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Croft RL, Byrd CT. A pilot study of an online self-compassion intervention for adults who stutter. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:518-531. [PMID: 37572047 PMCID: PMC10859552 DOI: 10.1080/17549507.2023.2236813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
PURPOSE The primary aim of this pilot study was to determine the preliminary effectiveness of an online self-compassion intervention for improving self-compassion and quality of life in adults who stutter. A secondary aim was to determine intervention acceptability and participant satisfaction. METHOD Participants included adults who stutter who completed an online self-compassion module once a week for six consecutive weeks. Pre- and post-intervention measures included the Self-Compassion Scale-Trait and the Overall Assessment of the Speaker's Experience of Stuttering. Participants also completed acceptability questionnaires weekly and post-intervention via quantitative and qualitative reports. RESULT Ten participants completed all six intervention modules, as well as pre- and post-intervention measures. Participants reported increased self-compassion and improved quality of life at post-intervention, as well as high intervention acceptability with regard to delivery format, content, duration, and relevance to stuttering and daily life. Individual variation was also observed across acceptability domains. CONCLUSION The present study provides pilot data supporting the use of online modules to increase self-compassion and decrease the negative impact of stuttering on the quality of life among adults who stutter. Future studies should employ larger sample sizes, compare outcomes to a control group, and determine if gains are maintained over time.
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Affiliation(s)
- Robyn L Croft
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, TX, USA
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Breda C, Santero S, Conti MV, Cena H. Programmes to manage food selectivity in individuals with autism spectrum disorder. Nutr Res Rev 2024:1-14. [PMID: 38385245 DOI: 10.1017/s0954422424000052] [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: 02/23/2024]
Abstract
Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders characterised by impaired social communication and restricted interests/repetitive behaviours. In this regard, sensory processing difficulties and delayed oral motor skills often predispose individuals with ASD to food selectivity (FS). It is usually associated with repetitive eating patterns that can lead to multiple malnutrition conditions. The objective of this narrative review is to present an overview about the existing nutritional interventions aiming at promoting a healthy eating pattern and addressing food selectivity among individuals with ASD. Regarding the interventions targeting nutrition education, the majority of the analysed studies failed to demonstrate their effectiveness. On the other hand, many educational interventions involving taste or cooking sessions, as well as behavioural interventions for FS, demonstrated effective results. Moreover, multidisciplinary in tailoring such programmes, including psychology speech therapy and nutritional skills, is acknowledged as a key approach.
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Affiliation(s)
- Chiara Breda
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Maria Vittoria Conti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy
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Lai IJ, Chang LC, Lee CK, Liao LL. Preliminary evaluation of a scenario-based nutrition literacy online programme for college students: a pilot study. Public Health Nutr 2023; 26:3190-3201. [PMID: 37927137 PMCID: PMC10755442 DOI: 10.1017/s1368980023002471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 10/03/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE This study aimed to develop and evaluate a scenario-based nutrition literacy (NL) online programme for Taiwanese college students. DESIGN A randomised pilot trial design was used in this study. SETTING The study was conducted at a university in Taiwan. The intervention consisted of a five-unit web-based NL programme including videos of real-life scenario-based stories, situational analysis teaching and after-unit quizzes. Theme-related website information and smartphone apps (both iOS and Android systems) were offered for reference in every unit. The NL measure consisted of a self-rated scale, a scenario-based test and a healthy eating behaviour survey. Paired sample t-tests and ANCOVA were performed to test the effects on NL and healthy eating behaviour. PARTICIPANTS Participants were ninety-eight students, with a retention rate of 98 %. The ratio of men to women was 0·2:1. Most students were freshmen (48 %). RESULTS Compared with the control group, the experimental group showed significant post-intervention improvements in the NL and healthy eating behaviours after controlling for pretest scores. CONCLUSIONS This pilot study offers preliminary evidence of the potential positive effects of implementing a scenario-based NL online programme for college students. It offers a possibly novel strategy to enhance health-promoting behaviours in Taiwanese universities. Further research with larger sample sizes and more rigorous designs is warranted to confirm and build upon these initial findings.
