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Beals E, Deierlein A, Katzow M. Clinical interventions to increase vegetable intake in children. Curr Opin Pediatr 2023; 35:138-146. [PMID: 36385196 PMCID: PMC10241539 DOI: 10.1097/mop.0000000000001203] [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] [Indexed: 11/18/2022]
Abstract
PURPOSE OF REVIEW Eating behaviors and dietary patterns begin in early childhood and persist into adolescence and adulthood, affecting lifelong acute and chronic disease risk. Vegetables provide a high density of necessary vitamins, minerals, and fiber. Dietary intake data show that children of all ages consume below the recommended range for vegetables. Pediatric providers are optimally positioned to promote vegetable intake in childhood. This review seeks to summarize lessons learned from behavioral interventions useful in the pediatric primary care setting to improve vegetable intake. RECENT FINDINGS Ten published studies tested behavioral interventions in primary care to increase child vegetable intake. Strategies tested include teaching healthy eating behaviors and role modeling to parents of infants, and motivational interviewing paired with frequent office visits and reminders for families of older children and adolescents. Some strategies suggested positive change, despite study quality being limited by underpowered samples, heterogeneity of outcome measures, and statistical analytic approach. SUMMARY Increased vegetable intake was achieved in infants through parental role-modeling when providers emphasized healthy dietary choices in parents. Older children increased their vegetable intake with motivational interviewing and frequent reminders from providers. Despite the high prevalence of inadequate vegetable intake among children, at present, there is only a modest body of literature to help guide pediatric providers in implementing practice-based interventions to improve vegetable intake in childhood, highlighting a need for high-quality research in this area.
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Affiliation(s)
- Elizabeth Beals
- Cohen Children’s Medical Center at Northwell Health, Queens, New York, USA
| | | | - Michelle Katzow
- Cohen Children’s Medical Center at Northwell Health, Queens, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Queens, New York, USA
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Bel-Serrat S, Greene E, Mullee A, Murrin CM. Theoretical and practical approaches for dietary behavior change in urban socioeconomically disadvantaged adolescents: a systematic review. Nutr Rev 2022; 80:1531-1557. [PMID: 35041005 PMCID: PMC9086747 DOI: 10.1093/nutrit/nuab120] [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] [Indexed: 11/14/2022] Open
Abstract
CONTEXT There is limited evidence on strategies used to promote dietary behavior changes in socioeconomically disadvantaged urban adolescents and on their effectiveness. OBJECTIVE A synthesis of nutrition interventions used in this group of adolescents is provided in this systematic review. DATA SOURCES Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO, and ERIC) were searched until November 2020 to identify relevant studies. DATA EXTRACTION Forty-six manuscripts (n = 38 intervention studies) met the inclusion criteria. Quality was assessed with the Effective Public Health Practice Project Quality Assessment Tool. A qualitative synthesis summarizing data on study characteristics was conducted. DATA ANALYSIS Studies were classified by intervention type as those focusing on hedonic determinants of dietary intake (n = 1), environmental changes to promote a specific dietary intake (n = 3), cognitive determinants (n = 29), and multicomponent strategies (n = 13). The social cognitive theory was the most applied theoretical framework, either alone or combined with other frameworks. Most of the intervention studies targeted multiple dietary outcomes, and success was not always reported for each. CONCLUSIONS Despite the heterogeneity of the studies and lack of combination of dietary outcomes into dietary scores or patterns to evaluate changes on the individuals' whole diets, long-term, theory-driven interventions targeting a single dietary factor seem promising in obtaining sustainable dietary behavior changes. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020188219.
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Affiliation(s)
- Silvia Bel-Serrat
- S. Bel-Serrat, E. Greene, and C.M. Murrin are with the National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. A. Mullee is with the Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
| | - Ellen Greene
- S. Bel-Serrat, E. Greene, and C.M. Murrin are with the National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. A. Mullee is with the Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
| | - Amy Mullee
- S. Bel-Serrat, E. Greene, and C.M. Murrin are with the National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. A. Mullee is with the Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
| | - Celine M Murrin
- S. Bel-Serrat, E. Greene, and C.M. Murrin are with the National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. A. Mullee is with the Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
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3
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Subtyping youngsters with obesity: A theory-based cluster analysis. Appetite 2022; 168:105723. [PMID: 34606939 DOI: 10.1016/j.appet.2021.105723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/15/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022]
Abstract
Psychological mechanisms play a crucial role in explaining weight gain. Aim of the present study was to identify subtypes in youngsters with obesity in line with these mechanisms. Defining homogeneous clusters within this heterogeneous group provides relevant information for personalized treatments. Data were collected in N = 572 participants (51% boys, aged 7-19) with extreme obesity (%BMI M = 187.8; SD = 30.9) recruited in an inpatient treatment centre. Based on psychological models of overweight/obesity, the Affect Regulation Model, the Reward Deficiency Model and The Dual Pathway Model, cluster variables were selected assessing emotional eating, reward reactivity and regulative capacities. Youngsters reported on emotional eating (DEBQ Emotional Eating) and reward sensitivity (BAS), while parents reported on children's regulative Executive Functions (BRIEF). Characteristics of the different clusters were examined concerning weight variables (pre and post treatment) and variables indexing problematic eating (DEBQ External Eating, Ch-EDE), affect regulation (FEEL-KJ) and depressive symptoms (CDI). Hierarchical cluster analyses supported the presence of three clusters, further evaluated by K-means cluster analyses. The cluster solutions differed according to age and sex (boys 7-13, boys 14-19, girls 7-13, girls 14-19). In all four age and gender subsamples, an "Emotional Eating" cluster displaying a vulnerable profile (high depression, maladaptive emotion regulation, problematic eating) and a "Reward Deficiency" cluster displaying a more resilient profile were detected. In girls 7-13, a "Weak Executive Functioning" indicative of insufficient self-regulative capacities, showed moderate to high emotional problems and problematic eating. In the other subgroups, the "Mean Level Functioning" cluster also showed elevated emotional problems and problematic eating. Given that different clusters can be identified, and given that these clusters have different profiles on emotional problems and problematic eating, subtyping youngsters with severe obesity is indicated, setting the stage for personalized treatments.
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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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5
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Blomkvist EAM, Wills AK, Helland SH, Hillesund ER, Øverby NC. Effectiveness of a kindergarten-based intervention to increase vegetable intake and reduce food neophobia amongst 1-year-old children: a cluster randomised controlled trial. Food Nutr Res 2021; 65:7679. [PMID: 34776826 PMCID: PMC8559443 DOI: 10.29219/fnr.v65.7679] [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] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/10/2021] [Accepted: 08/17/2021] [Indexed: 11/20/2022] Open
Abstract
Background Children's first years of life are crucial to their future health. Studies show that a varied diet with a high intake of vegetables is positive in several domains of health. The present low vegetable intake amongst children is, therefore, a concern. Food neophobia is a common barrier to vegetable intake in children. As most Norwegian children attend kindergarten from an early age, kindergartens could contribute to the prevention of food neophobia and the promotion of vegetable intake. Objective The aim of this study was to assess the effect of a cluster randomised trial amongst 1-year-old children in kindergarten to reduce food neophobia and promote healthy eating. Methods Kindergartens were randomly allocated to either a control group or one of two intervention groups. Both intervention groups (diet and diet + Sapere-method) were served a warm lunch meal including three alternating intervention vegetables, whilst the intervention group 2 (diet + Sapere) in addition received tools for weekly sensory lessons. The intervention was digitally administered via information and recipes on a study website. The control group did not receive any information. Parents completed digitally distributed questionnaires addressing food neophobia and food habits at baseline and post-intervention. Results The parents of 144 1-year-old children in 46 kindergartens completed the questionnaires, which were included in the main analysis. The results suggested a higher intake of the intervention vegetables in group 2 (diet + Sapere) compared to the control group. The effect on total vegetable intake was inconclusive. No effect was observed on the level of food neophobia in either of the intervention group. Conclusion This digitally delivered dietary and sensory intervention promoted the intake of intervention-targeted vegetables with inconclusive effect on total vegetable intake due to large loss to follow-up. No effect on the level of food neophobia was detected.
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Affiliation(s)
- Eli Anne Myrvoll Blomkvist
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Andrew K Wills
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Sissel Heidi Helland
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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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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Thorén A, Janson A, Persson M. 'Now she prefers jeans, like everyone else…' - Parents' experiences of group- and web-based treatment of children's obesity. Acta Paediatr 2021; 110:1869-1879. [PMID: 33554379 DOI: 10.1111/apa.15798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/22/2020] [Accepted: 02/03/2021] [Indexed: 12/18/2022]
Abstract
AIM Web-based interventions have shown promising results in paediatric obesity treatment with the potential to increase coverage of care. This study aimed to explore parental experiences about participating in an intervention to improve healthy behaviours and lower BMI-SDS in children with obesity. METHODS This was an interview study with an inductive qualitative approach. Data were collected from individual interviews with 14 parents of 5- to 13-year-old children with obesity. The respondents had participated in a family-based treatment intervention consisting of four group sessions followed by 12-week web-based support. The interviews were analysed using qualitative manifest and latent content. RESULTS The overarching theme 'A transformative journey of lifestyle changes for the whole family' described how the participation impacted the lifestyle of the whole family. Four categories: parental awareness, introducing new routines, negotiating family battles and a feeling of support, represented various experiences made by respondents. The parents shared predominantly positive experiences of the intervention but also expressed feelings of guilt and struggled to address their child's obesity. CONCLUSION Parents who participated in a study for children with obesity with a web-based component found the programme helpful for achieving healthier lifestyles for the whole family.
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Affiliation(s)
- Annelie Thorén
- Department of Clinical Sciences, Pediatrics Umeå University Umeå Sweden
- Department of Pediatrics Sollefteå hospital Sollefteå Sweden
| | - Annika Janson
- National Childhood Obesity Centre Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden
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Mooses K, Taveter K. Agent-Oriented Goal Models in Developing Information Systems Supporting Physical Activity Among Adolescents: Literature Review and Expert Interviews. J Med Internet Res 2021; 23:e24810. [PMID: 34009127 PMCID: PMC8173397 DOI: 10.2196/24810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/28/2020] [Accepted: 04/02/2021] [Indexed: 01/18/2023] Open
Abstract
Background Information and communication technologies (ICTs) are becoming increasingly popular in supporting the fight against low physical activity (PA) levels among adolescents. However, several ICT solutions lack evidence-based content. Therefore, there is a need to identify important features that have the potential to efficiently and consistently support the PA of adolescents using ICT solutions. Objective This study aims to create evidence-based models of requirements for ICT solutions supporting PA by combining scientific evidence from literature and health experts. In addition, we test the suitability of agent-oriented goal models in this type of modeling process. Methods A literature search of PubMed, Web of Science, and Scopus databases was conducted to identify evidence-based functional, quality, and emotional goals that have previously been proven to be relevant in supporting PAs among youth using ICT solutions. The identified goals were presented in the form of goal models. These models were used to collaborate with health experts to receive their input on the topic and suggestions for improvement. The initial goal models were improved based on the feedback from the experts. Results The results indicated that agent-oriented goal modeling is a suitable method for merging information from the literature and experts. One strength of agent-oriented goal models is that they present emotional requirements together with quality and functional requirements. Another strength is the possibility of presenting results from a literature review in a systematic manner and using them thereafter in the communication process with stakeholders. Agent-oriented goal models that were created were easy to understand for health experts without previous experience in requirements engineering, which facilitates and supports collaboration with nontechnical stakeholders. Conclusions The proposed agent-oriented goal models effectively merged information from scientific literature and experts in the field and presented early functional, quality, and emotional requirements in a holistic and coherent manner. We believe that the created models have high potential to help requirements engineers and developers to provide more efficient ICT solutions that support PA among adolescents in the future.
