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Tangeraas Hansen MJ, Storm M, Syre H, Dalen I, Husebø AML. Attitudes and self-efficacy towards infection prevention and control and antibiotic stewardship among nurses: A mixed-methods study. J Clin Nurs 2023; 32:6268-6286. [PMID: 36841961 DOI: 10.1111/jocn.16657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/06/2023] [Indexed: 02/27/2023]
Abstract
AIMS To gain a comprehensive understanding of nurses' infection control practices, antibiotics stewardship attitudes and self-efficacy when caring for patients with multidrug-resistant bacterial infections in a hospital setting. BACKGROUND Multidrug-resistant bacteria cause a substantial health burden by complicating infections and prolonging hospital stays. Attitudes and self-efficacy can inform professional behaviour. Nurses' attitudes and self-efficacy concerning multidrug-resistant bacteria, infection prevention and control and antibiotic stewardship are vital in keeping patients safe. DESIGN A descriptive and convergent mixed-methods design involving quantitative and qualitative approaches was used. METHODS Two hundred and seventeen nurses working in clinical practice at seven different hospital wards (i.e., general medicine, surgical, haematological and oncology) at a Norwegian university hospital were invited to participate. Data were collected in February and March 2020 via two questionnaires: the Multidrug-Resistant Bacteria Attitude Questionnaire and the General Perceived Self-Efficacy Scale (n = 131) and four focus group interviews (n = 22). The data were analysed using descriptive statistics and systematic text condensation. RESULTS Most nurses showed moderate knowledge, adequate behavioural intentions towards infection prevention and antibiotic stewardship, and high self-efficacy. However, they reported negative emotions towards their knowledge level and negative emotions towards nursing care. The nurses appeared uncertain about their professional influence and role in antibiotic stewardship practices. Organisational and relational challenges and ambivalent perceptions of nurses' role were potential explanations. CONCLUSION Nurses report moderate attitudes and high self-efficacy when caring for patients with multidrug-resistant bacterial infections. This study suggests that nurses experience organisational and relational factors in their work environment that challenge their attitudes towards infection prevention and control and antibiotic stewardship practices. Measures that strengthen their knowledge and emotional response underpin correct infection prevention and control behaviour. A role clarification is needed for antibiotic stewardship. No Patient or Public Contribution. RELEVANCE TO CLINICAL PRACTICE Measures to increase attitudes towards infection prevention and control, antibiotic stewardship and multidrug resistance is recommended. Measures should be taken to overcome organisational challenges. A clarification of the nurses' role in antibiotic stewardship is needed.
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Affiliation(s)
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Heidi Syre
- Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway
| | - Ingvild Dalen
- Section of Biostatistics, Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Anne Marie Lunde Husebø
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Rossiter C, Cheng H, Denney-Wilson E. Primary healthcare professionals' role in monitoring infant growth: A scoping review. J Child Health Care 2023:13674935231165897. [PMID: 36963017 DOI: 10.1177/13674935231165897] [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] [Indexed: 03/26/2023]
Abstract
Excessive weight gain in infancy is an established risk for childhood obesity. Primary healthcare professionals have regular contact with infants and are well placed to monitor their growth. This review explores primary healthcare professionals' practice in monitoring growth for infants from birth to 2 years, addressing assessment methods, practitioner confidence and interventions for unhealthy weight gain. Reviewers searched four databases for studies of primary healthcare professionals working in high-income countries that reported on practice monitoring infant growth. Thirty-six eligible studies documented health professionals' practice with infants. While most clinicians regularly weighed and measured infants, some did not record measurements comprehensively. Growth monitoring occurred regularly during well-child visits but was less common during unscheduled visits. Some participants were less proficient at interpreting growth trajectories or lacked confidence in detecting excessive weight gain and in communicating concerns to parents. Few interventions addressed unhealthy growth among infants. Primary healthcare professionals require support to monitor growth trajectories effectively, to communicate appropriately with parents and to engage them in developing healthy behaviours early. Strategies are also required to monitor infants not regularly attending primary health care.