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Affiliation(s)
- I-Ju Lai
- Department of Nutrition, I-Shou University, Kaohsiung, Taiwan
| | - Li-Chun Chang
- Department of Nursing, Chang Gung University of Science and Technology, Gueishan, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Ling Liao
- Department of Public Health, College of Health Science, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung City, Taiwan, 80708, Taiwan
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Mair JL, Salamanca-Sanabria A, Augsburger M, Frese BF, Abend S, Jakob R, Kowatsch T, Haug S. Effective Behavior Change Techniques in Digital Health Interventions for the Prevention or Management of Noncommunicable Diseases: An Umbrella Review. Ann Behav Med 2023; 57:817-835. [PMID: 37625030 PMCID: PMC10498822 DOI: 10.1093/abm/kaad041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Despite an abundance of digital health interventions (DHIs) targeting the prevention and management of noncommunicable diseases (NCDs), it is unclear what specific components make a DHI effective. PURPOSE This narrative umbrella review aimed to identify the most effective behavior change techniques (BCTs) in DHIs that address the prevention or management of NCDs. METHODS Five electronic databases were searched for articles published in English between January 2007 and December 2022. Studies were included if they were systematic reviews or meta-analyses of DHIs targeting the modification of one or more NCD-related risk factors in adults. BCTs were coded using the Behavior Change Technique Taxonomy v1. Study quality was assessed using AMSTAR 2. RESULTS Eighty-five articles, spanning 12 health domains and comprising over 865,000 individual participants, were included in the review. We found evidence that DHIs are effective in improving health outcomes for patients with cardiovascular disease, cancer, type 2 diabetes, and asthma, and health-related behaviors including physical activity, sedentary behavior, diet, weight management, medication adherence, and abstinence from substance use. There was strong evidence to suggest that credible source, social support, prompts and cues, graded tasks, goals and planning, feedback and monitoring, human coaching and personalization components increase the effectiveness of DHIs targeting the prevention and management of NCDs. CONCLUSIONS This review identifies the most common and effective BCTs used in DHIs, which warrant prioritization for integration into future interventions. These findings are critical for the future development and upscaling of DHIs and should inform best practice guidelines.
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Affiliation(s)
- Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
| | - Mareike Augsburger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
- Klenico Health AG, Zurich, Switzerland
| | - Bea Franziska Frese
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
- Centre for Digital Health Interventions, Institute of Technology Management, University of St.Gallen, St.Gallen, Switzerland
| | - Stefanie Abend
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Robert Jakob
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Tobias Kowatsch
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St.Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
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Benajiba N, Alhomidi M, Alsunaid F, Alabdulkarim A, Dodge E, Chavarria EA, Aboul-Enein BH. Video clips of the Mediterranean Diet on YouTube TM: A social Media Content Analysis. Am J Health Promot 2023; 37:366-374. [PMID: 36191140 PMCID: PMC9936443 DOI: 10.1177/08901171221132113] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The present study conducted a social media content analysis on videos describing the Mediterranean Diet (MedDiet) posted onYouTube. SETTING YouTube TM online video sharing and social media platform. METHOD Three independent content experts evaluated 141 YouTube videos on the MedDiet in August 2020 utilizing standard rubric and protocol. Data abstracted include media source(s) of posted videos, and viewer exposure/engagement metrics. Information quality was measured by each content expert independently through use of the DISCERN instrument, a 16-item tool designed to assess reliability, dependability, and trustworthiness of an online source, scores were then aggregated for analysis. RESULTS A majority of videos (n = 102, 72.3%) were educational in nature. A third of videos were less clear and less credible on information presented (n = 46, 32.6%). Most videos were posted by an individual (n = 79, 56%), and the majority of videos were rated as medium quality (n = 88, 62.4%). Overall level of user engagement as measured by number of "likes," "dislikes," and user comments varied widely across all sources of media. Exploratory correlation analysis suggests that the number of a video's views, comments, likes, and dislikes are not correlated with quality. CONCLUSION Study findings suggest that MedDiet health promotion and education via YouTube has the potential to reach and inform clients; however, existing video content and quality varies significantly. Future intervention research focused on MedDiet should further examine possible predictors of high quality MedDiet content utilizing diverse online video sharing platforms.
