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Chen JL, Guedes CM, Lung AE. Smartphone-based Healthy Weight Management Intervention for Chinese American Adolescents: Short-term Efficacy and Factors Associated With Decreased Weight. J Adolesc Health 2019; 64:443-449. [PMID: 30409751 DOI: 10.1016/j.jadohealth.2018.08.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/02/2018] [Accepted: 08/22/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE This study aimed to examine the short-term efficacy of a smartphone-based intervention for Chinese American adolescents who are overweight or obese and to explore factors associated with decreased body mass index (BMI). METHODS A randomized controlled study design was used. Intervention group received culturally appropriate and tailored educational program for weight management while control group received general health information. Anthropometrics, blood pressure, levels of physical and sedentary activity, diet, self-efficacy, and quality of life were assessed at baseline, 3 months, and 6 months. Linear mixed-effects models and regression models were used to analyze outcomes. RESULTS The study included 40 adolescent participants. Adolescents in the intervention reduced their BMI (z = -4.89, p < .001), BMI z score (z = -4.72, p < .001), sugary beverage (z = -.44, P = .001), and TV and computer time (z = -.51, p < .001) and increasing in self-efficacy in nutrition and physical activity significantly more than those in the control group. BMI reduction was significantly correlated with decreased fast food consumption and increased physical activity (F = 6.99, p = .007, r2 = .40). Being female and decreased sugary beverage consumption were related to decreased BMI z score (F = 8.38, p = .003, r2 = .511). CONCLUSIONS A culturally appropriate smartphone-based intervention has great potential to reduce obesity and improve adherence to a healthy lifestyle. Reducing sugary beverages and fast food intake and decreasing sedentary time are associated with decreased BMI among adolescents who are overweight or obese.
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Affiliation(s)
- Jyu-Lin Chen
- University of California San Francisco, San Francisco, California.
| | - Claudia Maria Guedes
- Department of Kinesiology, San Francisco State University, San Francisco, California
| | - Audrey E Lung
- North East Medical Services, San Francisco, California
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Schoner J, Chapman J, Fox EH, Iroz-Elardo N, Brookes A, MacLeod KE, Frank LD. Bringing health into transportation and land use scenario planning: Creating a National Public Health Assessment Model (N-PHAM). JOURNAL OF TRANSPORT & HEALTH 2018; 10:401-418. [PMID: 35350107 PMCID: PMC8958996 DOI: 10.1016/j.jth.2018.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There is mounting evidence linking land development and transportation investments to physical activity with resulting implications for chronic disease prevention. Links between the physical environment and health have traditionally focused on harmful exposures such as air pollution, noise, and traffic injury. Given limited funds and competition for how and where investments are made, there is a need to prioritize and target resources to maximize health benefits that can include activity related chronic disease prevention. The ability to apply this evidence to decision making has been limited by the complexity and inconsistency of research methods, and lack of a direct connection with the planning contexts in which decisions are made. Scenario planning tools provide a method to apply evidence with spatial planning decisions at a range of geographic scales. The US Environmental Protection Agency commissioned the development of a National Public Health Assessment Model (N-PHAM). This project utilized built and natural environment data at the block-group level and large population surveys to model the relationships of the environment with several health outcomes for a range of age and income groups. N-PHAM is the first health assessment tool that can connect to multiple existing scenario planning platforms utilizing nationally available data and can be consistently applied nationally. Such tools can empower communities to choose investments that have the greatest potential to improve public health and quality of life, reduce health care costs, and address environmental justice related disparities.
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Affiliation(s)
- Jessica Schoner
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Jim Chapman
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Eric H Fox
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Nicole Iroz-Elardo
- Urban Design 4 Health Inc., 353 Rockingham St., Rochester, NY 14620, USA
| | - Allen Brookes
- US Environmental Protection Agency, 200 S.W. 35th Street, Corvallis, OR 97333-4902, USA
| | - Kara E MacLeod
- Fielding School of Public Health, University of California, Los Angeles, Life Sciences Building, Office 5127, Los Angeles, CA 90095, USA
| | - Lawrence D Frank
- University of British Columbia Schools of Population & Public Health & Community & Regional Planning, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
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Chen JL, Guedes CM, Cooper BA, Lung AE. Short-Term Efficacy of an Innovative Mobile Phone Technology-Based Intervention for Weight Management for Overweight and Obese Adolescents: Pilot Study. Interact J Med Res 2017; 6:e12. [PMID: 28768612 PMCID: PMC5559653 DOI: 10.2196/ijmr.7860] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/26/2017] [Accepted: 06/13/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In the United States, approximately one-third of adolescents are now overweight or obese, and one in six is obese. This financial cost and the larger nonfinancial costs of obesity make obesity prevention and management for adolescents imperative for the health of the nation. However, primary care visits are typically brief, and primary care providers may lack adequate resources to help overweight or obese adolescents to manage weight issues. To augment the efficacy of primary care visits for adolescent weight management, mobile phone technology can be used as an adjunct treatment that provides additional opportunities for encouraging improvement in lifestyle, attainment, and maintenance of healthy weight. OBJECTIVE The purposes of this study were to (1) measure effects of an innovative mobile phone technology-based intervention for overweight and obese adolescents and to (2) examine the intervention's feasibility for use in primary care clinics. METHODS The mobile phone-based intervention had three components: use of the Fitbit Flex, participation in an online educational program, and receipt of biweekly text messages during the maintenance phase. A randomized controlled study design was utilized. Data regarding anthropometrics (body mass index [BMI] and waist-to-hip ratio), blood pressure, levels of physical and sedentary activity, diet, and self-efficacy regarding physical activity and diet were collected at baseline and at 3 and 6 months after the baseline assessment. RESULTS A total of 40 adolescents participated in the study. At the 6-month follow-up visit, compared to participants in the control group, the mobile phone-based intervention participants had significant improvement in BMI (z=-4.37, P=.001), diastolic blood pressure (z=-3.23, P=.001), physical activity days per week (z=2.58, P=.01), TV and computer time (z=-3.34, P=.001), servings of fruits and vegetables per day (z=2.74, P=.006), servings of soda and sweetened drinks (z=-3.19, P=.001), physical activity self-efficacy (z=2.75, P=.006), and dietary self-efficacy (z=5.05, P=.001). Medium to large effect sizes were found in these outcome variables. CONCLUSIONS The use of mobile technologies may offer a practical, reliable adjunct to weight management for overweight and obese adolescents in busy primary care clinics serving adolescents. TRIAL REGISTRATION Clinicaltrials.gov NCT 01693250; https://clinicaltrials.gov/ct2/show/NCT01693250? term=Adolescent+ obesity+AND+mhealth&rank=5 (Archived by WebCite at ).
