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Wagner MJ, Jeewa A, Pidborochynski T, Lemaire‐Paquette S, Khoury M, Cunningham C, Dhillon S, Laroussi NA, Vaujois L, Dallaire F, Schantz D, Armstrong K, Mawad W, Bradley TJ, Conway J. Exploring Health-Related Quality of Life in Children With Hypertrophic Cardiomyopathy and Relationship to Physical Activity. J Am Heart Assoc 2024; 13:e033968. [PMID: 38879453 PMCID: PMC11255765 DOI: 10.1161/jaha.123.033968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/15/2024] [Indexed: 06/19/2024]
Abstract
BACKGROUND Hypertrophic cardiomyopathy is a burdensome condition that inflicts both physical and psychological impairment on those with the disease, negatively impacting health-related quality of life (HRQoL). Given the abundance of evidence suggesting a role of physical activity (PA) in modulating HRQoL in healthy populations of children, we sought to determine the relationship between HRQoL and PA in children diagnosed with hypertrophic cardiomyopathy. METHODS AND RESULTS A multicenter prospective observational cohort study was conducted, with patients with hypertrophic cardiomyopathy aged 10 to 19 years being provided a wrist-worn activity tracker (Fitbit Charge HR) to wear for 14 days. Patients self-reported on Pediatric Quality of Life 4.0 quality of life inventory items, which were associated with PA metrics following covariate adjustment using linear regression. A total of 56 participants were recruited to the study. The median age at enrollment was 15.5 years (interquartile range, 13.8-16.8), and 16 out of 56 (29%) of the cohort were girls. The cohort reported decreased metrics of physical, psychosocial, and total summary scores compared with health reference populations, with scores comparable with that of published populations with chronic disease. Increased physical HRQoL scores were significantly associated with increased daily steps taken, distance traveled, and flights of stairs climbed. CONCLUSIONS These results show that impaired PA correlates with reduced HRQoL in children with hypertrophic cardiomyopathy, suggesting PA may partially mediate HRQoL in this population.
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Affiliation(s)
| | - Aamir Jeewa
- Department of Pediatrics, Division of CardiologyThe Hospital for Sick ChildrenTorontoONCanada
| | | | | | - Michael Khoury
- Department of PediatricsUniversity of AlbertaEdmontonABCanada
- Division of Pediatric CardiologyStollery Children’s HospitalEdmontonABCanada
| | - Chentel Cunningham
- Division of Pediatric CardiologyStollery Children’s HospitalEdmontonABCanada
| | - Santokh Dhillon
- Department of Pediatrics, Division of CardiologyIWK Health CentreHalifaxNSCanada
| | - Nassiba Alami Laroussi
- Division of Pediatric CardiologySainte‐Justine University Hospital Center, University of MontrealMontrealQCCanada
| | - Laurence Vaujois
- Department of Pediatric CardiologyCentre Hospitalier Universitaire Quebec‐LavalQuebec CityQCCanada
| | - Frederic Dallaire
- Division of Pediatric CardiologyUniversité de SherbrookeSherbrookeQCCanada
| | - Daryl Schantz
- Department of PediatricsVariety Children’s Heart CentreWinnipegMBCanada
| | - Kathryn Armstrong
- Department of PediatricsBritish Columbia Children’s HospitalVancouverBCCanada
| | - Wadi Mawad
- Department of PediatricsMontreal Children’s HospitalMontrealQCCanada
| | - Timothy J. Bradley
- Division of Pediatric CardiologyJim Pattison Children’s HospitalSaskatoonSKCanada
| | - Jennifer Conway
- Department of PediatricsUniversity of AlbertaEdmontonABCanada
- Division of Pediatric CardiologyStollery Children’s HospitalEdmontonABCanada
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Bin Baz SS, Malibarey WM, Alsalmi HA, Alzaydi MD, Alqahtani AM, Alghamdi RY. The Impact of a Healthy Lifestyle on Psychological Well-Being Among Saudi Adolescent Girls Attending Secondary Schools in Taif City, Saudi Arabia. Cureus 2023; 15:e50189. [PMID: 38186425 PMCID: PMC10771855 DOI: 10.7759/cureus.50189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
Background and objective A healthy lifestyle encompasses healthy eating, regular exercise, getting enough sleep, and avoiding smoking, drug abuse, and alcohol, which will help improve mental health and manage the symptoms of anxiety, stress, and depression. In this study, we aimed to evaluate the relationship between a healthy lifestyle and psychological well-being among Saudi adolescent girls. Materials and methods A cross-sectional study was conducted among adolescent girls in secondary schools in Taif City, Saudi Arabia. The main outcome measures were the Simple Lifestyle Indicator Questionnaire (SLIQ), Patient Health Questionnaire-2 (PHQ-2) and PHQ-9 (if PHQ-2-positive), Generalized Anxiety Disorder 7-item (GAD-7) questionnaire, and Perceived Stress Scale (PSS) scores. Results The age of the respondents ranged between 15 and 19 years with an arithmetic mean of 16.72 and a standard deviation (SD) of 0.96 years. Most of the students (58.3%) followed a healthy lifestyle whereas only 6.7% followed an unhealthy one. The prevalence of depression was 52.5%; moderately severe depression was observed in 14.8% and severe depression was seen in 6.9% of the schoolgirls. Moderate or severe anxiety was observed in 24.3% and 17.8% of schoolgirls, respectively. High perceived stress was observed in 18% of the students. There was a statistically significant association between students' lifestyle and the severity of depression, anxiety, and perceived stress (p<0.001). Conclusion While unhealthy lifestyles are not common among secondary schoolgirls in Taif City, we found a significant association between such lifestyles among students and the deterioration of their psychological well-being.