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Affiliation(s)
- Nada Benajiba
- Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofail University-CNESTEN, Kenitra, Morocco
| | - Maha Alhomidi
- Clinical Nutrition Program, Department of Health Sciences, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fahdah Alsunaid
- Clinical Nutrition Program, Department of Health Sciences, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Aljawharah Alabdulkarim
- Clinical Nutrition Program, Department of Health Sciences, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Elizabeth Dodge
- College of Graduate & Professional Studies, University of New England, Portland, ME, USA
| | - Enmanuel A. Chavarria
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Basil H. Aboul-Enein
- Department of Health Science, Johnson & Wales University, College of Health & Wellness, Providence, RI, USA,Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK,Basil H. Aboul-Enein, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
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Ab Hamid MR, Buhari SS, Md Noor H, Azizan N‘A, Md Nor N. Web-Based Nutrition and Physical Activity Education Intervention to Ameliorate Cardiometabolic Risks: A Single-Arm and Non-Randomized Feasibility Study. J Prim Care Community Health 2023; 14:21501319231214091. [PMID: 38041441 PMCID: PMC10693787 DOI: 10.1177/21501319231214091] [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: 09/06/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the feasibility of the D-PATH website to improve dietary and physical activity management for patients with cardiometabolic risk. METHODS A website called D-PATH was developed, consisting of 6 learning units for managing hypertension. A 4-week program was implemented, and a pre- and post-intervention assessment was conducted to measure acceptability and changes in knowledge, attitude and practice, dietary intake, physical activity, and anthropometric status. RESULTS The D-PATH website was acceptable in terms of understandability, actionability and cognitive load. Knowledge, attitude and practice, and physical activity levels were improved, but no changes were noted for dietary intake and blood pressure level. CONCLUSION The D-PATH website was accepted and feasible for the intervention study. This study has shed light on using the website to promote behavioral change in patients with cardiometabolic risks.
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Sutliffe JT, Lopez NV, Gardner JC, Carnot MJ, Adams AEM. The Nutritarian Women’s Health Study (NWHS): Cohort 1. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221135791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Plant-based dietary patterns are associated with chronic disease risk reduction, prevention, and reversal. As such, the Nutritarian diet is a dietary plan grounded in the daily consumption of micronutrient-dense, plant-rich foods that satisfy nutrient needs with a corresponding improvement in overall health. The Nutritarian Women’s Health Study was a fully-online intervention that included supportive, automated email messages, with participants self-reporting dietary adherence and anthropometric measurements quarterly. Changes in Body Mass Index (BMI) were not significant. The groups with the lowest baseline Waist-to-Height-Ratio (WHtR) showed an initial increase followed by a decrease. Responses related to dietary adherence showed that most participants easily consumed greens, beans, onions/garlic, berries, and seeds, avoided animal products, alcohol, and refined foods, but had difficulty with regularly consuming mushrooms and tomatoes. A midpoint questionnaire revealed participants consumed an overwhelming amount of their meals/snacks according to the dietary plan and about half found it easy/very easy to eat strictly Nutritarian. A large majority reported a positive change in health from participating in the study. The barriers to following the dietary plan include a busy lifestyle and the opposing views/pressures from friends, family, co-workers, and/or spouse/partner. It is important to evaluate this fully-online approach when considering future interventions.
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Affiliation(s)
- Jay T. Sutliffe
- Northern Arizona University, Flagstaff, AZ, USA (JTS, NVL, JCG, AEMA); and Chadron State College, Chadron, NE, USA (MJC)
| | - Nanette V. Lopez
- Northern Arizona University, Flagstaff, AZ, USA (JTS, NVL, JCG, AEMA); and Chadron State College, Chadron, NE, USA (MJC)
| | - Julia C. Gardner
- Northern Arizona University, Flagstaff, AZ, USA (JTS, NVL, JCG, AEMA); and Chadron State College, Chadron, NE, USA (MJC)
| | - Mary Jo Carnot
- Northern Arizona University, Flagstaff, AZ, USA (JTS, NVL, JCG, AEMA); and Chadron State College, Chadron, NE, USA (MJC)
| | - Alison E. M. Adams
- Northern Arizona University, Flagstaff, AZ, USA (JTS, NVL, JCG, AEMA); and Chadron State College, Chadron, NE, USA (MJC)
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Beck Silva KB, Miranda Pereira E, Santana MLPD, Costa PRF, Silva RDCR. Effects of computer-based interventions on food consumption and anthropometric parameters of adolescents: A systematic review and metanalysis. Crit Rev Food Sci Nutr 2022; 64:1617-1631. [PMID: 36062829 DOI: 10.1080/10408398.2022.2118227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This review aimed to systematically assess the effects of computer-based interventions for the promotion of healthy eating on anthropometric indicators and food consumption of adolescents at school. Relevant scientific articles were searched in MEDLINE/PubMed, Embase, Scopus, Lilacs, PsycINFO and Cochrane Library/CENTRAL following the recommendations by PRISMA guide in August 2021. The quality and risk of bias in the studies were assessed by two reviewers independently. The search strategy retained 13 studies for qualitative analysis. In total 9.603 adolescents of both sexes, were recruited in a school environment. According to studies with information for the meta-analysis, a reduction in the average consumption of fats in favor of computer-based intervention was identified (SMD: -0.14; 95% CI -0.24;-0.05). Considering the changes in the consumption of fruits and vegetables (SMD: 0.09; 95% CI -0.08; 0.26) and in the BMI (WMD: -0.02; 95% CI -0.18; 0.14), the analyses did not identify the effect of computer-based interventions on these parameters after follow-up. The results of this review demonstrate that there is evidence of the positive effect of using digital technology (website and CD-ROM) in educational programs with a focus on promoting a healthy lifestyle, with evidence on reducing fat consumption.
