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Wargers A, Elphick CM, Mölenberg FJM, Senequier A, Manios Y, Mavrogianni C, Murray C, Queral J, Tarro L, Williams CA, Vlachopoulos D, Jansen W. Stakeholder perspectives on the barriers and facilitators of engagement in healthy lifestyle behaviours in underrepresented adolescents: a focus group study from the European SEEDS project. BMC Public Health 2024; 24:1988. [PMID: 39054496 PMCID: PMC11270848 DOI: 10.1186/s12889-024-19419-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Obesity in adolescence has increased in the last decades. Adolescents fail to meet the recommended guidelines for physical activity (PA) and healthy diet. Adolescents with a low socioeconomic status (SES) particularly seem to have fewer healthy lifestyle behaviours. The European Science Engagement to Empower aDolescentS (SEEDS) project used an extreme citizen science approach to develop and implement healthy lifestyle behaviour interventions in high schools. As part of this project, key stakeholders were invited to reflect on the intentions of adolescents to engage in healthy lifestyle behaviours. The aim of this study was to gain stakeholder insights into the barriers and facilitators to healthy lifestyle behaviours of adolescents from low SES areas and on the possible role of these stakeholders in facilitating healthy lifestyle behaviours. METHODS Six semi-structured focus groups were conducted in four European countries with 28 stakeholders from different settings (schools, community, and government), like teachers, policy advisors and youth workers. The theoretical framework of focus groups was based on the Theory of Planned Behaviour. The main questions of the focus groups were centred on PA and healthy diet. The focus groups were qualitatively analysed in NVivo using thematic analysis to identify topics and themes. RESULTS According to stakeholders, adolescents have sufficient understanding of the importance of PA and a healthy diet, but nevertheless engage in unhealthy behaviour. Parents were mentioned as important facilitators for engaging adolescents in healthy lifestyle behaviours. Stakeholders listed lack of knowledge, time, and financial resources as barriers for adolescents from low SES families to engage in healthy lifestyle behaviours. The school environment was listed as an important facilitator of adolescents' healthy lifestyle changes, but stakeholders acknowledged that current school days, curriculum and buildings are not designed to promote healthy lifestyle behaviours. External support and collaboration with community and governmental stakeholders was seen as potentially beneficial to improve healthy lifestyle behaviours. CONCLUSIONS This study shows the variety of barriers adolescents from low SES areas face, and the need for a broader collaboration between key stakeholders to facilitate healthy lifestyle behaviours. Schools are regarded specifically as important facilitators. Currently, the school environment entails various barriers. However, when addressing those, schools can increase opportunities for healthy lifestyle behaviours of adolescents from low SES areas. TRIAL REGISTRATION This study is registered in ClinicalTrials.gov on 12/08/2021: NCT05002049.
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Affiliation(s)
- Annemieke Wargers
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Christopher M Elphick
- Children's Health and Exercise Research Centre, Department of Public Health and Sport Science, University of Exeter, Exeter, United Kingdom
| | - Famke J M Mölenberg
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Amandine Senequier
- Children's Health and Exercise Research Centre, Department of Public Health and Sport Science, University of Exeter, Exeter, United Kingdom
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, 17671, Greece
- Institute of Agri-food and Life Sciences, University Research & Innovation Center, H.M.U.R.I.C, Hellenic Mediterranean University, Crete, GR-71003, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, 17671, Greece
| | - Claire Murray
- European Citizen Science Association, c/o Museum für Naturkunde Invalidenstraße 43, 10115, Berlin, Germany
| | - Judit Queral
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, 43204, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, 43201, Spain
| | - Lucia Tarro
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, 43204, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Healthy Environment Chair, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, 43201, Spain
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Department of Public Health and Sport Science, University of Exeter, Exeter, United Kingdom
| | - Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Department of Public Health and Sport Science, University of Exeter, Exeter, United Kingdom
| | - Wilma Jansen
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
- Department of Social Development, City of Rotterdam, Rotterdam, the Netherlands.
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So JTH, Nambiar S, Byrne R, Gallegos D, Baxter KA. Designing Child Nutrition Interventions to Engage Fathers: Qualitative Analysis of Interviews and Co-Design Workshops. JMIR Pediatr Parent 2024; 7:e57849. [PMID: 38815260 PMCID: PMC11176881 DOI: 10.2196/57849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/10/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Fathers play a pivotal role in parenting and child feeding, but they remain underrepresented in intervention studies, especially those focused on disadvantaged populations. A better understanding of fathers' experiences and needs regarding support access and child nutrition information in the context of disadvantage can inform future interventions engaging fathers. OBJECTIVE This study aims to explore fathers' experiences; perceived enablers; and barriers to accessing support and information related to parenting, child feeding, and nutrition and to co-design principles for tailoring child nutrition interventions to engage fathers. METHODS Australian fathers of children aged 6 months to 5 years with lived experience of disadvantage participated in semistructured interviews and co-design workshops, primarily conducted via videoconference. Creative analogies were used to guide the ideation process in the workshops. RESULTS A total of 25 interviews and 3 workshops (n=10 participants) were conducted, with data analyzed using reflexive thematic analysis and the Capability, Opportunity, and Motivation-Behavior model. The interview data illuminated factors influencing fathers' initiation in seeking support for parenting, child feeding, and nutrition, including their experiences. It highlighted fathers' diverse information needs and the importance of an inclusive environment and encouragement. Enablers and barriers in accessing support related to parenting and child nutrition were identified at the individual (eg, personal goals and resource constraints), interpersonal (family support and false beliefs about men's caregiving role), organizational (inadequate fathering support), and systemic levels (father-inclusive practice and policy). Digital data collection methods enabled Australia-wide participation, overcoming work and capacity barriers. Videoconferencing technology was effectively used to engage fathers creatively. Key principles for engaging fathers were co-designed from the workshop data. Interventions and resources need to be father specific, child centered, and culturally appropriate; promote empowerment and collaboration; and provide actionable and accessible strategies on the what and how of child feeding. Fathers preferred multiformat implementation, which harnesses technology-based design (eg, websites and mobile apps) and gamification. It should be tailored to the child's age and targeted at fathers using comprehensive promotion strategies. CONCLUSIONS Fathers faced barriers to accessing support and information related to parenting and feeding that may not adequately address their needs. Future interventions could integrate the co-designed principles to engage fathers effectively. These findings have implications for health service delivery and policy development, promoting father-inclusive practice.
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Affiliation(s)
- Jeffrey Tsz Hei So
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Smita Nambiar
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Rebecca Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Kimberley A Baxter
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Calcaterra V, Vandoni M, Marin L, Carnevale Pellino V, Rossi V, Gatti A, Patanè P, Cavallo C, Re F, Albanese I, Silvestri D, De Nunzio A, Zuccotti G. Exergames to Limit Weight Gain and to Fight Sedentarism in Children and Adolescents with Obesity. CHILDREN (BASEL, SWITZERLAND) 2023; 10:928. [PMID: 37371160 DOI: 10.3390/children10060928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023]
Abstract
Exergames are defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). The players interact with the game through whole-body movements improving energy expenditure. Exergames may be effective in improving physical and psychological aspects of children and adolescents with obesity. In this narrative review, we synthesized the current evidence regarding the role of exergames in modifying body composition and weight and in promoting changes in sedentary behavior to define the benefits of active video games as useful tools for fighting sedentarism and to outline the future directions of exergaming as a supplementation exercise rather than a replacement in educational programs for pediatric obesity. Data from the literature indicate that exergames may offer an interesting impact on childhood obesity and may be considered a potential strategy for controlling weight gain and body composition, promote PA, and decrease time spent on sedentary behavior in children and adolescents with obesity. However, exergame use also has some limits, such as children's poor self-regulation and poor structuring of exergame use. Therefore, a prudent approach should be maintained, and additional high-quality research is needed to determine if exergames can be effectively used in the treatment of childhood obesity and if new digital media, as a supplementation of exercise rather than a replacement, could be considered to combat sedentary behavior in educational programs for pediatric obesity prevention.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Physiotherapy, Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Virginia Rossi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Pamela Patanè
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Caterina Cavallo
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Research and Development, LUNEX International University of Health, Exercise and Sports, Avenue du Parc des Sports, 50, 4671 Differdange, Luxembourg
| | - Fabio Re
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
| | - Ilaria Albanese
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Laboratory for Rehabilitation, Medicine and Sport (LARMS), 00133 Rome, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Dario Silvestri
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
| | - Alessandro De Nunzio
- Department of Research and Development, LUNEX International University of Health, Exercise and Sports, Avenue du Parc des Sports, 50, 4671 Differdange, Luxembourg
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Sciences, Università di Milano, 20122 Milan, Italy
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Walker JL, Dix C, Hardt J, Farletti R, Littlewood R. What Do Health Professionals and Parents Want as Part of an Online Childhood Obesity Prevention Program? Child Obes 2023; 19:88-101. [PMID: 35649200 DOI: 10.1089/chi.2021.0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: There are limited evidence-based programs for children living in Queensland, Australia, who are at risk of overweight or obesity. Despite the known importance of prevention initiatives, an online, locally relevant program supporting sustainable health behaviors does not exist. This study aimed to understand the perspectives of parents/guardians and health professionals regarding important aspects of an online childhood obesity prevention program. Methods: This pragmatic, mixed-methods study was conducted from March to December 2020. Recruitment included participants from two groups involved with children aged 2-17 years, health professionals, and parents/guardians. Phase 1 involved dissemination of an online survey. Questions addressed program structure, content delivery (including nutrition, physical activity, and parenting practices), program evaluation, and information dissemination. Descriptive statistics were used to describe survey data to inform the delivery of Phase 2, where two focus groups further explored the topics. Thematic analysis was used to investigate the qualitative data. Results: Twenty-eight health professionals and 11 parents/guardians completed the survey, and 14 health professionals and 6 parents/guardians participated in the focus groups. Participants believed that the most beneficial approach would target younger children with family-based interventions, via a nontraditional structure. There was a strong preference for interactive content, gamification, and practical resources to translate knowledge into practice. Parents emphasized that there should be no assumption of basic knowledge, and that decision fatigue is a barrier to engagement. Conclusion: Participants provided clear direction regarding key aspects for future development of an online prevention program, highlighting the importance of codesign to tailor the program to identified needs.
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Affiliation(s)
- Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Clare Dix
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Jessica Hardt
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.,Children's Health Queensland Hospital and Health Service, Queensland Health, South Brisbane, Queensland, Australia
| | - Rebecca Farletti
- Health and Wellbeing Queensland, Queensland Government, Milton, Queensland, Australia
| | - Robyn Littlewood
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia.,Health and Wellbeing Queensland, Queensland Government, Milton, Queensland, Australia
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Hardin HK, Bender AE, Killion CM, Moore SM. Materials and Methods for Recruiting Systematically Marginalized Youth and Families for Weight-Management Intervention Trials: Community Stakeholders' Perspectives. FAMILY & COMMUNITY HEALTH 2023; 46:13-27. [PMID: 36383230 PMCID: PMC9680002 DOI: 10.1097/fch.0000000000000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Rates of overweight and obesity are problematic among systematically marginalized youth; however, these youth and their families are a hard-to-reach research population. The purpose of our study was to identify facilitators and barriers for recruiting systematically marginalized families in youth weight-management intervention research. This study built upon existing evidence through involvement of youth, parents, community agency workers, and school nurses, and an exploration of both recruitment materials and processes. Seven focus groups were conducted with 48 participants from 4 stakeholder groups (youth, parents, school nurses, and community agency workers). A codebook approach to thematic analysis was used to identify key facilitator and barrier themes related to recruitment materials and processes across the stakeholder groups. Ecological systems theory was applied to contextualize the facilitators and barriers identified. Participants reported the need to actively recruit youth in the study through engaging, fun recruitment materials and processes. Participants reported greater interest in recruitment at community-based events, as compared to recruitment through health care providers, underscoring the depth of distrust that this sample group has for the health care system. Recommendations for recruitment materials and processes for weight-management intervention research with systematically marginalized families are proposed.