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McCarty G, Wyeth EH, Sullivan T, Crengle S, Nelson V, Derrett S. Health-related quality of life measures used with Indigenous children/youth in the Pacific Rim: a scoping review. BMJ Open 2023; 13:e070156. [PMID: 36997253 PMCID: PMC10069609 DOI: 10.1136/bmjopen-2022-070156] [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: 03/31/2023] Open
Abstract
OBJECTIVE To identify and describe (1) which health-related quality of life (HRQoL) measures have been used with Indigenous children/youth (aged 8-17 years) within the Pacific Rim; and (2) studies that refer to Indigenous health concepts in the use of child/youth HRQoL measures. DESIGN A scoping review. DATA SOURCES Ovid (Medline), PubMed, Scopus, Web of Science and CINAHL were searched up until 25 June 2020. ELIGIBILITY CRITERIA Eligible papers were identified by two independent reviewers. Eligible papers were written in English, published between January 1990 and June 2020 and included an HRQoL measure used in research with Indigenous child/youth populations (aged between 8 and 17 years) in the Pacific Rim region. DATA EXTRACTION AND SYNTHESIS Data extracted included study characteristics (year, country, Indigenous population, Indigenous sample size, age group), HRQoL measure characteristics (generic or condition-specific measure, child or adult measure, who completed the measure(s), dimensions, items and response scale of measure) and consideration of Indigenous concepts (created for Indigenous population, modified for Indigenous population, validated for Indigenous population, reliability in Indigenous populations, Indigenous involvement, reference to Indigenous theories/models/frameworks). RESULTS After removing duplicates, 1393 paper titles and abstracts were screened, and 543 had full-text review for eligibility. Of these, 40 full-text papers were eligible, reporting on 32 unique studies. Twenty-nine HRQoL measures were used across eight countries. Thirty-three papers did not acknowledge Indigenous concepts of health, and only two measures were specifically created for use with Indigenous populations. CONCLUSIONS There is a paucity of research investigating HRQoL measures used with Indigenous children/youth and a lack of involvement of Indigenous peoples in the development and use of HRQoL measures. We strongly recommend explicit consideration of Indigenous concepts when developing, validating, assessing and using HRQoL measures with Indigenous populations.
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Affiliation(s)
- Georgia McCarty
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Emma H Wyeth
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Trudy Sullivan
- Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Vicky Nelson
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Alanne S, Koivuniemi E, Löyttyniemi E, Laitinen K. Elementary School-Aged Children's and Parents' Report of Health-Related Quality of Life and Relationships with Lifestyle Measures: A Cross-Sectional Study. Nutrients 2023; 15:nu15051264. [PMID: 36904263 PMCID: PMC10005714 DOI: 10.3390/nu15051264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Supporting a child's health-promoting lifestyle is an investment in their future health and health-related quality of life (HRQoL). Particularly children with overweight and obesity may be at an increased risk of a poor HRQoL. Currently, a comprehensive evaluation of lifestyle factors and age in relation to HRQoL in healthy children and, further, separate child and parental proxy-reports of HRQoL are lacking. The aims of this cross-sectional study in Finland are to compare healthy elementary school-aged children's and parents' reports of the child's HRQoL, and to view them in relation to lifestyle markers. The HRQoL was measured with Pediatric Quality of Life InventoryTM 4.0, and the following lifestyle markers: leisure-time physical activity as MET, diet quality via a validated index (ES-CIDQ), sleeping time and screen time by questionnaires. Furthermore, age and BMI were recorded. Data were obtained from 270 primary school-aged children (6-13 years). Female gender, the child's older age (8-13 years), high physical activity level and less screen time were strong predictors of a higher HRQoL in both the child's and parental proxy-reports. Means to promote healthy lifestyles should be particularly targeted to young children, especially boys, and new ways to promote physical activity and other forms of free-time activities should be sought.
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Affiliation(s)
- Soili Alanne
- Department of Clinical Nutrition, Wellbeing Services of County of South Ostrobothnia, 60220 Seinäjoki, Finland
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, 20014 Turku, Finland
- Correspondence: ; Tel.: +358-50-4744092
| | - Ella Koivuniemi
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, 20014 Turku, Finland
- Functional Foods Forum (FFF), University of Turku, 20014 Turku, Finland
| | | | - Kirsi Laitinen
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, 20014 Turku, Finland
- Functional Foods Forum (FFF), University of Turku, 20014 Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, 20521 Turku, Finland
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Maessen SE, Swinburn BA, Taylor RW, Gerritsen S, Nichols M, Körner A, Kiess W, Hancock C, Cutfield WS. Slim Evidence to Suggest Preschoolers Are Emerging from the Obesity Epidemic. J Pediatr 2021; 236:292-296. [PMID: 33865860 DOI: 10.1016/j.jpeds.2021.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/22/2021] [Accepted: 04/09/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Sarah E Maessen
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Rachael W Taylor
- A Better Start-National Science Challenge, University of Auckland, Auckland, New Zealand; Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Gerritsen
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Melanie Nichols
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Antje Körner
- Center for Pediatric Research Leipzig (CPL), University Hospital for Children and Adolescents, Leipzig, Germany
| | - Wieland Kiess
- Center for Pediatric Research Leipzig (CPL), University Hospital for Children and Adolescents, Leipzig, Germany
| | | | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start-National Science Challenge, University of Auckland, Auckland, New Zealand.
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6
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Wild CE, Rawiri N, Willing EJ, Hofman PL, Anderson YC. Health system barriers to accessing care for children with weight issues in New Zealand: An interview-based study. J Health Serv Res Policy 2021; 26:234-241. [PMID: 34282958 DOI: 10.1177/13558196211016011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify barriers created and maintained by the health system affecting engagement in a family-based multidisciplinary healthy lifestyle programme for children and adolescents in New Zealand. METHODS We conducted 64 semi-structured interviews with participants of the programme (n = 71) with varying levels of engagement, including those who declined contact after their referral. Half the interviews were with families with Māori children, allowing for appropriate representation. Interviews were analysed using thematic analysis. RESULTS Five health system factors affecting engagement were identified: the national policy environment, funding constraints, lack of coordination between services, difficulty navigating the health system, and the cost of primary health care. CONCLUSIONS Engaging with a health system that creates and maintains substantial barriers to accessing services is difficult, affecting programme engagement, even where service-level barriers have been minimised. Lack of access remains a crucial barrier to improved health outcomes for children and their families experiencing childhood obesity in New Zealand. There is a need for comprehensive approaches that are accompanied by a clear implementation strategy and coordinated across sectors.