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Affiliation(s)
- Karine Brito Beck Silva
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Emile Miranda Pereira
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | | - Priscila Ribas Farias Costa
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Rita de Cássia Ribeiro Silva
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, Bahia, Brazil
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Buro AW, Gray HL, Kirby RS, Marshall J, Strange M, Hasan S, Holloway J. Pilot Study of a Virtual Nutrition Intervention for Adolescents and Young Adults With Autism Spectrum Disorder. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:853-862. [PMID: 36087955 PMCID: PMC10164280 DOI: 10.1016/j.jneb.2022.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Examine the impact of a virtual nutrition education program, Bringing Adolescent Learners with Autism Nutrition and Culinary Education (BALANCE), on dietary intake and psychosocial determinants of healthy eating in adolescents and young adults (AYA) with autism spectrum disorder (ASD). METHODS A sample of AYA with ASD aged 12-21 years (n = 27; 6 groups of 2-7 adolescents) participated in BALANCE, a Social Cognitive Theory-based intervention, for eight 30-45-minute lessons. Outcomes were compared using a pre-post design and included dietary intake (assessed using a food frequency questionnaire) and psychosocial determinants of healthy eating (assessed by a validated survey). Wilcoxon signed-rank tests compared preintervention and postintervention medians with an alpha level of 0.05. RESULTS Mean added sugar intake (P = 0.026) decreased, and behavioral strategies (P = 0.010), self-efficacy (P < 0.001), and outcome expectations (P = 0.009) improved. There was no difference in fruit or vegetable intake or other psychosocial determinants. CONCLUSIONS AND IMPLICATIONS The BALANCE intervention may improve psychosocial determinants and dietary behaviors in AYA with ASD. Future virtual programs may incorporate more assistance and support to be accessible for AYA with ASD of varying severity levels.
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Affiliation(s)
- Acadia W Buro
- College of Public Health, University of South Florida, Tampa, FL; Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL.
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, FL
| | | | - Mikaela Strange
- College of Public Health, University of South Florida, Tampa, FL
| | - Syed Hasan
- College of Public Health, University of South Florida, Tampa, FL
| | - Jamie Holloway
- School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL
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Kracht CL, Hutchesson M, Ahmed M, Müller AM, Ashton LM, Brown HM, DeSmet A, Maher CA, Mauch CE, Vandelanotte C, Yin Z, Whatnall M, Short CE, Staiano AE. E-&mHealth interventions targeting nutrition, physical activity, sedentary behavior, and/or obesity among children: A scoping review of systematic reviews and meta-analyses. Obes Rev 2021; 22:e13331. [PMID: 34476890 PMCID: PMC8865754 DOI: 10.1111/obr.13331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/02/2021] [Accepted: 07/21/2021] [Indexed: 12/16/2022]
Abstract
Childhood obesity is a public health concern. Electronic and mobile health (e-&mHealth) approaches can facilitate the delivery of interventions for obesity prevention and treatment. Synthesizing reviews of e-&mHealth interventions to improve weight and weight-related behaviors (physical activity, sedentary behavior, and diet) is useful to characterize the current scope of the literature and identify opportunities for future reviews and studies. Using a scoping review methodology, we aimed to evaluate the breadth and methodological quality of systematic reviews and meta-analyses of e-&mHealth interventions targeting weight and weight-related behaviors in children and adolescents aged <19 years. A systematic search of seven databases was conducted, including reviews published between 2000 and 2019. Review characteristics were extracted, and methodological quality was assessed using the AMSTAR 2 tool. Forty-five systematic reviews and meta-analyses were included. All reviews evaluated intervention efficacy (100%), but few assessed other aspects (20% in total) such as cost-effectiveness. Smartphone applications (47%), text messages (44%), and websites (35%) were the main modalities. Weight (60%), physical activity (51%), and diet (44%) were frequently assessed, unlike sedentary behavior (8%). Most reviews were rated as having critically low or low methodological quality (97%). Reviews that identify the effective active ingredients of interventions and explore metrics beyond efficacy are recommended.