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Affiliation(s)
- Kerli Mooses
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | - Kuldar Taveter
- Institute of Computer Science, University of Tartu, Tartu, Estonia
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9
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Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One 2021; 16:e0250231. [PMID: 33909666 PMCID: PMC8081248 DOI: 10.1371/journal.pone.0250231] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/03/2021] [Indexed: 11/18/2022] Open
Abstract
Web-based parent interventions designed to promote children’s healthy eating patterns can enhance parents’ engagement and facilitate behavior change. However, it is still unclear how much the existing programs focus on changing parental feeding practices, and if so, which behavioral methodologies are used and how effective these interventions are in changing these parental behaviors. This systematic review and meta-analysis studied randomized controlled trials of web-based interventions targeting parents of 0-12-year-old children, aiming to promote children’s healthy diet or prevent nutrition-related problems and reporting parental feeding behaviors as one of the outcomes. We conducted an electronic search in four databases from the earliest publication date until February 2020. Of the 1271 records found, we retained twelve studies about nine programs, comprising 1766 parents that completed the baseline evaluation. We found recent interventions, mainly directed to parents of young children, with small, non-clinical samples, and mostly theory-based. The programs were heterogeneous regarding the type of intervention delivered and its duration. The most assessed parental feeding practices were Restriction, Pressure to eat, and Food availability/accessibility. The behavior change techniques Instruction on how to perform the behavior, Demonstration of the behavior, and Identification of self as role model were frequently used. Meta-analytic results indicated that most programs’ effects were small for the evaluated parental practices, except for Food availability/accessibility that benefited the intervention group only when all follow-up measurements were considered. The development of high-quality and controlled trials with larger samples is needed to determine with greater certainty the interventions’ impact on parental feeding behaviors. The more frequent inclusion of measures to evaluate parental practices to support children’s autonomy and of self-regulatory strategies as intervention components should be considered when designing programs.
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Affiliation(s)
- Ana Isabel Gomes
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
- * E-mail:
| | - Ana Isabel Pereira
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
| | - Magda Sofia Roberto
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
| | - Klara Boraska
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
- Department of Psychology, Catholic University of Croatia, Zagreb, Republic of Croatia
| | - Luisa Barros
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
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10
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Martín-Payo R, Fernández-Álvarez MDM, Zabaleta-del-Olmo E, García-García R, González-Méndez X, Carrasco-Santos S. Feasibility Study of an Educational Intervention to Improve Water Intake in Adolescent Soccer Players: A Two-Arm, Non-Randomized Controlled Cluster Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031339. [PMID: 33540715 PMCID: PMC7908608 DOI: 10.3390/ijerph18031339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the feasibility of an educational intervention on hydration behavior in adolescent soccer players. A pilot study of a two-arm, non-randomized controlled cluster trial was conducted. A total of 316 players aged 13-16 agreed to participate. The response variables were the players' participation in the intervention, their perception of the knowledge acquired, the usefulness and the overall assessment of the intervention. Hydration patterns and acquisition of knowledge on hydration behavior were also assessed. The intervention involved two elements: posters and a web app. A total of 259 adolescents completed the study (intervention group (IG) = 131; control group (CG) = 128). 80.6% of the players responded to the survey assessing the feasibility of the intervention. The mean number of correct answers regarding behavior was significantly higher in the IG (3.54; SD = 1.162) than in the CG (2.64; SD = 1.174) (p < 0.001). The water consumption pattern at all the clubs was ad libitum. Of the players, 10% did not drink any water at all during the game. In conclusion, this intervention has been shown to be feasible for implementation with adolescent soccer players. It suggests that hydration guidelines should be informed by personal factors and that ad libitum water consumption should be avoided.
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Affiliation(s)
- Rubén Martín-Payo
- Faculty of Medicine and Health Sciences, University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain;
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
| | - María del Mar Fernández-Álvarez
- Faculty of Medicine and Health Sciences, University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain;
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Correspondence:
| | - Edurne Zabaleta-del-Olmo
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain;
- Gerència Territorial de Barcelona, Institut Català de la Salut, 08007 Barcelona, Spain
- Nursing Department, Nursing Faculty, Universitat de Girona, 17004 Girona, Spain
- Campus Bellaterra, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Rebeca García-García
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Hospital Universitario Central de Asturias, Avenida Roma s/n, 33011 Oviedo, Spain
| | - Xana González-Méndez
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Hospital Universitario San Agustín de Avilés, Camino de Heros 6, 33401 Avilés, Spain
| | - Sergio Carrasco-Santos
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Hospital Universitario San Agustín de Avilés, Camino de Heros 6, 33401 Avilés, Spain
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11
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Hayba N, Rissel C, Allman Farinelli M. Effectiveness of lifestyle interventions in preventing harmful weight gain among adolescents: A systematic review of systematic reviews. Obes Rev 2021; 22:e13109. [PMID: 32725749 DOI: 10.1111/obr.13109] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022]
Abstract
Obesity in adolescence is associated with stigma during school years, early emergence of co-morbidities in adulthood and premature mortality. Adolescence presents a key window of opportunity to intervene for building healthy eating and physical activity routines and prevent weight gain. This review of reviews assesses the evidence on the effectiveness of prevention interventions conducted with adolescents. Nine reviews assessing the effects of lifestyle interventions in adolescents (defined as age 10 to 19 years old) on weight gain were identified from the 10 health databases searched. Only four reviews conducted meta-analyses, of which, three (two exercise-focused) demonstrated positive changes in primary outcomes of body mass index (BMI) and/or BMI z-score (range of decrease in BMI from 0.06 to 0.47 kg/m2) ). Most were conducted in school settings, and all but two reviews were of low quality. Few reviews reported external validity components that would enable clearer directions for policy makers to implement in real-world settings. More than 140 distinct interventions were included in the reviews, but there remains a serious gap in evidence for effective interventions in adolescents.
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Affiliation(s)
- Nematullah Hayba
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Rissel
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman Farinelli
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Emley E, Dial L, Koerten H, Musher-Eizenman D. Variation in School District Nutrition Policies and Practices: Community Context Matters. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1795753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Vervoort L, Naets T, De Guchtenaere A, Tanghe A, Braet C. Using confidence interval-based estimation of relevance to explore bottom-up and top-down determinants of problematic eating behavior in children and adolescents with obesity from a dual pathway perspective. Appetite 2020; 150:104676. [PMID: 32198094 DOI: 10.1016/j.appet.2020.104676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
Abstract
Prevalence of overweight and obesity in children and adolescents is high, not only in Western countries but also in developing countries. Efforts to improve prevention and treatment programs are needed. Given their essential role in weight problems, knowledge of determinants of problematic eating behavior ('External Eating' and 'Emotional Eating') is crucial for intervention development. Inspired by Appelhans' Dual Process Theory of Eating Behavior, the present study evaluated the importance of top-down regulative capacities and bottom-up reactivity, using the CIBER approach. CIBER is an innovative statistical approach to test the importance of behavior determinants, based on confidence intervals, instead of significance testing of point estimates. Survey data on different aspects of executive functioning (as indices of regulative capacities: Inhibition, Cognitive Flexibility, Emotional Control, Initiation, Working Memory, Planning/Organizing, Organization of materials, and Monitoring) and reward sensitivity (as an index of reactivity) were collected in a large sample of children and adolescents (n = 572) with severe obesity (adjBMI > 180%). Results showed that Emotional Eating is determined by Emotional Control, while External Eating is determined by Reward Sensitivity. The finding that differential mechanisms underlie different aspects of problematic eating suggests the need for using tailored intervention techniques to address altered reactivity and weak regulative capacities.
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Affiliation(s)
- L Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
| | - T Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium; Odisee University College, Department Health Care (Dietetics), Gebroeders de Smetstraat 1, 9000, Gent, Belgium.
| | - A De Guchtenaere
- Zeepreventorium, Koninklijke Baan 5, 8420, De Haan, Belgium; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - A Tanghe
- Zeepreventorium, Koninklijke Baan 5, 8420, De Haan, Belgium.
| | - C Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
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Mannocci A, D’Egidio V, Backhaus I, Federici A, Sinopoli A, Ramirez Varela A, Villari P, La Torre G. Are There Effective Interventions to Increase Physical Activity in Children and Young People? An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3528. [PMID: 32443505 PMCID: PMC7277151 DOI: 10.3390/ijerph17103528] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Obesity and physical inactivity among children and young people are public health concerns. While numerous interventions to promote physical activity are available, little is known about the most effective ones. This study aimed to summarize the existing evidence on interventions that aim to increase physical activity. METHODS A systematic review of reviews was conducted. Systematic reviews and meta-analyses published from January 2010 until November 2017 were identified through PubMed, Scopus and the Cochrane Library. Two reviewers independently assessed titles and abstracts, performed data extraction and quality assessment. Outcomes as level of physical activity and body mass index were collected in order to assess the efficacy of interventions. RESULTS A total 30 studies examining physical activity interventions met the inclusion criteria, 15 systematic reviews and 15 meta-analyses. Most studies (N = 20) were implemented in the school setting, three were developed in preschool and childcare settings, two in the family context, five in the community setting and one miscellaneous context. Results showed that eight meta-analyses obtained a small increase in physical activity level, out of which five were conducted in the school, two in the family and one in the community setting. Most promising programs had the following characteristics: included physical activity in the school curriculum, were long-term interventions, involved teachers and had the support of families. CONCLUSION The majority of interventions to promote physical activity in children and young people were implemented in the school setting and were multicomponent. Further research is needed to investigate nonschool programs.
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Affiliation(s)
- Alice Mannocci
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00182 Rome, Italy; (A.M.); (I.B.); (P.V.); (G.L.T.)
| | - Valeria D’Egidio
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00182 Rome, Italy; (A.M.); (I.B.); (P.V.); (G.L.T.)
| | - Insa Backhaus
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00182 Rome, Italy; (A.M.); (I.B.); (P.V.); (G.L.T.)
| | | | | | | | - Paolo Villari
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00182 Rome, Italy; (A.M.); (I.B.); (P.V.); (G.L.T.)
| | - Giuseppe La Torre
- Department of Public Health and Infectious Disease, Sapienza University of Rome, 00182 Rome, Italy; (A.M.); (I.B.); (P.V.); (G.L.T.)
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Cornejo Müller A, Wachtler B, Lampert T. [Digital divide-social inequalities in the utilisation of digital healthcare]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:185-191. [PMID: 31915863 PMCID: PMC8057990 DOI: 10.1007/s00103-019-03081-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Today, health inequalities are one of the most important issues in public health worldwide. The digitalisation of healthcare is frequently attributed with the potential to reduce health inequalities. At the same time, effective internet usage is a prerequisite of the successful utilisation of digital health interventions. This might be a new obstacle for those who lack the necessary material resources or individual skills.Evidence on how exactly digital health interventions affect health inequalities is scarce. The aim of this study was to present a narrative review of the available literature. The majority of studies showed an association between the usage of digital health interventions and sociodemographic factors. The utilisation was generally higher among younger people and those with higher education and higher income. Only few studies showed no association. Other studies reported higher utilisation among those with higher levels of health literacy while health literacy showed a social gradient to the disadvantage of those in lower socioeconomic position. With a low overall level of evidence, there is currently no indication that digital health interventions are reducing health inequalities.The studies analysed in this review indicate that existing inequalities persist in the digital realm. Further evidence is needed to create a better understanding of the importance of sociodemographic factors for digital health interventions.
