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Singh H, Samkange-Zeeb F, Kolschen J, Herrmann R, Hübner W, Barnils NP, Brand T, Zeeb H, Schüz B. Interventions to promote health literacy among working-age populations experiencing socioeconomic disadvantage: systematic review. Front Public Health 2024; 12:1332720. [PMID: 38439762 PMCID: PMC10909862 DOI: 10.3389/fpubh.2024.1332720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Background Experiencing financial insecurity and being underserved is often associated with low health literacy, i.e., the ability to identify, obtain, interpret and act upon health information, which may result in poor health outcomes. Little is known about effective interventions for promoting health literacy among underserved populations. The objective of this systematic review is to summarize the literature on such interventions and identify characteristics that differentiate more effective interventions. Methods Following PRISMA guidelines we searched the databases SCOPUS, Pubmed, Web of Science core collection and CINAHL. We included primary studies with a quantitative study design and control groups testing interventions to increase health literacy or health knowledge in underserved populations between 18 and 65 years. Where possible, we converted effect sizes into Cohen's d and compared mean differences of intervention and control groups. Albatross plots were created to summarize the results according to different health literacy and health knowledge outcomes. Results We screened 3,696 titles and abstracts and 206 full texts. In total, 86 articles were analyzed, of which 55 were summarized in seven albatross plots. The majority of the studies (n = 55) were conducted in the United States and had a randomized controlled study design (n = 44). More effective intervention approaches assessed needs of participants through focus group discussions prior to conducting the intervention, used bilingual educational materials, and included professionals fluent in the first languages of the study population as intervention deliverers. Additionally, the use of educational materials in video and text form, fotonovelas and interactive group education sessions with role playing exercises were observed to be effective. Discussion Although the outcomes addressed in the included studies were heterogeneous, effective intervention approaches were often culturally sensitive and developed tailored educational materials. Interventions aiming to promote health literacy in underserved populations should hence consider applying similar approaches.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323801, PROSPERO registration ID: CRD42022323801.
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Affiliation(s)
- Himal Singh
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Florence Samkange-Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Jonathan Kolschen
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Ruben Herrmann
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Wiebke Hübner
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Núria Pedrós Barnils
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Tilman Brand
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Benjamin Schüz
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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Nieri T, Zimmer A, Vaca JM, Tovar A, Cheney A. A Systematic Review of Research on Non-Maternal Caregivers' Feeding of Children 0-3 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14463. [PMID: 36361342 PMCID: PMC9658782 DOI: 10.3390/ijerph192114463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Although people other than mothers participate in feeding, few interventions include non-maternal caregivers, especially those promoting healthy development among children aged 0-3 years. Understanding the role and influence of non-maternal caregivers is essential for the development and effectiveness of early childhood feeding interventions; yet, no reviews have examined non-maternal caregivers of children aged 0-3 years. This study assessed what is known about non-maternal caregivers' feeding of children aged 0-3. We systematically reviewed 38 empirical quantitative, qualitative, and mixed methods studies, cataloged in PubMed and Web of Science and published between 1/2000-6/2021. The studies showed that non-maternal caregivers engage in child feeding and their attitudes and behaviors affect child outcomes. Like mothers, non-maternal caregivers vary in the extent to which their knowledge and attitudes support recommended feeding practices and the extent to which they exhibit responsive feeding styles and practices. Children of broad ages were included in the studies; future research should include infant/toddler-only samples to allow for better assessment of age-specific feeding constructs. The studies also revealed issues specific to non-maternal caregivers that are unlikely to be addressed in interventions developed for mothers. Thus, the review highlighted features of non-maternal caregiving of children 0-3 years that could be addressed to support feeding and child outcomes.
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Affiliation(s)
- Tanya Nieri
- Department of Sociology, University of California Riverside, Riverside, CA 92521, USA
| | - Arianna Zimmer
- Center for Health Disparities Research, School of Medicine, University of California Riverside, Riverside, CA 92521, USA
| | - Jai Mica Vaca
- Department of Justice Studies, San Jose State University, San Jose, CA 95192, USA
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA
| | - Ann Cheney
- Department of Social Medicine, Population and Public Health, School of Medicine, University of California Riverside, Riverside, CA 92521, USA
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Mothers' perceptions on and learning from infant and young child-feeding videos displayed in Mother and Child Health Centers in Kenya: a qualitative and quantitative approach. Public Health Nutr 2021; 24:3845-3858. [PMID: 34034846 DOI: 10.1017/s1368980021002342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective was to explore mothers’ perceptions on educational videos on infant and young child-feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAP). DESIGN A set of forty-seven videos were displayed in health centres for 6 months. At 3 months, we conducted focus group discussions (FGD) with mothers and, at 6 months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design, we compared groups according to video viewing frequencies. SETTING The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. PARTICIPANTS Forty-three mothers with children aged 0–48 months participated in six FGD and 547 mothers of children aged 0–23 months in KAP interviews. RESULTS The mothers from the FGD found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breast-feeding (P = 0·06), complementary feeding knowledge (P = 0·01), complementary feeding attitudes (P = 0·08) and hygiene knowledge and practices (P = 0·003) were better among mothers who had seen videos three to four times, or five or more times, compared with mothers who had seen the videos once or twice. CONCLUSIONS Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current infant and young child-feeding education efforts in Kenya.
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Redden K, Safarian J, Schoenborn C, Shortall C, Gagnon AJ. Interventions to Support International Migrant Women's Reproductive Health in Western-Receiving Countries: A Systematic Review and Meta-Analysis. Health Equity 2021; 5:356-372. [PMID: 34084988 PMCID: PMC8170723 DOI: 10.1089/heq.2020.0115] [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] [Accepted: 03/29/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose: The reproductive health outcomes of international migrant women differ in comparison with receiving-country-born women, depending on country of birth and immigrant status. Effective interventions to support the reproductive health of international migrant women are not well known. Methods: We conducted a systematic review and meta-analysis of studies between 2010 and 2017 evaluating interventions directly or indirectly affecting the reproductive health (as defined by the World Health Organization) of international migrant women in Western-receiving countries. Results: Sixteen studies representing 5080 migrants were identified. Interventions consisted of linguistically (e.g., translated brochures) or culturally adapted (e.g., cultural narratives) routine care or new interventions. Meta-analysis showed that interventions increased rates of preventive reproductive health activities, including mammography, condom use, and Pap test completion, by almost 18% (95% confidence interval 7.61–28.3) compared with usual care or interventions not adapted to migrant women. Conclusion: Culturally and linguistically adapted care practices congruent with target populations of international migrant women are effective in improving their reproductive health outcomes, particularly their participation in preventative reproductive health activities.
