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Polfuss M, Smith K, Hopson B, Moosreiner A, Huang CC, Ravelli MN, Ding D, Huang Z, Rocque BG, White-Traut R, Van Speybroeck A, Sawin KJ. Body Composition and Energy Expenditure in Youth With Spina Bifida: Protocol for a Multisite, Cross-Sectional Study. JMIR Res Protoc 2024; 13:e52779. [PMID: 38954458 PMCID: PMC11252625 DOI: 10.2196/52779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Obesity prevalence in youth with spina bifida is higher than in their typically developing peers. Obesity is associated with lifelong medical, psychological, and economic burdens. Successful prevention or treatment of obesity in individuals with spina bifida is compromised by (1) the lack of valid and reliable methods to identify body fat in a clinical setting and (2) limited data on energy expenditure that are necessary to provide daily caloric recommendations. OBJECTIVE The objectives of this study will be to develop 2 algorithms for use in youth with spina bifida in a clinical setting, one to model body fat and one to predict total daily energy expenditure. In addition, physical activity and dietary intake will be described for the sample. METHODS This multisite, prospective, national clinical study will enroll 232 youth with myelomeningocele aged 5 to 18 years (stratified by age and mobility). Participants will be enrolled for 1 week. Data obtained include 4 measures of body composition, up to 5 height measures, a ramped activity protocol, and a nutrition and physical activity screener. Participants will wear an accelerometer for the week. On the final study day, 2 samples of urine or saliva, which complete the doubly labeled water protocol, will be obtained. The analysis will include descriptive statistics, Bland-Altman plots, concordance correlation, and regression analysis. RESULTS The study received extramural federal funding in July 2019. Data collection was initiated in March 2020. As of April 2024, a total of 143 (female participants: n=76, 53.1%; male participants: n=67, 46.9%) out of 232 participants have been enrolled. Data collection is expected to continue throughout 2024. A no-cost extension until November 2025 will be requested for data analysis and dissemination of findings. CONCLUSIONS This study furthers previous pilot work that confirmed the acceptability and feasibility of obtaining alternate height, body composition, and energy expenditure measures. The findings from this study will enhance screening, prevention, and treatment of abnormal weight status by facilitating the accurate identification of youths' weight status category and recommendations of daily caloric needs for this population that is at higher risk of obesity. Furthermore, the findings have the potential to impact outcomes for youth diagnosed with disabilities other than spina bifida who experience similar challenges related to alterations in body composition or fat distribution or measurement challenges secondary to mobility issues or musculoskeletal problems. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52779.
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Affiliation(s)
- Michele Polfuss
- School of Nursing, College of Health Professions and Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, United States
| | - Kathryn Smith
- Department of Pediatrics, USC Keck School of Medicine, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Betsy Hopson
- Department of Mediciine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Andrea Moosreiner
- Clinical and Translational Science Institute, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Chiang-Ching Huang
- Zilber College of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
| | - Michele N Ravelli
- Biotechnology Center, University of Wisconsin - Madison, Madison, WI, United States
| | - Dan Ding
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zijian Huang
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brandon G Rocque
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rosemary White-Traut
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, United States
- College of Nursing, University of Illinois at Chicago, Chicago, IL, United States
| | - Alexander Van Speybroeck
- Division of General Pediatrics, USC Keck School of Medicine, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Kathleen J Sawin
- School of Nursing, College of Health Professions and Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, United States
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Polfuss M, Bandini LG, Ravelli MN, Huang Z, Moosreiner A, Schoeller DA, Huang CC, Ding D, Berry C, Marston E, Hussain A, Shriver TC, Sawin KJ. Energy expenditure and weight-related behaviors in youth with Down syndrome: a protocol. Front Pediatr 2023; 11:1151797. [PMID: 37547107 PMCID: PMC10397728 DOI: 10.3389/fped.2023.1151797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Background The consequences of obesity are ominous, yet healthcare professionals are not adequately preventing or treating obesity in youth with Down syndrome (DS). Total daily energy expenditure (TDEE) is the energy expended in 24 h through physical activity and life-sustaining physiologic processes. An individual's TDEE is essential for determining the daily caloric intake needed to maintain or change body weight. Successful prevention and treatment of obesity in youth with DS is severely compromised by the lack of data on TDEE and information on weight-related behaviors for this high-risk population. This manuscript describes the protocol for the federally funded study that is in process to determine daily energy expenditure in a large cohort of children with DS. Methods This observational cross-sectional study will include a national sample of 230 youth with DS, stratified by age (5-11 and 12-18 years of age) and sex. Doubly Labeled Water analysis will provide the criterion body fat%, fat-free mass, and TDEE. To increase accessibility and decrease the burden on participants, the entire study, including obtaining consent and data collection, is conducted virtually within the participant's home environment on weekdays and weekends. The study team supervises all data collection via a video conferencing platform, e.g., Zoom. This study will (1) examine and determine average TDEE based on age and sex, (2) develop a prediction equation based on measured TDEE to predict energy requirements with a best-fit model based on fat-free mass, sex, age, and height and/or weight, and (3) use 24-hour dietary recalls, a nutrition and physical activity screener, wearable devices, and sleep questionnaire to describe the patterns and quality of dietary intake, sleep, and physical activity status in youth with DS. Discussion The lack of accurate information on energy expenditure and weight-related behaviors in youth with DS significantly impedes the successful prevention and treatment of obesity for this vulnerable population. The findings of this study will provide a further understanding of weight-related behaviors as obesity risk factors, currently not well understood for this population. This study will advance the science of weight management in individuals with disabilities and shift clinical practice paradigms.