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Affiliation(s)
- Heather K Hardin
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio (Drs Hardin, Killion, and Moore); and Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington (Dr Bender)
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de Pooter N, van den Eynde E, Raat H, Seidell JC, van den Akker EL, Halberstadt J. Perspectives of healthcare professionals on facilitators, barriers and needs in children with obesity and their parents in achieving a healthier lifestyle. PEC INNOVATION 2022; 1:100074. [PMID: 37213756 PMCID: PMC10194305 DOI: 10.1016/j.pecinn.2022.100074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 05/23/2023]
Abstract
Objective To explore the perspectives of healthcare professionals (HCPs) within an integrated care approach on the facilitators, barriers and needs in children with obesity and their parents in achieving a healthier lifestyle. Methods Semi-structured interviews were conducted with eighteen HCPs working within a Dutch integrated care approach. The interviews were analyzed by performing a thematic content analysis. Results Main facilitators identified by HCPs were support from parents and the social network. Main barriers were first and foremost family's lack of motivation, which was singled out as a precondition for starting the behavior change process. Other barriers were child's socio-emotional problems, parental personal problems, lack of parenting skills, parental lack of knowledge and skills regarding a healthier lifestyle, parental lack of problem awareness and HCP's negative attitude. To overcome these barriers, main needs that HCPs suggested were a tailored approach in healthcare and a supportive HCP. Conclusion The HCPs identified the breadth and complexity of underlying factors of childhood obesity, of which the family's motivation was pointed out as a critical factor to address. Innovation Understanding the patient's perspective is important for HCPs to provide the tailored care needed to address the complexity of childhood obesity.
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Affiliation(s)
- Naomi de Pooter
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands
- Corresponding author at: Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Amsterdam Public Health Institute, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Emma van den Eynde
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jacob C. Seidell
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | | | - Jutka Halberstadt
- Department of Health Sciences, Vrije Universiteit Amsterdam, the Netherlands
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Hoffmann SH, Paldam Folker A, Buskbjerg M, Paldam Folker M, Huber Jezek A, Lyngsø Svarta D, Nielsen Sølvhøj I, Thygesen L. Potential of Online Recruitment Among 15-25-Year Olds: Feasibility Randomized Controlled Trial. JMIR Form Res 2022; 6:e35874. [PMID: 35612877 PMCID: PMC9178448 DOI: 10.2196/35874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 11/20/2022] Open
Abstract
Background Recruiting young people for health and intervention studies by traditional methods has become increasingly challenging. The widespread access to the internet may offer new strategies for online recruitment. Objective This study aims to assess the feasibility of online recruitment for a randomized controlled trial evaluating the effectiveness of Mindhelper, an online national youth mental health promotion service. The target group was young Danes aged 15-25 in need of mental health promotion. Methods Advertisements for recruitment were set up on Facebook and Instagram. Browser history was collected for a subsample of participants. We compared basic characteristics of participants who completed the baseline survey and those who did not, as well as of participants who completed the follow-up survey and those who were lost to follow-up. The significance of these differences was tested with the Pearson chi-square test. Results A total of 560 Danes aged 15-25 were recruited within 1 month (ie, had completed the baseline survey). Among these participants, 356 (63.6%) were at risk of developing depression or stress. The average advertisement price per participant completing the baseline questionnaire was 31 DKK (approximately €4 [US $4.2]). The follow-up survey was sent to 545 participants, of whom 318 (58.3%) completed the survey. No statistically significant differences were observed in baseline characteristics of participants who completed the follow-up and those who were lost to follow-up in terms of gender (P=.45), age (P=.35), occupation (P=.17), cohabitation (P=.90), mental well-being (P=.26), mental illness (P=.44; impact of the illness, P=.05), or use of the internet when having a hard time (P=.92). Conclusions We conclude that it is feasible to recruit young Danes online for a large-scale randomized controlled trial assessing the effectiveness of Mindhelper. Trial Registration ClinicalTrials.gov NCT04650906; https://clinicaltrials.gov/ct2/show/NCT04650906
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Affiliation(s)
- Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mark Buskbjerg
- Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Marie Paldam Folker
- Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Andrea Huber Jezek
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Durita Lyngsø Svarta
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ida Nielsen Sølvhøj
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Team members influence retention in a First Peoples’ community-based weight-loss program. Prev Med Rep 2022; 26:101710. [PMID: 35141119 PMCID: PMC8814646 DOI: 10.1016/j.pmedr.2022.101710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/06/2022] [Accepted: 01/23/2022] [Indexed: 11/21/2022] Open
Abstract
Program completion is strongly influenced by teammate completion. Other factors influencing program completion vary with participation occasion. Previous participation and health behaviors do not influence subsequent completion.
The aim of this study was to evaluate program retention factors in a repeated team-based weight-loss and healthy lifestyle program for Aboriginal and Torres Strait Islander Peoples. Data comprised 3107 participants in 10 Aboriginal Knockout Health Challenge contests. Multiple variable and bivariate analyses compared age, gender, self-reported behaviors (physical activity and fruit and vegetable consumption) and objectively measured weight between completers and non-completers. First-time participants (n = 3107) who completed were more likely to be female, be older, weigh less and have more completing members in their team; only the number of team members completing was significant among participants (n = 1245) who took part in a second contest participation. Multivariate results were similar, with a participant’s odds of completing on their first and second participation occasion increasing by 1.16 and 1.18, respectively, with every teammate completed. Given that the strongest effect centered on a social factor, this highlights the importance of having community-driven design and the benefits of a group-based approach to engage and maintain First Peoples’ engagement in preventive health programs. Further, by identifying a change in factors associated with retention in successive weight-loss attempts, this study improves understanding of retention in weight-loss programs more generally.
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Bagabaldo PAA, Atienza LM, Castillo-Israel KAT, Estacio MAC, Gaban PJV, Maniwang JRC, Gapasin RP, Estribillo AGM, Cena-Navarro RB. ‘Saba’ banana (Musa acuminata x balbisiana BBB Group) peel pectin supplementation improves biomarkers of obesity and associated blood lipid disorders in obese hypercholesterolemic mice. Curr Res Food Sci 2022; 5:251-260. [PMID: 35146442 PMCID: PMC8801348 DOI: 10.1016/j.crfs.2022.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 10/27/2022] Open
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Jones HM, Oyebode O, Melendez-Torres GJ, Al-Khudairy L. Professional stakeholder's views of adolescent weight management programmes: a qualitative study. BMC Res Notes 2021; 14:125. [PMID: 33812371 PMCID: PMC8019507 DOI: 10.1186/s13104-021-05512-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/04/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Family-based multi-component weight management programmes are recommended for adolescents with obesity in England and Wales, however, these programmes suffer from poor uptake and high attrition rates. This study aimed to gather the views of professional stakeholders in a UK weight management programme to identify potential areas to target to improve engagement and success for such programmes. RESULTS Semi-structured interviews were conducted with those involved in the commissioning, referral, coordination or delivery of a weight management programme (n = 11). Interviews were analysed using qualitative content analysis. Three main categories developed: professional support, tailoring and intervention content. Participants recognised the importance of support from experienced professionals, as well as family and peers. There was agreement that longer-term support was needed for adolescents with obesity; suggestions included integrating follow-up support with schools and leisure services. Emotional and psychological support must be prioritised. Having a variety of delivery modes, such as group and one to one, particularly in the home environment, were recommended. Stakeholders agreed that weight management programmes for adolescents need to be more proactive at incorporating technology. By acting on the views of those that work closely with adolescents, engagement with weight management programmes may be improved.
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Affiliation(s)
- Helen M. Jones
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - Oyinlola Oyebode
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - G. J. Melendez-Torres
- Peninsula Technology Assessment Group, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Lena Al-Khudairy
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
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Drake CJ, Keith M, Dober MR, Evans S, Olive LS. A qualitative investigation into the perceived therapeutic benefits and barriers of a surf therapy intervention for youth mental health. Complement Ther Med 2021; 59:102713. [PMID: 33757830 DOI: 10.1016/j.ctim.2021.102713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE This study aims to investigate potential therapeutic pathways and barriers to participation in a surf therapy program for youth at risk of mental health problems from the perspective of participants, surf mentors and program coordinator. METHOD Nineteen individuals, consisting of youth (n = 9, 5 male, 4 female, M = 12.8, SD = 2.6), mentors (n = 9, male 5, female 4, M = 37.60, SD = 13.62) and the Ocean Mind program coordinator (n = 1, male, age 26 years), participated in semi-structured focus groups or follow-up interviews. This qualitative study analysed data using inductive thematic analysis. RESULTS Six themes were identified in total, with self-efficacy, interpersonal skills and forming a mentorship being potential therapeutic pathways of the surf therapy intervention. Surf instruction techniques and family engagement were both identified as potential barriers that negatively affect participant engagement. Additionally, the natural environment was identified as both a potential therapeutic pathway and a barrier. CONCLUSION Surf therapy interventions appears to hold a number of benefits for youth mental health via pathways relating to the promotion of mental health protective factors.
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Affiliation(s)
- Cameron J Drake
- School of Psychology, Deakin University, Locked Bag 20001, Geelong, Victoria, 3220 Australia.
| | - Michael Keith
- School of Psychology, Deakin University, Locked Bag 20001, Geelong, Victoria, 3220 Australia.
| | - Madeleine R Dober
- School of Psychology, Deakin University, Locked Bag 20001, Geelong, Victoria, 3220 Australia.
| | - Subhadra Evans
- School of Psychology, Deakin University, Locked Bag 20001, Geelong, Victoria, 3220 Australia; Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Lisa S Olive
- School of Psychology, Deakin University, Locked Bag 20001, Geelong, Victoria, 3220 Australia; Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia; IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Faculty of Health, Deakin University, Geelong, Victoria, Australia; Elite Sport and Mental Health, Orygen, University of Melbourne, Parkville, Victoria, Australia.