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Affiliation(s)
- Chelsea L Kracht
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Melinda Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Canada
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,School of Education, Faculty of Education and Arts, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Hannah M Brown
- Hunter New England Population Health, Newcastle, Australia.,Everymind, Newcastle, Australia
| | - Ann DeSmet
- Faculty of Psychology and Educational Sciences, Université Libre de Bruxelles, Brussels, Belgium.,Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Carol A Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Chelsea E Mauch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.,Nutrition and Health Program, Health & Biosecurity Business Unit, CSIRO, Adelaide, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, Australia
| | - Zenong Yin
- Department of Public Health, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Megan Whatnall
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Camille E Short
- Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, University of Melbourne, Parkville, Australia
| | - Amanda E Staiano
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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11
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Prowse R, Carsley S. Digital Interventions to Promote Healthy Eating in Children: Umbrella Review. JMIR Pediatr Parent 2021; 4:e30160. [PMID: 34842561 PMCID: PMC8663671 DOI: 10.2196/30160] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/27/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND eHealth and web-based service delivery have become increasingly common during the COVID-19 pandemic. Digital interventions may be highly appealing to young people; however, their effectiveness compared with that of the usual face-to-face interventions is unknown. As nutrition interventions merge with the digital world, there is a need to determine the best practices for digital interventions for children. OBJECTIVE The aim of this study is to examine the effectiveness of digital nutrition interventions for children on dietary outcomes compared with status quo interventions (eg, conventional face-to-face programming or nondigital support). METHODS We conducted an umbrella review of systematic reviews of studies assessing primary research on digital interventions aimed at improving food and nutrition outcomes for children aged <18 years compared with conventional nutrition education were eligible for inclusion. RESULTS In total, 11 systematic reviews published since 2015 were included (7/11, 64%, were of moderate quality). Digital interventions ranged from internet, computer, or mobile interventions to websites, programs, apps, email, videos, CD-ROMs, games, telehealth, SMS text messages, and social media, or a combination thereof. The dose and duration of the interventions varied widely (single to multiple exposures; 1-60 minutes). Many studies have been informed by theory or used behavior change techniques (eg, feedback, goal-setting, and tailoring). The effect of digital nutrition interventions for children on dietary outcomes is small and inconsistent. Digital interventions seemed to be the most promising for improving fruit and vegetable intake compared with other nutrition outcomes; however, reviews have found mixed results. CONCLUSIONS Owing to the heterogeneity and duration of digital interventions, follow-up evaluations, comparison groups, and outcomes measured, the effectiveness of these interventions remains unclear. High-quality evidence with common definitions for digital intervention types evaluated with validated measures is needed to improve the state of evidence, to inform policy and program decisions for health promotion in children. Now is the time for critical, robust evaluation of the adopted digital interventions during and after the COVID-19 pandemic to establish best practices for nutrition interventions for children.
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Affiliation(s)
- Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.,Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON, Canada
| | - Sarah Carsley
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON, Canada
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12
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Benajiba N, Dodge E, Khaled MB, Chavarria EA, Sammartino CJ, Aboul-Enein BH. Technology-based nutrition interventions using the Mediterranean diet: a systematic review. Nutr Rev 2021; 80:1419-1433. [PMID: 34664675 DOI: 10.1093/nutrit/nuab076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
CONTEXT Over the past 2 decades, overweight and obesity rates have increased exponentially, along with related comorbidities including type 2 diabetes, hypertension, cardiovascular disease, and some cancers. The Mediterranean Diet (MDiet) has been suggested as a potential way to mitigate the health burdens related to overweight and obesity. OBJECTIVE For this review, the literature on MDiet-focused digital interventions was examined to determine efficacy, best practices, and potential limitations. DATA SOURCES The search was conducted across 15 databases for relevant publications published through April 2020 in English, French, Spanish, Arabic, or Italian. DATA EXTRACTION Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using a combination of keywords and phrases and evaluated independently for relevance, merit, and inclusion and exclusion criteria. DATA ANALYSIS The systematic literature review resulted in 15 articles that met the search criteria. Ten interventions were delivered online, and 5 were delivered via smartphone using an app. The majority of online MDiet-focused interventions were effective, particularly when modeled after evidence-based and best-practice online nutrition education interventions. Such interventions also are effective for promoting positive health behaviors and health outcomes, such as increased physical activity, increased levels of high-density lipoprotein cholesterol, and a lower total high-density lipoprotein cholesterol ratio. CONCLUSION Technology-based interventions to educate and promote adherence to the MDiet are successful in helping individuals achieve the stated outcomes. More research is needed to determine the efficacy of MDiet interventions delivered via smartphone apps.