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Affiliation(s)
- Michele Polfuss
- College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, United States
| | - Linda G Bandini
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Michele N Ravelli
- Isotope Ratio Mass Spectrometry Laboratory, Biotechnology Center, University of Wisconsin, Madison, WI, United States
| | - Zijian Huang
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea Moosreiner
- Clinical and Translational Science Institute of Southeast Wisconsin, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Dale A Schoeller
- Isotope Ratio Mass Spectrometry Laboratory, Biotechnology Center, University of Wisconsin, Madison, WI, United States
| | - Chiang-Ching Huang
- Zilber School of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
| | - Dan Ding
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Cristen Berry
- Pediatric Translational Research Unit, Children's Wisconsin, Milwaukee, WI, United States
| | - Emma Marston
- College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
| | - Azeem Hussain
- Zilber School of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
| | - Timothy C Shriver
- Isotope Ratio Mass Spectrometry Laboratory, Biotechnology Center, University of Wisconsin, Madison, WI, United States
| | - Kathleen J Sawin
- College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
- Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, United States
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Yehuda MB, Barak S, Hutzler Y, Ng K, Giladi A, Meir LB, Marques A, Zigdon A, Zwilling M, Reges O, Fisch YH, Tesler R. Cardiovascular risk profiles clusters among children and adolescents with disabilities. BMC Public Health 2023; 23:896. [PMID: 37189074 DOI: 10.1186/s12889-023-15796-4] [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: 06/22/2022] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are a precursor for disabilities and death worldwide. Being overweight or obese in combination with physical inactivity and smoking habits may increase the risk for CVD and other health problems such as lower limb osteoarthritis, diabetes, stroke, and various cancer types among children and adolescents. The literature emphasizes the need to follow such groups and evaluate the risk of individuals developing CVD diseases. Therefore, the current study explores the variety of cardiovascular risks in children and adolescents' profiles clusters with and without disabilities. METHODS Data from 42 countries including Israel, was collected with the support of the world health organization (WHO, Europe) through a questionnaire from 11-19 years old school-aged. RESULTS The study finding shows that children and adolescents with disabilities demonstrated a higher prevalence of overweight than those who completed the HBSC youth behavior survey. Moreover, the prevalence of tobacco smoking and alcohol use was statisticaly significantly higher among the disabled group than the non-disabled group. In addition, socioeconomic status of responders who presented a very high CVD risk was found as significantly lower than those from the first and second low risk groups. CONCLUSION This led to the conclusion that children and adolescents with disability were at a higher risk of developing CVDs than their non-disabled peers. In addition, intervention programs tailored to the needs of adolescents with disability should consider lifestyle habit change and promoting healthy living thus improving their quality of life as well as reducing their risk of being exposed to severe CVD diseases.
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Affiliation(s)
| | - Sharon Barak
- Department of Nursing, Faculty of Health Science, Ariel University, Ari'el, Israel
| | | | - Kwok Ng
- Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Faculty of Education, University of Turku, Rauma, Finland
| | - Ariela Giladi
- School of Education, Bar Ilan University, Ramat Gan, Israel
| | | | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal
| | - Avi Zigdon
- Health Promotion Research Center, Ariel University, Ari'el, Israel
| | - Moti Zwilling
- Department of Economics & Business Administration, Faculty of Social Sciences, Ariel University, Ari'el, Israel
| | - Orna Reges
- Department of Health System Management, Faculty of Health Science, Ariel University, Ari'el, Israel
| | | | - Riki Tesler
- Health Promotion Research Center, Ariel University, Ari'el, Israel.
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Karatekin BD, Kacar G, Icagasioglu A. Obesity in ambulatory children with cerebral palsy in Turkey: A cross-sectional study. J Pediatr Rehabil Med 2023; 16:195-202. [PMID: 36847021 DOI: 10.3233/prm-210093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
PURPOSE Obesity prevalence and the relationship between obesity and motor function in children with ambulatory cerebral palsy (CP) were investigated. METHODS This was a cross-sectional study. The obesity profile of 75 children aged 2-18 years with ambulatory CP was investigated. GMFCS levels were recorded, and BMI was calculated using height and weight data and converted into Z-scores. Age- and gender-specific growth charts were used for children and adolescents. RESULTS The mean BMI of the participants was 17.78, with an obesity rate of 18.67% and an overweight rate of 16%. Gross motor function was found to be associated with height, weight, and BMI (p < 0.05). No relationship was found between obesity +overweight and gender and CP subtype (p > 0.05). CONCLUSION Turkish children with CP had a higher rate of obesity compared to typically developing peers and also their counterparts in other countries. There is a need for studies to identify the causes of obesity and to develop effective intervention programs for prevention of it in children with CP.
