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Ding EL, Watson KT, Makarechi L, James Ng TL, Huddleston D, Bui N, Tsai LL, Zoughbie DE. Social Induction via a Social Behavioral Intervention on Changes in Metabolic Risk Factors: A Randomized Controlled Trial in Rural Appalachia, United States. Mayo Clin Proc 2024; 99:1058-1077. [PMID: 38960495 DOI: 10.1016/j.mayocp.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 10/11/2023] [Accepted: 11/15/2023] [Indexed: 07/05/2024]
Abstract
OBJECTIVE To conduct a randomized controlled trial examining the effects of a social network intervention on health. PARTICIPANTS AND METHODS The Microclinic Social Network Program randomized controlled trial (implemented from June 1, 2011, through December 31, 2014) delivered weekly social-health classroom interventions for 9 to 10 months vs standard of care. Longitudinal multilevel analyses examined end-of-trial and 6-month post-intervention outcomes. Social network effects were estimated via a novel social induction ratio. RESULTS We randomized 494 participants, comprising 27 classroom clusters from five neighborhood cohorts. Compared with controls, the intervention showed decreased body weight -6.32 pounds (95% CI, -8.65 to -3.98; overall P<.001), waist circumference -1.21 inches (95% CI, -1.84 to -0.58; overall P<.001), hemoglobin A1c % change -1.60 (95% CI, -1.88 to -1.33; overall P<.001), mean arterial blood pressure -1.83 mm Hg (95% CI, -3.79 to 0.32; overall P<.01), borderline-increased high-density lipoprotein cholesterol 1.09 (95% CI, 0.01-2.17; P=.05; overall P=.01). At 6 months post-intervention, net improvements were: weight change 97% sustained (P<.001), waist circumference change 92% sustained (P<.001), hemoglobin A1c change 82.5% sustained (P<.001), high-density lipoprotein change 79% sustained (overall P=.01), and mean arterial blood pressure change greater than 100% sustained improvement of -4.21 mm Hg (P<.001). Mediation analysis found that diet and exercise did not substantially explain improvements. In the intent-to-treat analysis of social causal induction, the weight-change social induction ratio (SIR) was 1.80 for social-network weight change-meaning that social networks explained the greater weight loss in the intervention than controls. Furthermore, we observed an even stronger weight-loss SIR of 2.83 at 6 months post-intervention. CONCLUSION Results show intervention effectiveness for improving health in resource-limited communities, with SIR demonstrating that social-network effects helped induce such improvements. TRIAL REGISTRATION Clinicaltrials.gov Identifier NCT01651065.
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Affiliation(s)
- Eric L Ding
- Department of Public Health, New England Complex Systems Institute, MA, USA; Social Network Research Group, Microclinic International, CA, USA.
| | - Kathleen T Watson
- Social Network Research Group, Microclinic International, CA, USA; Department of Psychiatry and Behavioral Health, Stanford University, CA, USA
| | - Leila Makarechi
- Social Network Research Group, Microclinic International, CA, USA
| | - Tin Lok James Ng
- Social Network Research Group, Microclinic International, CA, USA; Department of Computer Science and Statistics, Trinity College Dublin, Ireland
| | | | - Nancy Bui
- Social Network Research Group, Microclinic International, CA, USA
| | - Leslie L Tsai
- Social Network Research Group, Microclinic International, CA, USA
| | - Daniel E Zoughbie
- Department of Public Health, New England Complex Systems Institute, MA, USA; Social Network Research Group, Microclinic International, CA, USA; Institute of International Studies, University of California at Berkeley, CA, USA
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Doberti Herrera T, Rodríguez Osiac L, Flores-Alvarado S, Pérez Ferrer C, Higuera D, de Oliveira Cardoso L. Relationship between body mass index and residential segregation in large cities of Latin America. BMC Public Health 2024; 24:1664. [PMID: 38909210 PMCID: PMC11193227 DOI: 10.1186/s12889-024-19074-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/06/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Obesity is a global health problem, and its connection with social and environmental factors is well-established. Social factors, such as urban segregation, may impact obesity through various mechanisms, including food and physical activity environments, as well as social norms and networks. This multilevel study aims to examine