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Zhao Y, Araki T. Diet quality and its associated factors among adults with overweight and obesity: findings from the 2015-2018 National Health and Nutrition Examination Survey. Br J Nutr 2024; 131:134-142. [PMID: 37462503 DOI: 10.1017/s0007114523001587] [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] [Indexed: 08/03/2023]
Abstract
The rate of adult severe obesity has been continually rising in the USA. While improving diet quality has been shown to reduce the risk of obesity, few studies have explored the differences in diet quality among adults with overweight and obesity by different weight statuses along with socio-demographic factors and physical activity using data from a nationally representative survey in the USA. The main goal of the study is to assess the diet quality of adults with overweight and obesity by examining differences in the Healthy Eating Index-2015 (HEI-2015) scores, using data from the 2015-2018 National Health and Nutrition Survey. Among 6746 adults with overweight and obesity (aged ≥ 20 years), severe obesity was prevalent (27 %), particularly among females, non-Hispanic Blacks and those with lower education and income. Compared to adults with overweight, adults with severe obesity had lower HEI-2015 total scores as well as component scores for total fruits, whole fruits, greens and beans, refined grains, sodium and saturated fats. Among adults with overweight and obesity, non-Hispanic Blacks had lower diet quality than non-Hispanic Asians; females had better diet quality than males; older adults had better diet quality than younger adults; adults with a college degree and above had better diet quality than those with less than a high school degree. Socio-demographic differences in diet quality and weight status should be considered in future obesity interventions to reduce adult severe obesity in the USA.
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Affiliation(s)
- Yajie Zhao
- International Agro-Informatics Laboratory, Department of Global Agricultural Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Japan
| | - Tetsuya Araki
- International Agro-Informatics Laboratory, Department of Global Agricultural Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Japan
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2
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Nyman SJ, Vogel ME, Heller GM, Hella JR, Illes RA, Kirkpatrick HA. Development and Evaluation of a Health Behavior Change Clinic in Primary Care: An Interdisciplinary Partnership. J Clin Psychol Med Settings 2023; 30:909-923. [PMID: 36869987 PMCID: PMC9985097 DOI: 10.1007/s10880-023-09945-5] [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] [Accepted: 01/31/2023] [Indexed: 03/05/2023]
Abstract
Providing effective healthy behavior change interventions within primary care presents numerous challenges. Obesity, tobacco use, and sedentary lifestyle negatively impact the health quality of numerous medical patients, particularly in underserved patient populations with limited resources. Primary Care Behavioral Health (PCBH) models, which incorporate a Behavioral Health Consultant (BHC), can offer point-of-contact psychological consultation, treatment, and also provide opportunities for interdisciplinary psychologist-physician clinical partnerships to pair a BHC's health behavior change expertise with the physician's medical care. Such models can also enhance medical training programs by providing resident physicians with live, case-based learning opportunities when partnered with a BHC to address patient health behaviors. We will describe the development, implementation, and preliminary outcomes of a PCBH psychologist-physician interdisciplinary health behavior change clinic within a Family Medicine residency program. Patient outcomes revealed significant reductions (p < .01) in weight, BMI, and tobacco use. Implications and future directions are discussed.
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Affiliation(s)
- Scott J. Nyman
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
- Department of Psychology, Ascension Genesys Family Health Center, 1460 N. Center Rd, Burton, MI 48509 USA
| | - Mark E. Vogel
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
| | - Grant M. Heller
- Spectrum Health Lakeland, Saint Joseph, MI USA
- Department of Psychiatry, Michigan State University College of Osteopathic Medicine, Lansing, MI USA
| | - Jennifer R. Hella
- Department of Research, Ascension Genesys Hospital, Grand Blanc, MI USA
| | - Rose A. Illes
- Florida State University Family Medicine Residency Program at Lee Health, Fort Myers, FL USA
| | - Heather A. Kirkpatrick
- Department of Clinical Health Psychology, Ascension Genesys Hospital, Grand Blanc, MI USA
- Departments of Family Medicine and Psychiatry, Michigan State University College of Human Medicine, Lansing, MI USA
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Kruschitz R, Fahrnberger M, Felsenreich DM, Ress C, Andersen B, Aydinkoc-Tuzcu K, Ciardi C, Huber SL, Kiefer FW. [Prevention and management of postinterventional weight regain]. Wien Klin Wochenschr 2023; 135:743-750. [PMID: 37821697 PMCID: PMC10567866 DOI: 10.1007/s00508-023-02273-6] [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: 08/14/2023] [Indexed: 10/13/2023]
Abstract
Decreasing levels of patient motivation or compliance are far from being the only causes of postinterventional weight regain after lifestyle, psychological, pharmacological and surgical interventions. Weight regain originates from a complex and individually varying set of central and peripheral mechanisms, with the overall purpose of increasing food intake by both stimulating hunger and reducing satiety (mediated by gastrointestinal hormones) and decreasing the body's energy demands (via metabolic adaption). These mechanisms counteract any attempts to reduce or maintain body weight in today's increasingly prevalent adipogenic environments. The knowledge about the biological mechanisms of body weight regulation should be taken into consideration when planning treatment programs for long-term weight reduction, including follow-up treatment for the prevention and individualized treatment of postinterventional weight regain. Therapeutic measures as well as the frequency of medical follow-ups should be based on the extent of weight regain.
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Affiliation(s)
- Renate Kruschitz
- Abteilung für Innere Medizin, Krankenhaus der Elisabethinen, Klagenfurt, Österreich
| | | | - Daniel Moritz Felsenreich
- Klinische Abteilung für Viszeralchirurgie, Universitätsklinik für Allgemeinchirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Claudia Ress
- Universitätsklinik für Innere Medizin I, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | | | - Kadriye Aydinkoc-Tuzcu
- 5. Medizinische Abteilung für Endokrinologie, Rheumatologie und Akutgeriatrie, Klinik Ottakring, Wien, Österreich
| | - Christian Ciardi
- Abteilung für Innere Medizin, Krankenhaus St. Vinzenz, Zams, Österreich
| | - Simone Leonore Huber
- 1. Medizinische Abteilung mit Diabetologie, Endokrinologie und Nephrologie, Karl Landsteiner Institut für Adipositas und Stoffwechselerkrankungen, Klinik Landstraße, Wien, Österreich
| | - Florian W Kiefer
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
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Davison GM, Monocello LT, Lipsey K, Wilfley DE. Evidence Base Update on Behavioral Treatments for Overweight and Obesity in Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:589-603. [PMID: 37683261 PMCID: PMC10586458 DOI: 10.1080/15374416.2023.2251164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE This review provides an update to a previous Evidence Base Update addressing behavioral treatments for overweight and obesity in children and adolescents. METHOD Articles were identified through a systematic search of the biomedical literature in PubMed/MEDLINE (1946-), Elsevier EMBASE (1947-), SCOPUS (1823-), Clarivate Web of Science Core Collection (WOS, 1900-), PsycINFO (1800-), The Cochrane Library and Clinicaltrials.gov published between June 2014 and August 2022. RESULTS Family-based treatment (FBT) remains a well-established treatment for overweight and obesity in children and is now well-established in adolescents and toddlers. Parent-only behavioral treatment remains well-established in children and is now well-established among adolescents and children. Possibly effective treatments continue to include FBT-parent only for adolescents, and behavioral weight loss (BWL) with a family component for adolescents, children, and toddlers. Several variations of FBT and BWL can now be considered possibly effective including FBT+motivational interviewing, FBT+social facilitation maintenance, group-based FBT, low-dose FBT, BWL+stress management, and camp-based BWL. Cognitive behavioral treatment (CBT) for adolescents also met criteria for possibly effective treatments. Current research has also established that behavioral treatments can be effectively delivered in alternative settings (e.g. primary care) and through alternative mediums (e.g. telehealth). CONCLUSIONS Research continues to support the use of multicomponent lifestyle interventions in accordance with recent recommendations from the American Academy of Pediatrics, the American Psychological Association, and the United State Preventative Services Task Force. However, more work is needed to ensure appropriate access for children with comorbid medical and psychiatric disorders and children from socially, politically, and economically marginalized groups.