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12
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Nagelhout GE, Abidi L, de Vries H. Reasons for (not) participating in a community-based health promotion program for low-income multi-problem households in the Netherlands: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:241-249. [PMID: 32633021 PMCID: PMC7818491 DOI: 10.1111/hsc.13087] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 05/23/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
People living in low-income multi-problem households may benefit from participation in a community-based health promotion program. Yet, low participation rates are often a problem. It is important to assess reasons for (not) participating to better tailor programs to the needs of this particular at-risk group. Back2Balance is a health promotion program for low-income multi-problem households from Apeldoorn, the Netherlands. We performed qualitative interviews among participants (n = 16) and non-participants (n = 12) of the program and asked them for their reasons for (not) participating in the program. Interview transcripts were thematically analysed using the Framework method. Participants indicated that reasons for participating encompassed intrapersonal motivators (e.g. to become healthier), interpersonal motivators (e.g. participating to get to know new people) and program level motivators (e.g. learning about a healthy lifestyle, and free or very low cost). Participants and non-participants outlined the importance of intrapersonal barriers (e.g. physical health problems), interpersonal barriers (e.g. family circumstances) and program level barriers (e.g. logistic issues, and not understanding or knowing about some part of the program). Concluding, combining health promotion with social interaction motivated participants to participate in the Back2Balance program. Yet, both participants and non-participants experienced many barriers for participation, some of which were related to their multi-problem situation.
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Affiliation(s)
- Gera E. Nagelhout
- Department of Health PromotionMaastricht University (CAPHRI)Maastrichtthe Netherlands
- IVO Research InstituteThe Haguethe Netherlands
| | - Latifa Abidi
- Department of Health PromotionMaastricht University (CAPHRI)Maastrichtthe Netherlands
| | - Hein de Vries
- Department of Health PromotionMaastricht University (CAPHRI)Maastrichtthe Netherlands
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13
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Kennedy BM, Davison G, Fowler LA, Rodriguez-Guzman E, Collins ML, Baker A, Cook S, Lindros J, Wilfley DE, Zebrick AJ, Staiano AE. Perceptions of a Pragmatic Family-Centered Approach to Childhood Obesity Treatment. Ochsner J 2021; 21:30-40. [PMID: 33828424 PMCID: PMC7993422 DOI: 10.31486/toj.19.0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Few studies have examined both parent and child preferences regarding family-based weight management programs (WMPs) delivered in primary care settings, especially among racial minority populations. The purpose of this study was to determine the perceptions that parents and their children/adolescents have about the components that should be included in a family-based WMP and to identify perceived preferences, benefits, and/or barriers to participation. Methods: A sample of 60 participants (30 parents and 30 children/adolescents) participated in 1 of 5 separate structured focus groups, using probing questions and the nominal group technique (NGT). Parents reported demographics for themselves and their children/adolescents. Themes from probing questions were identified using thematic analysis. Results: Parents were primarily African American (93%) and diverse in income. NGT sessions revealed that parents across all groups perceived that education on healthy eating, parental involvement, and effective program leaders are most important and have the greatest impact, while parental involvement was perceived as the easiest method to implement in a family-based WMP for childhood obesity. Children/adolescents perceived that education on healthy eating and exercise would have the greatest impact, while healthy eating and meal plans were perceived as the easiest methods to implement with a family. Parents and children/adolescents also identified improved psychological well-being (eg, decreased bullying, increased self-esteem, and motivation) as a desired program outcome. Conclusion: Parents and their children/adolescents highlighted the importance of physical and psychological health as targets in treatment. Feedback from patients can inform the design and implementation of family-based WMPs delivered in primary care settings.
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Affiliation(s)
| | - Genevieve Davison
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Lauren A. Fowler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | | | | | | | - Stephen Cook
- Department of Research, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY
| | | | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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14
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Grootens-Wiegers P, van den Eynde E, Halberstadt J, Seidell JC, Dedding C. The "Stages Towards Completion Model": what helps and hinders children with overweight or obesity and their parents to be guided towards, adhere to and complete a group lifestyle intervention. Int J Qual Stud Health Well-being 2020; 15:1735093. [PMID: 32148191 PMCID: PMC7144242 DOI: 10.1080/17482631.2020.1735093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose: Lifestyle interventions can be effective in the management of overweight and obesity in children. However, ineffective guidance towards interventions and high attrition rates affect health impacts and cost effectiveness. The aim of this study was to gain insight into the factors influencing participation, in particular guidance towards, adherence to and completion of an intervention. Methods: A narrative literature review was performed to identify factors related to participation, leading to the development of the “Stages towards Completion Model”. Semi-structured interviews (n = 33) and three focus group discussions (n = 25) were performed with children and parents who completed two different group lifestyle interventions, as well as with their coaches. Results: The main barrier to participating in a lifestyle intervention was the complex daily reality of the participants. The main facilitator to overcome these barriers was a personal approach by all professionals involved. Conclusions: Participation in a lifestyle intervention is not influenced by one specific factor, but by the interplay of facilitators and barriers. A promising way to stimulate participation and thereby increase the effectiveness of interventions would be an understanding of and respect for the complex circumstances of participants and to personalize guidance towards and execution of interventions.
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Affiliation(s)
- Petronella Grootens-Wiegers
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Medical Ethics and Health Law, Leiden University Medical Center, Leiden, The Netherlands
| | - Emma van den Eynde
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands.,Department of Pediatric Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jutka Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Christine Dedding
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Medical Humanities, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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15
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De Rosis S, Pennucci F, Noto G, Nuti S. Healthy Living and Co-Production: Evaluation of Processes and Outcomes of a Health Promotion Initiative Co-Produced with Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218007. [PMID: 33143198 PMCID: PMC7662519 DOI: 10.3390/ijerph17218007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/09/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
Co-production is an approach to designing, delivering, and evaluating public services through strict collaboration among professionals and the people using services with an equal and reciprocal relationship. Health promotion initiatives that include education services rarely use the co-production approach. Nevertheless, the value of co-production is widely recognized, although it is considered a normative good, and scarce and mixed evidence is available in literature. The purpose of this paper is to provide evidence supporting the hypothesis that a co-production approach, applied to an intervention for preventing obesity, can be effective and efficient. To this end, an evaluation of the processes, outputs meant as intermediate results, and behavioral and economic outcomes of a public health-promotion initiative co-produced and co-delivered with adolescents (beFood) was conducted. Mixed methods were used, including field-observations, two self-reported questionnaires, and an opportunity–cost analysis that compared beFood to traditional approaches of public health promotion. The co-production model was successfully implemented and appears to be effective—more than 5000 adolescents were reached by only 49 co-producer adolescents, who reported behavioral changes (e.g., eating better and practicing more physical activity). The cost analysis showed that the co-production approach was also efficient, producing relevant savings and potentially making available more than 3000 h of professionals’ time. This research can support a re-thinking of public institutions’ organization, public initiatives’ design, and public servants’ role.
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Affiliation(s)
- Sabina De Rosis
- Management and Healthcare Laboratory-Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (S.D.R.); (G.N.); (S.N.)
| | - Francesca Pennucci
- Management and Healthcare Laboratory-Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (S.D.R.); (G.N.); (S.N.)
- Correspondence: ; Tel.: +39-050-883865
| | - Guido Noto
- Management and Healthcare Laboratory-Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (S.D.R.); (G.N.); (S.N.)
- Department of Economics, University of Messina, 98122 Messina, Italy
| | - Sabina Nuti
- Management and Healthcare Laboratory-Institute of Management and Department EMbeDS, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (S.D.R.); (G.N.); (S.N.)
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16
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Crino ND, Parker HM, Gifford JA, Lau KYK, Greenfield EM, Donges CE, O'Dwyer NJ, Steinbeck KS, O'Connor HT. What do young women with obesity want from a weight management program? Eat Weight Disord 2020; 25:1303-1309. [PMID: 31473985 DOI: 10.1007/s40519-019-00763-z] [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: 03/06/2019] [Accepted: 07/27/2019] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Early adulthood is a high-risk time for weight gain; however, young women with obesity are difficult to recruit to weight management programs. To encourage participation and retention, it is important to understand what young women want from these programs. The purpose of the study was to explore participants' perspectives on the features of an ideal weight management program. METHODS Semi-structured interview schedules were used to elicit information from eight focus groups [27 women; mean age of 29.1 (± 5.1) years, mean body mass index (BMI; kg/m2) of 35.8 (± 2.9)]. The focus groups were transcribed, coded and analyzed qualitatively. RESULTS The themes that emerged were program content, format, program characteristics, program name, location and duration. A major finding from the study is that participants value a program that includes nutritional, psychological and lifestyle interventions, and includes components that are not traditionally part of weight management programs such as body acceptance, sexual health and dressing and grooming. A program name that conveys wellness and body positivity was valued. Participants highlighted the importance of individualized programs that are also tailored to the needs of young adults, and delivered by credible and approachable staff who provide accountability. Cost-effectiveness, flexibility, accessibility, time-commitment were important considerations and the use of a combination of virtual and in-person methods (including group interventions) appealed to this cohort. CONCLUSION Knowledge of program features which resonate with young women facilitates development of innovative ways to engage and support evidence-based weight management in this vulnerable group. LEVEL OF EVIDENCE V.
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Affiliation(s)
- Natalie D Crino
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.
| | - Helen M Parker
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia
| | - Janelle A Gifford
- Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia
| | - K Y Karen Lau
- Faculty of Science, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Eliya M Greenfield
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia
| | - Cheyne E Donges
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, 2795, Australia
| | - Nicholas J O'Dwyer
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia.,School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, 2795, Australia
| | - Katharine S Steinbeck
- The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW, 2145, Australia
| | - Helen T O'Connor
- Charles Perkins Centre, The University of Sydney, Building D17 John Hopkins Drive, Camperdown, NSW, 2006, Australia.,Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, 1825, Australia
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17
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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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18
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Watson PM, Dugdill L, Pickering K, Hargreaves J, Staniford LJ, Owen S, Murphy RC, Knowles ZR, Johnson LJ, Cable NT. Distinguishing factors that influence attendance and behaviour change in family-based treatment of childhood obesity: A qualitative study. Br J Health Psychol 2020; 26:67-89. [PMID: 32710510 DOI: 10.1111/bjhp.12456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 06/13/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES For the effective treatment of childhood obesity, intervention attendance and behaviour change at home are both important. The purpose of this study was to qualitatively explore influences on attendance and behaviour change during a family-based intervention to treat childhood obesity in the North West of England (Getting Our Active Lifestyles Started (GOALS)). DESIGN Focus groups with children and parents/carers as part of a broader mixed-methods evaluation. METHODS Eighteen focus groups were conducted with children (n = 39, 19 boys) and parents/carers (n = 34, 5 male) to explore their experiences of GOALS after 6 weeks of attendance (/18 weeks). Data were analysed thematically to identify influences on attendance and behaviour change. RESULTS Initial attendance came about through targeted referral (from health care professionals and letters in school) and was influenced by motivations for a brighter future. Once at GOALS, it was the fun, non-judgemental healthy lifestyle approach that encouraged continued attendance. Factors that facilitated behaviour change included participatory learning as a family, being accountable and gradual realistic goal setting, whilst challenges focussed on fears about the intervention ending and a lack of support from non-attending significant others. CONCLUSIONS Factors that influence attendance and behaviour change are distinct and may be important at different stages of the family's change process. Practitioners are encouraged to tailor strategies to support both attendance and behaviour change, with a focus on whole family participation within and outside the intervention.