the effect of socio-economic residential segregation of Latin American cities on the obesity of individuals within those cities. METHODS We analyzed data from national surveys for a total of 59,340 individuals of 18-70 years of age, conducted in 156 cities across Brazil, Chile, Colombia, and Mexico between 2007 and 2013. We adjusted two-level linear mixed models for body mass index (BMI) stratified by sex and country, controlling for age, educational level and poverty. Separate models were built for dissimilarity and isolation segregation indices. RESULTS The relationships between segregation indices and BMI were mostly not statistically significant, and in some cases, they were opposite to what was expected. The only significant relationships were observed in Colombian men, using the dissimilarity index (-7.5 [95% CI: -14.4, -0.5]) and in Colombian women, using the isolation index (-7.9 [95% CI: -14.1, -1.7]). CONCLUSIONS While individual-level factors cannot fully explain differences among people in the same city, segregation indices may help. However, we found that in some cases, the relationship between BMI and segregation indices is opposite to what is expected based on prior literature. This should be considered in examining the phenomenon. Further research on obesogenic environments in segregated neighborhoods could provide valuable evidence.
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Affiliation(s)
| | | | | | | | - Diana Higuera
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
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Del Pozo G, Ezan P, Moubassat M, Déchelotte P. Does so-called "healthy" content on instagram display balanced recipes? A pilot study in relation to the risk of unhealthy eating patterns in social network users. Appetite 2024; 200:107542. [PMID: 38844048 DOI: 10.1016/j.appet.2024.107542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE social networks (SN) including Instagram have increased in popularity. However, SN-mediated content may influence eating behaviors in a negative way. This study analyzed whether Instagram content claimed as "healthy" complies with nutritional guidelines. METHODS recipes posted in French on Instagram with the caption #healthy or similar ones were analyzed, once from February to May 2023 and again in April 2024. Health authorities' guidelines and food pyramid inclusion criteria were used for the quantitative and qualitative analysis, respectively. Recipes were then classified as balanced, partially unbalanced or unbalanced, with the two subgroups "restrictive" and "excessive", and according to the main protein source. RESULTS we coded a total of 114 courses (2 datasets of 57 courses each). Among these, 3 were classified as balanced main courses, 45 as partially unbalanced main courses and 66 as unbalanced main courses (21 were deemed as restrictive, 21 as excessive and 24 were otherwise inadequate), with a majority of hypocaloric courses. Approximately half of the recipes were vegetarian or vegan. DISCUSSION these results suggest that food recipes published on Instagram as #healthy may, at times, be far from nutritional guidelines and could rather promote unbalanced eating patterns. This suggest that food-related content on SN might be insufficiently moderated and that recipes referenced as #healthy should perhaps be accompanied by warnings and preventive measures. This observation, in addition to other detrimental behaviors displayed on SN (e.g. extreme physical activity or body image pressure) may contribute to the increased incidence of eating disorders (ED) associated with problematic SN use. Alerts on this risk and accessible tools for the prevention and early detection of ED risk in SN users are urgently needed.
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Affiliation(s)
- Gina Del Pozo
- Nutrition Department and UMR INSERM 1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis - UMR 1073, 22 Boulevard Gambetta, 76000, Rouen, France.
| | - Pascale Ezan
- (NIMEC - University Le Havre Normandie), Université Le Havre Normandie PRSH 25, Rue Philippe Lebon BP 1123, 76063, Le Havre cedex, France.
| | - Marilyn Moubassat
- Nutrition Department and UMR INSERM 1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis - UMR 1073, 22 Boulevard Gambetta, 76000, Rouen, France.
| | - Pierre Déchelotte
- Nutrition Department and UMR INSERM 1073, Nutrition, Inflammation and Microbiota-Gut-Brain Axis - UMR 1073, 22 Boulevard Gambetta, 76000, Rouen, France.
