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Thorsteinsdottir S, Njardvik U, Bjarnason R, Olafsdottir AS. Changes in Eating Behaviors Following Taste Education Intervention: Focusing on Children with and without Neurodevelopmental Disorders and Their Families: A Randomized Controlled Trial. Nutrients 2022; 14:4000. [PMID: 36235654 PMCID: PMC9571701 DOI: 10.3390/nu14194000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Fussy-eating children often display problematic behaviors around mealtimes, such as irritation, opposition, or may even throw tantrums. This may lead to reduced food variety and poor nutritional profiles, which may increase parents' worries about their children's diet, particularly when the children also have neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD). To investigate the effect of Taste Education on problematic mealtime behaviors, 81 children aged 8-12 years, with ND (n = 33) and without (n = 48), and their parents, participated in a 7-week Taste Education intervention. Children were matched on age, sex, and ND, and allocated at random into Immediate-intervention and Delayed-intervention groups. Parents completed the Meals in Our Household Questionnaire (MiOH). To examine changes in MiOH-scores, repeated-measures analysis-of-variance with time-points were used, with condition as factors (Immediate intervention and Delayed intervention). Baseline measures were adjusted for, and a robust linear mixed-model was fitted. Results showed superior outcomes for Intervention compared to waiting on all measures of MiOH, with stable effects through six-month follow-up. Differences were non-significant between children with and without ND. The Taste Education program suggests a promising, simple, and non-intrusive way to reduce children's problematic mealtime behaviors in the long term.
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Affiliation(s)
- Sigrun Thorsteinsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland
| | - Urdur Njardvik
- Faculty of Psychology, School of Health Sciences, University of Iceland, Saemundargata 12, 102 Reykjavik, Iceland
| | - Ragnar Bjarnason
- Faculty of Medicine, School of Health Sciences, University of Iceland, Laeknagardur 4th Floor, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland
- Department of Pediatrics, National University Hospital, Hringbraut, 101 Reykjavik, Iceland
| | - Anna S. Olafsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland
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Skjåkødegård HF, Conlon RPK, Hystad SW, Roelants M, Olsson SJG, Frisk B, Wilfley DE, Danielsen YS, Juliusson PB. Family-based treatment of children with severe obesity in a public healthcare setting: Results from a randomized controlled trial. Clin Obes 2022; 12:e12513. [PMID: 35218145 PMCID: PMC9286578 DOI: 10.1111/cob.12513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
To compare the effectiveness of family-based behavioural social facilitation treatment (FBSFT) versus treatment as usual (TAU) in children with severe obesity. Parallel-design, nonblinded, randomized controlled trial conducted at a Norwegian obesity outpatient clinic. Children aged 6-18 years referred to the clinic between 2014 and 2018 were invited to participate. Participants were randomly allocated using sequentially numbered, opaqued, sealed envelopes. FBSFT (n = 59) entailed 17 sessions of structured cognitive behavioural treatment, TAU (n = 55) entailed standard lifestyle counselling sessions every third month for 1 year. Primary outcomes included changes in body mass index standard deviation score (BMI SDS) and percentage above the International Obesity Task Force cut-off for overweight (%IOTF-25). Secondary outcomes included changes in sleep, physical activity, and eating behaviour. From pre- to posttreatment there was a statistically significant difference in change in both BMI SDS (0.19 units, 95% confidence interval [CI]: 0.10-0.28, p < .001) and %IOTF-25 (5.48%, 95%CI: 2.74-8.22, p < .001) between FBSFT and TAU groups. FBSFT participants achieved significant reductions in mean BMI SDS (0.16 units, (95%CI: -0.22 to -0.10, p < .001) and %IOTF-25 (6.53%, 95% CI: -8.45 to -4.60, p < .001), whereas in TAU nonsignificant changes were observed in BMI SDS (0.03 units, 95% CI: -0.03 to 0.09, p = .30) and %IOTF-25 (-1.04%, 95% CI: -2.99 to -0.90, p = .29). More FBSFT participants (31.5%) had clinically meaningful BMI SDS reductions of ≥0.25 from pre- to posttreatment than in TAU (13.0%, p = .021). Regarding secondary outcomes, only changes in sleep timing differed significantly between groups. FBSFT improved weight-related outcomes compared to TAU.
