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Morales-Cahuancama B, Verdezoto N, Gonzales-Achuy E, Quispe-Gala C, Bautista-Olortegui W, Hinojosa-Mamani P, Aparco JP. Exploring Children's Knowledge of Healthy Eating, Digital Media Use, and Caregivers' Perspectives to Inform Design and Contextual Considerations for Game-Based Interventions in Schools for Low-Income Families in Lima, Peru: Survey Study. JMIR Form Res 2024; 8:e49168. [PMID: 38743472 PMCID: PMC11134240 DOI: 10.2196/49168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The prevalence of overweight and obesity in schoolchildren is increasing in Peru. Given the increased use of digital media, there is potential to develop effective digital health interventions to promote healthy eating practices at schools. This study investigates the needs of schoolchildren in relation to healthy eating and the potential role of digital media to inform the design of game-based nutritional interventions. OBJECTIVE This study aims to explore schoolchildren's knowledge about healthy eating and use of and preferences for digital media to inform the future development of a serious game to promote healthy eating. METHODS A survey was conducted in 17 schools in metropolitan Lima, Peru. The information was collected virtually with specific questions for the schoolchild and their caregiver during October 2021 and November 2021 and following the COVID-19 public health restrictions. Questions on nutritional knowledge and preferences for and use of digital media were included. In the descriptive analysis, the percentages of the variables of interest were calculated. RESULTS We received 3937 validated responses from caregivers and schoolchildren. The schoolchildren were aged between 8 years and 15 years (2030/3937, 55.8% girls). Of the caregivers, 83% (3267/3937) were mothers, and 56.5% (2223/3937) had a secondary education. Only 5.2% (203/3937) of schoolchildren's homes did not have internet access; such access was through WiFi (2151/3937, 54.6%) and mobile internet (1314/3937, 33.4%). In addition, 95.3% (3753/3937) of schoolchildren's homes had a mobile phone; 31.3% (1233/3937) had computers. In relation to children's knowledge on healthy eating, 42.2% (1663/3937) of schoolchildren did not know the recommendation to consume at least 5 servings of fruits and vegetables daily, 46.7% (1837/3937) of schoolchildren did not identify front-of-package warning labels (FOPWLs), and 63.9% (2514/3937) did not relate the presence of an FOPWL with dietary risk. Most schoolchildren (3100/3937, 78.7%) preferred to use a mobile phone. Only 38.3% (1509/3937) indicated they preferred a computer. In addition, 47.9% (1885/3937) of caregivers considered that the internet helps in the education of schoolchildren, 82.7% (3254/3937) of caregivers gave permission for schoolchildren to play games with digital devices, and 38% (1495/3937) of caregivers considered that traditional digital games for children are inadequate. CONCLUSIONS The results suggest that knowledge about nutrition in Peruvian schoolchildren has limitations. Most schoolchildren have access to the internet, with mobile phones being the device type with the greatest availability and preference for use. Caregivers' perspectives on games and schoolchildren, including a greater interest in using digital games, provide opportunities for the design and development of serious games to improve schoolchildren's nutritional knowledge in Peru. Future research is needed to explore the potential of serious games that are tailored to the needs and preferences of both schoolchildren and their caregivers in Peru in order to promote healthy eating.
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Affiliation(s)
- Bladimir Morales-Cahuancama
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
- Programa Académico de Nutrición y Dietética, Facultad de ciencias de la salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Nervo Verdezoto
- School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | - Elena Gonzales-Achuy
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | - Cinthia Quispe-Gala
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | | | - Paul Hinojosa-Mamani
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
| | - Juan Pablo Aparco
- Centro Nacional de Alimentación, Nutrición y Vida Saludable, Instituto Nacional de Salud, Lima, Peru
- Escuela Profesional de Nutrición, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Bestle SMS, Lassen AD, Biltoft-Jensen AP, Matthiessen J, Gibbons SJ, Christensen BJ, Ersbøll BK, Trolle E. Reduction in intake of discretionary foods and drinks among Danish schoolchildren: dietary results from the real-life cluster-randomised controlled trial 'Are You Too Sweet?'. Public Health Nutr 2024; 27:e111. [PMID: 38528814 PMCID: PMC11036427 DOI: 10.1017/s1368980024000740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 01/15/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of the multicomponent intervention trial 'Are You Too Sweet?' in reducing discretionary foods and drinks intake among young schoolchildren. DESIGN The study was a 3·5-month two-arm cluster-randomised controlled trial among primary schoolchildren and their families. School health nurses provided guidance to families regarding discretionary foods and drinks for the children. Moreover, families were given a variety of knowledge- and capability-building materials to utilise at home. Dietary intake was assessed using a web-based 7-d dietary record. Linear mixed regression models were used to estimate intervention effects as changes in child intake of discretionary foods and drinks and sugar between groups. SETTING Six schools from a Danish municipality were randomised to the intervention group (n 4) or the control group (n 2). PARTICIPANTS A total of 153 children aged 5-7 years. RESULTS No significant reduction in the children's intake of total discretionary foods and drinks or discretionary foods alone was observed between the intervention and control group, while a decreased intake of discretionary drinks of 40·9 % (P = 0·045) was observed compared with control. Secondary subgroup analysis showed that children of parents with shorter educational level significantly reduced their intake of added sugar by 2·9 E% (P = 0·002). CONCLUSION The results of this study indicate that multicomponent interventions involving school health nurses may have some effects in reducing, especially, discretionary drinks.
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Affiliation(s)
- Sidse Marie Sidenius Bestle
- Division of Food Technology, National Food Institute,
Technical University of Denmark, Henrik Dams Allé, Building
202, Lyngby, Denmark
| | - Anne Dahl Lassen
- Division of Food Technology, National Food Institute,
Technical University of Denmark, Henrik Dams Allé, Building
202, Lyngby, Denmark
| | - Anja Pia Biltoft-Jensen
- Division of Food Technology, National Food Institute,
Technical University of Denmark, Henrik Dams Allé, Building
202, Lyngby, Denmark
| | - Jeppe Matthiessen
- Division of Food Technology, National Food Institute,
Technical University of Denmark, Henrik Dams Allé, Building
202, Lyngby, Denmark
| | - Sarah Jegsmark Gibbons
- Division of Food Technology, National Food Institute,
Technical University of Denmark, Henrik Dams Allé, Building
202, Lyngby, Denmark
| | | | - Bjarne Kjær Ersbøll
- Department of Applied Mathematics and Computer Science,
Technical University of Denmark, Lyngby,
Denmark
| | - Ellen Trolle
- Division of Food Technology, National Food Institute,
Technical University of Denmark, Henrik Dams Allé, Building
202, Lyngby, Denmark
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Gbaja-Biamila TA, Obiezu-Umeh C, Nwaozuru U, Oladele D, Engelhart A, Shato T, Mason S, Carter V, Iwelunmor-Ezepue J. Interventions connecting young people living in Africa to healthcare; a systematic review using the RE-AIM framework. FRONTIERS IN HEALTH SERVICES 2024; 4:1140699. [PMID: 38356690 PMCID: PMC10864512 DOI: 10.3389/frhs.2024.1140699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/02/2024] [Indexed: 02/16/2024]
Abstract
Introduction Africa's young people are among the least focused groups in healthcare linkage. The disproportionally high burden of youth-related health problems is a burden, especially in developing regions like Africa, which have a high population of young people. More information is needed about factors that impact linkages in healthcare and the sustainability of health interventions among young people in Africa. Methods A systematic literature search was performed from October 2020 to May 2022 in PubMed, CINAHL, Scopus, Global Health, and the Web of Science. Studies included in the review were conducted among young people aged 10-24 living in Africa, written in English, and published between 2011 and 2021. Results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data was analyzed using narrative synthesis, synthesizing the details of the RE-AIM reporting component. Interventions were systematically compared using the Cochrane Collaboration risk-of-bias tool to evaluate the rigor of each intervention. Results A total of 2,383 potentially relevant citations were obtained after an initial database search. Retained in the final group were seventeen articles from electronic data searches; among these articles, 16 interventions were identified. Out of the seventeen studies, nine (53%) were randomized controlled trials, three (18%) were quasi-experimental designs, and five (29%) were observational studies. At the same time, the included interventions were reported on 20 (76.92%) of the 26 components of the RE-AIM dimensions. In eastern Africa, twelve (80%) interventions were conducted, and all the interventions addressed linkage to care for young people in preventing and treating HIV. The least reported RE-AIM dimensions were implementing and maintaining interventions connecting young people to care. Discussion Timely care remains critical to treating and preventing ailments. This review indicates that interventions created to link young people to care, especially HIV care, can help link them to health care and strengthen the programs. It is also clear that further research with more extended follow-up periods is needed to examine connections to care in all other aspects of health and to bridge the gap between research and practice in the care of young people in Africa. Systematic Review Registration PROSPERO [CRD42022288227].