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Affiliation(s)
- Bilinc Dogruoz Karatekin
- Goztepe Prof Dr Suleyman Yalcin City Hospital, Physical Medicine and Rehabilitation, Istanbul Medeniyet University, Istanbul, Turkey
| | - Gulnihal Kacar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Afitap Icagasioglu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
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Modanloo S, Correll Q, Correll R, Major N, Quinlan M, Reszel J, Wilding J, Lin Zhou Z, Franck LS, Harrison D. Identifying research priorities with children, youth, and families: A scoping review. J Child Health Care 2023:13674935231151748. [PMID: 36647285 DOI: 10.1177/13674935231151748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Increased patient advocacy has resulted in a shift toward more active patient engagement in the research. A scoping review was conducted to explore the literature on healthcare research priority settings wherein children, youths, or their families were involved in the priority-setting process. Six databases including MEDLINE, CINAHL, PsycINFO, Embase, Web of Science, and Global Health and the James Lind Alliance website were searched up until September 2019. All primary studies involving children (<18 years of age) or families in developing research priorities in health care were included. All retrieved references were uploaded into Covidence, and two independent reviewers screened the search results. Descriptive thematic analysis was used to identify common themes. A total of 30 studies with 4247 participants were included. Less than half of the participants (n = 1237, (33%) were pediatric patients and their families. A total of 455 research priorities were identified. Three common themes emerged: (i) quality of care delivery, (ii) self-efficacy in health behaviors, and (iii) community engagement in care. This scoping review revealed priority research health topics from the perspectives of children, youths, or their families. The findings may be used as a foundation for future research to improve the health outcomes of children, youths, or their families according to their identified priorities.
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Affiliation(s)
- Shokoufeh Modanloo
- Arthur Labatt School of Nursing, Faculty of Health Sciences, 70383Western University, London, ON, Canada
| | - Quinn Correll
- Rankin School of Nursing, St Francis Xavier University, Antigonish, NS, Canada
| | - Rhonda Correll
- Children's Hospital of Eastern Ontario 274065(CHEO) Research Institute, Ottawa, ON, Canada
| | - Nathalie Major
- Children's Hospital of Eastern Ontario 274065(CHEO) Research Institute, Ottawa, ON, Canada
| | - Michelle Quinlan
- Children's Hospital of Eastern Ontario 274065(CHEO) Research Institute, Ottawa, ON, Canada
| | - Jessica Reszel
- Children's Hospital of Eastern Ontario 274065(CHEO) Research Institute, Ottawa, ON, Canada
| | - Jodi Wilding
- Children's Hospital of Eastern Ontario 274065(CHEO) Research Institute, Ottawa, ON, Canada
| | - Zhi Lin Zhou
- Children's Hospital of Eastern Ontario 274065(CHEO) Research Institute, Ottawa, ON, Canada
| | - Linda S Franck
- School of Nursing, 8783University of California, San Francisco, CA, USA
| | - Denise Harrison
- Department of Nursing, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
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Gour-Provençal G, Costa C. Metabolic Syndrome in Children With Myelomeningocele and the Role of Physical Activity: A Narrative Review of the Literature. Top Spinal Cord Inj Rehabil 2022; 28:15-40. [PMID: 36017122 DOI: 10.46292/sci21-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight into the baseline levels of aerobic fitness, endurance, and strength in this population in order to identify gaps in knowledge, suggest potential primary prevention strategies, and provide recommendations for future studies. Methods A literature review of articles published in English and French between 1990 and April 2020 was conducted. Results Obese adolescents with myelomeningocele have an increased prevalence of components of the metabolic syndrome. Children and adolescents with myelomeningocele have decreased aerobic fitness and muscular strength, decreased lean mass, and increased fat mass, all of which, when combined with higher levels of physical inactivity, put them at higher risk of developing metabolic syndrome and cardiovascular diseases. Conclusion Until more research is conducted, addressing weight-related challenges and promoting healthy habits (such as optimal activity levels) could be easily integrated into yearly myelomeningocele clinics. An actionable suggestion might be to systematically weigh and measure children in these clinics and utilize the results and trends as a talking point with the parents and children. The follow-up appointments could also be used to develop physical activity goals and monitor progress. We recommend that the health care practitioner tasked with this intervention (physician, nurse, etc.) should be aware of locally available accessible sports platforms and have knowledge of motivational interviewing to facilitate removal of perceived barriers to physical activity.
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Affiliation(s)
| | - Camille Costa
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
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Iqbal H, McEachan RRC, West J, Haith-Cooper M. Research priority setting in obesity: a systematic review. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2021; 31:1-17. [PMID: 34877248 PMCID: PMC8641289 DOI: 10.1007/s10389-021-01679-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022]
Abstract
AIM Obesity research priority setting, if conducted to a high standard, can help promote policy-relevant and efficient research. Therefore, there is a need to identify existing research priority setting studies conducted in the topic area of obesity and to determine the extent to which they followed good practice principles for research priority setting. METHOD Studies examining research priority setting in obesity were identified through searching the MEDLINE, PBSC, CINAHL, PsycINFO databases and the grey literature. The nine common themes of good practice in research priority setting were used as a methodological framework to evaluate the processes of the included studies. These were context, use of a comprehensive approach, inclusiveness, information gathering, planning for implementation, criteria, methods for deciding on priorities, evaluation and transparency. RESULTS Thirteen articles reporting research prioritisation exercises conducted in different areas of obesity research were included. All studies reported engaging with various stakeholders such as policy makers, researchers and healthcare professionals. Public involvement was included in six studies. Methods of research prioritisation commonly included both Delphi and nominal group techniques and surveys. None of the 13 studies fulfilled all nine of the good practice criteria for research priority setting, with the most common limitations including not using a comprehensive approach and lack of inclusivity and evaluating on their processes. CONCLUSION There is a need for research priority setting studies in obesity to involve the public and to evaluate their exercises to ensure they are of high quality.
