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Haile SR, Peralta GP, Raineri A, Rueegg S, Ulytė A, Puhan MA, Radtke T, Kriemler S. Determinants of health-related quality of life in healthy children and adolescents during the COVID-19 pandemic: Results from a prospective longitudinal cohort study. Eur J Pediatr 2024; 183:2273-2283. [PMID: 38411717 PMCID: PMC11035415 DOI: 10.1007/s00431-024-05459-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/28/2024]
Abstract
Understanding health-related quality of life (HRQOL) in children and adolescents, during a pandemic and afterwards, aids in understanding how circumstances in their lives impact their well-being. We aimed to identify determinants of HRQOL from a broad range of biological, psychological, and social factors in a large longitudinal population-based sample. Data was taken from a longitudinal sample (n = 1843) of children and adolescents enrolled in the prospective school-based cohort study Ciao Corona in Switzerland. The primary outcome was HRQOL, assessed using the KINDL total score and its subscales (each from 0, worst, to 100, best). Potential determinants, including biological (physical activity, screen time, sleep, etc.), psychological (sadness, anxiousness, stress), and social (nationality, parents' education, etc.) factors, were assessed in 2020 and 2021 and HRQOL in 2022. Determinants were identified in a data-driven manner using recursive partitioning to define homogeneous subgroups, stratified by school level. Median KINDL total score in the empirically identified subgroups ranged from 68 to 83 in primary school children and from 69 to 82 in adolescents in secondary school. The psychological factors sadness, anxiousness, and stress in 2021 were identified as the most important determinants of HRQOL in both primary and secondary school children. Other factors, such as physical activity, screen time, chronic health conditions, or nationality, were determinants only in individual subscales. CONCLUSION Recent mental health, more than biological, physical, or social factors, played a key role in determining HRQOL in children and adolescents during pandemic times. Public health strategies to improve mental health may therefore be effective in improving HRQOL in this age group. WHAT IS KNOWN • Assessing health-related quality of life (HRQOL) in children and adolescents aids in understanding how life circumstances impact their well-being. • HRQOL is a complex construct, involving biological, psychological, and social factors. Factors driving HRQOL in children and adolescents are not often studied in longitudinal population-based samples. WHAT IS NEW • Mental health (stress, anxiousness, sadness) played a key role in determining HRQOL during the coronavirus pandemic, more than biological or social factors. • Public health strategies to improve mental health may be effective in improving HRQOL in children.
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Affiliation(s)
- Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Gabriela P Peralta
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Alessia Raineri
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sonja Rueegg
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | | | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
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Rhodes ET, Phan TLT, Earley ER, Eneli I, Haemer MA, Highfield NC, Khan S, Kim G, Kirk S, Sullivan EM, Stoll JM, Werk LN, Zeribi KA, Forrest CB, Lannon C. Patient-Reported Outcomes to Describe Global Health and Family Relationships in Pediatric Weight Management. Child Obes 2024; 20:1-10. [PMID: 36827448 PMCID: PMC10790547 DOI: 10.1089/chi.2022.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Background: Patient-reported outcomes (PROs) can assess chronic health. The study aims were to pilot a survey through the PEDSnet Healthy Weight Network (HWN), collecting PROs in tertiary care pediatric weight management programs (PWMP) in the United States, and demonstrate that a 50% enrollment rate was feasible; describe PROs in this population; and explore the relationship between child/family characteristics and PROs. Methods: Participants included 12- to 18-year-old patients and parents of 5- to 18-year-olds receiving care at PWMP in eight HWN sites. Patient-Reported Outcomes Measurement Information System (PROMIS®) measures assessed global health (GH), fatigue, stress, and family relationships (FR). T-score cut points defined poor GH or FR or severe fatigue or stress. Generalized estimating equations explored relationships between patient/family characteristics and PROMIS measures. Results: Overall, 63% of eligible parents and 52% of eligible children enrolled. Seven sites achieved the goal enrollment for parents and four for children. Participants included 1447 children. By self-report, 44.6% reported poor GH, 8.6% poor FR, 9.3% severe fatigue, and 7.6% severe stress. Multiple-parent household was associated with lower odds of poor GH by parent proxy report [adjusted odds ratio (aOR) 0.69, 95% confidence interval (CI) 0.55-0.88] and poor FR by self-report (aOR 0.36, 95% CI 0.17-0.74). Parents were significantly more likely to report that the child had poor GH and poor FR when a child had multiple households. Conclusions: PROs were feasibly assessed across the HWN, although implementation varied by site. Nearly half of the children seeking care in PWMP reported poor GH, and family context may play a role. Future work may build on this pilot to show how PROs can inform clinical care in PWMP.
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Affiliation(s)
- Erinn T. Rhodes
- Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA
| | - Thao-Ly T. Phan
- Department of General Pediatrics, Nemours Children's Health System/Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Elizabeth R. Earley
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - Matthew A. Haemer
- Section of Nutrition, Department of Pediatrics, University of Colorado, Denver, CO, USA
| | | | - Saba Khan
- The Healthy Weight Program and Policy Lab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Grace Kim
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Shelley Kirk
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- The Heart Institute and Center for Better Health and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Janis M. Stoll
- Division of Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Lloyd N. Werk
- Department of Pediatrics, Nemours Children's Hospital, Orlando, FL, USA
| | - Karen Askov Zeribi
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Christopher B. Forrest
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carole Lannon
- Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Resnicow K, Delacroix E, Sonneville KR, Considine S, Grundmeier RW, Shu D, Faerber JA, Fiks AG, Steffes J, Harris D, Woo H, Proctor T, Wright ME, Shone LP, Barlow SE, Wasserman RC, Siegel R, Stockwell MS. Outcome of BMI2+: Motivational Interviewing to Reduce BMI Through Primary Care AAP PROS Practices. Pediatrics 2024; 153:e2023062462. [PMID: 38282541 PMCID: PMC10827646 DOI: 10.1542/peds.2023-062462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Pediatric obesity rates in the United States remain at an all-time high. Pediatric primary care clinicians and registered dietitians can help treat childhood obesity, and motivational interviewing (MI) has shown promising effects in prior trials. METHODS We randomized 18 pediatric primary care practices to receive the Brief Motivational Interviewing to Reduce BMI or BMI2+ intervention or continue with usual care (UC). Practices were recruited through the American Academy of Pediatrics Pediatric Research in Office Settings network. The intervention comprised 4 components1: in-person and telehealth MI counseling by pediatric clinicians; 4 recommended sessions,2 6 telephone MI counseling sessions from a registered dietitian,3 text message reminders and tailored motivational messages, and4 parent educational materials. The main outcome was the change in the percentage of the 95th percentile of BMI. The study was conducted 2017 through 2021. RESULTS There was a significant treatment x time interaction (b = 0.017, 95% confidence interval: [0.0066-0.027]) for the main outcome, favoring the UC group, with youth in the intervention arm showing a greater relative increase in their percent of the 95th percentile. CONCLUSIONS There was no overall benefit of the intervention and, contrary to expectations, youth in the intervention arm gained more weight, based on percent of the distance from the 95th percentile than matched youth from UC practices. The absolute excess weight gain among intervention relative to UC youth was small, approximately 0.5 BMI units and 1 kg over 2 years. We offer several potential explanations for these unexpected findings.
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Affiliation(s)
- Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Emerson Delacroix
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | | | - Shannon Considine
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | | | - Di Shu
- Department of Pediatrics, Children’s Hospital of Philadelphia, Pennsylvania
| | | | - Alexander G. Fiks
- Department of Pediatrics, Children’s Hospital of Philadelphia, Pennsylvania
| | - Jennifer Steffes
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois
| | - Donna Harris
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois
| | - Heide Woo
- Department of Pediatrics, University of California Los Angeles, Los Angeles, California
| | - Tim Proctor
- Physician’s Computer Company, Winooski, Vermont
| | | | | | - Sarah E. Barlow
- Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, Texas
| | | | - Robert Siegel
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Melissa S. Stockwell
- Division of Child Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York
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Reinbacher P, Draschl A, Smolle MA, Hecker A, Gaderer F, Lanner KB, Ruckenstuhl P, Sadoghi P, Leithner A, Nehrer S, Klestil T, Brunnader K, Bernhardt GA. The Impact of Obesity on the Health of the Older Population: A Cross-Sectional Study on the Relationship between Health-Related Quality of Life and Body Mass Index across Different Age Groups. Nutrients 2023; 16:51. [PMID: 38201881 PMCID: PMC10780898 DOI: 10.3390/nu16010051] [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: 11/05/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Obesity is strongly associated with mortality and morbidity, but there is a lack of data on its impact on health-related quality of life (HRQoL) across different age groups. Therefore, this study's objective was to determine the association between body mass index (BMI) and HRQoL in the Austrian adult population based on age groups using the 36-Item Short Form (SF-36) survey. METHODS The SF-36 survey was sent to 500 randomly assigned Austrian adults (response rate: 80.6%). This study assessed HRQoL subscale and component scores based on gender, level of education, smoking status, and alcohol consumption in 403 participants. RESULTS Increasing BMI is associated with a negative impact on all domains of physical health and social function. The study uncovered substantial variations in the impact of increasing BMI on HRQoL across different age groups, with a pronounced effect observed in the physical components, particularly among individuals aged 65-74. CONCLUSIONS BMI is negatively associated with the physical aspects of HRQoL and social function, affecting various adult age groups differently. Consequently, our results emphasize assessing different age groups and possible influencing factors on HRQoL, such as BMI, for further optimization in designing prevention programs against obesity.
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Affiliation(s)
- Patrick Reinbacher
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
| | - Alexander Draschl
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
- COREMED-Centre for Regenerative and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria
| | - Maria Anna Smolle
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Andrzej Hecker
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
- COREMED-Centre for Regenerative and Precision Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria
| | - Franz Gaderer
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Kay-Bernd Lanner
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
| | - Paul Ruckenstuhl
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Patrick Sadoghi
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Andreas Leithner
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Stefan Nehrer
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
| | - Thomas Klestil
- Faculty Health & Medicine, University for Continuing Education, 3500 Krems, Austria; (F.G.); (K.-B.L.)
- Department of Orthopaedics and Trauma, Landesklinikum Baden-Mödling, 2340 Mödling, Austria
| | - Kevin Brunnader
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
| | - Gerwin A. Bernhardt
- Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria; (P.R.); (P.R.); (P.S.); (A.L.); (K.B.); (G.A.B.)
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Hämäläinen L, Kohonen M, Laurikka J. Health-related quality of life is improved after coronary artery bypass graft surgery: a 1-year follow-up study. SCAND CARDIOVASC J 2023; 57:2284083. [PMID: 38010887 DOI: 10.1080/14017431.2023.2284083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 11/11/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES The purpose of this study was to detect changes in QoL after coronary artery bypass grafting surgeries (CABG) in one year, and to identify the possible predictive factors associated with the change. DESIGN A single-center prospective study of 501 patients was conducted between 2013 and 2018 using the EQ-5D VAS questionnaire for estimating the QoL. The patients filled in a questionnaire preoperatively, at 6 and at 12 months postoperatively. Univariate and multivariable logistic regression analyses were used to find out if certain pre-selected factors or EQ5D dimensions had independent effects on the observed EQ VAS scores. RESULTS QoL improved in all EQ-5D dimensions and in EQ VAS scores at 6 and at 12 months: the greatest changes in the number of reported problems were in the dimensions "mobility" (-34.2%, p<.001), "self-care" (-36.7%, p=.001) and "pain or discomfort" (-31.0%, p<.001). With the multivariable regression model, we could show that normal left ventricle ejection fraction (LVEF) and improvement in mobility and pain/discomfort dimensions were in association with improvement of EQ VAS score at 6 months. At 12 months this association was no longer detectable. CONCLUSIONS CABG procedure can improve patient's QoL when judged with EQ5D dimensions and related overall self-rated health (VAS). This improvement was seen both at 6 and at 12 months postoperatively. Except for LVEF, the other patient-specific risk factors we examined did not seem to affect QoL in the long term.