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Affiliation(s)
- Alejandro Cornejo Müller
- FG28 Soziale Determinanten der Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Benjamin Wachtler
- FG28 Soziale Determinanten der Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Thomas Lampert
- FG28 Soziale Determinanten der Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
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Brito Beck da Silva K, Ortelan N, Giardini Murta S, Sartori I, Couto RD, Leovigildo Fiaccone R, Lima Barreto M, Jones Bell M, Barr Taylor C, Ribeiro-Silva RDC. Evaluation of the Computer-Based Intervention Program Stayingfit Brazil to Promote Healthy Eating Habits: The Results from a School Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1674. [PMID: 31091683 PMCID: PMC6572183 DOI: 10.3390/ijerph16101674] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/04/2019] [Accepted: 05/05/2019] [Indexed: 12/16/2022]
Abstract
Interventions via the Internet are promising regarding the promotion of healthy habits among youth. The objective of this study was to evaluate the effect of an adapted version of StayingFit to promote healthy eating habits and the measurement adequacy of anthropometric markers among adolescents. A web school-based 12-month cluster-randomized controlled trial examining 7th to 9th grade students was conducted in twelve schools in Salvador, Bahia, Brazil. The schools' students were randomly distributed into the intervention and control groups. The intervention group participated in StayingFit, an online program designed to encourage and guide healthy eating habits and control body weight. Data on food consumption, anthropometry, physical activity level, and sedentary behavior were collected from all of the students at the beginning of and after the 12-month study. Demographic and socioeconomic data were collected at baseline. The baseline data indicated high rates of overweight (14.4% overweight and 8.5% obese), insufficiently active (87.6%), and sedentary (63.7%). Furthermore, few adolescents regularly consumed fruits (18.8%) and vegetables/legumes (16.4%). Generalized estimating equations (GEEs) were used to evaluate the effect of the intervention. At the end of the follow-up period, students in the intervention group had a 43% increased chance of regularly consuming beans (OR = 1.43, 95% CIs = 1.10-1.86) and a 35% decreased chance of regularly consuming soft drinks (OR = 0.65, 95% CIs = 0.50-0.84). No differences were found between the groups studied with regard to the anthropometric parameters. Despite these modest results, the implementation of a web intervention can be beneficial and help promote positive changes in adolescent eating habits.
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Affiliation(s)
- Karine Brito Beck da Silva
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, Salvador, BA 40.110-150, Brazil.
| | - Naiá Ortelan
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Osvaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, Salvador, BA 41745-7115, Brazil.
| | - Sheila Giardini Murta
- Departamento de Psicologia Clínica, Instituto de Psicologia, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, DF 70910-900, Brazil.
| | - Isabel Sartori
- Programa de Engenharia Industrial, PROTEC. Escola Politécnica-PEI, Universidade Federal da Bahia, Rua Aristídes Novis, 02, 6o andar, Federação, Salvador, BA 40210630, Brazil.
| | - Ricardo David Couto
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Bahia 40.170-115, Brasil.
| | - Rosemeire Leovigildo Fiaccone
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Osvaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, Salvador, BA 41745-7115, Brazil.
- Instituto de Matemática, Universidade Federal da Bahia, Av. Adhemar de Barros, s/n, Ondina, Salvador, BA 40.170-110, Brazil.
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Canela, Salvador, BA 40.110-040, Brazil.
| | - Maurício Lima Barreto
- Cidacs-Centro de Integração de Dados e Conhecimentos para Saúde, Instituto Gonçalo Moniz, Fundação Osvaldo Cruz, Ministério da Saúde, Parque Tecnológico da Bahia, Rua Mundo, 121, Trobogy, Salvador, BA 41745-7115, Brazil.
- Instituto Gonçalo Moniz (IGM), Fundação Osvaldo Cruz-FIOCRUZ-Bahia, Av. Waldemar Falcão, 121, Candeal, Salvador, BA 40.296-710, Brazil.
| | - Megan Jones Bell
- Headspace, Inc. 2415 Michigan Avenue, Santa Monica, CA 90404, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Craig Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Rita de Cássia Ribeiro-Silva
- Departamento de Ciências da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Av. Araújo Pinho, 32, Canela, Salvador, BA 40.110-150, Brazil.
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Dial LA, Musher-Eizenman DR. Healthy? Tasty? Children’s evaluative categorization of novel foods. COGNITIVE DEVELOPMENT 2019. [DOI: 10.1016/j.cogdev.2019.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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18
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Willmott TJ, Pang B, Rundle-Thiele S, Badejo A. Weight Management in Young Adults: Systematic Review of Electronic Health Intervention Components and Outcomes. J Med Internet Res 2019; 21:e10265. [PMID: 30724736 PMCID: PMC6381405 DOI: 10.2196/10265] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 01/11/2023] Open
Abstract
Background Young adulthood is a vulnerable period for unhealthy lifestyle adoption and excess weight gain. Scant attention has been focused on developing and evaluating effective weight gain prevention strategies for this age group. Electronic health (eHealth) offers potential as a cost-effective means of delivering convenient, individually-tailored, and contextually-meaningful interventions at scale. Objective The primary aim of this systematic review was to locate and synthesize the evidence on eHealth weight management interventions targeting young adults, with a particular focus on (eHealth) intervention components and outcomes. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was executed across the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EBSCO, EMBASE, Emerald, Education Resources Information Center, Medical Literature Analysis and Retrieval System Online, Ovid, ProQuest, PsycINFO, PubMed, Science Direct, Scopus, and Web of Science. Furthermore, 2 reviewers independently assessed records for eligibility: peer-reviewed, published in English, and report evaluations of eHealth weight management interventions targeting healthy young adults (aged 18-35 years). Data were then extracted from studies that met the criteria for inclusion. The methodological quality of studies was independently assessed by 2 reviewers using the Effective Public Health Practice Project’s (EPHPP) quality assessment tool. A comprehensive narrative evidence synthesis was then completed. Results Out of the 1301 studies assessed for eligibility, 24 met the criteria for inclusion. According to the EPHPP quality assessment tool, overall, 19 studies were as rated weak, 5 as moderate, and none as strong. The narrative synthesis of intervention outcomes found 8 studies reported positive weight-related outcomes, 4 reported mixed outcomes, and 12 did not report any significant changes in weight-related outcomes. The narrative synthesis of (eHealth) intervention components led to 3 levels of classification. A total of 14 studies were classified as Web-based, 3 as mobile-based, and 7 as multicomponent interventions. Following the narrative synthesis, 5 key strategies were thematically identified: self-regulation (goal setting and self-monitoring), tailored or personalized feedback, contact with an interventionist, social support, and behavioral prompts (nudges and reminders) and booster messages. Conclusions Findings highlight the limited evidence base for eHealth weight management interventions targeting young adults. The complex nature of weight management presents an ongoing challenge for interventionists to identify what works, for whom, how, and when. The quality of the evidence in this review was generally assessed as weak; however, assessment tools such as the EPHPP are principally concerned with what should be and this is seldom equivalent to what works. Thus, while sampling, study design and retention rates will remain key determining factors of reliability and validity, further research attention directed toward the development of guiding tools for community trials is warranted.
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Affiliation(s)
- Taylor Jade Willmott
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Bo Pang
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
| | - Abi Badejo
- Social Marketing @ Griffith, Griffith Business School, Griffith University, Nathan, Australia
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Sousa P, Duarte E, Ferreira R, Esperança A, Frontini R, Santos-Rocha R, Luís L, Dias SS, Marques N. An mHealth intervention programme to promote healthy behaviours and prevent adolescent obesity (TeenPower): A study protocol. J Adv Nurs 2019; 75:683-691. [DOI: 10.1111/jan.13905] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/25/2018] [Indexed: 01/12/2023]
Affiliation(s)
- Pedro Sousa
- School of Health Sciences; Polytechnic Institute of Leiria; Leiria Portugal
- Centre for Innovative Care and Health Technology; Polytechnic Institute of Leiria; Castelo Branco Portugal
| | - Emília Duarte
- School of Health Sciences Dr. Lopes Dias; Polytechnic Institute of Castelo Branco; Castelo Branco Portugal
| | - Regina Ferreira
- CIIS-UCP; UI-IPSantarém; School of Health Sciences; Polytechnic Institute of Santarém; Santarem Portugal
| | | | - Roberta Frontini
- Centre for Innovative Care and Health Technology; Polytechnic Institute of Leiria; Castelo Branco Portugal
| | - Rita Santos-Rocha
- Sport Sciences School of Rio Maior; Polytechnic Institute of Santarém; Santarem Portugal
- Neuromechanics of Human Movement Group; Interdisciplinary Centre for the Study of Human Performance; Faculty of Human Kinetics; University of Lisbon; Lisbon Portugal
| | - Luís Luís
- School of Health Sciences; Polytechnic Institute of Leiria; Leiria Portugal
- Centre for Innovative Care and Health Technology; Polytechnic Institute of Leiria; Castelo Branco Portugal
| | - Sara S. Dias
- School of Health Sciences; Polytechnic Institute of Leiria; Leiria Portugal
- Centre for Innovative Care and Health Technology; Polytechnic Institute of Leiria; Castelo Branco Portugal
- EpiDoC Unit; CEDOC; NOVA Medical School; Universidade Nova de Lisboa (NMS-UNL); Lisboa Portugal
| | - Nuno Marques
- Design and Arts Research Lab (LIDA); Observatory on Inclusion and Accessibility in Action (iACT) - CICS.NOVA.IPLeiria; Leiria Portugal
- School of Arts and Design (ESAD.CR); Polytechnic Institute of Leiria; Leiria Portugal
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20
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Chau MM, Burgermaster M, Mamykina L. The use of social media in nutrition interventions for adolescents and young adults-A systematic review. Int J Med Inform 2018; 120:77-91. [PMID: 30409348 PMCID: PMC6983924 DOI: 10.1016/j.ijmedinf.2018.10.001] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 09/12/2018] [Accepted: 10/01/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Social media is a potentially engaging way to support adolescents and young adults in maintaining healthy diets and learning about nutrition. This review identifies interventions that use social media to promote nutrition, examines their content and features, and evaluates the evidence for the use of such platforms among these groups. MATERIAL AND METHODS We conducted a systematic search of 5 databases (PubMed, CINAHL, EMBASE, PsycINFO, and ACM Digital Library) for studies that included: 1) adolescents and/or young adults (ages 10-19; ages 18-25); 2) a nutrition education or behavior change intervention component, or outcomes related to nutrition knowledge or dietary changes; and 3) a social media component that allowed users to communicate or share information with peers. RESULTS 16 articles were identified that included a social media component in a nutrition-related intervention for adolescents or young adults. Interventions included features in 7 categories: social media; communication; tracking health; education; tailoring; social support; and gamification. 11 out of the 16 studies had at least one significant nutrition-related clinical or behavioral outcome. CONCLUSION Social media is a promising feature for nutrition interventions for adolescents and young adults. A limited number of studies were identified that included social media. A majority of the identified studies had positive outcomes. We found that most studies utilized only basic social media features, did not evaluate the efficacy of social media components, and did not differentiate between the efficacy of social media compared to other delivery mechanisms.
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Affiliation(s)
- Michelle M Chau
- Department of Biomedical Informatics, Columbia University, 622 West 168th Street, PH-20, New York, NY, 10032, United States.
| | - Marissa Burgermaster
- Department of Biomedical Informatics, Columbia University, 622 West 168th Street, PH-20, New York, NY, 10032, United States
| | - Lena Mamykina
- Department of Biomedical Informatics, Columbia University, 622 West 168th Street, PH-20, New York, NY, 10032, United States
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21
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Khan KM, Bielko SL, McCullagh MC. Efficacy of hearing conservation education programs for youth and young adults: a systematic review. BMC Public Health 2018; 18:1286. [PMID: 30466413 PMCID: PMC6249850 DOI: 10.1186/s12889-018-6198-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 11/06/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Many youth and young adults experience high noise exposure compounded by lack of access to hearing health education. Although the need for hearing health education programs is evident, the efficacy of these programs for youth is unclear. We evaluated the literature for efficacy of various hearing conservation programs aimed at youth and young adults, and analyzed their strengths and limitations. METHODS Studies reporting results of hearing conservation or hearing loss prevention programs with youth or young adults, using randomized controlled trials, quasi-experimental designs, experimental design, or qualitative research, and published in peer-reviewed journals in English between 2001 and 2018 were included. Studies were found through searches of selected literature databases (i.e., PubMed, Google Scholar, NIOSH Toxline, and Scopus). Identified publications were assessed for relevance, and data were extracted from the studies deemed relevant. RESULTS A total of 10 studies were included. Very little evidence of efficacy of hearing conservation educational programs was found in these studies. Several methodological limitations including lack of rigorous study designs, inadequate power, and application of inappropriate statistical analysis were noted. Some use of technology in programs (e.g., smartphone apps, mobile phone text messages, and computers) was observed, but conclusions as to the effectiveness of these tools were limited by the small number of studies and small sample sizes. CONCLUSIONS The number of studies of educational hearing conservation programs for youth and young adults was low. The efficacy of the program was not reported in most studies, and it is difficult to draw public health conclusions from these studies due to their multiple methodological limitations. While use of technology in hearing conservation educational programs offers promise, its effectiveness has not been studied.
