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Warraitch A, Wacker C, Biju S, Lee M, Bruce D, Curran P, Khraisha Q, Hadfield K. Positive Impacts of Adolescent Involvement in Health Research: An Umbrella Review. J Adolesc Health 2024:S1054-139X(24)00121-6. [PMID: 38597838 DOI: 10.1016/j.jadohealth.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 04/11/2024]
Abstract
Despite an increased recognition of the right of adolescents to be involved in decisions that affect them, young people continue to be under-involved in health research. One of the reasons is a lack of awareness among researchers on the current evidence base around the benefits of involving adolescents. To address this, we conducted an umbrella review to synthesize the evidence on the positive impacts of adolescent involvement in health research. This umbrella review was preregistered with PROSPERO (CRD42021287467). We searched 11 databases, Google Scholar, PROSPERO, reference lists, 10 journals, websites of 472 organizations, and sought input from experts. Ultimately, we included 99 review articles. We found that adolescent involvement has many positive impacts on young people, including increased knowledge and skills; personal development; financial benefits; career and academic growth; enhanced relationships; and valuing their experience. The positive impacts of adolescent involvement on the research itself include increased relevance of the study to adolescents, improved recruitment, development of more adolescent-friendly materials, enhanced data collection and analysis, and more effective dissemination. Researchers also benefited from adolescents' involvement through increased knowledge, skills, and a shift in their attitudes. The evidence supporting the positive impacts of adolescent involvement in research is substantial but limited by a lack of rigorous evaluation, inconsistent reporting, and unclear evaluation methods.
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Affiliation(s)
- Azza Warraitch
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - Ciara Wacker
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Sanjana Biju
- Department of Social Work and Social Policy, Trinity College Dublin, Dublin, Ireland
| | - Maria Lee
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Delali Bruce
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Engineering, Stanford University, Stanford, California
| | - Paul Curran
- Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Qusai Khraisha
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Kristin Hadfield
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland; Department of Psychology, Trinity College Dublin, Dublin, Ireland
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Weaver E, Freeman N, Mack S, Titmuss A, Dowler J, Corpus S, Hyatt T, Ellis E, Sanderson C, Connors C, Moore E, Silver B, Azzopardi P, Maple-Brown L, Kirkham R. "I Don't Really Know What Diabetes Is": A Qualitative Study Exploring the Experiences of Aboriginal and Torres Strait Islander Young People Aged 10 to 25 Years Living With Type 2 Diabetes in Northern and Central Australia. Can J Diabetes 2022; 46:S1499-2671(22)00095-8. [PMID: 35963668 DOI: 10.1016/j.jcjd.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/14/2022] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Our aim in this study was to gain an understanding of the experiences of Aboriginal and Torres Strait Islander young people aged 10 to 25 years with type 2 diabetes (T2D) living in Northern and Central Australia. METHODS In this qualitative study we explored participants' experiences of T2D using a social constructionist epistemology and a phenomenologic methodology. Twenty-seven young people participated in semistructured in-depth interviews from 4 primary health-care sites. RESULTS Three major constructs emerged. Young people experienced a normalisation-shame paradox in response to their diagnosis (partly related to that "everyone has diabetes," as well as the fear that friends "might judge [me]"), had suboptimal levels of understanding of T2D ("I don't really know what diabetes is. I just need somebody to explain to me a bit more") and experienced multiple barriers inhibiting their T2D management. These included complex lives ("I have a rheumatic heart disease […] then they told me that I have diabetes…I have two things") and the availability of support ("[I] talk to my mum…I talk to my aunty too…I don't talk to anyone else"). Successful management requires support from health professionals and family and includes strengthening social networks and educational opportunities. CONCLUSIONS Our findings reinforce the need for alternative support systems tailored to the specific needs of young Aboriginal and Torres Strait Islander people with T2D. Enhanced models of care must be codesigned with young people and their communities and include a focus on shifting norms and expectations about youth T2D to reduce diabetes stigma and broaden social support and consider the delivery of health information in youth-friendly environments.