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Affiliation(s)
- Genevieve M. Davison
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Lawrence T. Monocello
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kim Lipsey
- Bernard Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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5
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Kumar A, Kompaniyets L, Belay B, Pierce SL, Grosse SD, Goodman AB. Body Mass Index and Associated Medical Expenditures in the US Among Privately Insured Individuals Aged 2 to 19 Years in 2018. JAMA Pediatr 2023; 177:827-836. [PMID: 37399028 PMCID: PMC10318546 DOI: 10.1001/jamapediatrics.2023.2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/14/2023] [Indexed: 07/04/2023]
Abstract
Importance Nearly 40% of US youth aged 2 to 19 years do not have a body mass index (BMI) in the healthy weight category. However, there are no recent estimates for BMI-associated expenditures using clinical or claims data. Objective To estimate medical expenditures among US youth across all BMI categories along with sex and age groups. Design, Setting, Participants This cross-sectional study used IQVIA's ambulatory electronic medical records (AEMR) data set linked with IQVIA's PharMetrics Plus Claims database from January 2018 through December 2018. Analysis was performed from March 25, 2022, through June 20, 2022. It included a convenience sample of a geographically diverse patient population from AEMR and PharMetrics Plus. The study sample included privately insured individuals with a BMI measurement in 2018 and excluded patients with pregnancy-related visits. Exposure BMI categories. Main Outcomes and Measures Total medical expenditures were estimated using generalized linear model regression with γ distribution and log-link function. For out-of-pocket (OOP) expenditures, a 2-part model was used that included logistic regression to estimate the probability of positive expenditures followed by generalized linear model. Estimates were shown with and without accounting for sex, race and ethnicity, payer type, geographic region, age interacted with sex and BMI categories, and confounding conditions. Results The sample included 205 876 individuals aged 2 to 19 years; 104 066 were male (50.5%) and the median age was 12 years. Compared with those with healthy weight, total and OOP expenditures were higher for all other BMI categories. Differences in total expenditures were highest for those with severe obesity ($909; 95% CI, $600-$1218) followed by underweight ($671; 95% CI, $286-$1055) compared with healthy weight. Differences in OOP expenditures were highest for those with severe obesity ($121; 95% CI, $86-$155) followed by underweight ($117; 95% CI, $78-$157) compared with healthy weight. Having underweight was associated with higher total expenditures at ages 2 to 5 years and 6 to 11 years by $679 (95% CI, $228-$1129) and $1166 (95% CI, $632-$1700), respectively; having severe obesity was associated with higher total expenditures at ages 2 to 5 years, 6 to 11 years, and 12 to 17 years by $1035 (95% CI, $208-$1863), $821 (95% CI, $414-$1227), and $1088 (95% CI, $594-$1582), respectively. Conclusions and Relevance The study team found medical expenditures to be higher for all BMI categories when compared with those with healthy weight. These findings may indicate potential economic value of interventions or treatments aimed at reducing BMI-associated health risks.
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Affiliation(s)
- Ashutosh Kumar
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brook Belay
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Samantha L. Pierce
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Scott D. Grosse
- Office of the Director, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alyson B. Goodman
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Scotto di Luzio S, Martinent G, Popa-Roch M, Ballereau M, Chahdi S, Escudero L, Guillet-Descas E. Obesity in Childhood and Adolescence: The Role of Motivation for Physical Activity, Self-Esteem, Implicit and Explicit Attitudes toward Obesity and Physical Activity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1177. [PMID: 37508674 PMCID: PMC10378282 DOI: 10.3390/children10071177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
The purpose of the present study was to compare attitudes toward body weight and physical activity in both regular-weight and overweight/obese children and adolescents, and assessing relations between attitudes and self-esteem, motivation for physical activity, life satisfaction and level of physical activity. A total of 126 children (Mage = 12.2, SD = 3.4), divided into two subsamples (i.e., overweight/obese, N = 44, and regular-weight), voluntarily participated in the study. A series of univariate analyses of variance was conducted to examine the differences in the study variables across the subsamples. Correlational analyses were conducted to examine the relationships among the variables. The results indicated that obese/overweight participants expressed a more positive implicit attitude toward the thin category than regular-weight participants. Furthermore, among overweight/obese participants, implicit attitude toward physical activity was significantly negatively correlated with explicit attitude toward physical activity and general self-esteem. Significant differences between obese/overweight and regular-weight participants indicated that the status in terms of weight played a key role in attitudes toward the explored constructs.
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Affiliation(s)
- Silvia Scotto di Luzio
- Laboratoire Développement, Individu, Processus, Handicap, Éducation (DIPHE), Université Lyon 2, 69676 Bron, France
| | - Guillaume Martinent
- Laboratoire sur les Vulnérabilités et L'innovation dans Le Sport (L-VIS), Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Maria Popa-Roch
- Maître de Conférences HDR, Université de Strasbourg, LISEC, 67000 Strasbourg, France
| | - Mathilde Ballereau
- Laboratoire sur les Vulnérabilités et L'innovation dans Le Sport (L-VIS), Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Soufyane Chahdi
- Laboratoire sur les Vulnérabilités et L'innovation dans Le Sport (L-VIS), Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Lucie Escudero
- Laboratoire sur les Vulnérabilités et L'innovation dans Le Sport (L-VIS), Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Emma Guillet-Descas
- Laboratoire sur les Vulnérabilités et L'innovation dans Le Sport (L-VIS), Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
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Spiezia C, Di Rosa C, Fintini D, Ferrara P, De Gara L, Khazrai YM. Nutritional Approaches in Children with Overweight or Obesity and Hepatic Steatosis. Nutrients 2023; 15:nu15112435. [PMID: 37299398 DOI: 10.3390/nu15112435] [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: 04/17/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
Childhood obesity is a global public health problem. Worldwide, 41 million children under 5 years and 340 million children and adolescents between 5 and 19 years are overweight. In addition, the recent COVID-19 epidemic has further amplified this social phenomenon. Obesity is a condition associated with various comorbidities, such as nonalcoholic fatty liver disease (NAFLD). The pathophysiology of NAFLD in obesity is intricate and involves the interaction and dysregulation of several mechanisms, such as insulin resistance, cytokine signaling, and alteration of the gut microbiota. NAFLD is defined as the presence of hepatic steatosis in more than 5% of hepatocytes, evaluated by histological analysis. It can evolve from hepatic steatosis to steatohepatitis, fibrosis, cirrhosis, hepatocellular carcinoma, and end-stage liver failure. Body weight reduction through lifestyle modification remains the first-line intervention for the management of pediatric NAFLD. Indeed, studies suggest that diets low in fat and sugar and conversely rich in dietary fibers promote the improvement of metabolic parameters. This review aims to evaluate the existing relationship between obesity and NAFLD in the pediatric population and to assess the dietary patterns and nutritional supplementations that can be recommended to prevent and manage obesity and its comorbidities.
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Affiliation(s)
- Chiara Spiezia
- Research Unit of Food Science and Human Nutrition, Department of Science and Technology for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Claudia Di Rosa
- Research Unit of Food Science and Human Nutrition, Department of Science and Technology for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Danilo Fintini
- Endocrinology and Diabetology Unit, Bambino Gesù Children's Hospital, IRCCS L.go S.Onofrio, 4-00165 Roma, Italy
| | - Pietro Ferrara
- Operative Research Unit of Pediatrics, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
| | - Laura De Gara
- Research Unit of Food Science and Human Nutrition, Department of Science and Technology for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Yeganeh Manon Khazrai
- Research Unit of Food Science and Human Nutrition, Department of Science and Technology for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Operative Research Unit of Nutrition and Prevention, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
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8
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Pervanidou P, Chatzidaki E, Nicolaides NC, Voutetakis A, Polychronaki N, Chioti V, Kitani RA, Kyrkopoulou E, Zarkogianni K, Kalafatis E, Mitsis K, Perakis Κ, Nikita K, Kanaka-Gantenbein C. The Impact of the ENDORSE Digital Weight Management Program on the Metabolic Profile of Children and Adolescents with Overweight and Obesity and on Food Parenting Practices. Nutrients 2023; 15:nu15071777. [PMID: 37049618 PMCID: PMC10097404 DOI: 10.3390/nu15071777] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023] Open
Abstract
Childhood obesity is a serious public health problem worldwide. The ENDORSE platform is an innovative software ecosystem based on Artificial Intelligence which consists of mobile applications for parents and health professionals, activity trackers, and mobile games for children. This study explores the impact of the ENDORSE platform on metabolic parameters associated with pediatric obesity and on the food parenting practices of the participating mothers. Therefore, the metabolic parameters of the 45 children (mean age: 10.42 years, 53% girls, 58% pubertal, mean baseline BMI z-score 2.83) who completed the ENDORSE study were evaluated. The Comprehensive Feeding Practices Questionnaire was used for the assessment of food parenting practices. Furthermore, regression analysis was used to investigate possible associations between BMI z-score changes and changes in metabolic parameters and food parenting practices. Overall, there was a statistically significant reduction in glycated hemoglobin (mean change = −0.10, p = 0.013), SGOT (mean change = −1.84, p = 0.011), and SGPT (mean change = −2.95, p = 0.022). Emotional feeding/food as reward decreased (mean change −0.21, p = 0.007) and healthy eating guidance increased (mean change = 0.11, p = 0.051). Linear regression analysis revealed that BMI z-score change had a robust and significant correlation with important metabolic parameters: HOMA-IR change (beta coefficient = 3.60, p-value = 0.046), SGPT change (beta coefficient = 11.90, p-value = 0.037), and cortisol change (beta coefficient = 9.96, p-value = 0.008). Furthermore, healthy eating guidance change had a robust negative relationship with BMI z-score change (beta coefficient = −0.29, p-value = 0.007). Conclusions: The Endorse digital weight management program improved several metabolic parameters and food parenting practices.
