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Pawellek S, Ziegeldorf A, Wulff H. [Strategies and effects of digital interventions in overweight and obesity treatments in children and adolescents-a systematic review]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:624-634. [PMID: 35320378 PMCID: PMC9064867 DOI: 10.1007/s00103-022-03512-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Rising obesity prevalence in childhood and adolescence are characterized by unhealthy lifestyles such as low physical activity due to high media use. Recent studies use the accessibility of this target group through digital media, whereby technologies represent new approaches in the intervention design of weight reduction. However, the question arises as to which digital combinations and methodological program concepts condition effective body mass index (BMI) changes. AIM To gain insights into effective program design and media use; digital intervention strategies for BMI reduction in overweight and obese children and adolescents will be analyzed and evaluated. METHODS A systematic review was conducted in the databases MEDLINE via PubMed, Science Direct, and Web of Science to analyze studies from 2016 to 2021 on changes in BMI and BMI z‑score of overweight and obese 6‑ to 18-year-olds. Methodological study quality was assessed according to the Cochrane Risk of Bias guidelines. RESULTS From 3974 studies, seven articles describing the use of fitness wristbands, smartphones, and computer-based programs were identified. All media achieved BMI reductions, with smartphone interventions via calls and messages causing the most significant changes. DISCUSSION Smartphones as providers of digital programs (e.g., apps) offer effective approaches to obesity reduction. Based on the data, the selection and combination of several media as well as the relevance of family involvement and the methodological foundation of the measures are confirmed. Due to the young age of the participants, media interventions must be made accessible to the target group.
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Affiliation(s)
- Sabine Pawellek
- Institut für Gesundheitssport und Public Health, Universität Leipzig, Jahnallee 59, 04109, Leipzig, Deutschland.
| | - Alexandra Ziegeldorf
- Institut für Gesundheitssport und Public Health, Universität Leipzig, Jahnallee 59, 04109, Leipzig, Deutschland
| | - Hagen Wulff
- Gesundheitserziehung/Gesundheitsbildung, Universität Potsdam, Potsdam, Deutschland
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Bhattacharya S, Agarwal P, Bera OP, Saleem SM, Shikha D, Vallabh V, Juyal R, Singh A. COVID-19 and childhood obesity (CO-BESITY) in the era of new normal life: A need for a policy research. J Public Health Res 2021; 10. [PMID: 34918498 PMCID: PMC9131485 DOI: 10.4081/jphr.2021.2673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/11/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In the era of new normal life (after Coronavirus Disease 2019 (COVID-19)), our children are experiencing the double threat of COVID-19 and Childhood Obesity (CO-BESITY). The rate of childhood obesity has been rapidly increasing in developed as well as low middle-income countries during the pandemic. DESIGN AND METHODS The current paper aims to identify the probable reasons of increase in childhood obesity during this pandemic and offers suggestions to reduce the burden of it. Literature search was done using PubMed, Google Scholar, and Scopus databases for the key terms "childhood obesity," "obesity," "pandemic," and/or childhood obesity. All the relevant articles were included to support the argument for this viewpoint. RESULTS Childhood obesity is a complicated disorder having diverse outcomes. The incidence of childhood obesity is clearly analysed from Bronfenbrenner's model of child development. The model examines an overabundance of bio-psycho-social backgrounds, risks, and probable outcomes on the development of a child. COVID-19 pandemic has disrupted the ecosystem of this dynamic model and has created an economic and social-cultural crisis that has ignited a chain reaction of stressors upon children and their families. In this paper, we have described how this Bronfenbrenner's model of child development also known as the Bioecological Model can be effective for the estimation and prevention of childhood obesity. CONCLUSION We propose that this Bioecological Model will help the children and their families further to understand and manage the problem of childhood obesity during this pandemic on their own.
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Affiliation(s)
| | | | | | | | - Deep Shikha
- Department of Community Medicine, HIMS, SRHU, Dehradun.
| | | | - Ruchi Juyal
- Department of Community Medicine, HIMS, SRHU, Dehradun.
| | - Amarjeet Singh
- Department of Community Medicine and SPH, PGIMER, Chandigarh.