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Affiliation(s)
- Laura Hämäläinen
- Finnish Cardiovascular Research Center Tampere, Tampere University, Tampere, Finland
| | - Mika Kohonen
- Tampere University Hospital Heart Center, Tampere, Finland
| | - Jari Laurikka
- Finnish Cardiovascular Research Center Tampere, Tampere University, Tampere, Finland
- Tampere University Hospital Heart Center, Tampere, Finland
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Tian J, Blizzard L, Campbell JA, Gall S, Dwyer T, Venn A. Association of body mass index from childhood to mid-adulthood with health-related quality of life in mid-adulthood. Qual Life Res 2023; 32:3349-3358. [PMID: 37668925 PMCID: PMC10624736 DOI: 10.1007/s11136-023-03497-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Most studies regarding the association of obesity with health-related quality of life (HRQoL) have assessed obesity at only one or two time points. We aimed to examine the associations of life course body mass index (BMI) from childhood with health-related quality of life (HRQoL) in mid-adulthood. METHODS Data were from a cohort study of Australian children (n = 2254, mean baseline age 12.0 (2.0) years in 1985, 46.8% male). Weight and height were measured at baseline and measured or self-reported on average 20, 25, and 30 years later. Age and sex-standardised BMI-z score was calculated at each time point. Physical and mental HRQoL and health state utilities (HSUs) were measured by SF-12 and SF-6D at the last adult follow-up. Linear regression was used to examine the associations adjusting for age, sex, and childhood health status. RESULTS Higher BMI-z score in childhood (βadjusted - 1.39, 95% CI - 1.73 to - 1.05) and increasing BMI-z score from childhood to young adulthood (βadjusted - 1.82, 95% CI - 2.17 to - 1.46) and from young to mid-adulthood (βadjusted - 1.77, 95% CI - 2.28 to - 1.26) were associated with lower physical HRQoL in mid-adulthood. Similar results were found for mid-adulthood HSUs (βadjusted ranged - 0.006 to - 0.014, all P < 0.05). Only increasing BMI-z score from young to mid-adulthood significantly related to poorer mental HRQoL (βadjusted - 0.74, 95% CI - 1.29 to - 0.19) in mid-adulthood. CONCLUSION High BMI from childhood to mid-adulthood had only modest associations with HRQoL and HSUs, with effects on physical HRQoL most apparent.
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Affiliation(s)
- Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Julie A Campbell
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
- The George Institute for Global Health, University of Oxford, Wellington Square, Oxford, UK
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
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Hayes A, Raghunandan R, Killedar A, Smith S, Cvejic E, Howell M, Petrou S, Lancsar E, Wong G, Craig J, Howard K. Reliability, acceptability, validity and responsiveness of the CHU9D and PedsQL in the measurement of quality of life in children and adolescents with overweight and obesity. Int J Obes (Lond) 2023:10.1038/s41366-023-01305-5. [PMID: 37072461 DOI: 10.1038/s41366-023-01305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND The Paediatric Quality of life Inventory (PedsQLTM) Generic Core Scales and the Child Health Utilities 9 Dimensions (CHU9D) are two paediatric health-related quality of life (HRQoL) measures commonly used in overweight and obesity research. However, no studies have comprehensively established the psychometric properties of these instruments in the context of paediatric overweight and obesity. The aim of this study was to assess the reliability, acceptability, validity and responsiveness of the PedsQL and the CHU9D in the measurement of HRQoL among children and adolescents living with overweight and obesity. SUBJECTS/METHODS Subjects were 6544 child participants of the Longitudinal Study of Australian Children, with up to 3 repeated measures of PedsQL and CHU9D and aged between 10 and 17 years. Weight and height were measured objectively by trained operators, and weight status determined using World Health Organisation growth standards. We examined reliability, acceptability, known group and convergent validity and responsiveness, using recognised methods. RESULTS Both PedsQL and CHU9D demonstrated good internal consistency reliability, and high acceptability. Neither instrument showed strong convergent validity, but PedsQL appears to be superior to the CHU9D in known groups validity and responsiveness. Compared with healthy weight, mean (95%CI) differences in PedsQL scores for children with obesity were: boys -5.6 (-6.2, -4.4); girls -6.7 (-8.1, -5.4) and differences in CHU9D utility were: boys -0.02 (-0.034, -0.006); girls -0.035 (-0.054, -0.015). Differences in scores for overweight compared with healthy weight were: PedsQL boys -2.2 (-3.0, -1.4) and girls -1.3 (-2.0, -0.6) and CHU9D boys: no significant difference; girls -0.014 (-0.026, -0.003). CONCLUSION PedsQL and CHU9D overall demonstrated good psychometric properties, supporting their use in measuring HRQoL in paediatric overweight and obesity. CHU9D had poorer responsiveness and did not discriminate between overweight and healthy weight in boys, which may limit its use in economic evaluation.
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Affiliation(s)
- Alison Hayes
- University of Sydney School of Public Health, Sydney, NSW, Australia.
| | - Rakhee Raghunandan
- University of Sydney School of Public Health, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Anagha Killedar
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Sarah Smith
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Erin Cvejic
- University of Sydney School of Public Health, Sydney, NSW, Australia
| | - Martin Howell
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australia National University, Canberra, ACT, Australia
| | - Germaine Wong
- University of Sydney School of Public Health, Sydney, NSW, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Kirsten Howard
- University of Sydney School of Public Health, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
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Saleh MS, Mohammed AM, Bassiouni D, Mostafa HH, Monir ZM. Evaluation of health-related quality of life and its domains in pediatric patients with cancer. J Egypt Natl Canc Inst 2023; 35:9. [PMID: 37062773 DOI: 10.1186/s43046-023-00168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/19/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Health-related quality of life has emerged as a significant component in pediatric oncology research during the last several decades. Measures of health-related quality of life provide a thorough assessment of the child's response to medical therapy, disease course, and adjustment outcomes in the context of pediatric oncology. METHODS The aim of the present study was to assess the cancer-specific health-related quality of life in cancer pediatric patients and to evaluate the contribution of its domains and some of the anthropometric, sociodemographic, and treatment-related variables on the overall quality of life, by using the PedsQL™ 3.0 Cancer Module. RESULTS The study included 110 cases. The mean value of the PedsQL™ 3.0 Cancer Module score was 49.3 ± 12.0. The lowest mean score of quality of life was for the "procedure anxiety" (8.7 ± 23.9), followed by the "worry" domains (16.6 ± 28.5). Higher "frequency of hospital visits" was associated with increased feeling of pain and treatment anxiety yet decrease in suffering from nausea and vice versa. The longer period of hospital admission for more than half of the recommended treatment period was associated with reduced pain suffering on the expense of increase in feeling of worry as well as communication problems. The perceived physical appearance was better among those patients who spent a treatment period for 3-6 months when compared to those who spent a treatment period less than 3 months or more than 6 months. There was a highly significant association between all the eight-cancer-specific quality-of-life domains except the pain domain- and the overall quality-of-life log scores. Nausea problem followed by worry and cognitive problems was the most effective domains on the overall quality-of-life score. CONCLUSION Cancer pediatric patients suffered low quality of life especially for anxiety procedure and worry domains with special consideration for the impact of nausea, worry, and cognitive problems on their perception of quality of life.
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Affiliation(s)
- Mai Sabry Saleh
- Department of Environmental and Occupational Medicine, National Research Centre, Giza, Egypt
| | - Asmaa Mahmoud Mohammed
- Department of Environmental and Occupational Medicine, National Research Centre, Giza, Egypt
| | - Dina Bassiouni
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Giza, Egypt
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Alanne S, Koivuniemi E, Löyttyniemi E, Laitinen K. Elementary School-Aged Children's and Parents' Report of Health-Related Quality of Life and Relationships with Lifestyle Measures: A Cross-Sectional Study. Nutrients 2023; 15:nu15051264. [PMID: 36904263 PMCID: PMC10005714 DOI: 10.3390/nu15051264] [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: 02/19/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Supporting a child's health-promoting lifestyle is an investment in their future health and health-related quality of life (HRQoL). Particularly children with overweight and obesity may be at an increased risk of a poor HRQoL. Currently, a comprehensive evaluation of lifestyle factors and age in relation to HRQoL in healthy children and, further, separate child and parental proxy-reports of HRQoL are lacking. The aims of this cross-sectional study in Finland are to compare healthy elementary school-aged children's and parents' reports of the child's HRQoL, and to view them in relation to lifestyle markers. The HRQoL was measured with Pediatric Quality of Life InventoryTM 4.0, and the following lifestyle markers: leisure-time physical activity as MET, diet quality via a validated index (ES-CIDQ), sleeping time and screen time by questionnaires. Furthermore, age and BMI were recorded. Data were obtained from 270 primary school-aged children (6-13 years). Female gender, the child's older age (8-13 years), high physical activity level and less screen time were strong predictors of a higher HRQoL in both the child's and parental proxy-reports. Means to promote healthy lifestyles should be particularly targeted to young children, especially boys, and new ways to promote physical activity and other forms of free-time activities should be sought.
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Affiliation(s)
- Soili Alanne
- Department of Clinical Nutrition, Wellbeing Services of County of South Ostrobothnia, 60220 Seinäjoki, Finland
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, 20014 Turku, Finland
- Correspondence: ; Tel.: +358-50-4744092
| | - Ella Koivuniemi
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, 20014 Turku, Finland
- Functional Foods Forum (FFF), University of Turku, 20014 Turku, Finland
| | | | - Kirsi Laitinen
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, 20014 Turku, Finland
- Functional Foods Forum (FFF), University of Turku, 20014 Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, 20521 Turku, Finland
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10
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Victoria-Montesinos D, Tárraga-Marcos A, Brazo-Sayavera J, Jiménez-López E, Gutiérrez-Espinoza H, Panisello Royo JM, Tárraga-López PJ, López-Gil JF. Adherence to the Mediterranean Diet and Health-Related Quality of Life during the COVID-19 Lockdown: A Cross-Sectional Study including Preschoolers, Children, and Adolescents from Brazil and Spain. Nutrients 2023; 15:nu15030677. [PMID: 36771384 PMCID: PMC9920644 DOI: 10.3390/nu15030677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Scientific literature has suggested positive associations between the Mediterranean diet (MD) and the health-related quality of life (HRQoL) in young populations. However, to our knowledge, this relationship is unexplored during a situation of social isolation (i.e., lockdown). The objective of the current study is to examine the relationship between the MD and HRQoL during the COVID-19 lockdown among preschoolers, children, and adolescents from Brazil and Spain. This cross-sectional study includes a sample of 1099 three- to seventeen-year-old participants (47.6% girls) who were recruited via social networks. The HRQoL was assessed with the EQ-5D-Y. The Quality Index for Children and Teenagers (KIDMED) questionnaire was applied to evaluate the relationship between the MD and HRQoL. The highest prevalence of reported problems was found for worried, sad, or unhappy participants (39.8%). Furthermore, the lowest proportion of HRQoL problems was observed for "mobility" (2.5%). The proportion of high adherence to the MD was 44.3%. Participants with greater MD adherence reported higher HRQoL mean scores when compared with those who did not adhere to the MD (83.7 ± 0.6 vs. 85.6 ± 0.7, respectively; p < 0.05). Adherence to the MD and especially daily fruit intake were related to higher HRQoL during the COVID-19 lockdown among Brazilian and Spanish young people aged three to seventeen years.