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Affiliation(s)
- Panagiota Pervanidou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Evi Chatzidaki
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Nicolas C. Nicolaides
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Antonis Voutetakis
- Department of Pediatrics, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Nektaria Polychronaki
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Vassiliki Chioti
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Rosa-Anna Kitani
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
| | - Eleni Kyrkopoulou
- Department of Economics, University of Piraeus, 18534 Pireas, Greece
| | - Konstantia Zarkogianni
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Eleftherios Kalafatis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Kostas Mitsis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece
| | | | - Konstantina Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
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9
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Bose C, Kinge AD, Sultana J, Biswas AK, Bhattacharya K, Syamal AK. Impact of a lifestyle intervention program on cardio-metabolic parameters among obese adults: A comparative population-based study in West Bengal, India. J Med Life 2023; 16:559-570. [PMID: 37305820 PMCID: PMC10251381 DOI: 10.25122/jml-2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/26/2022] [Indexed: 06/13/2023] Open
Abstract
The obesity epidemic is not only limited to high-income or urbanized societies, but has also become prevalent among rural communities, even in India. Approaches to modifiable behaviors, like unhealthy dietary habits or a sedentary lifestyle, could bring positive results among obese populations. This research aimed to assess the effectiveness of lifestyle intervention programs to prevent obesity and cardio-metabolic risks among Bengali obese adults (Body Mass Index of 25-30kg/m2). The population was selected from rural and urban communities of Hooghly district in west Bengal, India and included 121 participants (20-50 years), divided into four groups (rural male, rural female, urban male, and urban female) who underwent a 12-month intervention program. Anthropometric parameters, systolic and diastolic blood pressure, biochemical parameters (fasting blood glucose, fasting plasma insulin, Homeostatic Model Assessment for Insulin Resistance [HOMA-IR] and lipid profile), dietary habits, and physical activity profiles were assessed before the study (baseline), after 12 months of intervention (post-intervention), and after 24 months (follow-up), among all groups, to evaluate changes in data within and between the groups (rural vs. urban). The results showed a significant decline in anthropometric parameters and fasting blood glucose levels among all intervention groups, HOMA-IR in rural females, and serum triglyceride levels in urban groups. A significant improvement was noted regarding dietary habits and physical activity, even during follow-up. The impact of the intervention program did not show any rural-urban difference. The lifestyle intervention program was effective in reducing obesity and related health risks and promoting a healthy lifestyle among the target population.
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Affiliation(s)
- Chaitali Bose
- Post-Graduate Department of Physiology, Hooghly Mohsin College, University of Burdwan, Hooghly, West-Bengal, India
| | - Amol Dilip Kinge
- Department of Community Medicine, Government Medical College, Nandurbar, Maharastra, India
| | - Julekha Sultana
- Department of Community Medicine, Government Medical College, Nandurbar, Maharastra, India
| | - Ajoy Kumar Biswas
- Department of Medicine, G.D Hospital and Diabetes Institute Kolkata, Kolkata, West-Bengal, India
| | - Koushik Bhattacharya
- Department of Physiotherapy, School of Allied Health Sciences, Swami Vivekananda University, Barrackpore, West-Bengal, India
| | - Alak Kumar Syamal
- Post-Graduate Department of Physiology, Hooghly Mohsin College, University of Burdwan, Hooghly, West-Bengal, India
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10
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Cardel MI, Newsome FA, Pearl RL, Ross KM, Dillard JR, Hayes JF, Wilfley D, Keel PK, Dhurandhar EJ, Balantekin KN. Authors' Response. J Acad Nutr Diet 2023; 123:400-403. [PMID: 36206862 DOI: 10.1016/j.jand.2022.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Michelle I Cardel
- Adjunct Professor, Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL; Senior Director of Global Clinical Research & Nutrition, WW International Inc, City, State
| | - Faith A Newsome
- Graduate Research Assistant, Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Rebecca L Pearl
- Assistant Professor, Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Kathryn M Ross
- Associate Professor, Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Julia R Dillard
- Medical Student, University of Toledo College of Medicine and Life Sciences, Toledo, OH
| | - Jacqueline F Hayes
- Assistant Professor, Weight Control and Diabetes Research Center at the Miriam Hospital, Department of Psychiatry and Human Behavior, Brown University, Providence, RI
| | - Denise Wilfley
- Professor of Psychological and Brain Sciences, Professor of Medicine, Pediatrics and Psychiatry, Washington University in St Louis College of Medicine, St Louis, MO
| | - Pamela K Keel
- Distinguished Research Professor, Department of Psychology, Florida State University, Tallahassee, FL
| | | | - Katherine N Balantekin
- Assistant Professor and Clinical Assistant Professor, Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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11
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Voss C, Liu J, Chang A, Kosmas JA, Biehl A, Flynn RL, Kruzan KP, Wildes JE, Graham AK. Weight Loss Expectations of Adults With Binge Eating: Cross-sectional Study With a Human-Centered Design Approach. JMIR Form Res 2023; 7:e40506. [PMID: 36853750 PMCID: PMC10015344 DOI: 10.2196/40506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/17/2022] [Accepted: 01/03/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND People tend to overestimate their expectations for weight loss relative to what is achievable in a typical evidence-based behavioral weight management program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people who have overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight and shape concerns and often presents to treatment with the goal of losing weight. OBJECTIVE The aim of the study is to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting for a digital intervention, given that engagement and dropout are notable problems for digital behavior change interventions. We tested the hypotheses that (1) people who endorsed some or recurrent binge eating would expect to lose more weight than those who did not endorse binge eating and (2) people who endorsed a more severe versus a low or moderate overvaluation of weight and shape would have higher weight loss expectations. METHODS A total of 760 adults (n=504, 66% female; n=441, 58% non-Hispanic White) completed a web-based screening questionnaire. One-way ANOVAs were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight. RESULTS Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight or shape expected to lose the most weight compared to those with low or moderate levels of overvaluation of weight and shape. CONCLUSIONS In the sample, people interested in a study to inform a digital intervention for binge eating and weight management overestimated their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals' intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.
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Affiliation(s)
- Claire Voss
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jianyi Liu
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jacqueline A Kosmas
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Abigail Biehl
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Rebecca L Flynn
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Kaylee P Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Andrea K Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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12
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Okonya O, Siddiqui B, George D, Fugate C, Hartwell M, Vassar M. Use of behavioural change taxonomies in systematic reviews and meta-analyses regarding obesity management. Clin Obes 2023; 13:e12574. [PMID: 36515291 DOI: 10.1111/cob.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/15/2022] [Accepted: 11/13/2022] [Indexed: 12/15/2022]
Abstract
We investigated the prevalence of behavioural change taxonomies in systematic reviews and meta-analyses related to obesity management. In addition, we analysed the funding sources, author conflicts of interest statements, risk of bias, and favorability of the results in such studies to determine if there was a relationship between methodological quality and taxonomy use. We searched several databases including MEDLINE, Epistemonikos, Cochrane EDSR, Pubmed and Embase for systematic reviews and meta-analyses regarding the behavioural treatment of obesity. Screening and data extraction was performed in a masked, duplicate fashion. We performed statistical analyses to determine any significant association between use of taxonomy and study characteristics. Fifteen (of 186; 8.06%) systematic reviews used a taxonomy-nine used the BCTTv1, three used OXFAB, two used the CALO-RE and one used "Taxonomy of choice architecture techniques." Most interventions that referenced a taxonomy were self-mediated (6/60, 10%). Behavioural change taxonomies were mentioned in 10 (of 87, 11.49%) studies with a public funding source. Of the studies with favourable results, 14 studies (of 181, 7.73%) referred to a taxonomy. We found no statistically significant relationships between use of taxonomy and study characteristics. We found that systematic reviews regarding the management of obesity rarely mention a behavioural change taxonomy. Given the global burden of obesity, it is crucial that behavioural change techniques are reproducible and translatable. We recommend that researchers look further into how taxonomies affect the quality and reproducibility of behavioural interventions in an effort to improve patient outcomes.
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Affiliation(s)
- Ochije Okonya
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Bilal Siddiqui
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - David George
- Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Colony Fugate
- Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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13
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Burney V, Arnold-Saritepe A, McCann CM. Rethinking the Place of Qualitative Methods in Behavior Analysis. Perspect Behav Sci 2023; 46:185-200. [PMID: 37006599 PMCID: PMC10050534 DOI: 10.1007/s40614-022-00362-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 01/14/2023] Open
Abstract
AbstractSingle-case design research is pervasive and dominant in the field of behavior analysis (BA). It allows for effective application of behavior change technologies in a wide variety of real-world settings. However, as the field has grown, behavioral scholars have suggested incorporating other methods into the investigator’s toolbox to supplement single-case design. To date, the call to expand beyond using only variations of single-case design as the standard for behavior analytic research has gone largely unheard. Given the need for behavior analytic work to be more closely aligned with consumer and stakeholder needs and priorities, along with a proliferation of practitioners and researchers in the field, now is the time to consider the benefits of qualitative research methods for behavior analysts. In particular, in areas of social validity and in exploring diverse applied topics, qualitative methods may help the field of behavior analysis to achieve greater success with documenting the outcomes from behavior change interventions. The present article explores areas where behavior analysis may benefit from utilizing qualitative methods, namely social validity and breadth of topics for study, and provides examples of the value of qualitative research from other fields. A brief outline of qualitative research is provided alongside consideration of the seven dimensions of applied behavior analysis. In situations where single-case design does not offer behavior analysts sufficient methodological opportunity, qualitative research methods could form a powerful addition to the field of behavior analysis.