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Rozga M, Handu D. Current Systems-Level Evidence on Nutrition Interventions to Prevent and Treat Cardiometabolic Risk in the Pediatric Population: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2021; 121:2501-2523. [PMID: 33495106 DOI: 10.1016/j.jand.2020.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/07/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric individuals. This scoping review examines current evidence on interventions and exposures influencing pediatric cardiometabolic health to inform registered dietitian nutritionists working at each systems level, ranging from individual counseling to public policy. A literature search of MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, and other databases was conducted to identify evidence-based practice guidelines, systematic reviews, and position statements published in English from January 2017 until April 2020. Included studies addressed nutrition interventions or longitudinal exposures for participants 2 to 17 years of age who were healthy or had cardiometabolic risk factors. Studies were categorized according level of the social-ecological framework addressed. The databases and hand searches identified 2614 individual articles, and 169 articles were included in this scoping review, including 6 evidence-based practice guidelines, 141 systematic reviews, and 22 organization position statements. The highest density of systematic reviews focused on the effects of dietary intake (n = 58) and interventions with an individual child or family through counseling or education (n = 54). The least frequently examined levels of interventions or exposures were at the policy level (n = 12). Registered dietitian nutritionists can leverage this considerable body of recent systematic reviews to inform a systems-level, collaborative approach to prevention and treatment of pediatric cardiometabolic risk factors.
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Browne NT, Snethen JA, Greenberg CS, Frenn M, Kilanowski JF, Gance-Cleveland B, Burke PJ, Lewandowski L. When Pandemics Collide: The Impact of COVID-19 on Childhood Obesity. J Pediatr Nurs 2021; 56:90-98. [PMID: 33293199 PMCID: PMC7657263 DOI: 10.1016/j.pedn.2020.11.004] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 02/07/2023]
Affiliation(s)
| | - Julia A Snethen
- University of Wisconsin-Milwaukee, College of Nursing, WI 53211, USA..
| | | | - Marilyn Frenn
- Marquette University, College of Nursing, WI 53201, USA.
| | - Jill F Kilanowski
- Department of Food, Agricultural and Biological Engineering, The Ohio State University, OH 43210, USA.
| | - Bonnie Gance-Cleveland
- Loretta C. Ford Professor, University of Colorado Anschutz Medical Campus, CO 80045, United States of America.
| | - Pamela J Burke
- Boston Children's Hospital, Division of Adolescent and Young Adult Medicine, MA 02115, United States of America.
| | - Linda Lewandowski
- University of Toledo, College of Nursing, Collier Building, OH 43614-2598, United States of America.
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Haire-Joshu D, Schwarz C, Jacob R, Kristen P, Johnston S, Quinn K, Tabak R. Raising Well at Home: a pre-post feasibility study of a lifestyle intervention for caregivers and their child with obesity. Pilot Feasibility Stud 2020; 6:149. [PMID: 33042569 PMCID: PMC7541221 DOI: 10.1186/s40814-020-00692-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 09/21/2020] [Indexed: 01/15/2023] Open
Abstract
Background Few efficacious pediatric obesity interventions have been successfully translated and sustained in real-world practice, often due to inadequate fit with the priorities of under-resourced populations. Lifestyle interventions, which incorporate tailoring of essential weight loss ingredients and adaptation of mode and intensity to the living circumstances of children with obesity, are needed. The purpose of this pilot study was to test the feasibility and efficacy of a tailored lifestyle intervention for caregivers and their children with obesity, conducted in partnership with Envolve, Inc., a family of comprehensive health solutions and wholly owned subsidiary of Centene Corporation. Methods This 6-month pilot study employed a pretest-posttest design to assess the impact of a tailored lifestyle intervention delivered by peer coaches on (a) caregiver and child weight impacted by changes in dietary intake, walking, and screen time; (b) changes in the home environment; and (c) caregiver engagement and satisfaction. The intervention was delivered via 3 core home visits every 4-6 weeks, with additional support via text. Results The majority of caregivers were female (95.2%) and Black (73.7%). Children had median age of 11.1 years and majority were female (57.6%), with a median BMI near the 99th percentile (Mdn 98.8, IQR 3.5) or 118.3% (IQR 35.8) of the 95th percentile for their sex and age. Participants expressed high satisfaction with the program (mean range 96.7-100.0% agreement on satisfaction items). From baseline to post, caregivers' BMI decreased by 1.8% (p = 0.016, r = 0.22), while children's BMI percentile z-score decreased significantly (p = 0.023, r = 0.18) and BMI percent of the 95th percentile remained constant (p = 0.05, r = 0.15). Caregivers and children decreased sugar-sweetened beverage intake (p = 0.026, r = 0.22; p = 0.006, r = 0.23, respectively), reduced presence of soda in the home (p = 0.002, g = 0.43), and decreased screen time (p = 0.046, g = 0.22). Other eating and walking behaviors remained stable for caregivers and child. Conclusion The Raising Well at Home pilot demonstrated that tailored lifestyle interventions, delivered by peer coaches in the home and via text, are feasible and can improve weight, eating, and environmental measures of caregivers and children with obesity. Future work should determine the effectiveness, sustainability, and scalability of this intervention in sites located across the country. Trial registration ClinicalTrials.gov (NCT04224623). Registered 9 January 2020-retrospectively registered.