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Affiliation(s)
| | - Almudena Tárraga-Marcos
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha (UCLM), 02006 Albacete, Spain
| | - Javier Brazo-Sayavera
- PDU EFISAL, Centro Universitario Regional Noreste, Universidad de la República (UdelaR), Rivera 40000, Uruguay
- Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), 41013 Seville, Spain
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Héctor Gutiérrez-Espinoza
- Escuela de Fisioterapia, Universidad de las Américas, Quito 170504, Ecuador
- Correspondence: (P.J.T.-L.); (H.G.-E.)
| | | | - Pedro J. Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha (UCLM), 02006 Albacete, Spain
- Correspondence: (P.J.T.-L.); (H.G.-E.)
| | - José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA 02138, USA
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11
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Ward SL, VanBuren JM, Richards R, Holubkov R, Alvey JS, Jensen AR, Pollack MM, Burd RS. Evaluating the association between obesity and discharge functional status after pediatric injury. J Pediatr Surg 2022; 57:598-605. [PMID: 35090717 PMCID: PMC9808528 DOI: 10.1016/j.jpedsurg.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Children with obesity frequently have functional impairment after critical illness. Although obesity increases morbidity risk after trauma, the association with functional outcomes in children is unknown. OBJECTIVE To evaluate the association of weight with functional impairment at hospital discharge in children with serious injuries. METHODS This secondary analysis of a multicenter prospective study included children <15 years old with a serious injury. Four weight groups, underweight, healthy weight, overweight, and obesity/severe obesity were defined by body mass index z-scores. The functional status scale (FSS) measured impairment across six functional domains before injury and at hospital discharge. New domain morbidity was defined as a change ≥2 points. The association between weight and functional impairment was determined using logistic regression adjusting for demographics, physiological measures, injury details, presence of a severe head injury, and physical abuse. RESULTS Although most patients discharged with good/unchanged functional status, new domain morbidity occurred in 74 patients (17%). New FSS domain morbidity occurred in 13% of underweight, 14% of healthy weight, 15% of overweight, and 26% of obese/severe obese patients. Compared to healthy weight patients, those with obesity had more frequent new domain morbidity (p = 0.01), while the other weight groups had similar morbidity. However, after adjustment for confounders, weight was not associated with new functional morbidity at discharge. CONCLUSION Patients with obesity have greater frequency of new domain morbidity after a serious injury; however, after accounting for injury characteristics, weight group is not independently associated with new functional morbidity at hospital discharge after injury in children. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Shan L Ward
- Department of Pediatrics, UCSF Benioff Children's Hospitals Oakland, Oakland, CA, United States; Department of Pediatrics, UCSF Benioff Children's Hospitals San Francisco, San Francisco, CA, United States.
| | - John M VanBuren
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Rachel Richards
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Richard Holubkov
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Jessica S Alvey
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Aaron R Jensen
- Department of Surgery, University of California San Francisco and Division of Pediatric Surgery, UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States
| | - Murray M Pollack
- Department of Pediatrics, Children's National Health System and the George Washington University School of Medicine and Health Sciences, Washington DC, United States
| | - Randall S Burd
- Division of Trauma and Burn Surgery, Children's National Medical Center, Washington, DC, United States; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Assessment of Health-Related Quality of Life and Functional Outcomes after Pediatric Trauma Project Investigators
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12
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Wang Y, Clemens JL, Muriello M, Mu W, Smith CH, Tran PT, Rowe PC, Francomano C, Kline AD, Bodurtha J. Agreement between parent-proxy and child self-report in pediatric hypermobile Ehlers-Danlos syndrome. J Child Health Care 2022:13674935221110081. [PMID: 36128922 DOI: 10.1177/13674935221110081] [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: 11/16/2022]
Abstract
Hypermobile Ehlers-Danlos syndrome (hEDS) is a common disorder in children and adolescents that negatively impacts health-related quality of life (HRQOL). It can include chronic pain, fatigue, autonomic dysfunction, and mood problems. The objective of this study was to examine levels of agreement between children and parents in the setting of hEDS and HRQOL. Individuals with hEDS, ages 10-20 years, and their parents were recruited to complete a series of surveys. Instruments included pediatric quality of life generic and multidimensional fatigue scales, Functional Disability Index, Pain-Frequency-Severity-Duration scale, Brief Illness Perception Questionnaire, and Herth Hope Index. Agreement on each measure was evaluated using statistical calculations. Thirty-six parent-child dyads completed the surveys. There were no significant differences between the means of parent and child scores. There was moderate to strong agreement on all survey scores. However, the proportion of dyads with disagreement was relatively high for each individual score. Eighteen dyads disagreed on at least half of the surveys. Body mass index centile and child perception of cognitive fatigue most strongly predicted disagreement in total HRQOL score. Proxy-reporters for children and adolescents with hEDS may agree with their child on average. However, due to significant frequency of clinically important disagreement, information from both children and their parents should be sought whenever possible.
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Affiliation(s)
- You Wang
- Johns Hopkins University Krieger School of Arts and Sciences, Baltimore, MD, USA
| | | | | | - Weiyi Mu
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD
| | - Christy H Smith
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD
| | - Phuong T Tran
- Faculty of Pharmacy HUTECH University, Ho Chi Minh City, Vietnam
| | - Peter C Rowe
- Department of Pediatrics, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Clair Francomano
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Antonie D Kline
- Harvey Institute for Human Genetics, Greater Baltimore Medical Center, Towson, MD
| | - Joann Bodurtha
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD
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13
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Doi S, Isumi A, Fujiwara T. Association of Adverse Childhood Experiences Including Low Household Income and Peer Isolation With Obesity Among Japanese Adolescents: Results From A-CHILD Study. Front Public Health 2022; 10:754765. [PMID: 35480585 PMCID: PMC9037323 DOI: 10.3389/fpubh.2022.754765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adverse childhood experience (ACE) is a major risk factor for obesity in both adults and adolescents. Although, arguably, peer isolation and low household income could be conceived as of ACEs, few studies have included these experiences as ACEs. Objectives This study aims to examine whether ACEs, including peer isolation and low household income, are associated with obesity in adolescents. Methods We used pooled data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2016 and 2018, which is a school-based cross-sectional study in Adachi City, Tokyo, Japan, N = 6,946, 4th (9–10 years old), 6th (11–12 years old), and 8th (13–14 years old) grades. Among the eight items of ACEs, adolescents assessed one item, including peer isolation, and their caregivers assessed seven other items using questionnaires. The adolescents' body mass index (BMI) was measured in school health checkups and calculated to fit the World Health Organization (WHO) standards. Multinomial logistic regression was applied to investigate the association of the cumulative ACEs and each type of ACE with BMI, in which the study was conducted in 2020. Results The number of ACEs was not associated with overweight or obesity among adolescents after adjusting for covariates. As for each type of ACE, single parenthood and low household income showed a significant independent association with obesity. Conclusions The number of ACEs was not associated with overweight or obesity in Japanese adolescents, while single parenthood and low household income showed a significant positive association with obesity. Further longitudinal studies are needed to replicate this association among adolescents.
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Affiliation(s)
- Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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14
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Krueger H, Robinson S, Hancock T, Birtwhistle R, Buxton JA, Henry B, Scarr J, Spinelli JJ. Priorities among effective clinical preventive services in British Columbia, Canada. BMC Health Serv Res 2022; 22:564. [PMID: 35473549 PMCID: PMC9044882 DOI: 10.1186/s12913-022-07871-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite the long-standing experience of rating the evidence for clinical preventive services, the delivery of effective clinical preventive services in Canada and elsewhere is less than optimal. We outline an approach used in British Columbia to assist in determining which effective clinical preventive services are worth doing. Methods We calculated the clinically preventable burden and cost-effectiveness for 28 clinical preventive services that received a ‘strong or conditional (weak) recommendation for’ by the Canadian Task Force on Preventive Health Care or an ‘A’ or ‘B’ rating by the United States Preventive Services Task Force. Clinically preventable burden is the total quality adjusted life years that could be gained if the clinical preventive services were delivered at recommended intervals to a British Columbia birth cohort of 40,000 individuals over the years of life that the service is recommended. Cost-effectiveness is the net cost per quality adjusted life year gained. Results Clinical preventive services with the highest population impact and best value for money include services that address tobacco use in adolescents and adults, exclusive breastfeeding, and screening for hypertension and other cardiovascular disease risk factors followed by appropriate pharmaceutical treatment. In addition, alcohol misuse screening and brief counseling, one-time screening for hepatitis C virus infection in British Columbia adults born between 1945 and 1965, and screening for type 2 diabetes approach these high-value clinical preventive services. Conclusions These results enable policy makers to say with some confidence what preventive manoeuvres are worth doing but further work is required to determine the best way to deliver these services to all those eligible and to establish what supportive services are required. After all, if a clinical preventive service is worth doing, it is worth doing well.
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Affiliation(s)
- Hans Krueger
- H. Krueger & Associates Inc., Delta, Canada. .,School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| | | | - Trevor Hancock
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Richard Birtwhistle
- Department of Family Medicine and Public Health Sciences, Queen's University, Kingston, Canada.,Canadian Task Force on Preventive Health Care, Ottawa, Canada
| | - Jane A Buxton
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,BC Center for Disease Control, Vancouver, Canada
| | - Bonnie Henry
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,BC Ministry of Health, Victoria, Canada
| | - Jennifer Scarr
- Child Health BC, Provincial Health Services Authority, Vancouver, Canada
| | - John J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
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15
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Tugault-Lafleur CN, De-Jongh González O, Macdonald J, Bradbury J, Warshawski T, Ball GDC, Morrison K, Ho J, Hamilton J, Buchholz A, Mâsse L. Efficacy of the Aim2Be intervention in changing lifestyle behaviours among adolescents with overweight and obesity: A Randomized Controlled Trial (Preprint). J Med Internet Res 2022; 25:e38545. [PMID: 37097726 PMCID: PMC10170359 DOI: 10.2196/38545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/13/2022] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Aim2Be is a gamified lifestyle app designed to promote lifestyle behavior changes among Canadian adolescents and their families. OBJECTIVE The primary aim was to test the efficacy of the Aim2Be app with support from a live coach to reduce weight outcomes (BMI Z score [zBMI]) and improve lifestyle behaviors among adolescents with overweight and obesity and their parents versus a waitlist control group over 3 months. The secondary aim was to compare health trajectories among waitlist control participants over 6 months (before and after receiving access to the app), assess whether support from a live coach enhanced intervention impact, and evaluate whether the app use influenced changes among intervention participants. METHODS A 2-arm parallel randomized controlled trial was conducted from November 2018 to June 2020. Adolescents aged 10 to 17 years with overweight or obesity and their parents were randomized into an intervention group (Aim2Be with a live coach for 6 months) or a waitlist control group (Aim2Be with no live coach; accessed after 3 months). Adolescents' assessments at baseline and at 3 and 6 months included measured height and weight, 24-hour dietary recalls, and daily step counts measured with a Fitbit. Data on self-reported physical activity, screen time, fruit and vegetable intake, and sugary beverage intake of adolescents and parents were also collected. RESULTS A total of 214 parent-child participants were randomized. In our primary analyses, there were no significant differences in zBMI or any of the health behaviors between the intervention and control groups at 3 months. In our secondary analyses, among waitlist control participants, zBMI (P=.02), discretionary calories (P=.03), and physical activity outside of school (P=.001) declined, whereas daily screen time increased (P<.001) after receiving access to the app compared with before receiving app access. Adolescents randomized to Aim2Be with live coaching reported more time being active outside of school compared with adolescents who used Aim2Be with no coaching over 3 months (P=.001). App use did not modify any changes in outcomes among adolescents in the intervention group. CONCLUSIONS The Aim2Be intervention did not improve zBMI and lifestyle behaviors in adolescents with overweight and obesity compared with the waitlist control group over 3 months. Future studies should explore the potential mediators of changes in zBMI and lifestyle behaviors as well as predictors of engagement. TRIAL REGISTRATION ClinicalTrials.gov NCT03651284; https://clinicaltrials.gov/ct2/show/study/NCT03651284. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-020-4080-2.
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Affiliation(s)
- Claire N Tugault-Lafleur
- School of Nutrition Sciences, Faculty of Health Sciences, The University of Ottawa, Ottawa, ON, Canada
| | - Olivia De-Jongh González
- School of Population and Public Health, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | | | | | | | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Katherine Morrison
- Department of Pediatrics, Center for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada
| | - Josephine Ho
- Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Jill Hamilton
- Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Annick Buchholz
- Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Louise Mâsse
- School of Population and Public Health, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
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16
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Seum T, Meyrose AK, Rabel M, Schienkiewitz A, Ravens-Sieberer U. Pathways of Parental Education on Children's and Adolescent's Body Mass Index: The Mediating Roles of Behavioral and Psychological Factors. Front Public Health 2022; 10:763789. [PMID: 35321198 PMCID: PMC8936576 DOI: 10.3389/fpubh.2022.763789] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/31/2022] [Indexed: 12/20/2022] Open
Abstract
Aim The increasing body mass index (BMI) often followed by overweight and obesity is a global health problem of the 21st century. Children and adolescents with lower socioeconomic status are more affected than their counterparts. The mechanisms behind these differences must be well understood to develop effective prevention strategies. This analysis aims at examining the association of parental education as an indicator of the socioeconomic status on children's and adolescent's body mass index and the role of behavioral and psychological risk factors for a higher BMI longitudinally. Methods The analysis was based on a nationwide sample of N = 460 children and adolescents, aged 11 to 17 at baseline (2009-2012), who took part in the representative BELLA study, the mental health module of the German National Health Interview and Examination Survey among Children and Adolescents (KiGGS). A follow-up was conducted 5 years later. Using mediation analyses, the mediating effects of breakfast consumption, consumption of sugar-sweetened beverages, screen time, physical activity, mental health problems (Strengths and Difficulties Questionnaire), and health-related quality of life (KIDSCREEN-10) on the association of parent's years of education on their children's BMI were investigated. Results A lower level of parental education was significantly associated with a higher BMI in children and adolescents 5 years later. The association was partially mediated by breakfast consumption and total screen time, with breakfast consumption mediating 16.7% and total screen time 27.8% of the association. After controlling for age, gender, and migration status, only breakfast consumption remained a partial mediator (8.5%). Other included variables had no mediating effects. Conclusions Preventive measures should be mainly targeted at children and adolescents of parents with lower educational levels. Tailored strategies to prevent the development of overweight and obesity in this population among children and adolescents should promote daily breakfast consumption at home and reducing screen time.