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Affiliation(s)
- Cervantée Ek Wild
- Department of Paediatrics: Child and Youth Health, University of Auckland, New Zealand.,Liggins Institute, University of Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, New Zealand
| | - Ngauru Rawiri
- Liggins Institute, University of Auckland, New Zealand
| | - Esther J Willing
- Kōhatu - Centre for Hauora Māori, University of Otago, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, New Zealand.,Starship Children's Hospital, Auckland District Health Board, New Zealand
| | - Yvonne C Anderson
- Department of Paediatrics: Child and Youth Health, University of Auckland, New Zealand.,Liggins Institute, University of Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, New Zealand.,Paediatrician, Department of Paediatrics, Taranaki District Health Board, New Zealand
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7
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Physical health, behavioral and emotional functioning in children of gulf war veterans. Life Sci 2021; 282:119777. [PMID: 34197885 DOI: 10.1016/j.lfs.2021.119777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/07/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We examined whether the prevalence of medical and behavioral conditions is higher in children of deployed veterans (DVs) versus non-deployed veterans (NDVs) after the 1991 Gulf War. METHODS We examined 1387 children of 737 veterans. Children ages 2-18 had physical exams and parental reports of physical history and behavior. RESULTS Physical health was analyzed using GEE models. Behavioral health [total, internalizing, and externalizing behavior problems (TBP, IBP, EBP)] was analyzed with mixed-effects regression models. Analyses were conducted by age group (2-3, 4-11, 12-18), and gender (ages 4-11, 12-18). Children of DVs ages 2-3 had significantly worse dentition (13.9% vs. 4.8%, P = 0.03) and more EBP {least square means (lsmeans) 54.31 vs. 47.59, P = 0.02}. Children of DVs ages 4-11 had significantly more obesity (18.8% vs. 12.7%, P = 0.02). Among children 4-11, male children of DVs had significantly more TBP (lsmeans 70.68 vs. 57.34, P = 0.003), IBP (lsmeans 63.59 vs. 56.16, P = 0.002) and EBP (lsmeans 61.60 vs. 52.93, P = 0.03), but female children did not. For children ages 12-18, male children of DVs had more EBP (lsmeans 63.73 vs. 43.51, P = 0.008), while female children of DVs had fewer EBP (lsmeans 45.50 vs. 50.48, P = 0.02). Veteran military characteristics and mental health, and children's social status and health, including obesity, predicted children's TBP for one or more age groups. CONCLUSIONS Children of DVs experienced worse dentition, greater obesity, and more behavioral problems compared to NDV children, suggesting adverse health effects associated with parental deployment in need of further exploration.
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Guerrini Usubini A, Cattivelli R, Bertuzzi V, Varallo G, Rossi AA, Volpi C, Bottacchi M, Tamini S, De Col A, Pietrabissa G, Mannarini S, Castelnuovo G, Molinari E, Sartorio A. The ACTyourCHANGE in Teens Study Protocol: An Acceptance and Commitment Therapy-Based Intervention for Adolescents with Obesity: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126225. [PMID: 34207494 PMCID: PMC8296029 DOI: 10.3390/ijerph18126225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/18/2021] [Accepted: 06/04/2021] [Indexed: 12/21/2022]
Abstract
This Randomized Controlled Trial [(RCT) aims to evaluate the effectiveness of a brief Acceptance and Commitment Therapy (ACT)-based intervention combined with treatment as usual (TAU) compared to TAU only in improving psychological conditions in a sample of adolescents with obesity (body mass index, BMI > 97th percentile for age and sex) within the context of a wider multidisciplinary rehabilitation program for weight loss. Fifty consecutive adolescents (12-17 years) of both genders with obesity will be recruited among the patients hospitalized in a clinical center for obesity rehabilitation and randomly allocated into two experimental conditions: ACT + TAU vs. TAU only. Both groups will attend a three-week in-hospital multidisciplinary rehabilitation program for weight loss. The ACT + TAU condition comprises a psychological intervention based on ACT combined with a standard psychological assessment and support to the hospitalization. The TAU comprises the standard psychological assessment and support to the hospitalization. At pre- to post-psychological intervention, participants will complete the Avoidance and Fusion Questionnaire for Youth, the Psychological Well-Being Scale, the Depression Anxiety Stress Scale, the Difficulties in Emotion Regulation Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess psychological well-being as the primary outcome and experiential avoidance, psychological distress, emotional dysregulation, and emotional eating as secondary outcomes. Repeated-measures ANOVAs (2 × 2) will be conducted. The study will assess the effectiveness of a brief ACT-based intervention for adolescents with obesity in improving their psychological conditions by targeting specific core processes of the ACT framework (openness, awareness, and engagement). Future directions of the study will assess whether these psychological processes will contribute to addressing long-term weight loss.
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Affiliation(s)
- Anna Guerrini Usubini
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
- Correspondence:
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35139 Padova, Italy; (A.A.R.); (S.M.)
- Interdepartmental Center for Family Research, University of Padova, 35139 Padova, Italy
| | - Clarissa Volpi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
| | - Michela Bottacchi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
| | - Sofia Tamini
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
| | - Alessandra De Col
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35139 Padova, Italy; (A.A.R.); (S.M.)
- Interdepartmental Center for Family Research, University of Padova, 35139 Padova, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
- Istituto Auxologico Italiano, IRCCS, Division of Auxology, 28824 Piancavallo (VB), Italy
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Anderson YC, Wild CEK, Hofman PL, Cave TL, Taiapa KJ, Domett T, Derraik JGB, Cutfield WS, Grant CC, Willing EJ. Participants' and caregivers' experiences of a multidisciplinary programme for healthy lifestyle change in Aotearoa/New Zealand: a qualitative, focus group study. BMJ Open 2021; 11:e043516. [PMID: 33980517 PMCID: PMC8118004 DOI: 10.1136/bmjopen-2020-043516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Child and adolescent obesity continues to be a major health issue internationally. This study aims to understand the views and experiences of caregivers and participants in a child and adolescent multidisciplinary programme for healthy lifestyle change. DESIGN Qualitative focus group study. SETTING Community-based healthy lifestyle intervention programme in a mixed urban-rural region of Aotearoa/New Zealand. PARTICIPANTS Parents/caregivers (n=6) and children/adolescents (n=8) who participated in at least 6 months of an assessment and weekly session, family-based community intervention programme for children and adolescents affected by obesity. RESULTS Findings covered participant experiences, healthy lifestyle changes due to participating in the programme, the delivery team, barriers to engagement and improvements. Across these domains, four key themes emerged from the focus groups for participants and their caregivers relating to their experience: knowledge-sharing, enabling a family to become self-determining in their process to achieve healthy lifestyle change; the importance of connectedness and a family-based programme; the sense of a collective journey and the importance of a nonjudgemental, respectful welcoming environment. Logistical challenges and recommendations for improvement were also identified. CONCLUSIONS Policymakers need to consider the experiences of participants alongside quantitative outcomes when informing multidisciplinary intervention programmes for children and adolescents affected by obesity.Trial registration number Australian New Zealand Clinical Trials Registry (ANZCTR):12611000862943; Post-results.