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14
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C McSweeney Z, McSweeney MD, Huang SH, G Hill S. Predictors of successful weight loss in children treated at a community hospital-based tertiary care pediatric weight management program. J Child Health Care 2022; 26:612-624. [PMID: 34372677 DOI: 10.1177/13674935211037535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Childhood obesity is a major public health concern. However, predictors of successful outcomes for patients treated at multidisciplinary community hospital-based pediatric weight management programs remain poorly understood. We conducted a retrospective analysis to evaluate 633 pediatric patients from ages 2 to 18 at a tertiary pediatric weight management program in 2018. Predictors were evaluated in univariate comparisons, and significant variables were included in a linear regression analysis to identify factors associated with improvements in body mass index relative to the age- and sex-specific 95th percentile body mass index (%BMIp95). We found that male sex and increased number of clinical visits were independently and significantly associated with reductions in %BMIp95. Baseline %BMIp95, age, preferred language, and insurance status were not significant predictors of outcomes. A total of 398 (63%) patients experienced a decrease in %BMIp95 from baseline to follow-up. One quarter (24.8%) of patients experienced a decrease in %BMIp95 of at least 5%, a threshold associated with cardiometabolic improvements. Further, we observed significant improvements in cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, HbA1c, and waist circumference. These findings support a potential need for sex- and gender-tailored care as well as the benefits of increased access to pediatric weight management programs.
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Affiliation(s)
- Zina C McSweeney
- Memorial Healthcare System, 23454Joe DiMaggio Children's Hospital, Hollywood, FL, USA
| | | | - Shirley H Huang
- Pediatric Weight Management Program, 10848WakeMed Health and Hospitals, Raleigh, NC, USA
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - Samareh G Hill
- Pediatric Weight Management Program, 10848WakeMed Health and Hospitals, Raleigh, NC, USA
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
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15
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Hess JM, Jimenez EY, Ozechowski TJ, McCauley G, Sanders SG, Sedillo D, Vallabhan MK, Kong AS. Teen and caregiver perspectives on success, clinician role, and family involvement in ACTION PAC, a weight management intervention trial. PEC INNOVATION 2022; 1:100060. [PMID: 36643597 PMCID: PMC9835765 DOI: 10.1016/j.pecinn.2022.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Describe perspectives of teens and caregivers regarding motivations, successes, and challenges related to participation in ACTION PAC (ClinicalTrials.gov: NCT02502383), a two-year weight management trial. METHODS Intervention group participants received 16 short motivational interviewing (MI) sessions with school-based health center (SBHC) primary care clinicians over two years. Post-study, we conducted semi-structured interviews with purposefully sampled intervention group teens and their caregivers. Interviews were audio recorded, transcribed, and managed in NVivo 11. Three independent coders analyzed the data, developed a coding tree, examined how codes intersected and clarified relationships through memo writing. RESULTS The clinician's role and use of motivational interviewing and family involvement in behavior changes were cited as critical to success. Some adolescents noted difficulty in sustaining behavior changes post-intervention and social and systemic barriers to behavior change. CONCLUSION Future studies should identify strategies to sustain teen motivation, better involve families, and address systemic barriers. INNOVATION In this study, which simulated real-world SBHC conditions, adolescents appreciated the use of an MI approach and felt that was key to their success, indicating the potential to continue use of this approach to motivating behavior changes in SBHC settings.
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Affiliation(s)
- Julia Meredith Hess
- UNM Prevention Research Center, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Elizabeth Yakes Jimenez
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Timothy J. Ozechowski
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Grace McCauley
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Sarah G. Sanders
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Donna Sedillo
- Clinical and Translational Sciences Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Monique K. Vallabhan
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Alberta S. Kong
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
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16
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Sabrina Souza Santos T, Campos Victor J, Ribeiro Dias G, Cosmo de Moura Balbino A, Jaime PC, Lourenço BH. Self-efficacy among health professionals to manage therapeutic groups of patients with obesity: Scale development and validity evidences. J Interprof Care 2022; 37:418-427. [PMID: 35880767 DOI: 10.1080/13561820.2022.2085677] [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: 10/16/2022]
Abstract
Health professionals have to be confident to manage therapeutic groups of patients with obesity considering the potential of such approach to organize and provide health care. This study aimed to validate the scale of self-efficacy among health professionals to manage therapeutic groups of patients with obesity. Items were developed by an interprofessional group based on theoretical references on humanized healthcare. Scope, relevance, clarity, and comprehensibility of items and response options were evaluated by experts and health professionals. Using factor analysis and item response theory analysis, items with better discrimination were selected. The interpretation of the scores was proposed with a description of the self-efficacy around different levels. All steps were conducted using online forms. A pool of 21 items was proposed with up to five response options. Experts and health professionals retained 17 items with few changes in wording and four response options. The final scale was composed of 17 items, from which we derived three levels of self-efficacy (low, moderate, high). This study conceived a simple tool to assess health professionals' confidence in managing obesity in therapeutic groups, which may be helpful in designing and measuring the impact of interprofessional education programs to leverage health assistance quality.
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Affiliation(s)
- Thanise Sabrina Souza Santos
- Research Group on Nutrition Interventions, Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Jhessica Campos Victor
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Gabriela Ribeiro Dias
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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17
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Poulsen MN, Hosterman JF, Wood GC, Cook A, Wright L, Jamieson ST, Naylor A, Lutcher S, Mowery J, Seiler CJ, Welk GJ, Bailey-Davis L. Family-Based Telehealth Initiative to Improve Nutrition and Physical Activity for Children With Obesity and Its Utility During COVID-19: A Mixed Methods Evaluation. Front Nutr 2022; 9:932514. [PMID: 35898708 PMCID: PMC9309788 DOI: 10.3389/fnut.2022.932514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Guidelines recommend primary care providers refer children with obesity to behavioral interventions, but given limited program availability, access, and parental engagement, referrals remain rare. We developed telehealth coaching interventions for families whose children received care at a health system in Pennsylvania, United States in 2019-2020. Intervention referrals were facilitated by the pediatrician and/or project team for 6–12-year-old children with obesity following well-child visits. Participants chose one of three 26-week interventions focused on healthy eating, physical activity, or a hybrid clinical/nutrition intervention. Interventions engaged parents as change agents, enhancing self-efficacy to model and reinforce behavior and providing resources to help create a healthy home environment. We enrolled 77 of 183 eligible parent/child dyads. We used mixed methods to evaluate the interventions. Repeated measures models among participants showed significant reductions in obesogenic nutrition behaviors post-intervention and at 1-year follow-up, including a reduction in sugar-sweetened beverage intake of 2.14 servings/week (95% confidence interval: −3.45, −0.82). There were also improvements in obesoprotective nutrition behaviors (e.g., frequency of family meals, parental self-efficacy related to meal management). One year post-baseline, we observed no significant differences in changes in body mass index (BMI) z-scores comparing child participants with matched controls. Given potential impacts of COVID-19 community restrictions on study outcomes, we conducted qualitative interviews with 13 participants during restrictions, which exemplified how disrupted routines constrained children’s healthy behaviors but that intervention participation prepared parents by providing cooking and physical activities at home. Findings support the potential of a telehealth-delivered nutrition intervention to support adoption of healthy weight behaviors.
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Affiliation(s)
- Melissa N. Poulsen
- Department of Population Health Sciences, Geisinger, Danville, PA, United States
- *Correspondence: Melissa N. Poulsen,
| | | | - G. Craig Wood
- Obesity Institute, Geisinger, Danville, PA, United States
| | - Adam Cook
- Obesity Institute, Geisinger, Danville, PA, United States
| | - Lyndell Wright
- Obesity Institute, Geisinger, Danville, PA, United States
| | | | - Allison Naylor
- Obesity Institute, Geisinger, Danville, PA, United States
| | | | - Jacob Mowery
- Obesity Institute, Geisinger, Danville, PA, United States
| | | | - Gregory J. Welk
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Lisa Bailey-Davis
- Department of Population Health Sciences, Geisinger, Danville, PA, United States
- Obesity Institute, Geisinger, Danville, PA, United States
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18
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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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19
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Schneider E, Dourish CT, Higgs S. Utility of an experimental medicine model to evaluate efficacy, side-effects and mechanism of action of novel treatments for obesity and binge-eating disorder. Appetite 2022; 176:106087. [PMID: 35588993 DOI: 10.1016/j.appet.2022.106087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/22/2022] [Accepted: 05/12/2022] [Indexed: 11/02/2022]
Abstract
Obesity and Binge Eating Disorder (BED) are prevalent conditions that are associated with increased risk of morbidity and mortality. There is evidence that the use of pharmacotherapy alongside behavioural treatments can improve quality of life and reduce disease risk for patients with these disorders. However, there are few approved drug therapies for obesity, and these are limited by poor efficacy and/or side effects and only one drug has been approved for the treatment of BED. There is considerable potential to use experimental medicine models to identify new drug treatments for obesity and BED, with greater efficacy and an improved side effect profile, at an early stage of development. Here, we present a model developed in our laboratory that incorporates both behavioural and neuroimaging measures which can be used to facilitate drug development for obesity and BED. The results from validation studies conducted to date using our model suggest that it is sensitive to the effects of agents with behavioural, neurophysiological and neuropharmacological mechanisms of action known to be associated with weight loss and reductions in binge eating. Future studies using the model will be valuable to evaluate the potential efficacy and side-effects of new candidate drugs at an early stage in the development pipeline for both obesity and BED.