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Affiliation(s)
- Teresa Seum
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, Hamburg, Germany
| | - Matthias Rabel
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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17
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Benzing V, Gaillard P, Scheidegger D, Dössegger A, Nigg CR, Schmidt M. COVID-19: Physical Activity and Quality of Life in a Sample of Swiss School Children during and after the First Stay-at-Home. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2231. [PMID: 35206418 PMCID: PMC8871913 DOI: 10.3390/ijerph19042231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/27/2022] [Accepted: 02/10/2022] [Indexed: 01/26/2023]
Abstract
COVID-19 restrictions and the instructions to stay at home (SaH) may have had an impact on child behavior including physical activity (PA) and health-related quality of life (HRQoL) in Switzerland. Therefore, we investigated PA and HRQoL during and after the SaH in 57 Swiss school children aged 7 to 12 years (M = 10.44; SD = 1.34). PA was measured using accelerometry (Actigraph GT3X) and HRQoL using the Kid-KINDLR questionnaire. During and post data was compared using paired sample t-tests. Independent t-tests were used to compare the HRQoL of physically active children with non-physically active children. PA in light (d = -0.56), moderate (d = -0.44), moderate-to-vigorous (d = -0.28) as well as overall HRQoL (d = -0.66), psychological well-being (d = -0.48), self-esteem (d = -0.39), friends (d = -0.70) and everyday functioning (d = -0.44), were significantly lower during SaH than afterwards. Children who adhered to PA recommendations (+60 min of moderate-to-vigorous PA) during SaH had a better overall HRQoL (d = 0.61) and psychological well-being (d = 0.56) than those who did not. Since PA levels and HRQoL were lower during SaH compared to afterwards, it seems that the restrictions negatively impacted children's PA and HRQoL. During future SaHs, promoting children's PA and HRQoL seems important.
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Affiliation(s)
- Valentin Benzing
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - Patrice Gaillard
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - David Scheidegger
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - Alain Dössegger
- Swiss Federal Institute of Sport Magglingen (SFISM), 2532 Magglingen, Switzerland;
| | - Claudio R. Nigg
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland; (P.G.); (D.S.); (C.R.N.); (M.S.)
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18
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O'Neil PM, Rubino DM. Exploring the wider benefits of semaglutide treatment in obesity: insight from the STEP program. Postgrad Med 2022; 134:28-36. [PMID: 36691307 DOI: 10.1080/00325481.2022.2150006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Obesity negatively impacts patients' health-related quality of life (QOL) and is associated with a range of complications such as type 2 diabetes (T2D), cardiovascular disease, and sleep apnea, alongside decreased physical function, mobility, and control of eating. The Semaglutide Treatment Effect in People with obesity (STEP) trials compared once-weekly subcutaneous semaglutide 2.4 mg with placebo in adults with overweight or obesity, with or without T2D. This article reviews the effects of semaglutide 2.4 mg on QOL, control of eating, and body composition. Weight-related QOL was assessed using the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT), and health-related QOL was assessed with the 36-item Short Form Health Survey version 2 (SF-36v2®). Control of eating was evaluated using the Control of Eating questionnaire in a subgroup of participants in one trial. Body composition was evaluated via dual-energy x-ray absorptiometry in another trial, in a subgroup of participants with a body mass index of ≤40 kg/m2. All IWQOL-Lite-CT scores (Physical Function, Physical, Psychosocial, and Total Score) improved with semaglutide 2.4 mg significantly more than with placebo. Across the trials, changes in SF-36v2 scores were generally in favor of semaglutide versus placebo. There were significant improvements in all Control of Eating questionnaire domains (craving control, craving for savory, craving for sweet, and positive mood) up to week 52 with semaglutide treatment versus placebo, with improvements in craving control and craving for savory remaining significantly different at week 104. Body composition findings showed that reductions in total fat mass were greater with semaglutide versus placebo. These findings highlight the wider benefits that patients can experience with once-weekly subcutaneous semaglutide 2.4 mg, in addition to weight loss, including improvements in patients' wellbeing and ability to perform daily activities. Taken together, these are important considerations for primary care when incorporating pharmacotherapy for weight management.
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Affiliation(s)
- Patrick M O'Neil
- Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Domenica M Rubino
- Washington Center for Weight Management and Research, Arlington, VA, USA
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Amer S, Kateeb E. Factors related to dietary habits, energy drink consumption, and physical activity in marginalized Palestinian schools: A cross-sectional study. Health Promot Perspect 2021; 11:329-336. [PMID: 34660228 PMCID: PMC8501479 DOI: 10.34172/hpp.2021.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The current study assessed different dietary habits, energy drinks intake, body mass index (BMI) and physical activity and associated factors among Palestinian adolescents attending marginalized schools. Methods: A cross-sectional study targeted a random sample of 1480 students in the sixth andninth grades attending 20 marginalized public schools in the West Bank area of the occupied Palestinian Territories (oPt). Students were interviewed in-person by trained senior dental students about their dietary habits, physical activity, fathers’ employment and mothers’ level of education. Weight and height were measured, and BMI percentile was calculated. Descriptive statistics were generated for the study’s main variables and the dependent variables were compared by grade, gender, mothers’ level of education and father’s employment. Results: A total of 1282 students (98% response) completed the questionnaire. Of them, 6% were ‘underweight’ (fifth percentile or under) and 34% were ‘overweight’ or ‘obese’ (85thpercentile or over). Ninth graders had more added sugar than 6th graders (P=0.002), less frequent milk consumption (P<0.001), more frequent energy drink consumption (P=0.001),and less physical activity (P<0.0001). Frequency of carbonated and sweetened drink consumption was associated with being overweight or obese (P=0.016, P=0.001). Frequency of carbonated drinks consumption was higher among children of mothers with a high school level of education or less (P<0.001). In addition, children of mothers educated to high school level or below were associated with being underweight (P=0.05). Conclusion: Dietary habits and physical activity get worse between the ages of 12 and 15. Mothers’ level of education is an important factor in being overweight or underweight. Energy drink consumption among boys and milk consumption among girls are two challenges that need to be addressed urgently and adequately.
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Affiliation(s)
- Sami Amer
- MIT Media Lab, Massachusetts Institute of Technology, 77 Massachusetts Avenue Cambridge, MA 02139, USA
| | - Elham Kateeb
- Oral Health Research and Promotion Unit, Faculty of Dentistry, Al-Quds University, Jerusalem, State of Palestine
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Martínez-Vizcaíno V, Garrido-Miguel M, Redondo-Tébar A, Notario-Pacheco B, Rodríguez-Martín B, Sánchez-López M. The "Fat but Fit" Paradigm from a Children's Health-Related Quality of Life Perspective. Child Obes 2021; 17:449-456. [PMID: 34009010 DOI: 10.1089/chi.2021.0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The fat but fit paradigm originally argues that the detrimental influence of obesity on cardiovascular risk and mortality could be counterbalanced by normal to high cardiorespiratory fitness (CRF) levels. The aim of the study was to determine whether there is a relationship between categories of the fat but fit conceptual model and health-related quality of life (HRQoL) in children. Materials and Methods: Cross-sectional cluster analyses of the MOVI-daFit! baseline data were conducted in 507 children aged 9 to 11 years in Cuenca, Spain. BMI, body fat percentage, VO2 max estimate, and HRQoL (measured by the KIDSCREEN questionnaire) were assessed. Results: The cluster analysis of BMI/body fat percentage and VO2 max estimate z-scores resulted in a four-cluster solution that fit the four categories included in the fat but fit paradigm: fat unfit (FU), unfat unfit (UU), fat but fit (FF), and unfat fit (UF). Analysis of variance (ANOVA) models showed the expected mean trends by cluster category: an increasing trend (FU<UU<FF<UF) in terms of VO2 max estimate and, conversely, a decreasing trend (FU>FF>UU>UF) in terms of adiposity (p < 0.05). These models also indicated, in the whole sample, that schoolchildren in the FF and UF clusters scored higher on physical well-being, psychological well-being, and total HRQoL scores than their peers in the FU and UU clusters (p < 0.05). The results were similar regardless of gender and whether BMI or body fat percentage was used for clustering. Conclusions: This study reinforces the fat but fit paradigm with respect to a previously unexplored outcome, HRQoL, by indicating that CRF may be mediating in the relationship between obesity and HRQoL. Clinical Trial Registration number: NCT03236337.
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Affiliation(s)
- Vicente Martínez-Vizcaíno
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Medicine, Universidad Autónoma de Chile, Providencia Talca, Chile
| | - Miriam Garrido-Miguel
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Nursing, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Andrés Redondo-Tébar
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Blanca Notario-Pacheco
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Beatriz Rodríguez-Martín
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Health Sciences, Universidad de Castilla-La Mancha, Talavera de la Reina, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.,Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
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21
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Fernández-Álvarez MDM, Martín-Payo R, Zabaleta-del-Olmo E, García-García R, Cuesta-Izquierdo M, González-Méndez X. Evaluación de la calidad de la dieta y de la actividad física en jugadores de fútbol, de 13 a 16 años, del Principado de Asturias. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpedi.2020.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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22
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Fernández-Álvarez MDM, Martín-Payo R, Zabaleta-Del-Olmo E, García-García R, Cuesta M, Gonzalez-Méndez X. Assessment of diet quality and physical activity of soccer players aged 13 to 16, from the Principality of Asturias, Spain. An Pediatr (Barc) 2021; 95:33-39. [PMID: 34119459 DOI: 10.1016/j.anpede.2020.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/06/2020] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Diet and physical activity are factors that have key roles in childhood overweight and obesity prevention. Appropriate assessment of these factors is an essential task in public health. OBJECTIVE The main aims of the study are to assess body composition, physical activity, and adherence to Mediterranean diet of soccer players, aged 13 to 16 years old in Asturias, Spain. It also aims to evaluate the relationships between diet, physical activity, body composition, and personal characteristics. METHODS A cross-sectional descriptive survey approach was used involving children (n = 303) with a mean age of 14.15 years (SD = 1.06), and using the KIDMED and PAQ-A questionnaires to assess adherence to Mediterranean diet and level of physical activity, respectively. Body composition was represented using the participants' body mass index. RESULTS Approximately 23.1% of the participants were overweight or obese. With regards to adherence to Mediterranean diet, 54.8% of the participants had medium adherence, while 8.9% had low adherence. PAQ-A mean score was 2.69 (SD = 0.47). Excess weight was associated with being a goalkeeper (P = .001), higher PAQ-A (P = .011), and lower KIDMED scores (P = .032). Correlation analysis showed an inverse association between age and PAQ-A score (r = -0.122), and a direct association between KIDMED and PAQ-A scores (r = 0.152). CONCLUSION Participants had an adequate level of physical activity. However, they had an obesogenic profile similar to that of their age population, who were not soccer players. Actions to improve adherence to healthy diet practices are highly recommended.