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Affiliation(s)
- Debra Haire-Joshu
- Center for Obesity Prevention and Policy Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA.,Center for Diabetes Translation Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Cindy Schwarz
- Center for Obesity Prevention and Policy Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Rebekah Jacob
- Prevention Research Center in St. Louis, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Pat Kristen
- Centene Center for Health Transformation, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Shelly Johnston
- Center for Diabetes Translation Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Karyn Quinn
- Centene Center for Health Transformation, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
| | - Rachel Tabak
- Center for Diabetes Translation Research, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA.,Prevention Research Center in St. Louis, the Brown School, Washington University in St. Louis, One Brookings Drive, CB 1196, Saint Louis, MO 63130 USA
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Abstract
As avid users of technology, adolescents are a key demographic to engage when designing and developing technology applications for health. There are multiple opportunities for improving adolescent health, from promoting preventive behaviors to providing guidance for adolescents with chronic illness in supporting treatment adherence and transition to adult health care systems. This article will provide a brief overview of current technologies and then highlight new technologies being used specifically for adolescent health, such as artificial intelligence, virtual and augmented reality, and machine learning. Because there is paucity of evidence in this field, we will make recommendations for future research.
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Affiliation(s)
- Ana Radovic
- Department of Pediatrics, School of Medicine, University of Pittsburgh and University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania;
| | - Sherif M Badawy
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and.,Division of Hematology, Oncology, Neurooncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Thompson D, Baranowski T. Chatbots as extenders of pediatric obesity intervention: an invited commentary on "Feasibility of Pediatric Obesity & Pre-Diabetes Treatment Support through Tess, the AI Behavioral Coaching Chatbot". Transl Behav Med 2020; 9:448-450. [PMID: 31094432 DOI: 10.1093/tbm/ibz065] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Despite our best efforts, pediatric obesity remains an important public health issue. Although many different approaches to address this condition have been utilized, few have achieved long-term success. Technology is increasingly being explored as a convenient and accessible method for delivering behavioral interventions. Stephens and colleagues report the feasibility of using a behavioral coaching social chatbot, Tess, to extend a multicomponent pediatric obesity intervention for adolescents. We examine the pros and cons of this approach. Although social chatbots offer an interesting and novel method for promoting round-the-clock support, important issues and decisions must be carefully considered during the design phase to help ensure a safe environment for a vulnerable population.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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de Medeiros GCBS, de Azevedo KPM, Garcia DÁ, de Oliveira Segundo VH, de Sousa Mata ÁN, de Siqueira KSDP, Fernandes AKP, Santos RPD, de Brito Trindade DDB, de Oliveira Lyra C, Piuvezam G. Protocol for systematic reviews of school-based food and nutrition education intervention for adolescent health promotion: Evidence mapping and syntheses. Medicine (Baltimore) 2019; 98:e16977. [PMID: 31464944 PMCID: PMC6736443 DOI: 10.1097/md.0000000000016977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Nutrition is an important modifiable factor in combating overweight and obesity among adolescents. School has been indicated as an effective environment for influencing eating behavior; however, recent reviews assessing school-based interventions specifically for adolescents are scarce. Therefore, we propose the present systematic review with the aim to comprehensively review the quantitative and qualitative literature on the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits. METHODS We will search MEDLINE/PubMed, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, and ADOLEC. We will include randomized controlled trials (RCT), non-RCT, and controlled before-after studies. Risk of bias will be assessed using the EPOC Risk of Bias Tool for RCT, Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCT or controlled before-after, as well as the Critical Appraisal Skills Program (CASP) checklist for qualitative studies. We will analyze the overall strength of the evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Two independent researchers will conduct all evaluations and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed by the RevMan 5.3 software. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols. RESULT This review will evaluate the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits. The primary outcome will be changes in adolescent food consumption. Secondary outcomes will be biological parameters (e.g., body mass index (BMI), waist circumference (WC), body composition, etc); biochemical parameters (e.g., glycemia, triglycerides, total cholesterol, etc); qualitative evidences that support or explain the effect of school-based food and nutrition education interventions on adolescent food consumption. CONCLUSION The findings of this systematic review will summarize the latest evidence of the effects of school-based food and nutrition education interventions on adolescent health promotion. The findings will be an available reference for school-based interventions and other further research. REGISTRATION PROSPERO CRD42019116520.