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Affiliation(s)
- Halima Iqbal
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP UK
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK
| | - Rosemary R. C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, UK
| | - Melanie Haith-Cooper
- Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP UK
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Hutzler Y, Tesler R, Ng K, Barak S, Kazula H, Harel-Fisch Y. Physical activity, sedentary screen time and bullying behaviors: exploring differences between adolescents with and without disabilities. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2021. [DOI: 10.1080/02673843.2021.1875852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Yeshayahu Hutzler
- Academic College at Wingate, Wingate Institute, Netanya, Israel
- Israel Sport Center for the Disabled, Ramat-Gan, Israel
| | - Riki Tesler
- Department of Health Systems Management, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Kuopio Finland
- Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick Ireland
| | - Sharon Barak
- Department of Pediatric Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan
- Kaye Academic College of Education, Physical Education, Beer-Sheva, Israel
- College of Public Health, Ben Gurion University, Beer-Sheva, Israel
| | - Hadas Kazula
- Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Yossi Harel-Fisch
- Faculty of Social Sciences, School of Education, Bar-Ilan University, Ramat-Gan, Israel
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9
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Polfuss M, Forseth B, Schoeller DA, Huang CC, Moosreiner A, Papanek PE, Sawin KJ, Zvara K, Bandini L. Accuracy of body mass index in categorizing weight status in children with intellectual and developmental disabilities. J Pediatr Rehabil Med 2021; 14:621-629. [PMID: 34542044 PMCID: PMC9105647 DOI: 10.3233/prm-200727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To identify the accuracy of Body Mass Index (BMI) to categorize body weight in a sample of children with spina bifida and Down syndrome as compared to typically developing peers. METHODS A secondary analysis of 32 children with spina bifida, Down syndrome or no chronic illness. A calculated BMI was plotted on the Centers for Disease Control and Prevention age- and sex-specific BMI growth charts to determine each child's weight status. Percentage of body fat, obtained by labeled water, was plotted on two different body fat percentile reference curves, one derived from a whole body measure (DXA) of body fat and one by skin-fold measure. Differences in weight categories between calculated BMI and body fat percentile curves were reported. RESULTS The calculated BMI for children with a disability had significant misclassifications as a screening tool for body fat when compared to children without a disability. Misclassifications were increased with the body fat percentile reference curve derived from skin-fold measures and for children who primarily used a wheelchair. CONCLUSION The current recommendation to use BMI to categorize weight status is not useful for many children with disabilities. Further research to identify an alternative pragmatic strategy is necessary.
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Affiliation(s)
- Michele Polfuss
- College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, USA.,Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
| | - Bethany Forseth
- College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | - Dale A Schoeller
- Biotech Center and Nutritional Sciences, University of Wisconsin - Madison, Madison, WI, USA
| | - Chiang-Ching Huang
- Joseph J. Zilber School of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | - Andrea Moosreiner
- Clinical and Translational Science Institute of Southeastern, Medical College of Wisconsin, Wisconsin, Milwaukee, WI, USA
| | - Paula E Papanek
- Department of Physical Therapy, Marquette University, Milwaukee, WI, USA
| | - Kathleen J Sawin
- College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, USA.,Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, USA
| | - Kimberley Zvara
- Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA.,Physical Medicine and Rehabilitation, Children's Wisconsin, Milwaukee, WI, USA
| | - Linda Bandini
- Pediatrics, Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Boston, MA, USA.,Department of Health Sciences, Boston University, Sargent College, Boston, MA, USA
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Obesity and cardio-metabolic risk factors among children and adolescents with cerebral palsy. NUTR HOSP 2020; 37:685-691. [PMID: 32686452 DOI: 10.20960/nh.03009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: obesity and associated cardiometabolic complications are increasing among adults with cerebral palsy (CP). Information in children is scarce, and there is no consensus definition of obesity. Objectives: to describe the frequency of obesity and metabolic complications in children and adolescents with CP. Methods: a descriptive, cross-sectional study performed in two outpatient pediatric special needs centers. Demographic, anthropometric (Brooks 2011), and motor function (GMFCS) data, as well as antiepileptic use, were recorded. Fasting triglycerides (TG), total cholesterol (TC), vitamin D (25OHD), glycemia (GLY), and insulinemia levels were measured. The HOMA index was calculated. Results: sixty-five patients were enrolled. Aage was 10.8 ± 4.9 years; 63.1 % were male; 81.6 % had GMFCS IV-V; 43.5 % had a gastrostomy; and 83.1 % were on antiepileptics. According to their BMI, 15.4 % were underweight (< 10th percentile) and 10.8 % overweight (> 75th percentile). Overall, 6.1 % had TC ≥ 200 mg/dL, 21.4 % had TG ≥ 110 or 130 mg/dL, 4.6 % had GLY ≥ 100 mg/dL, 16.9 % had HOMA ≥ 3, and 76.9 % had 25OHD < 30 ng/mL. Children with BMI ≥ 75th percentile had higher HOMA and insulin resistance rates than those with BMI < 75th percentile. Elevated TGs were associated with high motor impairment and low vitamin D. HOMA was associated to feminine gender and BMI ≥ 75th percentile. Conclusions: the frequency of cardiometabolic risk factors was high in this sample of pediatric patients with CP, associated with overweight, low mobility, and vitamin D deficiency. We propose a BMI > 75th percentile as cutoff point for metabolic risk factors.