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Affiliation(s)
- Elizabeth Schneider
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
| | - Colin T Dourish
- P1vital Ltd, Howbery Park, Wallingford, OX10 8BA, United Kingdom; P1vital Products Ltd, Howbery Park, Wallingford, OX10 8BA, United Kingdom
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
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20
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Smith I, Hardy E, Mitchell S, Batson S. Semaglutide 2.4 Mg for the Management of Overweight and Obesity: Systematic Literature Review and Meta-Analysis. Diabetes Metab Syndr Obes 2022; 15:3961-3987. [PMID: 36569429 PMCID: PMC9769143 DOI: 10.2147/dmso.s392952] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Semaglutide has demonstrated safe and effective weight loss for overweight and obesity, including participants with concomitant type 2 diabetes mellitus (T2DM), in randomized placebo-controlled trials (RCTs). We conducted a systematic literature review (SLR) and network meta-analyses (NMA) to compare weekly semaglutide 2.4 mg with pharmacological comparators for weight management in overweight or obesity. METHODS The SLR was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. NMAs were performed to compare weight change for semaglutide 2.4 mg with comparators using data identified in the SLR. The populations of interest were total population, normal glucose tolerance, non-T2DM, pre-diabetes, and T2DM. Included outcomes were weight change from baseline (CFB, %) at 52 weeks and proportion of participants losing ≥5% baseline fasting body weight at 12 weeks (at full therapeutic dose). RESULTS The SLR identified 108 RCTs examining non-surgical interventions, of which 41 were considered for inclusion in the NMAs. In all populations, semaglutide 2.4 mg was associated with a greater percentage weight CFB with 52 weeks of treatment versus all available comparators. In all populations, semaglutide was associated with a higher likelihood of participants losing ≥5% of baseline fasting body weight at 12 weeks versus all available comparators. CONCLUSION In NMA, semaglutide 2.4 mg demonstrated effective weight loss (≥5%) in the total population and all subpopulations of glucose tolerance versus active comparators. Semaglutide is an effective treatment that may address unmet need in the management of overweight and obesity.
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Affiliation(s)
- Inger Smith
- White Box Health Economics Ltd, Worthing, West Sussex, UK
| | | | | | - Sarah Batson
- Mtech Access, Bicester, Oxfordshire, UK
- Correspondence: Sarah Batson, Mtech Access, 30 Murdock Road, Bicester, Oxfordshire, OX26 4PP, UK, Tel +44 1869 222 490, Email
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21
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Fu E, Neubert SW, Chang A, Smith JD, Graham AK. Characterizing behavior change techniques used in the self-management of binge eating and weight: Applying a user-centered design approach. Eat Behav 2022; 44:101591. [PMID: 34920208 PMCID: PMC8885842 DOI: 10.1016/j.eatbeh.2021.101591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/15/2021] [Accepted: 11/30/2021] [Indexed: 01/03/2023]
Abstract
User-centered design methods aim to increase intervention engagement by focusing on consumers' needs and preferences. We conducted a needs assessment (the first step in user-centered design) via a digital diary study to understand how individuals with recurrent binge eating (≥12 episodes in 3 months) and obesity (BMI ≥30 kg/m2) manage these problems in their day-to-day lives and the approaches they use to change their behavior. Specifically, we applied the Behavior Change Technique (BCT)-Taxonomy to characterize which standardized BCTs individuals use to change binge eating and health-related behaviors and their motivations to use them, to inform the design of a mobile intervention. We analyzed qualitative data from 22 adults (64% female, 32% White) who submitted 176 diary entries. For each entry, we coded the BCTs used, motivation for use, and whether the BCT(s) were perceived as beneficial for behavior change. Across participants, investigators identified 50 of the 93 standardized BCTs (54%). Each participant used an average of 12 (SD = 4) BCTs, most commonly Behavior Substitution (72.3%), Distraction (68.2%), Goal Setting (Behavior) (63.6%), Action Planning (59.1%) and Adding Objects to the Environment (59.1%). More BCTs were coded as beneficial (49%) versus detrimental (24%) or neutral (27%). Techniques were most commonly motivated by preventing binge eating (95.5%), losing weight (95.5%), reducing unhealthy food choices (90.9%), or managing stress (59.1%). Results help inform how interventions could be designed to support consumers in changing binge eating and weight-related behaviors, although such designs would need to be tested for their impact on engagement and outcomes.
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Affiliation(s)
- Emily Fu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Sarah W Neubert
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States of America
| | - Angela Chang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America
| | - J D Smith
- Department of Population Health Sciences, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, United States of America
| | - Andrea K Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States of America.
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22
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Majumdar I, Espino B, Harmon CM. Pediatric multidisciplinary weight management-how can we improve further? Endocrine 2021; 74:723-726. [PMID: 34599694 DOI: 10.1007/s12020-021-02885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Indrajit Majumdar
- Division of Pediatric Endocrinology, Department of Pediatrics, Jacob School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York and John R. Oishei Children's Hospital, Buffalo, NY, 14203, USA.
| | - Brittany Espino
- Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carroll M Harmon
- Department of Surgery, Jacob School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York and John R. Oishei Children's Hospital, Buffalo, NY, 14203, USA
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Rigamonti AE, Caroli D, Grugni G, Cella SG, Sartorio A. Frequent Medical Supervision Increases the Effectiveness of a Longitudinal Multidisciplinary Body Weight Reduction Program: A Real-World Experience in a Population of Children and Adolescents with Obesity. Nutrients 2021; 13:nu13103362. [PMID: 34684362 PMCID: PMC8539124 DOI: 10.3390/nu13103362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 12/11/2022] Open
Abstract
Regular medical supervision represents a fundamental component of the clinical management of obesity. In fact, when frequently supplied it reduces the risk of failure associated with any body weight reduction program (BWRP), resulting in body weight gain. The aim of the present study was to establish the potential beneficial effects of increasing medical supervision on weight loss and other auxometric and cardiometabolic parameters in a population of children and adolescents with obesity (n = 158; F/M = 94/64; age range 9.7-17.3 years; body mass index, BMI = 37.8 ± 6.9 kg/m2), followed up for one year in a real-world setting, after and before a 3-week in-hospital BWRP. Weight loss was significantly associated with medical supervision and changes in several auxometric and cardiometabolic parameters such as fat mass, fat-free mass, waist and hip circumferences, total and LDL cholesterols, triglycerides, glucose, insulin, HOMA-IR, systolic blood pressure and IDF criteria for the diagnosis of metabolic syndrome. As expected, weight loss and, congruently, medical supervision, were significantly higher in responsive and stable subjects than in those belonging to the non-responsive group and in responsive subjects than those belonging to the stable group. While weight loss was significantly higher in subjects having class 2 and 3 obesity than those belonging to class 1 obesity group, medical supervision was significantly higher in subjects having class 3 than those having class 1 obesity. Weight loss was significantly higher in subjects suffering from metabolic syndrome than those without; nevertheless, no significant difference was found in medical supervision between these groups. Finally, sex was associated with no differences in weight loss and medical supervision. In conclusion, based on the results of a real-world experience, frequent medical supervision increases the weight loss associated with a longitudinal multidisciplinary BWRP, with a parallel improvement of a set of auxometric and cardiometabolic parameters. Prospectively, incentivising regular medical supervision should reduce the risk of BWRP failure and body weight gain, thus contributing to counteract the detrimental transition from simple obesity to metabolic syndrome in pediatric patients.
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Affiliation(s)
- Antonello E. Rigamonti
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
- Correspondence: ; Tel.: +39-02-503-17013; Fax: +39-02-503-17011
| | - Diana Caroli
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
| | - Graziano Grugni
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
| | - Silvano G. Cella
- Department of Clinical Sciences and Community Health, University of Milan, 20129 Milan, Italy;
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy; (D.C.); (G.G.); (A.S.)
- Division of Auxology and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
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24
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Graham AK, Neubert SW, Chang A, Liu J, Fu E, Green EA, Kornfield R, Nicholas J. Applying User-Centered Design Methods to Understand Users' Day-to-Day Experiences Can Inform a Mobile Intervention for Binge Eating and Weight Management. Front Digit Health 2021; 3:651749. [PMID: 34713124 PMCID: PMC8521863 DOI: 10.3389/fdgth.2021.651749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/06/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction: Weight loss apps to date have not directly addressed binge eating. To inform the design of a new mobile behavioral intervention that addresses binge eating and weight management, we applied user-centered design methods to qualitatively assess how target intervention consumers experience these conditions in their day-to-day lives. Methods: The participants were 22 adults with self-reported obesity (body mass index ≥30) and recurrent binge eating (≥12 episodes in 3 months) who were interested in losing weight and reducing binge eating. The participants completed a digital diary study, which is a user-centered design technique for capturing individuals' day-to-day experiences in relevant contexts. Qualitative data describing the participants' experiences with binge eating and obesity were analyzed using thematic analysis. The results were then used to create personas (i.e., character archetypes of different intervention consumers). Results: The participants described triggers for binge eating and indicated that binge eating and excess weight negatively impact their mental health, physical health, and quality of life. The resulting personas reflected five different struggles individuals with these health problems experience in managing their binge eating and weight. Conclusions: Individuals with binge eating and obesity have varying precipitants of problematic eating as well as varying motivations for and challenges to behavior change. To meet the needs of all who seek intervention, an ideal intervention design will account for variations in these factors and be relevant to diverse experiences. Insights from the diary study and resulting personas will inform the next phases of the user-centered design process of iteratively designing prototypes and testing the intervention in practice.
