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Griffin KW, Williams C, Botvin CM, Sousa S, Botvin GJ. Effectiveness of a hybrid digital substance abuse prevention approach combining e-Learning and in-person class sessions. Front Digit Health 2022; 4:931276. [PMID: 35990017 PMCID: PMC9381808 DOI: 10.3389/fdgth.2022.931276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Effective school-based programs for preventing substance abuse offer considerable public health potential. Yet limited class time and uneven implementation fidelity can be barriers to widespread adoption and high-quality implementation. A hybrid digital approach may be effective and help address these barriers. Objective To evaluate the effectiveness of a hybrid substance abuse prevention program for middle school students consisting of e-learning modules and in-person class sessions. Design Twenty-three United States (U.S.) middle schools were randomly assigned either to an intervention condition (13 schools) or a treatment-as-usual control condition (10 schools) where standard health education material was delivered. There were 1,447 participants who completed the pre-test and post-test assessments, of which 48.3% were male and 51.7% female. Intervention The hybrid digital intervention consisted of 14 brief e-learning modules and six classroom sessions adapted from an evidence-based program designed for classroom implementation to increase knowledge of adverse consequences of substance use and improve social skills, personal coping skills, and skills for resisting social influences to smoke, drink, or use drugs. Measures Participating students completed online pre-test and post-test surveys to assess substance use, knowledge, and life skills. Results There were significant reductions in substance use for the hybrid digital condition compared to the control condition as well as significant increases in health knowledge, skills knowledge, and life skills. Conclusions A hybrid digital approach to substance abuse prevention is effective and offers potential for overcoming common barriers to widespread adoption and high-quality implementation.
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Affiliation(s)
- Kenneth W. Griffin
- Department of Global and Community Health, George Mason University, Fairfax, VA, United States
| | - Christopher Williams
- National Health Promotion Associates, White Plains, NY, United States
- Purchase College, State University of New York, Purchase, NY, United States
| | - Caroline M. Botvin
- National Health Promotion Associates, White Plains, NY, United States
- Teachers College, Columbia University, New York, NY, United States
| | - Sandra Sousa
- National Health Promotion Associates, White Plains, NY, United States
| | - Gilbert J. Botvin
- National Health Promotion Associates, White Plains, NY, United States
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, United States
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Tinner L, Palmer JC, Lloyd EC, Caldwell DM, MacArthur GJ, Dias K, Langford R, Redmore J, Wittkop L, Watkins SH, Hickman M, Campbell R. Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis. BMC Public Health 2022; 22:1111. [PMID: 35658920 PMCID: PMC9165543 DOI: 10.1186/s12889-022-13072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engagement in multiple substance use risk behaviours such as tobacco smoking, alcohol and drug use during adolescence can result in adverse health and social outcomes. The impact of interventions that address multiple substance use risk behaviours, and the differential impact of universal versus targeted approaches, is unclear given findings from systematic reviews have been mixed. Our objective was to assess effects of interventions targeting multiple substance use behaviours in adolescents. METHODS Eight databases were searched to October 2019. Individual and cluster randomised controlled trials were included if they addressed two or more substance use behaviours in individuals aged 8-25 years. Data were pooled in random-effects meta-analyses, reported by intervention and setting. Quality of evidence was assessed using GRADE. Heterogeneity was assessed using between-study variance, τ2 and Ι2, and the p-value of between-study heterogeneity statistic Q. Sensitivity analyses were undertaken using the highest and lowest intra-cluster correlation coefficient (ICC). RESULTS Of 66 included studies, most were universal (n=52) and school-based (n=41). We found moderate quality evidence that universal school-based interventions are likely to have little or no short-term benefit (up to 12 months) in relation to alcohol use (OR 0.94, 95% CI: 0.84, 1.04), tobacco use (OR 0.98, 95% CI: 0.83, 1.15), cannabis use (OR 1.06, 95% CI: 0.86, 1.31) and other illicit drug use (OR 1.09, 95% CI: 0.85, 1.39). For targeted school-level interventions, there was low quality evidence of no or a small short-term benefit: alcohol use (OR 0.90, 95% CI: 0.74-1.09), tobacco use (OR 0.86, 95% CI: 0.66, 1.11), cannabis use (OR 0.84, 95% CI: 0.66-1.07) and other illicit drug use (OR 0.79, 95% CI 0.62-1.02). There were too few family-level (n=4), individual-level (n=2) and combination level (n=5) studies to draw confident conclusions. Sensitivity analyses of ICC did not change results. CONCLUSIONS There is low to moderate quality evidence that universal and targeted school-level interventions have no or a small beneficial effect for preventing substance use multiple risk behaviours in adolescents. Higher quality trials and study reporting would allow better evidence syntheses, which is needed given small benefit of universal interventions can have high public health benefit. TRIAL REGISTRATION Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD011374. DOI: 10.1002/14651858.CD011374.
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Affiliation(s)
- Laura Tinner
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Jennifer C Palmer
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Deborah M Caldwell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Georgie J MacArthur
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Kaiseree Dias
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rebecca Langford
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - James Redmore
- York Teaching Hospitals NHS Foundation Trust, Wiggington Road, York, UK
| | - Linda Wittkop
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Matthew Hickman
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rona Campbell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
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Isabel Salazar Cobo M, Jager G, de Graaf C, Zandstra EH. Dynamic changes in hedonic and emotional responses to fruit varying in portion size. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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54
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Melendez-Torres GJ, Meiksin R, Witzel TC, Weatherburn P, Falconer J, Bonell C. eHealth Interventions to Address HIV and Other Sexually Transmitted Infections, Sexual Risk Behavior, Substance Use, and Mental Ill-health in Men Who Have Sex With Men: Systematic Review and Meta-analysis. JMIR Public Health Surveill 2022; 8:e27061. [PMID: 35384845 PMCID: PMC9021948 DOI: 10.2196/27061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/20/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background Men who have sex with men experience disproportionately high levels of HIV and other sexually transmitted infections (STIs), sexual risk behavior, substance use, and mental ill-health. These experiences are interrelated, and these interrelations are potentiated by structural conditions of discrimination, stigma, and unequal access to appropriate health services, and they magnify each other and have intersecting causal pathways, worsening both risk for each condition and risk for the negative sequelae of each condition. eHealth interventions could address these issues simultaneously and thus have wide-ranging and greater effects than would be for any 1 outcome alone. Objective We systematically reviewed the evidence for the effectiveness of eHealth interventions in addressing these outcomes separately or together. Methods We searched 19 databases for randomized trials of interactive or noninteractive eHealth interventions delivered via mobile phone apps, internet, or other electronic media to populations consisting entirely or principally of men who have sex with men to prevent HIV, STIs, sexual risk behavior, alcohol and drug use, or common mental illnesses. We extracted data and appraised each study, estimated meta-analyses where possible by using random effects and robust variance estimation, and assessed the certainty of our findings (closeness of the estimated effect to the true effect) by using GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Results We included 14 trials, of which 13 included active versus control comparisons; none reported mental health outcomes, and all drew from 12 months or less of follow-up postintervention. Findings for STIs drew on low numbers of studies and did not suggest consistent short-term (<3 months postintervention; d=0.17, 95% CI –0.18 to 0.52; I2=0%; 2 studies) or midterm (3-12 months postintervention, no meta-analysis, 1 study) evidence of effectiveness. Eight studies considering sexual risk behavior outcomes suggested a short-term, nonsignificant reduction (d=–0.14, 95% CI –0.30 to 0.03) with very low certainty, but 6 studies reporting midterm follow-ups suggested a significant impact on reducing sexual risk behavior (d=–0.12, 95% CI –0.19 to –0.05) with low certainty. Meta-analyses could not be undertaken for alcohol and drug use (2 heterogeneous studies) or for HIV infections (1 study for each of short-term or midterm follow-up), and alcohol outcomes alone were not captured in the included studies. Certainty was graded as low to very low for most outcomes, including all meta-analyses. Conclusions To create a comprehensive eHealth intervention that targets multiple outcomes, intervention evaluations should seek to generalize both mechanisms and components that are successfully used to achieve change in 1 outcome over multiple outcomes. However, additional evaluations of interventions seeking to address outcomes other than sexual risk behavior are needed before development and evaluation of a joined-up intervention.