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Affiliation(s)
| | - Rachel P. K. Conlon
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Sigurd W. Hystad
- Department of Psychosocial ScienceUniversity of BergenBergenNorway
| | - Mathieu Roelants
- Department of Public Health and Primary Care, KU LeuvenUniversity of LeuvenLeuvenBelgium
| | | | - Bente Frisk
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
- Department of PhysiotherapyHaukeland University HospitalBergenNorway
| | - Denise E. Wilfley
- Department of PsychiatryWashington University School of MedicineSt. LouisMissouriUSA
| | | | - Petur B. Juliusson
- Department of Clinical ScienceUniversity of BergenBergenNorway
- Children and Youth ClinicHaukeland University HospitalBergenNorway
- Department of Health Registry Research and DevelopmentNorwegian Institute of Public HealthBergenNorway
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Albornoz-Guerrero J, García S, de Sevilla GGP, Cigarroa I, Zapata-Lamana R. Characteristics of Multicomponent Interventions to Treat Childhood Overweight and Obesity in Extremely Cold Climates: A Systematic Review of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3098. [PMID: 33802875 PMCID: PMC8002607 DOI: 10.3390/ijerph18063098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 12/01/2022]
Abstract
AIM To analyze the characteristics of multicomponent interventions to reduce childhood overweight and obesity in territories with an extremely cold climate. METHODS A systematic review was conducted following the PRISMA statement. MEDLINE, PsycNet, SciELO, and grey literature databases were reviewed in the period between 2010 and 2020. RESULTS 29 articles were included (n = 4434 participants; 9.3 years; 56% women) with an average adherence of 86%, 100% being the highest adherence, for the physical activity and nutrition interventions. The primary variables studied were BMI, BMI Z-score BMI-SDS and, additionally, the secondary variables studied were nutritional status and physical and mental health. In 72% of the interventions presented, positive effects were seen on the reduction of BMI, including in parents and their children. The interventions were carried out mainly by nutritionists in health centers. The duration of the 29 interventions was ≤6 months and ≥12 months, in 59% and 41% of the studies, respectively. 57% of the studies reported post-intervention results. 86% of the interventions included a physical activity component, 80% included a nutrition component, 66% included a behavioral therapy component and 55% included an education component. Concerning the effects of the intervention on the primary outcome, in interventions with a duration equal to or less than six months, the most effective interventions included recreational activities, education, and nutritional programs. In interventions lasting 12 months or more, the most effective interventions included physical activity recommendations, nutritional and physical exercise programs, and cooking classes. CONCLUSIONS This systematic review analyzed the effectiveness of, and characterized, multicomponent interventions lasting for 6 and 12 months, aiming to treat childhood obesity in extremely cold climates. The most frequently used units of measurement were also analyzed and summarized. Evidence derived from RCT. These results can be useful for designing future interventions to treat childhood obesity in territories with an extremely cold climate.
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Affiliation(s)
- Javier Albornoz-Guerrero
- Departamento de Educación y Humanidades, Universidad de Magallanes, Punta Arenas 6200000, Chile;
| | - Sonia García
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | | | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Ángeles 4440000, Chile;
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Duncanson K, Shrewsbury V, Burrows T, Chai LK, Ashton L, Taylor R, Gow M, Ho M, Ells L, Stewart L, Garnett S, Jensen ME, Nowicka P, Littlewood R, Demaio A, Coyle DH, Walker JL, Collins CE. Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity: a systematic review with meta‐analysis. J Hum Nutr Diet 2020; 34:147-177. [DOI: 10.1111/jhn.12831] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022]
Affiliation(s)
- K. Duncanson
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - V. Shrewsbury
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - T. Burrows
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - L. K. Chai
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- Centre for Children’s Health Research Institute of Health and Biomedical Innovation Exercise and Nutrition Queensland University of Technology South Brisbane QLD Australia
| | - L. Ashton
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - R. Taylor
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
| | - M. Gow
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. Ho
- School of Nursing The University of Hong Kong Pokfulam Hong Kong
| | - L. Ells
- School of Clinical and Applied Sciences Leeds Beckett University Leeds UK
- Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence Middlesbrough UK
| | - L. Stewart
- Appletree Healthy Lifestyle Consultancy Perth UK
| | - S. Garnett
- Institute of Endocrinology and Diabetes The Children’s Hospital at Westmead Westmead NSW Australia
- Children’s Hospital at Westmead Clinical School The University of Sydney Westmead NSW Australia
