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Johnson JL, Coleman A, Kwarteng JL, Holmes AU, Kermah D, Bruce MA, Beech BM. The Association between Adult Sport, Fitness, and Recreational Physical Activity and Number and Age of Children Present in the Household: A Secondary Analysis Using NHANES. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5942. [PMID: 37297546 PMCID: PMC10253130 DOI: 10.3390/ijerph20115942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
Only one in three adults in the United States meets the weekly recommendation for physical activity (PA). The presence of children in the home may restrict adult PA. The purpose of this study was to examine the association between adult moderate and vigorous sport, fitness, and recreational physical activities and the number and age (0-5 and 6-17) of children in their household. Secondary data were drawn from the National Health and Nutrition Examination Survey (NHANES) from 2007-2016. Adults with complete survey data for self-reported moderate (MPA) and vigorous physical activities (VPA), number of children in the home, and other sociodemographic variables were included. The final sample included 2034 adults from 22-65 years of age. Analyses included ANOVAs and separate multivariable regression analyses to determine if the number of children in the household aged 0-5 and 6-17 were significant predictors of weekly moderate-to-vigorous physical activity (MVPA) after controlling for covariates. For MPA, no differences were found between adult PA regardless of the number and age of children in the home. For VPA, adults with two or more children aged 0-5 reported 80 fewer minutes of weekly VPA (p < 0.05) compared to those with no children or just one child in this age group after controlling for all covariates. Finally, adults with three or more children in the household aged 6-17 reported fifty fewer minutes of weekly VPA (p < 0.05) compared to those with no children, one, or just two in the household. These findings highlight a need to support the vigorous PA behaviors of this population, as the majority of the family-based PA intervention studies to date have primarily focused on family dyads.
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Affiliation(s)
- Jerraco L. Johnson
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, TX 76203, USA
| | - Ailton Coleman
- Department of Health Sciences, James Madison University, Harrisonburg, VA 22807, USA;
| | - Jamila L. Kwarteng
- Division of Community Health, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Ahondju U. Holmes
- University of Oklahoma Stephenson Cancer Center, Oklahoma City, OK 73014, USA;
| | - Dulcie Kermah
- Urban Health Institute Student Research Core Charles R., Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Marino A. Bruce
- Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX 77021, USA; (M.A.B.); (B.M.B.)
- UH Population Health, University of Houston, Houston, TX 77021, USA
| | - Bettina M. Beech
- Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX 77021, USA; (M.A.B.); (B.M.B.)
- UH Population Health, University of Houston, Houston, TX 77021, USA
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2
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McGovern C, Arcoleo K, Melnyk B. Sustained Effects From a School-Based Intervention Pilot Study for Children With Asthma and Anxiety. J Sch Nurs 2022; 38:347-357. [PMID: 32588717 PMCID: PMC9026658 DOI: 10.1177/1059840520934178] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Children with chronic conditions (i.e., asthma) are more likely to have anxiety or depressive symptoms. Comorbid asthma and anxiety in children leads to increased morbidity, causing children to miss instructional time and parent/caregiver (CG) work absences. Asthma educational programs and mental health interventions have been developed, though no scalable programs integrate asthma education and mental health behavioral interventions for school-aged children. This study evaluated the sustained preliminary effects of an integrated asthma education and cognitive behavioral skills-building program, Creating Opportunities for Personal Empowerment for Asthma. Thirty-two children ages 8-12 years with asthma and symptoms of anxiety received the intervention. At 6-weeks postintervention, anxiety and CG-reported behavioral symptoms were significantly reduced, there were fewer missed doses of asthma controller medications, and asthma-related self-efficacy, personal beliefs, and the children's understanding of asthma significantly increased. Most children (n = 29, 91%) reported continued use of coping skills.
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Affiliation(s)
- Colleen McGovern
- School of Nursing, University of North Carolina at Chapel Hill, NC, USA
| | | | - Bernadette Melnyk
- College of Nursing, The Ohio State University, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
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3
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Wilson M, Bindler RJ, Stanek K, Layton ME, Quock RM. Hyperbaric Oxygen Therapy for Pain, Opioid Withdrawal, and Related Symptoms: A Pilot Randomized Controlled Trial. Pain Manag Nurs 2022; 23:616-624. [PMID: 35393218 DOI: 10.1016/j.pmn.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/01/2022] [Accepted: 03/05/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pain, drug cravings, and opioid withdrawal symptoms can interfere with substance use disorder or opioid tapering treatment goals. AIM This pilot study investigated the feasibility of a protocol designed to test opioid withdrawal symptom relief relative to a sham condition after two consecutive days of hyperbaric oxygen therapy (HBOT) for adults prescribed daily methadone for opioid use disorder. METHOD Using a double-blind protocol, eight adults were randomized to receive either a full 90-minute HBOT dose in a pressurized chamber with 100% oxygen at 2.0 atmospheres absolute (ATA) or a sham condition receiving 21% oxygen (equivalent to room air within the chamber) at a minimal pressure of ≤1.3 ATA. Measures included study retention, treatment satisfaction, and pre- and post-intervention effects for opioid withdrawal symptoms, drug cravings, pain intensity and interference, sleep quality, and mood. RESULTS Study retention and treatment satisfaction was high. All measurements improved more, on average, for participants receiving full-dose HBOT treatment than among participants receiving sham treatments except for clinically observed withdrawal symptoms. The largest positive effects were observed in measurements of pain intensity and drug craving. CONCLUSIONS These pilot results provide evidence to support a fully powered study of HBOT as a potential treatment adjunct for adults receiving methadone for opioid use disorder. Trends towards symptom improvements were detected from pre- to post-HBOT in the full treatment arm versus sham condition. More research into novel non-pharmacologic options to relieve distressing symptoms related to pain and opioid use disorder is essential to improve clinical outcomes.
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Affiliation(s)
- Marian Wilson
- College of Nursing, Washington State University, Spokane, Washington; Program of Excellence in Addictions Research, Washington State University, Spokane, Washington; Sleep and Performance Research Center, Washington State University, Spokane, Washington.
| | - Ross J Bindler
- College of Nursing, Washington State University, Spokane, Washington.
| | - Karen Stanek
- Spokane Hyperbaric Center, Spokane Valley, Washington
| | - Matthew E Layton
- Program of Excellence in Addictions Research, Washington State University, Spokane, Washington; Sleep and Performance Research Center, Washington State University, Spokane, Washington; Department of Translational Medicine and Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - Raymond M Quock
- Department of Psychology, Washington State University, Pullman, Washington
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Grogg KA, Giacobbi PR, Blair EK, Haggerty TS, Lilly CL, Winters CS, Kelley GA. Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review. Am J Health Promot 2022; 36:714-737. [PMID: 35224998 DOI: 10.1177/08901171211051840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this scoping review was to systematically examine interventions that focused on physical activity assessment and promotion in clinical settings in the United States. DATA SOURCES A literature search was performed in 6 major databases to extract published peer-reviewed studies from 2008 to 2019. INCLUSION AND EXCLUSION CRITERIA Interventions with practicing health professionals in the United States who performed physical activity assessment and promotion with adult patients 18 years of age and older. Studies were excluded if they were published in non-English, observational or case study designs, or gray literature. DATA EXTRACTION Studies were screened and coded based on the population, intervention, comparison, outcomes and study setting for scoping reviews (PRISMA-ScR) framework. Of 654 studies that were identified and screened for eligibility, 78 met eligibility criteria and were independently coded by two coders. DATA SYNTHESIS Data were synthesized using qualitative and descriptive methods. RESULTS Forty-three of the included studies were randomized controlled trials with a majority being delivered by physicians and nurses in primary care settings. Fifty-six studies reported statistically significant findings in outcome measures such as anthropometrics and chronic disease risk factors, with 17 demonstrating improvements in physical activity levels as a result of the interventions. CONCLUSION The assessment and promotion of physical activity in clinical settings appears to be effective but warrants continued research.