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Affiliation(s)
- Titilola Abike Gbaja-Biamila
- Clinical Sciences Department, Nigerian Institute of Medical research, Lagos, Nigeria
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Chisom Obiezu-Umeh
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Ucheoma Nwaozuru
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - David Oladele
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Alexis Engelhart
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Thembekile Shato
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Stacey Mason
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
| | - Victoria Carter
- School of Social Work, Saint Louis University, St. Louis, MO, United States
| | - Juliet Iwelunmor-Ezepue
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States
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Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med 2023; 19:1321-1336. [PMID: 36722616 PMCID: PMC10315605 DOI: 10.5664/jcsm.10476] [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: 08/25/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 02/02/2023]
Abstract
STUDY OBJECTIVES This review synthesizes the pediatric behavioral sleep intervention (BSI) evidence base, summarizes challenges in translating BSIs from research to practice, and provides recommendations for integrating implementation science methods to advance pediatric BSI research. METHODS We briefly review the common behavioral sleep disturbances among youth, discuss the pediatric BSIs with well-established evidence, and identify gaps in pediatric BSI research. We then identify contributors to the dearth of research evaluating pediatric BSIs in accessible settings and present a model for applying implementation science strategies to address identified gaps across the continuum of translational research. RESULTS Relatively few BSI trials include older children and adolescents. Similarly, there is limited research evaluating BSIs among racially and ethnically minoritized children and families and/or those of lower socioeconomic status backgrounds. Access to scalable and easily disseminable tools to treat pediatric sleep disturbances early in their development is crucial for promoting positive child outcomes. To address these gaps, researchers should apply implementation science theories, models, and frameworks to design new interventions for implementation, adapt existing interventions with end users and settings in mind, conduct hybrid effectiveness-implementation trials, and test implementation strategies. CONCLUSIONS Given the prevalence and consequences of poor sleep across developmental periods, pediatric BSIs must be effective as well as adaptable, scalable, and easily disseminable. Implementation science theories, models, and frameworks can enhance access to, engagement in, and the implementation and dissemination of scalable BSIs across diverse pediatric care settings and heterogeneous populations. CITATION Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med. 2023;19(7):1321-1336.
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Affiliation(s)
- Jessica C. Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ariel A. Williamson
- Sleep Center, Division of Pulmonary and Sleep Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
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Doyle FL, Morawska A, Higgins DJ, Havighurst SS, Mazzucchelli TG, Toumbourou JW, Middeldorp CM, Chainey C, Cobham VE, Harnett P, Sanders MR. Policies are Needed to Increase the Reach and Impact of Evidence-Based Parenting Supports: A Call for a Population-Based Approach to Supporting Parents, Children, and Families. Child Psychiatry Hum Dev 2023; 54:891-904. [PMID: 34989941 PMCID: PMC8733919 DOI: 10.1007/s10578-021-01309-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 01/23/2023]
Abstract
Parents can be essential change-agents in their children's lives. To support parents in their parenting role, a range of programs have been developed and evaluated. In this paper, we provide an overview of the evidence for the effectiveness of parenting interventions for parents and children across a range of outcomes, including child and adolescent mental and physical health, child and adolescent competencies and academic outcomes, parental skills and competencies, parental wellbeing and mental health, and prevention of child maltreatment and family violence. Although there is extensive research showing the effectiveness of evidence-based parenting programs, these are not yet widely available at a population level and many parents are unable to access support. We outline how to achieve increased reach of evidence-based parenting supports, highlighting the policy imperative to adequately support the use of these supports as a way to address high priority mental health, physical health, and social problems.
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Affiliation(s)
- Frances L. Doyle
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia
- School of Psychology, The MARCS Institute for Brain Behaviour and Development, Transforming Early Education and Child Health (TeEACH) Research Centre, Translational Health Research Institute, Western Sydney University, Sydney, NSW Australia
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD Australia
| | - Daryl J. Higgins
- Institute of Child Protection Studies, Australian Catholic University, Melbourne, VIC, Australia
| | - Sophie S. Havighurst
- Mindful: Centre for Training and Research in Developmental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Trevor G. Mazzucchelli
- School of Psychology, Curtin University, Perth, WA Australia
- School of Psychology, The University of Queensland, Brisbane, QLD Australia
| | - John W. Toumbourou
- Centre for Social and Early Emotional Development, Deakin University, Geelong, VIC, Australia
| | - Christel M. Middeldorp
- Child Health Research Centre, The University of Queensland, Brisbane, QLD Australia
- Child and Youth Mental Health Service, Children’s Health Queensland Hospital and Health Service, Brisbane, QLD Australia
| | - Carys Chainey
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD Australia
| | - Vanessa E. Cobham
- School of Psychology, The University of Queensland, Brisbane, QLD Australia
- Child and Youth Mental Health Service, Children’s Health Queensland Hospital and Health Service, Brisbane, QLD Australia
| | - Paul Harnett
- School of Criminology and Criminal Justice, Griffith University, Brisbane, QLD, Australia
| | - Matthew R. Sanders
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD Australia
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Festl-Wietek T, Erschens R, Griewatz J, Zipfel S, Herrmann-Werner A. How to communicate with patients in written asynchronous online conversations: an intervention study with undergraduate medical students in a cross-over design. Front Med (Lausanne) 2023; 10:1026096. [PMID: 37275354 PMCID: PMC10232748 DOI: 10.3389/fmed.2023.1026096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 04/25/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction The patient-physician encounter is the core element in the treatment of patients and the diagnosis of disease. In these times of digitalization, patient-physician communication is increasingly taking place online: patients embrace new possibilities offered digitally, and physicians are encouraged to adapt accordingly. Since a huge part of online communication is written, this study aims to investigate how medical students communicate with patients online by focusing on their written competencies and whether an intervention might improve their competencies. Methods This study was performed in an explanatory cross-sectional manner with a cross-over design. Second-year medical students participated. An intervention was developed on how to formulate an appropriate written response to a patient's request and integrated a longitudinal communication class. The intervention consists of education on general set-up (e.g., greetings), syntax, spelling, content and kind of communication (e.g., appreciative attitude). After meeting a patient in a simulated role play medical students received the patient's request via a digital platform. The control group had the same simulated role play and the same task but they received the intervention on communication afterwards. Intervention and control group were statistically compared based on a checklist. Results Twenty-nine medical students took part in the study. The results showed that the medical students had basic competencies in dealing with written communication independent if they received the intervention (CG: M = 3.86 ± 1.23 vs. IG: M = 4.07 ± 1.03; p = 0.625). Similar results were also for the emotional competency ratings (MCG = 3.36 ± 1.08; MIG = 3.67 ± 0.98; p = 0.425).The intervention was able to lead to a more appreciative response toward patient. Discussion Intervention on basic competencies such as simple language and clear presentation might not be needed as an integral part in medical education. However, medical students should learn how to present empathic and authentic behavior in written online communication.
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Affiliation(s)
- Teresa Festl-Wietek
- TIME–Tübingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany
| | - Rebecca Erschens
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Jan Griewatz
- TIME–Tübingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
- Deanery of Students’ Affairs, Faculty of Medicine, Eberhard-Karls University of Tuebingen, Tuebingen, Germany
| | - Anne Herrmann-Werner
- TIME–Tübingen Institute for Medical Education, University of Tuebingen, Tuebingen, Germany
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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Cox-Martin E, Phimphasone-Brady P, Hoffecker L, Glasgow RE. Psychosocial Interventions for Pain Management in Breast Cancer Survivors: A RE-AIM Evaluation. J Clin Psychol Med Settings 2023; 30:182-196. [PMID: 35562602 DOI: 10.1007/s10880-022-09874-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 12/24/2022]
Abstract
Psychosocial interventions for breast-cancer-related pain are effective, yet over 45% of survivors continue to struggle with this often-chronic side effect. This study evaluated multilevel indicators that can influence successful translation of interventions into clinical practice. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was applied to evaluate reporting of individual and setting/staff-level intervention indicators. A systematic search and multi-step screening process identified 31 randomized controlled trials for psychosocial interventions for breast cancer-related pain. Average reporting of indicators for individual-level dimensions (Reach and Effectiveness) were 65.2% and 62.3%, respectively. Comparatively, indicators for setting/staff-level dimensions were reported at a lower average frequency (Implementation, 46.8%; Adoption, 15.2%; Maintenance, 7.7%). Low reporting of setting/staff-level dimensions suggests gaps in the sustained implementation of psychosocial interventions. Implementation science methods and frameworks could improve trial design and accelerate the translation of psychosocial interventions for breast cancer-related pain into clinical practice.