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Affiliation(s)
- María Del Mar Fernández-Álvarez
- Equipo de Investigación PRECAM, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
| | - Rubén Martín-Payo
- Equipo de Investigación PRECAM, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain.
| | - Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain; Departamento de Enfermería, Facultad de Enfermería, Universitat de Girona, Girona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Rebeca García-García
- Equipo de Investigación PRECAM, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain; Servicio de Pediatría, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | | | - Xana Gonzalez-Méndez
- Equipo de Investigación PRECAM, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain; Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Avilés, Spain
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Black WR, Borner KB, Beauchamp MT, Davis AM, Dreyer Gillette ML, Sweeney B, Hampl SE. Health-Related Quality of Life across Recent Pediatric Obesity Classification Recommendations. CHILDREN (BASEL, SWITZERLAND) 2021; 8:303. [PMID: 33921016 PMCID: PMC8071434 DOI: 10.3390/children8040303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022]
Abstract
Extreme body mass index (BMI) values (i.e., above the 97th and below the 3rd percentiles) are inaccurately represented on the Centers for Disease Control and Prevention's growth curves, which may limit the utility of BMI percentile and BMI z-score for capturing changes in clinical outcomes for patients at extreme weights. Modeling child obesity severity based upon the percentage of BMI in excess of the 95th percentile (BMI95pct) has been proposed as an improved metric to better capture variability in weight at extreme ends of growth curves, which may improve our understanding of relationships between weight status and changes in clinical outcomes. However, few studies have evaluated whether the use of BMI95pct would refine our understanding of differences in clinical psychosocial constructs compared to previous methods for categorization. This cross-sectional study evaluated child obesity severity based on BMI95pct to examine potential group differences in a validated, obesity-specific measure of Health-Related Quality of Life (HRQoL). Four hundred and sixty-five children with obesity completed Sizing Me Up, a self-report measure of HRQoL. Children were classified into categories based on BMI95pct (i.e., class I: ≥100% and <120%; class II: ≥120% and <140%; class III: ≥140%). The results indicate that children with class III obesity reported lower HRQoL than children with class I and class II obesity; however, there were no differences between Class II and Class I. In much of the previous literature, children with class II and class III obesity are often combined under the category "Severe Obesity" based upon BMI above the 99th percentile. This study suggests that grouping children from various classes together would neglect to capture critical differences in HRQoL. Future research including children with severe obesity should consider obesity classes to best account for functioning and clinical outcomes.
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Affiliation(s)
- William R. Black
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, The University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Kelsey B. Borner
- Department of Psychology and Behavioral Health, Children’s National Hospital, Washington, DC 20010, USA;
| | - Marshall T. Beauchamp
- Department of Psychology, University of Missouri–Kansas City, Kansas City, MO 6110, USA;
| | - Ann M. Davis
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, The University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Meredith L. Dreyer Gillette
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
| | - Brooke Sweeney
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
| | - Sarah E. Hampl
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 64108, USA; (A.M.D.); (M.L.D.G.); (B.S.); (S.E.H.)
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
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Pinquart M. Health-Related Quality of Life of Young People With and Without Chronic Conditions. J Pediatr Psychol 2021; 45:780-792. [PMID: 32642762 DOI: 10.1093/jpepsy/jsaa052] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this meta-analysis was to compare levels of health-related quality of life (HRQOL) among children with and without chronic physical and/or sensory conditions, based on PedsQL 4.0 General Core Scales. METHODS Studies were identified with electronic databases (CINAHL, PSYCINFO, MEDLINE, Google Scholar, PSYNDEX) and from the PedsQL website. We included controlled studies that compared PedsQL scores of children (mean age < 18 years) with and without chronic physical and/or sensory conditions and uncontrolled studies on children with chronic physical and/or sensory conditions from countries where data from peers without chronic conditions have been published. Random-effects meta-analyses were computed. RESULTS In total, 1,231 studies fulfilled the inclusion criteria. There were large declines of the total and physical score as well as medium-sized declines of psychosocial health and its subscales, based on criteria of interpreting effect sizes by Cohen [Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155-159]. Children with cerebral palsy and spina bifida showed the largest declines across all scales, but significant declines emerged in all compared 29 chronic conditions. We identified moderating effects of duration of the chronic condition, rater, child gender, country, sociodemographic equivalence of the compared groups, type of control condition, and publication status. CONCLUSIONS Young people with chronic health conditions should be screened for HRQOL, and the profile across different domains should be preferred over the use of a sum score. Child self-reports are particularly relevant for assessing emotional and social functioning. Effective measures aimed at improving HRQOL are needed, especially if the chronic condition leads to severe declines of physical functioning.
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Gunawardana S, Gunasinghe CB, Harshani MS, Seneviratne SN. Physical and psychosocial quality of life in children with overweight and obesity from Sri Lanka. BMC Public Health 2021; 21:86. [PMID: 33413215 PMCID: PMC7792320 DOI: 10.1186/s12889-020-10104-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/21/2020] [Indexed: 01/22/2023] Open
Abstract
Background While childhood obesity is rising rapidly in South Asia, there is limited research on quality of life (QoL) of children with overweight and obesity from the region. This study assessed physical and psychosocial QoL in Sri Lankan children attending a specialized obesity clinic, from both children’s and parents’ perspective, and modifiable social factors affecting QoL. Methods We performed cross-cultural translation of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 (Child-Self Report and Parent-Proxy forms), and assessed self-reported and parental-perception of physical and psychosocial QoL in 8–12 year-olds with overweight and obesity (n=110), referred for obesity management at a tertiary-care children’s hospital in Sri-Lanka. Body mass index (BMI) and pre-selected social factors affecting QoL were also assessed. Data were analyzed by non-parametric tests (Mann-Whitney U test, Wilcoxon test and Spearman correlation). Results The median physical QoL was lower than psychosocial QoL (78.1vs81.7, p=0.032) and physical QoL was inversely correlated with BMI. Parental-perception of children’s physical and psychosocial QoL correlated with child-reported QoL, but was lower. Being bullied (p=0.001) and not getting regular exercise (p=0.031) were associated with lower psychosocial QoL. Both physical and psychosocial QoL were lower in children having difficulties in finding suitable clothes (p< 0.001). Conclusions Children with overweight and obesity from Sri Lanka appeared to have greater impairment of physical QoL than psychosocial QoL. Higher BMI, bullying, lack of regular exercise and lack of suitable clothing, negatively affected QoL. Potential strategies to improve QoL include promoting regular exercise, addressing bullying and promoting availability of children’s clothes in larger sizes to fit children with overweight and obesity.
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Affiliation(s)
- S Gunawardana
- Faculty of Medicine, University of Colombo, No 25, Kynsey road, Colombo, Sri Lanka
| | - C B Gunasinghe
- Faculty of Medicine, University of Colombo, No 25, Kynsey road, Colombo, Sri Lanka
| | - M S Harshani
- Faculty of Medicine, University of Colombo, No 25, Kynsey road, Colombo, Sri Lanka
| | - S N Seneviratne
- Department of Pediatrics, Faculty of Medicine, University of Colombo, No.25, Kynsey Road, Colombo, Sri Lanka.
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Meixner L, Cohrdes C, Schienkiewitz A, Mensink GBM. Health-related quality of life in children and adolescents with overweight and obesity: results from the German KIGGS survey. BMC Public Health 2020; 20:1722. [PMID: 33198705 PMCID: PMC7670618 DOI: 10.1186/s12889-020-09834-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/04/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The well-being of persons with overweight and obesity, in particular of children and adolescents, may be impaired. The present study investigates the health-related quality of life (HRQoL) of girls and boys with overweight and obesity living in Germany as compared to those of normal-weight, while taking a selection of relevant determinants of HRQoL into account. METHODS The sample comprises 1771 children and adolescents aged 11 to 17 years that took part in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KIGGS Wave 2, 2014-2017). Sex-and age-specific BMI (kg/m2) percentiles were utilized to classify overweight and obesity. HRQoL was measured with the KIDSCREEN-27 questionnaire, which gathers detailed information about the five dimensions physical and psychological well-being, well-being regarding peers (i.e., social acceptance), parents (i.e., autonomy) and within the school environment. Multiple regression analyses were performed with HRQoL dimensions as outcomes to test for differences between children and adolescents with normal-weight vs. those with overweight and vs. those with obesity, separately for girls and boys. In a next step, age, physical activity, media consumption, social support and self-efficacy were considered as potential confounders in the analyses. RESULTS 18.7% of the children and adolescents under study were affected by overweight and among them 8.0% by obesity. After adjusting for potential confounders, overweight and obesity were associated with lower physical well-being as compared to normal weight in both sexes (boys with overweight: standardized beta [β] = -.14, standard error [SE] = .03, p < .001, and obesity: β = -.16, SE = .03, p < .001; girls with overweight: β = -.09, SE = .04, p = .011, and obesity: β = -.11, SE = .03, p = .003). Results moreover suggest lower levels of psychological (β = -.10, SE = .04, p = .002) and parent-related well-being (β = -.08, SE = .04, p = .036) of boys with obesity as compared to normal-weight peers. CONCLUSION HRQoL of German children and adolescents with overweight and obesity is impaired according to physical well-being in general, while psychological and parent-related well-being is particularly affected in boys. Public health approaches should therefore promote children and adolescents with overweight and obesity by improving diverse facets of HRQoL as well as relevant associated factors (i.e., media consumption, self-efficacy) in general and in boys in particular.
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Affiliation(s)
- Lara Meixner
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Caroline Cohrdes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany
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Christensen SF, Scherber RM, Brochmann N, Goros M, Gelfond J, Andersen CL, Flachs EM, Mesa R. Body Mass Index and Total Symptom Burden in Myeloproliferative Neoplasms Discovery of a U-shaped Association. Cancers (Basel) 2020; 12:E2202. [PMID: 32781663 PMCID: PMC7465643 DOI: 10.3390/cancers12082202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/30/2020] [Accepted: 08/02/2020] [Indexed: 12/18/2022] Open
Abstract
Elevated body mass index (BMI) is a global health problem, leading to enhanced mortality and the increased risk of several cancers including essential thrombocythemia (ET), a subtype of the Philadelphia-chromosome negative myeloproliferative neoplasms (MPN). Furthermore, evidence states that BMI is associated with the severity of symptom burden among cancer patients. MPN patients often suffer from severe symptom burden. The purpose of this study was to examine whether deviations from a normal BMI in an MPN population are associated with higher symptom burden and reduced quality of life (QoL). A combined analysis of two large cross-sectional surveys, the Danish Population-based Study, MPNhealthSurvey (n = 2044), and the international Fatigue Study (n = 1070), was performed. Symptoms and QoL were assessed using the validated Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF). Analysis of covariance was used to estimate the effects of different BMI categories on symptom scores while adjusting for age, sex, and MPN subtype. A U-shaped association between BMI and Total Symptom Burden was observed in both datasets with significantly higher mean scores for underweight and obese patients relative to normal weight (mean difference: underweight 5.51 (25.8%), p = 0.006; obese 5.70 (26.6%) p < 0.001). This is an important finding, as BMI is a potentially modifiable factor in the care of MPN patients.
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Affiliation(s)
| | - Robyn Marie Scherber
- Department of Hematology/Oncology, UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX 78229, USA;
- Hematologic Malignancies, Incyte Corporation, Wilmington, DE 19803, USA
| | - Nana Brochmann
- Department of Hematology, Zealand University Hospital, 4000 Roskilde, Denmark;
| | - Martin Goros
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.G.); (J.G.)
| | - Jonathan Gelfond
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX 78229, USA; (M.G.); (J.G.)
| | | | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen, Denmark;
| | - Ruben Mesa
- Department of Hematology/Oncology, UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX 78229, USA;
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Wright ME, Delacroix E, Sonneville KR, Considine S, Proctor T, Steffes J, Harris D, Shone LP, Woo H, Vaughan R, Grundmeier RW, Fiks AG, Stockwell MS, Resnicow K. Reducing paediatric overweight and obesity through motivational interviewing: study protocol for a randomised controlled trial in the AAP PROS research network. BMJ Open 2020; 10:e035720. [PMID: 32723736 PMCID: PMC7390232 DOI: 10.1136/bmjopen-2019-035720] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Primary care remains an underused venue for prevention and management of paediatric overweight and obesity. A prior trial demonstrated a significant impact of paediatrician/nurse practitioner (Ped/NP)-and registered dietitian (RD)-delivered motivational interviewing (MI) on child body mass index (BMI). The study described here will test the effectiveness of an enhanced version of this primary care-based MI counselling intervention on child BMI. METHODS AND ANALYSIS This cluster randomised effectiveness trial includes 24 Ped/NPs from 18 paediatric primary care practices that belong to the American Academy of Pediatrics (AAP) national Pediatric Research in Office Settings (PROS) practice-based research network. To date, practices have been randomised (nine to intervention and nine to usual care). Intervention Ped/NPs have been trained in MI, behavioural therapy, billing/coding for weight management and study procedures. Usual care Ped/NPs received training in billing/coding and study procedures only. Children 3- 11 years old with BMI >the 85th percentile were identified via electronic health records (EHRs). Parents from intervention practices have been recruited and enrolled. Over about 2 years, these parents are offered approximately 10 MI-based counselling sessions (about four in person sessions with their child's Ped/NP and up to six telephonic sessions with a trained RD). The primary outcome is change in child BMI (defined as per cent from median BMI for age and sex) over the study period. The primary comparison is between eligible children in intervention practices whose parents enrol in the study and all eligible children in usual care practices. Data sources will include EHRs, billing records, surveys and counselling call notes. ETHICS AND DISSEMINATION Institutional Review Board approval was obtained from the AAP. All Ped/NPs provided written informed consent, and intervention group parents provided consent and Health Insurance Portability and Accountability Act (HIPAA) authorisation. Findings will be disseminated through peer-reviewed publications, conference presentations and appropriate AAP channels. TRIAL REGISTRATION NUMBER NCT03177148; Pre-results.