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Affiliation(s)
- Kristin A Grogg
- West Virginia Clinical and Translational Science Institute, 5631West Virginia University School of Medicine and Honors College, Morgantown, WV, USA
| | - Peter R Giacobbi
- Department of Sport Sciences, Joint Appointment in Department of Social & Behavioral Sciences, 5631West Virginia University College of Physical Activity & Sport Sciences, School of Public Health, Morgantown, WV, USA
| | - Emma K Blair
- Department of Exercise Physiology, 5631West Virginia University, School of Medicine, Morgantown, WV, USA
| | - Treah S Haggerty
- Department of Family Medicine, 5631West Virginia University, School of Medicine, Morgantown, WV, USA
| | - Christa L Lilly
- Department of Biostatistics, 5631West Virginia University, School of Public Health, Morgantown, WV, USA
| | - Carena S Winters
- Department of Kinesiology, 4121Jacksonville University, Brooks Rehabilitation College of Healthcare Sciences, Jacksonville, FL, USA
| | - George A Kelley
- Department of Biostatistics, 5631West Virginia University, School of Public Health, Morgantown, WV, USA
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Campisi SC, Zasowski C, Shah S, Bradley-Ridout G, Madigan S, Szatmari P, Korczak DJ. Do Healthy Dietary Interventions Improve Pediatric Depressive Symptoms? A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:2495-2507. [PMID: 34302170 PMCID: PMC8634309 DOI: 10.1093/advances/nmab088] [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] [Received: 02/05/2021] [Revised: 04/05/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Dietary recommendations have been proposed as a way of impacting current and future mental health. There exists a limited body of conflicting literature related to pediatric nutritional interventions and depression. This meta-analysis aims to determine the efficacy of child and adolescent dietary interventions on depression. Systematic searches in electronic databases and gray literature were conducted. After screening 6725 citations, 17 studies were included in this systematic review. Quality assessment was performed using the Cochrane risk-of-bias tool and the Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental Studies. A meta-analysis of Hedges g values was calculated using the Hartung-Knapp-Sidik-Jonkman method. Publication bias was assessed with funnel plots and the Egger test. The results of the meta-analysis of the RCTs (k = 7) demonstrated a nonsignificant effect of dietary intervention (g = 0.05; 95% CI: -0.25, 0.35; P = 0.70) whereas the results of the pre-post intervention studies (k = 9) demonstrated a significant small-to-medium effect favoring dietary intervention for reducing depression (g = -0.45; 95% CI: -0.64, -0.27; P = 0.001). Publication bias was not detected by the Egger test or by funnel plot asymmetry. The current meta-analysis demonstrates that "healthy" dietary interventions for children or adolescents in the community have little impact on nonclinical depression. Confusion will persist until better-designed studies in pediatric nutritional psychiatry research focusing on adolescents with depressive illness are conducted.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Clare Zasowski
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Shailja Shah
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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6
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Cheng H, George C, Dunham M, Whitehead L, Denney-Wilson E. Nurse-led interventions in the prevention and treatment of overweight and obesity in infants, children and adolescents: A scoping review. Int J Nurs Stud 2021; 121:104008. [PMID: 34260995 DOI: 10.1016/j.ijnurstu.2021.104008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 06/01/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Nurses are well-placed in primary care, school and community settings to identify and manage paediatric overweight and obesity. This scoping review examined what types of nurse-led interventions have been undertaken for the prevention, treatment and management of obesity and overweight in infants, children and adolescents. DESIGN Scoping review. DATA SOURCES CINAHL, Cochrane Library, Embase, MEDLINE, ProQuest Central, ProQuest Dissertations & Theses Global, and Scopus. Searches were undertaken from inception to 2019. METHODS Database searches and handsearching were used to identify academic and grey literature, such as scientific reports and university theses and dissertations, on nurse-led interventions undertaken in school, primary health care and community settings. Studies focused on addressing overweight and obesity in children and adolescents, for studies published from 1999 onwards. Studies included focused on experimental and quasi-experimental research that implemented interventions, and described new practice or change in practice. RESULTS 117 references encompassing 83 studies or programs were selected for inclusion. 16 trials were analysed descriptively, and 67 trials were analysed descriptively and quantitatively. The analysis structured intervention settings and outcomes using the socioecological model, encompassing intrapersonal, interpersonal, community, organisation and policy factors. Studies included were clinically heterogeneous for intervention setting and multicomponent strategies. Education for nutrition, physical activity and behaviour change was the most common strategy used, and nutrition and physical activity knowledge most consistently improved after intervention. Nursing roles focused on education; counselling and behaviour change in primary care; advocacy in school and community environments; and implementing policy in child care settings. Fifty-four studies received financial or resource funding and support to implement the study. On sustainability, seven programs and two research studies were ongoing at time of writing. CONCLUSIONS While the clinical heterogeneity of studies makes synthesis of outcomes complex, it demonstrates the breadth of nursing interventions to address paediatric overweight and obesity. Incentives that encourage routine health promotion, upskilling of nurses, and embedding food and nutrition education into the school curricula, are suitable strategies that support nurse-led interventions against paediatric obesity. REGISTRATION NUMBER Not applicable. Tweetable abstract: Scoping r/v - what interventions are led by nurses to address paediatric obesity? 83 studies investigate nurses' work in school, primary health, community care.
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Affiliation(s)
- Heilok Cheng
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Susan Wakil Health Building, Camperdown, NSW, 2006, Australia; Centre of Research Excellence in Early Prevention of Childhood Obesity, The University of Sydney, Australia.
| | - Cobie George
- Australian College of Nursing, 1 Napier Close, Deakin, Australian Capital Territory, 2050, Australia.
| | - Melissa Dunham
- Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia.
| | - Lisa Whitehead
- Australian College of Nursing, 1 Napier Close, Deakin, Australian Capital Territory, 2050, Australia; Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia.
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Susan Wakil Health Building, Camperdown, NSW, 2006, Australia; Centre of Research Excellence in Early Prevention of Childhood Obesity, The University of Sydney, Australia; Sydney Institute for Women, Children and Families, King George V Building, Sydney Local Health District, Missenden Road, Camperdown, New South Wales, 2050, Australia.
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7
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Akdeniz Kudubeş A, Bektas M. Orginal Article: Psychometric Properties of the Turkish Version of the Healthy Lifestyle Belief Scale for Adolescents. J Pediatr Nurs 2020; 53:e57-e63. [PMID: 32139234 DOI: 10.1016/j.pedn.2020.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/12/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE Measuring the adolescent awareness of healthy lifestyle behaviors and the self-efficacy needed to change behaviors is an important step in improving the health of this population. The Healthy Lifestyle Beliefs Scale is one such instrument, and it has been used to measure the healthy behaviors of adolescents in the United States. This study aims to extend this instrument by evaluating its validity and reliability in Turkish adolescents. METHODS This methodological, descriptive, correlational study was conducted on 843 adolescents between October 2019 and November 2019. Data were collected using a socio-demographic information form and the Healthy Lifestyle Beliefs Scale. Factor analysis, Cronbach's alpha, and item-total score analysis were used for the data analysis. RESULTS The scale consisted of 16 items and three subscales. The three subscales were found to explain 57.66% of the total variance. The total factor loading was >0.30 in both exploratory and confirmatory factor analyses. In the confirmatory factor analysis, all the goodness of fit indexes were >0.91, and the root mean square error of approximation was <0.08. The Cronbach's alpha coefficient for the overall scale was 0.90, and the Cronbach's alpha values for the subscales were 0.79-0.84. DISCUSSION The Healthy Lifestyle Beliefs Scale for adolescents was found to be a valid and reliable measurement tool for the Turkish sample. PRACTICE IMPLICATIONS Determining the healthy lifestyle beliefs of adolescents can contribute to the creation of healthy lifestyle behaviors.