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Affiliation(s)
- Paula M Watson
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - Lindsey Dugdill
- Formerly School of Health Sciences, University of Salford, Salford, UK
| | - Katie Pickering
- Physical Activity, Wellbeing, and Public Health Research Group, Academy of Sport and Physical Activity, Sheffield Hallam University, UK
| | | | - Leanne J Staniford
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, UK
| | - Stephanie Owen
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - Rebecca C Murphy
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - Zoe R Knowles
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - Laura J Johnson
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
| | - N Timothy Cable
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
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19
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Cardiovascular Disease Prevention in Adolescents: eHealth, Co-Creation, and Advocacy. Med Sci (Basel) 2019; 7:medsci7020034. [PMID: 30813490 PMCID: PMC6410225 DOI: 10.3390/medsci7020034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death globally. Early atherosclerotic changes can begin to occur early in life and though adolescence. The prevalence of modifiable CVD risk factors, namely, smoking, poor diet quality, excessive alcohol intake, physical inactivity, and overweight and obesity can exacerbate the early onset of atherosclerosis. There is a need to improve modifiable risk factors during adolescence to prevent progression to CVD in later life. Electronic health (eHealth) behaviour change interventions are a potential solution for adolescents to improve CVD risk factors, given adolescents are digital frontrunners and digital technology is wide-reaching. The process of co-creating eHealth behaviour change interventions with adolescents is a promising strategy to improve intervention effectiveness and engagement. Additionally, effective youth advocacy is an emerging strategy for CVD prevention in adolescents. This narrative review evaluates published eHealth behaviour change interventions targeting cardiovascular disease risk factors in adolescents, which utilize a co-creation process, describe the emerging role of advocacy in CVD prevention for adolescents and provide recommendations for future interventions.
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20
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Understanding engagement in a family-focused, multicomponent, childhood weight management programme delivered in the community setting. Public Health Nutr 2019; 22:1471-1482. [PMID: 30724148 DOI: 10.1017/s1368980018003828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To describe public health nurses' (PHN) experiences of referring to, and families' experiences of being referred to, a multicomponent, community-based, childhood weight management programme and to provide insight into families' motivation to participate in and complete treatment. DESIGN Qualitative study using semi-structured interviews and the draw-and-write technique. SETTING Two geographical regions in the south and west of Ireland.ParticipantsNine PHN involved in the referral process, as well as ten parents and nine children who were referred to and completed the programme, participated in the present study. RESULTS PHN were afraid of misclassifying children as obese and of approaching the subject of excess weight with parents. Peer support from other PHN as well as training in how best to talk about weight with parents were potential strategies suggested to alleviate these fears. Parents recalled the anxiety provoked by the 'medical terminology' used during referral and their difficulty interpreting what it meant for the health of their child. Despite initial fears, concern for their children's future health was a major driver behind their participation. Children's enjoyment, the social support experienced by parents as well as staff enthusiasm were key to programme completion. CONCLUSIONS The present study identifies the difficulties of referring families to community weight management programmes and provides practical suggestions on how to support practitioners in making referrals. It also identifies key positive factors influencing parents' decisions to enrol in community weight management programmes. These should be maximised by staff and policy makers when developing similar programmes.
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21
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Jones HM, Al-Khudairy L, Melendez-Torres GJ, Oyebode O. Viewpoints of adolescents with overweight and obesity attending lifestyle obesity treatment interventions: a qualitative systematic review. Obes Rev 2019; 20:156-169. [PMID: 30375160 DOI: 10.1111/obr.12771] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/18/2018] [Accepted: 08/15/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Current UK guidance recommends that adolescents with obesity attend a family-based multi-component obesity intervention. However, these programmes suffer from low recruitment and high rates of attrition. Understanding the views of adolescents is necessary for developing future interventions. The aim of this systematic review was to synthesize and explore the views of adolescents who have attended an obesity intervention. METHODS Published literature was identified by searching six databases. Studies of adolescents (12-17 years) who attended an obesity intervention were examined. Only studies that collected and analysed data qualitatively were included. Full texts were analysed using thematic synthesis. RESULTS Twenty-eight studies were included. Thirty-five analytical themes were developed that were broadly divided into seven domains. Key themes included ensuring adolescents receive a 'tailored intervention' that involves 'active engagement'. Support from professionals, family and peers were valued highly. Adolescents expressed 'prior fears of attending interventions' and wanted 'longer term support'. 'Enjoyment of sport and physical activity' was evident, and adolescents were strongly motivated by improving body image and social desirability. DISCUSSION Considering the views of adolescents attending obesity interventions may help to inform policy makers in the development of future interventions. This may lead to an improvement in recruitment and attrition rates.
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Affiliation(s)
- H M Jones
- Warwick Medical School, University of Warwick, Coventry, UK
| | - L Al-Khudairy
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - O Oyebode
- Warwick Medical School, University of Warwick, Coventry, UK
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22
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Grové C. Using Social Networking Sites in Research: An Emerging Approach to Engaging With Young People Who Have a Parent With a Mental Illness and/or Substance Abuse Disorder. Front Psychiatry 2019; 10:281. [PMID: 31118908 PMCID: PMC6506785 DOI: 10.3389/fpsyt.2019.00281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 04/11/2019] [Indexed: 01/25/2023] Open
Abstract
The challenges involved in engaging young people who have a parent with a mental illness in research and in programs are well documented. Social networking sites provide a potentially useful medium to include at-risk youths and their families by removing some accessibility barriers that may prevent engagement and connection with individuals whose parents or family members have a mental illness. This paper examines how social networking sites can be used to recruit youths and/or their families and engage them in research. Applying a case study analysis, the implications of using social media as a tool for recruitment and data collection and the ethical considerations and limitations will be discussed. Results tentatively indicate that social networking sites may be an effective method to engage young people of parents with a mental illness. The study argues for more informed use of social platforms for the translation and dissemination of research and intervention prevention. Overall, this paper will contribute to public mental health practice through guidelines and policy about social media research with at-risk young people and their families.
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Affiliation(s)
- Christine Grové
- Faculty of Education, Monash University, Melbourne, VIC, Australia
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23
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Crino ND, Parker HM, Gifford JA, Lau KYK, Greenfield EM, Donges CE, O'Dwyer NJ, Steinbeck KS, O'Connor HT. Recruiting young women to weight management programs: Barriers and enablers. Nutr Diet 2018; 76:392-398. [PMID: 30575276 DOI: 10.1111/1747-0080.12505] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 10/25/2018] [Accepted: 11/12/2018] [Indexed: 12/17/2022]
Abstract
AIM Recruiting young women to weight management research programs is difficult. The purpose of this study was to gain insights into the barriers and motivators that influence participation and to explore effective methods of recruitment from the perspective of young women with obesity living in both urban and regional areas. METHODS Semi-structured interviews were used to elicit information from focus groups. The interviews were transcribed, coded and analysed qualitatively. Eight focus groups, which included a total of 27 women, were conducted. Participants had a mean age of 29.1 (±5.1) years and a mean body mass index of 35.8 (±2.9) kg/m2 . RESULTS The barriers to participation were multifaceted and largely similar across urban and regional participants. Fear of judgement and uncertainty about the process were major psychosocial barriers. A lack of tailoring of program content was an important program-related barrier. Physical barriers such as time commitment, cost and access were discussed extensively, particularly in urban groups. The provision of incentives and the use of positive language that focusses on the benefits of the intervention were viewed positively. Physical and virtual methods of recruitment were identified as potentially effective provided they were presented in media that this group is likely to use and can access in a private location. CONCLUSIONS The results of this study provide a greater understanding of the challenges faced by young women in relation to participation in weight management programs and some of the potential methods that could be utilised to facilitate participation.
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Affiliation(s)
- Natalie D Crino
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Helen M Parker
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - Janelle A Gifford
- Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
| | - K Y Karen Lau
- Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia
| | | | - Cheyne E Donges
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Nicholas J O'Dwyer
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia.,School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Katharine S Steinbeck
- The Children's Hospital at Westmead Clinical School, University of Sydney, New South Wales, Australia
| | - Helen T O'Connor
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia.,Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
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Øen G, Kvilhaugsvik B, Eldal K, Halding AG. Adolescents' perspectives on everyday life with obesity: a qualitative study. Int J Qual Stud Health Well-being 2018; 13:1479581. [PMID: 29912659 PMCID: PMC7012000 DOI: 10.1080/17482631.2018.1479581] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose: This study aimed to gain an in-depth understanding of the perspectives and life experiences of adolescents living with obesity. Methods: Five adolescents living with obesity were involved in repeated interviews, and qualitative content analysis was performed. Results: Three themes emerged: obesity as a multi-faceted and difficult to solve condition; obesity as a shameful and vulnerable subject; and bullying and fragile social relationships. Adolescents living with obesity described everyday life challenges as difficult to interpret and solve. Adolescents living with obesity perceived causes for obesity differently, and those who emphasised familial determinants seemed to face greater challenges. Lack of support from parents, trusted friends and health-care providers and bullying, shame, guilt and self-blame represented threats that decreased motivation for help seeking and successful life-style changes. The adolescents were ambivalent regarding disclosing their concerns and seeking help. The adolescents feared that health care providers would demand too much from them, and peers were perceived as a possible source of support. Conclusion: Care providers need to be skilled in assessing each individual’s resources and interpretations of their condition, to be able to communicate in a respectful, patient-centred manner and to assist adolescents to explore their ambivalence and set their own realistic goals. More research is needed.
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Affiliation(s)
- Gudbjørg Øen
- a Faculty of Health and Social sciences , Western Norway University of Applied Sciences , Bergen , Norway
| | - Bente Kvilhaugsvik
- b Faculty of Health and Social sciences , Western Norway University of Applied Sciences , Stord , Norway
| | - Kari Eldal
- c Faculty of Health and Social sciences , Western Norway University of Applied Sciences , Førde , Norway
| | - Anne-Grethe Halding
- c Faculty of Health and Social sciences , Western Norway University of Applied Sciences , Førde , Norway
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25
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Partridge SR, Redfern J. Strategies to Engage Adolescents in Digital Health Interventions for Obesity Prevention and Management. Healthcare (Basel) 2018; 6:E70. [PMID: 29933550 PMCID: PMC6163226 DOI: 10.3390/healthcare6030070] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 12/20/2022] Open
Abstract
Obesity is one of the greatest health challenges facing today’s adolescents. Dietary interventions are the foundation of obesity prevention and management. As adolescents are digital frontrunners and early adopters of technology, digital health interventions appear the most practical modality for dietary behavior change interventions. Despite the rapid growth in digital health interventions, effective engagement with adolescents remains a pertinent issue. Key strategies for effective engagement include co-designing interventions with adolescents, personalization of interventions, and just-in-time adaptation using data from wearable devices. The aim of this paper is to appraise these strategies, which may be used to improve effective engagement and thereby improve the dietary behaviors of adolescents now and in the future.
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Affiliation(s)
- Stephanie R Partridge
- Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW 2145, Australia.
- Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Julie Redfern
- Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, Westmead, NSW 2145, Australia.
- The George Institute for Global Health, The University of New South Wales, Camperdown, NSW 2006, Australia.
