Abstract
Issue and problem
In France according the group of age, 37% to 81% of the population are insufficiently active (ANSES, 2017). In addition, more than 40% of adults have prolonged sedentary ...behaviours (? 7 hours of day) (ANSES, 2017). Moreover, 7,6% of premature deaths in France could be attributable to physical inactivity (GOPA, 2021). In many territories, opportunities to adopt a physical active lifestyle need to be improved (IGAS, 2018). To tackle these major issues, the French government have implemented the Sport-Health Houses (SHH) program through the national sport health strategy 2019-2024.
Problem description
SHH have been launched in 2019 across the country. SHH are places were communities are welcomed and informed about multiples benefits of physical activity and sport. SHH also offer opportunities to evaluate people's fitness and to refer them to a ‘sport health' program through their own resources or through local stakeholders network. How the SSH program have been implemented across the country? Did SHH reach inactive people? How SHH impacted communities?
Results
Each year since 2019, the ministry of sport and the ministry of solidary and health have launched a call for project to local stakeholders to their organization become a SHH by complying selection requirements. In January 2022, 436 SSH were created on metropolitan and overseas territories with attention to the most vulnerable. Since 2020, beyond information about the benefits and opportunities to practice locally a physical activity, almost 697 000 inactive people were supported following a sport-health program of SHH in primary prevention of which 45 000 people in secondary or tertiary prevention. The impact evaluation of SHH to the communities is in progress
Lessons
A strong national policy can support the local level to develop Health-Enhancing the Physical Activity (HEPA) promotion. Moreover, it seems to be particularly relevant to develop SHH in territories with social inequalities to attract people generally far away of an active lifestyle.
Main messages
An approach linking the national and the local level is promising to develop HEPA.
Abstract
Background
There is strong evidence of the multiple benefits of physical activity on health in primary, secondary and tertiary prevention (WHO, 2020). However, economic evaluations are still ...needed to estimate direct and indirect costs that could be saved from various Health-Enhancing Physical Activity (HEPA) promotion strategies (Ding et al., 2020). Moreover, these savings might be influenced by specificities of the national health system. The aim of this study is to explore the economic impact of HEPA from different settings in France.
Methods
A systematic scoping review of grey and scientific literature was conducted. Relevant articles were identified through searching from PubMed, ScienceDirect, SportDiscus databases and from google. Searches were conducted in English and French between January 2000 and December 2020. A data extraction template was used to collect, organize and summarize data regarding the following variables: aim of the study, study population, study settings, methods, and main results.
Results
A total of 17 studies were included from the grey literature (n = 10) and the scientific peer-reviewed literature (n = 7). Data from each variables of interest were heterogeneous, making comparisons difficult. Studies were categorized in 5 types: studies aiming to estimate the cost of physical inactivity or the cost that could be saved from HEPA promotion in general population (n = 8); studies aiming to evaluate the medico-economic impact of a physical activity adapted program (n = 5); studies aiming to assess the economic benefit of active travel in a city (n = 3); study aiming to estimate the economic impact of physical activity from a company and its employee's perspectives (n = 1). Whatever the methods, the study population or the study setting, several tens of millions of euros to several billions of euros could be saved each year by investing in HEPA promotion.
Conclusions
HEPA promotion can lead to substantial saving. Methods should be standardized to more precisely estimate its extent in different settings in France. This could help policy-makers in their decision to invest in HEPA promotion, especially in phases of epidemics, where sedentarity and physical inactivity account for major health risks.
Abstract
Background
There is strong evidence showing that sedentary behaviour (SB) increase the risk to develop several chronic diseases and to premature death (Chau et al., 2015). A dose response ...relation is observed with a more marked risk when people spend more than 7 hours/day in sitting position (Ekelund et al., 2019). The study INCA 3 on the lifestyle habits of French population indicated that 40% of people between 18 and 79 years had a high risk for health conditions with more than 7 hours of daily SB (ANSES, 2017). The economic consequences of this risk have never been evaluated. The aim of this study was to estimate the economic burden of SB-related diseases in France.
Methods
From meta-analysis or large cohorts based on individual SB time, we identified relative risk (RR) to develop cardiovascular disease (CVD), colon cancer, breast cancer and all-causes premature death after co-variables adjustments including physical activity. From RR and prevalence of SB time in France, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the national health insurance were used to calculate the annual average costs per case for each disease. Then, disease-specific and total health-care costs attributable to prolonged SB time were calculated. Indirect costs for private sector and households were calculated in a second stage.