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Affiliation(s)
| | - Murat Bektas
- Dokuz Eylul University Faculty of Nursing, Turkey
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8
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Pratt KJ, Skelton JA, Lewis KH, Taylor CA, Spees C, Brown CL. Family Meal Practices and Weight Talk Between Adult Weight Management and Weight Loss Surgery Patients and Their Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:579-587. [PMID: 32527416 PMCID: PMC10173866 DOI: 10.1016/j.jneb.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 05/14/2023]
Abstract
OBJECTIVE To identify predictors associated with specific family meal practices and weight talk among patients participating in weight management programs (WMPs) and weight loss surgery (WLS) and their children. DESIGN Cross-sectional survey. SETTING Two US weight management centers. PARTICIPANTS 259 patients (aged ≥ 18 years) in either WMP (n = 101) or WLS (n = 158) and residing with a child (aged 2-18 years) MAIN OUTCOME MEASURE(S): Dependent variables: family meal practices (Project EAT) and weight talk (investigator-created). Covariates: family communication (Family Communication Scale), family discouragement for making eating habit change (Social Support for Eating Habits Survey), child age, sex, and perceived weight status, and WMP or WLS participation. ANALYSIS Binomial and ordinal regression models determined the odds of engaging in specific family meal practices and weight talk, including covariates. RESULTS Patients had increased odds of engaging in family dinners if they reported lower family discouragement (P = .003) and had younger children (P < .001), and increased odds of engaging in family breakfast if they had higher family communication (P = .002) and younger children (P = .020). Patients had increased odds of talking about their child's weight if their child was perceived to have an overweight/obese weight status (P < .001). Patients with older children had increased odds of talking about their weight with their child (P = .021). CONCLUSIONS AND IMPLICATIONS Additional research assessing the family meal practices and weight talk in the families of adults pursuing weight loss could yield important evidence that could lead to improved patient outcomes, and safely promote healthy behaviors and prevention of obesity in children.
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Affiliation(s)
- Keeley J Pratt
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH; Department of Surgery, The Wexner Medical Center, The Ohio State University, Columbus, OH.
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest University, Winston Salem, NC; Department of Epidemiology and Prevention, Wake Forest University, Winston Salem, NC
| | - Kristina H Lewis
- Department of Epidemiology and Prevention, Wake Forest University, Winston Salem, NC
| | - Christopher A Taylor
- Medical Dietetics Program, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
| | - Colleen Spees
- Medical Dietetics Program, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
| | - Callie L Brown
- Department of Pediatrics, Wake Forest University, Winston Salem, NC
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9
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McGovern CM, Arcoleo K, Melnyk B. COPE for asthma: Outcomes of a cognitive behavioral intervention for children with asthma and anxiety. ACTA ACUST UNITED AC 2020; 34:665-676. [PMID: 31697152 DOI: 10.1037/spq0000310] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Asthma is the most common childhood chronic condition and a major contributor to school absences and lost instructional time. Children with asthma have a higher risk of internalizing disorders, such as anxiety and depression, which can further complicate asthma management. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary effects of a manualized, cognitive-behavioral skills-building intervention for children with asthma and anxiety. The design for this study was a one-group, pre/posttest preexperimental with a 6-week follow-up. This article presents the immediate posttest follow-up results. Children between 8 and 12 years of age and their caregivers were recruited from three elementary schools in a large public school district in Ohio. Thirty-two children with asthma and symptoms of anxiety completed the Creating Opportunities for Personal Empowerment (COPE) for Asthma program. Caregivers completed surveys, but they did not participate in the intervention. Results indicated that the program was feasible to implement in small groups during the school day. Self-reported findings indicated a significant reduction in separation anxiety and increased personal beliefs, child-management self-efficacy, and asthma illness representations. Parents and caregivers reported symptom reduction in their children on the Pediatric Symptom Checklist. The subgroup of children scoring high on anxiety at baseline showed reductions with the intervention, having large positive effect sizes for separation and social anxiety as well as medium and large positive effect sizes on the personal beliefs and asthma illness representations, respectively. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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10
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Albright CA, Pratt KJ, Martin SB, Hulshult H, Brown CL, Lewis KH, Skelton JA. Family members' experiences with adult participation in weight management programs: Triadic perspectives from patients, partners and children. Clin Obes 2020; 10:e12354. [PMID: 31965733 PMCID: PMC9107074 DOI: 10.1111/cob.12354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/25/2019] [Accepted: 01/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Spouses are known to influence the outcomes of an individual's attempt at weight loss, but little is known about the broader influence of, and on, the family. The objectives were to explore: (a) the effects of an adult weight management program on the family and (b) family factors that help or hinder patient weight loss. METHODS A qualitative design was employed to explore triadic family members' experiences of patient participation in a weight management program. Semi-structured interviews were conducted with patients, partners and children (ages 7-18). Questions included support for patient participation and weight loss, dietary choices, meal preparation, physical activity routines, the home-food environment, communication about health and family dynamics. Thematic analysis was used, where codes and categories of codes were then grouped together to create themes and subthemes. RESULTS Nineteen triadic interviews were conducted (57 total). Seven themes emerged, including four related to Outcomes (objective 1): (a) shift in family dynamics, (b) family behaviour change, (c) child observations of family change, (d) indirect benefit to partner; and three related to Process (objective 2): (e) level of accountability, (f) patient perception of support and (g) support is essential and flexible. CONCLUSIONS Future research and clinical applications from these themes should seek to determine the positive behaviour change that was evident in the families that were interviewed, where the culmination of family interactions, expectations and concurrent partner weight loss indicates the potential longevity of weight management programs beyond patients' own participation.
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Affiliation(s)
| | - Keeley J. Pratt
- Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
| | - Sarah B. Martin
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Callie L. Brown
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristina H. Lewis
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joseph A. Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
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11
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Gow ML, Tee MSY, Garnett SP, Baur LA, Aldwell K, Thomas S, Lister NB, Paxton SJ, Jebeile H. Pediatric obesity treatment, self-esteem, and body image: A systematic review with meta-analysis. Pediatr Obes 2020; 15:e12600. [PMID: 32020780 DOI: 10.1111/ijpo.12600] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pediatric obesity impacts on multiple domains of psychological health, including self-esteem and body image. OBJECTIVE To determine the effect of multicomponent pediatric obesity treatment interventions on self-esteem and body image. METHODS A systematic search of published literature up to June 2019 was undertaken using electronic databases MEDLINE, EMBASE, Cochrane Library, and PsychINFO. Eligible studies implemented an obesity treatment intervention, including a dietary and physical activity component with/without a behavioral component, in children and adolescents with overweight/obesity, and assessed self-esteem and/or body image. Data were extracted by one reviewer and cross-checked. Meta-analysis was used to combine outcome data and moderator analysis conducted to identify intervention characteristics influencing outcomes. RESULTS 64 studies were identified. Meta-analysis of 49 studies (n = 10471) indicated that pediatric obesity treatment results in increased self-esteem postintervention (standardized mean difference, [SE] 0.34 [0.03], P < .001, I2 87%), maintained at follow-up (0.35 [0.05] P < .001, I2 79%, 17 studies). Similarly, meta-analysis of 40 studies (n = 2729) indicated improvements in body image postintervention (0.40 [0.03], P < .001, I2 73%), maintained at follow-up (0.41 [0.08], P < .001, I2 89%, 16 studies). CONCLUSIONS Pediatric obesity treatment improves self-esteem and body image in the short and medium term. These findings may underpin improvements in other psychological outcomes.
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Affiliation(s)
- Megan L Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Melissa S Y Tee
- The University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Weight Management Services, The Children's Hospital at Westmead, Sydney, Australia
| | - Katharine Aldwell
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Sarah Thomas
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
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Tirlea L, Bonham M, Dordevic A, Bristow C, Day K, Brennan L, Haines T, Murray M. Measuring Self-Esteem Changes in Children and Adolescents Affected by Overweight or Obesity: A Scoping Review of Instruments Currently Used in Multicomponent Weight-Management Interventions. Child Obes 2019; 15:485-501. [PMID: 31364864 DOI: 10.1089/chi.2019.0058] [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] [Indexed: 11/12/2022]
Abstract
Purpose: Children and adolescents affected by overweight or obesity are at risk of greater declines in self-esteem than healthy-weight individuals. Participation in multicomponent weight-management programs can positively influence self-esteem in children and adolescents affected by overweight or obesity; however, the variety of questionnaires used to assess self-esteem makes it difficult to compare changes across and identify effective interventions. This review identified and critically examined questionnaires currently used for monitoring self-esteem in children and adolescents. Methods: An electronic search, from 2007 onward, identified multicomponent weight-management interventions that included a measure of self-esteem. A second search identified studies that reported validation assessment of the questionnaires identified in search one. Results: Seven validated self-esteem questionnaires were employed across the 36 studies identified in search one, including (in descending order of use) Harter's Self-Perception Profiles for children and adolescents, Rosenberg Self-Esteem Scale, Marsh's Self-Description Questionnaire-I, Beck Youth Inventory II, Piers-Harris Self-Concept Scale, and Children and Youth Physical Self-Perception Profile. These tools measured global self-esteem (n = 1) as well as self-esteem as a series of subscales (multidimensional), such as physical appearance and social competence (n = 6). Conclusions: In the absence of changes in global self-esteem, multidimensional tools allow the examination of domains of self-esteem. The Harter's Self-Perception Profile for Children (SPPC) and adolescents questionnaire is an example of a tool that encompasses multidimensional aspects of self-esteem and global self-esteem and is appropriate for younger and older aged children and adolescents.