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Affiliation(s)
- Nada Benajiba
- Nada Benajiba is with the Department of Health Basic Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Elizabeth Dodge is with the College of Graduate & Professional Studies, University of New England, Portland, Maine, USA. Meghit Boumédiène Khaled is with the Faculty of Life and Natural Science, Department of Biology, Laboratory of Nutrition, Pathology, Biotechnology and Health, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria. Enmanuel A. Chavarria is with the Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA. Cara J. Sammartino is with the College of Health & Wellness, Department of Health Science, Johnson & Wales University, Providence, Rhode Island, USA. Basil H. Aboul-Enein is with the Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Elizabeth Dodge
- Nada Benajiba is with the Department of Health Basic Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Elizabeth Dodge is with the College of Graduate & Professional Studies, University of New England, Portland, Maine, USA. Meghit Boumédiène Khaled is with the Faculty of Life and Natural Science, Department of Biology, Laboratory of Nutrition, Pathology, Biotechnology and Health, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria. Enmanuel A. Chavarria is with the Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA. Cara J. Sammartino is with the College of Health & Wellness, Department of Health Science, Johnson & Wales University, Providence, Rhode Island, USA. Basil H. Aboul-Enein is with the Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Meghit Boumédiène Khaled
- Nada Benajiba is with the Department of Health Basic Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Elizabeth Dodge is with the College of Graduate & Professional Studies, University of New England, Portland, Maine, USA. Meghit Boumédiène Khaled is with the Faculty of Life and Natural Science, Department of Biology, Laboratory of Nutrition, Pathology, Biotechnology and Health, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria. Enmanuel A. Chavarria is with the Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA. Cara J. Sammartino is with the College of Health & Wellness, Department of Health Science, Johnson & Wales University, Providence, Rhode Island, USA. Basil H. Aboul-Enein is with the Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Enmanuel A Chavarria
- Nada Benajiba is with the Department of Health Basic Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Elizabeth Dodge is with the College of Graduate & Professional Studies, University of New England, Portland, Maine, USA. Meghit Boumédiène Khaled is with the Faculty of Life and Natural Science, Department of Biology, Laboratory of Nutrition, Pathology, Biotechnology and Health, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria. Enmanuel A. Chavarria is with the Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA. Cara J. Sammartino is with the College of Health & Wellness, Department of Health Science, Johnson & Wales University, Providence, Rhode Island, USA. Basil H. Aboul-Enein is with the Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Cara J Sammartino
- Nada Benajiba is with the Department of Health Basic Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Elizabeth Dodge is with the College of Graduate & Professional Studies, University of New England, Portland, Maine, USA. Meghit Boumédiène Khaled is with the Faculty of Life and Natural Science, Department of Biology, Laboratory of Nutrition, Pathology, Biotechnology and Health, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria. Enmanuel A. Chavarria is with the Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA. Cara J. Sammartino is with the College of Health & Wellness, Department of Health Science, Johnson & Wales University, Providence, Rhode Island, USA. Basil H. Aboul-Enein is with the Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Basil H Aboul-Enein
- Nada Benajiba is with the Department of Health Basic Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Elizabeth Dodge is with the College of Graduate & Professional Studies, University of New England, Portland, Maine, USA. Meghit Boumédiène Khaled is with the Faculty of Life and Natural Science, Department of Biology, Laboratory of Nutrition, Pathology, Biotechnology and Health, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria. Enmanuel A. Chavarria is with the Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA. Cara J. Sammartino is with the College of Health & Wellness, Department of Health Science, Johnson & Wales University, Providence, Rhode Island, USA. Basil H. Aboul-Enein is with the Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Buro AW, Gray HL, Kirby RS, Marshall J, Strange M, Pang T, Hasan S, Holloway J. Feasibility of a virtual nutrition intervention for adolescents with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1436-1450. [PMID: 34628975 DOI: 10.1177/13623613211051150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Adolescents with autism spectrum disorder are at an increased risk of unhealthy eating behaviors and obesity compared to their typically developing peers. Many nutrition interventions for this population focus on improving autism spectrum disorder symptoms or managing weight rather than addressing participants' healthy eating self-efficacy. The purpose of this study was to examine a virtual implementation of a new intervention for adolescents with autism spectrum disorder, Bringing Adolescent Learners with Autism Nutrition and Culinary Education. We used fidelity checklists, engagement records, and field notes to measure implementation. We also examined the feasibility of assessing outcome