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Affiliation(s)
- Kara Redden
- Ingram School of Nursing, McGill University, Montréal, Canada
| | | | - Claudia Schoenborn
- Research Centre in Health Policies and Health Systems, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Clare Shortall
- Doctors of the World UK, Part of the Médecins du Monde Network, London, United Kingdom
| | - Anita J Gagnon
- Ingram School of Nursing, McGill University, Montréal, Canada.,Reproductive Outcomes and Migration (ROAM) Collaboration
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Segura-Pérez S, Hromi-Fiedler A, Adnew M, Nyhan K, Pérez-Escamilla R. Impact of breastfeeding interventions among United States minority women on breastfeeding outcomes: a systematic review. Int J Equity Health 2021; 20:72. [PMID: 33676506 PMCID: PMC7936442 DOI: 10.1186/s12939-021-01388-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/18/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In the U.S., strong ethnic/racial, socioeconomic, demographic, and geographic breastfeeding (BF) inequities persist, and African American and Hispanic women are less likely to meet their breastfeeding goals compared to White women. This systematic review (SR) was designed to answer the question: What is the impact of breastfeeding interventions targeting ethnic/racial minority women in the U.S. on improving BF initiation, duration and exclusivity rates? METHODS The SR was conducted following the Institute of Medicine Guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The study protocol was developed and registered a priori in PROSPERO (ID#CRD42020177764). The electronical databases searched was MEDLINE All (Ovid). Search strategies were led by the team's expert public health librarian using both controlled vocabulary and free text queries and were tested against a validated set of relevant papers included in existing reviews. The GRADE methodology was used to assess the quality of the studies. RESULTS We included 60 studies that had randomized (n = 25), observational (n = 24), quasi-experimental (n = 9), or cross-sectional (n = 2) designs. The studies focused on populations that were multi-ethnic/racial (n = 22), only Hispanic (n = 24), only Black (n = 13), and only American Indian (n = 1). The study interventions were classified following the socioecological model: macrosystem/policy level (n = 6); community level (n=51), which included healthcare organizations (n = 34), The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (n = 9), and community organizations/public health institutions (n = 8); and interpersonal level (n = 3). CONCLUSIONS Policy and community level interventions delivered through WIC, healthcare facilities, and community agencies) are likely to improve BF outcomes among women of color. The combination of interventions at different levels of the socioecological model has not been studied among minority women in the U.S. Implementation science research is needed to learn how best to scale up and sustain effective BF interventions, taking into account the needs and wants of minority women. Thus, it is strongly recommended to conduct large scale implementation research studies addressesing how to strengthen the different health and social environments surrounding women of color in the U.S. to improving their BF outcomes.
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Affiliation(s)
| | | | - Misikir Adnew
- Yale School of Public Health, 135 College Street, New Haven, CT 06510 USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale School of Public Health, New Haven, USA
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Messito MJ, Mendelsohn AL, Katzow MW, Scott MA, Vandyousefi S, Gross RS. Prenatal and Pediatric Primary Care-Based Child Obesity Prevention Program: A Randomized Trial. Pediatrics 2020; 146:e20200709. [PMID: 32883807 PMCID: PMC7546096 DOI: 10.1542/peds.2020-0709] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To determine impact of a primary care-based child obesity prevention intervention beginning during pregnancy on early childhood weight outcomes in low-income Hispanic families. METHODS A randomized controlled trial comparing mother-infant pairs receiving either standard care or the Starting Early Program providing prenatal and postpartum nutrition counseling and nutrition parenting support groups targeting key obesity-related feeding practices in low-income groups. Primary outcomes were reduction in weight-for-age z-scores (WFAzs) from clinical anthropometric measures, obesity prevalence (weight for age ≥95th percentile), and excess weight gain (WFAz trajectory) from birth to age 3 years. Secondary outcomes included dose effects. RESULTS Pregnant women (n = 566) were enrolled in the third trimester; 533 randomized to intervention (n = 266) or control (n = 267). Also, 358 children had their weight measured at age 2 years; 285 children had weight measured at age 3 years. Intervention infants had lower mean WFAz at 18 months (0.49 vs 0.73, P = .04) and 2 years (0.56 vs 0.81, P = .03) but not at 3 years (0.63 vs 0.59, P = .76). No group differences in obesity prevalence were found. When generalized estimating equations were used, significant average treatment effects were detected between 10-26 months (B = -0.19, P = .047), although not through age 3 years. In within group dose analyses at 3 years, obesity rates (26.4%, 22.5%, 8.0%, P = .02) decreased as attendance increased with low, medium, and high attendance. CONCLUSIONS Mean WFAz and growth trajectories were lower for the intervention group through age 2 years, but there were no group differences at age 3. Further study is needed to enhance sustainability of effects beyond age 2.
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Affiliation(s)
| | - Alan L Mendelsohn
- Developmental and Behavioral Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine and
| | - Michelle W Katzow
- Division of General Pediatrics, Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Marc A Scott
- Department of Applied Statistics, Social Science, and Humanities, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York; and
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Cheney AM, Nieri T, Ramirez Zarate A, Garcia G, Vaca L, Valencia E, Versteeg C, Molina A, Castillo M, Tovar A. Grow well/Crecer bien: a protocol for research on infant feeding practices in low-income families. BMC Public Health 2020; 20:1431. [PMID: 32958017 PMCID: PMC7503435 DOI: 10.1186/s12889-020-09471-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of obesity among children remains high. Given obesity's significant lifelong consequences, there is great interest in preventing obesity early in life. There is a need to better understand the relation of common infant feeding styles and practices to obesity in infants using longitudinal study designs. There is also an urgent need to understand the role of caregivers other than mothers in feeding. A better understanding of variation in feeding styles and practices can inform the identification of risk groups and the tailoring of interventions to them. METHODS In partnership with Early Head Start programs across four counties in southern California, mothers and infants will be enrolled in a two-year longitudinal study collecting survey and anthropometric data. A subsample of mothers and their selected other caregivers will participate in qualitative research involving feeding diaries and dyadic interviews. The results will be used to develop and test an enhanced nutrition education program. DISCUSSION We outline a study methodology to examine feeding styles and practices and their association with early childhood obesity risk and enhance an existing intervention to promote healthy infant feeding and growth among children in low-income families.