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Affiliation(s)
- Emma Weaver
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
| | - Natasha Freeman
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Shiree Mack
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Angela Titmuss
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Paediatrics, Division of Women, Children and Youth, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - James Dowler
- Department of Paediatrics, Alice Springs Hospital, Northern Territory, Australia
| | - Sumaria Corpus
- Danila Dilba Health Services, Darwin, Northern Territory, Australia; Endocrine Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Teresa Hyatt
- Population and Primary Health Care, Top End Health Service, Northern Territory Department of Health, Darwin, Northern Territory, Australia
| | - Elna Ellis
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Cheryl Sanderson
- Danila Dilba Health Services, Darwin, Northern Territory, Australia; Aboriginal Medical Service Alliance Northern Territory, Alice Springs, Northern Territory, Australia
| | - Christine Connors
- Population and Primary Health Care, Top End Health Service, Northern Territory Department of Health, Darwin, Northern Territory, Australia
| | - Elizabeth Moore
- Aboriginal Medical Service Alliance Northern Territory, Alice Springs, Northern Territory, Australia
| | - Bronwyn Silver
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Peter Azzopardi
- Burnet Institute, Melbourne, Victoria, Australia; Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Louise Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Endocrine Department, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Renae Kirkham
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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Lin PY, Lee TY, Liu CY, Lee YJ. The Effect of Self-Efficacy in Self-Management on Diabetes Distress in Young People with Type 2 Diabetes. Healthcare (Basel) 2021; 9:healthcare9121736. [PMID: 34946462 PMCID: PMC8701179 DOI: 10.3390/healthcare9121736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/24/2021] [Accepted: 12/07/2021] [Indexed: 12/17/2022] Open
Abstract
To understand the relationship among glycemic control, self-efficacy in diabetes management, and diabetes distress in young people with type 2 diabetes, a cross-sectional descriptive study with convenience sampling was designed. A total of 60 young people who had type 2 diabetes (T2D), with 24 (40%) males and 36 (60%) females were included. The mean age was 17.2 and ranged from 10.5 to 24.5 years, and they completed a Perceived Diabetes Self-Management Scale, the Problem Areas in Diabetes Scale and their pharmacologic management and life adjustment. Glycated hemoglobin (HbA1c) was routinely drawn before the outpatient visit. HbA1c and diabetic distress were positively correlated. Self-efficacy was negatively correlated with HbA1c and diabetic distress. In the hierarchical multiple regression analysis, only the duration of illness and self-efficacy remained significant in the final model. The variance for the overall model was 64%, with self-efficacy alone explaining 30% of the variance. In addition, 31.6% of participants had extremely high levels of psychological distress. Conclusions: T2D is an early onset chronic disease, and the young people may have had other health problems, which made the diabetes management a complex process. Nursing staff should regularly assess both the confidence and ability to manage treatment regimen of young people with type 2 diabetes and their psychological distress.
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Affiliation(s)
- Pao-Yu Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
- Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, Taipei 112021, Taiwan
| | - Tzu-Ying Lee
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
- Correspondence:
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
| | - Yann-Jinn Lee
- Laboratory of Molecular Medicine, Department of Pediatric Endocrinology, MacKay Children’s Hospital, Taipei 104217, Taiwan;
- Department of Medical Research, MacKay Memorial Hospital, Taipei 104217, Taiwan
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Lake AJ, Bo A, Hadjiconstantinou M. Developing and Evaluating Behaviour Change Interventions for People with Younger-Onset Type 2 Diabetes: Lessons and Recommendations from Existing Programmes. Curr Diab Rep 2021; 21:59. [PMID: 34902067 DOI: 10.1007/s11892-021-01432-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
People with younger-onset type 2 diabetes (YOT2D, diagnosis before 40 years of age) are at higher risk of morbidity and premature mortality compared with their similar-age type 1 diabetes and later-onset type 2 diabetes peers. Despite recommendations for targeted, behavioural, and psychosocial approaches to optimising health outcomes, there are few such interventions for this group. Furthermore, evaluations of health behaviour change interventions targeting this priority population have proven challenging to complete. Despite this, there is little guidance for future behavioural programme developers. The aims of this paper are to synthesise lessons learned and recommendations from published evaluations of YOT2D-focused health behaviour change interventions, and illustrate challenges and solutions using case studies from our own experience. A rapid review of the literature identified 11 trials of behavioural interventions for YOT2D (5 randomised controlled trials, 6 pre/post studies). We sourced related needs assessment and development papers to describe the life course of each programme. We identified two development and two evaluation-related themes impacting successful trial execution. Development recommendations include ensuring appropriate adaptation of existing interventions to the unique challenges and characteristics of the target group, use of theory or theoretical frameworks throughout, and involvement of the priority population and key stakeholders from inception. Evaluation recommendations include planning for meaningful evaluation and development of age-appropriate Core Outcomes Sets. Future programme developers would benefit from closer attention to intervention development guidelines and a focus on supporting those with YOT2D to achieve behaviour change and diabetes self-management goals, ahead of change to biomedical outcomes.