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Bjerregaard AA, Zoughbie DE, Hansen JV, Granström C, Strøm M, Halldórsson ÞI, Meder IK, Willett WC, Ding EL, Olsen SF. An SMS chatbot digital educational program to increase healthy eating behaviors in adolescence: A multifactorial randomized controlled trial among 7,890 participants in the Danish National Birth Cohort. PLoS Med 2024; 21:e1004383. [PMID: 38875292 PMCID: PMC11178212 DOI: 10.1371/journal.pmed.1004383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/22/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Few cost-effective strategies to shift dietary habits of populations in a healthier direction have been identified. We examined if participating in a chatbot health education program transmitted by Short Messages Service ("SMS-program") could improve adolescent dietary behaviors and body weight trajectories. We also explored possible added effects of maternal or peer involvement. METHODS AND FINDINGS We conducted a randomized controlled trial (RCT) among adolescents from the Danish National Birth Cohort (DNBC). Eligible were adolescents who during 2015 to 2016 at age 14 years had completed a questionnaire assessing height, weight, and dietary habits. Two thirds were offered participation in an SMS-program, whereas 1/3 ("non-SMS group") received no offer. The SMS program aimed to improve 3 key dietary intake behaviors: sugar-sweetened beverages (SSBs), fruit and vegetables (FV), and fish. The offered programs had 3 factorially randomized schemes; the aims of these were to test effect of asking the mother or a friend to also participate in the health promotion program, and to test the effect of a 4-week individually tailored SMS program against the full 12-week SMS program targeting all 3 dietary factors. Height and weight and intakes of SSB, FV, and fish were assessed twice by a smartphone-based abbreviated dietary questionnaire completed at 6 months (m) and 18 m follow-up. Main outcome measures were (1) body mass index (BMI) z-score; and (2) an abbreviated Healthy Eating Index (mini-HEI, 1 m window, as mean of z-scores for SSB, FV, and fish). Among the 7,890 randomized adolescents, 5,260 were assigned to any SMS program; 63% (3,338) joined the offered program. Among the 7,890 randomized, 74% (5,853) and 68% (5,370) responded to follow-ups at 6 m and 18 m, respectively. Effects were estimated by intention-to-treat (ITT) analyses and inverse probability weighted per-protocol (IPW-PP) analyses excluding adolescents who did not join the program. Mean (standard deviation (SD)) mini-HEI at baseline, 6 m and 18 m was -0.01 (0.64), 0.01 (0.59), and -0.01 (0.59), respectively. In ITT-analyses, no effects were observed, at any time point, in those who had received any SMS program compared to the non-SMS group, on BMI z-score (6 m: -0.010 [95% confidence interval (CI) -0.035, 0.015]; p = 0.442, 18 m: 0.002 [95% CI -0.029, 0.033]; p = 0.901) or mini-HEI (6 m: 0.016 [95% CI -0.011, 0.043]; p = 0.253, 18m: -0.016 [95% CI -0.045, 0.013]; p = 0.286). In IPW-PP analyses, at 6 m, a small decrease in BMI z-score (-0.030 [95% CI -0.057, -0.003]; p = 0.032) was observed, whereas no significant effect was observed in mini-HEI (0.027 [95% CI -0.002, 0.056]; p = 0.072), among those who had received any SMS program compared to the non-SMS group. At 18 m, no associations were observed (BMI z-score: -0.006 [95% CI -0.039, 0.027]; p = 0.724, and mini-HEI: -0.005 [95% CI -0.036, 0.026]; p = 0.755). The main limitations of the study were that DNBC participants, though derived from the general population, tend to have higher socioeconomic status than average, and that outcome measures were self-reported. CONCLUSIONS In this study, a chatbot health education program delivered through an SMS program had no effect on dietary habits or weight trajectories in ITT analyses. However, IPW-PP-analyses, based on those 63% who had joined the offered SMS program, suggested modest improvements in weight development at 6 m, which had faded at 18 m. Future research should focus on developing gender-specific messaging programs including "booster" messages to obtain sustained engagement. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02809196 https://clinicaltrials.gov/study/NCT02809196.