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Affiliation(s)
- Ann M Cheney
- Department of Social Medicine Population and Public Health, 900 University Ave, Riverside, 92501, USA.
| | - Tanya Nieri
- Department of Sociology, University of California Riverside, Riverside, USA
| | - Ana Ramirez Zarate
- School of Public Policy, University of California Riverside, Riverside, USA
| | - Gretel Garcia
- Graduate School of Education, University of California Riverside, Riverside, USA
| | - Lucero Vaca
- Department of Social Medicine Population and Public Health, 900 University Ave, Riverside, 92501, USA
| | | | | | - Arlene Molina
- San Bernardino County Preschool Services Department, San Bernardino, USA
| | | | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, USA
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Application of video-based health education in improving mother's knowledge and attitudes about behavioral problems among preschool children. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.07.071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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McElfish PA, Rowland B, Riklon S, Aitaoto N, Sinclair KA, Ima S, Kadlubar SA, Goulden PA, Hudson JS, Mamis S, Long CR. Development and Evaluation of a Blood Glucose Monitoring YouTube Video for Marshallese Patients Using a Community-Based Participatory Research Approach. Policy Polit Nurs Pract 2019; 20:205-215. [PMID: 31537196 PMCID: PMC9524581 DOI: 10.1177/1527154419872834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to (a) describe the development of a culturally appropriate glucose monitoring video using a community-based participatory research approach and (b) assess the cultural appropriateness and effectiveness of the video. The topic of the video-using a glucometer and the importance of performing blood glucose checks-was chosen by Marshallese community stakeholders. The video was produced in Marshallese with English subtitles and disseminated through YouTube. Participants were recruited from August 16, 2016 to September 12, 2016 in a diabetes clinic that serves Marshallese patients in northwest Arkansas. Fifty participants completed a survey at pre- and postintervention, with questions capturing demographic information and questions on glucose monitoring self-efficacy using an adapted version of the Stanford Patient Education Research Center's Diabetes Self-Efficacy Scale. Twenty of those participants who completed the survey also completed semistructured interviews that assessed cultural appropriateness and effectiveness of the video. Participants reported significant increases in self-efficacy related to glucometer use and the importance of performing blood glucose checks (p < .001) and a 1.45% reduction in A1C between preintervention and 12 weeks postintervention (p = .006). Qualitative results indicated the video was both culturally appropriate and effective. The findings of this study were consistent with evidence in the literature, which shows health education videos can be effective at improving health behaviors. Using a community-based participatory research approach to prioritize video topics, and including members of the community in the creation and dissemination of the videos, could aid in ensuring the videos are effective and culturally appropriate.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sheldon Riklon
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Nia Aitaoto
- Nutrition & Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | | | - Shumona Ima
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Susan A Kadlubar
- Division of Medical Genetics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Peter A Goulden
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jonell S Hudson
- College of Pharmacy, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Sammie Mamis
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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Why video health education messages should be considered for all dental waiting rooms. PLoS One 2019; 14:e0219506. [PMID: 31310627 PMCID: PMC6634391 DOI: 10.1371/journal.pone.0219506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/25/2019] [Indexed: 02/06/2023] Open
Abstract
Objective Video is an effective, accessible, and low cost method of delivering health education messages to a wide audience. Dental waiting rooms provide an opportunity to deliver video oral health education interventions to receptive viewers. In this study we aim to evaluate firstly video oral health education in regards to patient preference, and secondly its ability to change both immediate and sustained self-reported intended health behaviours by patients. Method Data from 253 individuals from a public hospital dental waiting room were gathered using a previously validated survey following an oral health education video intervention, and analysed using descriptive analysis, Fischer’s Exact Test, and Wilcoxon Signed Ranks Test across 3 time intervals. Results Participants across all ages evaluated the video oral health education approach as easy to follow and understand (p<0.001), the content practical and useful (p<0.001), and that it was a better experience (p<0.01). Those watching between 5 and 20 minutes reported that video was the best format to present oral care information (p<0.02). At follow up, significant improvement in the tools used by participants to clean teeth was seen (39.8%, p<0.001), as well as reported reduction in sweet consumption frequency (21.3%, p<0.001) and in smoking (44.8%, p<0.02). Conclusion Video format oral health education used in dental waiting rooms was found to be effective in educating patients and instigating both immediate and sustained self-reported behaviour change. Significant improvement in tools used for oral hygiene and a reduction in sweets consumption were demonstrated, both of which are essential factors in reducing caries rates and improving oral health.
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Ismaeel A, Weems S, McClendon M, Morales FE. Interventions Aimed at Decreasing Obesity in Hispanic Children in the First 1000 Days: A Systematic Review. J Immigr Minor Health 2019; 20:1288-1293. [PMID: 29119306 DOI: 10.1007/s10903-017-0672-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The prevalence of obesity is higher among Hispanic children than among all other ethnicities, and recent efforts have been focused on addressing this growing disparity. The objective of this review was to examine the evidence for interventions designed to reduce obesity in Hispanic children in the first 1000 days of life and to assess and summarize the effectiveness of the interventions. A literature search was conducted using MEDLINE, Scopus, and PubMed. Included in the review were published studies that evaluated an intervention designed to prevent or reduce obesity in Hispanic children in the first 1000 days of life. Quality was assessed using the GRADE system. Out of 134 citations that were retrieved, 11 articles underwent full-text review, and 5 articles met study inclusion criteria. Only one study was of high quality, and the rest were of low or moderate quality. Three of the studies were lifestyle interventions, and two were educational interventions. Four out of the five interventions led to significant improvements in the outcome measures assessed. Very few published studies tested interventions in the population of Hispanic children ages 0-2 years. Limited evidence does suggest that these interventions may improve behaviors related to factors known to increase the risk for obesity. Future research should focus on designing interventions using common themes observed among successful studies. Further, these studies should also include clinical measures of obesity to further establish their effectiveness.