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Affiliation(s)
- Amelia J Lake
- School of Psychology, Deakin University, Geelong, VIC, 3220, Australia.
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne VIC, 3000, Australia.
| | - Anne Bo
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Slaght JL, Wicklow BA, Dart AB, Sellers EAC, Gabbs M, Carino M, McGavock JM. Physical activity and cardiometabolic health in adolescents with type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2021; 9:9/1/e002134. [PMID: 33990367 PMCID: PMC8127979 DOI: 10.1136/bmjdrc-2021-002134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/14/2021] [Accepted: 04/25/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Youth living with type 2 diabetes display increased risk of cardiovascular disease (CVD). It is unclear if regular physical activity (PA) modifies this risk. RESEARCH DESIGN AND METHODS We compared CVD risk factors in a cross-sectional study of 164 youth with type 2 diabetes stratified according to weekly vigorous-intensity PA. Outcomes were hemoglobin A1c (HbA1c), ambulatory blood pressure (BP; ambulatory 24-hour readings), plasma lipoproteins, and albuminuria. The main exposure, vigorous-intensity PA, was quantified with the Adolescent Physical Activity Recall Questionnaire. RESULTS Youth were 15±3 years, and 78% lived rurally and 68% were female, with a mean body mass index (BMI) Z-score of 2.4±1.1 and a mean HbA1c of 9.6% ±2.6%. Youth who participated in regular vigorous-intensity PA (40%; n=67) achieved nearly twice the dose of PA than peers who did not (62 vs 34 metabolic equivalent score-hour/week, p=0.001). After adjusting for duration of diabetes, BMI Z-score, sex, and smoking, youth who engaged in vigorous-intensity PA displayed lower HbA1c (9.1% vs 9.9%, p=0.052), diastolic BP (70 mm Hg vs 73 mm Hg, p=0.002), diastolic load (20% vs 26%, p=0.023), and mean arterial pressure (87.3 mm Hg vs 90.3 mm Hg, p<0.01), compared with youth who did not. Compared with youth who did not participate in regular vigorous-intensity PA, those who did also displayed lower odds of albuminuria after adjusting for duration of diabetes, sex, smoking, rural residence, and BMI Z-score (adjusted OR: 0.40, 95% CI 0.19 to 0.84). CONCLUSIONS Among youth with type 2 diabetes, participation in vigorous-intensity PA is associated with lower CVD risk.
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Affiliation(s)
- Jana L Slaght
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Brandy Alexandra Wicklow
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Pediatric Endocrinology and Metabolism, Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allison B Dart
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth A C Sellers
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Pediatric Endocrinology and Metabolism, Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Melissa Gabbs
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Marylin Carino
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan M McGavock
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
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Othman N, Wong YY, Lean QY, Mohd Noor N, Neoh CF. Factors affecting self-management among adolescents and youths with type 2 diabetes mellitus: A meta-synthesis. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Seear KH, Atkinson DN, Henderson-Yates LM, Lelievre MP, Marley JV. Maboo wirriya, be healthy: Community-directed development of an evidence-based diabetes prevention program for young Aboriginal people in a remote Australian town. EVALUATION AND PROGRAM PLANNING 2020; 81:101818. [PMID: 32512400 DOI: 10.1016/j.evalprogplan.2020.101818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/17/2019] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
Supporting healthy lifestyle behaviours is a key aspect of preventing type 2 diabetes which disproportionately affects disadvantaged groups from a younger age. Formative participatory research was undertaken to design a program for young Aboriginal people in a remote town in North West Australia with a high level of health needs and relatively few prevention initiatives. Focus groups and advisory discussions with Aboriginal community members were used to determine the nature of the program. The need for a comprehensive program was consistently expressed and limited healthy lifestyle knowledge and difficulties with healthy eating influenced by food environments were noted to be important. With guidance from the Derby Aboriginal Health Service, findings were integrated with previous international research evidence to develop a program tailored to local Aboriginal people aged 15-25 years and refine it after piloting. This 8-session program, 'Maboo wirriya, be healthy' involved an education component consistent with the US Diabetes Prevention Program and practical activities including group exercise. Changes to program structure and documentation were made after piloting for future use. The community-directed approach used in this study is vital to ensure relevance of localised chronic disease prevention programs in a range of settings.