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Affiliation(s)
- Emily Cox-Martin
- VA Puget Sound Health Care System, 9600 Veterans Dr SW, Tacoma, WA, 98493, USA.
| | | | - Lilian Hoffecker
- Strauss Health Sciences Library, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Russell E Glasgow
- Department of Family Medicine, and ACCORDS Center, University of Colorado School of Medicine, Aurora, CO, USA
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Collado-Soler R, Alférez-Pastor M, Torres FL, Trigueros R, Aguilar-Parra JM, Navarro N. A Systematic Review of Healthy Nutrition Intervention Programs in Kindergarten and Primary Education. Nutrients 2023; 15:nu15030541. [PMID: 36771248 PMCID: PMC9921877 DOI: 10.3390/nu15030541] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Childhood obesity and overweight rates are increasing in an exponential way. This type of diet-related health problem has consequences, not only at present but also for children's future lives. For these reasons, it is very important to find a solution, which could be nutrition intervention programs. The main objective of this article is to investigate the effectiveness of nutrition intervention programs in children aged 3-12 around the world. We used SCOPUS, Web of Science, and PubMed databases to carry out this systematic review and we followed the PRISMA statement. Two authors conducted literature searches independently, finding a total of 138 articles. Finally, after a thorough screening, a total of 19 articles were selected for detailed analysis. The results show that, in general, nutrition intervention programs are effective in improving knowledge and behaviors about healthy habits, and, consequently, that the body mass index value is reduced. However, it is true that we found differences between the incomes of families and geographical areas. In conclusion, we encourage school centers to consider including these types of programs in their educational program and bring awareness of the importance of families too.
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Affiliation(s)
- Rocio Collado-Soler
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Marina Alférez-Pastor
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Francisco L. Torres
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Rubén Trigueros
- Department of Language and Education, University of Antonio de Nebrija, 28015 Madrid, Spain
- Correspondence: (R.T.); (J.M.A.-P.)
| | - Jose M. Aguilar-Parra
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
- Correspondence: (R.T.); (J.M.A.-P.)
| | - Noelia Navarro
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
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Bailey-Davis L, Moore AM, Poulsen MN, Dzewaltowski DA, Cummings S, DeCriscio LR, Hosterman JF, Huston D, Kirchner HL, Lutcher S, McCabe C, Welk GJ, Savage JS. Comparing enhancements to well-child visits in the prevention of obesity: ENCIRCLE cluster-randomized controlled trial. BMC Public Health 2022; 22:2429. [PMID: 36572870 PMCID: PMC9792161 DOI: 10.1186/s12889-022-14827-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/06/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Obesity disproportionally impacts rural, lower-income children in the United States. Primary care providers are well-positioned to engage parents in early obesity prevention, yet there is a lack of evidence regarding the most effective care delivery models. The ENCIRCLE study, a pragmatic cluster-randomized controlled trial, will respond to this gap by testing the comparative effectiveness of standard care well-child visits (WCV) versus two enhancements: adding a patient-reported outcome (PRO) measure (PRO WCV) and PRO WCV plus Food Care (telehealth coaching and a grocery store tour). METHODS A total of 2,025 parents and their preschool-aged children (20-60 months of age) will be recruited from 24 Geisinger primary care clinics, where providers are randomized to the standard WCV, PRO WCV, or PRO WCV plus Food Care intervention arms. The PRO WCV includes the standard WCV plus collection of the PRO-the Family Nutrition and Physical Activity (FNPA) risk assessment-from parents. Parents complete the PRO in the patient-portal or in the clinic (own device, tablet, or kiosk), receive real-time feedback, and select priority topics to discuss with the provider. These results are integrated into the child's electronic health record to inform personalized preventive counseling by providers. PRO WCV plus Food Care includes referrals to community health professionals who deliver evidence-based obesity prevention and food resource management interventions via telehealth following the WCV. The primary study outcome is change in child body mass index z-score (BMIz), based on the World Health Organization growth standards, 12 months post-baseline WCV. Additional outcomes include percent of children with overweight and obesity, raw BMI, BMI50, BMIz extended, parent involvement in counseling, health behaviors, food resource management, and implementation process measures. DISCUSSION Study findings will inform health care systems' choices about effective care delivery models to prevent childhood obesity among a high-risk population. Additionally, dissemination will be informed by an evaluation of mediating, moderating, and implementation factors. TRIAL REGISTRATION ClinicalTrials.gov identifier (NCT04406441); Registered May 28, 2020.
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Affiliation(s)
- Lisa Bailey-Davis
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA ,Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Amy M. Moore
- grid.29857.310000 0001 2097 4281Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802 USA
| | - Melissa N. Poulsen
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - David A. Dzewaltowski
- grid.266813.80000 0001 0666 4105College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198 USA
| | - Stacey Cummings
- Department of Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Laina R. DeCriscio
- Health and Wellness, Steele Institute, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Jennifer Franceschelli Hosterman
- Department of Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA ,Departments of Internal Medicine and Pediatrics, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Daniel Huston
- Health and Wellness, Steele Institute, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - H. Lester Kirchner
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Shawnee Lutcher
- Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Carolyn McCabe
- grid.280776.c0000 0004 0394 1447Department of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA ,Center for Obesity & Metabolic Research, Geisinger, 100 N Academy Ave, Danville, PA 17822 USA
| | - Gregory J. Welk
- grid.34421.300000 0004 1936 7312Department of Kinesiology, Iowa State University, 103E Forker, 534 Wallace Rd, Ames, IA 50011 USA
| | - Jennifer S. Savage
- grid.29857.310000 0001 2097 4281Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802 USA
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Hammersley ML, Wyse RJ, Jones RA, Okely AD, Wolfenden L, Eckermann S, Xu J, Green A, Stacey F, Yoong SL, Jackson J, Innes-Hughes C, Li V, Rissel C. Telephone and Web-Based Delivery of Healthy Eating and Active Living Interventions for Parents of Children Aged 2 to 6 Years: Mixed Methods Process Evaluation of the Time for Healthy Habits Translation Trial. J Med Internet Res 2022; 24:e35771. [PMID: 35616994 PMCID: PMC9185338 DOI: 10.2196/35771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/16/2022] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Few translational trials have provided detailed reports of process evaluation results. Objective This study reported on findings from a mixed methods process evaluation of a large translational trial comparing 2 remotely delivered healthy eating and active living interventions with an active control, targeting parents of young children. Methods Mixed methods process evaluation data were collected as part of a 3-arm, partially randomized preference trial targeting parents of children aged 2 to 6 years from New South Wales, Australia. Recruitment strategies were assessed through the participant baseline questionnaire and a questionnaire completed by the health promotion staff involved in recruitment. Data on participants’ intervention preferences were collected at baseline and after the intervention. Intervention acceptability and demographic data were collected via a postintervention questionnaire (approximately 3 months after baseline), which was supplemented by qualitative participant interviews. Implementation data on intervention fidelity and withdrawal were also recorded. Differences in intervention acceptability, fidelity, and withdrawal rates between telephone and web-based interventions and between randomized and nonrandomized participants were analyzed. The significance level was set at P<.05 for all tests. The interview content was analyzed, key themes were drawn from participant responses, and findings were described narratively. Results Data were collected from 458 participants in the baseline survey and 144 (31.4%) participants in the 3-month postintervention survey. A total of 30 participants completed the qualitative interviews. A total of 6 health promotion staff members participated in the survey on recruitment strategies. Most participants were recruited from Early Childhood Education and Care services. There was a broad reach of the study; however, better take-up rates were observed in regional and rural areas compared with metropolitan areas. Parents with a university education were overrepresented. Most participants preferred the web-based medium of delivery at baseline. There was high acceptability of the web-based and telephone interventions. Participants found the healthy eating content to be the most useful component of the modules (web-based) and calls (telephone). They regarded text (web-based) or verbal (telephone) information as the most useful component. A high proportion of participants completed the telephone intervention compared with the web-based intervention; however, more participants actively withdrew from the telephone intervention. Conclusions This is one of the first studies to comprehensively report on process evaluation data from a translation trial, which demonstrated high acceptability of all interventions but a strong participant preference for the web-based intervention. This detailed process evaluation is critical to inform further implementation and be considered alongside the effectiveness outcomes.