| | - M. E. Jensen
- Priority Research Centre Grow Up Well and Faculty of Health and Medicine The University of Newcastle Callaghan NSW Australia
| | - P. Nowicka
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
| | - R. Littlewood
- Health and Wellbeing Queensland Queensland Government Milton QLD Australia
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - A. Demaio
- Victorian Health Promotion Foundation Carlton South VIC Australia
| | - D. H. Coyle
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The George Institute for Global Health University of New South Wales Sydney NSW Australia
| | - J. L. Walker
- School of Human Movement and Nutrition Sciences The University of Queensland St Lucia QLD Australia
| | - C. E. Collins
- School of Health Sciences Faculty of Health and Medicine Priority Research Centre for Physical Activity and Nutrition The University of Newcastle Callaghan NSW Australia
- The University of Newcastle Centre for Evidence Based Healthcare Informing Research (CEBHIR): a Joanna Briggs Institute Centre of Excellence Callaghan NSW Australia
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Njardvik U, Gunnarsdottir T, Olafsdottir AS, Craighead LW, Boles RE, Bjarnason R. Incorporating Appetite Awareness Training Within Family-Based Behavioral Treatment of Pediatric Obesity: A Randomized Controlled Pilot Study. J Pediatr Psychol 2019; 43:1017-1027. [PMID: 30010923 DOI: 10.1093/jpepsy/jsy055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 06/20/2018] [Indexed: 02/07/2023] Open
Abstract
Objective To assess additive effects of incorporating appetite awareness training (AAT), a strategy to encourage eating in response to hunger and satiety cues, within a family-based behavioral treatment (FBT) for childhood obesity. Methods Total 84 families with a child with obesity in the age range of 8-12 years, Body Mass Index Standard Deviation Score (BMI-SDS) ≥ 2, and a participating parent were randomly allocated to two conditions; standard FBT was compared with FBT incorporating AAT strategies (FBT-AAT). Treatment consisted of group therapy sessions (held separately for children and parents) as well as single-family (parent-child dyad) sessions (24 sessions total) delivered over 18 weeks at a tertiary care outpatient clinic. One booster session was provided 1-year posttreatment and a final follow-up assessment was conducted at 2 years. The primary outcome was change in child standardized body mass index (BMI-SDS). Results The two conditions did not differ significantly at posttest, but the FBT-AAT group was at a significantly lower weight compared with FBT at both the first-year, F(1, 82) = 4.150, p<.05, and the second-year follow-ups, F(1, 82) = 14.912, p <.001. It was notable that over the second-year of follow-up, the FBT-AAT group continued to show improvement, whereas the FBT group did not. Conclusions Incorporating specific self-regulatory training in attending to hunger and fullness signals during a standardized family-based treatment may have enhanced the long-term maintenance of treatment effects. Findings are promising and warrant further study.
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Affiliation(s)
| | | | - Anna S Olafsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, University of Iceland
| | | | - Richard E Boles
- Anschutz Medical Campus School of Medicine, University of Colorado
| | - Ragnar Bjarnason
- Faculty of Medicine, University of Iceland and Children's Medical Centre, Landspitali University Hospital, Reykjavik, Iceland
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Carr RM, Prestwich A, Kwasnicka D, Thøgersen-Ntoumani C, Gucciardi DF, Quested E, Hall LH, Ntoumanis N. Dyadic interventions to promote physical activity and reduce sedentary behaviour: systematic review and meta-analysis. Health Psychol Rev 2018; 13:91-109. [PMID: 30284501 DOI: 10.1080/17437199.2018.1532312] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Several interventions have targeted dyads to promote physical activity (PA) or reduce sedentary behaviour (SB), but the evidence has not been synthesised. Sixty-nine studies were identified from MEDLINE, PsycINFO, and Web of Science, and 59 were included in the main meta-analyses (providing 72 independent tests). Intervention details, type of dyadic goal, participant characteristics, and methodological quality were extracted and their impact on the overall effect size was examined. Sensitivity analyses tested effect robustness to (a) the effects of other statistically significant moderators; (b) outliers; (c) data included for participants who were not the main target of the intervention. Dyadic interventions had a small positive, highly heterogeneous, effect on PA g = .203, 95% CI [0.123-0.282], compared to comparison conditions including equivalent interventions targeting individuals. Shared target-oriented goals (where both dyad members hold the same PA goal for the main target of the intervention) and peer/friend dyads were associated with larger effect sizes across most analyses. Dyadic interventions produced a small homogeneous reduction in SB. Given dyadic interventions promote PA over-and-above equivalent interventions targeting individuals, these interventions should be more widespread. However, moderating factors such as the types of PA goal and dyad need to be considered to maximise effects.