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Affiliation(s)
| | - Rebecca Meiksin
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - T Charles Witzel
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Peter Weatherburn
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jane Falconer
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chris Bonell
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Braga-Pontes C, Simões-Dias S, Lages M, Guarino MP, Graça P. Nutrition education strategies to promote vegetable consumption in preschool children: the Veggies4myHeart project. Public Health Nutr 2022; 25:1061-1070. [PMID: 34702425 PMCID: PMC9991745 DOI: 10.1017/s1368980021004456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/27/2021] [Accepted: 10/17/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To test the efficacy of three nutrition education strategies on the intake of different vegetables in preschool children. DESIGN This is an experimental study conducted in four Portuguese preschools. The intervention consisted of 20-min educational sessions, once a week, for 5 weeks, with one of the following randomised educational strategies: Portuguese Food Wheel Guide (control), digital game, storybook, storybook and reward (stickers). All groups had repeated exposure to vegetables in all sessions. A pre- and post-test were conducted to determine vegetable intake, and a 6-month follow-up was realised. SETTING Preschools of Leiria district, Portugal. PARTICIPANTS A sample of 162 children aged 3 to 6 years. All eligible children attending the preschools were invited to participate. RESULTS All interventions tested were effective in increasing vegetable consumption both in the short and medium term, without statistically significant differences, compared to the control group. Stickers were more effective in the short term than in the medium term. CONCLUSIONS The nutritional education strategies associated with repeated exposure tested in this study were effective in promoting vegetable consumption in preschool children. The use of stickers may be a valid strategy to promote the consumption of vegetables less recognised by children.
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Affiliation(s)
- Cátia Braga-Pontes
- ciTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
- ESSLei – School of Health Sciences, Polytechnic Institute of Leiria, 2411-901Leiria, Portugal
- Faculty of Nutrition and Food Sciences of University of Porto, Porto, Portugal
| | - Sara Simões-Dias
- ciTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
- ESSLei – School of Health Sciences, Polytechnic Institute of Leiria, 2411-901Leiria, Portugal
- EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Marlene Lages
- ciTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Maria P Guarino
- ciTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
- ESSLei – School of Health Sciences, Polytechnic Institute of Leiria, 2411-901Leiria, Portugal
| | - Pedro Graça
- Faculty of Nutrition and Food Sciences of University of Porto, Porto, Portugal
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Merino-Godoy MÁ, Yot-Domínguez C, Conde-Jiménez J, de la Calle-Cabrera AM. Confirmatory Validation of an Evaluation Instrument for Interventions Based on the Healthy Habits App Healthy Jeart with Adolescents. J Pers Med 2022; 12:jpm12030470. [PMID: 35330469 PMCID: PMC8951124 DOI: 10.3390/jpm12030470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/25/2022] [Accepted: 03/11/2022] [Indexed: 02/05/2023] Open
Abstract
Mobile devices are widely used among young people, and their use for health promotion is in-creasing. Healthy Jeart is a mobile application aimed at promoting healthy life habits among people aged 8–16 years. The aim of this study was to develop and validate an instrument that allows evaluating the healthy knowledge, habits and attitudes learned by adolescents aged 12–16 years through the Healthy Jeart application. Attending to the content of Healthy Jeart, a first version of the evaluation instrument was generated. It was subjected to expert judgement. The second version was administered to 429 adolescents from six educational centres of Andalusia to carry out the validation of the construct through exploratory and confirmatory factor analyses. After exploration, a six-factor model was confirmed, with a very adequate level of fit and good internal consistency. The six factors were: (1) knowledge about eating and physical activity, (2) habits about eating and physical activity, (3) emotional health, (4) consumption of alcohol and drugs, (5) social relationships and (6) sexual activities and use of technologies. There are at least four instruments that could be used to measure health-promoting behaviours. However, this new instrument was created ad hoc. It measures exactly the results that can be expected. Healthy Jeart will now have a valid and reliable evaluation instrument: Ev-HealthyJRT v.1.0. Young people, teachers and other professionals who carry out health-promotion interventions based on Healthy Jeart with adolescents will have at their disposal an instrument integrated in this app that allows verifying the learning results. However, the validated instrument can be used for evaluation in other interventions, as long as the multiple and essential aspects of a healthy living are addressed as in Healthy Jeart.
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Affiliation(s)
| | - Carmen Yot-Domínguez
- Department of Didactics and Educational Organization, University of Seville, 41013 Seville, Spain
- Correspondence:
| | - Jesús Conde-Jiménez
- Department of Theory and History of Education and Social Pedagogy, University of Seville, 41013 Seville, Spain;
| | - Ana María de la Calle-Cabrera
- Department of Didactics of Language and Literature and Integrated Philologies, University of Seville, 41013 Seville, Spain;
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Kouvari M, Karipidou M, Tsiampalis T, Mamalaki E, Poulimeneas D, Bathrellou E, Panagiotakos D, Yannakoulia M. Digital Health Interventions for Weight Management in Children and Adolescents: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e30675. [PMID: 35156934 PMCID: PMC8887634 DOI: 10.2196/30675] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022] Open
Abstract
Background Recent meta-analyses suggest the use of technology-based interventions as a treatment option for obesity in adulthood. Similar meta-analytic approaches for children are scarce. Objective The aim of this meta-analysis is to examine the effect of technology-based interventions on overweight and obesity treatment in children and adolescents. Methods A systematic literature search was performed using MEDLINE (PubMed), Scopus, and Cochrane Library for randomized clinical trials to identify interventional studies published between January 2000 and February 2021. Results In total, 9 manuscripts from 8 clinical trials of 582 children or adolescents were considered eligible. BMI, BMI z-score, and other BMI-related baseline metrics during and after intervention were considered as primary outcomes. In 7 of 8 studies, a technology-based intervention was applied in addition to conventional care. Of the 8 studies, 6 studies were conducted in the United States, 1 in Australia, and 1 in northwestern Europe. In total, 5 studies included adolescents, whereas the rest addressed children aged 9 to 12 years. Intervention duration ranged from 3 to 24 months. Significant differences between groups in BMI metric changes were reported by 5 of the 8 studies. Pooled analysis revealed an overall significant decrease in BMI metrics in the intervention group (standardized mean difference –0.61, 95% CI –1.10 to –0.13; P=.01). Subgroup analysis revealed that significance was lost in case of no parental involvement (standardized mean difference –0.36, 95% CI –0.83 to 0.11; P=.14). The small number of clinical trials found, the varying study quality, and the study heterogeneity are some limitations of this review. Conclusions The studies reported herein describe functional and acceptable technology-based approaches, in addition to conventional treatments, to enhance weight loss in young populations.