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Affiliation(s)
- Anne Ahrendt Bjerregaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Daniel E Zoughbie
- University of California, Berkeley, California, United States of America
- New England Institute for Complex Systems, Cambridge, Massachusetts, United States of America
| | | | - Charlotta Granström
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Marin Strøm
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Þórhallur Ingi Halldórsson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Faculty of food science and nutrition, University of Iceland, Reykjavík, Iceland
| | - Inger Kristine Meder
- Secretariat of the Danish National Birth Cohort, Statens Serum Institut, Copenhagen, Denmark
| | - Walter Churchill Willett
- Department of Nutrition, Harvard TH Chan School of Public Health (for ELD: affiliation at time of project), Boston, Massachusetts, United States of America
| | - Eric L Ding
- New England Institute for Complex Systems, Cambridge, Massachusetts, United States of America
- Department of Nutrition, Harvard TH Chan School of Public Health (for ELD: affiliation at time of project), Boston, Massachusetts, United States of America
| | - Sjúrður Fróði Olsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- University of the Faroe Islands, Tórshavn, Faroe Islands
- Department of Nutrition, Harvard TH Chan School of Public Health (for ELD: affiliation at time of project), Boston, Massachusetts, United States of America
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Chao AM, Moore M, Wadden TA. The past, present, and future of behavioral obesity treatment. Int J Obes (Lond) 2024:10.1038/s41366-024-01525-3. [PMID: 38678143 DOI: 10.1038/s41366-024-01525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024]
Abstract
Over the last century, hundreds of evaluations have been conducted to examine weight-management interventions related to diet, physical activity, and behavior therapy. These investigations have contributed to a growing body of knowledge that has consistently advanced the field of obesity treatment, while also revealing some persistent challenges. This narrative review summarizes key findings from randomized controlled trials conducted in adults that have combined diet, physical activity, and behavior therapy, an approach variously referred to as behavioral treatment, comprehensive lifestyle modification, or intensive lifestyle intervention. The review shows that current behavioral approaches induce average reductions in baseline body weight of 5 to 10% at 6 to 12 months. Such losses have proven effective in reducing the risk of type 2 diabetes in persons with impaired glucose tolerance and in improving other obesity-related complications. These benefits have also been associated with reductions in healthcare costs. Despite these advances, behavioral treatment is challenged by the need for larger losses to achieve optimal improvements in health, by difficulties associated with maintaining weight loss, and by barriers limiting access to treatment. New anti-obesity medications, when combined with behavioral obesity treatment, hold promise of addressing the first two issues.
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Affiliation(s)
- Ariana M Chao
- Johns Hopkins School of Nursing, Baltimore, MD, USA.
| | - Molly Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Abreu TC, Mackenbach JD, Heuvelman F, Schoonmade LJ, Beulens JW. Associations between dimensions of the social environment and cardiometabolic risk factors: Systematic review and meta-analysis. SSM Popul Health 2024; 25:101559. [PMID: 38148999 PMCID: PMC10749911 DOI: 10.1016/j.ssmph.2023.101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/27/2023] [Accepted: 11/11/2023] [Indexed: 12/28/2023] Open
Abstract
Aim The social environment (SE), including social contacts, norms and support, is an understudied element of the living environment which impacts health. We aim to comprehensively summarize the evidence on the association between the SE and risk factors of cardiometabolic disease (CMD). Methods We performed a systematic review and meta-analysis based on studies published in PubMed, Scopus and Web of Science Core Collection from inception to 16 February 2021. Studies that used a risk factor of CMD, e.g., HbA1c or blood pressure, as outcome and social environmental factors such as area-level deprivation or social network size as independent variables were included. Titles and abstracts were screened in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale. Data appraisal and extraction were based on the study protocol published in PROSPERO. Data were synthesized through vote counting and meta-analyses. Results From the 7521 records screened, 168 studies reported 1050 associations were included in this review. Four meta-analyses based on 24 associations suggested that an unfavorable social environment was associated with increased risk of cardiometabolic risk factors, with three of them being statistically significant. For example, individuals that experienced more economic and social disadvantage had a higher "CVD risk scores" (OR = 1.54, 95%CI: 1.35 to 1.84). Of the 458 associations included in the vote counting, 323 (71%) pointed towards unfavorable social environments being associated with higher CMD risk. Conclusion Higher economic and social disadvantage seem to contribute to unfavorable CMD risk factor profiles, while evidence for other dimensions of the social environment is limited.