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26
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van der Heijden LB, Feskens EJM, Janse AJ. Maintenance interventions for overweight or obesity in children: a systematic review and meta-analysis. Obes Rev 2018; 19:798-809. [PMID: 29363283 DOI: 10.1111/obr.12664] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/28/2017] [Accepted: 12/07/2017] [Indexed: 11/28/2022]
Abstract
Childhood obesity is associated with significant health consequences. Although several intervention programmes for children result in weight loss or stabilization in the short-term, preventing relapse after treatment remains an important challenge. This systematic review summarizes the evidence about maintenance interventions after treatment in childhood obesity. Studies were identified by searching PubMed, Embase, Cochrane Library, Scopus, Web of Science, PsycINFO, CINAHL and SocINDEX. The primary outcome measure for this review was body mass index standard deviation score (BMI-Z-score). Data were pooled using quality effect models. Eleven studies (1,532 participants, age 2-18 years) were included, covering a wide range of maintenance approaches. Included studies varied widely in methodological quality. Pooled analysis showed that the BMI-Z-score of maintenance intervention participants remained stable, whereas control participants experienced a slight increase. No differences were observed regarding intensity and duration of therapy. A slight preference for 'face-to-face' versus 'on distance' interventions was shown. In summary, this review shows that, although there is limited quality data to recommend one maintenance intervention over another, continued treatment does have a stabilizing effect on BMI-Z-score. Considering the magnitude of the problem of childhood obesity, this is an important finding that highlights the need for further research on weight loss maintenance.
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Affiliation(s)
| | - E J M Feskens
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - A J Janse
- Department of Pediatrics, Hospital Gelderse Vallei, Ede, The Netherlands
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27
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Sundar TKB, Løndal K, Lagerløv P, Glavin K, Helseth S. Overweight adolescents' views on physical activity - experiences of participants in an internet-based intervention: a qualitative study. BMC Public Health 2018; 18:448. [PMID: 29618327 PMCID: PMC5885359 DOI: 10.1186/s12889-018-5324-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/15/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Overweight and obese adolescents are reported to be less physically active than their peers. Research-based knowledge about their views may contribute to a better understanding of key factors that may foster or undermine motivation for physical activity, and provide knowledge for the future development of interventions. This paper explores experiences of physical activity among overweight adolescents, age 13-14 years, participants in Young & Active, a web-based controlled trial intervention to increase physical activity (ClinicalTrials.gov NCT01700309). The theoretical perspective is based on Self-Determination Theory. METHODS Two qualitative post-intervention research interviews, with a nine-month interval, were conducted with 21 adolescents, 15 girls and 6 boys to study short-term and long-term changes. The informants were recruited from a total of 84 participants from the Young & Active intervention group. Data were analyzed using qualitative content analysis. RESULTS The participants associated physical activity with organized sports and physical education classes at school, and as a means of promoting good health and attractive bodies. A majority of the adolescents said that they experienced their health as poorer than other youths, and expressed worries about their fitness and future health. Mastering a physical activity, being together with friends and having fun promoted motivation to perform sports. Not mastering an activity, or not knowing the others made them less motivated. None of the adolescents highlighted the importance of informal active living when asked about their understanding and experiences of physical activity. Consistency was found between the first and second interviews. CONCLUSION This study adds to limited research on overweight and obese adolescents' experiences of physical activity. The participants' views reflect opinions in society about physical activity, and its importance for health. Viewing physical activity as conducted within organized sports makes it necessary to look into how these are organized, structured and led, and what can be done to support self-esteem, autonomous motivation and participation. The ability to choose among available, affordable and desirable physical activities, together with friends, may promote participation and maintenance.
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Affiliation(s)
- Turid Kristin Bigum Sundar
- Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Knut Løndal
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet -Oslo Metropolitan University, Oslo, Norway
| | - Per Lagerløv
- Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.,Department of Primary and Secondary Teacher Education, Faculty of Education and International Studies, OsloMet -Oslo Metropolitan University, Oslo, Norway
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28
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Perez AJ, Kebbe M, Holt NL, Gokiert R, Chanoine JP, Legault L, Morrison KM, Sharma AM, Ball GDC. Parent Recommendations to Enhance Enrollment in Multidisciplinary Clinical Care for Pediatric Weight Management. J Pediatr 2018; 192:122-129. [PMID: 29246332 DOI: 10.1016/j.jpeds.2017.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/26/2017] [Accepted: 09/14/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To explore parents' recommendations to enhance enrollment in multidisciplinary clinical care for managing pediatric obesity. STUDY DESIGN Data for this interpretative description study were collected through individual, semistructured interviews that were audiorecorded, transcribed verbatim, and analyzed thematically. Parents (n = 79) were recruited from 4 multidisciplinary weight management clinics in Canada located in Edmonton, Hamilton, Montreal, and Vancouver. RESULTS Most interviewed parents had children with obesity (body mass index ≥95th percentile; 84.2%), were female (87.3%), had postsecondary education (69.6%), and were white (75.9%). Parents' recommendations referred to enrollment opportunities, information about obesity services, motivation for treatment, and accessibility to obesity services. Specifically, parents recommended to increase referral options and follow-up contacts with families during the enrollment process, inform referring physicians and families about the availability and characteristics of obesity services, enhance families' motivation for treatment, prevent families from getting discouraged, make services more appealing to families, and address accessibility issues (eg, offering multiple options for appointment times, providing support for transportation). CONCLUSIONS Parents' recommendations support the need for family-centered approaches to enhance enrollment; however, their feasibility, acceptability, and effectiveness remain to be tested empirically.
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Affiliation(s)
- Arnaldo J Perez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Kebbe
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas L Holt
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Rebecca Gokiert
- Community-University Partnership, Faculty of Extension, University of Alberta, Edmonton, Alberta, Canada
| | - Jean-Pierre Chanoine
- Endocrinology and Diabetes Unit, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Laurent Legault
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Katherine M Morrison
- Department of Pediatrics and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Arya M Sharma
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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Prevention of Type 2 Diabetes in U.S. Hispanic Youth: A Systematic Review of Lifestyle Interventions. Am J Prev Med 2017; 53:519-532. [PMID: 28688727 PMCID: PMC5610076 DOI: 10.1016/j.amepre.2017.05.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/02/2017] [Accepted: 05/22/2017] [Indexed: 02/06/2023]
Abstract
CONTEXT Prevalence of type 2 diabetes mellitus (T2DM) in youth has increased rapidly in recent decades along with rises in childhood obesity. Disparities in risk and prevalence of T2DM are evident in Hispanic youth when compared with non-Hispanic whites. Targeted diabetes prevention programs have been recommended to reduce risk prior to adulthood in this population. This systematic review explores the effectiveness of lifestyle-based diabetes prevention interventions for Hispanic youth. EVIDENCE ACQUISITION PubMed, PsycINFO, Web of Science, and CENTRAL were searched from database inception to March 1, 2017, for studies that evaluated lifestyle-focused prevention trials targeting U.S. Hispanic youth under age 18 years. Fifteen publications met criteria for inclusion. EVIDENCE SYNTHESIS Of the 15 studies, 11 were RCTs; four were uncontrolled. Interventions were heterogeneous in intensity, content, and setting. Duration of most trials was 12-16 weeks. Mean age of participants ranged from 9.8 to 15.8 years, sample sizes were generally small, and the majority of participants were overweight (BMI ≥85th percentile). Three studies reported statistically significant reductions in mean BMI, four in BMI z-score, and six in fasting glucose/insulin. Study quality was moderate to high. Effect sizes were generally small to medium. CONCLUSIONS Evidence for the impact of lifestyle-based diabetes prevention interventions targeting U.S. Hispanic youth remains limited. Few interventions demonstrated success in reducing BMI and glucose regulation and follow-up times were brief. More studies are needed that recruit larger samples sizes, extend follow-up times, explore innovative delivery modalities, and examine effectiveness across sex and age.
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30
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Babatunde OA, Adams SA, Wirth MD, Eberth JM, Sofge J, Choi SK, Harmon BE, Davis L, Drayton R, Hurley TG, Brandt HM, Armstead CA, Hébert JR. Predictors of Retention among African Americans in a Randomized Controlled Trial to Test the Healthy Eating and Active Living in the Spirit (HEALS) Intervention. Ethn Dis 2017; 27:265-272. [PMID: 28811738 DOI: 10.18865/ed.27.3.265] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Retention of racial/ethnic minority groups into research trials is necessary to fully understand and address health disparities. This study was conducted to identify participants' characteristics associated with retention of African Americans (AAs) in a randomized controlled trial (RCT) of a behavioral intervention. METHODS Using data from an RCT conducted from 2009 to 2012 among AAs, participant-level factors were examined for associations with retention between three measurement points (ie, baseline, 3-month, and 12-month). Chi-square tests and logistic regression analyses were conducted to compare retained participants to those who were not retained in order to identify important predictors of retention. RESULTS About 57% of participants (n=238) were retained at 12 months. Baseline characteristics that showed a statistically significant association with retention status were age, marital status, body mass index (BMI), intervention group, enrollment of a partner in the study, and perceived stress score (PSS). Multivariable logistic regression that adjusted for age, BMI, and PSS showed the odds of being retained among participants who enrolled with a partner was 2.95 (95% CI: 1.87-4.65) compared with participants who had no study partner enrolled. The odds of being retained among participants who were obese and morbidly obese were .32 and .27 (95% CI: .14-.74 and .11-.69), respectively, compared with participants who had normal weight. CONCLUSION Having a partner enrolled in behavioral interventions may improve retention of study participants. Researchers also need to be cognizant of participants' obesity status and potentially target retention efforts toward these individuals.
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Affiliation(s)
- Oluwole A Babatunde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Swann Arp Adams
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,College of Nursing, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Connecting Health Innovations LLC, Columbia, SC
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Jameson Sofge
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Seul Ki Choi
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Brook E Harmon
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN
| | - Lisa Davis
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Ruby Drayton
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Thomas G Hurley
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Heather M Brandt
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Cheryl A Armstead
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Connecting Health Innovations LLC, Columbia, SC.,Department of Family and Preventive Medicine, School of Medicine, University of South Carolina, Columbia, SC
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31
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Moore SM, Killion CM, Andrisin S, Lissemore F, Primm T, Olayinka O, Borawski EA. Use of Appreciative Inquiry To Engage Parents as Codesigners of a Weight Management Intervention for Adolescents. Child Obes 2017; 13:182-189. [PMID: 28187267 PMCID: PMC5444421 DOI: 10.1089/chi.2016.0250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Focus groups are often used to involve families as codesigners of weight management interventions. Focus groups, however, are seldom designed to elicit families' strengths and positive experiences. The purpose of this study was to describe the use of the Appreciative Inquiry process in the conduct of focus groups to engage families in the design of a weight management intervention for adolescents. METHODS A convenience sample of 44 parents (84% female; 82% minority) of adolescent children with a BMI ≥ 85th percentile, who were in the 6th-8th grade in a large urban school, participated in focus groups designed to elicit family-positive experiences and strengths regarding healthy living. A structured set of questions based on the Appreciative Inquiry process was used in the focus groups. Analyses consisted of the constant comparative method to generate themes. RESULTS Parent-positive perceptions regarding their family's healthy living habits were reflected in five themes: (1) Having healthy children is a joy; (2) Becoming healthy is a process; (3) Engaging in healthy habits is a family affair; (4) Good health habits can be achieved despite obstacles; and (5) School, community, and social factors contribute to their family's health habits. Parents generated ideas to improve their families' health. CONCLUSIONS Focus groups based on the Appreciative Inquiry process were found to be a useful approach to discover features that are important to low-income, urban-living parents to include in an adolescent weight management program. Recommendations for designing and conducting focus groups based on the Appreciative Inquiry process are provided.