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Affiliation(s)
- Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Faculty of Health, University of Canberra, Canberra, Australia
| | - Melina Karipidou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dimitrios Poulimeneas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eirini Bathrellou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.,Faculty of Health, University of Canberra, Canberra, Australia
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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Sun Y, Li Y, He FJ, Liu H, Sun J, Luo R, Guo C, Zhang P. Process Evaluation of an Application-Based Salt Reduction Intervention in School Children and Their Families (AppSalt) in China: A Mixed-Methods Study. Front Public Health 2022; 10:744881. [PMID: 35359790 PMCID: PMC8963959 DOI: 10.3389/fpubh.2022.744881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Salt reduction is a cost-effective, and rather challenging public health strategy for controlling chronic diseases. The AppSalt program is a school-based multi-component mobile health (mhealth) salt reduction program designed to tackle the high salt intake in China. This mixed-methods process evaluation was conducted to investigate the implementation of this program across sites, identify factors associated with the implementation, and collect evidence to optimize the intervention design for future scale-up. Methods Mixed methods were used sequentially to collect data regarding five process evaluation dimensions: fidelity, dose delivered, dose received, reach, and context. Quantitative data were collected during the intervention process. Participation rate of intervention activities was calculated and compared across cities. The quantitative data was used for the selection of representative intervention participants for the qualitative interviews. Qualitative data were collected in face-to-face semi-structured interviews with purposively selected students (n = 33), adult family members (n = 33), teachers (n = 9), heads of schools (n = 9), key informants from local health, and education departments (n = 8). Thematic analysis technique was applied to analyze the interview transcripts using NVivo. The qualitative data were triangulated with the quantitative data during the interpretation phase. Results The total number of families recruited for the intervention was 1,124. The overall retention rate of the AppSalt program was 97%. The intervention was implemented to a high level of fidelity against the protocol. About 80% of intervention participants completed all the app-based salt reduction courses, with a significant difference across the three cities (Shijiazhuang: 95%; Luzhou: 73%; Yueyang: 64%). The smartphone app in this program was perceived as a feasible and engaging health education tool by most intervention participants and key stakeholders. Through the interviews with participants and key stakeholders, we identified some barriers to implementing this program at primary schools, including the left-behind children who usually live with their grandparents and have limited access of smartphones; perceived adverse effects of smartphones on children (e.g., eyesight damage); and overlooked health education curriculum at Chinese primary schools. Conclusion This process evaluation demonstrated the feasibility and acceptability of using smartphone applications delivered through the education system to engage families in China to reduce excessive salt intake. Clinical Trial Registration The AppSalt study was registered at www.chictr.org.cn, identifier: ChiCTR1800017553. The date of registration is August 3, 2018.
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Affiliation(s)
- Yuewen Sun
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Yuan Li
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Feng J He
- Barts and The London School of Medicine and Dentistry, Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Hueiming Liu
- Health Systems Science Department, The George Institute for Global Health, Sydney, NSW, Australia
| | - Jingwen Sun
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Rong Luo
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Chunlei Guo
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Puhong Zhang
- Nutrition and Lifestyle Department, The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Timpel P, Herrmann S, Flößel P, Beck H, Schwarz PE. Effectiveness of digital primary prevention interventions targeting physical activity, motor skills and nutrition in children aged 3-10 years in the setting of day care and primary school: protocol for a systematic review. BMJ Open 2021; 11:e053628. [PMID: 34949625 PMCID: PMC8705251 DOI: 10.1136/bmjopen-2021-053628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Available evidence points to an association of increased screen time and the availability of digital tools during childhood with negative health outcomes in later life. For many years, public discourse focused on restricting access and use of digital technologies below certain ages. However, little is known about the specific benefit of a responsible use of digital primary prevention in the setting of (early) childhood education. The objective of this evidence synthesis is to investigate the effectiveness of digital primary prevention interventions targeting physical activity, motor skills and/or nutrition in children aged 3-10 years in day-care facilities and (pre-) schools. METHODS AND ANALYSIS We present the rationale and methodological steps of a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures. Automated searches will be conducted by applying a pretested search strategy to the databases MEDLINE/PubMed, EMBASE and PsycInfo to identify relevant interventional (randomised controlled trials, controlled trials, crossover trials and pilot and feasibility) and observational (case-control, cohort) studies in English or German, with no date restrictions. The overall search will be complemented by backward, forward and additional hand searches. Two researchers will independently screen titles/abstracts and assess full texts by applying predefined eligibility criteria. Data extraction will be conducted by using a pretested data extraction sheet. The assessment of methodological quality will be performed independently by two review authors using the Critical Appraisals Skills Programme relevant to the study design applied in the given study. Additionally, qualitative content analysis will be conducted to analyse priorities for future research extracted from the discussion sections and conclusions of included studies. PROSPERO REGISTRATION NUMBER CRD42020207682.
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Affiliation(s)
- Patrick Timpel
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Sandra Herrmann
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Philipp Flößel
- UniversityCenter for Orthopedics, Trauma & Plastic Surgery, Section Sports Medicine and Rehabilitation, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Heidrun Beck
- UniversityCenter for Orthopedics, Trauma & Plastic Surgery, Section Sports Medicine and Rehabilitation, Technische Universität Dresden, Dresden, Sachsen, Germany
| | - Peter Eh Schwarz
- Medical Faculty Carl Gustav Carus, Department of Medicine III, Prevention and Care of Diabetes, Technische Universität Dresden, Dresden, Sachsen, Germany
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Seiwert KA, Butler L, Maynard D, Kinkade M, Nill DT. Improving Adolescent Self-Rated Health Using a Multiple Health Behavior Change eHealth Intervention. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.2001773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Lauren Butler
- First Hand, a Project of Cerner Charitable Foundation
| | | | | | - David T. Nill
- First Hand, a Project of Cerner Charitable Foundation
- Cerner Corporation
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Egan L, Gardner LA, Newton N, Champion K. eHealth interventions targeting poor diet, alcohol use, tobacco smoking and vaping among disadvantaged youth: A systematic review protocol (Preprint). JMIR Res Protoc 2021; 11:e35408. [PMID: 35560002 PMCID: PMC9143768 DOI: 10.2196/35408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/23/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Background Chronic disease burden is higher among disadvantaged populations. Preventing lifestyle risk behaviors such as poor diet, alcohol use, tobacco smoking, and vaping in adolescence is critical for reducing the risk of chronic disease and related harms in adolescence and adulthood. Although eHealth interventions are a promising prevention approach among the general population, it is unclear whether they adequately serve adolescents from disadvantaged backgrounds such as those living in geographically remote or lower socioeconomic areas. Objective This is the first systematic review to identify, evaluate, and synthesize evidence for the effectiveness of eHealth interventions targeting adolescents living in geographically remote or lower socioeconomic areas in preventing poor diet, alcohol use, tobacco smoking, and vaping. Methods A systematic search will be conducted in 7 electronic databases: the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PROSPERO, MEDLINE (Ovid), Embase (Ovid), Scopus, and PsycInfo (Ovid). The search will be limited to eHealth-based experimental studies (ie, randomized controlled trials and quasi-experimental studies) targeting diet, alcohol use, tobacco smoking, and vaping among adolescents (aged 10-19 years). Eligible studies will be those reporting on at least one marker of socioeconomic status (eg, social class, household income, parental occupation status, parental education, and family affluence) or geographical remoteness (eg, living in rural, regional, and remote areas, or living outside major metropolitan centers). One reviewer will screen all studies for eligibility, of which 25% will be double-screened. Data will be extracted and summarized in a narrative synthesis. Risk of bias will be assessed using the Cochrane Revised Risk of Bias Tool. Results As of December 2021, the title and abstract screening of 3216 articles was completed, and the full-text review was underway. The systematic review is expected to be completed in 2022. Conclusions This systematic review will provide an in-depth understanding of effective eHealth interventions targeting poor diet, alcohol use, tobacco smoking, and vaping among adolescents living in geographically remote or lower socioeconomic areas and the factors that contribute to their effectiveness. This in turn will provide critical knowledge to improve future interventions delivered to these populations. Trial Registration PROSPERO CRD42021294119; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=294119 International Registered Report Identifier (IRRID) PRR1-10.2196/35408