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Affiliation(s)
- Megan L Hammersley
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Rebecca J Wyse
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Wallsend, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Rachel A Jones
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Anthony D Okely
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Wallsend, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Simon Eckermann
- Illawarra Health and Medical Research Institute, Wollongong, Australia.,School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Joe Xu
- Centre for Population Health, New South Wales Ministry of Health, St Leonards, Sydney, Australia
| | - Amanda Green
- Centre for Population Health, New South Wales Ministry of Health, St Leonards, Sydney, Australia
| | - Fiona Stacey
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Wallsend, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Sze Lin Yoong
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Australia
| | - Jacklyn Jackson
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.,Hunter New England Population Health, Wallsend, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
| | - Christine Innes-Hughes
- Centre for Population Health, New South Wales Ministry of Health, St Leonards, Sydney, Australia
| | - Vincy Li
- Health Consult, Sydney, Australia
| | - Chris Rissel
- College of Medicine and Public Health, Flinders University, Darwin, Australia
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11
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Wilcox S, Day KR, Saunders RP, Jake-Schoffman DE, Kaczynski AT, Stucker J, Dunn CG, Bernhart JA. The Faith, Activity, and Nutrition (FAN) dissemination and implementation study: changes in and maintenance of organizational practices over 24 months in a statewide initiative. Int J Behav Nutr Phys Act 2022; 19:23. [PMID: 35236373 PMCID: PMC8889739 DOI: 10.1186/s12966-022-01253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have examined the impact of ecological health promotion interventions on organizational practices over time, especially in faith-based settings. This statewide dissemination and implementation study examined change in organizational practices and their predictors across a 24-month period, as well as maintenance of change. METHODS Using a pre-post quasi-experimental design, church coordinators from 92 United Methodist Churches in South Carolina (42% predominantly African American congregations) completed surveys at baseline, and immediate, 12-, and 24-months post-training regarding physical activity (PA) and healthy eating (HE) organizational practices consistent with the Faith, Activity, and Nutrition (FAN) program (opportunities, policies, pastor support, messages) and possible predictors. The study was guided by the RE-AIM framework and the Consolidated Framework for Implementation Research (CFIR). Mixed model repeated measures analyses examined change in organizational practices over time. Regression models examined CFIR predictors of 24-month PA and HE organizational practices, controlling for baseline practices. Churches were also classified as maintainers (implemented at 12 and 24 months), non-sustained implementers (implemented at 12 but not 24 months), delayed implementers (implemented at 24 but not 12 months), and low implementers (implemented at neither 12 nor 24 months) for each FAN component. RESULTS PA and HE organizational practices increased over time (p < .0001). CFIR domains (and constructs within) of intervention characteristics (adaptability, relative advantage, cost/time), inner setting (relative priority, organizational rewards, readiness, congregant needs), characteristics of the implementer (self-efficacy, perceived benefits), and implementation process (engaging opinion leaders, engaging champions) were important predictors of 24-month PA and HE organizational practices. Over half of churches implementing PA policies, PA messages, HE policies, and HE opportunities at 12 months were maintainers at 24 months, and one-third were maintainers for PA opportunities, HE messages, and PA and HE pastor support. Furthermore, 16% of 12-month non-implementers were delayed implementers at 24 months for PA policies and 31% were delayed implementers for HE policies. CONCLUSIONS This study makes important contributions to the faith-based health promotion literature by including a large sample of churches, testing an ecological intervention approach, and assessing organizational practices over a 24-month period. Study findings can guide technical assistance and program adaptations over time. TRIAL REGISTRATION This study was registered in clinicaltrials.gov NCT02868866 on August 16, 2016.
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Affiliation(s)
- Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. .,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Kelsey R Day
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Ruth P Saunders
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Danielle E Jake-Schoffman
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Andrew T Kaczynski
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jessica Stucker
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Caroline G Dunn
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - John A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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12
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Shin HD, Cassidy C, Weeks LE, Campbell LA, Drake EK, Wong H, Donnelly L, Dorey R, Kang H, Curran JA. Interventions to change clinicians' behavior related to suicide-prevention care in the emergency department: a scoping review. JBI Evid Synth 2021; 20:788-846. [PMID: 34907133 DOI: 10.11124/jbies-21-00149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review was to explore, characterize, and map the literature on interventions and intervention components implemented to change emergency department clinicians' behavior related to suicide prevention using the Behaviour Change Wheel as a guiding theoretical framework. INTRODUCTION An emergency department is a critical place for suicide prevention, yet patients are often discharged without proper suicide risk assessments and/or referrals. In response, we must support emergency department clinicians' behavior change to follow evidence-based suicide prevention strategies. However, reviews to date have yet to systematically and theoretically examine interventions' functional characteristics and how they can influence emergency department clinicians' behaviors related to suicide-prevention care. INCLUSION CRITERIA This review considered interventions that targeted emergency department clinicians' behavior change related to suicide prevention. Behavior change referred to observable practice changes as well as proxy measures of behavior change, including changes in knowledge and attitude. METHODS This review followed JBI methodology for scoping reviews. Searches included PubMed, PsycINFO, CINAHL, Embase, and gray literature, including targeted Google searches for relevant organizations/websites, ProQuest Dissertations and Theses Global, and Scopus conference papers (using a specific filter). This review did not apply any date limits, but our search was limited to the English language. Data extraction was undertaken using a charting table developed specifically for the review objective. Narrative descriptions of interventions were coded using the Behavior Change Wheel's intervention functions. Reported outcome measures were categorized. Findings are tabulated and synthesized narratively. RESULTS Forty-one studies were included from the database searches, representing a mixture of experimental (n = 2), quasi-experimental (n = 24), non-experimental (n = 12), qualitative (n = 1), and mixed methods (n = 2) approaches. An additional 29 citations were included from gray literature searches. One was a pilot mixed methods study, and the rest were interventions. In summary, this review included a total of 70 citations, describing 66 different interventions. Identified interventions comprised a wide range of Behaviour Change Wheel intervention functions to change clinicians' behavior: education (n = 48), training (n = 40), enablement (n = 36), persuasion (n = 21), environmental restructuring (n = 18), modeling (n = 7), and incentivisation (n = 2). Based on the Behaviour Change Wheel analysis, many interventions targeted more than one determinant of behavior change, often employing education and training to improve clinicians' knowledge and skills simultaneously. Among the 42 studies that reported outcome measures, effectiveness was measured at clinician (n = 38), patient (n = 4), and/or organization levels (n = 6). Few studies reported implementation outcomes, such as measures of reach (n = 4), adoption (n = 5), or fidelity (n = 1). There were no evaluation data reported on the interventions identified through Google searches. CONCLUSIONS Interventions included in this review were diverse and leveraged a range of mechanisms to change emergency department clinicians' behavior. However, most interventions relied solely on education and/or training to improve clinicians' knowledge and/or skills. Future research should consider diverse intervention functions to target both individual- and/or organization-level barriers for a given context. Secondly, the ultimate goal for changing emergency department clinicians' behavior is to improve patient health outcomes related to suicide-related thoughts and behaviors, but current research has most commonly evaluated clinicians' behavior in isolation of patient outcomes. Future studies should consider reporting patient-level outcomes alongside clinician-level outcomes.
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Affiliation(s)
- Hwayeon Danielle Shin
- School of Nursing, Dalhousie University, Halifax, NS, Canada Aligning Health Needs and Evidence for Transformative Change (AH-NET-C): A JBI Centre of Excellence, Halifax, NS, Canada Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada Faculty of Health, Dalhousie University, Halifax, NS, Canada Nova Scotia Health Authority, Halifax, NS, Canada
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13
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van Sluijs EMF, Brown HE, Coombes E, Hughes C, Jones AP, Morton KL, Guagliano JM. An online family-based self-monitoring and goal-setting intervention to improve children’s physical activity: the FRESH feasibility trial and three-arm pilot RCT. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Family-based physical activity promotion presents a promising avenue for promoting whole-family physical activity, but high-quality research is lacking.