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Affiliation(s)
- Shirley M. Moore
- Edward J. and Louise Mellen Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Cheryl M. Killion
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Sharon Andrisin
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Frances Lissemore
- Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Tonia Primm
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Oluwatomisin Olayinka
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Elaine A. Borawski
- Angela Bowen Williamson Professor of Community Nutrition, Departments of Epidemiology and Biostatistics and Nutrition, Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, School of Medicine, Cleveland, OH
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Gender differences in sleep hygiene practices and sleep quality in New Zealand adolescents aged 15 to 17 years. Sleep Health 2017; 3:77-83. [DOI: 10.1016/j.sleh.2017.02.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 01/30/2017] [Accepted: 02/01/2017] [Indexed: 11/22/2022]
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Kelleher E, Davoren MP, Harrington JM, Shiely F, Perry IJ, McHugh SM. Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review. Obes Rev 2017; 18:183-194. [PMID: 27862851 PMCID: PMC5245104 DOI: 10.1111/obr.12478] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/04/2016] [Accepted: 09/20/2016] [Indexed: 12/13/2022]
Abstract
The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of overweight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition.
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Affiliation(s)
- E Kelleher
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - M P Davoren
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - J M Harrington
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - F Shiely
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.,HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
| | - I J Perry
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - S M McHugh
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
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Musiat P, Winsall M, Orlowski S, Antezana G, Schrader G, Battersby M, Bidargaddi N. Paid and Unpaid Online Recruitment for Health Interventions in Young Adults. J Adolesc Health 2016; 59:662-667. [PMID: 27663927 DOI: 10.1016/j.jadohealth.2016.07.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/12/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE There is a growing need to identify new and innovative approaches to recruit representative samples of young adults in health intervention research. The current study used a data set of screening information from an online well-being intervention trial of young adults, to investigate cost-effectiveness of different recruitment strategies and whether the clinical and demographic characteristics of participants differed depending on paid or unpaid online recruitment sources. METHODS Data were collected from 334 18- to 25-year-old Australians. The study was advertised through a variety of paid and unpaid online recruitment channels (e.g., Google, Facebook, Twitter, YouTube, recruitment agency), with response rates to different recruitment channels tracked using unique Web links. Well-being of participants was measured using the Mental Health Continuum Short Form. Analyses consisted of independent t tests and χ2 tests. RESULTS Overall, unpaid recruitment channels had a considerably higher yield than paid recruitment channels. Of paid recruitment channels, a recruitment agency and paid Facebook advertisements attracted the largest number of individuals. This study also found differences between paid and unpaid online recruitment channels with regard to the well-being and mood of participants. CONCLUSIONS Although the success of online recruitment channels is likely subject to a complex interplay between the number of exposures, the targeted sample, the wording, and placement of the advertisement, as well as study characteristics, our study demonstrated that unpaid recruitment channels are more effective than paid channels and that paid and unpaid channels may result in samples with different characteristics.
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Affiliation(s)
- Peter Musiat
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Australia; Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Megan Winsall
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Australia; Young and Well Cooperative Research Centre, Abbotsford, Australia
| | - Simone Orlowski
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Australia; Young and Well Cooperative Research Centre, Abbotsford, Australia
| | - Gaston Antezana
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Australia; Young and Well Cooperative Research Centre, Abbotsford, Australia
| | - Geoffrey Schrader
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Australia
| | - Malcolm Battersby
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Australia
| | - Niranjan Bidargaddi
- Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Australia; Mental Health Informatics Research Unit, Country Health SA LHN Inc, Adelaide, Australia; Young and Well Cooperative Research Centre, Abbotsford, Australia
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Engström A, Abildsnes E, Mildestvedt T. "It's not like a fat camp" - A focus group study of adolescents' experiences on group-based obesity treatment. Int J Qual Stud Health Well-being 2016; 11:32744. [PMID: 27834179 PMCID: PMC5105318 DOI: 10.3402/qhw.v11.32744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2016] [Indexed: 01/15/2023] Open
Abstract
Background The health burden related to obesity is rising among children and adolescents along with the general population worldwide. For the individual as well as the society this trend is alarming. Several factors are driving the trend, and the solution seems to be multifaceted because long-lasting treatment alternatives are lacking. This study aims to explore adolescents’ and young adults’ motivation for attending group-based obesity treatment and social and environmental factors that can facilitate or hinder lifestyle change. Methods In this study, we arranged three focus groups with 17 participants from different obesity treatment programs in the west and south of Norway. The content in these programs differed, but they all used Motivational Interviewing as a teaching method. We conducted a data-driven analysis using systematic text condensation. Self-determination theory has been used as an explanatory framework. Results We identified four major themes: 1) motivation, 2) body experience and self-image, 3) relationships and sense of belonging, and 4) the road ahead. Many of the participants expressed external motivation to participate but experienced increasing inner motivation and enjoyment during the treatment. Several participants reported negative experiences related to being obese and appreciated group affiliation and sharing experiences with other participants. Conclusion Motivation may shift during a lifestyle course. Facilitating factors include achieving and experiencing positive outcomes as well as gaining autonomy support from other course participants and friends. Obstacles to change were a widespread obesogenic environment as well as feelings of guilt, little trust in personal achievements and non-supporting friends.
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Affiliation(s)
- Anna Engström
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway;
| | - Eirik Abildsnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Thomas Mildestvedt
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Herget S, Reichardt S, Grimm A, Petroff D, Käpplinger J, Haase M, Markert J, Blüher S. High-Intensity Interval Training for Overweight Adolescents: Program Acceptance of a Media Supported Intervention and Changes in Body Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1099. [PMID: 27834812 PMCID: PMC5129309 DOI: 10.3390/ijerph13111099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/30/2016] [Accepted: 10/25/2016] [Indexed: 12/26/2022]
Abstract
High-intensity interval training (HIIT) consists of short intervals of exercise at high intensity intermitted by intervals of lower intensity and is associated with improvement of body composition and metabolic health in adults. Studies in overweight adolescents are scarce. We conducted a randomized controlled trial in overweight adolescents to compare acceptance and attendance of HIIT with or without weekly motivational encouragement through text messages and access to a study website. HIIT was offered for six months (including summer vacation) twice a week (60 min/session). Participation rates were continuously assessed and acceptance was measured. Clinical parameters were assessed at baseline and after six months. Twenty-eight adolescents participated in this study (age 15.5 ± 1.4; 54% female). The standard deviation score for body mass index over all participants was 2.33 at baseline and decreased by 0.026 (95% CI -0.048 to 0.10) units, p = 0.49. Waist to height ratio was 0.596 at baseline and decreased by 0.013 (95% CI 0.0025 to 0.024), p = 0.023. Participation within the first two months ranged from 65% to 75%, but fell to 15% within the last three months. Attendance in the intervention group was 14% (95% CI -8 to 37), p = 0.18, higher than the control group. Overall program content was rated as "good" by participants, although high drop-out rates were observed. Summer months constitute a serious problem regarding attendance. The use of media support has to be assessed further in appropriately powered trials.
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Affiliation(s)
- Sabine Herget
- Integrated Research and Treatment Center (IFB) for Adiposity Diseases, University of Leipzig, Leipzig 04109, Germany.
- Faculty of Architecture and Social Sciences, University of Applied Sciences Leipzig (HTWK), Leipzig 04315, Germany.
| | - Sandra Reichardt
- Integrated Research and Treatment Center (IFB) for Adiposity Diseases, University of Leipzig, Leipzig 04109, Germany.
| | - Andrea Grimm
- Integrated Research and Treatment Center (IFB) for Adiposity Diseases, University of Leipzig, Leipzig 04109, Germany.
| | - David Petroff
- Integrated Research and Treatment Center (IFB) for Adiposity Diseases, University of Leipzig, Leipzig 04109, Germany.
- Clinical Trial Centre, University of Leipzig, Leipzig 04109, Germany.
| | - Jakob Käpplinger
- Integrated Research and Treatment Center (IFB) for Adiposity Diseases, University of Leipzig, Leipzig 04109, Germany.
| | - Michael Haase
- CityBootCamp Outdoor Fitness Training, Leipzig 04103, Germany.
| | - Jana Markert
- Integrated Research and Treatment Center (IFB) for Adiposity Diseases, University of Leipzig, Leipzig 04109, Germany.
| | - Susann Blüher
- Integrated Research and Treatment Center (IFB) for Adiposity Diseases, University of Leipzig, Leipzig 04109, Germany.
- Department of Pediatrics, University of Halle-Wittenberg, Halle 06108, Germany.
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Howie EK, McManus A, Smith KL, Fenner AA, Straker LM. Practical Lessons Learned from Adolescent and Parent Experiences Immediately and 12 Months following a Family-Based Healthy Lifestyle Intervention. Child Obes 2016; 12:401-9. [PMID: 27392196 DOI: 10.1089/chi.2016.0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Adolescence is a critical time to intervene and establish healthy long-term behaviors to decrease the impact of adult obesity in the future. The purpose of this study was to identify key intervention strategies and techniques for community interventions by analyzing the short-term and longer-term shared experiences of both adolescents with overweight or obesity and their parents involved in a community-based, healthy lifestyle intervention. METHODS Qualitative interviews and focus groups were conducted with teens (aged 12-16 years with a BMI above the 85th percentile) and their parents immediately following the 8-week intervention (n = 37 teens, n = 33 parents) and at 12 months follow-up (n = 23 teens, n = 20 parents). Results were analyzed thematically. RESULTS Both teens and parents reported high satisfaction with the program. Immediately following the 8-week intervention, teens reported enjoying participating in exercise with similar peers. Parents described inaccurate expectations from the program. After the 12-month follow-up, teens reported struggling with a cyclical pattern of health behaviors, and parents described a sense of loss following the intensive program and improved communication skills with their adolescent. CONCLUSIONS Several practical strategies emerged for use in future community programs for adolescents with overweight or obesity. Future programs should consider management of expectations, perceptions vs. outcomes, and the cyclical nature of behavior change in adolescents. Strategies for future health behavior change interventions with overweight adolescents should address time management, translation of knowledge into behavior change, successful implementation of practical goal-setting strategies, and increasing intrinsic motivation.
