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Provvidenza CF, Bonder R, McPherson AC. Putting weight-related conversations into practice: Lessons learned from implementing a knowledge translation casebook in a disability context. Child Care Health Dev 2024; 50:e13257. [PMID: 38587273 DOI: 10.1111/cch.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/31/2024] [Accepted: 03/04/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Due to reported challenges experienced by healthcare providers (HCPs) when having weight-related conversations with children with disabilities and their families, a knowledge translation (KT) casebook was developed, providing key communication principles with supportive resources. Our aim was to explore how the KT casebook could be implemented into a disability context. Study objectives were to develop and integrate needs-based implementation supports to help foster the uptake of the KT casebook communication principles. METHODS A sample of nurses, physicians, occupational therapists and physical therapists were recruited from a Canadian paediatric rehabilitation hospital. Informed by the Theoretical Domains Framework, group interviews were conducted with participants to understand barriers to having weight-related conversations in their context. Implementation strategies were developed to deliver the KT casebook content that addressed these identified barriers, which included an education workshop, simulations, printed materials, and a huddle and email strategy. Participant experiences with the implementation supports were captured through workshop evaluations, pre-post surveys and qualitative interviews. Post-implementation interviews were analysed using descriptive content analysis. RESULTS Ten HCPs implemented the KT casebook principles over 6 months. Participants reported that the workshop provided a clear understanding of the KT casebook content. While HCPs appreciated the breadth of the KT casebook, they found the abbreviated printed educational materials more convenient. Strategies developed to address participants' need for a sense of community and opportunities to learn from each other did not achieve their aim. Increased confidence in integrating the KT casebook principles into practice was not demonstrated, due, in part, to having few opportunities to practice. This was partly because of the increase in competing clinical demands at the onset of the COVID-19 pandemic. CONCLUSIONS Despite positive feedback on the product itself, changes in the organisational and environmental context limited the success of the implementation plan. Monitoring and adapting implementation processes in response to unanticipated changes is critical to the success of implementation efforts.
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Affiliation(s)
- Christine F Provvidenza
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Canada
| | - Revi Bonder
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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2
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Darling KE, Warnick J, Guthrie KM, Santos M, Jelalian E. Referral to Adolescent Weight Management Interventions: Qualitative Perspectives From Providers. J Pediatr Psychol 2023; 48:815-824. [PMID: 37776204 PMCID: PMC11009491 DOI: 10.1093/jpepsy/jsad068] [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: 04/25/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVE Current guidelines for treatment of obesity in adolescence include screening and referring youth with obesity to appropriate weight management (WM) care. However, prior work has not explored the referral process to adolescent WM programs, especially for youth from lower-income backgrounds, who are at increased risk of obesity and related negative health outcomes. This qualitative study sought to understand pediatricians' current practices regarding referrals to adolescent WM interventions with a focus on adolescents from lower-income backgrounds. METHODS Individual interviews were conducted with 11 medical providers that had referred at least 5 adolescents from low-income backgrounds to WM interventions. Applied thematic analysis was used for data analysis. RESULTS Identified themes included weight-related discussions with adolescents as potentially fraught, as providers want to address weight-related health concerns while being thoughtful about potential harm. Providers also noted varied factors affecting their decision to refer to WM programs, including health implications, perceived motivation of the patient and family, and availability of programs. Providers identified that many families experience shame or guilt around referral to WM. Few themes were identified regarding impact of income on weight-related conversations with adolescents. CONCLUSION Findings were novel in regard to discussions of weight in adolescents with obesity leading to WM referral. Despite being a primary focus of the present study, few themes were identified regarding specific considerations for adolescents from low-income backgrounds. Future clinical research should focus on provider-focused interventions to increase sensitivity regarding weight-related discussions and attention to diversity, equity, and inclusion.
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Affiliation(s)
- Katherine E Darling
- Weight Control and Diabetes Research Center, The Miriam Hospital, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA
| | - Jennifer Warnick
- Weight Control and Diabetes Research Center, The Miriam Hospital, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA
| | - Kate M Guthrie
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, USA
| | - Melissa Santos
- Division of Pediatric Psychology, Connecticut Children’s Medical Center, USA
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA
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3
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Puhl RM, Lessard LM, Pudney EV, Foster GD, Cardel MI. Motivations for engaging in or avoiding conversations about weight: Adolescent and parent perspectives. Pediatr Obes 2022; 17:e12962. [PMID: 36350198 DOI: 10.1111/ijpo.12962] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Little is known about parent and adolescent motivations for engaging in weight communication. OBJECTIVES To assess parent and adolescent motivations for engaging in, or avoiding, weight communication, and whether these reasons differed across sex, race/ethnicity, weight, and engagement in weight management. METHODS Independent samples of parents (N = 1936) and unrelated adolescents (N = 2032) completed questionnaires assessing their agreement with different reasons they engage in, or avoid, parent-adolescent weight communication, using 7-point Likert scales (strongly-disagree to strongly-agree). RESULTS Parents, irrespective of sex, race/ethnicity, and child's weight status, expressed stronger motivations for engaging in weight communication in order for their child to feel good about his/her weight and body size compared to being motivated because a health professional raised their child's weight as a concern. Adolescent motivations for weight communication with parents stemmed from health concerns and worry about their weight; avoidance stemmed from feeling embarrassed, upset, or not wanting to obsess about weight. Differences emerged across sex and race/ethnicity but were most pronounced by weight status and weight management. CONCLUSION Parents and adolescents have different motivations for engaging in or avoiding weight communication. Protecting adolescents' emotional wellbeing and body esteem are viewed as reasons for both engaging in or avoiding weight communication.