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Affiliation(s)
- Yvonne C Anderson
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Cervantée E K Wild
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children's Health, Auckland, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | | | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children's Health, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
- Starship Children's Health, Auckland, New Zealand
| | - Esther J Willing
- Kōhatu-Centre for Hauora Māori, University of Otago, Dunedin, New Zealand
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10
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Wild CEK, Cave TL, Willing EJ, Derraik JGB, Grant CC, Hofman PL, Anderson YC. Correspondence: systematic reviews do not always capture context of real-world intervention programmes for childhood obesity (response to Littlewood, et al., 2020 in BMC Public Health). BMC Public Health 2021; 21:501. [PMID: 33715630 PMCID: PMC7958484 DOI: 10.1186/s12889-021-10486-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/23/2021] [Indexed: 11/23/2022] Open
Abstract
In a recent issue of the BMC Public Health journal, Littlewood et al. described the results of a systematic review of interventions to prevent or treat childhood obesity in Māori or Pacific Island peoples. They found that studies to date have had limited impact on improving health outcomes for Māori and Pacific Island peoples, and suggest this may be due to a lack of co-design principles in the conception of the various studies. Ensuring that interventions are appropriate for groups most affected by obesity is critical; however, some inaccuracies should be noted in the explanation of these findings. There is a risk with systematic reviews that the context of intervention trials is lost without acknowledging the associated body of literature for programmes that refer to the ongoing commitment to communities and groups most affected by obesity.
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Affiliation(s)
- Cervantée E K Wild
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. .,Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, New Zealand. .,Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Esther J Willing
- Kōhatu - Centre for Hauora Māori, University of Otago, Dunedin, New Zealand
| | - José G B Derraik
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Yvonne C Anderson
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, New Zealand.,Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
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11
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Anderson YC, Wynter LE, O'Sullivan NA, Wild CEK, Grant CC, Cave TL, Derraik JGB, Hofman PL. Two-year outcomes of Whānau Pakari, a multi-disciplinary assessment and intervention for children and adolescents with weight issues: A randomized clinical trial. Pediatr Obes 2021; 16:e12693. [PMID: 32959996 DOI: 10.1111/ijpo.12693] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine whether 12-month BMI SDS reductions persisted at 24 months in a multi-disciplinary assessment and intervention program for children and adolescents with obesity, and whether secondary outcomes improved. METHODS This was a community-based 12-month RCT in Aotearoa/New Zealand. Eligible participants were aged 5 to 16 years with BMI ≥98th centile or BMI >91st centile with weight-related comorbidities. The low-intensity control received comprehensive home-based baseline assessments and advice, and 6-monthly follow-up. The high-intensity intervention received the same assessments and advice, but also weekly multidisciplinary sessions. Primary outcome was BMI SDS at 12 months. Secondary outcomes included cardiovascular and metabolic markers. RESULTS 121 participants (60% of participants at baseline) were assessed at 24 months. BMI SDS reduction at 12 months was lost at 24 months in the modified intention-to-treat analysis [Control -0.03 (95%CI -0.14, 0.09) and Intervention -0.02 (-0.12, 0.08); P = .93]. However, sweet drink intake was reduced, water intake increased, and there were improvements in cardiovascular fitness in the high-intensity intervention. ≥70% attendance in the high-intensity intervention resulted in a persistent BMI SDS reduction of -0.22 after 24 months (95%CI -0.38, -0.06). CONCLUSIONS This trial was negative in terms of primary outcome at 24 months. However, high engagement led to sustained treatment effect, and there were multiple improvements in health measures.
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Affiliation(s)
- Yvonne C Anderson
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Lisa E Wynter
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
| | - Niamh A O'Sullivan
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
| | | | - Cameron C Grant
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand.,Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
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12
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Overweight, obesity, weight-related behaviors, and health-related quality of life among high-school students in Turkey. Eat Weight Disord 2020; 25:1295-1302. [PMID: 31463887 DOI: 10.1007/s40519-019-00762-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/26/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the prevalence of overweight and obesity, and associated socio-demographic and lifestyle behaviors among a sample of high-school students in Turkey. This study also examined the effect of overweight and obesity on health-related quality of life in students. METHODS A cross-sectional survey of 1216 adolescents aged 14-18 years old was conducted from 2018 to 2019 in Turkey, using questionnaire forms and anthropometric measurements. Classification of BMI was based on the WHO reference weight categories. Factors linked to adolescent obesity were identified using the binary logistic regression model and the degree of association was revealed by determining the odds ratio, at a confidence interval (CI) of 95%. RESULTS The prevalence of overweight was 26.1%, while that of obese students was 12.8%. Factors associated with being obese included being in the 14-15 age group, being male, having dysfunctional family relationships, spending more than 3 h/day on screen time, and performing physical activity (≥ 60 min) two times or less per week. Obese adolescents reported significantly lower scores in physical and mental health. CONCLUSIONS In this study, more than one-third of the students were either overweight or obese. Obesity was associated with screen time, physical activity, and family relationship. Obesity in children had a negative impact on their quality of life. Therefore, increasing physical activity, lowering screen time, and having a healthy parent-adolescent relationship could contribute to reducing the prevalence of obesity in overweight/obese students. LEVEL OF EVIDENCE Level V, descriptive (cross-sectional) study.