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Affiliation(s)
- Ahmed Ismaeel
- Nutrition Sciences, Family and Consumer Sciences, Baylor University, One Bear Place #97346, Waco, TX, 76798, USA. .,Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA.
| | - Suzy Weems
- Nutrition Sciences, Family and Consumer Sciences, Baylor University, One Bear Place #97346, Waco, TX, 76798, USA
| | - Megan McClendon
- Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | - Flor Elisa Morales
- Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
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Li X, Huang Y, Yin R, Pan C, Cai Y, Wang Z. Visualized nutrition education and dietary behavioral change: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2018; 59:1976-1985. [PMID: 29727198 DOI: 10.1080/10408398.2018.1469466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Effectiveness of using visual approaches in health education and its influential factors were still in debate. This study aimed to asess the effects of visualized nutrition education on dietary knowledge and behavioral changes, and factors influencing them. A comprehensive search of PubMed, EMBASE, Scopus, and Cochrane Library was conducted. Eligible studies were trials assessed effects of visualized nutrition education on dietary knowledge or behavior changes, compared with non-visualized or no education group. Fourteen studies (n = 7,259) were qualitatively analyzed and 7 of them were included in the meta-analysis. We found a higher fiber intake in both short term (1.59 g/1000 kcals, 95% CI 0.90-2.27) and long term (1.36 g/1000 kcals, 95% CI 0.64-2.09). A marginal advantage was shown in short-term fruits and vegetables consumption (F&V consumption) (standardized mean difference [SMD] = 0.08, 95% CI -0.00 to 0.16). The education effects were more pronounced when education was delivered in series (SMDF&V consumption = 0.09, 95% CI 0.00-0.17), avoiding loss-framing (SMDFat intake = 0.31, 95% CI 0.10-0.51) and video modeling (SMDF&V consumption = 0.23, 95% CI 0.03-0.43), with short length plus cultural adaptation. Visualized nutrition education was overall promising in improving dietary behaviors. Delivering in series, short in length, with cultural adaptation were features tended to enlarge the benefits of visualized education while loss-framing and video modeling might be avoided.
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Affiliation(s)
- Xinyi Li
- a School of Public Health, Peking University Health Science Center , Beijing , China
| | - Yangmu Huang
- a School of Public Health, Peking University Health Science Center , Beijing , China
| | - Ruoyu Yin
- b Institute for Medical Humanities, Peking University Health Science Center , Beijing , China
| | - Chenyu Pan
- b Institute for Medical Humanities, Peking University Health Science Center , Beijing , China
| | - Yan Cai
- c School of Nursing, Peking University Health Science Center , Beijing , China
| | - Zhaokun Wang
- a School of Public Health, Peking University Health Science Center , Beijing , China
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Limaye NP, Rivas-Nieto AC, Carcamo CP, Blas MM. Nuestras Historias- Designing a novel digital story intervention through participatory methods to improve maternal and child health in the Peruvian Amazon. PLoS One 2018; 13:e0205673. [PMID: 30396200 PMCID: PMC6218201 DOI: 10.1371/journal.pone.0205673] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/29/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In rural areas of the Loreto region within the Peruvian Amazon, maternal mortality rate is above the national average and the majority of women deliver at home without care from a trained health care provider. METHODS To develop community-tailored videos that could be used for future interventions, we conducted Photovoice and digital storytelling workshops with community health workers (CHW) and mothers from 13 rural communities in the Parinari district. Through Photovoice we recognized local barriers to healthy pregnancies. Participants (n = 28) were trained in basic photography skills and ethics. They captured photos representing perceived pregnancy-related road-blocks and supports, and these photos identified central themes. Participants recorded personal stories and "storyboarded" to develop digital stories around these themes, and a Digital Story Curriculum called Nuestras Historias (Our Stories), was created. An acceptability survey of the digital stories was then conducted including 47 men (M) and 60 women (F). RESULTS According to the PhotoVoice workshops, pregnancy-related problems included: lack of partner support, domestic violence, early pregnancies, difficulty attending prenatal appointments, and complications during pregnancy and delivery. Over 30 stories on these themes were recorded. Seven were selected based on clarity, thematic relevance, and narrative quality and were edited by a professional filmmaker. The acceptability survey showed that local participants found the digital stories novel (M = 89.4%, F = 83.3%), relatable (M = 89.4%, F = 93.2%), educational (M = 91.5%, F = 93.3%) and shareable (M = 100%, F = 100%). Over 90% of respondents rated the digital stories as "Excellent" or "Good", found the videos "Useful" and considered them "Relevant" to their communities. CONCLUSIONS The digital stories address community-specific problems through narrative persuasion using local voices and photography. This combination had a high acceptability among the target population and can serve as a model for developing educational strategies in a community-tailored manner. This package of seven videos will be further evaluated through a cluster randomized trial.