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Affiliation(s)
- Rebecca M Puhl
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA.,Department of Human Development & Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Leah M Lessard
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut, USA
| | - Ellen V Pudney
- Department of Pediatrics, Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Gary D Foster
- WW International, Inc., New York, New York, USA.,Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michelle I Cardel
- WW International, Inc., New York, New York, USA.,Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
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4
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Anderson NN, Gagliardi AR. Development, characteristics and impact of quality improvement casebooks: a scoping review. Health Res Policy Syst 2021; 19:123. [PMID: 34496875 PMCID: PMC8425030 DOI: 10.1186/s12961-021-00777-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background Quality improvement (QI) casebooks, compilations of QI experiences, are one way to share experiential knowledge that healthcare policy-makers, managers and professionals can adapt to their own contexts. However, QI casebook use, characteristics and impact are unknown. We aimed to synthesize published research on QI prevalence, development, characteristics and impact. Methods We conducted a scoping review by searching MEDLINE, EMBASE, CINAHL and SCOPUS from inception to 4 February 2021. We extracted data on study characteristics and casebook definitions, development, characteristics (based on the WIDER [Workgroup for Intervention Development and Evaluation Research] framework) and impact. We reported findings using summary statistics, text and tables. Results We screened 2999 unique items and included five articles published in Canada from 2011 to 2020 describing three studies. Casebooks focused on promoting positive weight-related conversations with children and parents, coordinating primary care-specialist cancer management, and showcasing QI strategies for cancer management. All defined casebooks similarly described real-world experiences of developing and implementing QI strategies that others could learn from, emulate or adapt. In all studies, casebook development was a multistep, iterative, interdisciplinary process that engages stakeholders in identifying, creating and reviewing content. While casebooks differed in QI topic, level of application and scope, cases featured common elements: setting or context, QI strategy details, impacts achieved, and additional tips for implementing strategies. Cases were described with a blend of text, graphics and tools. One study evaluated casebook impact, and found that it enhanced self-efficacy and use of techniques to improve clinical care. Although details about casebook development and characteristics were sparse, we created a template of casebook characteristics, which others can use as the basis for developing or evaluating casebooks. Conclusion Future research is needed to optimize methods for developing casebooks and to evaluate their impact. One approach is to assess how the many QI casebooks available online were developed. Casebooks should be evaluated alone or in combination with other interventions that support QI on a range of outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00777-z.
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Affiliation(s)
- Natalie N Anderson
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
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5
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Abdin S, Heath G, Welch RK. Health professionals' views and experiences of discussing weight with children and their families: A systematic review of qualitative research. Child Care Health Dev 2021; 47:562-574. [PMID: 33565647 DOI: 10.1111/cch.12854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/23/2020] [Accepted: 02/03/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Healthcare professionals are ideally placed to discuss weight management with children and families to treat and prevent childhood obesity. The aim of this review was to collect and synthesize primary research evidence relating to health professional's views and experiences of discussing weight with children and their families. METHODS Systematic searches were conducted using the following databases: MEDLINE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE (OVID), PsycINFO (OVID) and Healthcare Management Information Consortium (HMIC). Twenty-six full text qualitative studies published in English Language journals since inception to October 2019 were included. Papers were quality assessed and synthesized using an inductive thematic analysis approach. RESULTS Data analysis generated five themes: sensitivity of the issue, family-professional relationships, whole systems approach, professional competency and sociocultural context. CONCLUSION Supporting behaviour change through discussion of healthy weight with children and families is an important part of the health professional's role. Tailored information for professionals, including resources and training, facilitates them to confidently talk to children and families about weight prioritized within interventions. The success of such interventions requires commitment from a range of professionals to ensure healthy weight is tackled through a whole system approach.