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13
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Wild CE, Rawiri NT, Willing EJ, Hofman PL, Anderson YC. Determining barriers and facilitators to engagement for families in a family-based, multicomponent healthy lifestyles intervention for children and adolescents: a qualitative study. BMJ Open 2020; 10:e037152. [PMID: 32895279 PMCID: PMC7478027 DOI: 10.1136/bmjopen-2020-037152] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Recruitment and retention in child and adolescent healthy lifestyle intervention services for childhood obesity is challenging, and inequalities across social groups are persistent. This study aimed to understand the barriers and facilitators to engagement in a multicomponent assessment-and-intervention healthy lifestyle programme for children and their families, based in the home and community. DESIGN Qualitative interview-based study of past users (n=76) of a family-based multicomponent healthy lifestyle programme in a mixed urban-rural region of New Zealand. Semistructured, home-based interviews were conducted and thematically analysed with peer debriefing for validity. PARTICIPANTS Families were selected through stratified random sampling to include a range of levels of engagement, including those who declined their referral, with equal numbers of interviews with Indigenous and non-Indigenous families. RESULTS Three interactive and compounding determinants were identified as influencing engagement in Whānau Pakari: acute and chronic life stressors, societal norms of weight and body size and historical experiences of healthcare. These determinants were present across societal, system and healthcare service levels. A negative referral experience to Whānau Pakari often resulted in participants declining further input or disengaging from the programme. A fourth domain, respectful and compassionate healthcare, was identified as a mitigator of these three themes, facilitating participant engagement despite previous negative experiences. CONCLUSIONS While participant engagement in healthy lifestyle programmes is affected by determinants which appear to operate outside immediate service provision, the programme is an opportunity to acknowledge past instances of stigma and the wider challenges of healthy lifestyle change. The experience of the referral to Whānau Pakari is important for setting the scene for future engagement in the programme. Respectful, compassionate care is critical to enhanced retention in multidisciplinary healthy lifestyle programmes and ongoing engagement in healthcare services overall.
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Affiliation(s)
| | - Ngauru T Rawiri
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Esther J Willing
- Kōhatu - Centre for Hauora Māori, University of Otago, Dunedin, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children's Health, Auckland, New Zealand
| | - Yvonne C Anderson
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
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14
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Breinker JL, Schmidt R, Hübner C, Cämmerer J, Körner A, Sergeyev E, Kiess W, Hilbert A. [Psychological Parameters of Adolescent Patients Prior to Obesity Treatment]. Psychother Psychosom Med Psychol 2020; 71:35-41. [PMID: 32823357 DOI: 10.1055/a-1197-3155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Overweight and obesity in children and adolescents are highly prevalent and persistent. Current weight loss treatments are rarely individualized and show only small to moderate efficacy. Only rarely, psychopathological parameters are considered. The present study evaluated the psychopathology of adolescents with overweight and obesity (N=201, ages 12-17 years) prior to obesity treatment. The data were analyzed for age and sex effects. Self-report questionnaires assessed general symptom burden, eating disorder and general psychopathology, weight-related self-stigmatization, and physical and mental quality of life. Girls showed higher rates of weight-related self-stigmatization and higher disordered eating behavior compared to boys. Older adolescents reported a lower quality of life compared to younger adolescents. In normative comparisons with population-based samples and norms, adolescents with overweight and obesity showed significantly adverse outcomes in all parameters. Thus, this study identified psychopathology as an important factor in adolescents with high weight status that may affect obesity treatment. Future studies should examine psychopathology more differentially and determine therapeutic resources in adolescent overweight and obesity.
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Affiliation(s)
- Julius Lars Breinker
- Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Forschungsbereich Verhaltensmedizin, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Leipzig
| | - Ricarda Schmidt
- Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Forschungsbereich Verhaltensmedizin, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Leipzig
| | - Claudia Hübner
- Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Forschungsbereich Verhaltensmedizin, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Leipzig
| | - Jana Cämmerer
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Zentrum für Pädiatrische Forschung, Universitätsmedizin Leipzig
| | - Antje Körner
- Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Forschungsbereich Verhaltensmedizin, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Leipzig
| | - Elena Sergeyev
- Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Forschungsbereich Verhaltensmedizin, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Leipzig
| | - Wieland Kiess
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Zentrum für Pädiatrische Forschung, Universitätsmedizin Leipzig.,LIFE Forschungszentrum für Zivilisationskrankheiten, Universität Leipzig
| | - Anja Hilbert
- Integriertes Forschungs- und Behandlungszentrum (IFB) AdipositasErkrankungen, Forschungsbereich Verhaltensmedizin, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Leipzig
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15
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Colmenarejo G. Machine Learning Models to Predict Childhood and Adolescent Obesity: A Review. Nutrients 2020; 12:E2466. [PMID: 32824342 PMCID: PMC7469049 DOI: 10.3390/nu12082466] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 12/19/2022] Open
Abstract
The prevalence of childhood and adolescence overweight an obesity is raising at an alarming rate in many countries. This poses a serious threat to the current and near-future health systems, given the association of these conditions with different comorbidities (cardiovascular diseases, type II diabetes, and metabolic syndrome) and even death. In order to design appropriate strategies for its prevention, as well as understand its origins, the development of predictive models for childhood/adolescent overweight/obesity and related outcomes is of extreme value. Obesity has a complex etiology, and in the case of childhood and adolescence obesity, this etiology includes also specific factors like (pre)-gestational ones; weaning; and the huge anthropometric, metabolic, and hormonal changes that during this period the body suffers. In this way, Machine Learning models are becoming extremely useful tools in this area, given their excellent predictive power; ability to model complex, nonlinear relationships between variables; and capacity to deal with high-dimensional data typical in this area. This is especially important given the recent appearance of large repositories of Electronic Health Records (EHR) that allow the development of models using datasets with many instances and predictor variables, from which Deep Learning variants can generate extremely accurate predictions. In the current work, the area of Machine Learning models to predict childhood and adolescent obesity and related outcomes is comprehensively and critically reviewed, including the latest ones using Deep Learning with EHR. These models are compared with the traditional statistical ones that used mainly logistic regression. The main features and applications appearing from these models are described, and the future opportunities are discussed.