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Affiliation(s)
- Khalid M. Khan
- Department of Environmental Health, School of Public Health, Indiana University-Bloomington, 1025 E Seventh Street, Room 025E, Bloomington, IN 47405 USA
| | - Sylvanna L. Bielko
- Department of Environmental Science, Public Health, and Sustainable Development, School of Applied and Natural Sciences, Taylor University, Upland, IN USA
| | - Marjorie C. McCullagh
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI USA
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Effectiveness and Behavioral Mechanisms of Social Media Interventions for Positive Nutrition Behaviors in Adolescents: A Systematic Review. J Adolesc Health 2018; 63:531-545. [PMID: 30197198 DOI: 10.1016/j.jadohealth.2018.06.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/13/2018] [Accepted: 06/10/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine the effectiveness of social media-based interventions in promoting positive changes in nutrition behaviors amongst adolescents, and identify the behavior change technique(s) (BCT(s)) that were used in effective interventions. METHODS MEDLINE, Embase, PsycINFO, Cinahl, and Cochrane library were systematically searched. Eligible studies included: participants aged 13-18 years; use of one or more social media platform(s) in the intervention; a comparison group not exposed to the social media-based intervention; nutrition- and diet-related behavior outcome(s); and an experimental study design. BCTs were identified using a behavior change taxonomy. Quality and risk of bias assessments were also conducted. RESULTS Seven eligible interventions were included, varying from internet-only programs to in-person programs with internet or website-based component(s). Studies used relatively outdated forms of social media such as purpose-built discussion boards or chat rooms rather than commercial social media interfaces (e.g. Facebook). Five of the seven interventions demonstrated improvements in at least one nutrition behavior. The most common improvement was for fruit or vegetable intake, and two of four studies showed improvements for sugar-sweetened beverage consumption. The most common BCT used was social support, followed by demonstration of behavior, self-monitoring, goal setting, and feedback. CONCLUSIONS The current evidence base is equivocal with respect to changing overall dietary behaviors, as increasing intakes of desirable food groups were more successful than decreasing unfavorable food habits. Further research using better quality interventions, full description of the BCTs, long-term follow-up, and popular contemporary social media platforms to build the evidence base are required.
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Clasby B, Hughes N, Catroppa C, Morrison E. Community-based interventions for adolescents following traumatic brain injury: A systematic review. NeuroRehabilitation 2018; 42:345-363. [PMID: 29660966 DOI: 10.3233/nre-172385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chronic impairment following childhood traumatic brain injury has the potential to increase risk of negative outcomes. This highlights potential value in community-based rehabilitation programs. OBJECTIVES To identify research studies examining existing intervention programmes available in community-based rehabilitation to adolescents following TBI to assist with the transition back into the community. METHODS A systematic review of community-based interventions was conducted across different national contexts. All included studies involved a clinical population with TBI, aged 11 to 25 years inclusive. Risk of bias was rated for each included study. RESULTS Seventeen studies were identified for inclusion in the review, of these eleven distinct interventions were found. The quality of evidence was largely weak and highly variable. CONCLUSION The results suggest some improvement in adolescent outcomes following community-based interventions, however higher quality evidence is needed to support specific interventions.
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Affiliation(s)
- Betony Clasby
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,The University of Birmingham, Birmingham, UK
| | - Nathan Hughes
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,The University of Sheffield, Sheffield, UK.,The University of Melbourne, Melbourne, VIC, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,The University of Melbourne, Melbourne, VIC, Australia
| | - Elle Morrison
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Richardson B, Goldberg L, Aston M, Campbell-Yeo M. eHealth versus equity: Using a feminist poststructural framework to explore the influence of perinatal eHealth resources on health equity. J Clin Nurs 2018; 27:4224-4233. [PMID: 29964310 DOI: 10.1111/jocn.14592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/28/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022]
Abstract
AIMS AND OBJECTIVES To explore whether and how eHealth resources targeted to families during the perinatal period effectively reach a diverse population or further oppress marginalised groups. BACKGROUND eHealth is often intended to reach a broad population, thus health content must be relatively generalised which limits the ability to tailor health education and interventions to individual needs. Generalisation of health information has historically represented a hegemonic depiction of the health consumer, especially within the perinatal period, often disregarding the diversity that exists in the world and perpetuating heteronormative constructs within healthcare systems as a result. DESIGN A critical review of the literature regarding perinatal eHealth resources was conducted using a feminist poststructuralist approach for analysis. Included literature addresses the development, implementation and/or evaluation of perinatal eHealth resources. DISCUSSION This approach uncovered hegemonic discourses related to the current state of perinatal eHealth resources. Nurses and midwives have the unique advantage of interacting and understanding diverse populations. Thus, nurses and midwives are integral to the development, implementation and evaluation of eHealth resources to reduce social health inequity. RELEVANCE TO CLINICAL PRACTICE This paper acts as an exemplar on how to apply feminist poststructuralism to highlight inequities that exist and identifies strategies for nurses and midwives to become involved in the development of eHealth resources or advocate for greater visibility within current resources.
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Affiliation(s)
- Brianna Richardson
- Dalhousie University School of Nursing, Halifax, NS, Canada.,Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Lisa Goldberg
- Dalhousie University School of Nursing, Halifax, NS, Canada
| | - Megan Aston
- Dalhousie University School of Nursing, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- Dalhousie University School of Nursing, Halifax, NS, Canada.,Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
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Chagas CMDS, Pontes e Silva TB, Reffatti LM, Botelho RBA, Toral N. Rango Cards, a digital game designed to promote a healthy diet: a randomized study protocol. BMC Public Health 2018; 18:910. [PMID: 30041639 PMCID: PMC6056995 DOI: 10.1186/s12889-018-5848-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/13/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Several food and nutrition education actions have been described in the literature, with emphasis on the recommended use of innovative methods when addressing a young audience. Digital games are an attractive, dynamic, and motivating resource for teaching and learning practices, and adolescents form the group that readily accepts and adopts new technologies. Adapting dietary and nutritional guidelines to change dietary behavior is a challenge, and game-based learning has several benefits that can be used in this sense. Thus, this study aims to outline a nutritional intervention for school-aged adolescents from the Federal District, Brazil, whose object is a digital card game aimed at promoting healthy dietary practices. METHODS In this randomized study with intervention and control groups, we propose a nutritional intervention for adolescents studying in Federal District private schools. The intervention group will be introduced to Rango Cards, a digital game specifically developed for this study. The purpose of the game is to present the concept of an adequate and healthy diet using simple information in a playful context. This game features cards for foods/meals, characters, and healthy habits. The players' choices may lead them to winning or losing. Theme selection and phase order were designed to provide a learning experience. The control group will not receive any material during the study. Both groups will complete questionnaires before and after the intervention. The game is expected to improve food knowledge and self-efficacy in the adoption of healthy practices, thus contributing to appropriate dietary consumption. DISCUSSION The game was designed as a food and nutrition education tool based on Brazilian dietary guidelines. We believe that Rango Cards will provide a comprehensive experience on the topic, improving the students' autonomy, motivation, and pleasure of learning. TRIAL REGISTRATION RBR-72zvxv June 29, 2018; Retrospectively registered.
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Affiliation(s)
- Carolina Martins dos Santos Chagas
- University of Brasilia School of Health Sciences, Darcy Ribeiro College Campus, Brasilia, Federal District, Postal Code 70910-900 Brazil
| | - Tiago Barros Pontes e Silva
- University of Brasilia Institute of Arts, Darcy Ribeiro College Campus, Brasilia, Federal District, Postal Code 70910-900 Brazil
| | - Luiggi Monteiro Reffatti
- Fira Soft, SGAS 904 Complex A, ASCEB, Block J, 2nd Floor, Brasília, Federal District, Postal Code 70390-040 Brazil
| | - Raquel Braz Assunção Botelho
- University of Brasilia School of Health Sciences, Graduate Program in Human Nutrition, Darcy Ribeiro College Campus, Brasilia, Federal District, Postal Code 70910-900 Brazil
| | - Natacha Toral
- University of Brasilia School of Health Sciences, Graduate Program in Human Nutrition, Darcy Ribeiro College Campus, Brasilia, Federal District, Postal Code 70910-900 Brazil
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Mirzaei A, Nourmoradi H, Zavareh MSA, Jalilian M, Mansourian M, Mazloomi S, Mokhtari N, Mokhtari F. Food Safety Knowledge and Practices of Male Adolescents in West of Iran. Open Access Maced J Med Sci 2018; 6:908-912. [PMID: 29875870 PMCID: PMC5985871 DOI: 10.3889/oamjms.2018.175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/10/2018] [Accepted: 03/23/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND: Every year many people around the world become infected with food-borne infections. Insufficient knowledge and skills related to food safety and hygiene are among the factors affecting the incidence of food-borne diseases, especially in adolescents. AIM: The purpose of this study was to determine the knowledge and practices associated with food safety and hygiene in Ilam city male adolescents. MATERIAL AND METHODS: Three hundred and eighty of male adolescents aged 13 to 19 were selected randomly and entered the cross-sectional study. Data were collected using a researcher-made questionnaire From December 2016 to February 2017. Descriptive statistics, Pearson correlation, independent t-test and one-way ANOVA were used to analyse the data in SPSS software (version 19.0). RESULTS: The findings of the study showed a positive and significant relationship between knowledge and practices related to food safety and hygiene (r = 0.122; p = 0.018). Also, the findings showed that food safety knowledge and practice of adolescents were significantly affected by the level of their education, parental education level, parental employment status and household economic conditions, (p < 0.005). Also, the results showed that the participants generally obtained 57.74% of the knowledge score and 57.63% of practices score. The subjects had the most knowledge about food supply and storage (60%), and the highest practice was related to personal and environmental hygiene, (61.73%). CONCLUSION: The inadequacy of knowledge and performance of adolescents about food safety and hygiene shows the need for implementation of health education interventions in this area.
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Affiliation(s)
- Amin Mirzaei
- Department of Public Health, School of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Heshmatollah Nourmoradi
- Biotechnology and Medical Plant Research Center, Ilam University of Medical Sciences, Ilam, Iran.,Department of Environmental Health, School of Health, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Mohsen Jalilian
- Department of Public Health, School of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sajad Mazloomi
- Department of Environmental Health, School of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Neda Mokhtari
- Department of Psychology, School of Humanities, Islamic Azad University, Ilam, Iran
| | - Fariba Mokhtari
- Department of Public Health, School of Health, Ilam University of Medical Sciences, Ilam, Iran
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Eklund C, Elfström ML, Eriksson Y, Söderlund A. User experiences from a web-based, self-management programme: struggling with what I need when stress management is about me. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1468814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Caroline Eklund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Magnus L. Elfström
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Yvonne Eriksson
- School of Innovation, Design and Engineering, Mälardalen University, Eskilstuna, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Wickham CA, Carbone ET. "Just Say It Like It Is!" Use of a Community-Based Participatory Approach to Develop a Technology-Driven Food Literacy Program for Adolescents. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2017; 38:83-97. [PMID: 29283040 DOI: 10.1177/0272684x17749572] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
FuelUp&Go! is a technology-driven food literacy program consisting of six in-person skill building sessions as well as fitness trackers, text messages, and a companion website. A community-based participatory research approach was used with adolescents who were recruited to participate in a Kid Council. Qualitative data were collected about the use of surveys, program activities, recipes, technology and text messages, and music and incentives. Changes suggested by Kid Councilmembers informed the design and development of a pilot program. Participants were recruited for the pilot program and completed pre- and postintervention surveys. The results indicated food-related knowledge remained low but increased from baseline to follow-up. Attitudes toward vegetables and physical activity increased slightly. Self-reported participation in physical activity and consumption of sugar-added beverages moved in positive directions. These findings suggest that community-based participatory research approach is an effective approach to engage adolescents in the development of a technology-driven food literacy program.