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Affiliation(s)
- Shanara Abdin
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, Bristol, UK.,Public Health and Wellbeing, City of Wolverhampton Council, Wolverhampton, UK
| | - Gemma Heath
- Department of Psychology, University of Wolverhampton, Wolverhampton, UK
| | - Richard K Welch
- Public Health and Wellbeing, City of Wolverhampton Council, Wolverhampton, UK
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Puhl RM, Lessard LM. Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice. Curr Obes Rep 2020; 9:402-411. [PMID: 33079337 DOI: 10.1007/s13679-020-00408-8] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW This review summarizes recent evidence on weight stigma experienced by youth with overweight or obesity. We examine the prevalence and sources of weight-based victimization targeting youth, consequences of these stigmatizing experiences for their psychological and physical health, and considerations for addressing weight stigma in clinical practice and pediatric care. RECENT FINDINGS Weight stigma is highly prevalent among youth with high body weight, who are targets of weight-based victimization from peers, parents, and teachers. These experiences place youth at risk for psychological distress (primarily depressive symptoms, low self-esteem, and suicidal ideation), worse social and academic outcomes, and adverse physical health consequences including maladaptive eating behaviors, lower physical activity, substance use, and weight gain. Healthcare professionals and clinicians have important roles to play in efforts to help reduce weight stigma and support youth with obesity. Fundamental to these efforts is the use of supportive, compassionate, and non-stigmatizing communication with youth and their families.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, USA.
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 0610, USA.
| | - Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 0610, USA
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Carsley S, Pope E, Tu K, Parkin PC, Toulany A, Birken CS. Association between Weight Status and Mental Health Service Utilization in Children and Adolescents. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2020; 29:229-240. [PMID: 33184567 PMCID: PMC7595256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous literature reports inconsistent associations between obesity and mental health. The objective of this study was to determine the association between weight status and mental health service utilization in Ontario children and youth. METHODS A cross-sectional study of children 0 to 18 years, identified using primary care electronic medical records from the EMRPC database in Ontario, Canada was conducted. Height and weight data were extracted to calculate BMI and linked to administrative data on mental health related outpatient visits, emergency department visits, and hospitalizations. Multivariable logistic regression models were performed. RESULTS A total of 50,565 children were included. Overall, 2.2% were underweight, 70.4% had a normal weight, 18.3% were overweight, 6.9% had obesity and 2.2% had severe obesity. 28.2% of all children had at least one mental health visit. Multivariable analyses showed children with overweight, obesity, and severe obesity were 1.11 (95% CI 1.05-1.17), 1.18 (95% CI 1.08-1.27) and 1.39 (95% CI 1.22-1.59) times more likely to have an outpatient mental health visit compared to children with normal weight. CONCLUSION Increased weight status was associated with mental health related outpatient visits and emergency department visits. This study may inform policy makers' planning of mental health resources for children with obesity and severe obesity.
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Affiliation(s)
- Sarah Carsley
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
- ICES, Toronto, Ontario
| | - Eliza Pope
- Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario
- Toronto Western Hospital Family Health Team, University Health Network, Toronto, Ontario
| | - Patricia C Parkin
- Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences, the Hospital for Sick Children; Pediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, the Hospital for Sick Children, Toronto, Ontario
- Department of Pediatric Medicine, University of Toronto, Toronto, Ontario
| | - Alene Toulany
- ICES, Toronto, Ontario
- Department of Pediatric Medicine, University of Toronto, Toronto, Ontario
| | - Catherine S Birken
- Peter Gilgan Centre for Research and Learning, Child Health Evaluative Sciences, the Hospital for Sick Children; Pediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, the Hospital for Sick Children, Toronto, Ontario
- Department of Pediatric Medicine, University of Toronto, Toronto, Ontario
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8
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Bonder R, Provvidenza CF, Hubley D, McPherson AC. Putting positive weight-related conversations into practice: The pilot implementation of a Knowledge Translation Casebook. Child Care Health Dev 2020; 46:360-368. [PMID: 32083751 DOI: 10.1111/cch.12762] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/17/2020] [Accepted: 01/19/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in discussing weight with children and their parents but report barriers such as lack of training and supports. These barriers are especially prevalent within specialized populations such as children with autism spectrum disorder (ASD). To address this, a Knowledge Translation Casebook on positive weight-related conversations was developed by a research team at a Canadian paediatric hospital. The purpose of the current pre-implementation pilot study was to explore initial acceptability and adoption of the Casebook into clinical settings. METHODS An interactive, multimodal education workshop was created to provide HCPs with knowledge and training on how to have positive weight-related conversations with children and parents. Two workshops were conducted using the same curriculum but delivered either in-person or online. Participants were drawn from a team of clinicians at a teaching hospital whose care focuses on medication management for clients with ASD and clinicians participating in a distance learning programme on best practice care for clients with ASD. Participants completed a demographic questionnaire, workshop evaluation, and a pre-workshop and post-workshop questionnaire. Descriptive statistics were used to summarize demographic, questionnaire, and survey data. Answers to open-ended questions were analysed using content analysis. RESULTS Participants agreed that the workshop gave them a clear understanding of the Casebook's content and helped them easily navigate the Casebook. Based on raw scores, self-efficacy in having weight-related conversations seemed to increase from pre-to post-workshop, but reported weight-management clinical practice scores did not change over time. However, the small sample precluded in-depth statistical analysis. CONCLUSIONS The Casebook was acceptable and appeared to increase self-efficacy about having weight-related conversations with children with ASD and parents. More robust implementation strategies are needed to foster the uptake of best practices in weight-related conversations into clinical practice.