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Affiliation(s)
- Taymara C. Abreu
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Joreintje D. Mackenbach
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Fleur Heuvelman
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
| | - Linda J. Schoonmade
- University Library, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Joline W.J. Beulens
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Utrecht, the Netherlands
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, Noord-Holland, the Netherlands
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Wieland ML, Molina L, Goodson M, Capetillo GP, Osman A, Ahmed Y, Elmi H, Nur O, Iteghete SO, Torres-Herbeck G, Dirie H, Clark MM, Lohr AM, Smith K, Zeratsky K, Rieck T, Herrin J, Valente TW, Sia IG. Healthy immigrant community study protocol: A randomized controlled trial of a social network intervention for cardiovascular risk reduction among Hispanic and Somali adults. Contemp Clin Trials 2024; 138:107465. [PMID: 38309526 PMCID: PMC10923143 DOI: 10.1016/j.cct.2024.107465] [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: 08/15/2023] [Revised: 12/18/2023] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Immigrants to the United States face structural barriers that contribute to rising cardiovascular risk factors and obesity after immigration. This manuscript describes the development of the Healthy Immigrant Community protocol and baseline measures for a stepped wedge cluster randomized trial to test the effectiveness of a social network intervention for cardiovascular risk reduction among two immigrant populations. METHODS We developed a social network-informed, community-based, participatory research-derived health promotion intervention with Hispanic and Somali immigrant communities in Minnesota consisting of mentoring, educational and motivational sessions, group activities, and a community toolkit for healthy weight loss delivered by culturally concordant health promoters (HPs) to their social networks. Using a stepped wedge cluster randomized design, social network-based groups were randomly assigned to receive the intervention either immediately or after a delay of one year. Outcomes, measured at baseline, 6 months, 12 months, and 24 months, were derived from the American Heart Association's "Life's Simple 7": BMI and waist circumference, blood pressure, fasting blood glucose, total cholesterol, physical activity level, and dietary quality. RESULTS A total of 51 HPs were enrolled and randomized (29 Hispanic; 22 Somali). There were 475 participants enrolled in the study, representing a mean social network group size of 8 (range, 5-12). The mean BMI of the sample (32.2) was in the "obese" range. CONCLUSION Processes and products from this Healthy Immigrant Community protocol are relevant to other communities seeking to reduce cardiovascular risk factors and negative health behaviors among immigrant populations by leveraging the influence of their social networks.
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Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership.