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Scholten MR, Kelders SM, Van Gemert-Pijnen JE. Self-Guided Web-Based Interventions: Scoping Review on User Needs and the Potential of Embodied Conversational Agents to Address Them. J Med Internet Res 2017; 19:e383. [PMID: 29146567 PMCID: PMC5709656 DOI: 10.2196/jmir.7351] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/24/2017] [Accepted: 09/08/2017] [Indexed: 12/28/2022] Open
Abstract
Background Web-based mental health interventions have evolved from innovative prototypes to evidence-based and clinically applied solutions for mental diseases such as depression and anxiety. Open-access, self-guided types of these solutions hold the promise of reaching and treating a large population at a reasonable cost. However, a considerable factor that currently hinders the effectiveness of these self-guided Web-based interventions is the high level of nonadherence. The absence of a human caregiver apparently has a negative effect on user adherence. It is unknown to what extent this human support can be handed over to the technology of the intervention to mitigate this negative effect. Objective The first objective of this paper was to explore what is known in literature about what support a user needs to stay motivated and engaged in an electronic health (eHealth) intervention that requires repeated use. The second objective was to explore the current potential of embodied conversational agents (ECAs) to provide this support. Methods This study reviews and interprets the available literature on (1) support within eHealth interventions that require repeated use and (2) the potential of ECAs by means of a scoping review. The rationale for choosing a scoping review is that the subject is broad, diverse, and largely unexplored. Themes for (1) and (2) were proposed based on grounded theory and mapped on each other to find relationships. Results The results of the first part of this study suggest the presence of user needs that largely remain implicit and unaddressed. These support needs can be categorized as task-related support and emotion-related support. The results of the second part of this study suggest that ECAs are capable of engaging and motivating users of information technology applications in the domains of learning and behavioral change. Longitudinal studies must be conducted to determine under what circumstances ECAs can create and maintain a productive user relationship. Mapping the user needs on the ECAs’ capabilities suggests that different kinds of ECAs may provide different solutions for improving the adherence levels. Conclusions Autonomous ECAs that do not respond to a user’s expressed emotion in real time but take on empathic roles may be sufficient to motivate users to some extent. It is unclear whether those types of ECAs are competent enough and create sufficient believability among users to address the user’s deeper needs for support and empathy. Responsive ECAs may offer a better solution. However, at present, most of these ECAs have difficulties to assess a user’s emotional state in real time during an open dialogue. By conducting future research with relationship theory–based ECAs, the added value of ECAs toward user needs can be better understood.
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Affiliation(s)
- Mark R Scholten
- Centre for eHealth & Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Saskia M Kelders
- Centre for eHealth & Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
| | - Julia Ewc Van Gemert-Pijnen
- Centre for eHealth & Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
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Chamberland K, Sanchez M, Panahi S, Provencher V, Gagnon J, Drapeau V. The impact of an innovative web-based school nutrition intervention to increase fruits and vegetables and milk and alternatives in adolescents: a clustered randomized trial. Int J Behav Nutr Phys Act 2017; 14:140. [PMID: 29037203 PMCID: PMC5644089 DOI: 10.1186/s12966-017-0595-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 10/09/2017] [Indexed: 01/13/2023] Open
Abstract
Background The increase in overweight and obesity in adolescents and its health-related consequences highlight the need to develop strategies, which could help them adopt healthy eating habits. The objective of this study was to evaluate the impact of an innovative web-based school nutrition intervention (Team Nutriathlon) aimed at promoting the consumption of vegetables and fruit (V/F) and milk and alternatives (M/A) in high school students and to identify facilitators and/or barriers influencing its success. Methods Ten classes of first and second year secondary students (grades 7 and 8) from the Québec City region were randomized into two groups (control n = 89 and intervention n = 193). Participants in the intervention (Team Nutriathlon) were to increase their consumption of V/F and M/A using an innovative web-based platform, developed for this study, over 6 weeks. The control group followed the regular school curriculum. The number of servings of V/F and M/A consumed by students per day was compared between the two groups before, during, immediately after and 10 weeks after the intervention using a web-based platform. Main outcome measures included V/F and M/A servings and facilitators and/or barriers of program success. Repeated measures linear fixed effects models were used to assess the impact of Team Nutriathlon on V/F and M/A consumption. A P-value of <0.05 was considered significant. Results Students in the intervention reported a significant increase of 3 servings and 1.8 servings per day of V/F and M/A, respectively, compared to the control group (P < 0.05); however, this was only observed in the short-term. Some factors contributing to the success of Team Nutriathlon included the team aspect of the program, use of the technology and recording results outside of classroom hours. Conclusion Team Nutriathlon represents an innovative web-based nutrition program which positively impacts V/F and M/A consumption among high school students. Using web-based or technological platforms may help youth adopt healthy eating habits that will have implications later in adulthood; however, further studies are needed to determine their long-term effects. Trial registration NCT03117374 (retrospectively registered).
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Affiliation(s)
- Karine Chamberland
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada
| | - Marina Sanchez
- Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada
| | - Shirin Panahi
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada.,Département de Kinésiologie, Université Laval, Québec City, QC, G1V 0A6, Canada
| | - Véronique Provencher
- Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec City, QC, Canada
| | - Jocelyn Gagnon
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada.,Centre de Recherche Interuniversitaire sur la Formation et la Profession Enseignante (CRIFPE-Laval), Université Laval, Québec City, QC, Canada
| | - Vicky Drapeau
- Département de l'éducation Physique, Faculté des Sciences de l'éducation, Université Laval, Québec City, QC, G1V 0A6, Canada. .,Centre de recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada. .,Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec City, QC, Canada. .,Centre de Recherche Interuniversitaire sur la Formation et la Profession Enseignante (CRIFPE-Laval), Université Laval, Québec City, QC, Canada.
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Khan KM, Evans SS, Bielko SL, Rohlman DS. Efficacy of technology-based interventions to increase the use of hearing protections among adolescent farmworkers. Int J Audiol 2017; 57:124-134. [PMID: 28918682 DOI: 10.1080/14992027.2017.1374568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Adolescent farmworkers are exposed to loud noise during farm activities. We present a prospective study that evaluated the efficacy of low-cost, technology-based intervention approaches in high schools to enhance the use of hearing protection among adolescent farmworkers. DESIGN Six high schools in Iowa that agreed to participate in the study were divided into three equal groups through cluster-randomisation with each group receiving one of the three formats of hearing protection intervention: (a) classroom training, (b) classroom training coupled with smartphone app training and (c) computer training. Participants completed baseline (pre-training) and six-week post-intervention surveys for assessing hearing protection knowledge, attitudes and behaviour. STUDY SAMPLE Seventy participants from six schools were initially enrolled but 50 completed both pre- and post-intervention surveys. RESULTS In most cases, all three groups showed significant improvement in hearing protection knowledge, attitude and frequency of use from pre- to post-intervention. However, changes between groups were statistically non-significant. CONCLUSIONS Although all three formats led to improvements on hearing protection knowledge, attitude and behaviour, the findings of the study, perhaps due to the small sample size, did not allow us to detect whether technology-based hearing protection interventions were more effective than the traditional face-to-face training for adolescent farmworkers.
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Affiliation(s)
- Khalid M Khan
- a Department of Environmental Health, School of Public Health , Indiana University , Bloomington , IN , USA and
| | - Sydney S Evans
- a Department of Environmental Health, School of Public Health , Indiana University , Bloomington , IN , USA and
| | - Sylvanna L Bielko
- a Department of Environmental Health, School of Public Health , Indiana University , Bloomington , IN , USA and
| | - Diane S Rohlman
- b Occupational and Environmental Health , College of Public Health, The University of Iowa , Iowa City , IA , USA
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Callender C, Liu Y, Moore CE, Thompson D. The baseline characteristics of parents and African American girls in an online obesity prevention program: A feasibility study. Prev Med Rep 2017; 7:110-115. [PMID: 28652960 PMCID: PMC5477066 DOI: 10.1016/j.pmedr.2017.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/15/2017] [Accepted: 05/15/2017] [Indexed: 12/01/2022] Open
Abstract
The objective of this paper was to identify the relationships and associations between child and parent characteristics with child fruit and vegetable (FV) consumption in an online obesity prevention program for 8-10 year old African American girls. Girls and a parent (n = 342 child-parent pairs) in the southwestern US completed baseline data collection from 2012 to 2014. Girls and a parent completed self-report questionnaires online. Girls also completed two unannounced 24 hour telephone-based dietary recalls. The relationships of parent demographic characteristics, child FV intake, and psychosocial variables (child and parent) were examined by analysis of variance. Pearson correlation coefficients were calculated to determine the relationships between psychosocial variables and child FV intake. Child FV intake was significantly greater in the highest household education (p = 0.001) and income groups (p = 0.004). FV home availability was higher with older parents (p = 0.007) and two-parent households (p = 0.033). Child FV intake was positively related to child FV preferences (p < 0.001), FV home availability (p = 0.022), and FV home accessibility (p = 0.002) but was negatively related to family barriers to FV consumption (p = 0.000). The study highlighted significant findings between child FV consumption and parent psychosocial variables and demographic characteristics that may offer insights for the design of effective obesity prevention interventions for 8-10 year old African American girls. ClinicaTrials.gov (NCT01481948).
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Affiliation(s)
- Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
| | - Carolyn E. Moore
- Texas Woman's University, Department of Nutrition and Food Sciences, 6700 Fannin St, Houston, TX 77030, United States
| | - Deborah Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, United States
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Brumana L, Arroyo A, Schwalbe NR, Lehtimaki S, Hipgrave DB. Maternal and child health services and an integrated, life-cycle approach to the prevention of non-communicable diseases. BMJ Glob Health 2017; 2:e000295. [PMID: 29082005 PMCID: PMC5656183 DOI: 10.1136/bmjgh-2017-000295] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/10/2017] [Accepted: 04/30/2017] [Indexed: 12/31/2022] Open
Abstract
Described as the ‘invisible epidemic’, non-communicable diseases (NCDs) are the world’s leading cause of death. Most are caused by preventable factors, including poor diet, tobacco use, harmful use of alcohol and physical inactivity. Diabetes, cancer and cardiovascular and chronic lung diseases were responsible for 38 million (68%) of global deaths in 2012. Since 1990, proportionate NCD mortality has increased substantially as populations have aged and communicable diseases decline. The majority of NCD deaths, especially premature NCD deaths (<70 years, 82%), occur in low-income and middle-income countries, and among poor communities within them. Addressing NCDs is recognised as central to the post-2015 agenda; accordingly, NCDs have a specific objective and target in the Sustainable Development Goals. While deaths from NCDs occur mainly in adulthood, many have their origins in early life, including through epigenetic mechanisms operating before conception. Good nutrition before conception and interventions aimed at preventing NCDs during the first 1000 days (from conception to age 2 years), childhood and adolescence may be more cost-effective than managing established NCDs in later life with costly tests and drugs. Following a life-course approach, maternal and child health interventions, before delivery and during childhood and adolescence, can prevent NCDs and should influence global health and socioeconomic development. This paper describes how such an approach may be pursued, including through the engagement of non-health sectors. It also emphasises evaluating and documenting related initiatives to underwrite systematic and evidence-based cross-sectoral engagement on NCD prevention in the future.