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Affiliation(s)
- Erin K Howie
- 1 School of Physiotherapy and Exercise Science, Curtin University , Perth, Australia
| | - Alexandra McManus
- 2 Faculty of Health Sciences, Centre of Excellence Science, Seafood and Health (CESSH) Curtin University , Perth, Australia
| | - Kyla L Smith
- 1 School of Physiotherapy and Exercise Science, Curtin University , Perth, Australia
| | - Ashley A Fenner
- 3 School of Psychology and Speech Pathology, Curtin University , Perth, Australia
| | - Leon M Straker
- 1 School of Physiotherapy and Exercise Science, Curtin University , Perth, Australia
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Fenner AA, Howie EK, Davis MC, Straker LM. Relationships between psychosocial outcomes in adolescents who are obese and their parents during a multi-disciplinary family-based healthy lifestyle intervention: One-year follow-up of a waitlist controlled trial (Curtin University's Activity, Food and Attitudes Program). Health Qual Life Outcomes 2016; 14:100. [PMID: 27389034 PMCID: PMC4936224 DOI: 10.1186/s12955-016-0501-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 06/21/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Limited studies have investigated relationships in psychosocial outcomes between adolescents who are obese and their parents and how psychosocial outcomes change during participation in a physical activity and healthy eating intervention. This study examined both adolescent and parent psychosocial outcomes while participating in a one - year multi-disciplinary family-based intervention: Curtin University's Activity, Food, and Attitudes Program (CAFAP). METHODS Following a waitlist control period, the intervention was delivered to adolescent (n = 56, ages 11-16) and parent participants over 8 weeks, with one-year maintenance follow-up. Adolescent depression and quality of life, family functioning, and parent depression, anxiety, and stress were assessed at six time points: baseline and prior to intervention (e.g., waitlist control period), immediately following intervention, and at 3, 6, and 12 months post-intervention. Relationships between adolescent and parent psychosocial outcomes were assessed using Spearman correlations and changes in both adolescent and parent outcomes were assessed using linear mixed models. Changes in adolescent psychosocial outcomes were compared to changes in behavioural (physical activity and healthy eating) and physical (weight) outcomes using independent samples t-tests. RESULTS The majority of psychosocial outcomes were significantly correlated between adolescents and parents across the one-year follow-up. Adolescent depression, psychosocial and physical quality of life outcomes significantly improved before or following intervention and were maintained at 6-months or one-year follow-up. Parent symptoms of depression, anxiety, and stress were reduced during waitlist and primarily remained improved. Changes in adolescent psychosocial outcomes were shown to be partially associated with behavioural changes and independent of physical changes. CONCLUSIONS Adolescents in CAFAP improved psychosocial and physical quality of life and reversed the typical trajectory of depressive symptoms in adolescents who are obese during a one-year maintenance period. CAFAP was also effective at maintaining reductions in parent symptoms of depression, anxiety, and stress demonstrated during the waitlist period. TRIAL REGISTRATION The trial was registered with the Australian and New Zealand Clinical Trials Registry (No. 12611001187932 ).
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Affiliation(s)
- Ashley A. Fenner
- />School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Erin K. Howie
- />School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Melissa C. Davis
- />School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
| | - Leon M. Straker
- />School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
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Kitzman-Ulrich HE, Wilson DK, Lyerly JE. Qualitative Perspectives from African American Youth and Caregivers for Developing the Families Improving Together (FIT) for Weight Loss Intervention. CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY 2016; 4:263-274. [PMID: 27800292 DOI: 10.1037/cpp0000147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study obtained qualitative data from African American (AA) youth and caregiver dyads to inform the Families Improving Together (FIT) for Weight Loss Trial. Focus groups were conducted with 55 AA parent and caregiver dyads to gather perspectives on facilitators and barriers, motivators, and program preferences for health and weight loss using a socio-ecological framework. Four main themes emerged: using a positive health promotion framework for weight loss programs, social support and the role of parents in providing positive support, using a socio-ecological approach to examine factors that contribute to weight, and creating programs that are convenient, fun, and reduce barriers to participation. The findings from this study were used to develop the FIT intervention and indicate important individual, interpersonal, and environmental factors to consider when developing weight management and healthy lifestyle programs for AA families.
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Langlois J, Omorou AY, Vuillemin A, Lecomte E, Briançon S. Participation d’adolescents en surpoids de milieu défavorisé à une intervention de promotion de l’activité physique à l’école. SANTÉ PUBLIQUE 2016. [DOI: 10.3917/spub.160.0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Andrade S, Lachat C, Cardon G, Ochoa-Avilés A, Verstraeten R, Van Camp J, Ortiz J, Ramirez P, Donoso S, Kolsteren P. Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk: subgroups analysis from a cluster-randomized trial. BMC Pediatr 2016; 16:51. [PMID: 27102653 PMCID: PMC4840972 DOI: 10.1186/s12887-016-0588-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 04/12/2016] [Indexed: 12/18/2022] Open
Abstract
Background Adolescents with overweight and poor physical fitness have an increased likelihood of developing cardiovascular diseases during adulthood. In Ecuador, a health promotion program improved the muscular strength and speed-agility, and reduced the decline of the moderate-to-vigorous physical activity of adolescents after 28 months. We performed a sub-group analysis to assess the differential effect of this intervention in overweight and low-fit adolescents. Methods We performed a cluster-randomized pair matched trial in schools located in Cuenca–Ecuador. In total 20 schools (clusters) were pair matched, and 1440 adolescents of grade 8 and 9 (mean age of 12.3 and 13.3 years respectively) participated in the trial. For the purposes of the subgroup analysis, the adolescents were classified into groups according to their weight status (body mass index) and aerobic capacity (scores in the 20 m shuttle run and FITNESSGRAM standards) at baseline. Primary outcomes included physical fitness (vertical jump, speed shuttle run) and physical activity (proportion of students achieving over 60 min of moderate–to-vigorous physical activity/day). For these primary outcomes, we stratified analysis by weight (underweight, normal BMI and overweight/obese) and fitness (fit and low fitness) groups. Mixed linear regression models were used to assess the intervention effect. Results The prevalence of overweight/obesity, underweight and poor physical fitness was 20.3 %, 5.8 % and 84.8 % respectively. A higher intervention effect was observed for speed shuttle run in overweight (β = −1.85 s, P = 0.04) adolescents compared to underweight (β = −1.66 s, P = 0.5) or normal weight (β = −0.35 s, P = 0.6) peers. The intervention effect on vertical jump was higher in adolescents with poor physical fitness (β = 3.71 cm, P = 0.005) compared to their fit peers (β = 1.28 cm, P = 0.4). The proportion of students achieving over 60 min of moderate-to-vigorous physical activity/day was not significantly different according to weight or fitness status. Conclusion Comprehensive school-based interventions that aim to improve diet and physical activity could improve speed and strength aspects of physical fitness in low-fit and overweight/obese adolescents. Trial registration Clinicaltrials.gov identifier NCT01004367. Registered October 28, 2009. Electronic supplementary material The online version of this article (doi:10.1186/s12887-016-0588-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Susana Andrade
- Food Nutrition and Health Program, Universidad de Cuenca, Avenida 12 de Abril y Loja, 010202, Cuenca, Ecuador. .,Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium.
| | - Carl Lachat
- Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium.,Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
| | - Angélica Ochoa-Avilés
- Food Nutrition and Health Program, Universidad de Cuenca, Avenida 12 de Abril y Loja, 010202, Cuenca, Ecuador.,Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium
| | - Roosmarijn Verstraeten
- Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium.,Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - John Van Camp
- Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium
| | - Johana Ortiz
- Food Nutrition and Health Program, Universidad de Cuenca, Avenida 12 de Abril y Loja, 010202, Cuenca, Ecuador.,Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium
| | - Patricia Ramirez
- Food Nutrition and Health Program, Universidad de Cuenca, Avenida 12 de Abril y Loja, 010202, Cuenca, Ecuador
| | - Silvana Donoso
- Food Nutrition and Health Program, Universidad de Cuenca, Avenida 12 de Abril y Loja, 010202, Cuenca, Ecuador
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium.,Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
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Vangeepuram N, Townsend K, Arniella G, Goytia C, Horowitz CR. Recruitment in Clinical Versus Community-Based Sites for a Pilot Youth Diabetes Prevention Program, East Harlem, New York, 2011-2012. Prev Chronic Dis 2016; 13:E14. [PMID: 26820046 PMCID: PMC4747439 DOI: 10.5888/pcd13.150449] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction Little is known about successful strategies for recruitment of youth for research. The objective of this study was to compare clinical sites with community sites in the recruitment of teenagers for a new youth diabetes prevention program in East Harlem, New York. Methods We assessed diabetes risk for youth (aged 13–19 y) by measuring body mass index (BMI). We then screened overweight and obese youth for prediabetes using oral glucose tolerance testing, had them complete a health and lifestyle survey, and enrolled prediabetic youth into peer-led workshops. The recruitment strategies were 1) clinical referrals and 2) screenings at community sites. We compared the number of adolescents screened, the proportion eligible for testing, the proportion diagnosed with prediabetes, baseline characteristics, and the retention rates between those recruited in clinical and community sites. Results In 3 months, we completed BMI screening for 156 adolescents from community sites and 30 from clinical sites. Overall, 47% were at risk for diabetes on the basis of BMI, and 63% returned for diabetes testing; 35% had prediabetes, and 1 teenager had diabetes. Clinical sites yielded higher rates of diabetes risk on the basis of BMI and higher rates of return for screening and diagnosed prediabetes. Although demographics and BMI did not vary by recruitment site, we found differences in behaviors, self-efficacy, body image, and social support. There were no differences by recruitment site in workshop enrollment or completion or return for follow-up. Conclusion Both recruitment strategies were successful, and participants from both groups had high rates of undiagnosed prediabetes. Our approach allowed access to more adolescents and opportunities for education about diabetes in the community.
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Affiliation(s)
- Nita Vangeepuram
- Departments of Pediatrics and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1202A, New York, NY 10029.
| | - Kenya Townsend
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Crispin Goytia
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Carol R Horowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
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Cutts J, Maxwell MV, Kushner RF, Mechanick JI. Community Engagement and Networks: Leveraging Partnerships to Improve Lifestyle. LIFESTYLE MEDICINE 2016. [DOI: 10.1007/978-3-319-24687-1_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Vangeepuram N, Carmona J, Arniella G, Horowitz CR, Burnet D. Use of Focus Groups to Inform a Youth Diabetes Prevention Model. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:532-539.e1. [PMID: 26420055 PMCID: PMC4668804 DOI: 10.1016/j.jneb.2015.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To explore minority adolescents' perceptions of their diabetes risk, barriers and facilitators to adopting lifestyle changes, and ideas for adapting a youth diabetes prevention model. METHODS The study was conducted at collaborating community sites in East Harlem, NY. Trained moderators facilitated focus groups, which were audio taped and transcribed. Participants were 21 Latino and African American adolescents aged 14-18 years with a family history of diabetes and no reported personal history of diabetes. The phenomenon of interest was youth input in adapting a diabetes prevention model. Two researchers independently coded transcripts, identified major themes, compared findings, and resolved differences through discussion and consensus. RESULTS Dominant themes included (1) the impact of diabetes on quality of life within adolescents' personal networks; (2) conflict between changing diet and activity and their current lifestyle; (3) lifestyle choices being dictated by cost, mood, body image, and environment, not health; and (4) family, social, and environmental pressures reinforcing sedentary behaviors and unhealthy diets. CONCLUSIONS AND IMPLICATIONS Themes from youth focus groups were framed in the context of an existing youth diabetes prevention conceptual model, with results informing expansion of the model and identification and organization of potential intervention components.