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Affiliation(s)
- Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, 522555The University of Sydney, New South Wales, Australia
| | - Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, 522555The University of Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, 522555The University of Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), Australia
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3
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Côté MK, Gagné MH. Changes in practitioners' attitudes, perceived training needs and self-efficacy over the implementation process of an evidence-based parenting program. BMC Health Serv Res 2020; 20:1092. [PMID: 33246447 PMCID: PMC7694945 DOI: 10.1186/s12913-020-05939-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 11/18/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Evidence-based family support programs such as the Triple P - Positive Parenting Program have the potential to enhance the well-being of children and families. However, they cannot achieve their expected outcomes if insufficient attention is paid to the implementation process. It has been demonstrated that practitioners' attitudes towards evidence-based programs (EBPs), perceived training needs and self-efficacy for working with parents influence implementation outcomes (e.g., program acceptability, adoption, adherence and sustainability). At the same time, the experience of being involved in the implementation process of an EBP could enhance practitioners' perceptions of the initiative. This study aimed to assess changes in practitioner's attitudes, perceived training needs and self-efficacy over a two-year EBP implementation process, in interaction with their appraisal of their organization's capacity to implement the EPB. METHODS In the province of Quebec, Canada, Triple P was implemented and evaluated in two communities. Ninety-nine practitioners from various organizations completed questionnaires shortly before their training in Triple P and two years later. RESULTS Findings show that practitioners who displayed more initial skepticism regarding their organization's capacity to implement the program reported greater improvements in attitudes over time, while practitioners who showed more optimism at baseline reported a greater decrease in their perceived training needs. Practitioners' self-efficacy increased moderately regardless of perceived organizational capacity. CONCLUSIONS These results are encouraging given that more positive perceptions of EBPs could foster the systematic use of these programs in communities, for the potential benefit of a greater number of families.
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Affiliation(s)
- Marie-Kim Côté
- Université Laval, 2325 rue de l’Université, Québec, QC G1V 0A6 Canada
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4
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Caron EB, Drake KL, Stewart CE, Muggeo MA, Ginsburg GS. Intervention Adherence and Self-Efficacy as Predictors of Child Outcomes in School Nurse-Delivered Interventions for Anxiety. J Sch Nurs 2020; 38:249-258. [PMID: 32410495 DOI: 10.1177/1059840520925522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the association between two implementation factors, nurse-reported intervention adherence and self-efficacy, and children's outcomes in school nurse-delivered anxiety interventions. Data were collected in a pilot randomized controlled effectiveness trial with 54 children and 21 school nurses. Nurses implemented either a cognitive behavioral or relaxation-skills-only intervention. Nurse questionnaires assessed implementation factors. Independent evaluators assessed changes in children's anxiety symptoms at postintervention and at 3-month follow-up using clinical improvement and global functioning scales. Regression analyses indicated that greater intervention adherence was associated with greater anxiety symptom improvement at follow-up. Nurse self-efficacy interacted with intervention group, such that nurses with higher self-efficacy who implemented the cognitive behavioral intervention tended to have children show improvement and higher postintervention functioning. The impact of implementation factors on children's outcomes may differ depending on intervention type. Self-efficacy may be important for nurses using relatively complex interventions. Intervention adherence should be supported through training and consultation.
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Affiliation(s)
- E B Caron
- Department of Psychological Science, Fitchburg State University, MA, USA
| | - Kelly L Drake
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.,Anxiety Treatment Center of Maryland, Columbia, MD, USA
| | - Catherine E Stewart
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, West Hartford, CT, USA
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5
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Börjesson U, Wigren M, Billhult A, Nordeman L, Gunnarsson R. Providing Mothers with a Pedometer and Subsequent Effect on the Physical Activity of Their Children: A Randomized Controlled Trial of Children with Obesity. Child Obes 2020; 16:20-25. [PMID: 31580727 DOI: 10.1089/chi.2019.0078] [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] [Indexed: 11/12/2022]
Abstract
Background: Obesity continues to rise, particularly among children, and is one of the greatest public health challenges of the 21st century. Physical activity may reduce weight and increase well-being. A pedometer study from the United States, Australia, and Sweden showed that boys need to walk 15,000 steps/day, and girls 12,000 steps/day to maintain a healthy profile. Research shows children with obesity have limited physical activity and they may need parent support to increase their physical activity level. Objective: The aim of this randomized controlled study was to estimate the effect of mothers using pedometers on their children's daily number of steps. Methods: Children/adolescents aged 6-16 years were included and all of them received a pedometer and a step diary. In the intervention group, their mothers received pedometers but not so in the control group. Fifty children were randomized and 32 could be followed-up for 24 weeks. There was no difference in outcome between groups in intention to treat analysis. A complete case analysis showed that the intervention group increased their daily steps (2400, 95% confidence interval 430-4500) compared with the control group (p = 0.019). Conclusions: Involving and activating mothers may increase the children and adolescent's physical activity if implemented more successfully than was done in this study.