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11
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Hawwash D, Pinxten W, Raneri JE, Kolsteren P, Lachat C. Uptake and impact of priority setting exercises in nutrition research publications. Eur J Clin Nutr 2020; 75:198-208. [PMID: 32855521 DOI: 10.1038/s41430-020-00729-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/01/2020] [Accepted: 08/07/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess how priority setting exercises for nutrition research are considered in publication. DESIGN Cross-sectional design. SETTINGS First, a citation analysis of priority setting exercises found in nutrition research until 2019 was conducted. The reasons for citation were extracted from the text of citing papers and the reasons were defined as: (i) acting on the research questions identified as priorities, (ii) acknowledging the priority setting exercise, (iii) using the same method, or (iv) previous knowledge to support evidence. Second, a survey with authors of the priority setting exercises was done to understand priority setters' perspectives on the impact and satisfaction of their work. PARTICIPANTS Twenty-one priority setting exercise papers were included. In all, 434 citing papers were found, of which 338 were considered in the citation analysis. A sample of 17 authors representing 13 priority setting exercise papers completed the impact and satisfaction survey. RESULTS Half of the priority setting exercise papers were published by 2013. After excluding self-citations (n = 60), the priority setting papers had on average 18 citations. Priority setting exercises had a median of 1 (IQR = 0-1) citing manuscript that acted on the recommendations produced from priority setting exercises. Authors of the priority setting exercises expressed a desire for increased uptake of the results of the priority setting exercises by funding agencies. Key barriers for uptake were identified as challenges in involving stakeholders and the general public for participation in the priority setting exercise. CONCLUSIONS Priority settings exercises are important efforts to guide nutrition research toward effective allocation of resources. However, there seems to be a limited consideration of these priority setting exercises in research papers.
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Affiliation(s)
- Dana Hawwash
- Department of Food Technology, Safety and Health, Ghent University, Gent, Belgium
| | - Wim Pinxten
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Jessica E Raneri
- Department of Food Technology, Safety and Health, Ghent University, Gent, Belgium
| | - Patrick Kolsteren
- Department of Food Technology, Safety and Health, Ghent University, Gent, Belgium
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Ghent University, Gent, Belgium.
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Hennessy M, Byrne M, Laws R, Mc Sharry J, O'Malley G, Heary C. Childhood obesity prevention: priority areas for future research and barriers and facilitators to knowledge translation, coproduced using the nominal group technique. Transl Behav Med 2020; 9:759-767. [PMID: 30011024 DOI: 10.1093/tbm/iby074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Childhood obesity is a significant public health challenge, yet research priorities for childhood obesity prevention are not established. Coproduction of priorities leads to research which may be more translatable to the domains of policy and practice. The aim of the present study was to identify knowledge gaps and research priorities in addition to facilitators and barriers to knowledge translation in childhood obesity prevention. The nominal group technique involving consensus building with researchers, policymakers, and practitioners was employed during workshops at a national obesity conference held over 2 days in May 2017. Seventy-seven people participated in the first round of research prioritization on Day 1, while 14 stakeholders participated on Day 2. The top five research priorities identified were as follows: (i) Evaluate (including economic evaluation) current programs to inform practice and policy; (ii) How to change culture toward addressing the determinants of health; (iii) Implementation science: process; (iv) How to integrate obesity prevention into existing service structures; (v) How to enhance opportunities for habitual physical activity, including free play and active travel. Key themes emerging from this research prioritization exercise were the importance of funding and resources, coproduction of research, and a focus on both implementation research and social determinants within the field of childhood obesity prevention. The coproduced research priorities may help to shape the research agendas of funders and researchers, and aid in the conduct of policy-relevant research and the translation of research into practice in childhood obesity prevention.