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Affiliation(s)
- Loredana Tirlea
- Faculty of Health, Arts, and Design, Swinburne University of Technology, Hawthorn, Australia
| | - Maxine Bonham
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Australia
| | - Aimee Dordevic
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Australia
| | - Claire Bristow
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Australia.,Faculty of Education, Monash Education, Clayton, Australia
| | - Kaitlin Day
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Australia
| | - Leah Brennan
- School of Psychology, Australian Catholic University, Fitzroy, Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Margaret Murray
- Department of Nutrition, Dietetics, and Food, Monash University, Notting Hill, Australia.,School of Chemistry, Monash University, Clayton, Australia
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13
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Jebeile H, Gow ML, Baur LA, Garnett SP, Paxton SJ, Lister NB. Association of Pediatric Obesity Treatment, Including a Dietary Component, With Change in Depression and Anxiety: A Systematic Review and Meta-analysis. JAMA Pediatr 2019; 173:e192841. [PMID: 31524933 PMCID: PMC6749546 DOI: 10.1001/jamapediatrics.2019.2841] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Children and adolescents with obesity are at higher risk of developing depression and anxiety, and adolescent dieting is a risk factor for the development of depression. Therefore, determining the psychological effect of obesity treatment interventions is important to consider. OBJECTIVE To investigate the association between obesity treatment interventions, with a dietary component, and the change in symptoms of depression and anxiety in children and adolescents with overweight/obesity. DATA SOURCES Searches of MEDLINE, Embase, Cochrane Library, and PsychINFO were conducted from inception to August 2018. Hand searching of references was conducted to identify missing studies. STUDY SELECTION Obesity treatment interventions, with a dietary component, conducted in children and adolescents (age <18 years) with overweight/obesity, and validated assessment of depression and/or anxiety were included. DATA EXTRACTION AND SYNTHESIS Data were independently extracted by 1 reviewer and checked for accuracy. Meta-analysis, using a random-effects model, was used to combine outcome data and moderator analysis conducted to identify intervention characteristics that may influence change in depression and anxiety. The meta-analyses were finalized in May 2019. MAIN OUTCOMES AND MEASURES Change in symptoms of depression and anxiety postintervention and at the latest follow-up. RESULTS Of 3078 articles screened, 44 studies met inclusion criteria with a combined sample of 3702 participants (age range, 5.6 to 16.6 years) and intervention duration of 2 weeks to 15 months. Studies reported either no change or a statistically significant reduction in symptoms of depression or anxiety. Meta-analyses of 36 studies found a reduction in depressive symptoms postintervention (standardized mean difference [SE], -0.31 [0.04]; P < .001), maintained at follow-up in 11 studies at 6 to 16 months from baseline (standardized mean difference [SE], -0.25 [0.07]; P < .001). Anxiety was reduced postintervention (10 studies; standardized mean difference [SE], -0.38 [0.10]; P < .001) and at follow-up (4 studies; standardized mean difference [SE], -0.32 [0.15]; P = .03). Longer intervention duration was associated with a greater reduction in anxiety (R2 = 0.82; P < .001). Higher body mass index z score at baseline was associated with a greater reduction in depression (R2 = 0.19; P = .03). CONCLUSIONS AND RELEVANCE Structured, professionally run pediatric obesity treatment is not associated with an increased risk of depression or anxiety and may result in a mild reduction in symptoms. Treatment of weight concerns should be considered within the treatment plan for young people with depression and obesity.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Megan L. Gow
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Louise A. Baur
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P. Garnett
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Natalie B. Lister
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia,Institute of Endocrinology and Diabetes and Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
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14
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Pratt KJ, Ferriby M, Brown CL, Noria S, Needleman B, Skelton JA. Adult weight management patients' perceptions of family dynamics and weight status. Clin Obes 2019; 9:e12326. [PMID: 31232524 PMCID: PMC10179550 DOI: 10.1111/cob.12326] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/07/2019] [Accepted: 05/23/2019] [Indexed: 01/26/2023]
Abstract
Our overall objective was to describe the parent-child, romantic, and family dynamics of adult weight management program (WMP) patients, and associations with children's and partners' weight status. First, we determined if family functioning mediated the effect between parent-child feeding practices and perceived child weight status, and romantic relationship anxiety and avoidance and perceived partner weight status. Second, we assessed if perceived child and partner weight status moderated the associations between family functioning and parent-child feeding practices and romantic relationship anxiety and avoidance, respectively. Patients (N=203) who resided with a child and partner from two WMPs completed assessments of parent-child feeding practices (Child Feeding Questionnaire), romantic relationship anxiety and avoidance (Relationship Structures Questionnaire), family functioning (Family Assessment Device General Functioning Scale), and perceived child and partner weight status. Bivariate analyses determined differences in weight status and relationship dynamics and family functioning, and mediation and moderation analyses were conducted to answer the two research questions. Family functioning was not a mediator between romantic relationship dynamics and partner weight status or parent-child dynamics and child weight status. Lower family functioning was associated with higher parent-child restrictive feeding practices, only among children with overweight/obesity. Similarly, lower family functioning was associated with higher anxiety and avoidance in romantic relationships, only for partners with overweight/obesity. Patients with children and/or partners with overweight/obesity reported more impaired family dynamics and functioning, compared to patients with children and/or partners with a healthy weight status.
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Affiliation(s)
- Keeley J Pratt
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
- Department of Surgery, The Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Megan Ferriby
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
| | - Callie L Brown
- Department of Pediatrics, Wake Forest University, Winston Salem, North Carolina
| | - Sabrena Noria
- Department of Surgery, The Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Bradley Needleman
- Department of Surgery, The Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest University, Winston Salem, North Carolina
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15
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The Effect of Nurse-Led Diet and Physical Activity Program for Health on Diet and Physical Activity Behavior of Children. J Phys Act Health 2019; 16:504-511. [PMID: 31154916 DOI: 10.1123/jpah.2018-0278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/17/2019] [Accepted: 03/02/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Many health problems encountered in childhood, adolescence, and adulthood periods arise from problematic eating behavior, an unhealthy dietary approach, and inactive lifestyles. The aim of this study was to determine the effect of the Diet and Physical Activity Program for Health, under the leadership of a nurse, on the dietary and physical activity behaviors of children. METHODS This study was planned in a quasi-experimental design with pretesting, posttesting, follow-up testing, and a control group. The study was conducted with 114 students in 2 schools. A total of 12 hours of training was given to the experimental group for 6 weeks. Institutional permission required for performing the study and an ethical consent from the commission for clinical trials of Marmara University institute of health sciences were received. RESULTS The results of the study reveal that Diet and Physical Activity Program for Health in posttest and follow-up periods was effective in improving dietary and physical activity behaviors of children within the program. However, the program's effect on dietary and physical activity self-efficacy was limited. CONCLUSION The results of the study indicate that this program was effective in development of children's behavior regarding diet and physical activity.