measures, including a food frequency questionnaire (FFQ), psychosocial survey, height, and weight. We recruited adolescents with autism spectrum disorder aged 12-21 years. Six groups of 2-7 adolescents (27 total) participated in the intervention and pre-/post-intervention measurements. Bringing Adolescent Learners with Autism Nutrition and Culinary Education consisted of eight weekly lessons: exploring taste, flavor, and texture; mealtimes and rules; food groups and nutrients; moderation; beverages; cooking; well-being; sustaining healthy eating habits. The virtual implementation was feasible based on lesson attendance, participation, homework completion, fidelity, and prevalence of technical difficulties. Evaluation was also feasible based on response rate, completion, and data quality for the food frequency questionnaire, psychosocial survey, and height and weight measurements. Bringing Adolescent Learners with Autism Nutrition and Culinary Education may be used in virtual settings to reach diverse populations of adolescents with autism spectrum disorder. Future research is needed to evaluate the impact of Bringing Adolescent Learners with Autism Nutrition and Culinary Education on dietary behavior and obesity outcomes.
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Stacey F, Delaney T, Ball K, Zoetemeyer R, Lecathelinais C, Wolfenden L, Seward K, Wyse R. A Cluster Randomized Controlled Trial Evaluating the Impact of Tailored Feedback on the Purchase of Healthier Foods from Primary School Online Canteens. Nutrients 2021; 13:2405. [PMID: 34371914 PMCID: PMC8308818 DOI: 10.3390/nu13072405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
Few online food ordering systems provide tailored dietary feedback to consumers, despite suggested benefits. The study aim was to determine the effect of providing tailored feedback on the healthiness of students' lunch orders from a school canteen online ordering system. A cluster randomized controlled trial with ten government primary schools in New South Wales, Australia was conducted. Consenting schools that used an online canteen provider ('Flexischools') were randomized to either: a graph and prompt showing the proportion of 'everyday' foods selected or a standard online ordering system. Students with an online lunch order during baseline data collection were included (n = 2200 students; n = 7604 orders). Primary outcomes were the proportion of foods classified as 'everyday' or 'caution'. Secondary outcomes included: mean energy, saturated fat, sugar, and sodium content. There was no difference over time between groups on the proportion of 'everyday' (OR 0.99; p = 0.88) or 'caution' items purchased (OR 1.17; p = 0.45). There was a significant difference between groups for average energy content (mean difference 51 kJ; p-0.02), with both groups decreasing. There was no difference in the saturated fat, sugar, or sodium content. Tailored feedback did not impact the proportion of 'everyday' or 'caution' foods or the nutritional quality of online canteen orders. Future research should explore whether additional strategies and specific feedback formats can promote healthy purchasing decisions.
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Affiliation(s)
- Fiona Stacey
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Tessa Delaney
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, VIC 3125, Australia;
| | - Rachel Zoetemeyer
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kirsty Seward
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Rebecca Wyse
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW 2287, Australia; (T.D.); (R.Z.); (C.L.); (L.W.); (K.S.); (R.W.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Hildrey R, Karner H, Serrao J, Lin CA, Shanley E, Duffy VB. Pediatric Adapted Liking Survey (PALS) with Tailored Nutrition Education Messages: Application to a Middle School Setting. Foods 2021; 10:579. [PMID: 33801962 PMCID: PMC8001433 DOI: 10.3390/foods10030579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/23/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022] Open
Abstract
We tested the feasibility of a school-based, liking-based behavioral screener (Pediatric Adapted Liking Survey (PALS)) and message program to motivate healthy diet and activity behaviors. Students, recruited from middle- (n = 195) or low-income (n = 310) schools, online-reported: likes/dislikes of foods/beverages and physical/sedentary activities, scored into healthy behavior indexes (HBI); perceived food insecurity; and sleep indicators. Students received tailored motivating or reinforcing messages (aligned with behavior change theories) and indicated their willingness to improve target behaviors as well as program feasibility (acceptability; usefulness). Although HBIs averaged lower in the lower versus middle-income school, frequencies of food insecurity were similar (39-44% of students). Students in both schools reported sleep concerns (middle-income school-43% reported insufficient hours of sleep/night; low-income school-55% reported excessive daytime sleepiness). Students across both schools confirmed the PALS acceptability (>85% agreement to answering questions quickly and completion without help) and usefulness (≥73% agreed PALS got them thinking about their behaviors) as well as the tailored message acceptability (≥73% reported the messages as helpful; learning new information; wanting to receive more messages) and usefulness (73% reported "liking" to try one behavioral improvement). Neither message type nor response varied significantly by food insecurity or sleep measures. Thus, this program feasibly delivered students acceptable and useful messages to motivate healthier behaviors and identified areas for school-wide health promotion.