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Affiliation(s)
- Margaret E Wright
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois, USA
- Pediatric Research in Office Settings, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Emerson Delacroix
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Shannon Considine
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Tim Proctor
- Physician's Computer Company, Winooski, Vermont, USA
| | - Jennifer Steffes
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois, USA
- Pediatric Research in Office Settings, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Donna Harris
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois, USA
- Pediatric Research in Office Settings, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Laura P Shone
- Primary Care Research, American Academy of Pediatrics, Itasca, Illinois, USA
- Pediatric Research in Office Settings, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Heide Woo
- Department of Paediatrics, University of California Los Angeles, Los Angeles, California, USA
| | - Roger Vaughan
- Department of Hospital Biostatistics, The Rockefeller University, New york City, New york, USA
| | - Robert W Grundmeier
- Department of Paediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Alexander G Fiks
- Pediatric Research in Office Settings, American Academy of Pediatrics, Itasca, Illinois, USA
- Department of Paediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Melissa S Stockwell
- Pediatric Research in Office Settings, American Academy of Pediatrics, Itasca, Illinois, USA
- Departments of Pediatrics and Population and Family Health, Columbia University Irving Medical Center, New york City, New york, USA
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Family-based treatment program contributors to child weight loss. Int J Obes (Lond) 2020; 45:77-83. [PMID: 32546860 PMCID: PMC7738379 DOI: 10.1038/s41366-020-0604-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/08/2020] [Accepted: 05/14/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Multicomponent family-based behavioral treatment (FBT) program for pediatric obesity includes nutrition and physical activity education, as well as behavior therapy techniques. Studies suggest that parent weight loss is the best predictor of child weight loss in FBT. However, given the important role that parents play in the implementation of FBT for their child, isolating the effects of specific FBT treatment component requires consideration of parent influences over time. METHODS The following treatment components were assessed: stimulus control (high/low-fat food items in home), nutrition knowledge, energy intake, physical activity, and parental monitoring, as well as weekly anthropometric measures. Adjusted models of interest using inverse probability weights were used to evaluate the effect of specific FBT components on time-varying child weight loss rate, adjusting for time-varying influence of parent weight loss. RESULTS One hundred thirty-seven parent-child dyads (CHILD: mean BMI = 26.4 (3.7) and BMIz = 2.0 (0.3); mean age = 10.4 (1.3); 64.1% female; ADULT: mean BMI = 31.9 (6.3); mean age = 42.9 (6.5); 30.1% Hispanic parents; 87.1% female) participated in an FBT program. In traditional model, adult BMI change (b = 0.08; p < 0.01) was the most significant predictor of child weight loss rates and no other treatment components were significant (p's > 0.1). In models that accounted for potential influences from parental weight loss and differential attendance during treatment period, lower availability of high-fat items (b = 1.10, p < 0.02), higher availability of low-fat items (b = 3.73; p < 0.01), and higher scores on parental monitoring practices (b = 1.10, p < 0.01) were associated with greater rates of weight loss, respectively. CONCLUSION Results suggest that outside of parent weight change, changes in stimulus control strategies at home and improved parental-monitoring practices are important FBT components for child weight loss.
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Sundar TKB, Riiser K, Småstuen MC, Opheim R, Løndal K, Glavin K, Helseth S. Health-related quality of life among 13-14 year old adolescents with overweight-a mixed methods approach. Health Qual Life Outcomes 2020; 18:161. [PMID: 32471437 PMCID: PMC7260808 DOI: 10.1186/s12955-020-01413-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study, Young & Active, with the aim of increasing physical activity (PA), reducing BMI and promoting HRQoL. METHODS Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents' HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13-14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52. RESULTS HRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. CONCLUSION The use of the KIDSCREEN 52 instrument gave important indications about the adolescents' HRQoL and need for additional follow up. The qualitative data provided an in-depth understanding that nuanced the findings and widened our knowledge of the adolescents HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL.
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Affiliation(s)
- T K B Sundar
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, University of Oslo, P. O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - K Riiser
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - M C Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - R Opheim
- Department of Nursing Science, Institute of Health and Society, University of Oslo, P. O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - K Løndal
- Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway
| | - K Glavin
- VID Specialized University, Faculty of Health Studies, P.O. Box 184, Vinderen, NO-0319, Oslo, Norway
| | - S Helseth
- Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, N-0130, Oslo, Norway.
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Benítez-Andrades JA, Arias N, García-Ordás MT, Martínez-Martínez M, García-Rodríguez I. Feasibility of Social-Network-Based eHealth Intervention on the Improvement of Healthy Habits among Children. SENSORS (BASEL, SWITZERLAND) 2020; 20:E1404. [PMID: 32143458 PMCID: PMC7085577 DOI: 10.3390/s20051404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 01/14/2023]
Abstract
This study shows the feasibility of an eHealth solution for tackling eating habits and physical activity in the adolescent population. The participants were children from 11 to 15 years old. An intervention was carried out on 139 students in the intervention group and 91 students in the control group, in two schools during 14 weeks. The intervention group had access to the web through a user account and a password. They were able to create friendship relationships, post comments, give likes and interact with other users, as well as receive notifications and information about nutrition and physical activity on a daily basis and get (virtual) rewards for improving their habits. The control group did not have access to any of these features. The homogeneity of the samples in terms of gender, age, body mass index and initial health-related habits was demonstrated. Pre- and post-measurements were collected through self-reports on the application website. After applying multivariate analysis of variance, a significant alteration in the age-adjusted body mass index percentile was observed in the intervention group versus the control group, as well as in the PAQ-A score and the KIDMED score. It can be concluded that eHealth interventions can help to obtain healthy habits. More research is needed to examine the effectiveness in achieving adherence to these new habits.
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Affiliation(s)
- José Alberto Benítez-Andrades
- SALBIS Research Group, Department of Electric, Systems and Automatics Engineering, University of León, Campus of Vegazana s/n, León, 24071 León, Spain
| | - Natalia Arias
- SALBIS Research Group, Department of Nursing and Physiotherapy Health Science School, University of León, Avenida Astorga s/n, Ponferrada, 24401 León, Spain;
| | - María Teresa García-Ordás
- SECOMUCI Research Groups, Escuela de Ingenierías Industrial e Informática, Universidad de León, Campus de Vegazana s/n, C.P. 24071 León, Spain; (M.T.G.-O.); (I.G.-R.)
| | | | - Isaías García-Rodríguez
- SECOMUCI Research Groups, Escuela de Ingenierías Industrial e Informática, Universidad de León, Campus de Vegazana s/n, C.P. 24071 León, Spain; (M.T.G.-O.); (I.G.-R.)
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Mâsse LC, Vlaar J, Macdonald J, Bradbury J, Warshawski T, Buckler EJ, Hamilton J, Ho J, Buchholz A, Morrison KM, Ball GDC. Aim2Be mHealth intervention for children with overweight and obesity: study protocol for a randomized controlled trial. Trials 2020; 21:132. [PMID: 32014057 PMCID: PMC6998843 DOI: 10.1186/s13063-020-4080-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background The prevalence of overweight and obesity remains high in Canada, and the current standard for the treatment of childhood obesity is in-person, family-based, multidisciplinary interventions that target lifestyle behaviors (e.g., diet, physical activity, and sedentary behaviors). These programs are costly to operate, have limited success, and report recruitment and retention challenges. With recent advances in technology, mobile health or mHealth has been presented as a viable alternative to in-person interventions for behavior change, especially with teens. Purpose The primary aim of this study is to test the efficacy of Aim2Be, a gamified app based on behavior change theory with health coaching to improve weight outcomes (i.e., decrease in standardized body mass index (zBMI)) and lifestyle behaviors (i.e., improve dietary quality, increase fruit and vegetable intake, reduce sugar-sweetened beverage intake, increase physical activity, and reduce screen time) among children 10- to 17-years old with overweight or obesity versus their peers randomized into a waitlist control condition. The secondary aims of this study are to 1) test whether supplementing the Aim2Be program with health coaching increases adherence and 2) examine the mediators and moderators of adherence to the Aim2Be intervention. Methods We will employ a randomized controlled trial design and recruit 200 child and parent dyads to participate in the study (2019–2020). Participants will be recruited from Canadian pediatric weight management clinics and through online advertisements. Child participants must be between the ages of 10 and 17 years, have overweight or obesity, be able to read English at least at a grade 5 level, and have a mobile phone or home computer with internet access. Following baseline data collection, participants will be randomized into intervention and waitlist control groups. Intervention participants will receive access to Aim2Be, with access to health coaching. After having their data collected for 3 months, the control group will gain access to Aim2Be, with no access to health coaching. Participants will control their frequency and duration of app usage to promote autonomy. Discussion Findings from this study will determine the efficacy of using Aim2Be in improving child weight outcomes and lifestyle behaviors and guide future mHealth interventions for pediatric weight management. Trial registration ClinicalTrials.gov, NCT03651284. Registered 29 August 2018.
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Affiliation(s)
- Louise C Mâsse
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, F508 - 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Janae Vlaar
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, F508 - 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Janice Macdonald
- Childhood Obesity Foundation, Robert HN Ho Research Centre, 771A - 2635 Laurel Street, VGH Hospital Campus, Vancouver, BC, V5 1M9, Canada
| | - Jennifer Bradbury
- Childhood Obesity Foundation, Robert HN Ho Research Centre, 771A - 2635 Laurel Street, VGH Hospital Campus, Vancouver, BC, V5 1M9, Canada
| | - Tom Warshawski
- Childhood Obesity Foundation, Robert HN Ho Research Centre, 771A - 2635 Laurel Street, VGH Hospital Campus, Vancouver, BC, V5 1M9, Canada
| | - E Jean Buckler
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, F508 - 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Jill Hamilton
- Division of Endocrinology, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, 555 University Avenue, Toronto, ON,, M5G 1X8, Canada
| | - Josephine Ho
- Cumming School of Medicine, Department of Pediatrics, University of Calgary, Calgary, AB, T2N 4N1, Canada
| | - Annick Buchholz
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Katherine M Morrison
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, 1280 Main Street W., HSC-3A, Hamilton, ON, L8S 4K1,, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 1C9, Canada
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Killedar A, Lung T, Petrou S, Teixeira-Pinto A, Tan EJ, Hayes A. Weight status and health-related quality of life during childhood and adolescence: effects of age and socioeconomic position. Int J Obes (Lond) 2020; 44:637-645. [PMID: 31949296 DOI: 10.1038/s41366-020-0529-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 12/10/2019] [Accepted: 01/07/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Overweight and obesity in children is associated with poor health-related quality of life (HRQoL), but the nuances of this relationship across different age and socio-demographic groups are not well-established. The aim of this study is to examine how the association between weight status and HRQoL changes with age and socioeconomic position (SEP) throughout childhood and adolescence. METHODS We used data from the Longitudinal Study of Australian Children (LSAC), a cohort study in which children were interviewed biennially from ages 4 to 17 years over seven waves of data. Measurements of HRQoL (using PedsQLTM), body mass index (BMI), and socio-demographic characteristics were collected at each interview. Of the 4983 children recruited into the study, we included data from 4083 children (a total of 24,446 observations). We used generalised estimating equations to assess whether age and SEP modified the association between weight status and HRQoL, after controlling for sex, long-term medical condition, language spoken to child and maternal smoking status. RESULTS Age was a significant modifier of the association between weight status and HRQoL, with adjustment for known predictors of HRQoL (P < 0.001). At age 4, children with obesity had, on average, a 0.99 (95% CI 0.02-1.96) point lower PedsQL total score than children at healthy weight. This difference became clinically important by age 9 at 4.50 (95% CI 3.86-5.13) points and increased to 6.69 (95% CI 5.74-7.64) points by age 17. There was no evidence that SEP modified the relationship between weight status and HRQoL (P > 0.05). CONCLUSIONS Our results demonstrate that the relationship between overweight and obesity status and poor HRQoL is strengthened with increasing age through childhood and adolescence, but is not affected by SEP. Paediatricians, researchers and carers of children with obesity should acknowledge HRQoL outcomes, particularly for older children and adolescents.