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Affiliation(s)
- Lyra Egan
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Lauren Anne Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Prowse R, Carsley S. Digital Interventions to Promote Healthy Eating in Children: Umbrella Review. JMIR Pediatr Parent 2021; 4:e30160. [PMID: 34842561 PMCID: PMC8663671 DOI: 10.2196/30160] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/27/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND eHealth and web-based service delivery have become increasingly common during the COVID-19 pandemic. Digital interventions may be highly appealing to young people; however, their effectiveness compared with that of the usual face-to-face interventions is unknown. As nutrition interventions merge with the digital world, there is a need to determine the best practices for digital interventions for children. OBJECTIVE The aim of this study is to examine the effectiveness of digital nutrition interventions for children on dietary outcomes compared with status quo interventions (eg, conventional face-to-face programming or nondigital support). METHODS We conducted an umbrella review of systematic reviews of studies assessing primary research on digital interventions aimed at improving food and nutrition outcomes for children aged <18 years compared with conventional nutrition education were eligible for inclusion. RESULTS In total, 11 systematic reviews published since 2015 were included (7/11, 64%, were of moderate quality). Digital interventions ranged from internet, computer, or mobile interventions to websites, programs, apps, email, videos, CD-ROMs, games, telehealth, SMS text messages, and social media, or a combination thereof. The dose and duration of the interventions varied widely (single to multiple exposures; 1-60 minutes). Many studies have been informed by theory or used behavior change techniques (eg, feedback, goal-setting, and tailoring). The effect of digital nutrition interventions for children on dietary outcomes is small and inconsistent. Digital interventions seemed to be the most promising for improving fruit and vegetable intake compared with other nutrition outcomes; however, reviews have found mixed results. CONCLUSIONS Owing to the heterogeneity and duration of digital interventions, follow-up evaluations, comparison groups, and outcomes measured, the effectiveness of these interventions remains unclear. High-quality evidence with common definitions for digital intervention types evaluated with validated measures is needed to improve the state of evidence, to inform policy and program decisions for health promotion in children. Now is the time for critical, robust evaluation of the adopted digital interventions during and after the COVID-19 pandemic to establish best practices for nutrition interventions for children.
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Affiliation(s)
- Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.,Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON, Canada
| | - Sarah Carsley
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON, Canada
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O’Brien KM, Barnes C, Yoong S, Campbell E, Wyse R, Delaney T, Brown A, Stacey F, Davies L, Lorien S, Hodder RK. School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews. Nutrients 2021; 13:4113. [PMID: 34836368 PMCID: PMC8618558 DOI: 10.3390/nu13114113] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
Schools are identified as a key setting to influence children's and adolescents' healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education; food environment; all three HPS framework domains; or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies.
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Affiliation(s)
- Kate M. O’Brien
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Serene Yoong
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
- Faculty of Health, Arts and Design, Swinburne University of Technology, John Street, Hawthorn, VIC 3122, Australia
| | - Elizabeth Campbell
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Tessa Delaney
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Alison Brown
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Fiona Stacey
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Lynda Davies
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
| | - Sasha Lorien
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
| | - Rebecca K. Hodder
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia; (C.B.); (S.Y.); (E.C.); (R.W.); (T.D.); (A.B.); (S.L.); (R.K.H.)
- Priority Research Centre in Health and Behaviour, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Population Health, Longworth Avenue Wallsend, Newcastle, NSW 2287, Australia;
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, Newcastle, NSW 2308, Australia
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van Sluijs EMF, Ekelund U, Crochemore-Silva I, Guthold R, Ha A, Lubans D, Oyeyemi AL, Ding D, Katzmarzyk PT. Physical activity behaviours in adolescence: current evidence and opportunities for intervention. Lancet 2021; 398:429-442. [PMID: 34302767 PMCID: PMC7612669 DOI: 10.1016/s0140-6736(21)01259-9] [Citation(s) in RCA: 226] [Impact Index Per Article: 75.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/13/2021] [Accepted: 05/07/2021] [Indexed: 01/12/2023]
Abstract
Young people aged 10-24 years constitute 24% of the world's population; investing in their health could yield a triple benefit-eg, today, into adulthood, and for the next generation. However, in physical activity research, this life stage is poorly understood, with the evidence dominated by research in younger adolescents (aged 10-14 years), school settings, and high-income countries. Globally, 80% of adolescents are insufficiently active, and many adolescents engage in 2 h or more daily recreational screen time. In this Series paper, we present the most up-to-date global evidence on adolescent physical activity and discuss directions for identifying potential solutions to enhance physical activity in the adolescent population. Adolescent physical inactivity probably contributes to key global health problems, including cardiometabolic and mental health disorders, but the evidence is methodologically weak. Evidence-based solutions focus on three key components of the adolescent physical activity system: supportive schools, the social and digital environment, and multipurpose urban environments. Despite an increasing volume of research focused on adolescents, there are still important knowledge gaps, and efforts to improve adolescent physical activity surveillance, research, intervention implementation, and policy development are urgently needed.
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Affiliation(s)
- Esther M F van Sluijs
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Regina Guthold
- Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO, Geneva, Switzerland
| | - Amy Ha
- Department of Sports Science and Physical Education, Faculty of Education, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - David Lubans
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, NSW, Australia
| | - Adewale L Oyeyemi
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | - Ding Ding
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Peter T Katzmarzyk
- Population and Public Health Sciences, Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Seiterö A, Thomas K, Löf M, Müssener U. Using Mobile Phones in Health Behaviour Change - an Exploration of Perceptions among Adolescents in Sweden. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2021. [DOI: 10.1080/02673843.2021.1930561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Anna Seiterö
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kristin Thomas
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Sweden
| | - Ulrika Müssener
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Darker CD, Moore E, Flynn E, O'Neill M, Doherty L, McMahon J, McLoughlin O, Rouine E, Ivers JH, Allwright S, McGrath D, Seery A, McAndrew M, Barrett E, Tanner M, Bennett AE, Brennan S, Mullin M, Barry JM. Development and proposed evaluation of an eHealth learning tool for undergraduate university students in Ireland. Health Promot Int 2021; 37:6289848. [PMID: 34056643 DOI: 10.1093/heapro/daab071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Undergraduate university students are at a critical stage of development in terms of their academic, social, psychological and behavioural health. Patterns established during these formative years can last a lifetime. eHealth tools have the potential to be engaging, convenient and accessible to a wide range of students by providing health information and enhancing the uptake of positive health behaviours. The 'Healthy Trinity Online Tool' (H-TOT) was developed in collaboration with students and a transdisciplinary team with decades of experience between them in terms of research, clinical responsibility and service delivery. Developmental steps undertaken included: a literature review to formulate the topic content choices; a survey of students to check the relevance and suitability of topics identified; and, the tacit experience of the development team. This co-design model led to the development of content encompassing academic life, healthy eating, physical activity, mood, financial matters, alcohol, tobacco, drugs and relaxation. Qualitative focus groups were subsequently conducted for in-depth exploration of the usage and functionality of H-TOT. The theoretical underpinnings include the locus of control and social cognitive theory. Evidence-based behavioural change techniques are embedded throughout. During early pre-piloting of H-TOT, the team identified and solved content functionality problems. The tone of the content was also revised to ensure it was non-judgemental. To make the H-TOT as interactive as possible, video scenarios were included and all content was audio-recorded to allow playback for students with visual or learning difficulties. Evaluation plans for the pilot year of H-TOT are outlined.