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Affiliation(s)
- Luisa Brumana
- UNICEF Regional Office for Latin America and the Caribbean, Panama City, Panama
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Latulippe K, Hamel C, Giroux D. Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies. J Med Internet Res 2017; 19:e136. [PMID: 28450271 PMCID: PMC5427250 DOI: 10.2196/jmir.6731] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/09/2017] [Accepted: 03/02/2017] [Indexed: 01/08/2023] Open
Abstract
Background eHealth is developing rapidly and brings with it a promise to reduce social health inequalities (SHIs). Yet, it appears that it also has the potential to increase them. Objectives The general objective of this review was to set out how to ensure that eHealth contributes to reducing SHIs rather than exacerbating them. This review has three objectives: (1) identifying characteristics of people at risk of experiencing social inequality in health; (2) determining the possibilities of developing eHealth tools that avoid increasing SHI; and (3) modeling the process of using an eHealth tool by people vulnerable to SHI. Methods Following the EPPI approach (Evidence for Policy and Practice of Information of the Institute of Education at the University of London), two databases were searched for the terms SHIs and eHealth and their derivatives in titles and abstracts. Qualitative, quantitative, and mixed articles were included and evaluated. The software NVivo (QSR International) was employed to extract the data and allow for a metasynthesis of the data. Results Of the 73 articles retained, 10 were theoretical, 7 were from reviews, and 56 were based on empirical studies. Of the latter, 40 used a quantitative approach, 8 used a qualitative approach, 4 used mixed methods approach, and only 4 were based on participatory research-action approach. The digital divide in eHealth is a serious barrier and contributes greatly to SHI. Ethnicity and low income are the most commonly used characteristics to identify people at risk of SHI. The most promising actions for reducing SHI via eHealth are to aim for universal access to the tool of eHealth, become aware of users’ literacy level, create eHealth tools that respect the cultural attributes of future users, and encourage the participation of people at risk of SHI. Conclusions eHealth has the potential to widen the gulf between those at risk of SHI and the rest of the population. The widespread expansion of eHealth technologies calls for rigorous consideration of interventions, which are not likely to exacerbate SHI.
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Affiliation(s)
- Karine Latulippe
- Department of Studies of Teaching and Learning, Laval University, Québec, QC, Canada
| | - Christine Hamel
- Department of Studies of Teaching and Learning, Laval University, Québec, QC, Canada
| | - Dominique Giroux
- Faculté de médecine, Département de réadaptation, Laval University, Québec, QC, Canada.,Centre d'Excellence du Vieillissement de Québec, Chu de Québec, Québec, QC, Canada
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Meng J, Peng W, Shin SY, Chung M. Online Self-Tracking Groups to Increase Fruit and Vegetable Intake: A Small-Scale Study on Mechanisms of Group Effect on Behavior Change. J Med Internet Res 2017; 19:e63. [PMID: 28264793 PMCID: PMC5359417 DOI: 10.2196/jmir.6537] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 01/04/2017] [Accepted: 02/08/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Web-based interventions with a self-tracking component have been found to be effective in promoting adults' fruit and vegetable consumption. However, these interventions primarily focus on individual- rather than group-based self-tracking. The rise of social media technologies enables sharing and comparing self-tracking records in a group context. Therefore, we developed an online group-based self-tracking program to promote fruit and vegetable consumption. OBJECTIVE This study aims to examine (1) the effectiveness of online group-based self-tracking on fruit and vegetable consumption and (2) characteristics of online self-tracking groups that make the group more effective in promoting fruit and vegetable consumption in early young adults. METHODS During a 4-week Web-based experiment, 111 college students self-tracked their fruit and vegetable consumption either individually (ie, the control group) or in an online group characterized by a 2 (demographic similarity: demographically similar vs demographically diverse) × 2 (social modeling: incremental change vs ideal change) experimental design. Each online group consisted of one focal participant and three confederates as group members or peers, who had their demographics and fruit and vegetable consumption manipulated to create the four intervention groups. Self-reported fruit and vegetable consumption were assessed using the Food Frequency Questionnaire at baseline and after the 4-week experiment. RESULTS Participants who self-tracked their fruit and vegetable consumption collectively with other group members consumed more fruits and vegetables than participants who self-tracked individually (P=.01). The results did not show significant main effects of demographic similarity (P=.32) or types of social modeling (P=.48) in making self-tracking groups more effective in promoting fruit and vegetable consumption. However, additional analyses revealed the main effect of performance discrepancy (ie, difference in fruit and vegetable consumption between a focal participant and his/her group members during the experiment), such that participants who had a low performance discrepancy from other group members had greater fruit and vegetable consumption than participants who had a high performance discrepancy from other group members (P=.002). A mediation test showed that low performance discrepancy led to greater downward contrast (b=-0.78, 95% CI -2.44 to -0.15), which in turn led to greater fruit and vegetable consumption. CONCLUSIONS Online self-tracking groups were more effective than self-tracking alone in promoting fruit and vegetable consumption for early young adults. Low performance discrepancy from other group members lead to downward contrast, which in turn increased participants' fruit and vegetable consumption over time. The study highlighted social comparison processes in online groups that allow for sharing personal health information. Lastly, given the small scale of this study, nonsignificant results with small effect sizes might be subject to bias.
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Affiliation(s)
- Jingbo Meng
- Michigan State University, Department of Communication, East Lansing, MI, United States
| | - Wei Peng
- Michigan State University, Department of Media and Information, East Lansing, MI, United States
| | - Soo Yun Shin
- Michigan State University, Department of Communication, East Lansing, MI, United States
| | - Minwoong Chung
- Michigan State University, Department of Communication, East Lansing, MI, United States
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Park BK, Nahm ES, Rogers VE, Choi M, Friedmann E, Wilson M, Koru G. A Facebook-Based Obesity Prevention Program for Korean American Adolescents: Usability Evaluation. J Pediatr Health Care 2017; 31:57-66. [PMID: 26952300 DOI: 10.1016/j.pedhc.2016.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 02/07/2016] [Accepted: 02/08/2016] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Adolescent obesity is one of the most serious global public health challenges. Social networking sites are currently popular among adolescents. Therefore, the obesity prevention program for Korean American adolescents was developed on the most popular social networking site, Facebook. The purpose of this study was to evaluate the usability of a culturally tailored Facebook-based obesity prevention program for Korean American adolescents (Healthy Teens). METHOD An explorative descriptive design of usability testing was used. Usability testing employing one-on-one observation, the think-aloud method, audio taping, screen activity capture, and surveys was performed. Twenty participants were recruited from two Korean language schools (mean age, 15.40 ± 1.50 years). Recruitment and user testing was performed between February and April 2014. Content analysis, using the inductive coding approach, was performed by three coders to analyze transcriptions. Descriptive statistics were used to analyze quantitative data including demographic characteristics, perceived usability, eHealth literacy, and health behaviors. RESULTS Testing revealed several usability issues in content, appearance, and navigation. Participants' comments regarding content were positive. Although the Facebook platform provided limited flexibility with respect to building the site, participants described the program's appearance as appropriate. Most participants did not experience difficulty in navigating the program. DISCUSSION Our preliminary findings indicated that participants perceived the Healthy Teens program as usable and useful. This program could be used as a robust platform for the delivery of health education to adolescents. Further research is required to assess the effects of Facebook-based programs on adolescent obesity prevention.
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Van Lippevelde W, Vangeel J, De Cock N, Lachat C, Goossens L, Beullens K, Vervoort L, Braet C, Maes L, Eggermont S, Deforche B, Van Camp J. Using a gamified monitoring app to change adolescents' snack intake: the development of the REWARD app and evaluation design. BMC Public Health 2016; 16:725. [PMID: 27494932 PMCID: PMC4974720 DOI: 10.1186/s12889-016-3286-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As the snacking pattern of European adolescents is of great concern, effective interventions are necessary. Till now health promotion efforts in children and adolescents have had only limited success in changing adolescents' eating patterns and anthropometrics. Therefore, the present study proposes an innovative approach to influence dietary behaviors in youth based on new insights on effective behavior change strategies and attractive intervention channels to engage adolescents. This article describes the rationale, the development, and evaluation design of the 'Snack Track School' app. The aim of the app is to improve the snacking patterns of Flemish 14- to 16-year olds. METHODS The development of the app was informed by the systematic, stepwise, iterative, and collaborative principles of the Intervention Mapping protocol. A four week mHealth intervention was developed based on the dual-system model with behavioral change strategies targeting both the reflective (i.e., active learning, advance organizers, mere exposure, goal-setting, monitoring, and feedback) and automatic processes (i.e., rewards and positive reinforcement). This intervention will be evaluated via a controlled pre-post design in Flemish schools among 1400 adolescents. DISCUSSION When this intervention including strategies focused on both the reflective and automatic pathway proves to be effective, it will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion (i.e., incorporation of learning theories in intervention programs). TRIAL REGISTRATION NCT02622165 registrated November 15, 2015 on clinicaltrials.gov.
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Affiliation(s)
- W Van Lippevelde
- Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium.
| | - J Vangeel
- Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 -bus 3603, Leuven, Belgium
| | - N De Cock
- Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium
| | - C Lachat
- Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium
| | - L Goossens
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium
| | - K Beullens
- Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 -bus 3603, Leuven, Belgium
| | - L Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium
| | - C Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium
| | - L Maes
- Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium
| | - S Eggermont
- Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 -bus 3603, Leuven, Belgium
| | - B Deforche
- Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium
| | - J Van Camp
- Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium
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Pedersen S, Grønhøj A, Thøgersen J. Texting your way to healthier eating? Effects of participating in a feedback intervention using text messaging on adolescents' fruit and vegetable intake. HEALTH EDUCATION RESEARCH 2016; 31:171-184. [PMID: 26850061 DOI: 10.1093/her/cyv104] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/20/2015] [Indexed: 06/05/2023]
Abstract
This study investigates the effects of a feedback intervention employing text messaging during 11 weeks on adolescents' behavior, self-efficacy and outcome expectations regarding fruit and vegetable intake. A pre- and post-survey was completed by 1488 adolescents school-wise randomly allocated to a control group and two experimental groups. Both experimental groups set weekly goals on fruit and vegetable intake, reported their consumption daily and subsequently received feedback on their performance via mobile text messaging (Short Message Service [SMS]). The second experimental group also received, in addition, a 45-min nutrition education session from a dietitian during school. The direct effects of the interventions were not significant. However, for adolescents participating in the SMS routines, there were significant effects of the level of engagement in the intervention, reflected in the number of sent text messages, on intervention outcomes. Participants sending more than half of the possible text messages significantly increased their fruit and vegetable intake. Participants sending between 10% and 50% of the possible text messages experienced a significant drop in self-efficacy and those sending less than 10% experienced a significant drop in outcome expectations. The findings suggest that participants' active engagement in an intervention is crucial to its success. Implications for health-promoting interventions are discussed.
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Affiliation(s)
- Susanne Pedersen
- MAPP, Department of Management, Business and Social Sciences, Aarhus University, Bartholins Allé 10, Aarhus C 8000, Denmark
| | - Alice Grønhøj
- MAPP, Department of Management, Business and Social Sciences, Aarhus University, Bartholins Allé 10, Aarhus C 8000, Denmark
| | - John Thøgersen
- MAPP, Department of Management, Business and Social Sciences, Aarhus University, Bartholins Allé 10, Aarhus C 8000, Denmark
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Eldridge G, Paul L, Bailey SJ, Ashe CB, Martz J, Lynch W. Effects of parent-only childhood obesity prevention programs on BMIz and body image in rural preteens. Body Image 2016; 16:143-53. [PMID: 26851605 DOI: 10.1016/j.bodyim.2015.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/13/2015] [Accepted: 12/29/2015] [Indexed: 10/22/2022]
Abstract
This experiment compared body image (BI) and BMI changes resulting from two parent-only obesity prevention interventions aimed at 8-12 year olds. Parents in the experimental intervention attended ten face-to-face educational sessions, while parents in the minimal (control) intervention received similar mailed information. Parent-child dyads (N=150) were semi-randomly assigned to intervention groups. Children were assessed before, after, and 6 months following the interventions; children did not attend experimental intervention sessions. Child BI assessments included weight and size perception, weight management goals, body esteem, and appearance attitudes. Significant effects included small decreases in BMIz scores and overweight dissatisfaction, as well as improvements in aspects of body esteem and appearance attitudes. Some BI effects were gender-specific. Decreases in overweight dissatisfaction were greater following the experimental treatment. Neither treatment reduced body size misperception. Thus, parent-only obesity prevention interventions can reduce body weight and body image concerns among rural preteens.