Results
In France, 66 528 premature deaths/year appear related to a daily SB time ≥ 8,6 hours Each year prolonged SB cost 559 millions € for the national health insurance, including 359 millions € for CVD (≥ 10 hours of daily SB), 170 millions € for breast cancer (≥ 6 hours of daily SB), and 31 millions € for colon cancer (≥ 5 hours of TV/day).
Conclusions
These preliminary results showed that many deaths could be avoided by reducing prolonged SB prevalence in France. Moreover, direct health-care costs attributable to SB related diseases represent a high economic burden for the French health system. To address this issue, strong responses should be implemented to tackle SB, complementary to physical activity promotion.
Abstract
Background
There is strong evidence showing that sedentary behaviour time increase the risk to develop several chronic diseases and to premature death. The economic consequences of this risk ...have never been evaluated in France. The aim of this study was to estimate the economic burden of prolonged sedentary behaviour in France.
Methods
Based on individual sedentary behaviour time, relative risk to develop cardiovascular disease, colon cancer, breast cancer and all-causes of premature mortality were identified. From relative risk and prevalence of sedentary behaviour time, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the National Health Insurance were used to calculate the annual average costs per case for each disease. Disease-specific and total healthcare costs attributable to prolonged sedentary behaviour time were calculated. Indirect costs from productivity loss due to morbidity and premature mortality were estimated using a friction cost approach.
Results
In France, 51 193 premature deaths/year appear related to a prolonged daily sedentary behaviour time. Each year prolonged sedentary behaviour cost 494 million € for the national health insurance. Yearly productivity loss due to premature mortality attributable to prolonged sedentary behaviour cost 507 million € and yearly productivity loss due to morbidity cost between 43 and 147 million €.
Conclusion
Significant saving and many deaths could be avoided by reducing prolonged sedentary behaviour prevalence in France. To address this issue, strong responses should be implemented to tackle sedentary behaviour, complementary to physical activity promotion.
The implementation of strategies to prevent mobility disability in seniors at-risk with a strong focus on exercise is a public health imperative. These strategies must follow a pragmatic, structured ...and personalized approach. In order to obtain short, medium and long-term benefits, it is essential to consider the coordination of adapted physical exercise programs and to harmonize good practices. In support of national policies for the prevention of loss of autonomy, it is important to define clear guidelines to conduct effective programs. These programs should have a strong emphasis on evidence-based literature and should be validated by a consensus of multi-professional experts. The aim of this consensus is to outline the steps implementing these programs, to present their constituent elements and their practical application. Conception and elaboration of these programs should include frequency, intensity, duration, type of work, volume and individual progressiveness. Programs should also be focused on a personalised approach to develop participant health education, self-efficacy and empowerment for physical activity to ensure long-term health related behaviours. Moreover, trained professionals must supervise these programs in order to assure participants safety and program effectiveness. These guidelines will support policies for the prevention of loss of autonomy and mobility, throughout their development over the national territory.
La mise en oeuvre de stratégies de prévention de la perte de mobilité chez les seniors à risque résolument tournée vers l'exercice physique est un impératif de santé publique. Ces stratégies doivent ...suivre une approche pragmatique, structurée et personnalisée. Afin d'obtenir des bénéfices à court, moyen et long-terme, il est primordial d'envisager la coordination de programmes d'exercices physiques adaptés et d'harmoniser les bonnes pratiques. À l'appui des politiques nationales de prévention de la perte d'autonomie, il est important de définir clairement des recommandations sur la conduite de tels programmes. Ceux-ci doivent s'appuyer sur la littérature scientifique et être validés par un consensus d'experts pluri professionnels. Le but de ce consensus est d'exposer les étapes de mise en oeuvre de ces programmes, d'en présenter les éléments constitutifs ainsi que leur application pratique. La conception et l'élaboration de ces programmes d'exercice physique doivent intégrer la fréquence, l'intensité, la durée, le type de travail, le volume et la progressivité individuelle. Ces programmes doivent être encadrés par des professionnels expérimentés afin de garantir la sécurité des participants et l'efficacité du programme. Ces recommandations permettront d'être un appui aux politiques de prévention de la perte d'autonomie et de la mobilité, en vue de leur développement sur le territoire national.
Abstract
France, as a Member State of WHO Europe, plays a major role in the European strategy on physical activity, nutrition and health within a global framework for the fight against ...non-communicable diseases.
France has adopted a National Sport Health Strategy for 2019-2024 intended to promote sports and physical activities (SPA) as a fully-fledged determinant of health and well-being lifelong. It is consistent with other strategies or plans implemented by other ministerial departments.