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Affiliation(s)
- Catherine D Darker
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Emma Moore
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Ellen Flynn
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Mary O'Neill
- School of Medicine, Trinity Centre for Health Sciences, St James's Healthcare Campus, Old Stone Building, Dublin, D08 W9RT, Ireland
| | - Lena Doherty
- Faculty of Health Sciences, The University of Dublin, Trinity College, College Street, Dublin, D02 PN40, Ireland
| | - Jean McMahon
- Library Services, Tallaght University Hospital, Tallaght, Dublin, D24 NR04, Ireland
| | - Orla McLoughlin
- Student Counselling Service, 7-9 Leinster Street South, Dublin, D02 K104, Ireland
| | - Eimear Rouine
- Office of Chief Operating Officer, The University of Dublin, Trinity College, West Theatre, Dublin, D02 PN40, Ireland
| | - Jo-Hanna Ivers
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - Shane Allwright
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
| | - David McGrath
- College Health Service, The University of Dublin, Trinity College, College Street, House 47, Dublin, D02 PN40, Ireland
| | - Aidan Seery
- Senior Tutor Office, The University of Dublin, Trinity College, College Street, House 27, Dublin, D02 PN40, Ireland
| | - Martin McAndrew
- Senior Tutor Office, The University of Dublin, Trinity College, College Street, House 27, Dublin, D02 PN40, Ireland
| | - Emer Barrett
- Discipline of Physiotherapy, Trinity Centre for Health Sciences, St James's Healthcare Campus, Dublin, D08 W9RT, Ireland
| | - Michelle Tanner
- Trinity College Sports Centre, The University of Dublin, Trinity College, 43 Pearse Street, Dublin, D02 WO85, Ireland
| | - Annemarie E Bennett
- Unit of Nutrition and Dietetics, Discipline of Clinical Medicine, Trinity Centre for Health Sciences, St James's Healthcare Campus, Dublin, D08 W9RT, Ireland
| | - Sabina Brennan
- ADAPT Centre, O'Reilly Institute, The University of Dublin, Trinity College, College Street, Dublin, D02 PN40, Ireland
| | - Martina Mullin
- College Health Service, The University of Dublin, Trinity College, College Street, House 47, Dublin, D02 PN40, Ireland
| | - Joe M Barry
- Discipline of Public Health & Primary Care, Institute of Population Health Sciences, School of Medicine, Trinity College Dublin, Russell Centre, Tallaght Cross, Dublin, D24 DH74, Ireland
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Liu X, Xiao R, Tang F, Wu S. Mindfulness-based intervention to reduce multiple health risk behaviors in Chinese undergraduates:a randomized controlled trial. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wolfenden L, Barnes C, Lane C, McCrabb S, Brown HM, Gerritsen S, Barquera S, Véjar LS, Munguía A, Yoong SL. Consolidating evidence on the effectiveness of interventions promoting fruit and vegetable consumption: an umbrella review. Int J Behav Nutr Phys Act 2021; 18:11. [PMID: 33430879 PMCID: PMC7798190 DOI: 10.1186/s12966-020-01046-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/27/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The overarching objective was to examine the effectiveness of intervention strategies to promote fruit and vegetable consumption. To do this, systematic review evidence regarding the effects of intervention strategies was synthesized; organized, where appropriate, by the setting in which the strategies were implemented. Additionally, we sought to describe gaps in the review of evidence; that is, where evidence regarding the effectiveness of recommended policy actions had not been systematically synthesised. METHODS We undertook a systematic search of electronic databases and the grey literature to identify systematic reviews describing the effects of any intervention strategy targeting fruit and/or vegetable intake in children or adults of any age. RESULTS The effects of 32 intervention strategies were synthesised from the 19 included reviews. The strategies were mapped across all three broad domains of the NOURISHING framework (i.e. food environment, food system and behaviour change communication), but covered just 14 of the framework's 65 sub-policy areas. There was evidence supporting the effectiveness of 19 of the 32 intervention strategies. The findings of the umbrella review suggest that intervention strategies implemented within schools, childcare services, homes, workplaces and primary care can be effective, as can eHealth strategies, mass media campaigns, household food production strategies and fiscal interventions. CONCLUSIONS A range of effective strategy options are available for policy makers and practitioners interested in improving fruit and/or vegetable intake. However, the effects of many strategies - particularly those targeting agricultural production practices, the supply chain and the broader food system - have not been reported in systematic reviews. Primary studies assessing the effects of these strategies, and the inclusion of such studies in systematic reviews, are needed to better inform national and international efforts to improve public health nutrition. TRIAL REGISTRATION The review protocol was deposited in a publicly available Open Science framework prior to execution of the search strategy. https://osf.io/unj7x/.
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Affiliation(s)
- Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia.
- Corporación Actuemos, Santiago, Chile.
| | - Courtney Barnes
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Cassandra Lane
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Hannah M Brown
- School of Medicine and Public Health, The University of Newcastle, Hunter New England Population Health, Locked Bag 10 Wallsend NSW, Newcastle, NSW, 2287, Australia
| | - Sarah Gerritsen
- Corporación Actuemos, Santiago, Chile
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Simon Barquera
- Corporación Actuemos, Santiago, Chile
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Lesly Samara Véjar
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Ana Munguía
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Sze Lin Yoong
- Swinburne University of Technology, School of Health Sciences, Hawthorn, VIC, Australia
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Haug S, Castro RP, Wenger A, Schaub MP. Efficacy of a smartphone-based coaching program for addiction prevention among apprentices: study protocol of a cluster-randomised controlled trial. BMC Public Health 2020; 20:1910. [PMID: 33317488 PMCID: PMC7734780 DOI: 10.1186/s12889-020-09995-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A large proportion of apprentices shows addictive behaviours like cigarette smoking, alcohol, cannabis, or compulsive Internet use, others do not show such behaviours at all. ready4life is a smartphone application-based coaching program for apprentices, which takes into account the heterogeneity of adolescent addictive behaviour by promoting life skills and reducing risk behaviours. The main objective of the planned study is to test the efficacy of ready4life for addiction prevention among apprentices in Switzerland within a controlled trial. METHODS/DESIGN The efficacy of the ready4life coaching program will be tested in comparison to an assessment only control group, within a cluster-randomised controlled trial with one follow-up assessment after 6 months. At the beginning of the program, participants of the intervention group will receive an individual profile, showing areas in which they have sufficient resources and in which there is a need for coaching. Based on this feedback, they can select two out of the following six program modules: stress, social skills, Internet use, tobacco/e-cigarettes, cannabis, and alcohol. Participants of the intervention group will receive individualised coaching by a conversational agent (chatbot) for a period of four months. The coaching relies on motivational and social-cognitive principles of behaviour change. Within weekly dialogues, the coach provides individually tailored information in different formats, such as videoclips, texts, or pictures. Study participants will be 1318 apprentices with a minimum age of 15, recruited in approximately 100 vocational school classes in Switzerland. Primary outcome will be a composite measure for addictive behaviours including (1) at risk-drinking, (2) tobacco/e-cigarette smoking, (3) cannabis use, and (4) problematic Internet use. DISCUSSION The study will reveal whether this universally implementable but individually tailored intervention approach is effective in preventing the onset and escalation of addictive behaviors among apprentices. TRIAL REGISTRATION ISRCTN59908406 (registration date: 21/10/2020).