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Affiliation(s)
- Revi Bonder
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Ontario, Canada
| | | | - Darlene Hubley
- Teaching and Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Institute, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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9
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Curtin C, Hyman SL, Boas DD, Hassink S, Broder-Fingert S, Ptomey LT, Gillette MD, Fleming RK, Must A, Bandini LG. Weight Management in Primary Care for Children With Autism: Expert Recommendations. Pediatrics 2020; 145:S126-S139. [PMID: 32238539 DOI: 10.1542/peds.2019-1895p] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Abstract
Research suggests that the prevalence of obesity in children with autism spectrum disorder (ASD) is higher than in typically developing children. The US Preventive Services Task Force and the American Academy of Pediatrics (AAP) have endorsed screening children for overweight and obesity as part of the standard of care for physicians. However, the pediatric provider community has been inadequately prepared to address this issue in children with ASD. The Healthy Weight Research Network, a national research network of pediatric obesity and autism experts funded by the US Health Resources and Service Administration Maternal and Child Health Bureau, developed recommendations for managing overweight and obesity in children with ASD, which include adaptations to the AAP's 2007 guidance. These recommendations were developed from extant scientific evidence in children with ASD, and when evidence was unavailable, consensus was established on the basis of clinical experience. It should be noted that these recommendations do not reflect official AAP policy. Many of the AAP recommendations remain appropriate for primary care practitioners to implement with their patients with ASD; however, the significant challenges experienced by this population in both dietary and physical activity domains, as well as the stress experienced by their families, require adaptations and modifications for both preventive and intervention efforts. These recommendations can assist pediatric providers in providing tailored guidance on weight management to children with ASD and their families.
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Affiliation(s)
- Carol Curtin
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts; .,Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Susan L Hyman
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,University of Rochester Medical Center, Rochester, New York
| | - Diane D Boas
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,The Barbara Bush Children's Hospital, Maine Medical Center, Portland, Maine
| | - Sandra Hassink
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Institute for Healthy Childhood Weight, American Academy of Pediatrics, Itasca, Illinois
| | - Sarabeth Broder-Fingert
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Boston Medical Center and School of Medicine, Boston University, Boston, Massachusetts
| | - Lauren T Ptomey
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,University of Kansas Medical Center, Kansas City, Kansas
| | - Meredith Dreyer Gillette
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Children's Mercy Kansas City and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Richard K Fleming
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,University of Massachusetts Boston, Boston, Massachusetts
| | - Aviva Must
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,School of Medicine, Tufts University, Boston, Massachusetts; and
| | - Linda G Bandini
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, Massachusetts.,Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts
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10
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McPherson AC, Chen L, O'Neil J, Vanderbom KA. Nutrition, metabolic syndrome, and obesity: Guidelines for the care of people with spina bifida. J Pediatr Rehabil Med 2020; 13:637-653. [PMID: 33325412 PMCID: PMC7838992 DOI: 10.3233/prm-200753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Nutritional challenges and a lack of activity can lead to health problems across the lifespan for people with spina bifida. Children and adults with spina bifida are also at greater risk of being classified as overweight or obese compared to their peers without the condition. Therefore, early recognition of nutrition problems, weight management counseling, and timely referrals for evaluation and management of diet and activity can help those with spina bifida and their families achieve a healthy lifestyle. This article details the development of the Nutrition, Metabolic Syndrome and Obesity Guidelines, which are part of the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida. It discusses the identification and management of poor nutrition and prevention of obesity for children, adolescents, and adults with spina bifida and highlights areas requiring further research.
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Affiliation(s)
- Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Lorry Chen
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Joseph O'Neil
- Indiana University School of Medicine, Riley Hospital for Children Indiana University Health, Indianapolis, IN, USA
| | - Kerri A Vanderbom
- National Center on Health, Physical Activity and Disability, University of Alabama at Birmingham/Lakeshore Research Collaborative, Birmingham, AL, USA
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