| | | | - Miriam Goodson
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership; Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Ahmed Osman
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Yahye Ahmed
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | - Hindi Elmi
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Omar Nur
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | | | - Gloria Torres-Herbeck
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | | | - Matthew M Clark
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership
| | | | - Katherine Zeratsky
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Thomas Rieck
- Rochester Healthy Community Partnership; Department of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, USA
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thomas W Valente
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Irene G Sia
- Rochester Healthy Community Partnership; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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Lim J, Cornwell B. Social network-structural position and obesity: Evidence from a national study. Soc Sci Med 2023; 329:116006. [PMID: 37302274 DOI: 10.1016/j.socscimed.2023.116006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Abstract
This study expands on research on the social-structural bases of obesity by examining the role played by individuals' positions within their egocentric social networks in shaping body mass index. We argue that individuals' tendency to be a bridge between otherwise unconnected people can affect body mass index. Furthermore, health-specific resources flowing through their networks might interact with this network-structural position to shape this association. Using multivariate analyses of recent nationally representative data on older Americans, we find that occupying a bridging position within a network is negatively related to the likelihood of being obese. Moreover, people who have this bridging potential tend to benefit more from health-related knowledge in their networks than those who do not have it. Our findings underscore the importance of considering social network position and the functional specificity of ties in understanding the structural bases of health problems like obesity. We close by discussing implications of these findings for future work on obesity including potential insights into important health disparities.
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Affiliation(s)
- Jaeun Lim
- Department of Sociology, Cornell University, Ithaca, NY, 14853, USA.
| | - Benjamin Cornwell
- Department of Sociology, Cornell University, Ithaca, NY, 14853, USA.
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9
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Gonzalez CJ, Copeland M, Shapiro MF, Moody J. Associations of peer generational status on adolescent weight across Hispanic immigrant generations: A social network analysis. Soc Sci Med 2023; 323:115831. [PMID: 36931036 DOI: 10.1016/j.socscimed.2023.115831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/30/2022] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Childhood obesity disproportionately impacts Hispanics in the United States (US), the nation's largest ethnic minority population. However, even among Hispanic children, those born in the US are at increased risk of developing obesity than those not born in the US (i.e. first-generation Hispanics). The objective of this study is to assess whether ethnic and generational differences in the friend networks of Hispanic adolescents moderate the association between immigrant generation and weight. METHODS We analyzed data from first-generation, second-generation, and third-generation Hispanic 12 to 19 year-old participants in Wave 1 of the Longitudinal Study of Adolescent to Adult Health (Add Health). Using multivariable linear regression, we examined the association between generational status and body mass index (BMI), and whether the ethnic and generational composition of friends moderated that association. RESULTS Higher generational status was associated with higher BMI. The ethnic and generational composition of friends was not independently associated with BMI among Hispanic adolescents. However, a social network with a greater proportion of second-generation Hispanics was positively associated with BMI among first-generation Hispanics, and negatively associated with BMI among second-generation Hispanics. CONCLUSIONS The generational status of peers in Hispanic adolescents' social networks, particularly the proportion that are second-generation Hispanic, moderates the positive association between immigrant generation and BMI. Moreover, this moderation effect is different across immigrant generations so that the proportion of second-generation adolescents within a social network is associated with higher BMI in first-generation Hispanic adolescents, but with lower BMI among those who are second-generation. These results were confirmed in sensitivity analyses. Our findings suggest that the generational composition of social networks alters the association between the generational status and weight of Hispanic adolescents, and thus that social factors within those networks may contribute to those associations.
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Affiliation(s)
- Christopher J Gonzalez
- Department of Medicine, Weill Medical College of Cornell University, 525 E 68th St., New York, NY, 10065, USA.
| | - Molly Copeland
- Department of Sociology, Michigan State University, East Lansing, MI, 48824, USA
| | - Martin F Shapiro
- Department of Medicine, Weill Medical College of Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - James Moody
- Department of Sociology, Duke University, Durham, NC, 27708, USA
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10
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Abstract
The substantial literature on interactions between places/spaces and well-being/health often differentiate between physical and social aspects of geographical location. This paper sidesteps this dualism, instead considering places as sociomaterial assemblages of human and non-human materialities. It uses this posthuman and 'new materialist' perspective to explore how place-assemblages affect human capacities, in terms of both health and social dis/advantage. Based on secondary analysis of interview data on human/place interactions, it analyses the physical, sociocultural, psychological and emotional effects of place-assemblages, assessing how these produce opportunities for, and constraints upon human bodies. It than assesses how these emergent capacities affect both social dis/advantage and well-being. This analysis of how place-assemblages contribute positively or negatively to health and dis/advantage offers possibilities for further research and for social and public health policy.