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Affiliation(s)
| | - Margareta Wigren
- Region Västra Götaland Närhälsan, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden
| | - Annika Billhult
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Lena Nordeman
- Region Västra Götaland Närhälsan, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden.,Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ronny Gunnarsson
- Region Västra Götaland Närhälsan, Research and Development Primary Health Care, Research and Development Center Södra Älvsborg, Borås, Sweden.,Unit of Primary Health Care, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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6
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Enö Persson J, Bohman B, Tynelius P, Rasmussen F, Ghaderi A. Prevention of Childhood Obesity in Child Health Services: Follow-Up of the PRIMROSE Trial. Child Obes 2019; 14:99-105. [PMID: 29232526 DOI: 10.1089/chi.2017.0117] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Childhood obesity is an urgent public health concern, and there's a need for long-term, high-quality, primary prevention trials targeting parents of young children. The aim of the current study was to evaluate the long-term effect of a parental support program based on motivational interviewing (MI). METHODS A cluster randomized controlled trial was carried out in eight Swedish counties. Participating families (N = 1355) were enrolled when the child was 9 months old, and participated in nine sessions during ∼39 months. The aim was to pomote healthy food and physical activity (PA) habits using MI and principles from cognitive behavioral therapy. Nurses in Swedish child health services delivered the intervention, and the control group received usual healthcare. The current study was a 1-year follow-up of effects on children's weight-related measures. Regression analyses were conducted using generalized estimating equations, including analyses to investigate potential parental moderators of the effect. RESULTS There were no statistically significant intervention effects at follow-up [BMI difference = -0.13, p = 0.29, overweight relative risk (RR) = 0.96, p = 0.78, obesity RR = 0.57, p = 0.20]. Maternal waist circumference and unhealthy eating and paternal PA moderated the effect, but effects were small and failed to reach statistical significance after correction for multiple comparisons. CONCLUSIONS A parent-focused primary prevention intervention based on MI delivered within child health services did not result in effects at 1-year follow-up. The results were in line with those obtained at post-assessment and indicated no late onset of effect. Further studies exploring individual and contextual factors influencing the outcome are called for.
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Affiliation(s)
- Johanna Enö Persson
- 1 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
| | - Benjamin Bohman
- 1 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden .,2 Centre for Psychiatry Research , Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Per Tynelius
- 3 Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet , Stockholm, Sweden .,4 Centre for Epidemiology and Community Medicine, Stockholm County Council, Health Care Services , Stockholm, Sweden
| | - Finn Rasmussen
- 5 Department of Health Sciences, Lund University , Lund, Sweden
| | - Ata Ghaderi
- 1 Department of Clinical Neuroscience, Karolinska Institutet , Stockholm, Sweden
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Enö Persson J, Bohman B, Forsberg L, Beckman M, Tynelius P, Rasmussen F, Ghaderi A. Proficiency in Motivational Interviewing among Nurses in Child Health Services Following Workshop and Supervision with Systematic Feedback. PLoS One 2016; 11:e0163624. [PMID: 27685152 PMCID: PMC5042524 DOI: 10.1371/journal.pone.0163624] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 09/12/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research on training in motivational interviewing (MI) has shown eroding skills after workshops not followed by additional training input (supervision/coaching). There is a need for more research evaluating different types and lengths of post-workshop training with follow-up periods extending six months. This study is an extension of a previous evaluation of the level of proficiency in MI after workshop and four sessions of supervision among nurses in Swedish child health services. AIMS To explore the level of MI proficiency among nurses participating in an intervention to prevent childhood obesity (n = 33), after receiving five additional sessions of supervision including feedback on observed practice, as well as level of proficiency at follow-up. METHODS Level of proficiency was measured 4 and 12 months after completed supervision using recorded practice samples coded according to the Motivational Interviewing Treatment Integrity (MITI) Code. Potential predictors of outcome were investigated. RESULTS Proficiency remained on the same levels after nine sessions of supervision as after four sessions, and was generally low. The percentage of nurses reaching the proficiency level ranged from 18.2 to 54.5% across indicators. MI-spirit had increased significantly at follow-up, and the rest of the indicators remained on the same levels. No predictors of outcome were found. CONCLUSIONS Comprehensive training programs with prolonged post-workshop supervision and feedback on observed practice may help to sustain but not improve participants' proficiency in MI. Potential explanations to the results and suggestions for future research are discussed.