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Affiliation(s)
- Gonzalo Colmenarejo
- Biostatistics and Bioinformatics Unit, IMDEA Food, CEI UAM+CSIC, E28049 Madrid, Spain
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16
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Simon SL, Behn CD, Laikin A, Kaar JL, Rahat H, Cree-Green M, Wright KP, Nadeau KJ. Sleep & Circadian Health are Associated with Mood & Behavior in Adolescents with Overweight/Obesity. Behav Sleep Med 2020; 18:550-559. [PMID: 31218887 PMCID: PMC6923622 DOI: 10.1080/15402002.2019.1629444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/09/2019] [Accepted: 05/26/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE/BACKGROUND Rates of overweight/obesity and insufficient/delayed sleep are high among adolescents and are also unique risk factors for mood/behavior difficulties. This study aimed to evaluate relationships between sleep/circadian health and mood/behavior in a cohort of adolescents with overweight/obesity. PARTICIPANTS Twenty-two adolescents (16.4 ± 1.1 years) with overweight/obesity attending high school completed in the study. METHODS Participants completed one week of home sleep monitoring (actigraphy), questionnaires assessing chronotype (diurnal preference; Morningness/Eveningness Scale for Children) and mood/behavior (Strengths & Difficulties Questionnaire), and had in-laboratory salivary melatonin sampling on a Thursday or Friday during the academic year. RESULTS Linear regressions revealed later weekday bedtime and shorter weekday time in bed and sleep duration were associated with worse mood/behavior scores. Shorter duration of melatonin secretion and greater "eveningness" were also associated with worse mood/behavior scores. CONCLUSIONS Short and late sleep, shorter melatonin secretion, and eveningness chronotype are associated with worse mood/behavior symptoms in a cohort of adolescents with overweight/obesity. Clinicians should assess for both sleep and mood/behavior symptoms and further research is needed to evaluate the impact of improved sleep on mood/behavior in adolescents with overweight/obesity.
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Affiliation(s)
- Stacey L. Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
| | - Cecilia Diniz Behn
- Department of Applied Mathematics & Statistics, Colorado School of Mines, Golden, CO
| | - Andrea Laikin
- Pediatric Mental Health Institute, Children’s Hospital Colorado, Aurora, CO
| | - Jill L. Kaar
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
| | - Haseeb Rahat
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
| | - Melanie Cree-Green
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
| | - Kenneth P. Wright
- Sleep & Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kristen J. Nadeau
- Department of Pediatrics, University of Colorado Anschutz Medical Campus & Children’s Hospital Colorado, Aurora, CO
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17
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Wild CEK, O'Sullivan NA, Lee AC, Cave TL, Willing EJ, Cormack DM, Hofman PL, Anderson YC. Survey of Barriers and Facilitators to Engagement in a Multidisciplinary Healthy Lifestyles Program for Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:528-534. [PMID: 31780274 DOI: 10.1016/j.jneb.2019.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/14/2019] [Accepted: 10/20/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To understand facilitators and barriers to engagement in a multidisciplinary assessment and intervention program for children and adolescents with obesity, particularly for Māori, the Indigenous people of New Zealand. METHODS Whānau Pakari participants and caregivers (n = 71, 21% response rate) referred to the family-based healthy lifestyles program in Taranaki, New Zealand, were asked to participate in a confidential survey, which collected self-reported attendance levels and agreement with statements around service accessibility and appropriateness and open-text comments identifying barriers and facilitators to attendance. RESULTS Self-reported attendance levels were higher when respondents reported sessions to be conveniently located (P = .03) and lower when respondents considered other priorities as more important for their family (P = .02). Māori more frequently reported that past experiences of health care influenced their decision to attend (P = .03). Facilitators included perceived convenience of the program, parental motivation to improve child health, and ongoing support from the program. CONCLUSIONS AND IMPLICATIONS Program convenience and parental and/or self-motivation to improve health were facilitators of attendance. Further research is required to understand the relationship between past experiences with health care and subsequent engagement with services.
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Affiliation(s)
| | - Niamh A O'Sullivan
- Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Pediatrics, Taranaki District Health Board, New Plymouth, New Zealand
| | - Arier C Lee
- Section of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Esther J Willing
- Kōhatu-Centre for Hauora Māori, University of Otago, Dunedin, New Zealand
| | - Donna M Cormack
- Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland District Health Board, Auckland, New Zealand
| | - Yvonne C Anderson
- Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Pediatrics, Taranaki District Health Board, New Plymouth, New Zealand
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18
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Madrigal MA, López M, Sánchez A, Cao MJ, Castro MJ, Jiménez JM. Type 1 Diabetes Mellitus in Pediatric Patients and Its Impact on Relationships in the Family Environment. Diabetes Metab Syndr Obes 2020; 13:4973-4980. [PMID: 33364801 PMCID: PMC7751600 DOI: 10.2147/dmso.s281949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study is to assess the impact of type 1 diabetes mellitus on family environment relationships, as well as the management and approach to this disease. PATIENTS AND METHODS One hundred one children, 52.47% male and 47.52% female, with an average age of 8.55 ± 4.01 years, diagnosis of type 1 diabetes mellitus. Quantitative cross-sectional descriptive study was conducted using the validated questionnaires "Modified Diabetes Quality of Life" and "Questionnaire for the assessment of psychological impact in parents/guardians of diabetic children". RESULTS Most of the children (70.3% versus 29.7%) identified diabetes as unpleasant or not fun. The ≤5-year-olds expressed that they felt concerned about the consequences of being diabetic (8.1% by age group), as opposed to the 10-year-olds who did not feel concerned (85.1% by age group), P <0.001. The family environment was affected in 98.1% (n=99) of the cases. CONCLUSION Self-care of type 1 diabetes mellitus in pediatric patients is a complex process that impacts the family environment and their relationship with their peers, especially for children under the age of 5. Fear, concern and insecurity were prevalent feelings in children suffering type 1 diabetes mellitus.