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Affiliation(s)
- Neha P. Limaye
- Department of Internal Medicine-Pediatrics, Harvard Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Boston Medical Center, Boston, Massachusetts, United States of America
| | - Andrea C. Rivas-Nieto
- Department of Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar P. Carcamo
- Department of Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Magaly M. Blas
- Department of Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Andrade EL, Evans WD, Barrett ND, Cleary SD, Edberg MC, Alvayero RD, Kierstead EC, Beltran A. Development of the place-based Adelante social marketing campaign for prevention of substance use, sexual risk and violence among Latino immigrant youth. HEALTH EDUCATION RESEARCH 2018; 33:125-144. [PMID: 29329436 PMCID: PMC6658711 DOI: 10.1093/her/cyx076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 11/29/2017] [Indexed: 05/15/2023]
Abstract
Immigrant Latino youth represent a high-risk subgroup that should be targeted with health promotion efforts. However, there are considerable barriers to engagement in health-related programming. Little is known about the engagement possibilities of social marketing campaigns and digital strategies for traditionally 'hard-to-reach' immigrants, underscoring the importance of testing these techniques with immigrant Latino adolescents. We developed and piloted a place-based social marketing campaign in coordination with the branded, Positive Youth Development-based (PYD) Adelante intervention targeting risk factors for co-occurring youth substance abuse, sexual risk and violence. Building on prior research, we conducted a four-phase formative research process, and planned the Adelante social marketing campaign based on findings from one group interview and ongoing consultation with Adelante staff (n=8) and four focus groups with youth (n=35). Participants identified four overarching campaign themes, and suggested portrayal of resilient, proud youth who achieved goals despite adversity. Youth guided selection of campaign features and engagement strategies, including message/visual content, stylistic elements, and a mixed language approach. We developed a 12-month campaign to be delivered via print ads, multi-platform social media promotion, contests, youth-generated videos, blog posts, and text messaging. We describe the process and outcome of campaign development and make recommendations for future campaigns.
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Affiliation(s)
- E L Andrade
- Department of Prevention and Community Health, The George Washington University, Washington, DC 20052, USA
| | - W D Evans
- Department of Prevention and Community Health, The George Washington University, Washington, DC 20052, USA
| | - N D Barrett
- Department of Prevention and Community Health, The George Washington University, Washington, DC 20052, USA
| | - S D Cleary
- Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC 20052, USA
| | - M C Edberg
- Department of Prevention and Community Health, The George Washington University, Washington, DC 20052, USA
| | - R D Alvayero
- Maryland Multicultural Youth Centers, 8700 Georgia Ave, Suite 500 Silver Spring, MD 20910, USA
| | - E C Kierstead
- Department of Prevention and Community Health, The George Washington University, Washington, DC 20052, USA
| | - A Beltran
- Department of Prevention and Community Health, The George Washington University, Washington, DC 20052, USA
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Albrecht L, Scott SD, Hartling L. Knowledge translation tools for parents on child health topics: a scoping review. BMC Health Serv Res 2017; 17:686. [PMID: 28962637 PMCID: PMC5622461 DOI: 10.1186/s12913-017-2632-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/22/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND An emerging field of knowledge translation (KT) research has begun to focus on health consumers, particularly in child health. KT tools provide health consumers with research knowledge to inform health decision-making and may foster 'effective consumers'. Thus, the purpose of this scoping review was to describe the state of the field of previously published effectiveness research on child health-related KT tools for parents/caregivers to understand the evidence-base, identify gaps, and guide future research efforts. METHODS A health research librarian developed and implemented search strategies in 8 databases. One reviewer conducted screening using pre-determined criteria. A second reviewer verified 10% of screening decisions. Data extraction was performed by one reviewer. A descriptive analysis was conducted and included patient-important outcome classification, WIDER Recommendation checklist, and methodological quality assessment. RESULTS Seven thousand nine hundred fifty two independent titles and abstracts were reviewed, 2267 full-text studies were retrieved and reviewed, and 18 articles were included in the final data set. A variety of KT tools, including single- (n = 10) and multi-component tools (n = 10), were evaluated spanning acute (n = 4), chronic (n = 5) and public/population health (n = 9) child health topics. Study designs included: cross-sectional (n = 4), before-after (n = 1), controlled before-after (n = 2), cohort (n = 1), and RCTs (n = 10). The KT tools were evaluated via single primary outcome category (n = 11) and multiple primary outcome categories (n = 7). Two studies demonstrated significant positive effects on primary outcome categories; the remaining studies demonstrated mixed effects (n = 9) and no effect (n = 3). Overall, methodological quality was poor; studies lacked a priori protocols (n = 18) and sample size calculations (n = 13). Overall, intervention reporting was also poor; KT tools lacked description of theoretical underpinnings (n = 14), end-user engagement (n = 13), and preliminary research (n = 9) to inform the current effectiveness evaluation. CONCLUSIONS A number of child health-related knowledge translation tools have been developed for parents/caregivers. However, numerous outcomes were used to assess impact and there is limited evidence demonstrating their effectiveness. Moreover, the methodological rigor and reporting of effectiveness studies is limited. Careful tool development involving end-users and preliminary research, including usability testing and mixed methods, prior to large-scale studies may be important to advance the science of KT for health consumers.
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Affiliation(s)
- Lauren Albrecht
- Department of Pediatrics & Research Coordinator, Faculty of Nursing, University of Alberta, 5-147 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, 3rd floor Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Lisa Hartling
- Department of Pediatrics, University of Alberta, 4-472 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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Weihrauch-Blüher S, Koormann S, Brauchmann J, Wiegand S. [Electronic media in obesity prevention in childhood and adolescence]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:1452-1464. [PMID: 27757512 DOI: 10.1007/s00103-016-2455-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The increasing prevalence of childhood obesity is - amongst other factors - due to changed leisure time habits with decreased physical activity and increased media consumption. However, electronic media such as tablets and smartphones might also provide a novel intervention approach to prevent obesity in childhood and adolescence. OBJECTIVES A summary of interventions applying electronic media to prevent childhood obesity is provided to investigate short term effects as well as long term results of these interventions. METHODS A systematic literature search was performed in PubMed/Web of Science to identify randomized and/or controlled studies that have investigated the efficacy of electronic media for obesity prevention below the age of 18. RESULTS A total of 909 studies were identified, and 88 studies were included in the analysis. Active video games did increase physical activity compared to inactive games when applied within a peer group. Interventions via telephone had positive effects on certain lifestyle-relevant behaviours. Interventions via mobile were shown to decrease dropout rates by sending regular SMS messages. To date, interventions via smartphones are scarce for adolescents; however, they might improve cardiorespiratory fitness. The results from internet-based interventions showed a trend towards positive effects on lifestyle-relevant behaviors. The combination of different electronic media did not show superior results compared to interventions with only one medium. Interventions via TV, DVD or video-based interventions may increase physical activity when offered as an incentive, however, effects on weight status were not observed. DISCUSSION Children and adolescents currently grow up in a technology- and media-rich society with computers, tablets, smartphones, etc. used daily. Thus, interventions applying electronic media to prevent childhood obesity are contemporary. Available studies applying electronic media are however heterogeneous in terms of applied medium and duration. Positive effects on body composition were not observed, but only on certain lifestyle-relevant behaviours. In addition, these effects could only be seen in the short term. Follow-up data are currently scarce.