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Affiliation(s)
- Kimberley H Seear
- The Rural Clinical School of Western Australia, University of Western Australia, 12 Napier Terrace (PO Box 1377), Broome WA 6725, Australia.
| | - David N Atkinson
- The Rural Clinical School of Western Australia, University of Western Australia, 12 Napier Terrace (PO Box 1377), Broome WA 6725, Australia.
| | | | - Matthew P Lelievre
- Derby Aboriginal Health Service, 1 Stanley Street (PO Box 1155) Derby WA 6728, Australia.
| | - Julia V Marley
- The Rural Clinical School of Western Australia, University of Western Australia, 12 Napier Terrace (PO Box 1377), Broome WA 6725, Australia; Kimberley Aboriginal Medical Services, 12 Napier Terrace (PO Box 1377), Broome WA 6725, Australia.
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Shulman R, Slater M, Khan S, Jones C, Walker JD, Jacklin K, Green ME, Frymire E, Shah BR. Prevalence, incidence and outcomes of diabetes in Ontario First Nations children: a longitudinal population-based cohort study. CMAJ Open 2020; 8:E48-E55. [PMID: 31992559 PMCID: PMC6996034 DOI: 10.9778/cmajo.20190226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND First Nations people are known to have a higher risk of childhood-onset type 2 diabetes, yet population-level data about diabetes in First Nations children are unavailable. In a partnership between Chiefs of Ontario and academic researchers, we describe the epidemiologic features and outcomes of diabetes in First Nations children in Ontario. METHODS We created annual cohorts from 1995/96 to 2014/15 using data from the Registered Persons Database linked with the federal Indian Register. We used the Ontario Diabetes Database to identify children with all types of diabetes and calculated the prevalence and incidence for First Nations children and other children in Ontario. We describe glycemic control in First Nations children and other children in 2014. RESULTS In 2014/15, there were 254 First Nations children and 10 144 other children with diagnosed diabetes in Ontario. From 1995/96 to 2014/15, the prevalence increased from 0.17 to 0.57 per 100 children, and the annual incidence increased from 37 to 94 per 100 000 per year among First Nations children. In 2014/15, the prevalence of diabetes was 0.62/100 among First Nations girls and 0.36/100 among other girls. The mean glycosylated hemoglobin level among First Nations children was 9.1% (standard deviation 2.7%) and for other children, 8.5% (standard deviation 2.1%). INTERPRETATION First Nations children have substantially higher rates of diabetes than non-Aboriginal children in Ontario; this is likely driven by an increased incidence of type 2 diabetes and increased risk for diabetes among First Nations girls. There is an urgent need for strategies to address modifiable factors associated with the risk of diabetes, improve access to culturally sensitive diabetes care and improve outcomes for First Nations children.
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Affiliation(s)
- Rayzel Shulman
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont.