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16
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Arias Ramos N, Calvo Sánchez MD, Fernández-Villa T, Ovalle Perandones MA, Fernández García D, Marqués-Sánchez P. Social exclusion of the adolescent with overweight: study of sociocentric social networks in the classroom. Pediatr Obes 2018; 13:614-620. [PMID: 30110716 DOI: 10.1111/ijpo.12396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/09/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple studies have shown the social consequences of suffering overweight, with social exclusion or isolation as some of the most important. In order to study the social patterns among adolescents, we have set as objectives to analyse the position of the individual within their network from a sociocentric perspective, comparing the relational pattern of the adolescents suffering from overweight with those who are normal weight. METHOD This was a cross-sectional descriptive study using logistic regression and social network analysis. We analysed the contact patterns of 235 adolescents in 11 social networks, classifying contact into three levels of intensity: minimum, intermediate and maximum (friendship). The WHO reference was used for the variable of overweight. RESULTS The prevalence of overweight was 30.2% (25.5% overweight and 4.7% obesity). An analysis of the relational patterns of individuals with overweight showed that at the minimum contact level, they established fewer relationships and less closeness (odds ratio [OR]: 2.32; confidence interval [CI] 95%: 1.17-4.66; p-value: 0.016). This effect was more marked in female adolescents. At intermediate contact level, they had few relationships and low prestige (OR: 3.29; CI: 95%; 1.03-10.51; p-value: 0.045, OR: 3.18; CI: 95%; 1.00-10.04; p-value: 0.049, respectively). At maximum contact level (friendship), female adolescents related little with other adolescents (OR: 3.78; CI: 95%; 1.07-13.32; p-value: 0.038). CONCLUSIONS Adolescents with overweight take up peripheral positions within their social network, choosing by themselves not to establish contact with others. Social network analysis is crucial to detect adolescents with overweight at risk of exclusion and help alleviate psychological and social deficits.
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Affiliation(s)
- N Arias Ramos
- SALBIS Research Group. Health Science School. Department of Nursing and Physiotherapy, University of Leon, León, Spain
| | - M D Calvo Sánchez
- Administrative Law, Law Faculty, Universty of Salamanca, Salamanca, Spain
| | - T Fernández-Villa
- The Research Group in Gene-Environment and Health Interactions, Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, University of León, León, Spain
| | - M A Ovalle Perandones
- Department of Library and Information Science, School of Humanities, Communication and Library, University Carlos III of Madrid, Madrid, Spain
| | - D Fernández García
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of León, León, Spain
| | - P Marqués-Sánchez
- Head of SALBIS Research Group. Health Science School. Department of Nursing and Physiotherapy, University of Leon, León, Spain
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17
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Abstract
Stress and negative emotions pose a major threat to public health, by increasing the risk of obesity. Since the management process for emotions (emotion regulation; ER) is developed in childhood, we present a novel conceptual framework model for the role of ER in the prevention and treatment of childhood obesity. A narrative review of the literature by electronic database search (MEDLINE, Web of Knowledge and Scopus) was conducted of observational and interventional/experimental literature on ER and obesity and the underlying concepts. We also present an overview of ER intervention techniques. Our model indicates that childhood ER is a link between stress and obesity. Stress along with ineffective ER leads to abnormal cortisol patterns, emotional eating, sedentary lifestyle, reduction of physical activity, and sleep problems. Simultaneously, a healthy lifestyle could show benefits on ER and in developing adaptive ER strategies. In the development of obesity and ER, parents also play a role. By contrast, effective ER skills decrease obesity-related unhealthy behaviour and enhance protective factors, which boost health. The literature contains some observational studies of children but very few intervention studies, most of which are pilot or on-going studies. In conclusion, encouraging effective ER could be a useful new approach for combating and treating childhood obesity. Future ER intervention studies are needed to confirm the validity of this model in children.
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18
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Uijtdewilligen L, Brown HE, Müller-Riemenschneider F, Lim YW, Brage S, van Sluijs EM. A systematic review of methods to measure family co-participation in physical activity. Obes Rev 2017; 18:1454-1472. [PMID: 28967183 PMCID: PMC6219698 DOI: 10.1111/obr.12589] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/18/2017] [Accepted: 06/19/2017] [Indexed: 01/29/2023]
Abstract
The family environment is key in influencing children's health behaviours. Encouraging family co-participation in physical activity may therefore be an effective approach to increasing children's physical activity levels. Yet, little is known about how to best assess family co-participation in physical activity. This review summarizes methods to measure family co-participation in physical activity, which was defined as joint physical activities including at least one healthy child (0-18 years) and one other family member. Methods were identified through a systematic literature search, cross-referencing pre-selected reviews and contacting research groups. Thirty-seven measurement methods were included. Questionnaires were the most common method used, with the majority assessing frequency of co-participation and few also assessing duration and type. Reliability and internal consistency of scales were often reported, but rarely specified for the item(s) relevant to co-participation. Other methods of measuring co-participation included diaries, event history calendars, direct observations and accelerometry combined with diary, ecological momentary assessment or global positioning systems (GPS). Whilst a large number of measurement methods of family co-participation in physical activity exist, few are comprehensive and/or report acceptable psychometric properties. Future work should focus on reaching consensus in defining family co-participation in physical activity, and subsequently developing reliable and valid measures.
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Affiliation(s)
- L Uijtdewilligen
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - H E Brown
- UKCRC Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - F Müller-Riemenschneider
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore.,Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre Berlin, Germany
| | - Y W Lim
- National University of Singapore, Saw Swee Hock School of Public Health, Singapore, Singapore
| | - S Brage
- UKCRC Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - E M van Sluijs
- UKCRC Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
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19
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Wilson M, Ramsay S, Young KJ. Engaging Overweight Adolescents in a Health and Fitness Program Using Wearable Activity Trackers. J Pediatr Health Care 2017; 31:e25-e34. [PMID: 28501356 DOI: 10.1016/j.pedhc.2017.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/03/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Our objectives were to (a) examine feasibility and receptivity of overweight adolescents joining a community-based group fitness program and (b) test preliminary efficacy of a 12-week pilot intervention designed to promote health, fitness, and self-efficacy for the identified teens. METHODS The 12-week fitness program for overweight adolescents was developed and included planned physical activities, nutrition classes, and goal-setting sessions. A one-group pre-/posttest study design evaluated 20 participants from grades 10 through 12 who enrolled in the program pilot study. Participants were given a wearable activity tracker that captured data using an Internet-based platform. Outcome measures included body mass index, screen time, fitness, and cardiovascular measures. RESULTS A community fitness program for overweight adolescents was successfully implemented. High school students were receptive to the intervention and reported high program satisfaction. Positive effects included measurements of strength, systolic blood pressure, weight, and screen time behaviors. DISCUSSION This study provides evidence to support the feasibility, acceptance, and preliminary effects of the pilot program with overweight adolescents.
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20
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Shapiro M, Reid A, Olsen B, Taasan M, McNamara J, Nguyen M. Topiramate, zonisamide and weight loss in children and adolescents prescribed psychiatric medications: A medical record review. Int J Psychiatry Med 2017; 51:56-68. [PMID: 26681236 DOI: 10.1177/0091217415621266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Childhood obesity is a growing epidemic that is contributed to by the use of psychopharmacological agents, such as antipsychotics. This study represents a preliminary investigation into the effectiveness of two anticonvulsants that were hypothesized to reduce weight in a pediatric sample seeking treatment at a psychiatric clinic. METHODS The electronic medical records of a university-based child and adolescent psychiatric clinic were reviewed for patients who were first prescribed either topiramate or zonisamide between 1 July 2011 and 30 June 2013. Based on inclusionary criteria, the review identified 47 children or adolescents. RESULTS Multilevel modeling was utilized for study analyses. Including the full sample and controlling for confounders, anticonvulsant dosage was uniquely associated with an average reduction in body mass index of 1.3 (dosages above 200 mg) to 4.1 (dosages below 50 mg) every six months of treatment. Exlucing patients whose baseline body mass index was below 25.0 and controlling for confounders, anticonvulsant dosage was uniquely associated with an average reduction in body mass index of 3.2 (dosages above 200 mg) to 6.1 (dosages below 50 mg) every six months of treatment. Weight reduction was not statistically different between topiramate or zonisamide. Anticonvulsants were associated with an increase in body mass index, yet the benefits of the two anticonvulsants on weight loss remained despite the counteractive effects of antipsychotics. CONCLUSIONS Results provide preliminary evidence that topiramate and zonisamide may be utilized for weight loss in a pediatric psychopharmacological treatment seeking sample, even if antipsychotics are also prescribed. A randomized controlled trial investigating the impact of topiramate and zonisamide on weight reduction is warranted.