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Affiliation(s)
- Anagha Killedar
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia.
| | - Thomas Lung
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Stavros Petrou
- Warwick Medical School, University of Warwick, Coventry, UK.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
| | - Armando Teixeira-Pinto
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia
| | - Eng Joo Tan
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia
| | - Alison Hayes
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, 2006, Australia
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Ortiz-Pinto MA, Ortiz-Marrón H, Rodríguez-Rodríguez A, Casado-Sánchez L, Cuadrado-Gamarra JI, Galán I. Parental perception of child health status and quality of life associated with overweight and obesity in early childhood. Qual Life Res 2019; 29:163-170. [PMID: 31583617 DOI: 10.1007/s11136-019-02313-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE The aim was to assess perceived health status and health-related quality of life (HRQL) according to persistence of and variation in weight status among children from the age of 4 to 6 years. METHODS Longitudinal study of 1883 participants in the ELOIN cohort (Madrid Region, Spain), with physical examination at ages 4 and 6 years. Perceived health status and HRQL were assessed using parent-reported Kidscreen-10 scores, with excess weight being defined on the basis of body mass index (BMI) using the WHO reference tables (z-BMI > 1 standard deviation), and abdominal obesity being defined on the basis of waist circumference (percentile ≥ 90) using the tables proposed by Fernández et al. Variation in these two parameters at age 6 years was associated with incident cases of suboptimal health by logistic regression, and with HRQL by linear regression. RESULTS Compared to children without excess weight or abdominal obesity in both periods, incident cases of excess weight or abdominal obesity had odds ratios (ORs) of suboptimal health of 2.41 (95% CI 1.21 to 4.80) and 2.99 (95% CI 1.31 to 6.84) respectively. In terms of HRQL, children with remission of excess weight had a higher Kidscreen-10 score: β coefficient = 2.02 (95% CI 0.36 to 3.68), whereas new cases of abdominal obesity had a lower Kidscreen-10 score: β = - 2.22 (95% CI - 4.40 to - 0.03). CONCLUSIONS Incident cases of excess weight and abdominal obesity had a higher risk of suboptimal health. Incident cases of abdominal obesity were also associated with worse HRQL.
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Affiliation(s)
- Maira Alejandra Ortiz-Pinto
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, c/Monforte de Lemos 5, 28029, Madrid, Spain.,Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain.,Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | | | | | | | | | - Iñaki Galán
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, c/Monforte de Lemos 5, 28029, Madrid, Spain. .,Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain.
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Hails KA, Shaw DS. Associations Between Boys' Early Childhood Exposure to Family and Neighborhood Poverty and Body Mass Index in Early Adolescence. J Pediatr Psychol 2019; 44:1009-1018. [PMID: 31233133 PMCID: PMC6761930 DOI: 10.1093/jpepsy/jsz047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To test relations between exposure to poverty, in the forms of family income and neighborhood deprivation, during three developmental stages, and children's body mass index (BMI) in early adolescence. METHODS Data came from a longitudinal sample of racially diverse, urban, low-income boys. Interactions between family income to needs and census-derived neighborhood deprivation at three developmental stages-early childhood (18 and 24 months), preschool-to-school entry (3.5 and 6 years), and school-age (8 and 10 years)-were tested in relation to BMI at age 11. RESULTS There was a significant interaction whereby higher income predicted lower BMI only in the context of low levels of neighborhood deprivation in early childhood. In high-deprivation neighborhoods, higher income was associated with risk for overweight/obesity in early adolescence. This pattern was found to be specific to income and neighborhood deprivation measured in early childhood. CONCLUSIONS Findings have implications for policy relevant to obesity prevention. More research on associations between early exposure to poverty and later risk for obesity on low-income samples is warranted, as the relationship is likely complex and influenced by many different factors, including the family and neighborhood food environments and child health behaviors.
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D'avila HF, Poll FA, Reuter CP, Burgos MS, Mello ED. Health-related quality of life in adolescents with excess weight. J Pediatr (Rio J) 2019; 95:495-501. [PMID: 29957249 DOI: 10.1016/j.jped.2018.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/23/2018] [Accepted: 04/23/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To identify health-related quality of life in adolescents with excess weight and associated factors, such as gender, age, and weight categories. METHOD A cross-sectional study with collected and secondary data from 276 adolescents aged between 10 and 19 years with overweight and obesity, and whose parents or guardians authorized their participation. Anthropometric data, pubertal development, and the PedsQL 4.0 questionnaire were collected for the health-related quality of life assessment. Categorical data were described as numbers and percentages. For the description of health-related quality of life subscales, medians and the 25th and 75th percentiles were used, as well as the Mann-Whitney test for comparisons between age group, gender, and weight categories. RESULTS The median health-related quality of life total score was 78.3 (68.5-87.4). The lowest scale was the "emotional score", 65 (50-80). Higher health-related quality of life was found in boys in most of the scores (p<0.05), except for the "school score" (p=0.09). Regarding the age group, the median of the "physical scores" (p=0.03) and "social score" (p=0.02) were significantly lower in the group younger than 14 years. When separated according to weight categories, it was verified that obese adolescents differed significantly in relation to the "physical score" (p=0.00), "school score" (p=0.04), and "total score" (p=0.02) of the health-related quality of life. However, there was no significant difference between the emotional, social, and psychosocial scores. CONCLUSIONS Adolescents with overweight and obesity show losses in the health-related quality of life and also between the different domains, when separated by age, gender, and weight categories.
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Affiliation(s)
- Helen F D'avila
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
| | - Fabiana A Poll
- Universidade de Santa Cruz do Sul (UNISC), Departamento de Educação Física e Saúde, Santa Cruz do Sul, RS, Brazil
| | - Cézane P Reuter
- Universidade de Santa Cruz do Sul (UNISC), Departamento de Educação Física e Saúde, Santa Cruz do Sul, RS, Brazil
| | - Miria S Burgos
- Universidade de Santa Cruz do Sul (UNISC), Departamento de Educação Física e Saúde, Santa Cruz do Sul, RS, Brazil
| | - Elza D Mello
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
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Health‐related quality of life in adolescents with excess weight. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Silva N, Pereira M, Otto C, Ravens-Sieberer U, Canavarro MC, Bullinger M. Do 8- to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires. Qual Life Res 2019; 28:1725-1750. [PMID: 31055778 DOI: 10.1007/s11136-019-02189-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE This meta-analytic review aimed to estimate the magnitude of health-related quality of life (HrQoL) impairments, as assessed by the KIDSCREEN questionnaires, both self- and parent-reported, in 8- to 18-years-old children/adolescents with chronic health conditions. METHODS To identify studies using the KIDSCREEN questionnaires, three electronic databases (PubMed, PsycINFO, EBSCOhost Psychology & Behavioral Sciences) were searched. The final search (February 14-15, 2018) revealed 528 non-duplicated articles, of which 23 papers (21 studies) directly compared the HrQoL of pediatric patients to community/healthy controls and were included in the meta-analysis. Pooled mean differences (MD) with 95% CIs were estimated using the inverse-variance random-effects method. RESULTS Of the 21 studies, 16 used self-reports, one used parent-reports and four adopted a multi-informant approach. Self-reported data were retrieved from 20 studies (4852 cases/28,578 controls), and parent-reported data were retrieved from four studies (511 cases/433 controls). Pediatric patients presented significant HrQoL impairments in the domains of physical well-being (MD = - 4.84, 95% CI - 6.44/- 3.24 for self-reports; MD = - 6.86, 95% CI - 10.42/- 3.29 for parent-reports) and peers and social support (MD = - 1.29, 95% CI - 2.25/- 0.34 for self-reports; MD = - 3.90, 95% CI - 5.28/- 2.52 for parent-reports), compared to community/healthy peers. Between-studies heterogeneity was explained by diagnostic categories, instrument version and informants. CONCLUSIONS The identification of significant HrQoL impairments among pediatric patients, specifically in the physical and social domains, highlights the importance of routine psychosocial assessment and intervention in primary pediatric healthcare services. Specific recommendations include the use of profile measures, both self- and parent-reports, and the prioritization of oncology, endocrinology and neurology services.
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Affiliation(s)
- Neuza Silva
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal. .,Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W26, 20246, Hamburg, Germany.
| | - Marco Pereira
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Christiane Otto
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W29, 20246, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W29, 20246, Hamburg, Germany
| | - Maria Cristina Canavarro
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences of the University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, W26, 20246, Hamburg, Germany
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Miri SF, Javadi M, Lin CY, Griffiths MD, Björk M, Pakpour AH. Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: A randomized controlled trial. Diabetes Metab Syndr 2019; 13:2190-2197. [PMID: 31235156 DOI: 10.1016/j.dsx.2019.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/21/2019] [Indexed: 11/26/2022]
Abstract
AIM To assess the effectiveness of a cognitive-behavioral treatment (CBT) program on weight reduction among Iranian adolescents who are overweight. METHODS Using a randomized controlled trial design, 55 adolescents who were overweight (mean [SD] age = 14.64 [1.69] years; zBMI = 2.18 [0.65]) were recruited in the CBT program and 55 in the treatment as usual (TAU; mean age = 14.88 [1.50]; zBMI = 2.09 [0.57]) group. All the participants completed several questionnaires (Child Dietary Self-Efficacy Scale; Weight Efficacy Lifestyle questionnaire; Physical Exercise Self-Efficacy Scale; Pediatric Quality of Life Inventory; and self-reported physical activity and diet) and had their anthropometrics measured (height, weight, waist and hip circumferences, and body fat). RESULTS The CBT group consumed significantly more fruits and juice, vegetables, and dairy in the 6-month follow-up as compared with the TAU group (p-values <0.001). The CBT group consumed significantly less sweet snacks, salty snacks, sweet drinks, sausages/processed meat, and oils in the six-month follow-up compared with the TAU group (p-values<0.001). Additionally, the waist circumference, BMI, waist-hip ratio, and fat mass were significantly decreased in the CBT group in the six-month follow-up compared with the TAU group (p-values<0.005). The CBT group significantly improved their psychosocial health, physical activity, and health-related quality of life (p-values<0.001). CONCLUSION The CBT program showed its effectiveness in reducing weight among Iranian adolescents who were overweight. Healthcare providers may want to adopt this program to treat excess weight problems among adolescents.
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Affiliation(s)
- Seyedeh Fatemeh Miri
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Javadi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Maria Björk
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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Faith MS, Hittner JB, Hurston SR, Yin J, Greenspan LC, Quesenberry CP, Gunderson EP. Association of Infant Temperament With Subsequent Obesity in Young Children of Mothers With Gestational Diabetes Mellitus. JAMA Pediatr 2019; 173:424-433. [PMID: 30855657 PMCID: PMC6503510 DOI: 10.1001/jamapediatrics.2018.5199] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Infant temperament is associated with excess weight gain or childhood obesity risk in samples of healthy individuals, although the evidence has been inconsistent. To our knowledge, no prior research has examined this topic among children exposed to gestational diabetes mellitus (GDM) in utero. OBJECTIVE To prospectively evaluate infant temperament in association with overweight and obesity status at ages 2 to 5 years among children born to mothers who experienced GDM. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study took place at Kaiser Permanente Northern California medical centers. We studied singleton infants delivered at 35 weeks' gestational age or later to mothers who had been diagnosed with GDM. Data were collected from 2009 to 2016, and data analysis occurred from June 2017 to October 2018. EXPOSURES The primary exposures in the child's first year were soothability, distress to limitations, and activity aspects of temperament, as assessed by a validated questionnaire. Modifiable covariates in the child's first year included breastfeeding intensity and duration monthly ratio scores, along with the timing of the introduction of sugary beverages and complementary foods. MAIN OUTCOMES AND MEASURES The primary outcome was child overweight and obesity status, assessed at ages 2 to 5 years. Multinomial logistic regression models estimated adjusted odds ratios and 95% CIs for infants whose temperaments were measured at 6 to 9 weeks of age and categorized as elevated (≥75th percentile) or not elevated in the 3 domains. We controlled for nonmodifiable and modifiable covariates across models. RESULTS A total of 382 mother-infant pairs participted, including 130 infants (34.0%) who were non-Hispanic white, 126 infants (33.0%) who were Hispanic, 96 infants (25.1%) who were Asian, 26 infants (6.8%) who were non-Hispanic black, and 4 infants (1.1%) who were of other races/ethnicities. In descriptive analyses, elevated infant soothability and activity temperaments were associated with the early introduction of 100% fruit juice and/or sugar-sweetened beverages (at ages <6 months) and shorter breastfeeding duration (from 0 to <3 months), while elevated distress to limitations was associated with early introduction of complementary foods (at ages <4 months). Elevated soothability consistently was associated with a higher odds of later childhood obesity, with adjusted odds ratios across models ranging from 2.22 (95% CI, 1.04-4.73) to 2.54 (95% CI, 1.28-5.03). Greater breastfeeding intensity and duration (12-month combined) score was associated with lower odds of obesity, independent of infant temperament and other covariates. CONCLUSIONS AND RELEVANCE Among this high-risk population of infants, elevated soothability was associated with early childhood obesity risk, perhaps in part because caregivers use sugary drinks to assuage infants. Soothability temperament may be a novel screening target for early obesity prevention interventions involving responsive feeding and emotion regulation.