| | - Morgan Slater
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Shahriar Khan
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Carmen Jones
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Jennifer D Walker
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Kristen Jacklin
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Michael E Green
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Eliot Frymire
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Baiju R Shah
- The Hospital for Sick Children (Shulman); ICES (Shulman, Slater, Khan, Walker, Green, Frymire, Shah); Departments of Pediatrics (Shulman, Green) and Medicine (Shah), University of Toronto, Toronto, Ont.; Department of Family Medicine (Slater), Queen's University, Kingston, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.; School of Rural and Northern Health (Walker), Laurentian University, Sudbury, Ont.; Memory Keepers Medical Discover Team (Jacklin), Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, Minn.; Health Services and Policy Research Institute (Khan, Green, Frymire), Queen's University, Kingston, Ont.; Division of Endocrinology (Shah), Sunnybrook Health Sciences Centre, Toronto, Ont
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McGavock J, Durksen A, Wicklow B, Malik S, Sellers EA, Blydt-Hansen T, Chateau D, Dart A. Determinants of Readiness for Adopting Healthy Lifestyle Behaviors Among Indigenous Adolescents with Type 2 Diabetes in Manitoba, Canada: A Cross-Sectional Study. Obesity (Silver Spring) 2018. [PMID: 29533530 DOI: 10.1002/oby.22148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether the readiness for adopting healthy lifestyle behaviors was associated with mental health and comorbid conditions in youth with T2D. METHODS A cross-sectional comparison of various measures of mental health (distress, stress, resilience) and comorbid conditions (glycated hemoglobin, adiposity, hypertension) was conducted within a cohort of indigenous youth with T2D living in Canada, stratified according to their readiness to adopt healthy lifestyle behaviors based on Prochaska's transtheoretical model. RESULTS Within the entire cohort (n = 162), only 14% were considered ready to adopt all healthy lifestyle behaviors. The readiness to adopt all lifestyle behaviors was associated with higher positive mental health (47 vs. 39 units; P < 0.05) and sense of mastery (40 vs. 37 units; P < 0.05), lower perceived stress (27 vs. 29 units; P < 0.05) and distress (8 vs. 10 units; P < 0.05), and better glycemic control (HbA1c: 8.4 ± 2.6% vs. 9.7 ± 2.8%; P < 0.05) compared with youth who were not ready to adopt all lifestyle behaviors. CONCLUSIONS The readiness for adopting healthy lifestyle behaviors is low among adolescents with T2D. Being ready to adopt healthy lifestyle behaviors is associated with better mental health and glycemic control.
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Affiliation(s)
- Jonathan McGavock
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anita Durksen
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brandy Wicklow
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sayma Malik
- Department of Clinical Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Ac Sellers
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tom Blydt-Hansen
- Section of Nephrology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Dan Chateau
- Manitoba Centre for Health Policy, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allison Dart
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme, University of Manitoba, Winnipeg, Manitoba, Canada
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10
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Vujcich D, Thomas J, Crawford K, Ward J. Indigenous Youth Peer-Led Health Promotion in Canada, New Zealand, Australia, and the United States: A Systematic Review of the Approaches, Study Designs, and Effectiveness. Front Public Health 2018; 6:31. [PMID: 29497608 PMCID: PMC5818867 DOI: 10.3389/fpubh.2018.00031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/29/2018] [Indexed: 11/24/2022] Open
Abstract
Background Youth peer-led interventions have become a popular way of sharing health information with young people and appear well suited to Indigenous community contexts. However, no systematic reviews focusing on Indigenous youth have been published. We conducted a systematic review to understand the range and characteristics of Indigenous youth-led health promotion projects implemented and their effectiveness. Methods A systematic search of Medline, Embase, and ProQuest Social Sciences databases was conducted, supplemented by gray literature searches. Included studies focused on interventions where young Indigenous people delivered health information to age-matched peers. Results Twenty-four studies were identified for inclusion, based on 20 interventions (9 Australian, 4 Canadian, and 7 from the United States of America). Only one intervention was evaluated using a randomized controlled study design. The majority of evaluations took the form of pre–post studies. Methodological limitations were identified in a majority of studies. Study outcomes included improved knowledge, attitude, and behaviors. Conclusion Currently, there is limited high quality evidence for the effectiveness of peer-led health interventions with Indigenous young people, and the literature is dominated by Australian-based sexual health interventions. More systematic research investigating the effectiveness of peer-led inventions is required, specifically with Indigenous populations. To improve health outcomes for Indigenous youth, greater knowledge of the mechanisms and context under which peer-delivered health promotion is effective in comparison to other methods of health promotion is needed.