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Affiliation(s)
- Susann Weihrauch-Blüher
- IFB Adipositas Erkrankungen, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Deutschland.
| | - Stefanie Koormann
- IFB Adipositas Erkrankungen, Universitätsmedizin Leipzig, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Deutschland
| | - Jana Brauchmann
- Interdisziplinäres SPZ, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Susanna Wiegand
- Interdisziplinäres SPZ, Charité Universitätsmedizin Berlin, Berlin, Deutschland
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Chaet AV, Morshedi B, Wells KJ, Barnes LE, Valdez R. Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review. J Med Internet Res 2016; 18:e214. [PMID: 27511437 PMCID: PMC4997005 DOI: 10.2196/jmir.5794] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/22/2016] [Accepted: 07/08/2016] [Indexed: 11/15/2022] Open
Abstract
Background As consumer health information technology (IT) becomes more thoroughly integrated into patient care, it is critical that these tools are appropriate for the diverse patient populations whom they are intended to serve. Cultural differences associated with ethnicity are one aspect of diversity that may play a role in user-technology interactions. Objective Our aim was to evaluate the current scope of consumer health IT interventions targeted to the US Spanish-speaking Latino population and to characterize these interventions in terms of technological attributes, health domains, cultural tailoring, and evaluation metrics. Methods A narrative synthesis was conducted of existing Spanish-language consumer health IT interventions indexed within health and computer science databases. Database searches were limited to English-language articles published between January 1990 and September 2015. Studies were included if they detailed an assessment of a patient-centered electronic technology intervention targeting health within the US Spanish-speaking Latino population. Included studies were required to have a majority Latino population sample. The following were extracted from articles: first author’s last name, publication year, population characteristics, journal domain, health domain, technology platform and functionality, available languages of intervention, US region, cultural tailoring, intervention delivery location, study design, and evaluation metrics. Results We included 42 studies in the review. Most of the studies were published between 2009 and 2015 and had a majority percentage of female study participants. The mean age of participants ranged from 15 to 68. Interventions most commonly focused on urban population centers and within the western region of the United States. Of articles specifying a technology domain, computer was found to be most common; however, a fairly even distribution across all technologies was noted. Cancer, diabetes, and child, infant, or maternal health were the most common health domains targeted by consumer health IT interventions. More than half of the interventions were culturally tailored. The most frequently used evaluation metric was behavior/attitude change, followed by usability and knowledge retention. Conclusions This study characterizes the existing body of research exploring consumer health IT interventions for the US Spanish-speaking Latino population. In doing so, it reveals three primary needs within the field. First, while the increase in studies targeting the Latino population in the last decade is a promising advancement, future research is needed that focuses on Latino subpopulations previously overlooked. Second, preliminary steps have been taken to culturally tailor consumer health IT interventions for the US Spanish-speaking Latino population; however, focus must expand beyond intervention content. Finally, the field should work to promote long-term evaluation of technology efficacy, moving beyond intermediary measures toward measures of health outcomes.
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Affiliation(s)
- Alexis V Chaet
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
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Gross RS, Mendelsohn AL, Gross MB, Scheinmann R, Messito MJ. Randomized Controlled Trial of a Primary Care-Based Child Obesity Prevention Intervention on Infant Feeding Practices. J Pediatr 2016; 174:171-177.e2. [PMID: 27113376 PMCID: PMC4925185 DOI: 10.1016/j.jpeds.2016.03.060] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/16/2016] [Accepted: 03/23/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the effects of a child obesity prevention intervention, beginning in pregnancy, on infant feeding practices in low-income Hispanic families. STUDY DESIGN The Starting Early randomized controlled trial enrolled pregnant women at a third trimester visit. Women (n = 533) were randomly allocated to a standard care control group or an intervention group participating in prenatal and postpartum individual nutrition/breastfeeding counseling and subsequent nutrition and parenting support groups coordinated with well-child visits. Outcome measures included infant feeding practices and maternal infant feeding knowledge at infant age 3 months, using questions adapted from the Infant Feeding Practices Study II and an infant 24-hour diet recall. RESULTS A total of 456 families completed 3-month assessments. The intervention group had higher prevalence of exclusive breastfeeding on the 24-hour diet recall (42.7% vs 33.0%, P = .04) compared with controls. The intervention group reported a higher percentage of breastfeeding vs formula feeding per day (mean [SD] 67.7 [39.3] vs 59.7 [39.7], P = .03) and was less likely to introduce complementary foods and liquids compared with controls (6.3% vs 16.7%, P = .001). The intervention group had higher maternal infant feeding knowledge scores (Cohen d, 0.29, 95% CI .10-.48). The effect of Starting Early on breastfeeding was mediated by maternal infant feeding knowledge (Sobel test 2.86, P = .004). CONCLUSIONS Starting Early led to increased exclusive breastfeeding and reduced complementary foods and liquids in 3-month-old infants. Findings document a feasible and effective infrastructure for promoting breastfeeding in families at high risk for obesity in the context of a comprehensive obesity prevention intervention. TRIAL REGISTRATION ClinicalTrials.gov: NCT01541761.