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Affiliation(s)
- Jyu-Lin Chen
- School of Nursing, Department of Family Health Care Nursing, University of California San Francico, San Francisco, CA, United States
| | - Claudia M Guedes
- Department of Kinesiology, San Francisco State University, San Francisco, CA, United States
| | - Bruce A Cooper
- School of Nursing, University of California San Francisco, San Francsico, CA, United States
| | - Audrey E Lung
- Department of Pediatrics, North East Medical Services, San Francisco, CA, United States
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Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput JP, Saunders TJ, Katzmarzyk PT, Okely AD, Connor Gorber S, Kho ME, Sampson M, Lee H, Tremblay MS. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab 2016; 41:S240-65. [DOI: 10.1139/apnm-2015-0630] [Citation(s) in RCA: 656] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.
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Affiliation(s)
- Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Stephen Hunter
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Nicholas Kuzik
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Casey E. Gray
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Veronica J. Poitras
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Travis J. Saunders
- Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | | | - Anthony D. Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Sarah Connor Gorber
- Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Michelle E. Kho
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Helena Lee
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
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Hager ER, Witherspoon DO, Gormley C, Latta LW, Pepper MR, Black MM. The perceived and built environment surrounding urban schools and physical activity among adolescent girls. Ann Behav Med 2014; 45 Suppl 1:S68-75. [PMID: 23334761 DOI: 10.1007/s12160-012-9430-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Neighborhood perceived/built environment and physical activity (PA) associations have been examined for adolescents around homes, but not surrounding schools. PURPOSE The purpose of this paper is to examine if positive perceptions/built environment in neighborhoods surrounding schools predict PA among low-income, urban adolescent girls. METHODS Measures include: minutes in moderate-vigorous PA (MVPA, ankle accelerometry), perceptions of the school environment (questionnaire), built environment (neighborhood audit). Analyses include multi-level models. RESULTS Two hundred twenty-four sixth and seventh grade girls [mean(sd) age = 12.1(0.7) years] from 12 schools serving low-income, primarily African American communities; mean MVPA 35.4 min (mean days assessed = 5.8). Girls in schools with more positive perceptions of the neighborhood environment surrounding the school were less active (β = 7.2, p = 0.043). Having "places to go within walking distance" (perceptions) and number of food stores near school (built environment) positively relate to MVPA (β = 5.5, p = 0.042 and β = 0.59, p = 0.047). CONCLUSIONS Among neighborhoods surrounding urban schools, positive perceptions do not predict PA; accessibility, via both perceived and built environment, support PA.
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Affiliation(s)
- Erin R Hager
- Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD 21201, USA.
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Park JM, Han AK, Cho YH. Construct equivalence and latent means analysis of health behaviors between male and female middle school students. Asian Nurs Res (Korean Soc Nurs Sci) 2011; 5:216-21. [PMID: 25030523 DOI: 10.1016/j.anr.2011.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 11/22/2011] [Accepted: 11/25/2011] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the construct equivalence of the five general factors (subjective health, eating habits, physical activities, sedentary lifestyle, and sleeping behaviors) and to compare the latent means between male and female middle school students in Incheon, Korea. METHODS The 2008 Korean Youth Risk Behavior Survey data was used for analysis. Multigroup confirmatory factor analysis was performed to test whether the scale has configural, metric, and scalar invariance across gender. RESULTS Configural invariance, metric invariance, and factor invariance were satisfied for latent means analysis (LMA) between genders. Male and female students were significantly different in LMA of all factors. Male students reported better subjective health, consumed more fast food and carbonated drinks, participated in more physical activities, showed less sedentary behavior, and enjoyed better quality of sleep than female students. CONCLUSION Health providers should consider gender differences when they develop and deliver health promotion programs aimed at adolescents.
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Affiliation(s)
- Jeong Mo Park
- Department of Nursing, Kyungin Women's College, Incheon, Korea
| | - Ae Kyung Han
- College of Nursing, Eulji University, Seongnam, Korea
| | - Yoon Hee Cho
- College of Nursing, Eulji University, Seongnam, Korea
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