users.
Sven Schneider, Adriana D’Agostino, Simone Weyers, Katharina Diehl and Johannes Gruber
The “deprivation amplification” hypothesis states that individuals who are already socially disadvantaged experience a further contextual disadvantage regarding their access to health relevant facilities. This hypothesis is investigated for the first time for Germany, led by the question as to whether deprived neighborhoods experience worse access to physical activity facilities than affluent ones. We differentiate between facilities for children and adolescents vs. for adults, and between free vs. fee-based facilities.
We identified all physical activity facilities by traversing each neighborhood by foot or bicycle in the framework of a systematic audit. Number, location, and type of facilities were recorded and visualized. The investigation area encompassed 18 social areas in a major German city with 92,000 inhabitants and an area of 12.0 km2.
A lower socioeconomic area status was related to a higher availability of physical activity facilities for children and adolescents (7.11/1000 minors in deprived social areas versus 4.46/1000 minors in affluent social areas; P < .05). For adults, the pattern was similar but not significant (P ≥ .05). These results were also shown in analyses in which only free facilities were taken into consideration.
Our study cannot support the “deprivation amplification” hypothesis regarding the availability of physical activity facilities.