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Affiliation(s)
- Miguel Angel Madrigal
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María López
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
- Correspondence: María LópezFaculty of Nursing, Universidad de Valladolid, Avda Ramón y Cajal, Nº 7, Valladolid, SpainTel +34 983184056 Email
| | - Alicia Sánchez
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María José Cao
- Faculty of Nursing, Universidad de Valladolid, Valladolid, Spain
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19
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Butler ÉM, Derraik JGB, Taylor RW, Cutfield WS. Prediction Models for Early Childhood Obesity: Applicability and Existing Issues. Horm Res Paediatr 2019; 90:358-367. [PMID: 30739117 DOI: 10.1159/000496563] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/03/2019] [Indexed: 11/19/2022] Open
Abstract
Statistical models have been developed for the prediction or diagnosis of a wide range of outcomes. However, to our knowledge, only 7 published studies have reported models to specifically predict overweight and/or obesity in early childhood. These models were developed using known risk factors and vary greatly in terms of their discrimination and predictive capacities. There are currently no established guidelines on what constitutes an acceptable level of risk (i.e., risk threshold) for childhood obesity prediction models, but these should be set following consideration of the consequences of false-positive and false-negative predictions, as well as any relevant clinical guidelines. To date, no studies have examined the impact of using early childhood obesity prediction models as intervention tools. While these are potentially valuable to inform targeted interventions, the heterogeneity of the existing models and the lack of consensus on adequate thresholds limit their usefulness in practice.
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Affiliation(s)
- Éadaoin M Butler
- A Better Start - National Science Challenge, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- A Better Start - National Science Challenge, New Zealand, .,Liggins Institute, University of Auckland, Auckland, New Zealand, .,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden,
| | - Rachael W Taylor
- A Better Start - National Science Challenge, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Wayne S Cutfield
- A Better Start - National Science Challenge, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
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20
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Chiavaroli V, Gibbins JD, Cutfield WS, Derraik JGB. Childhood obesity in New Zealand. World J Pediatr 2019; 15:322-331. [PMID: 31079339 DOI: 10.1007/s12519-019-00261-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/15/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Paediatric obesity has reached epidemic proportions globally, resulting in significant adverse effects on health and wellbeing. Early life events, including those that happen before, during, and after pregnancy can predispose children to later obesity. The purpose of this review is to examine the magnitude of obesity among New Zealand children and adolescents, and to determine their underlying risk factors and associated comorbidities. DATA SOURCES PubMed, Web of Science, and Google Scholar searches were performed using the key terms "obesity", "overweight", "children", "adolescents", and "New Zealand". RESULTS Obesity is a major public health concern in New Zealand, with more than 33% of children and adolescents aged 2-14 years being overweight or obese. Obesity disproportionately affects Māori (New Zealand's indigenous population) and Pacific children and adolescents, as well as those of lower socioeconomic status. New Zealand's obesity epidemic is associated with numerous health issues, including cardiometabolic, gastrointestinal, and psychological problems, which also disproportionately affect Māori and Pacific children and adolescents. Notably, a number of factors may be useful to identify those at increased risk (such as demographic and anthropometric characteristics) and inform possible interventions. CONCLUSIONS The prevalence of overweight and obese children and adolescents in New Zealand is markedly high, with a greater impact on particular ethnicities and those of lower socioeconomic status. Alleviating the current burden of pediatric obesity should be a key priority for New Zealand, for the benefit of both current and subsequent generations. Future strategies should focus on obesity prevention, particularly starting at a young age and targeting those at greatest risk.
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Affiliation(s)
| | - John D Gibbins
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. .,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand. .,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand. .,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China. .,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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21
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Anderson YC, Kirkpatrick K, Dolan GMS, Wouldes TA, Grant CC, Cave TL, Wild CEK, Derraik JGB, Cutfield WS, Hofman PL. Do changes in weight status affect cognitive function in children and adolescents with obesity? A secondary analysis of a clinical trial. BMJ Open 2019; 9:e021586. [PMID: 30782863 PMCID: PMC6367974 DOI: 10.1136/bmjopen-2018-021586] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES It is unclear whether an association exists between obesity in children/adolescents and cognitive function, and whether the latter can be altered by body mass index (BMI) standard deviation score (SDS) reductions. We aimed to determine whether an association exists between BMI SDS and cognitive function in children/adolescents with obesity engaged in an obesity intervention. Second, we sought to determine if BMI SDS reduction at 12 months was associated with improved cognitive function. DESIGN Secondary analysis of a clinical trial. PARTICIPANTS Participants (n=69) were recruited from an obesity intervention. Eligible participants (recruited June 2013 to June 2015) were aged 6-16 years, with a BMI ≥98th centile or BMI >91st centile with weight-related comorbidities. OUTCOME MEASURES Primary outcome measure was change in BMI SDS from baseline at 12 months. Dependent variables of cognitive functioning and school achievement were assessed at baseline and 12 months, using dependent variables of cognitive functioning (elements of Ravens Standard Progressive Matrices, Wide Range Achievement Test-fourth edition and Wechsler Intelligence Scale for Children-fourth edition). RESULTS At baseline, BMI SDS was not associated with all aspects of cognitive function tested (n=69). Reductions in BMI SDS over time did not alter cognitive function overall. However, there was a greater reduction in comprehension standard scores in participants who increased their BMI SDS (adjusted estimated difference -6.1, 95% CI -11.6 to -0.6; p=0.03). CONCLUSIONS There were no observed associations between BMI SDS and cognitive function in participants, apart from comprehension in the exploratory analyses, which may have been a random finding. Further studies need to include larger longitudinal cohorts incorporating a wider BMI range at entry to determine whether our findings persist. TRIAL REGISTRATION NUMBER ANZCTR12611000862943; Pre-results.