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Affiliation(s)
- Andrea K. Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sarah W. Neubert
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jianyi Liu
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Emily Fu
- Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Emilie A. Green
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Rachel Kornfield
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer Nicholas
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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25
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Graham AK, Munson SA, Reddy M, Neubert SW, Green EA, Chang A, Spring B, Mohr DC, Wildes JE. Integrating User-Centered Design and Behavioral Science to Design a Mobile Intervention for Obesity and Binge Eating: Mixed Methods Analysis. JMIR Form Res 2021; 5:e23809. [PMID: 33970114 PMCID: PMC8145081 DOI: 10.2196/23809] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/01/2020] [Accepted: 12/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background Accounting for how end users engage with technologies is imperative for designing an efficacious mobile behavioral intervention. Objective This mixed methods analysis examined the translational potential of user-centered design and basic behavioral science to inform the design of a new mobile intervention for obesity and binge eating. Methods A total of 22 adults (7/22, 32% non-Hispanic White; 8/22, 36% male) with self-reported obesity and recurrent binge eating (≥12 episodes in 3 months) who were interested in losing weight and reducing binge eating completed a prototyping design activity over 1 week. Leveraging evidence from behavioral economics on choice architecture, participants chose treatment strategies from 20 options (aligned with treatment targets composing a theoretical model of the relation between binge eating and weight) to demonstrate which strategies and treatment targets are relevant to end users. The process by which participants selected and implemented strategies and their change in outcomes were analyzed. Results Although prompted to select one strategy, participants selected between 1 and 3 strategies, citing perceived achievability, helpfulness, or relevance as selection reasons. Over the week, all practiced a strategy at least once; 82% (18/22) struggled with implementation, and 23% (5/22) added a new strategy. Several themes emerged on successes and challenges with implementation, yielding design implications for supporting users in behavior change. In postexperiment reflections, 82% (18/22) indicated the strategy was helpful, and 86% (19/22) planned to continue use. One-week average within-subject changes in weight (–2.2 [SD –5.0] pounds) and binge eating (–1.6 [SD –1.8] episodes) indicated small clinical improvement. Conclusions Applying user-centered design and basic behavioral science yielded design insights to incorporate personalization through user choice with guidance, which may enhance engagement with and potential efficacy of digital health interventions.
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Affiliation(s)
- Andrea K Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sean A Munson
- Department of Human Centered Design & Engineering, University of Washington, Seattle, WA, United States
| | - Madhu Reddy
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Communication Studies, Northwestern University, Chicago, IL, United States
| | - Sarah W Neubert
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Emilie A Green
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, United States
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer E Wildes
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
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26
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Veling H, Verpaalen IAM, Liu H, Mosannenzadeh F, Becker D, Holland RW. How can food choice best be trained? Approach-avoidance versus go/no-go training. Appetite 2021; 163:105226. [PMID: 33766617 DOI: 10.1016/j.appet.2021.105226] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/02/2021] [Accepted: 03/17/2021] [Indexed: 11/26/2022]
Abstract
Behavior toward appetitive stimuli can be changed by motor response training procedures in which participants approach or respond to some stimuli and avoid or inhibit behavior to other stimuli. There is discussion in the literature whether effects are different when participants approach versus avoid stimuli during approach-avoidance training compared to when they respond versus not respond to stimuli during go/no-go training. Here, we directly compared effects of approach-avoidance training and go/no-go training on food choice within the same rigorous experimental protocol. Results showed that both training procedures influence food choice such that participants preferred Approach over Avoidance food items, and Go over NoGo food items, and these training effects were not statistically different. The present work suggests any inconsistencies in the literature on possible differences in effectiveness of these training procedures may be explained by differences in methods employed. The present work also raises new theoretical and applied questions about motor response training as a means to change behavior.
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Affiliation(s)
- Harm Veling
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Iris A M Verpaalen
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Huaiyu Liu
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | | | - Daniela Becker
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Rob W Holland
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
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27
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Schiestl ET, Rios JM, Parnarouskis L, Cummings JR, Gearhardt AN. A narrative review of highly processed food addiction across the lifespan. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110152. [PMID: 33127423 PMCID: PMC7750273 DOI: 10.1016/j.pnpbp.2020.110152] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/20/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022]
Abstract
Evidence is growing that highly processed (HP) foods (i.e., foods high in refined carbohydrates and fat) are highly effective in activating reward systems and may even be capable of triggering addictive processes. Unlike traditional drugs of abuse, exposure to HP foods is common very early in development. HP food addiction has been associated with negative outcomes, including higher body mass index (BMI), more frequent binge eating, greater failure in weight loss treatment trials, and poorer mental and physical health. Although most research on HP food addiction has been conducted using adult samples, research on this topic now spans across the life span beginning in utero and extending through older adulthood. HP food addiction and related reward-based changes are associated with negative outcomes at every life stage, which has important implications for developmentally tailored prevention and treatment efforts. Using a developmentally informed approach, the current study comprehensively reviews the existing research on HP food addiction across the lifespan and highlights important areas of future research.
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Affiliation(s)
| | - Julia M Rios
- University of Michigan, United States of America
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28
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Gowey MA, Neumeier WH, Henry S, Wadley VG, Phillips J, Hayden KM, Espeland MA, Coday M, Lewis CE, Dutton GR. Executive function in individuals with clinically significant weight loss via behavioral intervention. Obes Sci Pract 2021; 7:25-34. [PMID: 33680489 PMCID: PMC7909588 DOI: 10.1002/osp4.458] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Executive function (EF) is associated with obesity development and self-management. Individuals who demonstrate or self-report poorer EF performance tend to have poorer short-term outcomes in obesity treatment. There may be distinct behavioral self-management strategies and EF domains related to initial weight loss as compared to weight loss maintenance. OBJECTIVE To characterize EF in individuals who achieved clinically significant weight loss via behavioral intervention and examine potential differences in EF between those who maintained versus regained lost weight. METHODS Participants who previously achieved ≥5% weight loss via lifestyle intervention were included (N = 44). "Maintainers" (n = 16) maintained this minimum level of weight loss for ≥1 year. "Regainers" (n = 28) regained some or all initially lost weight. Performance-based EF, intelligence quotient, health literacy, depression, anxiety, binge eating, demographics, and medical/weight history were assessed using a cross-sectional design. Descriptive statistics and age-, gender-, education-adjusted reference ranges were used to characterize EF. Analyses of covariance were conducted to examine EF differences between maintainers and regainers. RESULTS The sample consisted primarily of females with obesity over age 50. Approximately half self-identified as African-American. Decision-making performance was better in maintainers than regainers (p = 0.003, partη2 = 0.19). There were no differences between maintainers and regainers in inhibitory control, verbal fluency, planning/organization, cognitive flexibility, or working memory (ps > 0.05, partη2s = 0.003-0.07). At least 75% of the sample demonstrated average-above average EF test performance, indicated by scaled scores ≥13 or t-scores > 60. CONCLUSIONS Most individuals with obesity who achieved clinically significant weight loss via behavioral intervention had average to above average EF. Individuals who maintained (vs. regained) their lost weight performed better on tests of decision-making.
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Affiliation(s)
| | - William H. Neumeier
- U.S. Army Research Institute of Environmental MedicineNatickMassachusettsUSA
| | - Samantha Henry
- Department of NeurologyBaylor College of MedicineHoustonTexasUSA
| | | | | | | | | | - Mace Coday
- University of Tennessee Health Science CenterMemphisTennesseeUSA
| | - Cora E. Lewis
- University of Alabama at BirminghamBirminghamAlabamaUSA
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29
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Effect of individual- versus collective-based nutritional-lifestyle intervention on the atherogenic index of plasma in children with obesity: a randomized trial. Nutr Metab (Lond) 2021; 18:11. [PMID: 33436021 PMCID: PMC7805105 DOI: 10.1186/s12986-020-00537-w] [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: 07/28/2020] [Accepted: 12/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background The Atherogenic Index of Plasma is a predictive biomarker of atherosclerosis in adults but there is a lack of studies in paediatric population aimed at evaluating the longitudinal changes of the AIP and of the cardiometabolic blood profile related to nutritional interventions. The aim of this study was to compare the effect of individual- versus collective-based nutritional-lifestyle intervention on the Atherogenic Index of Plasma in schoolchildren with obesity. Methods One-hundred sixty-four children aged 6–12 years with Body Mass Index z-score > 2 referred to the Paediatric Obesity Clinic, San Paolo Hospital, Milan, Italy, were consecutively enrolled and randomized to undergo to either an individual- (n = 82) or a collective- (n = 82) based intervention promoting a balanced normo-caloric diet and physical activity. In addition, the individual intervention included a tailored personalized nutritional advice and education based on the revised Coventry, Aberdeen, and London-Refined taxonomy. Both at baseline and after 12 months of intervention, dietary habits and anthropometric measures were assessed, a fasting blood sample were taken for biochemistry analysis. Results The participation rate at 12 months was 93.3% (n = 153 patients), 76 children in the individual-intervention and 77 children in the collective intervention. At univariate analysis, mean longitudinal change in Atherogenic Index of Plasma was greater in the individual than collective intervention (− 0.12 vs. − 0.05), as well as change in triglyceride-glucose index (− 0.22 vs. − 0.08) and Body Mass Index z-score (− 0.59 vs. − 0.37). At multiple analysis, only change in Body Mass Index z-score remained independently associated with intervention (odds ratio 3.37). Conclusion In children with obesity, an individual-based nutritional and lifestyle intervention, including techniques from the CALO-RE taxonomy, could have an additional beneficial effect over a collective-based intervention, although the actual size of the effect remains to be clarified. Trial Registration Clinical Trials NCT03728621
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30
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Woo S, Park KH. Motivating Children and Adolescents in Obesity Treatment. J Obes Metab Syndr 2020; 29:260-269. [PMID: 32843587 PMCID: PMC7789025 DOI: 10.7570/jomes20026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/10/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022] Open
Abstract
Enhancing motivation is a crucial issue in pediatric obesity interventions, as behavioral changes related to food intake and physical exercise are difficult to carry out with an insufficient level of motivation. In the treatment setting, low motivation towards change may lead to early termination or inadequate treatment outcomes. This paper reviews widely-used models of motivation, including the transtheoretical model of change, self-determination theory, and motivational interviewing (MI). We introduce useful strategies based on each theoretical model to enhance motivation, such as an importance and confidence scale and a decisional balance technique. A review of recent MI interventions in children and adolescents is presented to discuss the efficacy of MI-based interventions and considerations for applying MI in pediatric obesity.