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Affiliation(s)
- Severin Haug
- Swiss Research Institute for Public Health and Addiction at Zurich University, Konradstrasse 32, 8005 Zurich, Switzerland
| | - Raquel Paz Castro
- Swiss Research Institute for Public Health and Addiction at Zurich University, Konradstrasse 32, 8005 Zurich, Switzerland
| | - Andreas Wenger
- Swiss Research Institute for Public Health and Addiction at Zurich University, Konradstrasse 32, 8005 Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction at Zurich University, Konradstrasse 32, 8005 Zurich, Switzerland
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Shagiwal SS, Groenestein E, Schop‐Etman A, Jongerling J, van der Waal J, Noordzij G, Denktas S. Effectiveness of behavioral interventions and behavior change techniques for reducing soft drink intake in disadvantaged adolescents: A systematic review and meta-analysis. Obes Sci Pract 2020; 6:708-734. [PMID: 33354348 PMCID: PMC7746974 DOI: 10.1002/osp4.452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/06/2023] Open
Abstract
Reducing sugar-sweetened beverage (SSB) intake is an important dietary target, especially among socioeconomically disadvantaged ethnic minority adolescents. This review and meta-analysis evaluated the effectiveness of behavioural interventions aiming to reduce SSB intake in socioeconomically disadvantaged ethnic minority adolescents and examined which behaviour change techniques (BCTs) were most effective. A systematic search was conducted using the PRISMA criteria. Quality assessments were done using the Cochrane criteria. In a narrative synthesis, studies were divided into effective and non-effective, and relative effectiveness ratios of individual BCTs were calculated. Pooled standardized mean differences (SMDs) and their 95% confidence intervals were estimated with random-effects models using cluster robust methods. Twenty-two studies were included in the qualitative synthesis. A meta-analysis (n = 19) revealed no significant between-group differences in reduction of SSB intake. Five self-regulatory BCTs had an effectiveness ratio >50%: feedback, goal-setting, action planning, self-monitoring and problem-solving/barrier identification. The risk of bias assessments were judged to be moderate to high risk for randomized controlled trials (RCTs) studies and low to moderate for pre-post studies. There was no indication of publication bias. In conclusion, self-regulatory BCTs may be effective components to change SSB behaviour. However, high-quality research is needed to evaluate the effectiveness of behavioural interventions and identify BCTs effective for reducing SSB intake among disadvantaged adolescents with ethnic minority backgrounds.
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Affiliation(s)
- S. S. Shagiwal
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - E. Groenestein
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - A. Schop‐Etman
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - J. Jongerling
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - J. van der Waal
- Department of Public Administration and Sociology, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
| | - G. Noordzij
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
- Erasmus University CollegeErasmus UniversityRotterdamThe Netherlands
| | - S. Denktas
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral SciencesErasmus UniversityRotterdamThe Netherlands
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Froome HM, Townson C, Rhodes S, Franco-Arellano B, LeSage A, Savaglio R, Brown JM, Hughes J, Kapralos B, Arcand J. The Effectiveness of the Foodbot Factory Mobile Serious Game on Increasing Nutrition Knowledge in Children. Nutrients 2020; 12:E3413. [PMID: 33172094 PMCID: PMC7694779 DOI: 10.3390/nu12113413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 12/26/2022] Open
Abstract
The interactive and engaging nature of serious games (i.e., video games designed for educational purposes) enables deeper learning and facilitates behavior change; however, most do not specifically support the dissemination of national dietary guidelines, and there are limited data on their impact on child nutrition knowledge. The Foodbot Factory serious game mobile application was developed to support school children in learning about Canada's Food Guide; however, its impacts on nutrition knowledge have not been evaluated. The objective of this study was to determine if Foodbot Factory effectively improves children's knowledge of Canada's Food Guide, compared to a control group (control app). This study was a single-blinded, parallel, randomized controlled pilot study conducted among children ages 8-10 years attending Ontario Tech University day camps. Compared to the control group (n = 34), children who used Foodbot Factory (n = 39) had significant increases in overall nutrition knowledge (10.3 ± 2.9 to 13.5 ± 3.8 versus 10.2 ± 3.1 to 10.4 ± 3.2, p < 0.001), and in Vegetables and Fruits (p < 0.001), Protein Foods (p < 0.001), and Whole Grain Foods (p = 0.040) sub-scores. No significant difference in knowledge was observed in the Drinks sub-score. Foodbot Factory has the potential to be an effective educational tool to support children in learning about nutrition.
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Affiliation(s)
- Hannah M. Froome
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (H.M.F.); (C.T.); (B.F.-A.); (J.M.B.)
| | - Carly Townson
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (H.M.F.); (C.T.); (B.F.-A.); (J.M.B.)
| | - Sheila Rhodes
- Faculty of Education, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (S.R.); (A.L.); (J.H.)
| | - Beatriz Franco-Arellano
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (H.M.F.); (C.T.); (B.F.-A.); (J.M.B.)
| | - Ann LeSage
- Faculty of Education, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (S.R.); (A.L.); (J.H.)
| | - Rob Savaglio
- Faculty of Business and Information Technology, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (R.S.); (B.K.)
| | - Jacqueline Marie Brown
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (H.M.F.); (C.T.); (B.F.-A.); (J.M.B.)
| | - Janette Hughes
- Faculty of Education, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (S.R.); (A.L.); (J.H.)
| | - Bill Kapralos
- Faculty of Business and Information Technology, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (R.S.); (B.K.)
| | - JoAnne Arcand
- Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, ON L1G 0C5, Canada; (H.M.F.); (C.T.); (B.F.-A.); (J.M.B.)
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Ringeval M, Wagner G, Denford J, Paré G, Kitsiou S. Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis. J Med Internet Res 2020; 22:e23954. [PMID: 33044175 PMCID: PMC7589007 DOI: 10.2196/23954] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status. OBJECTIVE The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes. METHODS A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components. RESULTS Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD -1.48, 95% CI -2.81 to -0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD -10.62, 95% CI -35.50 to 14.27; P=.40 and standardized MD -0.11, 95% CI -0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component. CONCLUSIONS The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450.