Objectives
To assess the feasibility, acceptability and preliminary effectiveness of FRESH (Families Reporting Every Step to Health), a child-led online family-based physical activity intervention; and to identify effective and resource-efficient family recruitment strategies.
Design
The project consisted of (1) a randomised feasibility trial, (2) a randomised controlled pilot trial and (3) a systematic review and Delphi study.
Setting
Norfolk/Suffolk counties, UK.
Participants
Families, recruited from schools, workplaces and community settings, were eligible to participate if one child aged 7–11 years and one adult responsible for their care provided written consent; all family members could participate.
Interventions
The FRESH intervention, guided by self-determination theory, targeted whole families and was delivered via an online platform. All family members received pedometers and were given website access to select family step challenges to ‘travel’ to target cities around the world, log steps, and track progress as they virtually globetrotted. Families were randomised to FRESH intervention, pedometer-only or control arm.
Main outcome measures
Physical (e.g. blood pressure), psychosocial (e.g. family functioning) and behavioural (e.g. device-measured family physical activity) measures were collected at baseline and at 8- and 52-week follow-up. A mixed-methods process evaluation assessed the acceptability of the intervention and evaluation.
Data sources review
Systematic search of four databases (Cochrane Library, PubMed, PsycINFO and SCOPUS).
Review methods
Articles were screened in duplicate, and data extraction was fully checked. Academic experts participated in the three-round Delphi study. Data were combined to identify effective and resource-efficient family recruitment strategies.
Inclusion criteria
Included generally healthy school-aged children and at least one adult; intervention attempted to change physical activity, sedentary behaviour, screen use, diet, or prevent overweight/obesity in multiple family members; presented relevant measure of effect in children and adults.
Results
The feasibility study (12 families, 32 participants; 100% retention at 8 weeks) demonstrated the feasibility and acceptability of FRESH, but highlighted that adaptations were required. Of 41 families recruited in the pilot study (149 participants), 98% and 88% were retained at the 8-week and 52-week follow-up, respectively. More children in the FRESH arm self-reported doing more family physical activity, and they thought that FRESH was fun. There were no notable between-group differences in children’s outcomes. Change in moderate to vigorous physical activity at 8 weeks favoured FRESH intervention adults [vs. control: 9.4 minutes/week (95% confidence interval 0.4 to 18.4) vs. pedometer only: 15.3 (95% confidence interval 6.0 to 24.5)], and was stronger in fathers, but this was not maintained. In 49 included studies, apart from recruitment settings and strategies used (reported in 84% and 73% of the studies, respectively), recruitment details were scarce. School-based recruitment was predominant. The Delphi study identified a wide range of recruitment settings and strategies.
Limitations
Recruitment was the main limitation of the FRESH studies; generalisability of the proposed recruitment strategies may be limited.
Conclusions
This study has demonstrated the feasibility and acceptability of the FRESH intervention. However, we failed to recruit the target sample size and were unable to demonstrate a signal of effectiveness. Future research should employ a multifaceted recruitment approach.
Future work
Further refinements to intervention delivery and recruitment methods should be investigated.
Study registration
Current Controlled Trials ISRCTN12789422 and PROSPERO CRD42019140042.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Esther MF van Sluijs
- Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Helen E Brown
- Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Emma Coombes
- Norwich Medical School and Centre for Diet and Activity Research (CEDAR), University of East Anglia, Norwich, UK
| | - Claire Hughes
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Andrew P Jones
- Norwich Medical School and Centre for Diet and Activity Research (CEDAR), University of East Anglia, Norwich, UK
| | - Katie L Morton
- Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Justin M Guagliano
- Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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14
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Pinheiro-Carozzo NP, Murta SG, Vinha LGDA, da Silva IM, Fontaine AMGV. Beyond effectiveness of the Strengthening Families Program (10-14): a scoping RE-AIM-based review. PSICOLOGIA-REFLEXAO E CRITICA 2021; 34:16. [PMID: 34131838 PMCID: PMC8206301 DOI: 10.1186/s41155-021-00182-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/17/2021] [Indexed: 11/18/2022] Open
Abstract
A scoping review, based on the RE-AIM framework, was conducted to analyze evidence of reach, effectiveness, adoption, implementation, and maintenance of the Strengthening Families Program (10-14), a preventive family-based substance abuse program for adolescents. Sixty-five articles were included. The results disclosed that effectiveness, implementation, and maintenance at the individual-level were the most evaluated aspects, while reach, maintenance at the setting-level, and adoption were the least investigated aspects. Positive effects on drug abuse prevention and protective parenting factors were found in the U.S. studies. Likewise, Latin American studies have shown the improvement of parenting practices. However, European studies have produced mixed results, with predominantly null effects on substance abuse. The implementation quality was high. There is no available evidence of adoption and maintenance at the setting-level by the organizations that implemented it. New studies must examine the reach, adoption, and sustainability of the program to lay foundations for its future use as an instrument of public policies.
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Affiliation(s)
- Nádia P Pinheiro-Carozzo
- Departamento de Psicologia, Centro de Ciências Humanas, Universidade Federal do Maranhão, Cidade Universitária Dom Delgado, Avenida dos Portugueses, 1966, Bacanga, São Luis, MA, 65080-805, Brazil.
| | - Sheila G Murta
- Departamento de Psicologia Clínica, Instituto de Psicologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Brasília, DF, 70910-900, Brazil
| | - Luís Gustavo do A Vinha
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Brasília, DF, 70910-900, Brazil
| | - Isabela M da Silva
- Departamento de Psicologia Clínica, Instituto de Psicologia, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Brasília, DF, 70910-900, Brazil
| | - Anne Marie G V Fontaine
- Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
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15
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Harms LSE, Gerards SMPL, Kremers SPJ, Bessems KMHH, van Luijk C, Arslan T, Mombers FM, Gubbels JS. Involving Parents in Promoting Healthy Energy Balance-Related Behaviors in Preschoolers: A Mixed Methods Impact and Process Evaluation of SuperFIT. Nutrients 2021; 13:1605. [PMID: 34064826 PMCID: PMC8150277 DOI: 10.3390/nu13051605] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Parental involvement is an essential component of obesity prevention interventions for children. The present study provides a process and impact evaluation of the family component of SuperFIT. SuperFIT is a comprehensive, integrated intervention approach aiming to improve energy balance-related behaviors (EBRBs) of young children (2-4 years). A mixed methods design combined in-depth interviews with parents (n = 15) and implementers (n = 3) with questionnaire data on nutritional and physical activity-related parenting practices (CFPQ and PPAPP), the physical home environment (EPAO_SR) (n = 41), and intervention appreciation (n = 19). Results were structured using the concepts of reach, adoption, implementation, and perceived impact. Findings indicated that the families reached were mostly those that were already interested in the topic. Participants of the intervention appreciated the information received and the on-the-spot guidance on their child's behavior. Having fun was considered a success factor within the intervention. Parents expressed the additional need for peer-to-peer discussion. SuperFIT increased awareness and understanding of parents' own behavior. Parents made no changes in daily life routines or the physical home environment. Translating knowledge and learned strategies into behavior at home has yet to be achieved. To optimize impact, intervention developers should find the right balance between accessibility, content, and intensity of interventions for parents.
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Affiliation(s)
- Lisa S. E. Harms
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (S.M.P.L.G.); (S.P.J.K.); (K.M.H.H.B.); (C.v.L.); (T.A.); (F.M.M.); (J.S.G.)
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16
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Internal and External Validity of Social Media and Mobile Technology-Driven HPV Vaccination Interventions: Systematic Review Using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework. Vaccines (Basel) 2021; 9:vaccines9030197. [PMID: 33652809 PMCID: PMC7996801 DOI: 10.3390/vaccines9030197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/12/2021] [Accepted: 02/23/2021] [Indexed: 12/26/2022] Open
Abstract
Social media human papillomavirus (HPV) vaccination interventions show promise for increasing HPV vaccination rates. An important consideration for the implementation of effective interventions into real-world practice is the translation potential, or external validity, of the intervention. To this end, we conducted a systematic literature review to describe the current body of evidence regarding the external validity of social media HPV vaccination-related interventions. Constructs related to external validity were based on the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework. Seventeen articles published between 2006 and 2020 met the inclusion criteria. Three researchers independently coded each article using a validated RE-AIM framework. Discrepant codes were discussed with a fourth reviewer to gain consensus. Of these 17 studies, 3 were pilot efficacy studies, 10 were randomized controlled trials (RCTs) to evaluate effectiveness, 1 was a population-based study, and 3 did not explicitly state which type of study was conducted. Reflecting this distribution of study types, across all studies the mean level of reporting RE-AIM dimensions varied with reach recording 90.8%, effectiveness (72.1%), adoption (40.3%), implementation (45.6%), and maintenance (26.5%). This review suggests that while the current HPV vaccination social media-driven interventions provide sufficient information on internal validity (reach and effectiveness), few have aimed to gather data on external validity needed to translate the interventions into real world implementation. Our data suggest that implementation research is needed to move HPV vaccination-related interventions into practice. Included in this review are recommendations for enhancing the design and reporting of these HPV vaccination social media-related interventions.