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Affiliation(s)
- Nita Vangeepuram
- Departments of Pediatrics and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Address: 1 Gustave L. Levy Place Box 1202A, New York, NY 10029, Phone: 917-478-2106, Fax: 212-996-9685
| | - Jane Carmona
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY 10029
| | - Guedy Arniella
- Institute for Family Health, 1824 Madison Ave, NY, NY, 10035, Phone: 212-423-4796
| | - Carol R. Horowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1077, New York, NY 10029, Phone: 212-659-9567
| | - Deborah Burnet
- Department of Pediatrics, University of Chicago, AMB B226B, MC 2007 5841 South Maryland Avenue, Chicago, IL 60637, Phone: 773-702-4582
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Schalkwijk AAH, Bot SDM, de Vries L, Westerman MJ, Nijpels G, Elders PJM. Perspectives of obese children and their parents on lifestyle behavior change: a qualitative study. Int J Behav Nutr Phys Act 2015; 12:102. [PMID: 26283232 PMCID: PMC4539727 DOI: 10.1186/s12966-015-0263-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 08/07/2015] [Indexed: 11/14/2022] Open
Abstract
Background In order to improve and optimize future behavioral family lifestyle intervention programs, more information on the perceptions of obese children and their parents of these programs is needed. As such, the aim of this qualitative study is 1) to explore the expectations of obese children and their parents in relation to lifestyle interventions; 2) to identify barriers to making lifestyle changes that parents and children face within their social context (within the family, at school and amongst friends and peers) as well as the things that facilitate these changes and 3) to identify the needs of obese children and their parents in the context of a lifestyle intervention. Methods A qualitative study using semi-structured interviews was conducted. Interviewees were participants in a lifestyle intervention program in the Netherlands. Results Eighteen children (mean age 10 years) and 24 parents were interviewed. The respondents expected to lose weight by being physically active or by eating healthily. Parents struggled with adopting and adhering to new rules and the absence of support of family members. Children struggled with inconsistent parenting and a lack of support from their parents. Bullying experienced at school impeded the children in their ability to make the necessary changes. Support from peers, on the other hand, stimulated their progress. Parents identified the need for the general practitioner to discuss overweight in a non-offensive way and to show an interest in the process of weight loss. Conclusions Participants in a lifestyle behavior intervention program benefit from parental support and help from their (extended) family, peers and friends. They would also profit from the sustained involvement of their general practitioner in assisting in the maintenance of lifestyle behavior changes. Electronic supplementary material The online version of this article (doi:10.1186/s12966-015-0263-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A A H Schalkwijk
- Department of General Practice & Elderly Care Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - S D M Bot
- Department of General Practice & Elderly Care Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - L de Vries
- Department of General Practice & Elderly Care Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - M J Westerman
- Department of Methodology and Statistics, Institute of Health Sciences and the EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - G Nijpels
- Department of General Practice & Elderly Care Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - P J M Elders
- Department of General Practice & Elderly Care Medicine and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Reece LJ, Bissell P, Copeland RJ. 'I just don't want to get bullied anymore, then I can lead a normal life'; Insights into life as an obese adolescent and their views on obesity treatment. Health Expect 2015; 19:897-907. [PMID: 27403849 PMCID: PMC4989446 DOI: 10.1111/hex.12385] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Adolescent obesity is a complex condition involving social, emotional, behavioural and cultural issues. DESIGN One-to-one interviews and small focus groups with overweight and obese young people were conducted. Qualitative research is an appropriate method to explore the complexity of this issue. SETTING AND PARTICIPANTS Overweight and obese adolescent's attending a community weight management intervention in South Yorkshire. MAIN VARIABLES STUDIED Interviews aimed to explore the experiences of obese adolescents and their perspectives towards obesity treatment. RESULTS Adolescent's provided detailed accounts of their perspectives on weight gain, alluding to disordered patterns of eating and overeating, reported as being triggered by social and emotional factors, and in particular, bullying. Avoidance of bullying and a desire to integrate socially with peers were key drivers to seek treatment. Young people reported what they should do to lose weight, yet responsibility for successful weight loss and lifestyle change was repeatedly attributed to the treatment received, as opposed to viewing this as a combination of self-motivation coupled with support provided by friends and family. CONCLUSION Weight loss programmes need to consider the complex experience of obese young people in their design, focusing on how to implement long-term lifestyle changes.
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Affiliation(s)
- Lindsey J Reece
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK
| | - Paul Bissell
- Professor School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert J Copeland
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK.,National Centre for Sport and Exercise Medicine NCSEM, Sheffield, UK
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Ganter C, Chuang E, Aftosmes-Tobio A, Blaine RE, Giannetti M, Land T, Davison KK. Community stakeholders' perceptions of barriers to childhood obesity prevention in low-income families, Massachusetts 2012-2013. Prev Chronic Dis 2015; 12:E42. [PMID: 25811497 PMCID: PMC4375987 DOI: 10.5888/pcd12.140371] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Introduction The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social–ecological approaches to obesity prevention that encompass multiple community sectors. Programs that successfully engage low-income families in making healthy choices are greatly needed, yet little is known about the extent to which stakeholders understand the complexity of barriers encountered by families. The objective of this study was to contextually frame barriers faced by low-income families reported by community stakeholders by using the Family Ecological Model (FEM). Methods From 2012 through 2013, we conducted semistructured interviews with 39 stakeholders from 2 communities in Massachusetts that were participating in a multisector intervention for childhood obesity prevention. Stakeholders represented schools; afterschool programs; health care; the Special Supplemental Nutrition Program for Women, Infants, and Children; and early care and education. Interviews were audio-recorded, transcribed, coded, and summarized. Results Stakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with FEM and reflected awareness of the broader contextual factors (eg, availability of community resources, family culture, education) and social and emotional dynamics within families (eg, parent knowledge, social norms, distrust of health care providers, chronic life stressors) that could affect family adoption of healthy lifestyle behaviors. Furthermore, results illustrated a level of consistency in stakeholder awareness across multiple community sectors. Conclusion The congruity of stakeholder perspectives with those of low-income parents as summarized in FEM and across community sectors illustrates potential for synergizing the efforts necessary for multisector, multilevel community interventions for the prevention of childhood obesity.
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Affiliation(s)
- Claudia Ganter
- Department of Nutrition, Harvard School of Public Health, Landmark Center, 401 Park Drive, 3rd floor East, Boston, MA 01225. . Ms. Ganter is also affiliated with the Technical University of Berlin, Department of Health Care Management, Berlin, Germany
| | - Emmeline Chuang
- University of California, Los Angeles, Los Angeles, California (Dr. Chuang was at University of California, San Diego, at the time this article was written)
| | | | | | - Mary Giannetti
- Montachusett Opportunity Council, Fitchburg, Massachusetts
| | - Thomas Land
- Massachusetts Department of Public Health, Boston, Massachusetts
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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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Straker LM, Howie EK, Smith KL, Fenner AA, Kerr DA, Olds TS, Abbott RA, Smith AJ. The impact of Curtin University's activity, food and attitudes program on physical activity, sedentary time and fruit, vegetable and junk food consumption among overweight and obese adolescents: a waitlist controlled trial. PLoS One 2014; 9:e111954. [PMID: 25375109 PMCID: PMC4222962 DOI: 10.1371/journal.pone.0111954] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/30/2014] [Indexed: 01/26/2023] Open
Abstract
Background To determine the effects of participation in Curtin University's Activity, Food and Attitudes Program (CAFAP), a community-based, family-centered behavioural intervention, on the physical activity, sedentary time, and healthy eating behaviours of overweight and obese adolescents. Methods In this waitlist controlled clinical trial in Western Australia, adolescents (n = 69, 71% female, mean age 14.1 (SD 1.6) years) and parents completed an 8-week intervention followed by 12 months of telephone and text message support. Assessments were completed at baseline, before beginning the intervention, immediately following the intervention, and at 3-, 6-, and 12- months follow-up. The primary outcomes were physical activity and sedentary time assessed by accelerometers and servings of fruit, vegetables and junk food assessed by 3-day food records. Results During the intensive 8-week intervention sedentary time decreased by −5.1 min/day/month (95% CI: −11.0, 0.8) which was significantly greater than the rate of change during the waitlist period (p = .014). Moderate physical activity increased by 1.8 min/day/month (95% CI: −0.04, 3.6) during the intervention period, which was significantly greater than the rate of change during the waitlist period (p = .041). Fruit consumption increased during the intervention period (monthly incidence rate ratio (IRR) 1.3, 95% CI: 1.10, 1.56) and junk food consumption decreased (monthly IRR 0.8, 95% CI: 0.74, 0.94) and these changes were different to those seen during the waitlist period (p = .004 and p = .020 respectively). Conclusions Participating in CAFAP appeared to have a positive influence on the physical activity, sedentary and healthy eating behaviours of overweight and obese adolescents and many of these changes were maintained for one year following the intensive intervention. Trial Registration Australia and New Zealand Clinical Trials Registry ACTRN12611001187932
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Affiliation(s)
- Leon M. Straker
- School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
- * E-mail:
| | - Erin K. Howie
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Kyla L. Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Ashley A. Fenner
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Deborah A. Kerr
- School of Public Health, Curtin University, Perth, Australia
| | - Tim S. Olds
- Health and Use of Time (HUT) Group, University of South Australia, Adelaide, Australia
| | - Rebecca A. Abbott
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Anne J. Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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Smith KL, Kerr DA, Fenner AA, Straker LM. Adolescents just do not know what they want: a qualitative study to describe obese adolescents' experiences of text messaging to support behavior change maintenance post intervention. J Med Internet Res 2014; 16:e103. [PMID: 24713407 PMCID: PMC4004140 DOI: 10.2196/jmir.3113] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 02/19/2014] [Accepted: 03/13/2014] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Adolescents are considered a hard to reach group and novel approaches are needed to encourage good health. Text messaging interventions have been reported as acceptable to adolescents but there is little evidence regarding the use of text messages with overweight and obese adolescents to support engagement or behavior change after the conclusion of a healthy lifestyle program. OBJECTIVE The intent of this study was to explore the opinions of overweight adolescents and their parents regarding the use of text messages as a support during the maintenance period following an intervention. METHODS This paper reports on the findings from focus groups conducted with adolescents (n=12) and parents (n=13) who had completed an eight-week intensive intervention known as Curtin University's Activity, Food and Attitudes Program (CAFAP). Focus groups were conducted three months post intensive intervention. Participants were asked about their experiences of the prior three-month maintenance phase during which adolescents had received tri-weekly text messages based on the self-determination theory and goal-setting theory. Participants were asked about the style and content of text messages used as well as how they used the text messages. Data were analyzed using content and thematic analyses. RESULTS Two clear themes emerged from the focus groups relating to (1) what adolescents liked or thought they wanted in a text message to support behavior change, and (2) how they experienced or responded to text messages. Within the "like/want" theme, there were five sub-themes relating to the overall tone of the text, frequency, timing, reference to long-term goals, and inclusion of practical tips. Within the "response to text" theme, there were four sub-themes describing a lack of motivation, barriers to change, feelings of shame, and perceived unfavorable comparison with other adolescents. What adolescents said they wanted in text messages often conflicted with their actual experiences. Parent reports provided a useful secondary view of adolescent experience. CONCLUSIONS The conflicting views described in this study suggest that overweight and obese adolescents may not know or have the ability to articulate how they would best be supported with text messages during a healthy lifestyle maintenance phase. Further, supporting both engagement and behavior change simultaneously with text messaging may not be possible. Intervention texts should be personalized as much as possible and minimize feelings of guilt and shame in overweight and obese adolescents. Future research with text messaging for overweight and obese adolescents should incorporate clear intervention aims and evaluation methods specifically related to adolescent engagement or behavior change. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12611001187932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611001187932.
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Affiliation(s)
- Kyla L Smith
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia.
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