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Affiliation(s)
- Galen Eldridge
- 4-Health Project, Montana State University Extension, Bozeman, MT 59717, USA.
| | - Lynn Paul
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA.
| | - Sandra J Bailey
- Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA.
| | - Carrie Benke Ashe
- 4-Health Project, Montana State University Extension, Bozeman, MT 59717, USA.
| | - Jill Martz
- 4-Health Project, Montana State University Extension, Bozeman, MT 59717, USA.
| | - Wesley Lynch
- Department of Psychology, Montana State University, Bozeman, MT 59717, USA.
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Kite J, Indig D, Mihrshahi S, Milat A, Bauman A. Assessing the usefulness of systematic reviews for policymakers in public health: A case study of overweight and obesity prevention interventions. Prev Med 2015; 81:99-107. [PMID: 26303371 DOI: 10.1016/j.ypmed.2015.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Systematic reviews (SRs) should include policy-relevant information in order to more readily inform policy and practice. We investigated whether SRs of overweight and obesity prevention interventions are framed in such a way that maximises their usefulness for policymakers. METHOD We conducted a systematic review of SRs of overweight and obesity prevention interventions published in 4 databases any time up to December 2014. We analysed the SRs for their usefulness to policymakers, using a coding frame developed based on literature around what policymakers want and need from systematic reviews. Systematic reviews were assessed for a) policy links and framing; b) quality assessment and conflict of interest statements: and c) discussion of policy implications. RESULTS Of the 153 SRs that met the inclusion criteria, very few (7%) had authors from policy-based organisations, 48% had funding from such organisations, and almost a third (31%) framed their introduction or aims around policy. Most (69%) discussed issues affecting generalisability of the SR findings but only a quarter (24%) discussed cost or cost-effectiveness of the intervention under investigation. Less than a third (29%) of SRs discussed the policy implications of their findings. SRs that were policy-framed were significantly more likely to discuss costs (PR=1.8, 95%CI 1.0-3.0) and policy implications (PR=2.5, 95%CI 1.5-4.0). CONCLUSION SRs should discuss the policy and practice implications of their findings to maximise the influence of SRs on policy making. It is recommended that SR guidelines are updated to include generalisability and discussion of policy and practice implications as a requirement.
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Affiliation(s)
- James Kite
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
| | - Devon Indig
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
| | - Seema Mihrshahi
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
| | - Andrew Milat
- NSW Ministry of Health, 73 Miller St, North Sydney, NSW, Australia.
| | - Adrian Bauman
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
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Avis JLS, Holt NL, Maximova K, van Mierlo T, Fournier R, Padwal R, Cave AL, Martz P, Ball GDC. The Development and Refinement of an e-Health Screening, Brief Intervention, and Referral to Treatment for Parents to Prevent Childhood Obesity in Primary Care. Telemed J E Health 2015; 22:385-94. [PMID: 26451901 DOI: 10.1089/tmj.2015.0128] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Nearly one-third of Canadian children can be categorized as overweight or obese. There is a growing interest in applying e-health approaches to prevent unhealthy weight gain in children, especially in settings that families access regularly. Our objective was to develop and refine an e-health screening, brief intervention, and referral to treatment (SBIRT) for parents to help prevent childhood obesity in primary care. MATERIALS AND METHODS Our SBIRT, titled the Resource Information Program for Parents on Lifestyle and Education (RIPPLE), was developed by our research team and an e-health intervention development company. RIPPLE was based on existing SBIRT models and contemporary literature on children's lifestyle behaviors. Refinements to RIPPLE were guided by feedback from five focus groups (6-10 participants per group) that documented perceptions of the SBIRT by participants (healthcare professionals [n = 20], parents [n = 10], and researchers and graduate trainees [n = 8]). Focus group commentaries were transcribed in real time using a court reporter. Data were analyzed thematically. RESULTS Participants viewed RIPPLE as a practical, well-designed, and novel tool to facilitate the prevention of childhood obesity in primary care. However, they also perceived that RIPPLE may elicit negative reactions from some parents and suggested improvements to specific elements (e.g., weight-related terms). CONCLUSIONS RIPPLE may enhance parents' awareness of children's weight status and motivation to change their children's lifestyle behaviors but should be improved prior to implementation. Findings from this research directly informed revisions to our SBIRT, which will undergo preliminary testing in a randomized controlled trial.
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Affiliation(s)
- Jillian L S Avis
- 1 Department of Pediatrics, University of Alberta , Edmonton, Alberta, Canada
| | - Nicholas L Holt
- 2 Faculty of Physical Education and Recreation, University of Alberta , Edmonton, Alberta, Canada
| | - Katerina Maximova
- 3 School of Public Health, University of Alberta , Edmonton, Alberta, Canada
| | - Trevor van Mierlo
- 4 Evolution Health Systems Inc., Toronto, Ontario, Canada .,5 Business School, University of Reading, Oxfordshire, United Kingdom
| | - Rachel Fournier
- 4 Evolution Health Systems Inc., Toronto, Ontario, Canada .,5 Business School, University of Reading, Oxfordshire, United Kingdom
| | - Raj Padwal
- 6 Department of Medicine, University of Alberta , Edmonton, Alberta, Canada
| | - Andrew L Cave
- 7 Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada
| | - Patricia Martz
- 8 Public Health and Wellness Branch , Health Services Division, Ministry of Health, Government of Alberta, Edmonton, Alberta, Canada
| | - Geoff D C Ball
- 1 Department of Pediatrics, University of Alberta , Edmonton, Alberta, Canada .,9 Pediatric Centre for Weight and Health, Stollery Children's Hospital , Edmonton, Alberta, Canada
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Reinwand DA, Crutzen R, Elfeddali I, Schneider F, Schulz DN, Smit ES, Stanczyk NE, Tange H, Voncken-Brewster V, Walthouwer MJL, Hoving C, de Vries H. Impact of Educational Level on Study Attrition and Evaluation of Web-Based Computer-Tailored Interventions: Results From Seven Randomized Controlled Trials. J Med Internet Res 2015; 17:e228. [PMID: 26446779 PMCID: PMC4642402 DOI: 10.2196/jmir.4941] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/08/2015] [Accepted: 09/22/2015] [Indexed: 11/16/2022] Open
Abstract
Background Web-based computer-tailored interventions have shown to be effective in improving health behavior; however, high dropout attrition is a major issue in these interventions. Objective The aim of this study is to assess whether people with a lower educational level drop out from studies more frequently compared to people with a higher educational level and to what extent this depends on evaluation of these interventions. Methods Data from 7 randomized controlled trials of Web-based computer-tailored interventions were used to investigate dropout rates among participants with different educational levels. To be able to compare higher and lower educated participants, intervention evaluation was assessed by pooling data from these studies. Logistic regression analysis was used to assess whether intervention evaluation predicted dropout at follow-up measurements. Results In 3 studies, we found a higher study dropout attrition rate among participants with a lower educational level, whereas in 2 studies we found that middle educated participants had a higher dropout attrition rate compared to highly educated participants. In 4 studies, no such significant difference was found. Three of 7 studies showed that participants with a lower or middle educational level evaluated the interventions significantly better than highly educated participants (“Alcohol-Everything within the Limit”: F2,376=5.97, P=.003; “My Healthy Behavior”: F2,359=5.52, P=.004; “Master Your Breath”: F2,317=3.17, P=.04). One study found lower intervention evaluation by lower educated participants compared to participants with a middle educational level (“Weight in Balance”: F2,37=3.17, P=.05). Low evaluation of the interventions was not a significant predictor of dropout at a later follow-up measurement in any of the studies. Conclusions Dropout attrition rates were higher among participants with a lower or middle educational level compared with highly educated participants. Although lower educated participants evaluated the interventions better in approximately half of the studies, evaluation did not predict dropout attrition. Further research is needed to find other explanations for high dropout rates among lower educated participants.
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Affiliation(s)
- Dominique A Reinwand
- CAPHRI, Department of Health Promotion, Maastricht University, Maastricht, Netherlands.
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Lee JY, Park HA, Min YH. Transtheoretical Model-based Nursing Intervention on Lifestyle Change: A Review Focused on Intervention Delivery Methods. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:158-67. [PMID: 26160246 DOI: 10.1016/j.anr.2015.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/17/2014] [Accepted: 03/13/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The transtheoretical model (TTM) was used to provide tailored nursing for lifestyle management such as diet, physical activity, and smoking cessation. The present study aims to assess the provision of intervention delivery methods, intervention elements, and stage-matched interventions, in order to identify ways in which information technology is used in the TTM-based research. METHODS The relevant literature was selected by two researchers using inclusion criteria after searching for "TTM (transtheoretical or stage of change)" and "nursing" from the databases PubMed and CINAHL. The selected studies were categorized in terms of study characteristics, intervention delivery method, intervention element, and use and level of stage-matched intervention. RESULTS A total of 35 studies were selected including eight studies that used information communication technology (ICT). Nine different intervention delivery methods were used, of which "face-to-face" was the most common at 24 times. Of the 35 studies, 26 provided stage-matched interventions. Seven different intervention elements were used, of which "counseling" was the most common at 27 times. Of all the intervention elements, tailored feedback used ICT the most at seven instances out of nine, and there was a significant difference in the rate of ICT usage among intervention elements. CONCLUSIONS ICT is not yet actively used in the TTM-based nursing interventions. Stage-matched interventions and TTM concepts were shown to be in partial use also in the TTM-based interventions. Therefore, it is necessary to develop a variety of ways to use ICT in tailored nursing interventions and to use TTM frameworks and concepts.
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Affiliation(s)
- Joo Yun Lee
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Hyeoun-Ae Park
- College of Nursing, Seoul National University, Seoul, South Korea; Systems Biomedical Informatics Research Center, Seoul National University, Seoul, South Korea.
| | - Yul Ha Min
- College of Nursing, Gachon University, Incheon, South Korea
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Reinwand DA, Schulz DN, Crutzen R, Kremers SP, de Vries H. Who Follows eHealth Interventions as Recommended? A Study of Participants' Personal Characteristics From the Experimental Arm of a Randomized Controlled Trial. J Med Internet Res 2015; 17:e115. [PMID: 25963607 PMCID: PMC4468602 DOI: 10.2196/jmir.3932] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/10/2014] [Accepted: 01/14/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Computer-tailored eHealth interventions to improve health behavior have been demonstrated to be effective and cost-effective if they are used as recommended. However, different subgroups may use the Internet differently, which might also affect intervention use and effectiveness. To date, there is little research available depicting whether adherence to intervention recommendations differs according to personal characteristics. OBJECTIVE The aim was to assess which personal characteristics are associated with using an eHealth intervention as recommended. METHODS A randomized controlled trial was conducted among a sample of the adult Dutch population (N=1638) testing an intervention aimed at improving 5 healthy lifestyle behaviors: increasing fruit and vegetable consumption, increasing physical activity, reducing alcohol intake, and promoting smoking cessation. Participants were asked to participate in those specific online modules for which they did not meet the national guideline(s) for the respective behavior(s). Participants who started with fewer than the recommended number of modules of the intervention were defined as users who did not follow the intervention recommendation. RESULTS The fewer modules recommended to participants, the better participants adhered to the intervention modules. Following the intervention recommendation increased when participants were older (χ(2)1=39.8, P<.001), female (χ(2)1=15.8, P<.001), unemployed (χ(2)1=7.9, P=.003), ill (χ(2)1=4.5, P=.02), or in a relationship (χ(2)1=7.8, P=.003). No significant relevant differences were found between groups with different levels of education, incomes, or quality of life. CONCLUSION Our findings indicate that eHealth interventions were used differently by subgroups. The more frequent as-recommended intervention use by unemployed, older, and ill participants may be an indication that these eHealth interventions are attractive to people with a greater need for health care information. Further research is necessary to make intervention use more attractive for people with unhealthy lifestyle patterns.
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Affiliation(s)
- Dominique A Reinwand
- CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, Maastricht, Netherlands.