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Affiliation(s)
- Mickael Ringeval
- École des Sciences de la Gestion, Université du Québec à Montréal, Montreal, QC, Canada
| | - Gerit Wagner
- Research Chair in Digital Health, HEC Montreal, Montreal, QC, Canada
| | - James Denford
- Department of Management, Faculty of Social Sciences and Humanities, Royal Military College of Canada, Kingston, ON, Canada
| | - Guy Paré
- Research Chair in Digital Health, HEC Montreal, Montreal, QC, Canada
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
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Gardner LA, Champion KE, Parmenter B, Grummitt L, Chapman C, Sunderland M, Thornton L, McBride N, Newton NC. Clustering of Six Key Risk Behaviors for Chronic Disease among Adolescent Females. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7211. [PMID: 33023089 PMCID: PMC7579129 DOI: 10.3390/ijerph17197211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/28/2022]
Abstract
Chronic diseases are the leading cause of disability and mortality globally. In Australia, females are at heightened risk. This research explored the prevalence, patterns, and correlates of six key risk behaviors (physical inactivity, poor diet, recreational screen time, inadequate sleep, alcohol use, and smoking) among adolescent females and whether knowledge of health guidelines was associated with adherence. Adolescent females completed an anonymous online questionnaire (N = 687; Mage = 13.82). Logistic regression assessed the association between knowledge and adherence. A Latent Class Analysis (LCA) and three-step procedure identified risk behavior clusters and their correlates. Despite positive health self-ratings (77% good/very good), most participants reported insufficient moderate-to-vigorous physical activity (MVPA; 89%), vegetable intake (89%), and excessive screen time (63%). Knowledge of guidelines was associated with adherence for MVPA, vegetable intake, sleep, and alcohol abstinence. Three classes emerged: "moderate risk" (76%), "relatively active, healthy eaters" (19%), and "excessive screen users" (5%). These risk-behavior clusters were associated with perceived value of academic achievement and physical wellbeing. Adolescent females commonly perceive they are in good health, despite engaging in unhealthy behaviors. Public health interventions should utilize effective behavior change strategies, adopt a multiple health behavior change approach (MHBC), and be tailored to specific risk profiles and values among females.
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Affiliation(s)
- Lauren A. Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Katrina E. Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Belinda Parmenter
- Department of Exercise Physiology, School of Medical Sciences, UNSW Sydney, Sydney 2052, Australia;
| | - Lucinda Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth 6102, Australia;
| | | | - Nicola C. Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney 2006, Australia; (K.E.C.); (L.G.); (C.C.); (M.S.); (L.T.); (N.C.N.)
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Champion KE, Gardner LA, McGowan C, Chapman C, Thornton L, Parmenter B, McBride N, Lubans DR, McCann K, Spring B, Teesson M, Newton NC. A Web-Based Intervention to Prevent Multiple Chronic Disease Risk Factors Among Adolescents: Co-Design and User Testing of the Health4Life School-Based Program. JMIR Form Res 2020; 4:e19485. [PMID: 32720898 PMCID: PMC7420628 DOI: 10.2196/19485] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chronic diseases are the leading cause of death worldwide. Addressing key lifestyle risk factors during adolescence is critical for improving physical and mental health outcomes and reducing chronic disease risk. Schools are ideal intervention settings, and electronic health (eHealth) interventions afford several advantages, including increased student engagement, scalability, and sustainability. Although lifestyle risk behaviors tend to co-occur, few school-based eHealth interventions have targeted multiple behaviors concurrently. OBJECTIVE This study aims to summarize the co-design and user testing of the Health4Life school-based program, a web-based cartoon intervention developed to concurrently prevent 6 key lifestyle risk factors for chronic disease among secondary school students: alcohol use, smoking, poor diet, physical inactivity, sedentary recreational screen time, and poor sleep (the Big 6). METHODS The development of the Health4Life program was conducted over 18 months in collaboration with students, teachers, and researchers with expertise relevant to the Big 6. The iterative process involved (1) scoping of evidence and systematic literature review; (2) consultation with adolescents (N=815) via a cross-sectional web-based survey to identify knowledge gaps, attitudes, barriers, and facilitators in relation to the Big 6; (3) content and web development; and (4) user testing of the web-based program with students (n=41) and teachers (n=8) to evaluate its acceptability, relevance, and appeal to the target audience. RESULTS The co-design process resulted in a six-module, evidence-informed program that uses interactive cartoon storylines and web-based delivery to engage students. Student and teacher feedback collected during user testing was positive in terms of acceptability and relevance. Commonly identified areas for improvement concerned the length of modules, age appropriateness of language and alcohol storyline, the need for character backstories and links to syllabus information, and feasibility of implementation. Modifications were made to address these issues. CONCLUSIONS The Health4Life school-based program is the first universal, web-based program to concurrently address 6 important chronic disease risk factors among secondary school students. By adopting a multiple health behavior change approach, it has the potential to efficiently modify the Big 6 risk factors within one program and to equip young people with the skills and knowledge needed to achieve and maintain good physical and mental health throughout adolescence and into adulthood.
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Affiliation(s)
- Katrina Elizabeth Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lauren Anne Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Cyanna McGowan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Belinda Parmenter
- Department of Exercise Physiology, School of Medical Sciences, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Nyanda McBride
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - David R Lubans
- Priority Research Centre for Physical Activity and Nutrition, Faculty of Education and Arts, University of Newcastle, Callaghan, Australia
| | - Karrah McCann
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola Clare Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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75
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García Del Castillo JA, García Del Castillo-López Á, Dias PC, García-Castillo F. Social networks as tools for the prevention and promotion of health among youth. PSICOLOGIA-REFLEXAO E CRITICA 2020; 33:13. [PMID: 32671490 PMCID: PMC7363753 DOI: 10.1186/s41155-020-00150-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
The emergence of information and communication technologies (ICT) has generated a number of research questions, related to their use and potential risk, but also potentials for prevention or health promotion. Online social networks have become an important source of information for users as well as a tool for social relations. As traditional social networks, they can act as vehicles to improve the health of adolescents and youth, as well as play a key role in an educational context. The aim of this work is then to explore the theoretical relevance of ICT, particularly on online social networks, on disease prevention and health promotion of communicable diseases. Literature review points out the role of online social networks, particularly in the field of sexual health, body image, especially eating habits and overweight, as well as smoking and alcohol dependence. Data allow us to understand how online social network behavior and interaction is related to their burden and interventions developed in sexual health and addiction show positive results. More efforts in body image are needed in order to use these tools for prevention and promotion of health from early age.