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Affiliation(s)
- Michael Shapiro
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Adam Reid
- Division of Medical Psychology, Department of Psychiatry, University of Florida, Gainesville, FL, USA Division of Clinical & Health Psychology, Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Brian Olsen
- Division of Medical Psychology, Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Michael Taasan
- Division of Medical Psychology, Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Joseph McNamara
- Division of Medical Psychology, Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Mathew Nguyen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida, Gainesville, FL, USA
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21
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Sapienza G, Helena Schoen T, Fisberg M. Social Competence and Obesity in Teenagers: An Analysis of the Last Ten Years of Studies. Health (London) 2017. [DOI: 10.4236/health.2017.912119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Chan SM, Melnyk BM, Chen ACC. Chinese Version of the Healthy Lifestyle Beliefs Scale for Taiwanese Adolescents: A Psychometric Study. J Pediatr Nurs 2017; 32:19-24. [PMID: 27765539 DOI: 10.1016/j.pedn.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 10/08/2016] [Accepted: 10/10/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Taiwanese adolescents' unhealthy lifestyles (e.g., unhealthy eating and sedentary behavior) are associated with excess weight and obesity, which affect their physical and mental health (e.g., depression). Because adolescents' beliefs about healthy lifestyles predict their actual lifestyles, a valid and reliable tool to measure their beliefs about healthy lifestyles is needed. METHODS The Healthy Lifestyle Behavior Scale (HLBS) was translated into Chinese based on recommended guidelines. A convenience sample of 186 Taiwanese adolescents completed the Chinese version Healthy Lifestyle Behavior Scale (CHLBS) anonymously. We used Cronbach's α to determine the internal consistency of the CHLBS and exploratory and confirmatory factor analyses to examine the factor structure. RESULTS The Cronbach's α for the CHLBS was .94. Exploratory analysis suggested that there were two factors and explained 57% of the total variance. The confirmatory factor analysis indicated an acceptable fit. CONCLUSION The CHLBS is a reliable and valid scale. It can be used to gather information about Taiwanese adolescents' beliefs about healthy lifestyles, which will assist in developing culturally and developmentally relevant interventions.
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Affiliation(s)
- Shu-Min Chan
- Department of Nursing, Shu Zen College of Medicine and Management, No.452, Huanqiu Rd. Luzhu Dist, Kaohsiung City 82144, Taiwan, ROC.
| | - Bernadette Mazurek Melnyk
- Ohio State University, Associate Vice President for Health Promotion, University Chief Wellness Officer, Dean, College of Nursing, 120 Newton Hall 1585 Neil Avenue Columbus, OH 43210, United States
| | - Angela Chia-Chen Chen
- College of Nursing and Health Innovation, Department of Nursing, Arizona State University, 500 N. 3rd Street Phoenix, AZ 85004, United States
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23
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Tshililo RA, Netshikweta LM, Tshitangano GT, Nemathaga HL. Factors influencing weight control practices amongst the adolescent girls in Vhembe District of Limpopo Province, South Africa. Afr J Prim Health Care Fam Med 2016; 8:e1-4. [PMID: 27380855 PMCID: PMC4913444 DOI: 10.4102/phcfm.v8i2.952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 04/04/2016] [Accepted: 04/14/2016] [Indexed: 11/16/2022] Open
Abstract
Background The incidence of overweight is increasing amongst adolescents in many countries around the world. Healthy and unhealthy weight control practices are common amongst overweight and non-overweight adolescents. Aim The aim of this study was to explore factors influencing weight control practices amongst adolescent girls. Setting The study was conducted at selected secondary schools of Vhembe District of Limpopo Province, South Africa. Methods A qualitative, exploratory, descriptive and contextual design was used. Non-probability, purposive sampling was used to select adolescents who are practicing weight control. In-depth interviews were conducted with 30 participants. Data were analysed according to Tesch’s open-coding method. Results This study revealed that adolescent girls are influenced by a variety of factors to control their weights. These included individual factors, such as body image dissatisfaction; family factors, caused by parental criticism about adolescent weight; and environmental factors, which contain peer group endorsement of dieting. Conclusion Adolescents are exposed to many unhealthy weight control practices, as a way of controlling excess weight. So it is of importance for healthcare providers to make them aware of healthy practices.
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Affiliation(s)
- Rose A Tshililo
- Department of Advanced Nursing Science, University of Venda.
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24
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Militello LK, Melnyk BM, Hekler E, Small L, Jacobson D. Correlates of Healthy Lifestyle Beliefs and Behaviors in Parents of Overweight or Obese Preschool Children Before and After a Cognitive Behavioral Therapy Intervention With Text Messaging. J Pediatr Health Care 2016; 30:252-60. [PMID: 26429638 DOI: 10.1016/j.pedhc.2015.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/24/2015] [Accepted: 08/31/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Significant gaps exist in the published literature regarding the treatment of overweight/obesity in preschool-aged children, especially in primary care settings. Parental influence plays an important factor in the development of healthy behaviors in children, yet there is no consensus about why some behavior change intervention strategies for parents of young children are more influential and effective than others. OBJECTIVE The purpose of this secondary data analysis was to assess correlations among the study variables (healthy lifestyle beliefs, perceived difficulty, and healthy lifestyle behaviors) in parents of overweight/obese preschool children. A second aim explored if the parent's level of cognitive beliefs and perceived difficulty of engaging in healthy lifestyle behaviors correlated with text messaging cognitive behavioral support. METHODS Fifteen preschool-parent dyads from primary care clinics completed a 7-week cognitive behavioral skills building intervention. Beck's Cognitive Theory guided the intervention content, and Fogg's Behavior Model guided the implementation. The intervention was delivered using a combination of face-to-face clinic visits and ecological momentary interventions using text messaging. RESULTS Supported are the interconnected relationships among the study variables, that is, parental healthy lifestyle beliefs, thoughts, and behaviors. At baseline, parental healthy lifestyle belief scores significantly correlated with perceived difficulty (rs = 0.598, p < .05) and healthy lifestyle behaviors (rs = 0.545, p < .05). These associations strengthened after the intervention. Furthermore, as parental healthy lifestyle beliefs increased and perceived difficulty lessened, their response rate and subsequent feedback lessened to the static text messaging support. DISCUSSION Findings from this study support the interconnections between parents' thoughts, feelings, and actions toward healthy lifestyles. As parental beliefs became stronger through cognitive behavioral skills building and tailored text messaging, the need for general support via text messaging lessened, warranting additional research.
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Brown HE, Atkin AJ, Panter J, Wong G, Chinapaw MJM, van Sluijs EMF. Family-based interventions to increase physical activity in children: a systematic review, meta-analysis and realist synthesis. Obes Rev 2016; 17:345-60. [PMID: 26756281 PMCID: PMC4819691 DOI: 10.1111/obr.12362] [Citation(s) in RCA: 198] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Family-based interventions represent a potentially valuable route to increasing child physical activity (PA) in children. A dual meta-analysis and realist synthesis approach examined existing interventions to assist those developing programmes to encourage uptake and maintenance of PA in children. DESIGN Studies were screened for inclusion based on including participants aged 5-12 years, having a substantive aim of increasing PA by engaging the family and reporting on PA outcome. Duplicate data extraction and quality assessment were conducted. Meta-analysis was conducted in STATA. Realist synthesis included theory development and evidence mapping. RESULTS Forty-seven studies were included, of which three received a 'strong' quality rating, 21 'moderate' and 23 'weak'. The meta-analysis (19 studies) demonstrated a significant small effect in favour of the experimental group (standardized mean difference: 0.41; 95%CI 0.15-0.67). Sensitivity analysis, removing one outlier, reduced this to 0.29 (95%CI 0.14-0.45). Realist synthesis (28 studies) provided insight into intervention context (particularly, family constraints, ethnicity and parental motivation), and strategies to change PA (notably, goal-setting and reinforcement combined). CONCLUSION This review provides key recommendations to inform policy makers and other practitioners in developing evidence-based interventions aimed at engaging the family to increase PA in children, and identifies avenues for future research.