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Rosenvinge JH, Pettersen G. Epidemiology of eating disorders part III: social epidemiology and case definitions revisited. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/21662630.2015.1022197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Avis JL, Cave AL, Donaldson S, Ellendt C, Holt NL, Jelinski S, Martz P, Maximova K, Padwal R, Wild TC, Ball GD. Working With Parents to Prevent Childhood Obesity: Protocol for a Primary Care-Based eHealth Study. JMIR Res Protoc 2015; 4:e35. [PMID: 25831265 PMCID: PMC4390613 DOI: 10.2196/resprot.4147] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/03/2015] [Accepted: 02/03/2015] [Indexed: 11/13/2022] Open
Abstract
Background Parents play a central role in preventing childhood obesity. There is a need for innovative, scalable, and evidence-based interventions designed to enhance parents’ motivation to support and sustain healthy lifestyle behaviors in their children, which can facilitate obesity prevention. Objective (1) Develop an online screening, brief intervention, and referral to treatment (SBIRT) eHealth tool to enhance parents’ concern for, and motivation to, support children’s healthy lifestyle behaviors, (2) refine the SBIRT eHealth tool by assessing end-user acceptability, satisfaction, and usability through focus groups, and (3) determine feasibility and preliminary effectiveness of the refined SBIRT eHealth tool through a randomized controlled trial. Methods This is a three-phase, multi-method study that includes SBIRT eHealth tool development (Phase I), refinement (Phase II), and testing (Phase III).
Phase I: Theoretical underpinnings of the SBIRT tool, entitled the Resource Information Program for Parents on Lifestyle and Education (RIPPLE), will be informed by concepts applied within existing interventions, and content will be based on literature regarding healthy lifestyle behaviors in children. The SBIRT platform will be developed in partnership between our research team and a third-party intervention development company.
Phase II: Focus groups with parents, as well as health care professionals, researchers, and trainees in pediatrics (n=30), will explore intervention-related perceptions and preferences. Qualitative data from the focus groups will inform refinements to the aesthetics, content, structure, and function of the SBIRT.
Phase III: Parents (n=200) of children—boys and girls, 5 to 17 years old—will be recruited from a primary care pediatric clinic while they await their children’s clinical appointment. Parents will be randomly assigned to one of five groups—four intervention groups and one control group—as they complete the SBIRT. The randomization function is built into the tool. Parents will complete the eHealth SBIRT using a tablet that will be connected to the Internet. Subsequently, parents will be contacted via email at 1-month follow-up to assess (1) change in concern for, and motivation to, support children’s dietary and physical activity behaviors (primary outcome), and (2) use of online resources and referrals to health services for obesity prevention (secondary outcome). Results This research was successfully funded and received ethics approval. Development of the SBIRT started in summer 2012, and we expect all study-related activities to be completed by fall 2016. Conclusions The proposed research is timely and applies a novel, technology-based application designed to enhance parents concern for, and motivation to, support children’s healthy lifestyle behaviors and encourage use of online resources and community services for childhood obesity prevention. Overall, this research builds on a foundation of evidence supporting the application of SBIRTs to encourage or “nudge” individuals to make healthy lifestyle choices. Findings from Phase III of this project will directly inform a cluster randomized controlled trial to study the effectiveness of our intervention across multiple primary care-based settings. Trial Registration ClinicalTrials.gov NCT02330588; http://clinicaltrials.gov/ct2/show/NCT02330588 (Archived by WebCite at http://www.webcitation.org/6WyUOeRlr).
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Affiliation(s)
- Jillian Ls Avis
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
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Cremers HP, Mercken L, Candel M, de Vries H, Oenema A. A Web-based, computer-tailored smoking prevention program to prevent children from starting to smoke after transferring to secondary school: randomized controlled trial. J Med Internet Res 2015; 17:e59. [PMID: 25759248 PMCID: PMC4371791 DOI: 10.2196/jmir.3794] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 11/06/2014] [Accepted: 11/23/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoking prevalence rates among Dutch children increase rapidly after they transit to secondary school, in particular among children with a low socioeconomic status (SES). Web-based, computer-tailored programs supplemented with prompt messages may be able to empower children to prevent them from starting to smoke when they transit to secondary school. OBJECTIVE The main aim of this study is to evaluate whether computer-tailored feedback messages, with and without prompt messages, are effective in decreasing children's smoking intentions and smoking behavior after 12 and 25 months of follow-up. METHODS Data were gathered at baseline (T0), and after 12 months (T1) and 25 months (T2) of follow-up of a smoking prevention intervention program called Fun without Smokes. A total of 162 schools were randomly allocated to a no-intervention control group, an intervention prompt group, or an intervention no-prompt group. A total of 3213 children aged 10 to 12 years old participated in the study and completed a Web-based questionnaire assessing their smoking intention, smoking behavior, and sociocognitive factors, such as attitude, social influence, and self-efficacy, related to smoking. After completion, children in the intervention groups received computer-tailored feedback messages in their own email inbox and those messages could be accessed on the intervention website. Children in the prompt group received prompt messages, via email and short message service (SMS) text messaging, to stimulate them to reuse the intervention website with nonsmoking content. Multilevel logistic regression analyses were performed using multiple imputations to assess the program effects on smoking intention and smoking behavior at T1 and T2. RESULTS A total of 3213 children participated in the Fun without Smokes study at T0. Between T0 and T1 a total of 1067 children out of the original 3213 (33.21%) dropped out of the study. Between T0 and T2 the number of children that did not participate in the final measurement was 1730 out of the original 3213 (53.84%). No significant program effects were observed for any of the intervention groups compared to the control group at T1 for the intention to engage in smoking-prompt, OR 0.67 (95% CI 0.30-1.50), no-prompt, OR 0.76 (95% CI 0.34-1.67)-or for smoking behavior-prompt, OR 1.13 (95% CI 0.13-9.98), no-prompt, OR 0.50 (95% CI 0.04-5.59). Similar nonsignificant program effects were found at T2 for the intention to start smoking-prompt, OR 0.78 (95% CI 0.26-2.32), no-prompt, OR 1.31 (95% CI 0.45-3.82)-and smoking behavior-prompt, OR 0.53 (95% CI 0.12-2.47), no-prompt, OR 1.01 (95% CI 0.24-4.21). CONCLUSIONS This study showed that the Web-based, computer-tailored feedback messages with and without prompt messages were not effective in modifying children's smoking intentions and smoking behavior as compared to no information. Future smoking prevention interventions are recommended to start closer to the age of actual smoking uptake. Furthermore, future studies on Web-based, computer-tailored smoking prevention programs should focus on assessing and controlling exposure to the educational content and the response to the prompt messages. TRIAL REGISTRATION Netherlands Trial Register NTR3116; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3116 (Archived by WebCite at http://www.webcitation.org/6O0wQYuPI).
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Affiliation(s)
- Henricus-Paul Cremers
- Maastricht University, Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht, Netherlands.
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Mackey E, Schweitzer A, Hurtado ME, Hathway J, DiPietro L, Lei KY, Klein CJ. The feasibility of an e-mail-delivered intervention to improve nutrition and physical activity behaviors in African American college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2015; 63:109-117. [PMID: 25611932 PMCID: PMC4334675 DOI: 10.1080/07448481.2014.990971] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 11/07/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate the feasibility and acceptability of an e-mail-delivered program to promote nutrition and physical activity in African American college students. PARTICIPANTS Forty-seven students (76% female, aged 18-20 years). METHODS Students participated in a 24-week randomized controlled trial, receiving either general health information or the intervention focused on diet and physical activity. RESULTS At baseline, 80.9% and 76.0% of participants reported interest in improving diet and physical activity, respectively. Participants evidenced poor nutrition behaviors and 46% were overweight or obese. At 24 weeks, most participants (70% control, 84% intervention) were "somewhat" or "very" satisfied with the program. The program was feasible to administrate, with the exception of measurement of physical activity using accelerometers. CONCLUSIONS An innovative e-mail-delivered program promoting positive health behaviors appears to be feasible and acceptable in African American college students. Further research is needed to evaluate program efficacy in this population, including prevention of excess weight gain.
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Affiliation(s)
- Eleanor Mackey
- Department of Psychology and Behavioral Health Children's National Health Systems, Washington, DC
| | - Amy Schweitzer
- Center for Translational Science, Children's National Health Systems, Washington, DC
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland
| | | | - Joanne Hathway
- Center for Translational Science, Children's National Health Systems, Washington, DC
| | - Loretta DiPietro
- Department of Exercise Sciences, George Washington University, Exercise Sciences, Washington, DC
| | - Kai Y. Lei
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland
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Horodyska K, Luszczynska A, van den Berg M, Hendriksen M, Roos G, De Bourdeaudhuij I, Brug J. Good practice characteristics of diet and physical activity interventions and policies: an umbrella review. BMC Public Health 2015; 15:19. [PMID: 25604454 PMCID: PMC4306239 DOI: 10.1186/s12889-015-1354-9] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/05/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND This umbrella review aimed at eliciting good practice characteristics of interventions and policies aiming at healthy diet, increasing physical activity, and lowering sedentary behaviors. Applying the World Health Organization's framework, we sought for 3 types of characteristics, reflecting: (1) main intervention/policy characteristics, referring to the design, targets, and participants, (2) monitoring and evaluation processes, and (3) implementation issues. This investigation was undertaken by the DEDPIAC Knowledge Hub (the Knowledge Hub on the DEterminants of DIet and Physical ACtivity), which is an action of the European Union's joint programming initiative. METHODS A systematic review of reviews and stakeholder documents was conducted. Data from 7 databases was analyzed (99 documents met inclusion criteria). Additionally, resources of 7 major stakeholders (e.g., World Health Organization) were systematically searched (10 documents met inclusion criteria). Overall, the review yielded 74 systematic reviews, 16 position review papers, and 19 stakeholders' documents. Across characteristics, 25% were supported by ≥ 4 systematic reviews. Further, 25% characteristics were supported by ≥ 3 stakeholders' documents. If identified characteristics were included in at least 4 systematic reviews or at least 3 stakeholders' documents, these good practice characteristics were classified as relevant. RESULTS We derived a list of 149 potential good practice characteristics, of which 53 were classified as relevant. The main characteristics of intervention/policy (n = 18) fell into 6 categories: the use of theory, participants, target behavior, content development/management, multidimensionality, practitioners/settings. Monitoring and evaluation characteristics (n = 18) were grouped into 6 categories: costs/funding, outcomes, evaluation of effects, time/effect size, reach, the evaluation of participation and generalizability, active components/underlying processes. Implementation characteristics (n = 17) were grouped into eight categories: participation processes, training for practitioners, the use/integration of existing resources, feasibility, maintenance/sustainability, implementation partnerships, implementation consistency/adaptation processes, transferability. CONCLUSIONS The use of the proposed list of 53 good practice characteristics may foster further development of health promotion sciences, as it would allow for identification of success vectors in the domains of main characteristics of interventions/policies, their implementation, evaluation and monitoring processes.
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Affiliation(s)
- Karolina Horodyska
- grid.433893.60000000121840541Department of Psychology, University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238 Wroclaw, Poland
| | - Aleksandra Luszczynska
- grid.433893.60000000121840541Department of Psychology, University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238 Wroclaw, Poland
- Trauma, Health, & Hazards Center, University of Colorado, 1861 Austin Bluffs Pkwy, Colorado Springs, CO 80933-7150 USA
| | - Matthijs van den Berg
- grid.31147.300000000122080118National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 Bilthoven, the Netherlands
| | - Marieke Hendriksen
- grid.31147.300000000122080118National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 Bilthoven, the Netherlands
| | - Gun Roos
- SIFO – National Institute for Consumer Research, Sandakerveien 24 C, Building B Oslo, P.O. BOX 4682, Nydalen, N-0405, Oslo Norway
| | - Ilse De Bourdeaudhuij
- grid.5342.00000000120697798Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
| | - Johannes Brug
- grid.16872.3a000000040435165XVU University Medical Center, Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
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Prioste A, Fonseca H, Sousa P, Gaspar P, Francisco R, do Céu Machado M. Put Yourself in My Shoes: Perspectives of Adolescents about What Makes an Obesity Intervention Effective. Health (London) 2015. [DOI: 10.4236/health.2015.714201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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