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Affiliation(s)
- Marita Hennessy
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jenny Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Grace O'Malley
- Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.,Association for the Study of Obesity on the Island of Ireland, Dublin, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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13
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Wittmeier K, Brockman GH, Garcia AP, Woodgate RL, Ball GDC, Wicklow B, Sellers E, Jong G', Sibley KM. Access to Multidisciplinary Care for Pediatric Weight Management: Exploring Perspectives of the Health Care Team within Canada and the United States. Child Obes 2019; 15:363-370. [PMID: 31099587 DOI: 10.1089/chi.2019.0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: In Canada and the United States, most families referred for pediatric weight management services do not start treatment. Of families who initiate care, many discontinue before the program ends. Parents and youth have reported difficulties in accessing services as an important barrier to starting or completing programming. The purpose of this study was to understand barriers and identify potential solutions related to access to care from the perspective of health care team members from Canada and the United States. Methods: Qualitative description method guided the study design. Participants were health care team members, purposefully recruited through Canadian and US-based pediatric weight management program registries. Telephone interviews were conducted with participants between February and May 2017. Interviews were transcribed verbatim and analyzed using content analysis. Results: Eighteen individuals from 16 sites participated (n = 8 Canada, n = 8 United States). Access barriers and potential solutions were related to: (1) referral and eligibility, (2) wait lists and program capacity, (3) logistics and costs, and (4) stigma and weight bias. Barriers were similar between Canadian and US sites, with the exception of cost-related barriers. Conclusions: Health care providers from Canada and the United States reported multiple societal, organizational, service, and family-level barriers to accessing multidisciplinary pediatric weight management care. Proposed solutions suggest that service providers can play a key role alongside families to improve access to appropriate care. Further research is needed to demonstrate the feasibility and effectiveness of proposed solutions.
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Affiliation(s)
- Kristy Wittmeier
- 1Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,2Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Gwenyth H Brockman
- 3George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
| | - Arnaldo Perez Garcia
- 4Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Roberta L Woodgate
- 2Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.,5College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Geoff D C Ball
- 6Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Brandy Wicklow
- 1Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,2Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Sellers
- 1Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,2Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Geert 't Jong
- 1Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,2Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathryn M Sibley
- 3George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada.,7Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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14
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McPherson AC, Biddiss E, Chen L, Church PT, de Groot JF, Keenan S, King G, Lui T, Maltais DB, Mérette C, Moffet H, Moola F, Schwellnus H. Children and Teens in Charge of their Health (CATCH): A protocol for a feasibility randomised controlled trial of solution-focused coaching to foster healthy lifestyles in childhood disability. BMJ Open 2019; 9:e025119. [PMID: 30837255 PMCID: PMC6429893 DOI: 10.1136/bmjopen-2018-025119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Children with physical disabilities are rarely included in interventions to promote healthy lifestyles, despite being at higher risk for suboptimal dietary and physical activity behaviours. The Children and Teens in Charge of their Health study explores the feasibility and acceptability of conducting a randomised controlled trial (RCT) of a strengths-based, solution-focused coaching intervention for improving and sustaining physical activity and healthy dietary habits in children and young people with physical disabilities. METHODS AND ANALYSIS Thirty children aged 10-18 years with a diagnosis of spina bifida or cerebral palsy who are able to set healthy lifestyle goals will be recruited from two children's rehabilitation hospitals in Ontario, Canada. Participants will be enrolled in the study for twelve months. All participants will receive standard care and printed information about healthy lifestyles. Of the 30 participants, 15 will be randomised to receive a coaching intervention for the first 6 months. Health indicators and psychosocial outcomes will be assessed by blinded assessors four times: at the start of the trial, immediately postintervention (6 months after randomisation), and at 3 and 6 months postintervention (9 and 12 months after randomisation, respectively). Predefined success criteria will be used to assess the feasibility of trial processes such as recruitment, attrition, stratification and intervention fidelity. Acceptability and perceived impact of the intervention will be explored qualitatively. ETHICS AND DISSEMINATION The study has been approved by Holland Bloorview Kids Rehabilitation Hospital's Research Ethics Board (Ref: 17-752). A knowledge translation planning template will be used to ensure our findings have maximum reach. TRIAL REGISTRATION NUMBER NCT03523806.
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Affiliation(s)
- Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Biddiss
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Lorry Chen
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Paige Terrien Church
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Janke F de Groot
- Child Development and Exercise Center, Wilhelmina's Children Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - Sarah Keenan
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Toni Lui
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Desiree B Maltais
- Center for Interdisciplinary Research in Rehabilita, CIUSSS-CN, Quebec City, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Chantal Mérette
- Department of Psychiatry and Neuroscience, Laval University, Quebec City, Quebec, Canada
| | - Hélène Moffet
- Center for Interdisciplinary Research in Rehabilita, CIUSSS-CN, Quebec City, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Fiona Moola
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Heidi Schwellnus
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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15
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Lopez-Vargas P, Tong A, Crowe S, Alexander SI, Caldwell PHY, Campbell DE, Couper J, Davidson A, De S, Fitzgerald DA, Haddad S, Hill S, Howell M, Jaffe A, James LJ, Ju A, Manera KE, McKenzie A, Morrow AM, Odgers HL, Pinkerton R, Ralph AF, Richmond P, Shaw PJ, Singh-Grewal D, van Zwieten A, Wake M, Craig JC. Research priorities for childhood chronic conditions: a workshop report. Arch Dis Child 2019; 104:237-245. [PMID: 30279157 DOI: 10.1136/archdischild-2018-315628] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/25/2018] [Accepted: 08/29/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic conditions are the leading cause of mortality, morbidity and disability in children. However, children and caregivers are rarely involved in identifying research priorities, which may limit the value of research in supporting patient-centred practice and policy. OBJECTIVE To identify priorities of patients, caregivers and health professionals for research in childhood chronic conditions and describe the reason for their choices. SETTING An Australian paediatric hospital and health consumer organisations. METHODS Recruited participants (n=73) included patients aged 8 to 14 years with a chronic condition (n=3), parents/caregivers of children aged 0 to 18 years with a chronic condition (n=19), representatives from consumer organisations (n=13) and health professionals including clinicians, researches (n=38) identified and discussed research priorities. Transcripts were thematically analysed. RESULTS Seventy-eight research questions were identified. Five themes underpinned participants' priorities: maintaining a sense of normality (enabling participation in school, supporting social functioning, promoting understanding and acceptance), empowering self-management and partnership in care (overcoming communication barriers, gaining knowledge and skills, motivation for treatment adherence, making informed decisions, access and understanding of complementary and alternative therapies),strengthening ability to cope (learning to have a positive outlook, preparing for home care management, transitioning to adult services), broadening focus to family (supporting sibling well-being, parental resilience and financial loss, alleviating caregiver burden), and improving quality and scope of health and social care (readdressing variability and inequities, preventing disease complications and treatment side effects, identifying risk factors, improving long-term outcomes, harnessing technology, integrating multidisciplinary services). CONCLUSION Research priorities identified by children, caregivers and health professionals emphasise a focus on life participation, psychosocial well-being, impact on family and quality of care. These priorities may be used by funding and policy organisations in establishing a paediatric research agenda.