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Affiliation(s)
- Rachel Hildrey
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (R.H.); (H.K.); (J.S.); (E.S.)
| | - Heidi Karner
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (R.H.); (H.K.); (J.S.); (E.S.)
| | - Jessica Serrao
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (R.H.); (H.K.); (J.S.); (E.S.)
| | - Carolyn A. Lin
- Communications Department, University of CT, Storrs, CT 06269-1101, USA;
| | - Ellen Shanley
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (R.H.); (H.K.); (J.S.); (E.S.)
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269-1101, USA; (R.H.); (H.K.); (J.S.); (E.S.)
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16
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Werner SS, Binder N, Toews I, Schünemann HJ, Meerpohl JJ, Schwingshackl L. Use of GRADE in evidence syntheses published in high-impact-factor nutrition journals: A methodological survey. J Clin Epidemiol 2021; 135:54-69. [PMID: 33588024 DOI: 10.1016/j.jclinepi.2021.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/08/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To identify and describe the use of the GRADE approach for rating the certainty of evidence in nutrition systematic reviews (SRs). STUDY DESIGN AND SETTING We systematically searched for SRs using GRADE that were published between 2015 and 2019 in the 10 "nutrition" journals with the highest impact factor according to the JCR 2018. RESULTS Out of 800 SRs, 55 SRs of randomized control trials (RCTs) and/or nonrandomized studies (NRSs) used GRADE. Forty-seven SRs (5.9%) rated the outcome specific certainty of evidence (n = 36 in 2018/2019). We identified a total of 465 certainty of evidence outcome ratings (n = 335 RCT ratings), ranging from very-low (28.8%) to low (41%), moderate (26.5%), and high (3.7%). Very-low and high certainty of evidence ratings accounted for 61.4% and 0.8% of ratings in SRs of NRSs, compared to 16.1% and 4.8% in SRs of RCTs. Certainty of evidence was downgraded mostly for risk of bias (37.8%) and imprecision (33%) in SRs of RCTs and for imprecision (32.7%), risk of bias (29.4%) and inconsistency (29%) in SRs of NRSs. CONCLUSION Our study suggests a need for directing more attention toward strengthening acceptance of GRADE as well as building knowledge of the GRADE methodology in nutrition evidence synthesis.
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Affiliation(s)
- Sarah S Werner
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nadine Binder
- Institute of Digitalization in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Ingrid Toews
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, Department of Medicine, McMaster University, Hamilton, Canada
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Integrating Nutrition into Outpatient Oncology Care-A Pilot Trial of the NutriCare Program. Nutrients 2020; 12:nu12113590. [PMID: 33238490 PMCID: PMC7700247 DOI: 10.3390/nu12113590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/11/2020] [Accepted: 11/20/2020] [Indexed: 01/06/2023] Open
Abstract
Nutrition is an essential part of oncology care; however, nutrition advice and guidance are not always provided. This six-week pilot pretest-posttest intervention was designed to test the feasibility and effectiveness of integrating a nutrition education program (NutriCare) into outpatient oncology care. Twenty breast cancer survivors were recruited through Tufts Medical Centre. Nutrition impact symptoms and demographics were collected at baseline, dietary quality and quality of life measures were collected pre and post-intervention and an evaluation form was completed post-intervention. Forty-four percent of eligible participants were recruited, and 90% of those completed the study. The NutriCare program was well received with participants reporting that goals were feasible (94.4%), the program had a positive impact on their diet (77.8%), and over 80% would recommend the program. There was an interest in continuing with the program (89%) and in receiving additional guidance from the healthcare team (83%). There was a significant improvement (p = 0.04) in physical function over the six weeks; however, no additional significant differences in quality of life or dietary quality were seen. In conclusion, cancer survivors were positive about the NutriCare program and its integration into practice.
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