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Affiliation(s)
| | | | - Daniel Ángel Garcia
- Department of Physiotherapy, San Antonio de Murcia Catholic University, Spain
| | | | | | | | | | | | | | - Clélia de Oliveira Lyra
- Department of Nutrition, Federal University of Rio Grande do Norte
- Graduate Program in Public Health, UFRN, Natal, Brazil
| | - Grasiela Piuvezam
- Graduate Program in Public Health, UFRN, Natal, Brazil
- Department of Public Health, UFRN, Natal, Brazil
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Leung MM, Mateo KF, Verdaguer S, Wyka K. Testing a Web-Based Interactive Comic Tool to Decrease Obesity Risk Among Minority Preadolescents: Protocol for a Pilot Randomized Control Trial. JMIR Res Protoc 2018; 7:e10682. [PMID: 30413399 PMCID: PMC6251980 DOI: 10.2196/10682] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 12/15/2022] Open
Abstract
Background Childhood obesity is a public health crisis, particularly in low-income, minority populations in the United States. Innovative and technology-enhanced interventions may be an engaging approach to reach at-risk youth and their parents to improve dietary behaviors and feeding practices. However, such tools are limited, especially ones that are theory-based; co-developed with user-centered approaches; tailored to low-income, minority preadolescents; and include parent-focused content. Objective The objectives of this study include assessing the feasibility and acceptability and exploring the potential impact of the Intervention INC (Interactive Nutrition Comics for urban, minority preadolescents) Web-based tool, which is focused on decreasing childhood obesity risk in black/African American and Latino children aged 9 to 12 years. Methods Intervention INC is underpinned by the narrative transportation theory, social cognitive theory, and health belief model, and it was co-developed by children and parents from the intended population. The child component consists of a 6-chapter interactive nutrition comic optimized for use on tablet devices, a goal-setting and self-assessment feature, and weekly text/email messages and reminders. The parental component consists of 6 Web-based newsletters, access to the child comic, and weekly text/email messages and reminders. The tool was evaluated using a pilot, single-blind, 2-group randomized controlled study design. Child-parent dyads were randomized to either the experimental or comparison group and assigned to a targeted behavior (increase fruit/vegetable or water intake) based on initial screening questions. Data were collected at 4 time points: baseline (T1), intervention midpoint (T2), intervention endpoint (T3), and 3 months postintervention (T4). Primary measures comprise usage, usability, and feasibility of the Web-based tool. Secondary measures comprise dietary knowledge, preferences, and intake and anthropometric measures (for child) and feeding practices and home food environment (for parent). Results Study enrollment was completed in November 2017. A total of 89 child-parent dyads were randomized to either the experimental (n=44) or comparison (n=45) group. Data analysis is currently being conducted. Conclusions This study aims to implement and assess an innovative approach to deliver health messages and resources to at-risk minority preadolescents and their parents. If found to be acceptable, engaging, feasible, and a potential approach to improve dietary behaviors, a full-fledged randomized controlled trial will be conducted to assess its efficacy and potential impact. Trial Registration ClinicalTrials.gov NCT03165474; https://clinicaltrials.gov/ct2/show/NCT03165474 (Archived by WebCite at http://www.webcitation.org/73122IjgP) International Registered Report Identifier (IRRID) RR1-10.2196/10682
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Affiliation(s)
- May May Leung
- School of Urban Public Health, Hunter College, New York, NY, United States
| | - Katrina F Mateo
- School of Urban Public Health, Hunter College, New York, NY, United States.,Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Sandra Verdaguer
- School of Urban Public Health, Hunter College, New York, NY, United States.,Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Katarzyna Wyka
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
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