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Affiliation(s)
- Rachel S. Gross
- Department of Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Bronx, NY
| | - Alan L. Mendelsohn
- Department of Pediatrics, Division of Developmental - Behavioral Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY
| | - Michelle B. Gross
- Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY
| | | | - Mary Jo Messito
- Department of Pediatrics, Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY
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Andrade EL, Evans WD, Edberg MC, Cleary SD, Villalba R, Batista IC. Victor and Erika Webnovela: An Innovative Generation @ Audience Engagement Strategy for Prevention. JOURNAL OF HEALTH COMMUNICATION 2015; 20:1465-72. [PMID: 26252644 PMCID: PMC4654645 DOI: 10.1080/10810730.2015.1018648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Entertainment-education (E-E) approaches for young audiences continue to evolve in order to keep stride with younger generations' affinity for technology. E-E and novelas have been used with a wide variety of audiences in the United States, in particular hard-to-reach Latino populations, and have demonstrated effectiveness in disseminating culturally relevant prevention information for a wide variety of health-related risk factors and behaviors. This study discusses the formative research and active engagement of Latino youth living in Langley Park, Maryland, for the development and filming of an innovative 6-episode webnovela titled Victor and Erika (V&E). V&E is part of a larger branding strategy of the Adelante Positive Youth Development intervention that seeks to prevent substance abuse, sexual risk, and interpersonal violence among Latino youth; V&E is also an intervention component. The V&E webnovela is a dramatic portrayal of the lives of 2 immigrant Latino teenagers that also disseminates risk prevention messages. The storyline represents the turning the corner (to a better life) theme that underlies the Adelante intervention brand. Formative research was conducted for character development (n = 20) and creative development of the episodes (n = 14). Results of the formative research showed that youth recommended inclusion of the following topics in V&E episodes: sex, unintended pregnancy, fidelity, trust, family dynamics, immigration status, violence, school dropout, respect, home life, and poverty. Detailed character and episode descriptions are provided, and the implications of using the V&E series as a tool for in-person and online engagement of youth and the dissemination of prevention messages are also discussed.
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Affiliation(s)
- Elizabeth L Andrade
- a Department of Prevention and Community Health , The George Washington University Milken Institute School of Public Health , Washington , District of Columbia , USA
| | - W Douglas Evans
- a Department of Prevention and Community Health , The George Washington University Milken Institute School of Public Health , Washington , District of Columbia , USA
| | - Marc C Edberg
- a Department of Prevention and Community Health , The George Washington University Milken Institute School of Public Health , Washington , District of Columbia , USA
| | - Sean D Cleary
- a Department of Prevention and Community Health , The George Washington University Milken Institute School of Public Health , Washington , District of Columbia , USA
| | - Ricardo Villalba
- b Maryland Multicultural Youth Centers , Hyattsville , Maryland , USA
| | - Idalina Cubilla Batista
- a Department of Prevention and Community Health , The George Washington University Milken Institute School of Public Health , Washington , District of Columbia , USA
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Chang SM, Grantham-McGregor SM, Powell CA, Vera-Hernández M, Lopez-Boo F, Baker-Henningham H, Walker SP. Integrating a Parenting Intervention With Routine Primary Health Care: A Cluster Randomized Trial. Pediatrics 2015; 136:272-80. [PMID: 26148947 DOI: 10.1542/peds.2015-0119] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE More than 200 million children globally do not attain their developmental potential. We hypothesized that a parent training program could be integrated into primary health center visits and benefit child development. METHODS We conducted a cluster randomized trial in the Caribbean (Jamaica, Antigua, and St Lucia). Fifteen centers were randomly assigned to the control (n = 250 mother-child pairs) and 14 to the intervention (n = 251 mother-child pairs) groups. Participants were recruited at the 6- to 8-week child health visit. The intervention used group delivery at 5 routine visits from age 3 to 18 months and comprised short films of child development messages, which were shown in the waiting area; discussion and demonstration led by community health workers; and mothers' practice of activities. Nurses distributed message cards and a few play materials. Primary outcomes were child cognition, language, and hand-eye coordination and secondary outcomes were caregiver knowledge, practices, maternal depression, and child growth, measured after the 18-month visit. RESULTS Eight-five percent of enrolled children were tested (control = 210, intervention = 216). Loss did not differ by group. Multilevel analyses showed significant benefits for cognitive development (3.09 points; 95% confidence interval: 1.31 to 4.87 points; effect size: 0.3 SDs). There were no other child benefits. There was a significant benefit to parenting knowledge (treatment effect: 1.59; 95% confidence interval: 1.01 to 2.17; effect size: 0.4). CONCLUSIONS An innovative parenting intervention, requiring no additional clinic staff or mothers' time, was integrated into health services, with benefits to child cognitive development and parent knowledge. This is a promising strategy that merits further evaluation at scale.
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Affiliation(s)
- Susan M Chang
- Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica
| | | | - Christine A Powell
- Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica
| | | | - Florencia Lopez-Boo
- Social Protection and Health Division, Inter-American Development Bank, Washington, District of Columbia; and
| | - Helen Baker-Henningham
- Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica; School of Psychology, Bangor University, Bangor, United Kingdom
| | - Susan P Walker
- Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica;
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Laws R, Campbell KJ, van der Pligt P, Russell G, Ball K, Lynch J, Crawford D, Taylor R, Askew D, Denney-Wilson E. The impact of interventions to prevent obesity or improve obesity related behaviours in children (0-5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review. BMC Public Health 2014; 14:779. [PMID: 25084804 PMCID: PMC4137086 DOI: 10.1186/1471-2458-14-779] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 07/17/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Children from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families. METHODS Searches of major electronic databases identified articles published from 1993-2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity. RESULTS Thirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m(2) to -0.54 kg/m(2) for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3-5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery. CONCLUSION There is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required. TRIAL REGISTRATION PROSPERO Registration no: CRD42013006536.
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Affiliation(s)
- Rachel Laws
- />Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - Karen J Campbell
- />Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - Paige van der Pligt
- />Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Georgina Russell
- />Faculty of Health, University of Technology, Sydney, NSW Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - Kylie Ball
- />Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - John Lynch
- />School of Population Health, University of Adelaide, Adelaide, SA Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - David Crawford
- />Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - Rachael Taylor
- />University of Otago, Dunedin, New Zealand
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - Deborah Askew
- />Inala Indigenous Health Service, Inala, QLD, Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
| | - Elizabeth Denney-Wilson
- />Faculty of Health, University of Technology, Sydney, NSW Australia
- />Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC), Kragujevac, Australia
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Bensley RJ, Hovis A, Horton KD, Loyo JJ, Bensley KM, Phillips D, Desmangles C. Accessibility and preferred use of online Web applications among WIC participants with Internet access. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:S87-S92. [PMID: 24810002 DOI: 10.1016/j.jneb.2014.02.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 02/11/2014] [Accepted: 02/11/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This study examined the current technology use of clients in the western Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) region and the preferences these current clients have for using new technologies to interact with WIC. METHODS Cross-sectional convenience sample for online survey of WIC clients over 2 months in 2011. RESULTS A weighted sample of 8,144 participants showed that the majority of WIC clients have access to the Internet using a computer or mobile phone. E-mail, texting, and Facebook were technologies most often used for communication. Significant differences (P < .05) existed between age groups and Facebook use, education level and technology use for education delivery, and education level and use of video chat. CONCLUSIONS AND IMPLICATIONS Technologies should be considered for addressing WIC clients' needs, including use of text messaging and smartphone apps for appointments, education, and other WIC services; online scheduling and nutrition education; and a stronger Facebook presence for connecting with WIC clients and breastfeeding support.