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Affiliation(s)
- Pamela Lopez-Vargas
- Kids Research Institute, The Children's Hospital, Westmead, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia
| | - Allison Tong
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Stephen I Alexander
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Department of Nephrology, The Children's Hospital, Westmead, New South Wales, Australia
| | - Patrina Ha Yuen Caldwell
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Department of Nephrology, The Children's Hospital, Westmead, New South Wales, Australia.,Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Dianne E Campbell
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Allergy and Immunology, The Children's Hospital, Westmead, New South Wales, Australia
| | - Jennifer Couper
- Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia.,Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew Davidson
- Department of Anaesthesiology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sukanya De
- Department of Nephrology, The Children's Hospital, Westmead, New South Wales, Australia
| | - Dominic A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital, Westmead, New South Wales, Australia
| | - Suzy Haddad
- Patient and Carer Representative, Sydney, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | - Martin Howell
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam Jaffe
- Department of Respiratory Medicine, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Laura J James
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Angela Ju
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karine E Manera
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Anne McKenzie
- Western Australian Health Translation Network, The University of Western Australia, Perth, Western Australia, Australia
| | - Angie M Morrow
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Kids Rehab, The Children's Hospital, Westmead, New South Wales, Australia
| | - Harrison Lindsay Odgers
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ross Pinkerton
- Hummingbird House - Children's Hospice, Brisbane, Queensland, Australia
| | - Angelique F Ralph
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter Richmond
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,Department of General Paediatrics and Immunology, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia
| | - Peter J Shaw
- Cancer Centre for Children, The Children's Hospital, Westmead, New South Wales, Australia
| | - Davinder Singh-Grewal
- Department of Rheumatology, The Children's Hospital, Westmead, New South Wales, Australia
| | - Anita van Zwieten
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics & The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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16
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Hawwash D, Pinxten W, Bonn NA, Verstraeten R, Kolsteren P, Lachat C. Perspective: Consideration of Values When Setting Priorities in Nutrition Research: Guidance for Transparency. Adv Nutr 2018; 9:671-687. [PMID: 30204831 PMCID: PMC6247169 DOI: 10.1093/advances/nmy039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Nutrition research can guide interventions to tackle the burden of diet-related diseases. Setting priorities in nutrition research, however, requires the engagement of various stakeholders with diverse insights. Consideration of what matters most in research from a scientific, social, and ethical perspective is therefore not an automatic process. Systematic ways to explicitly define and consider relevant values are largely lacking. Here, we review existing nutrition research priority-setting exercises, analyze how values are reported, and provide guidance for transparent consideration of values while setting priorities in nutrition research. Of the 27 (n = 22 peer-reviewed manuscripts and 5 grey literature documents) studies reviewed, 40.7% used a combination of different methods, 59.3% described the represented stakeholders, and 49.1% reported on follow-up activities. All priority-setting exercises were led by research groups based in high-income countries. Via an iterative qualitative content analysis, reported values were identified (n = 22 manuscripts). Three clusters of values (i.e., those related to impact, feasibility, and accountability) were identified. These values were organized in a tool to help those involved in setting research priorities systematically consider and report values. The tool was finalized through an online consultation with 7 international stakeholders. The value-oriented tool for priority setting in nutrition research identifies and presents values that are already implicitly and explicitly represented in priority-setting exercises. It provides guidance to enable explicit deliberation on research priorities from an ethical perspective. In addition, it can serve as a reporting tool to document how value-laden choices are made during priority setting and help foster the accountability of stakeholders involved.