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Affiliation(s)
- Yvonne C Anderson
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Kaye Kirkpatrick
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
| | | | - Trecia A Wouldes
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
- Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
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22
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Ambak R, Mohamad Nor NS, Puteh N, Mohd Tamil A, Omar MA, Shahar S, Ahmad NA, Aris T. The effect of weight loss intervention programme on health-related quality of life among low income overweight and obese housewives in the MyBFF@home study. BMC Womens Health 2018; 18:111. [PMID: 30066637 PMCID: PMC6069293 DOI: 10.1186/s12905-018-0591-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Obesity is an emerging global public health concern as it is related to chronic diseases and its impact to health related quality of life. The aim of this study was to assess the effect of weight reduction on health related quality of life (HRQOL) among obese and overweight housewives. METHODS Data on 123 obese and overweight housewives in the intervention group from the MyBFF@home study were utilised. A validated Malaysian Malay version of Obesity Weight Loss Quality of Life (OWLQOL) questionnaire was administered at baseline and 6 months after intervention. Descriptive analysis, univariate analysis, paired t-test and multiple logistic regression were performed using SPSS Version 22. RESULTS Mean body mass index (BMI) was 31.5 kg/m2 (SD:4.13), with 51 participants classified as overweight (41.5%) while 72 were obese (58.5%). About 72% of the housewives experienced weight reduction (62% reduced weight less than 5% and 11% reduced weight more than 5% of their baseline weight). There was a significant improvement in HRQOL with a pre-intervention total mean score of 59.82 (SD: 26.60) and post-intervention of 66.13 (SD: 22.82), p-value < 0.001. By domain, the highest post intervention mean score was self-image 71.46 (SD: 22.85), followed by social stigma 68.77 (SD: 28.70), physical 61.83 (SD: 24.25) and trying to lose weight 61.24 (SD: 27.32). There was no significant association between weight reduction and HRQOL improvement. CONCLUSION Weight loss intervention programme utilizing behavioural modification has led to a significant improvement in HRQOL among overweight and obese housewives.
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Affiliation(s)
- Rashidah Ambak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Noor Safiza Mohamad Nor
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Norhanizam Puteh
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Azmi Mohd Tamil
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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23
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Anderson YC, Leung W, Grant CC, Cave TL, Derraik JGB, Cutfield WS, Pereira NM, Hofman PL, Sullivan TA. Economic evaluation of a multi-disciplinary community-based intervention programme for New Zealand children and adolescents with obesity. Obes Res Clin Pract 2018; 12:293-298. [PMID: 29779834 DOI: 10.1016/j.orcp.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/25/2018] [Accepted: 04/27/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine whether Whānau Pakari, a home-based, 12-month multi-disciplinary child obesity intervention programme was cost-effective when compared with the prior conventional hospital-based model of care. METHODS Whānau Pakari trial participants were recruited January 2012-August 2014, and randomised to either a high-intensity intervention (weekly sessions for 12 months with home-based assessments and advice, n=100) or low-intensity control (home-based assessments and advice only, n=99). Trial participants were aged 5-16 years, resided in Taranaki, Aotearoa/New Zealand (NZ), with a body mass index (BMI) ≥98th centile or BMI >91st centile with weight-related comorbidities. Conventional group participants (receiving paediatrician assessment with dietitian input and physical activity/nutrition support, n=44) were aged 4-15 years, and resided in the same or another NZ centre. The change in BMI standard deviation score (SDS) at 12 months from baseline and programme intervention costs, both at the participant level, were used for the economic evaluation. A limited health funder perspective with costs in 2016 NZ$ was taken. RESULTS The per child 12-month Whānau Pakari programme costs were significantly lower than in the conventional group. In the low-intensity group, costs were NZ$939 (95% CI: 872, 1007) (US$648) lower than the conventional group. In the high-intensity intervention group, costs were NZ$155 (95% CI: 89, 219) (US$107) lower than in the conventional group. BMI SDS reductions were similar in the three groups. CONCLUSIONS A home-based, multi-disciplinary child obesity intervention had lower programme costs per child, greater reach, with similar BMI SDS outcomes at 12 months when compared with the previous hospital-based conventional model.
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Affiliation(s)
- Yvonne C Anderson
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand; Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - William Leung
- Wellington School of Medicine, University of Otago, Wellington, New Zealand
| | - Cameron C Grant
- Department of Paediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland District Health Board, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland District Health Board, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Nicola M Pereira
- Child Health Service, Midcentral District Health Board, Palmerston North, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand; Starship Children's Health, Auckland District Health Board, Auckland, New Zealand
| | - Trudy A Sullivan
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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24
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Anderson YC, Wynter LE, Grant CC, Cave TL, Derraik JGB, Cutfield WS, Hofman PL. A Novel Home-Based Intervention for Child and Adolescent Obesity: The Results of the Whānau Pakari Randomized Controlled Trial. Obesity (Silver Spring) 2017; 25:1965-1973. [PMID: 29049868 DOI: 10.1002/oby.21967] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/27/2017] [Accepted: 07/17/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To report 12-month outcomes from a multidisciplinary child obesity intervention program, targeting high-risk groups. METHODS In this unblinded randomized controlled trial, participants (recruited January 2012-August 2014) were aged 5 to 16 years, resided in Taranaki, Aotearoa/New Zealand, and had BMI ≥ 98th percentile or BMI > 91st percentile with weight-related comorbidities. Randomization was by minimization (age and ethnicity), with participants assigned to an intense intervention group (home-based assessments at 6-month intervals and a 12-month multidisciplinary program with weekly group sessions) or to a minimal-intensity control group with home-based assessments and advice at each 6-month follow-up. The primary outcome was the change in BMI standard deviation score (SDS) at 12 months from baseline. A mixed model analysis was undertaken, incorporating all 6- and 12-month data. RESULTS Two hundred and three children were randomly assigned (47% Māori, 43% New Zealand European, 53% female, 28% from the most deprived quintile, mean age 10.7 years, mean BMI SDS 3.12). Both groups displayed a change in BMI SDS at 12 months from baseline (-0.12 control, -0.10 intervention), improvements in cardiovascular fitness (P < 0.0001), and improvements in quality of life (P < 0.001). Achieving ≥ 70% attendance in the intense intervention group resulted in a change in BMI SDS of -0.22. CONCLUSIONS This program achieved a high recruitment of target groups and a high rate of BMI SDS reduction, irrespective of intervention intensity. If retention is optimized, the intensive program doubles its effect.
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Affiliation(s)
- Yvonne C Anderson
- Department of Pediatrics, Taranaki District Health Board, New Plymouth, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Lisa E Wynter
- Department of Pediatrics, Taranaki District Health Board, New Plymouth, New Zealand
| | - Cameron C Grant
- Department of Pediatrics, Child and Youth Health, University of Auckland, Auckland, New Zealand
- Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start, National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start, National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
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