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Affiliation(s)
- R M Carr
- a School of Psychology, Curtin University , Perth , Western Australia
| | - A Prestwich
- b School of Psychology, University of Leeds , Leeds , UK
| | - D Kwasnicka
- a School of Psychology, Curtin University , Perth , Western Australia
| | | | - D F Gucciardi
- c School of Physiotherapy and Exercise Science, Curtin University , Perth , Western Australia
| | - E Quested
- a School of Psychology, Curtin University , Perth , Western Australia
| | - L H Hall
- b School of Psychology, University of Leeds , Leeds , UK
| | - N Ntoumanis
- a School of Psychology, Curtin University , Perth , Western Australia
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7
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Mead E, Brown T, Rees K, Azevedo LB, Whittaker V, Jones D, Olajide J, Mainardi GM, Corpeleijn E, O'Malley C, Beardsmore E, Al‐Khudairy L, Baur L, Metzendorf M, Demaio A, Ells LJ. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev 2017; 6:CD012651. [PMID: 28639319 PMCID: PMC6481885 DOI: 10.1002/14651858.cd012651] [Citation(s) in RCA: 210] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Child and adolescent overweight and obesity has increased globally, and can be associated with significant short- and long-term health consequences. This is an update of a Cochrane review published first in 2003, and updated previously in 2009. However, the update has now been split into six reviews addressing different childhood obesity treatments at different ages. OBJECTIVES To assess the effects of diet, physical activity and behavioural interventions (behaviour-changing interventions) for the treatment of overweight or obese children aged 6 to 11 years. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS as well as trial registers ClinicalTrials.gov and ICTRP Search Portal. We checked references of studies and systematic reviews. We did not apply any language restrictions. The date of the last search was July 2016 for all databases. SELECTION CRITERIA We selected randomised controlled trials (RCTs) of diet, physical activity, and behavioural interventions (behaviour-changing interventions) for treating overweight or obese children aged 6 to 11 years, with a minimum of six months' follow-up. We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity. DATA COLLECTION AND ANALYSIS Two review authors independently screened references, extracted data, assessed risk of bias, and evaluated the quality of the evidence using the GRADE instrument. We contacted study authors for additional information. We carried out meta-analyses according to the statistical guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS We included 70 RCTs with a total of 8461 participants randomised to either the intervention or control groups. The number of participants per trial ranged from 16 to 686. Fifty-five trials compared a behaviour-changing intervention with no treatment/usual care control and 15 evaluated the effectiveness of adding an additional component to a behaviour-changing intervention. Sixty-four trials were parallel RCTs, and four were cluster RCTs. Sixty-four trials were multicomponent, two were diet only and four were physical activity only interventions. Ten trials had more than two arms. The overall quality of the evidence was low or very low and 62 trials had a high risk of bias for at least one criterion. Total duration of trials ranged from six months to three years. The median age of participants was 10 years old and the median BMI z score was 2.2.Primary analyses demonstrated that behaviour-changing interventions compared to no treatment/usual care control at longest follow-up reduced BMI, BMI z score and weight. Mean difference (MD) in BMI was -0.53 kg/m2 (95% confidence interval (CI) -0.82 to -0.24); P < 0.00001; 24 trials; 2785 participants; low-quality evidence. MD in BMI z score was -0.06 units (95% CI -0.10 to -0.02); P = 0.001; 37 trials; 4019 participants; low-quality evidence and MD in weight was -1.45 kg (95% CI -1.88 to -1.02); P < 0.00001; 17 trials; 1774 participants; low-quality evidence.Thirty-one trials reported on serious adverse events, with 29 trials reporting zero occurrences RR 0.57 (95% CI 0.17 to 1.93); P = 0.37; 4/2105 participants in the behaviour-changing intervention groups compared with 7/1991 participants in the comparator groups). Few trials reported health-related quality of life or behaviour change outcomes, and none of the analyses demonstrated a substantial difference in these outcomes between intervention and control. In two trials reporting on minutes per day of TV viewing, a small reduction of 6.6 minutes per day (95% CI -12.88 to -0.31), P = 0.04; 2 trials; 55 participants) was found in favour of the intervention. No trials reported on all-cause mortality, morbidity or socioeconomic effects, and few trials reported on participant views; none of which could be meta-analysed.As the meta-analyses revealed substantial heterogeneity, we conducted subgroup analyses to examine the impact of type of comparator, type of intervention, risk of attrition bias, setting, duration of post-intervention follow-up period, parental involvement and baseline BMI z score. No subgroup effects were shown for any of the subgroups on any of the outcomes. Some data indicated that a reduction in BMI immediately post-intervention was no longer evident at follow-up at less than six months, which has to be investigated in further trials. AUTHORS' CONCLUSIONS Multi-component behaviour-changing interventions that incorporate diet, physical activity and behaviour change may be beneficial in achieving small, short-term reductions in BMI, BMI z score and weight in children aged 6 to 11 years. The evidence suggests a very low occurrence of adverse events. The quality of the evidence was low or very low. The heterogeneity observed across all outcomes was not explained by subgrouping. Further research is required of behaviour-changing interventions in lower income countries and in children from different ethnic groups; also on the impact of behaviour-changing interventions on health-related quality of life and comorbidities. The sustainability of reduction in BMI/BMI z score and weight is a key consideration and there is a need for longer-term follow-up and further research on the most appropriate forms of post-intervention maintenance in order to ensure intervention benefits are sustained over the longer term.