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Affiliation(s)
- Daniel Vujcich
- Aboriginal Health Council of Western Australia, Perth, WA, Australia.,University of Western Australia, Perth, WA, Australia.,University of Notre Dame, Fremantle, WA, Australia
| | - Jessica Thomas
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Flinders University, Adelaide, SA, Australia
| | - Katy Crawford
- Kimberley Aboriginal Medical Service, Broome, WA, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Flinders University, Adelaide, SA, Australia
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11
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McGavock J, Wicklow B, Dart AB. Type 2 diabetes in youth is a disease of poverty. Lancet 2017; 390:1829. [PMID: 29082873 DOI: 10.1016/s0140-6736(17)32461-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 09/05/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Jonathan McGavock
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada.
| | - Brandy Wicklow
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Allison B Dart
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
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12
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Kaar JL, Simon SL, Schmiege SJ, Nadeau KJ, Kelsey MM. Adolescent's Health Behaviors and Risk for Insulin Resistance: A Review of the Literature. Curr Diab Rep 2017; 17:49. [PMID: 28526994 DOI: 10.1007/s11892-017-0881-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW One-third of US adolescents are obese, and related comorbidities exist in this population. Preventing early indicators of these diseases, such as insulin resistance (IR), may impact future morbidity and mortality. Interventions to date have only focused on diet or exercise. Additional targets to prevent disease are needed. This paper reviews the evidence in adolescents examining multiple health behaviors that have been associated with IR. RECENT FINDINGS Health behaviors (i.e., diet, activity, sleep) have been individually examined as possible contributors to disease, but an understanding of the complex interplay between these behaviors is lacking. A better understanding of how multiple health behaviors contribute to IR in adolescents is needed. Future studies using both advanced statistical methodology and robust measures of each health behavior may facilitate better understanding of the impact of lifestyle factors on IR and guide intervention strategies to reduce the risk of disease.
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Affiliation(s)
- Jill L Kaar
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA.
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 395, Aurora, CO, 80045, USA
| | - Sarah J Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13120 East 19th Avenue, Mail Stop C288-04, Aurora, CO, 80045, USA
| | - Kristen J Nadeau
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA
| | - Megan M Kelsey
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA
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13
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Wielgosz A, Dai S, Walsh P, McCrea-Logie J, Celebican E. Comorbid Conditions in Canadians Hospitalized Because of Diabetes. Can J Diabetes 2017; 42:106-111. [PMID: 28579199 DOI: 10.1016/j.jcjd.2017.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/28/2017] [Accepted: 03/07/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The number of hospital discharges involving type 1 or type 2 diabetes as the first-listed diagnosis has increased over the past few decades. Such cases are commonly associated with various comorbidities. We analyzed data collected from hospital separations in Canada to determine the number and proportion of comorbid conditions in Canadians hospitalized because of diabetes. METHODS The most responsible diagnosis (MRDx) of diabetes (ICD-10-CA: E10 [type 1 diabetes] or E11 [type 2 diabetes]) was identified from acute care hospital separations (Discharge Abstract Database) from 2013 to 2014 in all Canadian jurisdictions except Quebec. Hospital separations were calculated by 5-year age groups and sex. The most common comorbid (secondary) diagnoses were identified for hospital separations with diabetes as the MRDx, and the average lengths of stay associated with diabetes were determined. RESULTS The total number of hospital separations in 2013-2014 in Canada (excluding Quebec) with diabetes as the MRDx in all ages was 30,422, and males represented more than half (58.7%) of the separations. The median age group when diabetes is the MRDx is 60 to 64. For all patients hospitalized with an MRDx of diabetes, there were 2.2% deaths. Hypertension was the most common comorbid diagnosis in patients with diabetes as the MRDx, followed by glomerular disorders, peripheral angiopathy and acute renal failure. CONCLUSIONS Hospitalizations resulting from diabetes are associated with vascular comorbidities, and hypertension is the most common. Prevention of shared predisposing factors should reduce the burden of hospitalizations associated with diabetes.
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Affiliation(s)
- Andreas Wielgosz
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
| | - Sulan Dai
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Peter Walsh
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Jennifer McCrea-Logie
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Ece Celebican
- Ece Celebican, Faculty of Law, University of Ottawa, Ottawa, Ontario, Canada
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14
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Shah BR. Innovating in the Delivery of Diabetes Care. Can J Diabetes 2015; 39:441-2. [PMID: 26498220 DOI: 10.1016/j.jcjd.2015.09.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 09/28/2015] [Accepted: 09/28/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Baiju R Shah
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada..
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