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Affiliation(s)
- Dana Hawwash
- Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium
| | - Wim Pinxten
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Noémie Aubert Bonn
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | | | - Patrick Kolsteren
- Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium
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17
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Walker M, McPherson AC. Weight management services for an underserved population: a rapid review of the literature. Disabil Rehabil 2018; 42:274-282. [DOI: 10.1080/09638288.2018.1497713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Meaghan Walker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Amy C. McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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18
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Odgers HL, Tong A, Lopez-Vargas P, Davidson A, Jaffe A, McKenzie A, Pinkerton R, Wake M, Richmond P, Crowe S, Caldwell PHY, Hill S, Couper J, Haddad S, Kassai B, Craig JC. Research priority setting in childhood chronic disease: a systematic review. Arch Dis Child 2018; 103:942-951. [PMID: 29643102 DOI: 10.1136/archdischild-2017-314631] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/07/2018] [Accepted: 03/12/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate research priority setting approaches in childhood chronic diseases and to describe the priorities of stakeholders including patients, caregivers/families and health professionals. DESIGN We conducted a systematic review of MEDLINE, Embase, PsycINFO and CINAHL from inception to 16 October 2016. Studies that elicited stakeholder priorities for paediatric chronic disease research were eligible for inclusion. Data on the prioritisation process were extracted using an appraisal checklist. Generated priorities were collated into common topic areas. RESULTS We identified 83 studies (n=15 722). Twenty (24%) studies involved parents/caregivers and four (5%) children. The top three health areas were cancer (11%), neurology (8%) and endocrine/metabolism (8%). Priority topic areas were treatment (78%), disease trajectory (48%), quality of life/psychosocial impact (48%), disease onset/prevention (43%), knowledge/self-management (33%), prevalence (30%), diagnostic methods (28%), access to healthcare (25%) and transition to adulthood (12%). The methods included workshops, Delphi techniques, surveys and focus groups/interviews. Specific methods for collecting and prioritising research topics were described in only 60% of studies. Most reviewed studies were conducted in high-income nations. CONCLUSIONS Research priority setting activities in paediatric chronic disease cover many discipline areas and have elicited a broad range of topics. However, child/caregiver involvement is uncommon, and the methods often lack clarity. A systematic and explicit process that involves patients and families in partnership may help to inform a more patient and family-relevant research agenda in paediatric chronic disease.
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Affiliation(s)
- Harrison Lindsay Odgers
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Pamela Lopez-Vargas
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Kid's Research Institute, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Andrew Davidson
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, France.,Department of Anaesthesiology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Adam Jaffe
- Department of Respiratory Medicine, The Sydney Children's Hospital Network, Sydney, New South Wales, Australia.,Discipline of Paediatrics, The University of New South Wales, Sydney, New South Wales, Australia
| | - Anne McKenzie
- Western Australian Health Translation Network, The University of Western Australia, Perth, Western Australia, Australia
| | - Ross Pinkerton
- Department of Oncology, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
| | - Melissa Wake
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, France.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Peter Richmond
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,Departments of General Paediatrics and Immunology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | | | - Patrina Ha Yuen Caldwell
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Nephrology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Sophie Hill
- Center for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | - Jennifer Couper
- Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Suzy Haddad
- Patient and Carer Representative, Sydney, New South Wales, Australia
| | - Behrouz Kassai
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Centre d'Investigation Clinique de Lyon, Lyon, France
| | - Jonathan C Craig
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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19
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Fairbrother G, Dougherty D, Pradhananga R, Simpson LA. Road to the Future: Priorities for Child Health Services Research. Acad Pediatr 2017; 17:814-824. [PMID: 28457940 DOI: 10.1016/j.acap.2017.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 01/21/2017] [Accepted: 04/17/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Prior health services research (HSR) agendas for children have been published, but major ones are now over 15 years old and do not reflect augmented understanding of the drivers and determinants of children's health; recent changes in the organization, financing, and delivery of health care; a growing emphasis on population health; and major demographic shifts in the population. A policy-relevant research agenda that integrates knowledge gained over the past 2 decades is essential to guide future child HSR (CHSR). We sought to develop and disseminate a robust, domestically focused, policy-oriented CHSR agenda. METHODS The new CHSR agenda was developed through a series of consultations with leaders in CHSR and related fields. After each round of consultation, the authors synthesized the previous experts' guidance to help inform subsequent discussions. The multistep process in generation of the agenda included identification of major policy-relevant research domains and specification of high-value research questions for each domain. Stakeholders represented in the discussions included those with expertise in child and family advocacy, adult health, population health, community development, racial and ethnic disparities, women's health, health economics, and government research funders and programs. RESULTS In total, 180 individuals were consulted in developing the research agenda. Six priority domains were identified for future research, including both enduring and emerging emphases: 1) framing children's health issues so that they are compelling to policy-makers; 2) addressing poverty and other social determinants of child health and wellbeing; 3) promoting equity in population health and health care; 4) preventing, diagnosing, and treating high priority health conditions in children; 5) strengthening performance of the health care system; and 6) enhancing the CHSR enterprise. Within these 6 domains, 40 specific topics were identified as the most pertinent for future research. Three overarching and crosscutting themes that affect research across the domains were also noted: the need for syntheses to build on the current, and sometimes extensive, evidence base to avoid duplication; the interrelated nature of the domains, which could lead to synergies in research; and the need for multidisciplinary collaborations in conducting research because research studies will look beyond the health sector. CONCLUSIONS The priorities presented in the agenda are policy-oriented and include a greater emphasis on how findings are framed and communicated to support action. We expect that the agenda will be useful for immediate uptake by investigators and research funders.
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