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Affiliation(s)
- H E Brown
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - A J Atkin
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - J Panter
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - G Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - M J M Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - E M F van Sluijs
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Militello L, Melnyk BM, Hekler EB, Small L, Jacobson D. Automated Behavioral Text Messaging and Face-to-Face Intervention for Parents of Overweight or Obese Preschool Children: Results From a Pilot Study. JMIR Mhealth Uhealth 2016; 4:e21. [PMID: 26976387 PMCID: PMC4810011 DOI: 10.2196/mhealth.4398] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/11/2015] [Accepted: 11/11/2015] [Indexed: 12/15/2022] Open
Abstract
Background Children are 5 times more likely to be overweight at the age of 12 years if they are overweight during the preschool period. Objective The purpose of this study was to establish the feasibility, acceptability, and preliminary effects of a cognitive behavioral intervention (TEXT2COPE) synergized with tailored mobile technology (mHealth) on the healthy lifestyle behaviors of parents of overweight and obese preschoolers delivered in a primary care setting. Methods Fifteen preschooler-parent dyads recruited through primary care clinics completed a manualized 7-week cognitive behavioral skills building intervention. Beck’s Cognitive Theory guided the TEXT2COPE intervention content and Fogg’s Behavior Model guided the implementation. The intervention employed a combination of face-to-face clinic visits and ecological momentary interventions using text messaging (short message service, SMS). To enhance the intervention’s relevance to the family’s needs, parents dictated the wording of the text messages and also were able to adapt the frequency and timing of delivery throughout program implementation. Results Self-reported findings indicate that the program is feasible and acceptable in this population. The intervention showed preliminary effects with significant improvements on parental knowledge about nutrition (P=.001) and physical activity (P=.012) for their children, parental beliefs (P=.001) toward healthy lifestyles, and parental behaviors (P=.040) toward engaging in healthy lifestyle choices for their children. Effect sizes were medium to large for all variables. The timing, frequency, and wording of the text messages were tailored to the individual families, with 69% of parents (9/13) increasing the frequency of the tailored SMS from being sent once weekly to as many as 5 times a week. Conclusions Utilizing a cognitive behavioral skills intervention with SMS has great potential for supporting clinical care of overweight and obese preschool children and their families. Further exploration of the potential effects on health and behavioral outcomes is warranted.
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Affiliation(s)
- Lisa Militello
- The Ohio State University, College of Nursing, Columbus, OH, United States.
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Pbert L, Druker S, Barton B, Olendzki B, Andersen V, Persuitte G, Bram J, Kurtz S, Powers EM, Crawford S, Geller AC. Use of a FITLINE to Support Families of Overweight and Obese Children in Pediatric Practices. Child Obes 2016; 12:33-43. [PMID: 26788762 DOI: 10.1089/chi.2015.0101] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The American Academy of Pediatrics (AAP) recommends a staged approach to pediatric weight management, starting with helping families to make targeted dietary and activity changes. This pilot study evaluated the preliminary efficacy of a pediatric practice-based referral program to support parents in helping their overweight/obese children improve their weight-related behaviors and BMI. METHODS A nonrandomized intervention study with contemporaneous control was used. Parents and their children ages 8-12 with BMI ≥85th percentile (N = 37) were recruited from a pediatric practice serving a low-income, multiethnic population. Providers delivered brief intervention and referred families to six weekly FITLINE telephone counseling sessions with a nutritionist who guided parents in helping their child make AAP-recommended changes. Child BMI and parent survey of child diet and physical activity were completed at baseline and 3 months. Medical record data from 44 children matched for age and BMI were collected. RESULTS Mean change in BMI from baseline to 3-month follow-up was -0.49 BMI units (standard deviation [SD], 0.95; p = 0.007) for the FITLINE group and 0.35 BMI units (SD, 0.96; p = 0.02) for the control group. Adjusting for baseline BMI, age, and sex, children in the FITLINE condition reduced BMI significantly more than children in the control condition (mean difference = -0.89; p = 0.0003). Significant improvements in many dietary and sedentary behaviors also were noted. CONCLUSIONS The FITLINE program reduced short-term BMI and improved dietary and sedentary behaviors. A randomized, controlled trial is warranted to assess the program's efficacy and potential to serve as a model for reducing obesity in pediatric practice.
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Affiliation(s)
- Lori Pbert
- 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA
| | - Susan Druker
- 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA
| | - Bruce Barton
- 2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Worcester, MA
| | - Barbara Olendzki
- 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA
| | - Victoria Andersen
- 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA
| | - Gioia Persuitte
- 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA
| | - Jennifer Bram
- 3 Department of Pediatrics, University of Massachusetts Medical School , Worcester, MA
| | - Stephen Kurtz
- 2 Department of Quantitative Health Sciences, University of Massachusetts Medical School , Worcester, MA
| | - E Michael Powers
- 4 School of Medicine, Vanderbilt University Medical Center , Nashville, TN
| | - Sybil Crawford
- 1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School , Worcester, MA
| | - Alan C Geller
- 5 Department of Social and Behavioral Sciences, Harvard School of Public Health , Boston, MA
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Sherwood NE, JaKa MM, Crain AL, Martinson BC, Hayes MG, Anderson JD. Pediatric Primary Care-Based Obesity Prevention for Parents of Preschool Children: A Pilot Study. Child Obes 2015; 11:674-82. [PMID: 26478951 PMCID: PMC4677530 DOI: 10.1089/chi.2015.0009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The Healthy Homes/Healthy Kids Preschool (HHHK-Preschool) pilot program is an obesity prevention intervention integrating pediatric care provider counseling and a phone-based program to prevent unhealthy weight gain among 2- to 4-year-old children at risk for obesity (BMI percentile between the 50th and 85th percentile and at least one overweight parent) or currently overweight (85th percentile ≤ BMI < 95th percentile). The aim of this randomized, controlled pilot study was to evaluate the feasibility, acceptability, and potential efficacy of the HHHK-Preschool intervention. METHODS Sixty parent-child dyads recruited from pediatric primary care clinics were randomized to: (1) the Busy Bodies/Better Bites Obesity Prevention Arm or the (2) Healthy Tots/Safe Spots safety/injury prevention Contact Control Arm. Baseline and 6-month data were collected, including measured height and weight, accelerometry, previous day dietary recalls, and parent surveys. Intervention process data (e.g., call completion) were also collected. RESULTS High intervention completion and satisfaction rates were observed. Although a statistically significant time by treatment interaction was not observed for BMI percentile or BMI z-score, post-hoc examination of baseline weight status as a moderator of treatment outcome showed that the Busy Bodies/Better Bites obesity prevention intervention appeared to be effective among children who were in the overweight category at baseline relative to those who were categorized as at risk for obesity (p = 0.04). CONCLUSIONS HHHK-Preschool pilot study results support the feasibility, acceptability, and potential efficacy in already overweight children of a pediatric primary care-based obesity prevention intervention integrating brief provider counseling and parent-targeted phone coaching. What's New: Implementing pediatric primary care-based obesity interventions is challenging. Previous interventions have primarily involved in-person sessions, a barrier to sustained parent involvement. HHHK-preschool pilot study results suggest that integrating brief provider counseling and parent-targeted phone coaching is a promising approach.
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Affiliation(s)
- Nancy E. Sherwood
- HealthPartners Institute for Education and Research, Bloomington, MN
| | - Meghan M. JaKa
- HealthPartners Institute for Education and Research, Bloomington, MN
| | - A. Lauren Crain
- HealthPartners Institute for Education and Research, Bloomington, MN
| | | | - Marcia G. Hayes
- HealthPartners Institute for Education and Research, Bloomington, MN
| | - Julie D. Anderson
- HealthPartners Institute for Education and Research, Bloomington, MN
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Chen JL, Kwan M, Liu K, Yu F. The Feasibility and Efficacy of Healthy Weight Management Program for Low Income Chinese American Overweight and Obese Children in a Primary Care Clinic. J Pediatr Nurs 2015; 30:821-8. [PMID: 25704988 DOI: 10.1016/j.pedn.2015.01.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 01/26/2015] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Childhood obesity is one of the most prevalent public health concerns. METHOD A pre and post study design was used to explore the efficacy of an obesity prevention program. Children had weight, height, blood pressure, and waist circumference measured, and completed self-reported questionnaires on food intake, knowledge, self-efficacy, and health-related quality of life. Parents completed demographic and acculturation surveys. RESULTS Seventy children participated in the study. Results demonstrated significant reduction of BMI, systolic blood pressure, and fast food consumption and improvement of self-efficacy, knowledge, and quality of life. DISCUSSION Childhood obesity intervention is feasible and has short-term efficacy.