The four axes of the NSHS are: 1/Promoting health and well-being through physical activity and sports, 2/Developing the offer of and participation in adapted physical actvities for therapeutic purposes and prevention of loss of autonomy; 3/Better protecting sports people’s health and improving safety of activities whatever their intensity; 4/Improving and disseminating knowledge on the impacts on physical condition and health of engaging in sports and physical activities.
One of the key measure of the NSHS is indexing of “Maisons Sport Santé”, Health Sport-Houses (HSH) aimed at receiving and orientating all those wishing to engage in, develop or resume sport or physical activities for health or wellbeing reasons, whatever their age, state of health or frailty. Following 3 calls for projects, 436 HSH have been recognized since 2019 and cover almost whole French territory. HSH can be integrated within an association, a hospital, a sports establishment or as digital platforms. A particular attention is paid to people with highly sedentary lifestyles and those with limited autonomy. People with chronic or long-term diseases (cancer, diabetes, heart disease, asthma, Alzheimer etc.) to whom physical activities adapted to their limitations have been prescribed are also priority targets.
“Month of Sport and Physical Activities” is a large-scale communication campaign to promote the benefits of sport and physical activities to a wide range of population. The aim is to spread recommendations on SPA and the fight against sedentary behavior, to make SPA accessible to everyone and to encourage people and make them aware of the possibilities to practice in their daily life. Another goal is to give visibility to current actions in this area, to enable French people carry out an analysis of their physical condition and to spur them to (re) start a physical activity training.
Background There is strong evidence of the multiple benefits of physical activity on health in primary, secondary and tertiary prevention (WHO, 2020). However, economic evaluations are still needed ...to estimate direct and indirect costs that could be saved from various Health-Enhancing Physical Activity (HEPA) promotion strategies (Ding et al., 2020). Moreover, these savings might be influenced by specificities of the national health system. The aim of this study is to explore the economic impact of HEPA from different settings in France. Methods A systematic scoping review of grey and scientific literature was conducted. Relevant articles were identified through searching from PubMed, ScienceDirect, SportDiscus databases and from google. Searches were conducted in English and French between January 2000 and December 2020. A data extraction template was used to collect, organize and summarize data regarding the following variables: aim of the study, study population, study settings, methods, and main results. Results A total of 17 studies were included from the grey literature (n = 10) and the scientific peer-reviewed literature (n = 7). Data from each variables of interest were heterogeneous, making comparisons difficult. Studies were categorized in 5 types: studies aiming to estimate the cost of physical inactivity or the cost that could be saved from HEPA promotion in general population (n = 8); studies aiming to evaluate the medico-economic impact of a physical activity adapted program (n = 5); studies aiming to assess the economic benefit of active travel in a city (n = 3); study aiming to estimate the economic impact of physical activity from a company and its employee's perspectives (n = 1). Whatever the methods, the study population or the study setting, several tens of millions of euros to several billions of euros could be saved each year by investing in HEPA promotion. Conclusions HEPA promotion can lead to substantial saving. Methods should be standardiz
A purification method is developed to determine
90
Sr in radioactive waste. A separation based on Sr-resin® with a pretreatment using TRU-resin® provides satisfactory Sr recovery yields before the
90
...Sr measurement by liquid scintillation counting (LSC) regardless the analyzed samples with low or high activity level. The selectivity of the procedure is checked by measuring the
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Y ingrowth after different days of separation without waiting for secular equilibrium. In order to obtain a REACH compliant method without scintillation cocktails, a plastic scintillation resin selective for Sr is implemented on the basis of the developed protocol. The optimized method is applied successfully to representative nuclear waste including samples with high Pu content (effluents, concretes and sludges).
90
Sr radiochemical method using nitric acid for Sr and Ca separation was optimized using design of experiments methodology. Nitric acid concentration and total volume of solution were determined as ...influencing factors applying Plackett–Burman design. These parameters were then optimized using Box–Behnken experimental design. An optimal nitric acid concentration of 63% and a total solution volume of 26 mL were found to achieve a Sr recovery of 93% with only 5% of Ca for a single precipitation. The developed procedure was applied on real radwaste samples: effluent, sludge and concrete. By comparison of the recovery and the
90
Sr activity measurement with the results of the in-house standard method based on fuming nitric acid, the optimized method with concentrated nitric acid was validated. The fuming nitric acid can now be eliminated for
90
Sr radioactive waste characterization.