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Affiliation(s)
- Myles S. Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo–State University of New York, Buffalo
| | - James B. Hittner
- Department of Psychology, College of Charleston, Charleston, South Carolina
| | - Shanta R. Hurston
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | - Jie Yin
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | | | - Charles P. Quesenberry
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | - Erica P. Gunderson
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
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A Systematic Review of Data Collection Techniques Used to Measure Preschool Children's Knowledge of and Preference for Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060964. [PMID: 30889836 PMCID: PMC6466374 DOI: 10.3390/ijerph16060964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 11/27/2022]
Abstract
Background: Early childhood has been identified as a crucial period in which children develop physical activity preferences and behaviors. Both the knowledge of and preferences for physical activity are key proximal indicators of activity choices in children. Thus, accurate data collection tools are required to measure these variables. This review evaluates the data collection techniques that have been utilised to assess preschool children’s knowledge of and preference for physical activity, and examines the validity and reliability of existing techniques. Methods: A systematic search for relevant studies published from 1980 through to December 2017 was conducted via ProQuest, CINAHL, Embase, Scopus, ERIC, PubMed, MEDLINE, and ScienceDirect. Results: Fourteen studies were eligible for inclusion in the review. The identified studies employed a limited but disparate range of techniques to assess children’s physical activity knowledge and preferences. Findings reveal that four techniques were consistently used across the reviewed studies, including: interviews, structured play-based activities, questionnaires, and observations. Only four out of 14 included studies reported the assessment of the validity of the data collection tool used, and six reported testing the measures for at least one type of reliability. Conclusion: There is a need for validated and reliable measures to assess children’s knowledge of and preference for physical activity. Greater consideration is required to align data collection techniques with the characteristics, needs and abilities of this study population.
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Jardí C, Aranda N, Bedmar C, Ribot B, Elias I, Aparicio E, Arija V. Ingesta de azúcares libres y exceso de peso en edades tempranas. Estudio longitudinal. An Pediatr (Barc) 2019; 90:165-172. [DOI: 10.1016/j.anpedi.2018.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/20/2018] [Accepted: 03/28/2018] [Indexed: 12/11/2022] Open
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Health-related quality-of-life model in adolescents with different body composition. Eat Weight Disord 2019; 24:143-150. [PMID: 29557055 DOI: 10.1007/s40519-018-0501-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 03/14/2018] [Indexed: 12/22/2022] Open
Abstract
The purpose of the present study was to develop and evaluate a causal model of health-related quality of life (HRQoL) in adolescents with different body composition. The participants were 209 adolescents (107 women and 102 men) ranging from 10 to 15 years of age. A model based on that proposed by Wilson and Cleary (JAMA 273(1):59-65, 1995) was elaborated. The body composition of the participants was analyzed. They were asked to complete a battery of questionnaires composed of the following factors: biological status (BS; included body mass index and weight), symptomatic psychological status (SPS; included the variables of drive for thinness and food concerns), functional status (FS; composed of physical activity, food consumption estimation, and socioeconomic status), and HRQoL, which included the dimensions of psychological well-being, autonomy and relationship with parents, social support and peers, and the academic environment. Structural equation modeling produced a model, which obtained an adequate fit for the prediction of HRQoL (χ2(38) = 51.88, p = .07; NNFI = 0.97, CFI = 0.98, GFI = 0.95, and RMSEA = 0.04). The main outcome demonstrated the indirect effect of BS (0.44) and SPS (- 0.45) as well as a direct effect of FS (0.21) on HRQoL. In addition, a second path was observed, BS has an indirect effect on FS (0.34) and FS on HRQoL (0.21). These results provide empirical support for the evaluated model.Level of evidence: Level V, Descriptive study.
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Lebacq T, Dujeu M, Méroc E, Moreau N, Pedroni C, Godin I, Castetbon K. Perceived social support from teachers and classmates does not moderate the inverse association between body mass index and health-related quality of life in adolescents. Qual Life Res 2018; 28:895-905. [DOI: 10.1007/s11136-018-2079-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 11/29/2022]
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Murray M, Pearson JL, Dordevic AL, Bonham MP. The impact of multicomponent weight management interventions on quality of life in adolescents affected by overweight or obesity: a meta-analysis of randomized controlled trials. Obes Rev 2018; 20:278-289. [PMID: 30358046 DOI: 10.1111/obr.12774] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/23/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Abstract
Adolescents affected by overweight or obesity report similar quality of life to adolescents with cancer. While weight management is important for physiological outcomes, it is unclear whether weight management improves quality of life in this age group. This meta-analysis assessed the impact of multicomponent weight management interventions on quality of life in adolescents affected by overweight or obesity. Ovid PsycINFO, Ovid Medline, Ovid Embase, Cochrane Library, Scopus and CINAHL Plus databases were searched up to July 2017. Eight eligible studies were randomized controlled trials of multicomponent weight management interventions for adolescents (10 to 19 years) affected by overweight or obesity, with quality of life and weight measurements. Meta-analyses determined a positive effect on quality of life (mean difference 0.20 [0.11, 0.29]; p < 0.01) and weight (mean difference 0.30 [0.12, 0.47]; p < 0.01) following intervention. There was no correlation between weight loss and improvements in quality of life (R2 = 0.103). Rather than weight loss, intervention factors such as parental involvement, group settings and a focus on psychosocial well-being appeared linked to improvements in quality of life. The reduced quality of life reported by this group may be due to social consequences of obesity, rather than actual weight.
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Affiliation(s)
- M Murray
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - J L Pearson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - A L Dordevic
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - M P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
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Borner KB, Mitchell TB, Gray JS, Davis AM, Pont SJ, Sweeney BR, Hampl S, Dreyer Gillette ML. Factor Structure of a Spanish Translation of an Obesity-Specific Parent-Report Measure of Health-Related Quality of Life. J Pediatr Psychol 2018; 43:1028-1037. [PMID: 29771361 DOI: 10.1093/jpepsy/jsy030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 04/17/2018] [Indexed: 11/12/2022] Open
Abstract
Objective Latino youth are disproportionately affected by pediatric obesity and consequently experience impaired health-related quality of life (HRQOL). Although many caregivers of Latino youth do not speak English fluently, no validated Spanish translations of obesity-specific HRQOL measures exist for this population. Therefore, non-English-speaking Latino parents have typically been excluded from analyses related to HRQOL. This study assesses the factor structure of a Spanish translation of a parent-report measure of obesity-specific HRQOL, Sizing Them Up, in a treatment-seeking sample of children with obesity. Methods Structural equation modeling was used to assess the factor structure of the 6-subscale, 22-item Sizing Them Up measure in 154 parents of treatment-seeking Latino youth (5-18 years of age). Analyses exploring internal consistency and convergent validity were also conducted. Results Acceptable measurement fit was achieved for the six-factor solution. However, the higher-order model assessing Total HRQOL did not reach acceptable levels, as results found that the Positive Social Attributes (PSA) subscale was not representative of Total HRQOL; internal consistency and convergent validity results also supported this finding. Conclusions The current study provides support for the utility of a modified version of Sizing Them Up, excluding the PSA Scale, as a parent-report measure of obesity-specific HRQOL in treatment-seeking Latino youth with obesity.
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Affiliation(s)
- Kelsey B Borner
- Division of Pain Medicine, Children's National Medical Center
| | | | - Jane S Gray
- Texas Child Study Center, Dell Children's Medical Center, University of Texas at Austin
| | - Ann M Davis
- Center for Children's Healthy Lifestyles & Nutrition.,University of Kansas Medical Center
| | - Stephen J Pont
- Texas Department of State Health Services, Office of Science and Population Health.,University of Texas at Austin, Dell Medical School & College of Communications
| | - Brooke R Sweeney
- Center for Children's Healthy Lifestyles & Nutrition.,Department of Pediatrics, Division of General Academic Pediatrics, Children's Mercy Kansas City.,University of Missouri Kansas City School of Medicine
| | - Sarah Hampl
- Center for Children's Healthy Lifestyles & Nutrition.,Department of Pediatrics, Division of General Academic Pediatrics, Children's Mercy Kansas City
| | - Meredith L Dreyer Gillette
- Center for Children's Healthy Lifestyles & Nutrition.,Department of Pediatrics, Division of Developmental and Behavioral Sciences, Children's Mercy Kansas City
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Effectiveness and safety of Noofen® in children with autonomic dysfunction with a lack of adaptive capacity and reduced cognitive function. Fam Med 2018. [DOI: 10.30841/2307-5112.3.2018.146800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Brown V, Tan EJ, Hayes AJ, Petrou S, Moodie ML. Utility values for childhood obesity interventions: a systematic review and meta-analysis of the evidence for use in economic evaluation. Obes Rev 2018; 19:905-916. [PMID: 29356315 DOI: 10.1111/obr.12672] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/12/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Abstract
Rigorous estimates of preference-based utilities are important inputs into economic evaluations of childhood obesity interventions, yet no published review currently exists examining utility by weight status in paediatric populations. A comprehensive systematic literature review and meta-analysis was therefore undertaken, pooling data on preference-based health state utilities by weight status in children using a random-effects model. Tests for heterogeneity were performed, and publication bias was assessed. Of 3,434 potentially relevant studies identified, 11 met our eligibility criteria. Estimates of Cohen's d statistic suggested a small effect of weight status on preference-based utilities. Mean utility values were estimated as 0.85 (95% uncertainty interval [UI] 0.84-0.87), 0.83 (95% UI 0.81-0.85), 0.82 (95% UI 0.79-0.84) and 0.83 (95% UI 0.80-0.86) for healthy weight, overweight, obese and overweight/obese states, respectively. Meta-analysis of studies reporting utility values for both healthy weight and overweight/obese participants found a statistically significant weighted mean difference (0.015, 95% UI 0.003-0.026). A small but statistically significant difference was also estimated between healthy weight and overweight participants (0.011, 95% UI 0.004-0.018). Study findings suggest that paediatric-specific benefits of obesity interventions may not be well reflected by available utility measures, potentially underestimating cost-effectiveness if weight loss in childhood/adolescence improves health or well-being.
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Affiliation(s)
- V Brown
- Deakin Health Economics, Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
| | - E J Tan
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A J Hayes
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - S Petrou
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,Warwick Medical School, University of Warwick, Coventry, UK
| | - M L Moodie
- Deakin Health Economics, Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
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Weight Misperception and Health-Related Quality of Life in Appalachian Adolescents in the United States. Matern Child Health J 2018; 21:168-176. [PMID: 27430940 DOI: 10.1007/s10995-016-2106-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction There is limited research on the relation between weight misperceptions and health-related quality of life (HRQoL) among U.S. adolescents. Methods Baseline data (n = 1509) collected in 2012 from the Team Up for Healthy Living project were used. Measures included BMI percentiles calculated from measured height and weight; self-perception of weight status; and the 23-item PedsQL™ Inventory. Multiple linear regression was performed after adjustment for covariates to examine associations between weight misperception and HRQoL. Results Compared to accurate weight perception, weight underestimation was associated with higher total HRQoL (β = 2.41), physical health (β = 2.77), and emotional (β = 2.83), social (β = 2.47) and psychosocial functioning (β = 2.38) (all p < 0.05). Weight overestimation was associated with lower social functioning (β = -13.13, p < 0.05). Stratified by gender, associations were observed only in males. Discussion Weight underestimation had greater association with HRQoL than weight overestimation; and varied by gender. Better understanding of these associations will assist in improving the health of adolescents in Southern Appalachia.
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