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Affiliation(s)
- Jyu-Lin Chen
- School of Nursing, University of California, San Francisco, CA.
| | - Monica Kwan
- North East Medical Services, San Francisco, CA
| | - Katrina Liu
- North East Medical Services, San Francisco, CA
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Gulley T, Boggs D. Time perspective and the theory of planned behavior: moderate predictors of physical activity among central Appalachian adolescents. J Pediatr Health Care 2014; 28:e41-7. [PMID: 24793985 DOI: 10.1016/j.pedhc.2014.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 02/07/2014] [Accepted: 02/23/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to determine how well time perspective and the Theory of Planned Behavior (TPB) predicted physical activity among adolescents residing in the central Appalachian region of the United States. METHOD A descriptive, correlational design was used. The setting was a rural high school in central Appalachia. The sample included 185 students in grades 9 through 12. Data were collected in school. Variables included components of the TPB, time perspective, and various levels of exercise. Data were analyzed using Pearson's correlation coefficients and multiple regression analysis. RESULTS The TPB was a moderate predictor of exercise frequency among central Appalachian adolescents, accounting for 42% of the variance. Time perspective did not add to the predictive ability of the TPB to predict exercise frequency in this sample. DISCUSSION This study provides support for the TPB for predicting frequency of exercise among central Appalachian adolescents. By understanding the role of the TPB in predicting physical activity among adolescents, nurse practitioners will be able to adapt intervention strategies to improve the physical activity behaviors of this population.
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31
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Palmer F, Davis MC. Reliability and validity of the parent efficacy for child healthy weight behaviour (PECHWB) scale. Child Care Health Dev 2014; 40:398-404. [PMID: 23594151 DOI: 10.1111/cch.12069] [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] [Accepted: 03/17/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Interventions for childhood overweight and obesity that target parents as the agents of change by increasing parent self-efficacy for facilitating their child's healthy weight behaviours require a reliable and valid tool to measure parent self-efficacy before and after interventions. Nelson and Davis developed the Parent Efficacy for Child Healthy Weight Behaviour (PECHWB) scale with good preliminary evidence of reliability and validity. The aim of this research was to provide further psychometric evidence from an independent Australian sample. METHODS Data were provided by a convenience sample of 261 primary caregivers of children aged 4-17 years via an online survey. PECHWB scores were correlated with scores on other self-report measures of parenting efficacy and 2- to 4-week test-retest reliability of the PECHWB was assessed. RESULTS The results of the study confirmed the four-factor structure of the PECHWB (Fat and Sugar, Sedentary Behaviours, Physical Activity, and Fruit and Vegetables) and provided strong evidence of internal consistency and test-retest reliability, as well as good evidence of convergent validity. CONCLUSION Future research should investigate the properties of the PECHWB in a sample of parents of overweight or obese children, including measures of child weight and actual child healthy weight behaviours to provide evidence of the concurrent and predictive validity of PECHWB scores.
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Affiliation(s)
- F Palmer
- School of Psychology and Speech Pathology, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
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Small L, Bonds-McClain D, Melnyk B, Vaughan L, Gannon AM. The preliminary effects of a primary care-based randomized treatment trial with overweight and obese young children and their parents. J Pediatr Health Care 2014; 28:198-207. [PMID: 23511090 PMCID: PMC3690141 DOI: 10.1016/j.pedhc.2013.01.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 01/04/2013] [Accepted: 01/17/2013] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Twenty-three percent of preschoolers are overweight/obese, which puts these children at risk for the development of chronic health comorbidities. The purpose of this randomized control pilot study was to determine the feasibility and preliminary effects of a theoretically based, primary care intervention on the physical outcomes of 60 overweight/obese preschool/early school-aged 4- to 8-year-old children. METHODS After recruitment and baseline assessment, parent-child dyads were randomly assigned to either the treatment or the control condition. Four intervention sessions were conducted with the parents in their child's primary health care office. The impact of the intervention was evaluated by assessing child anthropometric measures (e.g., waist, waist-by-height ratio, and body mass index [BMI]) immediately, 3 months, and 6 months after the intervention period. RESULTS Analysis of variance models suggested that children in the experimental group were found to have reduced waist circumference and waist-by-height ratio immediately after the intervention that persisted for 3 and 6 months (f = 0.33, 0.35, respectively). BMI and BMI percentile were not differentially affected. DISCUSSION These promising findings suggest that a primary care-based, parent-focused overweight/obesity treatment program is feasible and demonstrated positive preliminary effects, improving the children's overall health trajectory.
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Sherwood NE, Levy RL, Langer SL, Senso MM, Crain AL, Hayes MG, Anderson JD, Seburg EM, Jeffery RW. Healthy Homes/Healthy Kids: a randomized trial of a pediatric primary care-based obesity prevention intervention for at-risk 5-10 year olds. Contemp Clin Trials 2013; 36:228-43. [PMID: 23816490 DOI: 10.1016/j.cct.2013.06.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 06/21/2013] [Accepted: 06/22/2013] [Indexed: 12/28/2022]
Abstract
Pediatric primary care is an important setting in which to address obesity prevention, yet relatively few interventions have been evaluated and even fewer have been shown to be effective. The development and evaluation of cost-effective approaches to obesity prevention that leverage opportunities of direct access to families in the pediatric primary care setting, overcome barriers to implementation in busy practice settings, and facilitate sustained involvement of parents is an important public health priority. The goal of the Healthy Homes/Healthy Kids (HHHK 5-10) randomized controlled trial is to evaluate the efficacy of a relatively low-cost primary care-based obesity prevention intervention aimed at 5 to 10 year old children who are at risk for obesity. Four hundred twenty one parent/child dyads were recruited and randomized to either the obesity prevention arm or a Contact Control condition that focuses on safety and injury prevention. The HHHK 5-10 obesity prevention intervention combines brief counseling with a pediatric primary care provider during routine well child visits and follow-up telephone coaching that supports parents in making home environmental changes to support healthful eating, activity patterns, and body weight. The Contact Control condition combines the same provider counseling with telephone coaching focused on safety and injury prevention messages. This manuscript describes the study design and baseline characteristics of participants enrolled in the HHHK 5-10 trial.
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Affiliation(s)
- Nancy E Sherwood
- HealthPartners Institute for Education and Research, Bloomington, MN 55440-1524, USA.
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Vine M, Hargreaves MB, Briefel RR, Orfield C. Expanding the role of primary care in the prevention and treatment of childhood obesity: a review of clinic- and community-based recommendations and interventions. J Obes 2013; 2013:172035. [PMID: 23710345 PMCID: PMC3655557 DOI: 10.1155/2013/172035] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 03/20/2013] [Indexed: 12/24/2022] Open
Abstract
Although pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand the provider role. We reviewed the literature published from 2005 to 2012 to (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings and (2) synthesize the evidence of important characteristics, factors, or strategies in successful community-based models. The review identified 96 articles that provide evidence of how primary care providers can successfully prevent and treat childhood obesity by coordinating efforts within the primary care setting and through linkages to obesity prevention and treatment resources within the community. By aligning the most promising interventions with recommendations published over the past decade by the Institute of Medicine, the American Academy of Pediatrics, and other health organizations, we present nine areas in which providers can promote the prevention and treatment of childhood obesity through efforts in clinical and community settings: weight status assessment and monitoring, healthy lifestyle promotion, treatment, clinician skill development, clinic infrastructure development, community program referrals, community health education, multisector community initiatives, and policy advocacy.
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Affiliation(s)
- Michaela Vine
- Mathematica Policy Research, 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139, USA.
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