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Affiliation(s)
- Emma Mead
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Tamara Brown
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
- Durham University Queen's CampusSchool of Medicine, Pharmacy and HealthDurhamUKTS17 6BH
| | - Karen Rees
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Liane B Azevedo
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Victoria Whittaker
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Dan Jones
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Joan Olajide
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Giulia M Mainardi
- School of Medicine, University of São PauloDepartment of Preventive MedicineSão PauloBrazilCEP 01246 903
| | - Eva Corpeleijn
- University Medical Centre GroningenDepartment of EpidemiologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Claire O'Malley
- Durham University Queen's CampusSchool of Medicine, Pharmacy and HealthDurhamUKTS17 6BH
| | | | - Lena Al‐Khudairy
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Louise Baur
- The University of SydneyDepartment of Paediatrics and Child HealthLocked Bag 4001WestmeadAustraliaNSW 2145
| | - Maria‐Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupMoorenstr. 5DüsseldorfGermany40225
| | | | - Louisa J Ells
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
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Martins LCCDO, Ferreira EAP, Silva LCCD, Almeida FP. Seguimento de Regras Nutricionais em Crianças com Excesso de Peso. PSICOLOGIA: TEORIA E PESQUISA 2015. [DOI: 10.1590/0102-37722015011465033041] [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
Foram avaliados efeitos de instruções, treino de relato verbal (TRV) e treino de automonitoração (TA), com e sem a presença do cuidador principal, sobre o seguimento de regras nutricionais em crianças com excesso de peso. Participaram duas crianças (P1: menino de 9 anos; P2: menina de 11 anos) e suas cuidadoras, por meio de entrevistas em ambulatório. Após instruções, P1 manteve e P2 melhorou o conhecimento das orientações nutricionais. Os Índices de adesão à dieta obtidos por P2 foram mais elevados do que os obtidos por P1 em todas as fases. Houve mudança com significância clínica após introdução de TRV em ambos os participantes. Discute-se a eficácia dos procedimentos de intervenção utilizados e a importância da presença do cuidador.
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Gunnarsdottir T, Njardvik U, Olafsdottir AS, Craighead LW, Bjarnason R. The role of parental motivation in family-based treatment for childhood obesity. Obesity (Silver Spring) 2011; 19:1654-62. [PMID: 21455125 DOI: 10.1038/oby.2011.59] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study investigated the role of parental motivation (importance, confidence and readiness) for predicting dropout and outcome from family-based behavioral treatment for childhood obesity. Parent and child demographics, adherence to treatment, and weight loss parameters were also explored as potential predictors. Eighty-four obese children (BMI-standard deviation scores (SDS) >2.14) and a participating parent with each child started treatment consisting of 12 weeks of group and individual treatment sessions (24 sessions total) delivered over a period of 18 weeks. Sixty-one families (73%) completed treatment and attended follow-up at 1 year after treatment. Child session attendance and completion of self-monitoring records served as measures of adherence. In regression analyses, parent reports (pretreatment) of confidence for doing well in treatment was the strongest predictor of treatment completion (P = 0.003) as well as early treatment response (weight loss at week 5) (P = 0.003). This variable remained a significant predictor of child weight loss at post-treatment (P = 0.014), but was not associated with child outcome at 1-year follow-up (P > 0.05). The only significant predictor of child weight loss at that point was child baseline weight (P = 0.001). However, pretreatment parent ratings of importance of and readiness for treatment did not predict dropout or weight loss at any point. The results underscore the importance of addressing parental motivation, specifically parental confidence for changing lifestyle related behaviors, early in the treatment process. Doing so may reduce treatment dropout and enhance treatment outcome.
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