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Affiliation(s)
- Johanna Enö Persson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Benjamin Bohman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatric Research, Stockholm Health Care Services, Stockholm, Sweden
| | | | - Maria Beckman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Per Tynelius
- Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Health Care Services, Stockholm, Sweden
| | - Finn Rasmussen
- Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Health Care Services, Stockholm, Sweden
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Döring N, Ghaderi A, Bohman B, Heitmann BL, Larsson C, Berglind D, Hansson L, Sundblom E, Magnusson M, Blennow M, Tynelius P, Forsberg L, Rasmussen F. Motivational Interviewing to Prevent Childhood Obesity: A Cluster RCT. Pediatrics 2016; 137:peds.2015-3104. [PMID: 27244793 DOI: 10.1542/peds.2015-3104] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective was to evaluate a manualized theory-driven primary preventive intervention aimed at early childhood obesity. The intervention was embedded in Swedish child health services, starting when eligible children were 9 to 10 months of age and continuing until the children reached age 4. METHODS Child health care centers in 8 Swedish counties were randomized into intervention and control units and included 1355 families with 1369 infants. Over ∼39 months, families in the intervention group participated in 1 group session and 8 individual sessions with a nurse trained in motivational interviewing, focusing on healthy food habits and physical activity. Families in the control group received care as usual. Primary outcomes were children's BMI, overweight prevalence, and waist circumference at age 4. Secondary outcomes were children's and mothers' food and physical activity habits and mothers' anthropometrics. Effects were assessed in linear and log-binominal regression models using generalized estimating equations. RESULTS There were no statistically significant differences in children's BMI (β = -0.11, 95% confidence interval [CI]: -0.31 to 0.08), waist circumference (β = -0.48, 95% CI: -0.99 to 0.04), and prevalence of overweight (relative risk = 0.95, 95% CI: 0.69 to 1.32). No significant intervention effects were observed in mothers' anthropometric data or regarding mothers' and children's physical activity habits. There was a small intervention effect in terms of healthier food habits among children and mothers. CONCLUSIONS There were no significant group differences in children's and mothers' anthropometric data and physical activity habits. There was, however, some evidence suggesting healthier food habits, but this should be interpreted with caution.