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17
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Shonkoff E, Folta SC, Fitopoulos T, Ramirez CN, Bluthenthal R, Pentz MA, Chou CP, Dunton GF. A positive deviance-based qualitative study of stress, coping, and feeding practices among low-income, Hispanic mothers whose children do versus do not meet guidelines for fruit and vegetable intake. HEALTH EDUCATION RESEARCH 2020; 35:584-604. [PMID: 33367771 PMCID: PMC8463094 DOI: 10.1093/her/cyaa037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 09/04/2020] [Indexed: 06/12/2023]
Abstract
Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being 'high-risk' for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one's attention away from stressors; comparison group mothers tended to report stress about managing their child's eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.
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Affiliation(s)
- Eleanor Shonkoff
- School of Health Sciences, Merrimack College, North Andover, MA 01845, USA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Theodore Fitopoulos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Cynthia N Ramirez
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Ricky Bluthenthal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Mary Ann Pentz
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Chih-Ping Chou
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA
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18
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Brown M, Roman NV. Using the RE-AIM framework to identify and describe nutritional feeding styles and intervention model best practices for primary caregivers in Africa: A narrative review. Nutr Health 2020; 27:171-180. [PMID: 33269666 DOI: 10.1177/0260106020977053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Current research shows that across the world people are eating poorly. This is leading to increased incidences of nutrition-related health problems. AIM This paper aims to provide a synthesis of research on the nutritional feeding programs and nutritional models used by primary caregivers in Africa, in order to identify best practice models, programs, and processes from the field of nutritional and feeding intervention development. METHODS The research used a narrative review methodology. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was used to disseminate results to allow for cross-comparison of core components inherent in health promotion interventions. We chose the RE-AIM framework as it facilitates the development, delivery, and evaluation of health interventions. RESULTS After screening a total of 8220 articles, four studies were deemed relevant for the purposes of this review. The selected studies were the only ones that discussed nutrition interventions or programs with a very clear aim and purpose, even though they did not include any information on implementation, review or evaluation of these interventions/program. No studies focusing on the African context were deemed relevant as none of them focused on best practice models for nutrition education interventions or programs. CONCLUSIONS Of a review of over 8220 articles, four studies were found that discuss nutritional feeding programs and nutritional models used by primary caregivers. Of these four, only one focused on enablers, barriers, and resources, all of which are essential for engaging in health behavior change. And only one focused on sustainability of the interventions.
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Affiliation(s)
- Melissa Brown
- Child and Family Studies, Social Work Department, 108325University of the Western Cape, Bellville, South Africa
| | - Nicolette V Roman
- Child and Family Studies, Social Work Department, 108325University of the Western Cape, Bellville, South Africa
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Involving Parents to Help Improve Children's Energy Balance-Related Behaviours Through a School-Based Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134838. [PMID: 32635615 PMCID: PMC7369705 DOI: 10.3390/ijerph17134838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/26/2020] [Accepted: 07/02/2020] [Indexed: 11/16/2022]
Abstract
The Challenge Me intervention aimed to indirectly involve parents in a school-based intervention, by challenging primary school children to perform physical activity (PA) and nutrition-related activities with their parents. The aim of this study is to gain insight in whether this was a feasible strategy to engage children and parents, especially those of vulnerable populations. An exploratory cross-sectional study design was applied. Four primary schools implemented the intervention. Data consisted of challenges completed (intervention posters) and child and family characteristics (questionnaires and anthropometric measurements). Associations between challenges performed and child and family characteristics were assessed using linear regression analysis. Of the 226 study participants, 100% performed at least one challenge, and 93% performed at least one challenge involving parents. Children who performed more PA challenges were often younger, a sports club member, lived in higher socioeconomic status neighbourhoods, of Western ethnicity and from larger families. Regarding nutrition challenges involving parents, younger children performed more challenges. There was no difference in intervention engagement regarding gender, weight status, PA preference, healthy nutrition preference, or the Family PA and Family Nutrition Climate. Challenge Me has potential in involving parents in a school-based intervention. However, certain characteristics were associated with higher involvement.
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Iwelunmor J, Nwaozuru U, Obiezu-Umeh C, Uzoaru F, Ehiri J, Curley J, Ezechi O, Airhihenbuwa C, Ssewamala F. Is it time to RE-AIM? A systematic review of economic empowerment as HIV prevention intervention for adolescent girls and young women in sub-Saharan Africa using the RE-AIM framework. Implement Sci Commun 2020; 1:53. [PMID: 32885209 PMCID: PMC7427963 DOI: 10.1186/s43058-020-00042-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/24/2020] [Indexed: 01/12/2023] Open
Abstract
Background Economic empowerment (EE) HIV prevention programs for adolescent girls and young women (AGYW) in sub-Saharan Africa are gaining traction as effective strategies to reduce HIV risk and vulnerabilities among this population. While intervention effectiveness is critical, there are numerous factors beyond effectiveness that shape an intervention’s impact. The objective of this systematic review was to assess the reporting of implementation outcomes of EE HIV prevention programs for AGYW in SSA, as conceptualized in the RE-AIM (reach, efficacy/effectiveness, adoption, implementation, and maintenance) framework. Methods We searched PubMed, Ovid/MEDLINE, Science Direct, Ebscohost, PsycINFO, Scopus, and Web of Science for EE HIV interventions for AGYW in SSA. Study selection and data extraction were conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Two researchers coded each article using a validated RE-AIM data extraction tool and independently extracted information from each article. The reporting of RE-AIM dimensions were summarized and synthesized across included interventions. Results A total of 25 unique interventions (reported in 45 articles) met the predefined eligibility criteria. Efficacy/effectiveness 19(74.4%) was the highest reported RE-AIM dimension, followed by adoption 17(67.2%), reach 16(64.0%), implementation 9(38.0%), and maintenance 7(26.4%). Most interventions reported on RE-AIM components such as sample size 25(100.0%), intervention location 24(96.0%), and measures and results for at least one follow-up 24(96.0%). Few reported on RE-AIM components such as characteristics of non-participants 8(32.0%), implementation costs 3(12.0%), and intervention fidelity 0(0.0%). Conclusions Results of the review emphasize the need for future economic empowerment HIV prevention interventions for AGYW in SSA to report multiple implementation strategies and highlight considerations for translating such programs into real-world settings. Researchers should pay close attention to reporting setting-level adoption, implementation cost, and intervention maintenance. These measures are needed for policy decisions related to the full merit and worth of EE HIV interventions and their long-term sustainability for AGYW.