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Affiliation(s)
- Sarah Woo
- Major in Biomedical Science, Department of Medical Sciences, Hallym University College of Medicine, Chuncheon, Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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31
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Rajbhandari-Thapa J, Ingels JB, Chung SR, Thapa K, Chen Z, Zhang D. In-patient obesity diagnosis, use of surgical treatment and associated costs by payer type in the United States: Analysis of the National Inpatient Sample, 2011 through 2014. Clin Obes 2020; 10:e12385. [PMID: 32627391 PMCID: PMC8627372 DOI: 10.1111/cob.12385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/27/2020] [Accepted: 05/31/2020] [Indexed: 11/30/2022]
Abstract
This study aims to examine the trend in the diagnosis of obesity and the use of surgical treatment in in-patient settings as well as per person and national costs associated with the surgical treatment of obesity. We conducted cross-sectional and trend analyses of in-patient obesity diagnosis and surgical treatment for obesity using data from the National Inpatient Sample (2011-2014) of adult patients in the United States aged 18 years and older. We studied the rate of in-patient obesity diagnosis among hospitalized patients, the rate of bariatric surgery among patients diagnosed with obesity in the hospital, and the costs associated with surgical treatment. Trend analyses showed a statistically significant increase in the proportion of (a) hospitalized patients diagnosed with obesity, and (b) bariatric surgery among those diagnosed with obesity and among different socio-demographic and insurance groups. Despite the increase in the national in-patient cost, the average in-patient cost per hospitalization associated with bariatric surgery decreased from 2012 to 2014. With the increase in the rate of diagnosed obesity and bariatric surgery among hospitalized patients and the decrease in the average in-patient cost, future research should address the short- and long-term cost-effectiveness of bariatric surgery on chronic diseases.
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Affiliation(s)
- Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Justin B. Ingels
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Sae R. Chung
- Department of Financial Planning, Housing and Consumer Economics, College of Family and Consumer Sciences, University of Georgia, Athens, Georgia
| | - Kiran Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
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32
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Salam RA, Padhani ZA, Das JK, Shaikh AY, Hoodbhoy Z, Jeelani SM, Lassi ZS, Bhutta ZA. Effects of Lifestyle Modification Interventions to Prevent and Manage Child and Adolescent Obesity: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E2208. [PMID: 32722112 PMCID: PMC7468898 DOI: 10.3390/nu12082208] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/30/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023] Open
Abstract
The objective of this review was to assess the impact of lifestyle interventions (including dietary interventions, physical activity, behavioral therapy, or any combination of these interventions) to prevent and manage childhood and adolescent obesity. We conducted a comprehensive literature search across various databases and grey literature without any restrictions on publication, language, or publication status until February 2020. We included randomized controlled trials and quasi-experimental studies from both high income countries (HIC) and low-middle-income countries (LMICs). Participants were children and adolescents from 0 to 19 years of age. Studies conducted among hospitalized children and children with any pre-existing health conditions were excluded from this review. A total of 654 studies (1160 papers) that met the inclusion criteria were included in this review. A total of 359 studies targeted obesity prevention, 280 studies targeted obesity management, while 15 studies targeted both prevention and management. The majority of the studies (81%) were conducted in HICs, 10% of studies were conducted in upper middle income countries, while only 2% of the studies were conducted in LMICs. The most common setting for these interventions were communities and school settings. Evidence for the prevention of obesity among children and adolescents suggests that a combination of diet and exercise might reduce the BMI z-score (MD: -0.12; 95% CI: -0.18 to -0.06; 32 studies; 33,039 participants; I2 93%; low quality evidence), body mass index (BMI) by 0.41 kg/m2 (MD: -0.41 kg/m2; 95% CI: -0.60 to -0.21; 35 studies; 47,499 participants; I2 98%; low quality evidence), and body weight (MD: -1.59; 95% CI: -2.95 to -0.23; 17 studies; 35,023 participants; I2 100%; low quality evidence). Behavioral therapy alone (MD: -0.07; 95% CI: -0.14 to -0.00; 19 studies; 8569 participants; I2 76%; low quality evidence) and a combination of exercise and behavioral therapy (MD: -0.08; 95% CI: -0.16 to -0.00; 9 studies; 7334 participants; I2 74%; low quality evidence) and diet in combination with exercise and behavioral therapy (MD: -0.13; 95% CI: -0.25 to -0.01; 5 studies; 1806 participants; I2 62%; low quality evidence) might reduce BMI z-score when compared to the control group. Evidence for obesity management suggests that exercise only interventions probably reduce BMI z-score (MD: -0.13; 95% CI: -0.20 to -0.06; 12 studies; 1084 participants; I2 0%; moderate quality evidence), and might reduce BMI (MD: -0.88; 95% CI: -1.265 to -0.50; 34 studies; 3846 participants; I2 72%) and body weight (MD: -3.01; 95% CI: -5.56 to -0.47; 16 studies; 1701 participants; I2 78%; low quality evidence) when compared to the control group. and the exercise along with behavioral therapy interventions (MD: -0.08; 95% CI: -0.16 to -0.00; 8 studies; 466 participants; I2 49%; moderate quality evidence), diet along with behavioral therapy interventions (MD: -0.16; 95% CI: -0.26 to -0.07; 4 studies; 329 participants; I2 0%; moderate quality evidence), and combination of diet, exercise and behavioral therapy (MD: -0.09; 95% CI: -0.14 to -0.05; 13 studies; 2995 participants; I2 12%; moderate quality evidence) also probably decreases BMI z-score when compared to the control group. The existing evidence is most favorable for a combination of interventions, such as diet along with exercise and exercise along with behavioral therapy for obesity prevention and exercise alone, diet along with exercise, diet along with behavioral therapy, and a combination of diet, exercise, and behavioral therapy for obesity management. Despite the growing obesity epidemic in LMICs, there is a significant dearth of obesity prevention and management studies from these regions.
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Affiliation(s)
- Rehana A. Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi 74800, Pakistan; (R.A.S.); (Z.A.P.); (J.K.D.); (A.Y.S.); (Z.H.)
| | - Zahra A. Padhani
- Division of Women and Child Health, Aga Khan University Hospital, Karachi 74800, Pakistan; (R.A.S.); (Z.A.P.); (J.K.D.); (A.Y.S.); (Z.H.)
| | - Jai K. Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi 74800, Pakistan; (R.A.S.); (Z.A.P.); (J.K.D.); (A.Y.S.); (Z.H.)
| | - Amina Y. Shaikh
- Division of Women and Child Health, Aga Khan University Hospital, Karachi 74800, Pakistan; (R.A.S.); (Z.A.P.); (J.K.D.); (A.Y.S.); (Z.H.)
| | - Zahra Hoodbhoy
- Division of Women and Child Health, Aga Khan University Hospital, Karachi 74800, Pakistan; (R.A.S.); (Z.A.P.); (J.K.D.); (A.Y.S.); (Z.H.)
| | - Sarah Masroor Jeelani
- Department of Trauma & Orthopaedics, Macclesfield District General Hospital, East Cheshire NHS Trust Victoria Rd, Macclesfield SK10 3BL, UK;
| | - Zohra S. Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, SA 5005, Australia;
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
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Wright RR, Nelson R, Garcia S, Butler A. Health Behavior Change in the Classroom: A Means to a Healthy End? J Prim Prev 2020; 41:445-472. [DOI: 10.1007/s10935-020-00605-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Rombeek M, De Jesus S, Prapavessis H, Dempsey AA, Fraser D, Welisch E, Altamirano-Diaz L, Norozi K. Improving remote lifestyle intervention studies in children: Participant and caregiver feedback of the smart heart study. PATIENT EDUCATION AND COUNSELING 2020; 103:1326-1334. [PMID: 32089389 DOI: 10.1016/j.pec.2020.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES We sought to describe and analyze the quantitative and qualitative feedback obtained from participants and their caregivers of the Smart Heart study, a successful 12-month lifestyle intervention for children with overweight or obesity and congenital heart disease that provided remote lifestyle counseling, to improve future lifestyle interventions in children. METHODS Thirty-six participants and caregivers were polled using a standard program evaluation questionnaire at the end of the intervention. Feedback was compiled into themes, and facilitators and barriers to program success were identified. RESULTS There was a high level of satisfaction with the intervention and staff interactions as well as a low perceived burden of participation. There were also specific concerns, including mixed impressions regarding technology usage and a less impressive indication of actual impactful behavior change. CONCLUSIONS The study identified five themes, and corresponding facilitators and barriers to participant compliance, from the Smart Heart intervention feedback and offered suggestions for improving future lifestyle behavioral intervention study designs in children. PRACTICE IMPLICATIONS Remote smartphone counseling is effective and efficient. It is recommended that the counseling messages are specific, the counseling schedule is patient-centric, patient burden is limited, methods with immediate patient feedback are used and family is included when feasible.