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Affiliation(s)
- Nora Döring
- Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, and
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Benjamin Bohman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatric Research, Health Care Services, Stockholm, Sweden
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark; The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia; National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christel Larsson
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Berglind
- Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, and
| | - Lena Hansson
- Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, and
| | - Elinor Sundblom
- Centre for Epidemiology and Community Medicine, Health Care Services, Stockholm County Council, Solna, Sweden
| | - Margaretha Magnusson
- Department of Women's and Children's Health, Uppsala University and Central Child Healthcare Unit, Uppsala University Hospital, Uppsala, Sweden; and
| | - Margareta Blennow
- Department of Clinical Science and Education, Child Health Services, Södersjukhuset, Stockholm, Sweden
| | - Per Tynelius
- Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, and Centre for Epidemiology and Community Medicine, Health Care Services, Stockholm County Council, Solna, Sweden
| | - Lars Forsberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Finn Rasmussen
- Child and Adolescent Public Health Epidemiology, Department of Public Health Sciences, and Centre for Epidemiology and Community Medicine, Health Care Services, Stockholm County Council, Solna, Sweden;
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Self-efficacy and Knowledge of Nurse Practitioners to Prevent Pediatric Obesity. J Nurse Pract 2015. [DOI: 10.1016/j.nurpra.2015.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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10
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Döring N, Hansson LM, Andersson ES, Bohman B, Westin M, Magnusson M, Larsson C, Sundblom E, Willmer M, Blennow M, Heitmann BL, Forsberg L, Wallin S, Tynelius P, Ghaderi A, Rasmussen F. Primary prevention of childhood obesity through counselling sessions at Swedish child health centres: design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised trial. BMC Public Health 2014; 14:335. [PMID: 24717011 PMCID: PMC3995501 DOI: 10.1186/1471-2458-14-335] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 04/02/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Childhood obesity is a growing concern in Sweden. Children with overweight and obesity run a high risk of becoming obese as adults, and are likely to develop comorbidities. Despite the immense demand, there is still a lack of evidence-based comprehensive prevention programmes targeting pre-school children and their families in primary health care settings. The aims are to describe the design and methodology of the PRIMROSE cluster-randomised controlled trial, assess the relative validity of a food frequency questionnaire, and describe the baseline characteristics of the eligible young children and their mothers. METHODS/DESIGN The PRIMROSE trial targets first-time parents and their children at Swedish child health centres (CHC) in eight counties in Sweden. Randomisation is conducted at the CHC unit level. CHC nurses employed at the participating CHC received training in carrying out the intervention alongside their provision of regular services. The intervention programme, starting when the child is 8-9 months of age and ending at age 4, is based on social cognitive theory and employs motivational interviewing. Primary outcomes are children's body mass index and waist circumference at four years. Secondary outcomes are children's and mothers' eating habits (assessed by a food frequency questionnaire), and children's and mothers' physical activity (measured by accelerometer and a validated questionnaire), and mothers' body mass index and waist circumference. DISCUSSION The on-going population-based PRIMROSE trial, which targets childhood obesity, is embedded in the regular national (routine) preventive child health services that are available free-of-charge to all young families in Sweden. Of the participants (n = 1369), 489 intervention and 550 control mothers (75.9%) responded to the validated physical activity and food frequency questionnaire at baseline (i.e., before the first intervention session, or, for children in the control group, before they reached 10 months of age). The food frequency questionnaire showed acceptable relative validity when compared with an 8-day food diary. We are not aware of any previous RCT, concerned with the primary prevention of childhood obesity through sessions at CHC that addresses healthy eating habits and physical activity in the context of a routine child health services programme. TRIAL REGISTRATION ISRCTN16991919.
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Affiliation(s)
- Nora Döring
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
| | - Lena M Hansson
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
| | - Elina Scheers Andersson
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
| | - Benjamin Bohman
- Department of Clinical Neuroscience, Karolinska Institutet, Division of Psychology, Stockholm, Sweden
| | - Maria Westin
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
| | - Margaretha Magnusson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Christel Larsson
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
- Department of Food and Nutrition, Umeå University, Umeå, Sweden
| | - Elinor Sundblom
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Health Care Services, Stockholm, Sweden
| | - Mikaela Willmer
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
| | - Margareta Blennow
- Department of Clinical Science and Education, Child Health Services, Södersjukhuset, Stockholm, Sweden
| | - Berit L Heitmann
- Research Unit for Dietary Studies, Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorder, University of Sydney, Sydney, Australia
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lars Forsberg
- Department of Clinical Neuroscience, Karolinska Institutet, Centre of Psychiatry Research, Stockholm, Sweden
| | - Sanna Wallin
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
| | - Per Tynelius
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Health Care Services, Stockholm, Sweden
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Division of Psychology, Stockholm, Sweden
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institutet, Child and Adolescent Public Health Epidemiology, Tomtebodavägen 18A, Stockholm SE-171 77, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Health Care Services, Stockholm, Sweden
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