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Affiliation(s)
- Juliet Iwelunmor
- College for Public Health and Social Justice, Saint Louis University, Salus Center, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Ucheoma Nwaozuru
- College for Public Health and Social Justice, Saint Louis University, Salus Center, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Chisom Obiezu-Umeh
- College for Public Health and Social Justice, Saint Louis University, Salus Center, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Florida Uzoaru
- College for Public Health and Social Justice, Saint Louis University, Salus Center, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - John Ehiri
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, AZ 85724 USA
| | - Jami Curley
- College for Public Health and Social Justice, Saint Louis University, Salus Center, 3545 Lafayette Avenue, Saint Louis, MO 63104 USA
| | - Oliver Ezechi
- Nigerian Institute of Medical Research, 6 Edmund Crescent, Yaba, Lagos State Nigeria
| | - Collins Airhihenbuwa
- School of Public Health, Global Research Against Noncommunicable Diseases, Georgia State University, 140 Decatur Street SE, Atlanta, GA 30303 USA
| | - Fred Ssewamala
- Brown School, Washington University in Saint Louis, 1 Brookings Drive, Saint Louis, MO 63130 USA
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21
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Ben Cheikh A, Maatoug J, Ghammam R, Chouikha F, Mallat A, Ghannem H. Effect of a school-based intervention in eating habits among school children: quasi experimental study, Tunisia. Int J Adolesc Med Health 2020; 33:157-164. [PMID: 32549142 DOI: 10.1515/ijamh-2018-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/04/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The present study aimed to assess whether six months intervention program with parents' implication in primary schools is able to decrease morning snack consumption among children aged 6-12 years. METHODS We carried out a quasi-experimental study with two groups of schoolchildren in the region of Sousse (Tunisia) from 2015 to 2016. One primary school in each group was selected. In each school, we randomly selected a sample size of schoolchildren and their parents. The intervention was based on healthy eating habits promotion. RESULTS The consumption of morning snacks the day before data collection, reported by children, decreased significantly in post-intervention in both intervention and control groups. The decrease of consumption of morning snacks was significantly higher in intervention group (p=0.009). According to parents, the proportion of children who had the habit of eating morning snack decreased significantly from pre to post-intervention in intervention group (p<0.001). CONCLUSION A healthy environment should be created through effective school policies to prevent obesity.
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Affiliation(s)
- Asma Ben Cheikh
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jihène Maatoug
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia.,Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Rim Ghammam
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia.,Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Firas Chouikha
- Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Amal Mallat
- Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
| | - Hassen Ghannem
- Faculty of medicine of Sousse, University of Sousse, Sousse, Tunisia.,Department of Epidemiology - Sousse, University Hospital Center Farhat Hached, Sousse, Tunisia
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22
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Wilcox S, Saunders RP, Jake-Schoffman D, Hutto B. The Faith, Activity, and Nutrition (FAN) Dissemination and Implementation Study: 24-Month Organizational Maintenance in a Countywide Initiative. Front Public Health 2020; 8:171. [PMID: 32528919 PMCID: PMC7247868 DOI: 10.3389/fpubh.2020.00171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/20/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction: Despite the important role that faith-based organizations can play in eliminating health disparities, few studies have focused on organizational change and maintenance of interventions in this setting, making their long-term impact unknown. This study reports 24-month maintenance of the Faith, Activity, and Nutrition (FAN) program in a southeastern county. Previously reported findings of reach, adoption, implementation, and effectiveness are also summarized. Methods: Church coordinators from 35 intervention churches (97% predominantly African American) located in a rural, medically underserved county in South Carolina were interviewed at baseline (2015), and 12- and 24-months post-training regarding implementation of physical activity (PA) and healthy eating (HE) components of the FAN program. Guided by the RE-AIM framework, organizational maintenance was defined as church coordinator-reported 24-month implementation of the four FAN components (providing opportunities, setting guidelines/policies, sharing messages, engaging pastor). Repeated measures analyses (mixed models) examined change in implementation over time. Churches were also classified as maintainers, non-sustained implementers, and low implementers for each FAN component. Statistical analyses were conducted in 2019. Results: Church coordinators reported significantly greater implementation of both PA and HE FAN components at 12 and 24 months compared to baseline (medium to large effects). The percentage of churches classified as maintainers ranged from 21 to 42 and 27 to 94% across PA and HE components, respectively. Most churches (58% for PA, 97% for HE) were maintaining at least one FAN component at 24 months. Conclusions: These promising findings position FAN well for the national implementation study now underway. Trial Registration: This study is registered at www.clinicaltrials.gov NCT02868866.
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Affiliation(s)
- Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Ruth P Saunders
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Danielle Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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23
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Walch TJ, Rosenkranz RR, Schenkelberg MA, Fees BS, Dzewaltowski DA. Parent adoption and implementation of obesity prevention practices through building children's asking skills at family child care homes. EVALUATION AND PROGRAM PLANNING 2020; 80:101810. [PMID: 32126415 DOI: 10.1016/j.evalprogplan.2020.101810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 01/15/2020] [Accepted: 02/24/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Early childhood education programs provide a setting to reach children and parents to modify home environments to prevent obesity. The Healthy Opportunities for Physical Activity and Nutrition Home (HOP'N) Home project was a novel approach that linked Family Child Care Homes (FCCH) to home environments by developing children's asking skills for healthful home environmental change through curricular activities. OBJECTIVE To evaluate the feasibility of engaging parents in obesity prevention practices through building children's asking skills at FCCH. METHODS FCCHs (n = 5 settings) and children (n = 25; aged 3-5 years; female = 36 %; non-Hispanic white = 91 %; low socioeconomic status = 28 %; overweight/obese = 52 %) and parents (n = 25) participated in a pre-post cohort design. We assessed children's body mass index and self-report variables at three time points. HOP'N Home included continuous staff training, group time, dramatic play, meal prompts, songs, and home activities. RESULTS FCCH providers implemented 83%-100% of intervention activities. All parents (100 %) adopted the program, most (87 %) returned completed homework activities to FCCHs, and over 90 % implemented changes in the home. Percent of overweight/obese children decreased from pre-intervention (50 %) to post-intervention (29 %,p = 0.06) and follow-up (38 %,p = 0.06). CONCLUSIONS It is feasible to build children's asking skills and pair this strategy with home activities to engage parents to prevent obesity.
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Affiliation(s)
- Tanis J Walch
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, 58202, United States.
| | - Richard R Rosenkranz
- Department of Food, Nutrition, Dietetics, & Health, Kansas State University, Manhattan, KS, 66503, United States
| | - Michaela A Schenkelberg
- School of Health and Kinesiology, University of Nebraska Omaha, Omaha, NE 68182 United States
| | - Bronwyn S Fees
- Family Studies and Human Services, Kansas State University, Manhattan, KS, 66503, United States
| | - David A Dzewaltowski
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, 68198, United States; Buffett Early Childhood Institute, University of Nebraska, Omaha, NE, 68106, United States
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Zeiler M, Kuso S, Nacke B, Klesges LM, Waldherr K. Evaluating reach, adoption, implementation and maintenance of Internet-based interventions to prevent eating disorders in adolescents: a systematic review. Eur J Public Health 2020; 30:179-188. [PMID: 31410447 PMCID: PMC8266527 DOI: 10.1093/eurpub/ckz130] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Past research has yielded promising results on the effectiveness of Internet-based interventions to prevent eating disorders (EDs) in adolescents, but further information is needed to evaluate the public health impact of their large-scale dissemination. This article used an established framework to systematically review the extent to which indicators of the reach, effectiveness, adoption, implementation and maintenance [cf. Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM)-framework] of universal and targeted online ED prevention programmes are reported in the literature, in order to estimate their future dissemination potential. METHODS The literature search was conducted on PubMed, Web of Science and PsycINFO, and complemented by searching existing reviews and the reference lists of the studies included. Twenty-two studies published between 2000 and April 2019 met the inclusion criteria. We extracted data on a total of 43 indicators, within RE-AIM dimensions for each article, including qualitative coding of fostering and hindering factors. RESULTS Reach (55.0%) and implementation (54.0%) were the dimensions reported on most frequently, followed by effectiveness (46.8%), adoption (34.7%) and maintenance (18.2%). While internal validity indicators were frequently reported (e.g. sample size, effects and intervention intensity), most studies failed to report on elements of external validity, such as representativeness of participants and settings, adoption rates, implementation costs and programme sustainability. CONCLUSIONS Evidence indicates that Internet-based ED prevention programmes can reach a large number of adolescents and can be feasibly implemented in school settings. However, given the paucity of large-scale dissemination studies available for review, the degree to which schools are willing to adopt preventive interventions, as well as the transferability of programmes to different settings and geographical regions remains unclear.