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Affiliation(s)
- Meghan Rombeek
- Department of Paediatrics, Western University, London, Canada
| | - Stefanie De Jesus
- Department of Paediatrics, Western University, London, Canada; School of Kinesiology, Western University, London, Canada
| | | | - Adam A Dempsey
- Department of Paediatrics, Western University, London, Canada; Paediatric Cardiopulmonary Research Laboratory, London Health Science Centre, London, Canada
| | - Douglas Fraser
- Department of Paediatrics, Western University, London, Canada; Children's Health Research Institute, London, Canada; Translational Research Centre, London, Canada; Lawson Health Research Institute, London, Canada
| | - Eva Welisch
- Department of Paediatrics, Western University, London, Canada; Paediatric Cardiopulmonary Research Laboratory, London Health Science Centre, London, Canada; Children's Health Research Institute, London, Canada
| | - Luis Altamirano-Diaz
- Department of Paediatrics, Western University, London, Canada; Paediatric Cardiopulmonary Research Laboratory, London Health Science Centre, London, Canada; Children's Health Research Institute, London, Canada
| | - Kambiz Norozi
- Department of Paediatrics, Western University, London, Canada; Paediatric Cardiopulmonary Research Laboratory, London Health Science Centre, London, Canada; Children's Health Research Institute, London, Canada; Lawson Health Research Institute, London, Canada; Department of Paediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Germany.
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The global burden of disease attributable to high body mass index in 195 countries and territories, 1990-2017: An analysis of the Global Burden of Disease Study. PLoS Med 2020; 17:e1003198. [PMID: 32722671 PMCID: PMC7386577 DOI: 10.1371/journal.pmed.1003198] [Citation(s) in RCA: 342] [Impact Index Per Article: 85.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity represents an urgent problem that needs to be properly addressed, especially among children. Public and global health policy- and decision-makers need timely, reliable quantitative information to develop effective interventions aimed at counteracting the burden generated by high body mass index (BMI). Few studies have assessed the high-BMI-related burden on a global scale. METHODS AND FINDINGS Following the methodology framework and analytical strategies used in the Global Burden of Disease Study (GBD) 2017, the global deaths and disability-adjusted life years (DALYs) attributable to high BMI were analyzed by age, sex, year, and geographical location and by Socio-demographic Index (SDI). All causes of death and DALYs estimated in GBD 2017 were organized into 4 hierarchical levels: level 1 contained 3 broad cause groupings, level 2 included more specific categories within the level 1 groupings, level 3 comprised more detailed causes within the level 2 categories, and level 4 included sub-causes of some level 3 causes. From 1990 to 2017, the global deaths and DALYs attributable to high BMI have more than doubled for both females and males. However, during the study period, the age-standardized rate of high-BMI-related deaths remained stable for females and only increased by 14.5% for males, and the age-standardized rate of high-BMI-related DALYs only increased by 12.7% for females and 26.8% for males. In 2017, the 6 leading GBD level 3 causes of high-BMI-related DALYs were ischemic heart disease, stroke, diabetes mellitus, chronic kidney disease, hypertensive heart disease, and low back pain. For most GBD level 3 causes of high-BMI-related DALYs, high-income North America had the highest attributable proportions of age-standardized DALYs due to high BMI among the 21 GBD regions in both sexes, whereas the lowest attributable proportions were observed in high-income Asia Pacific for females and in eastern sub-Saharan Africa for males. The association between SDI and high-BMI-related DALYs suggested that the lowest age-standardized DALY rates were found in countries in the low-SDI quintile and high-SDI quintile in 2017, and from 1990 to 2017, the age-standardized DALY rates tended to increase in regions with the lowest SDI, but declined in regions with the highest SDI, with the exception of high-income North America. The study's main limitations included the use of information collected from some self-reported data, the employment of cutoff values that may not be adequate for all populations and groups at risk, and the use of a metric that cannot distinguish between lean and fat mass. CONCLUSIONS In this study, we observed that the number of global deaths and DALYs attributable to high BMI has substantially increased between 1990 and 2017. Successful population-wide initiatives targeting high BMI may mitigate the burden of a wide range of diseases. Given the large variations in high-BMI-related burden of disease by SDI, future strategies to prevent and reduce the burden should be developed and implemented based on country-specific development status.
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Weinheimer EA, Chang A, Neubert SW, Wildes JE, Graham AK. Past, current, and future willingness to engage with treatment targets: Applying user-centered design to inform the design of a mobile behavioral intervention. Int J Eat Disord 2020; 53:611-617. [PMID: 32112592 PMCID: PMC7271441 DOI: 10.1002/eat.23252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE User-centered design can improve engagement with and the potential efficacy of behavioral interventions, but is underutilized in health care. This work demonstrates how design methodologies can inform the design of a mobile behavioral intervention for binge eating and obesity. METHOD A needs assessment was conducted with end-users (N = 22 adults with obesity and recurrent binge eating [≥12 episodes in 3 months] who were interested in losing weight and addressing binge eating), which included assessing participants' past/current and future willingness to engage with 20 treatment targets for managing binge eating and weight. Targets focused on improving dietary intake, increasing physical activity, and reducing overvaluation of weight and/or shape, unhealthy weight control practices, and negative affect. RESULTS Participants' past and current use of targets varied. For all targets except those addressing unhealthy weight control practices, on average, participants had increasing levels of willingness to try targets. Among participants not currently using a target, at least some were willing to use every target again. DISCUSSION Findings inform ways to personalize how users begin treatment. Furthermore, this study exemplifies how user-centered design can inform ways to ensure that digital interventions are designed to meet end-users' needs to improve engagement and clinical impact.
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Affiliation(s)
| | - Angela Chang
- Center for Behavioral Intervention Technologies, Northwestern University,Department of Medical Social Sciences, Northwestern University
| | | | - Jennifer E. Wildes
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago
| | - Andrea K. Graham
- Center for Behavioral Intervention Technologies, Northwestern University,Department of Medical Social Sciences, Northwestern University,Address correspondence to Andrea K. Graham, PhD, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611; Phone: 312-503-5266;
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Hart CN, Jelalian E, Raynor HA. Behavioral and social routines and biological rhythms in prevention and treatment of pediatric obesity. AMERICAN PSYCHOLOGIST 2020; 75:152-162. [PMID: 32052991 PMCID: PMC7839074 DOI: 10.1037/amp0000599] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A growing body of research supports the potential importance of behavioral and social routines for children's health promotion and obesity risk reduction. Evidence in support of this comes from multiple lines of research, which suggest that specific behavioral routines, namely, eating and sleep routines, may be protective against excessive weight gain and development of pediatric obesity. Emerging work also supports the potential importance of the timing of these behavioral routines. From a circadian perspective, alignment of behavioral and social routines with underlying circadian rhythms may be particularly important for enhancing children's weight regulation. Specifically, engaging in appropriately timed behavioral routines may serve to entrain circadian rhythms that affect metabolism and weight regulation. Thus, in addition to promoting healthier eating, activity, and sleep behaviors for prevention and treatment of pediatric obesity, it may also be important to consider promotion of consistency in, and optimal timing of, these behaviors in an effort to enhance extant prevention and treatment approaches. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Chantelle N Hart
- Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Hollie A Raynor
- Department of Nutrition, College of Education, Health and Human Sciences, University of Tennessee
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Gowda S, Seibert T, Uli N, Farrell R. Pediatric Obesity: Endocrinologic and Genetic Etiologies and Management. CURRENT CARDIOVASCULAR RISK REPORTS 2019. [DOI: 10.1007/s12170-019-0632-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Mojica CM, Liang Y, Foster BA, Parra-Medina D. The Association Between Acculturation and Parental Feeding Practices in Families With Overweight and Obese Hispanic/Latino Children. FAMILY & COMMUNITY HEALTH 2019; 42:180-188. [PMID: 31107728 PMCID: PMC6581037 DOI: 10.1097/fch.0000000000000226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study examines the association between acculturation and parental feeding practices in low-income Latinos. Overweight/obese children (N = 117), aged 5 to 14 years, and their parents were recruited from a rural health clinic. Findings show that more acculturated parents have greater control over their child's eating behavior (P = .04). Parents who perceive their child as having a weight problem also have more control over their child's eating behavior (P = .02). Control measured from regulation of how much and when the child should eat to offering sweets and screen time for good behavior. Results underscore the need for interventions to consider parental acculturation and perceptions of child weight.
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Affiliation(s)
- Cynthia M Mojica
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis (Dr Mojica); Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore (Dr Liang); Division of Hospital Medicine, School of Medicine, Oregon Health & Science University, Portland (Dr Foster); and Director, Latino Research Institute, Mexican American and Latina/o Studies, University of Texas at Austin (Dr Parra-Medina)
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