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Affiliation(s)
- Robert J Bensley
- Department of Human Performance and Health Education, Western Michigan University, Kalamazoo, MI.
| | | | | | | | - Kara M Bensley
- School of Public Health, University of Washington, Seattle, WA
| | - Diane Phillips
- Center for Food Assistance and Nutrition, Altarum Institute, Ann Arbor, MI
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Anticipatory guidance preferences of Latina migrant farmworker mothers. J Pediatr Health Care 2013; 27:164-71. [PMID: 23611456 PMCID: PMC3635038 DOI: 10.1016/j.pedhc.2011.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/05/2011] [Accepted: 08/13/2011] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The purpose of the study was to learn preferences of Latina migrant farmworker mothers regarding the presentation of health education materials by discussing the strengths and weaknesses of numerous mixed-media samples. METHOD This community-based participatory study was qualitative and descriptive in design. Focus groups were conducted in Spanish in four Midwest migrant camps with a convenience sample of mothers (N = 31). Adult learning and cultural care theories guided the study. Various modes of educational materials on various topics were presented. RESULTS Mothers preferred comic book-style handouts, games, food replicas, text in English/Spanish, and digital video discs or digital versatile discs, but almost none of them had media-playing equipment. They did not like black-and-white photos or cartoon-like illustrations. Identified themes of importance were colored illustrations, sizes mothers could easily carry in purses, and limited verbiage on a page. DISCUSSION The knowledge gained in this study will be used to customize health promotion interventions that are sensitive to migrant farmworker-preferred learning styles. The findings from this study can inform other interventions with Latino populations and serve as a prototype for other populations of immigrant non-English-speaking mothers.
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Identifying Barriers Preventing Latina Women from Accessing WIC Online Health Information. J Immigr Minor Health 2013; 16:699-705. [DOI: 10.1007/s10903-013-9801-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Videos to influence: a systematic review of effectiveness of video-based education in modifying health behaviors. J Behav Med 2012. [DOI: 10.1007/s10865-012-9480-7] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vaughn S. Stroke and heart disease prevention education via telenovela: a focus group's evaluation. Rehabil Nurs 2012; 37:215-9. [PMID: 22949274 DOI: 10.1002/rnj.53] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate a telenovela, "La Familia Nutritiva y Balanceada," for cultural context and its efficacy as an educational tool to promote positive health behaviors in Latino families. METHOD Ethnography was employed to interpret cultural health behaviors of 12 Latinas through a focus group after viewing the telenovela, a culturally accepted form of entertainment education. RESULTS Analysis of the transcribed interview revealed three recurrent themes: Not all fat is bad; add fruits and vegetables daily to diet; and children need to be involved. The group purported that the inclusion of children in the marketing and preparation of the food would translate into better food habits. DISCUSSION Participants demonstrated basic knowledge between food and health, and acknowledged that they gained an appreciation for good fat in the diet. The group related the telenovela would be a good tool for clinics, health fairs, and schools. CONCLUSION Latinos are at high risk for cardiovascular disease and stroke. Health education messages need to incorporate cultural norms into an intervention that supports a behavior change, such as improved nutrition. Studies support that Latinos connect to media, such as telenovela and interpersonal communication, which make these appropriate choices for health education tools.
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Affiliation(s)
- Stephanie Vaughn
- Undergraduate Nursing Program, California State University at Fullerton, Fullerton, CA, USA.
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Montague E, Perchonok J. Health and wellness technology use by historically underserved health consumers: systematic review. J Med Internet Res 2012; 14:e78. [PMID: 22652979 PMCID: PMC3799608 DOI: 10.2196/jmir.2095] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 03/28/2012] [Accepted: 04/25/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The implementation of health technology is a national priority in the United States and widely discussed in the literature. However, literature about the use of this technology by historically underserved populations is limited. Information on culturally informed health and wellness technology and the use of these technologies to reduce health disparities facing historically underserved populations in the United States is sparse in the literature. OBJECTIVE To examine ways in which technology is being used by historically underserved populations to decrease health disparities through facilitating or improving health care access and health and wellness outcomes. METHODS We conducted a systematic review in four library databases (PubMed, PsycINFO, Web of Science, and Engineering Village) to investigate the use of technology by historically underserved populations. Search strings consisted of three topics (eg, technology, historically underserved populations, and health). RESULTS A total of 424 search phrases applied in the four databases returned 16,108 papers. After review, 125 papers met the selection criteria. Within the selected papers, 30 types of technology, 19 historically underserved groups, and 23 health issues were discussed. Further, almost half of the papers (62 papers) examined the use of technology to create effective and culturally informed interventions or educational tools. Finally, 12 evaluation techniques were used to assess the technology. CONCLUSIONS While the reviewed studies show how technology can be used to positively affect the health of historically underserved populations, the technology must be tailored toward the intended population, as personally relevant and contextually situated health technology is more likely than broader technology to create behavior changes. Social media, cell phones, and videotapes are types of technology that should be used more often in the future. Further, culturally informed health information technology should be used more for chronic diseases and disease management, as it is an innovative way to provide holistic care and reminders to otherwise underserved populations. Additionally, design processes should be stated regularly so that best practices can be created. Finally, the evaluation process should be standardized to create a benchmark for culturally informed health information technology.
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Affiliation(s)
- Enid Montague
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA.
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