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Teesson M, Champion KE, Newton NC, Kay-Lambkin F, Chapman C, Thornton L, Slade T, Sunderland M, Mills K, Gardner LA, Parmenter B, Lubans DR, Hides L, McBride N, Allsop S, Spring BJ, Smout S, Osman B. Study protocol of the Health4Life initiative: a cluster randomised controlled trial of an eHealth school-based program targeting multiple lifestyle risk behaviours among young Australians. BMJ Open 2020; 10:e035662. [PMID: 32665344 PMCID: PMC7359380 DOI: 10.1136/bmjopen-2019-035662] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 05/11/2020] [Accepted: 05/29/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Lifestyle risk behaviours, including alcohol use, smoking, poor diet, physical inactivity, poor sleep (duration and/or quality) and sedentary recreational screen time ('the Big 6'), are strong determinants of chronic disease. These behaviours often emerge during adolescence and co-occur. School-based interventions have the potential to address risk factors prior to the onset of disease, yet few eHealth school-based interventions target multiple behaviours concurrently. This paper describes the protocol of the Health4Life Initiative, an eHealth school-based intervention that concurrently addresses the Big 6 risk behaviours among secondary school students. METHODS AND ANALYSIS A multisite cluster randomised controlled trial will be conducted among year 7 students (11-13 years old) from 72 Australian schools. Stratified block randomisation will be used to assign schools to either the Health4Life intervention or an active control (health education as usual). Health4Life consists of (1) six web-based cartoon modules and accompanying activities delivered during health education (once per week for 6 weeks), and a smartphone application (universal prevention), and (2) additional app content, for students engaging in two or more risk behaviours when they are in years 8 and 9 (selective prevention). Students will complete online self-report questionnaires at baseline, post intervention, and 12, 24 and 36 months after baseline. Primary outcomes are consumption of sugar-sweetened beverages, moderate-to-vigorous physical activity, sleep duration, sedentary recreational screen time and uptake of alcohol and tobacco use. ETHICS AND DISSEMINATION This study has been approved by the University of Sydney (2018/882), NSW Department of Education (SERAP no. 2019006), University of Queensland (2019000037), Curtin University (HRE2019-0083) and relevant Catholic school committees. Results will be presented to schools and findings disseminated via peer-reviewed journals and scientific conferences. This will be the first evaluation of an eHealth intervention, spanning both universal and selective prevention, to simultaneously target six key lifestyle risk factors among adolescents. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12619000431123), 18 March 2019.
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Affiliation(s)
- Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Katherine Mills
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Belinda Parmenter
- Department of Exercise Physiology, University of NSW, Sydney, New South Wales, Australia
| | - David R Lubans
- School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Bonnie J Spring
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Bridie Osman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
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Brown JM, Savaglio R, Watson G, Kaplansky A, LeSage A, Hughes J, Kapralos B, Arcand J. Optimizing Child Nutrition Education With the Foodbot Factory Mobile Health App: Formative Evaluation and Analysis. JMIR Form Res 2020; 4:e15534. [PMID: 32301743 PMCID: PMC7195667 DOI: 10.2196/15534] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/25/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Early nutrition interventions to improve food knowledge and skills are critical in enhancing the diet quality of children and reducing the lifelong risk of chronic disease. Despite the rise of mobile health (mHealth) apps and their known effectiveness for improving health behaviors, few evidence-based apps exist to help engage children in learning about nutrition and healthy eating. OBJECTIVE This study aimed to describe the iterative development and user testing of Foodbot Factory, a novel nutrition education gamified app for children to use at home or in the classroom and to present data from user testing experiments conducted to evaluate the app. METHODS An interdisciplinary team of experts in nutrition, education (pedagogy), and game design led to the creation of Foodbot Factory. First, a literature review and an environmental scan of the app marketplace were conducted, and stakeholders were consulted to define the key objectives and content of Foodbot Factory. Dietitian and teacher stakeholders identified priority age groups and learning objectives. Using a quasi-experimental mixed method design guided by the Iterative Convergent Design for Mobile Health Usability Testing approach, five app user testing sessions were conducted among students (ages 9-12 years). During gameplay, engagement and usability were assessed via direct observations with a semistructured form. After gameplay, qualitative interviews and questionnaires were used to assess user satisfaction, engagement, usability, and knowledge gained. RESULTS The environmental scan data revealed that few evidence-based nutrition education apps existed for children. A literature search identified key nutrients of concern for Canadian children and techniques that could be incorporated into the app to engage users in learning. Foodbot Factory included characters (2 scientists and Foodbots) who initiate fun and engaging dialogue and challenges (minigames), with storylines incorporating healthy eating messages that align with the established learning objectives. A total of five modules were developed: drinks, vegetables and fruit, grain foods, animal protein foods, and plant protein foods. Seven behavior change techniques and three unique gamified components were integrated into the app. Data from each user testing session were used to inform and optimize the next app iteration. The final user testing session demonstrated that participants agreed that they wanted to play Foodbot Factory again (12/17, 71%), that the app is easy to use (12/17, 71%) and fun (14/17, 88%), and that the app goals were clearly presented (15/17, 94%). CONCLUSIONS Foodbot Factory is an engaging and educational mHealth intervention for the Canadian public that is grounded in evidence and developed by an interdisciplinary team of experts. The use of an iterative development approach is a demonstrated method to improve engagement, satisfaction, and usability with each iteration. Children find Foodbot Factory to be fun and easy to use, and can engage children in learning about nutrition.
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Affiliation(s)
- Jacqueline Marie Brown
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Robert Savaglio
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Graham Watson
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Allison Kaplansky
- Faculty of Community Services, Ryerson University, Toronto, ON, Canada
| | - Ann LeSage
- Faculty of Education, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Janette Hughes
- Faculty of Education, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Bill Kapralos
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
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Benítez-Andrades JA, Arias N, García-Ordás MT, Martínez-Martínez M, García-Rodríguez I. Feasibility of Social-Network-Based eHealth Intervention on the Improvement of Healthy Habits among Children. SENSORS (BASEL, SWITZERLAND) 2020; 20:E1404. [PMID: 32143458 PMCID: PMC7085577 DOI: 10.3390/s20051404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 01/14/2023]
Abstract
This study shows the feasibility of an eHealth solution for tackling eating habits and physical activity in the adolescent population. The participants were children from 11 to 15 years old. An intervention was carried out on 139 students in the intervention group and 91 students in the control group, in two schools during 14 weeks. The intervention group had access to the web through a user account and a password. They were able to create friendship relationships, post comments, give likes and interact with other users, as well as receive notifications and information about nutrition and physical activity on a daily basis and get (virtual) rewards for improving their habits. The control group did not have access to any of these features. The homogeneity of the samples in terms of gender, age, body mass index and initial health-related habits was demonstrated. Pre- and post-measurements were collected through self-reports on the application website. After applying multivariate analysis of variance, a significant alteration in the age-adjusted body mass index percentile was observed in the intervention group versus the control group, as well as in the PAQ-A score and the KIDMED score. It can be concluded that eHealth interventions can help to obtain healthy habits. More research is needed to examine the effectiveness in achieving adherence to these new habits.
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Affiliation(s)
- José Alberto Benítez-Andrades
- SALBIS Research Group, Department of Electric, Systems and Automatics Engineering, University of León, Campus of Vegazana s/n, León, 24071 León, Spain
| | - Natalia Arias
- SALBIS Research Group, Department of Nursing and Physiotherapy Health Science School, University of León, Avenida Astorga s/n, Ponferrada, 24401 León, Spain;
| | - María Teresa García-Ordás
- SECOMUCI Research Groups, Escuela de Ingenierías Industrial e Informática, Universidad de León, Campus de Vegazana s/n, C.P. 24071 León, Spain; (M.T.G.-O.); (I.G.-R.)
| | | | - Isaías García-Rodríguez
- SECOMUCI Research Groups, Escuela de Ingenierías Industrial e Informática, Universidad de León, Campus de Vegazana s/n, C.P. 24071 León, Spain; (M.T.G.-O.); (I.G.-R.)
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Affiliation(s)
- Marion Henderson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G2 3AX, UK
| | - Craig Donnachie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G2 3AX, UK
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