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Affiliation(s)
- Michael Zeiler
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Stefanie Kuso
- FernFH Distance Learning University of Applied Sciences, Wr. Neustadt, Austria
| | - Barbara Nacke
- Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Dresden, Germany
| | - Lisa M Klesges
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Karin Waldherr
- FernFH Distance Learning University of Applied Sciences, Wr. Neustadt, Austria
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Mehdizadeh A, Nematy M, Vatanparast H, Khadem-Rezaiyan M, Emadzadeh M. Impact of Parent Engagement in Childhood Obesity Prevention Interventions on Anthropometric Indices among Preschool Children: A Systematic Review. Child Obes 2020; 16:3-19. [PMID: 31479311 DOI: 10.1089/chi.2019.0103] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Home environment, modeling of weight-related behaviors, and general parenting style are very important predictors of obesity in children. The effect of parent engagement in prevention of obesity in children is not clear. The main objective of this systematic review was to address the effects of parent engagement in obesity prevention interventions on anthropometric changes among preschool children. Methods: PubMed/Medline, Cochrane Library, ISI Web of Knowledge, Scopus, Science Direct, and Google Scholar were searched. Eligible studies were randomized controlled trials in last 10 years (from 2008 until February 14, 2018), which had a parent engagement in obesity prevention interventions (as an intervention) and children's anthropometric indices (as an outcome). Results: Twenty-six studies were included. Half of studies targeted both parents and children, and the rest targeted only parents. Types of interventions ranged from a simple motivational interviewing to professional skill training approaches. Studies that targeted overweight or obese children in their intervention containing training sessions followed by maintenance for parents and those that focused on individual support for overweight children and their parents, resulted in higher improvement in BMI and other outcomes. Conclusions: Anthropometric indices and BMI are not appropriate for reflecting the effectiveness of parent engagement in obesity prevention interventions. Having an individual component in the intervention and focusing more on parents vs. children in the intervention may result in improvement in anthropometric outcomes. Focusing on weight-related behaviors as the main outcome in both, children and parents, rather than anthropometric indices, is highly recommended for future reviews.
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Affiliation(s)
- Atieh Mehdizadeh
- Department of Clinical Nutrition, Qaem Educational, Research, and Treatment Center, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohsen Nematy
- Metabolic Syndrome Research Centers, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Majid Khadem-Rezaiyan
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Emadzadeh
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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26
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Influence of parenting styles in the context of adolescents' energy balance-related behaviors: Findings from the FLASHE study. Appetite 2019; 142:104364. [DOI: 10.1016/j.appet.2019.104364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 06/28/2019] [Accepted: 07/08/2019] [Indexed: 01/20/2023]
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27
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Innella N, Jameson BE. Interventions that impact weight status in Hispanic preschool children. Public Health Nurs 2019; 37:25-38. [PMID: 31633235 DOI: 10.1111/phn.12677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objectives of this systematic review of literature include: (a) describe the intervention strategies; (b) examine the outcomes as they pertain to the child (individual level), families (interpersonal level), and community or culture (organizational level); and (c) develop a foundation of interventional approaches that specifically target obesogenic behaviors in Hispanic preschool-aged children. DESIGN A systematic review of literature was performed. The theoretical framework was the Socioecological Model. SAMPLE Twenty-four total articles were used for this review. MEASUREMENTS The method used was the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Of the 24 studies reviewed, 36% focused on the individual, 56% were interpersonal (focused on parents), and 9% focused on the organizational level. CONCLUSION Interventions that are culturally competent, directed at families, and include healthy dietary intake along with a physical activity component are most effective at lowering obesity in Hispanic preschool children.
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Zhang Y, Reyes Peralta A, Arellano Roldan Brazys P, Hurtado GA, Larson N, Reicks M. Development of a Survey to Assess Latino Fathers’ Parenting Practices Regarding Energy Balance–Related Behaviors of Early Adolescents. HEALTH EDUCATION & BEHAVIOR 2019; 47:123-133. [DOI: 10.1177/1090198119878769] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Latino adolescents face challenges to performing energy balance–related behaviors (EBRBs) to prevent childhood obesity, including healthy dietary intake, adequate physical activity, and limited screen time. Fathers are underrepresented in family-based obesity interventions but could be influential in shaping the EBRBs of Latino children. Three types of parenting practices (setting expectations/limits, role modeling, managing availability and accessibility) have shown relatively consistent positive relationships with children’s EBRBs in studies that have mostly involved mothers. The purpose of this study was to develop measures to assess Latino fathers’ parenting practices based on existing measurement instruments, focus groups and cognitive testing. Criterion validity of the measures (40 items) was examined with Latino fathers and their early adolescents (10-14 years old, n = 96 dyads) who were predominantly from low-income, two-parent households. Criterion validity was indicated by significantly higher intakes of fruit and vegetables; lower intakes of sugar-sweetened beverages, sweets/salty snacks and fast foods; more weekly physical activity hours; and fewer daily screen time hours among adolescents who reported high versus low levels/frequencies of supportive parenting practices. In addition, nearly all scales of adolescent-reported paternal behavioral modeling and availability/accessibility practices were significantly correlated with adolescents’ corresponding EBRBs (r = 0.22 to 0.54). However, poor validity and agreement with early adolescents’ reports were found for most father-reported parenting practices. Overall, this study indicated that the measures were acceptable for assessing adolescents’ report of Latino fathers’ parenting practices around EBRBs. The findings also indicate the importance of including early adolescents’ reports in measuring paternal parenting practices.
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Affiliation(s)
- Youjie Zhang
- Medical College of Soochow University, Suzhou, Jiangsu, China
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Group-based exercise interventions for increasing physical activity in cancer survivors: a systematic review of face-to-face randomized and non-randomized trials. Support Care Cancer 2019; 27:1601-1612. [DOI: 10.1007/s00520-019-04670-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
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30
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Myers J, Riggs E, Lee JL, Gibbons K, Naughton G. Confident and Understanding Parents (CUPs) - a child nutrition and active play pilot intervention for disadvantaged families attending Supported Playgroups in Victoria, Australia. Health Promot J Austr 2019; 30 Suppl 1:43-51. [PMID: 30623503 DOI: 10.1002/hpja.229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/02/2019] [Indexed: 01/18/2023] Open
Abstract
ISSUE ADDRESSED Health and nutrition inequalities are prevalent among families from socio-economically disadvantaged backgrounds. However, there is limited evidence of targeted early childhood nutrition and active play approaches due to the methodological challenges in engaging vulnerable families in research. METHODS The aim of this paper was to report findings from a pilot intervention called Confident and Understanding Parents (CUPs). CUPs aims to improve child nutrition and active play-related outcomes for children in vulnerable families. The intervention was delivered in six Supported Playgroups (SPs) in two disadvantaged locations in Victoria. Surveys incorporated knowledge and confidence measures and were administered pre- and post-training of SP facilitators along with pre-, immediately post and and 3 months postintervention to SP facilitators and parents. Qualitative data were collected via debriefing discussions with SP facilitators and ethnographic observations during SP sessions. Thematic analyses of qualitative data and statistical quantitative analyses were conducted. RESULTS Nine SP facilitators completed training, of whom six delivered CUPs in SPs with 64 parents of children aged 0 to 4 years from socially disadvantaged backgrounds. Forty-three parents (66%) attended a minimum of 50% of SP sessions with CUPs delivery. SP facilitators and parents demonstrated improved knowledge and confidence following the pilot. Learnings for implementation were identified. CONCLUSION Overall, the CUPs intervention reached and engaged vulnerable families. A strength of the intervention is the flexibility offered to SP facilitators in selecting key messages and the strong focus on "local" translation of key child nutrition and active play messages within existing early childhood settings. A further strength was the adaptation of evaluation methodology to optimise the engagement of vulnerable families. SO WHAT?: This pilot study provides insights about engaging vulnerable families in a nutrition and active play intervention to promote child health. These promising findings warrant further implementation and rigorous evaluation of CUPs.
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Affiliation(s)
- Judith Myers
- Murdoch Children's Research Institute, Policy and Equity Research Group, Parkville, Vic., Australia.,College of Health and Biomedicine, Victoria University, St Albans, Vic., Australia
| | - Elisha Riggs
- Murdoch Children's Research Institute, Intergenerational Health Research Group, Melbourne, Vic., Australia.,Department of General Practice, University of Melbourne, Melbourne, Vic., Australia
| | - Ju-Lin Lee
- Murdoch Children's Research Institute, Policy and Equity Research Group, Parkville, Vic., Australia
| | - Kay Gibbons
- Murdoch Children's Research Institute, Policy and Equity Research Group, Parkville, Vic., Australia.,College of Health and Biomedicine, Victoria University, St Albans, Vic., Australia.,Australian Catholic University, Fitzroy, Vic., Australia
| | - Geraldine Naughton
- Murdoch Children's Research Institute, Policy and Equity Research Group, Parkville, Vic., Australia.,Australian Catholic University, Fitzroy, Vic., Australia
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Are Family Routines Modifiable Determinants of Preschool Children’s Eating, Dietary Intake, and Growth? A Review of Intervention Studies. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0207-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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