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Affiliation(s)
- Nick J. Fox
- Nick J. Fox, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, UK.
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11
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Roordink EM, Steenhuis IHM, Kroeze W, Hoekstra T, Jacobs N, van Stralen MM. Social Environmental Predictors of Lapse in Dietary Behavior: An Ecological Momentary Assessment Study Amongst Dutch Adults Trying to Lose Weight. Ann Behav Med 2023:7000437. [PMID: 36694372 PMCID: PMC10354841 DOI: 10.1093/abm/kaac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND When losing weight, most individuals find it difficult to maintain a healthy diet. Social environmental conditions are of pivotal importance in determining dietary behavior. To prevent individuals from lapsing, insight in social environmental predictors of lapse in dietary behavior is needed. PURPOSE Identify social environmental predictors of lapse in dietary behavior, using ecological momentary assessment (EMA) amongst Dutch adults trying to lose weight. METHODS Adults (N = 81) participated in two 7-day EMA weeks. Six times a day semi-random prompts were sent. At each prompt, participants indicated whether a lapse had occurred and responded to questions assessing social support, descriptive norm, injunctive norm, social pressure, presence of others, and current location. Generalized estimating equations were used to examine associations with lapse. RESULTS Injunctive norm (OR = 1.07, 95% CI = 1.03-1.11), descriptive norm (OR = 1.04, 95% CI = 1.02-1.07), and social pressure (OR = 1.09, 95% CI = 1.05-1.14), all toward diverting from diet plans, predicted lapses. Social support toward sticking to diet plans and presence of others did not predict lapses. When controlling for a prior lapse, all other associations became nonsignificant. Lapses occurred most often at home and gradually occurred more often during the day. CONCLUSIONS Traditional public health perspectives have mainly focused on individual choice and responsibility for overweight related unhealthy lifestyles. This study shows that there may be opportunities to enhance intervention programs by also focusing on social norms and social pressure. The involvement of partners or housemates may create more awareness of the impact of (unintentional) social pressure on risk of lapsing, and reduce the level of exerted social pressure.
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Affiliation(s)
- Eline M Roordink
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.,Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Nele Jacobs
- Department of Lifespan Psychology, Faculty of Psychology, Open Universiteit, Heerlen, The Netherlands.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
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12
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Nam S, Jung S, Vlahov D, Latkin C, Kershaw T, Whittemore R. Body mass index and obesity-related behaviors in African American church-based networks: A social network analysis. PLoS One 2023; 18:e0281145. [PMID: 36913354 PMCID: PMC10010537 DOI: 10.1371/journal.pone.0281145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 01/17/2023] [Indexed: 03/14/2023] Open
Abstract
A growing body of research suggests that obesity can be understood as a complex and biobehavioral condition influenced by social relationships ─social networks. Social network analysis allows us to examine how an individual's network characteristics (e.g., popularity) are associated with obesity and obesity-related behaviors. The objectives of the study were to (a) examine whether network members in African American churches are similar in body mass index (BMI) and obesity-related behaviors (physical activity, eating, alcohol consumption) and (b) examine whether an individual's network characteristics, such as popularity (i.e., receiving nominations from peers) and expansiveness (i.e., sending nominations to peers) are associated with BMI and obesity-related behaviors. We used a cross-sectional study design and conducted social network analysis using Exponential random graph models with three African American church-based social networks (network A, B, and C, n = 281). There were no significant network members' similarities on BMI in the three church-based networks. One out of three networks showed similarities in fruit and vegetable consumption (network B), fast food consumption (network C), physical activity, sedentary behaviors, and alcohol consumption (network A). African Americans with a high BMI were more popular, as were individuals with greater fat intake and alcohol consumption. Our findings support the perspective that we need to improve obesity-related behaviors by targeting influential individuals and existing ties and to develop obesity interventions using social networks. The degree to which our findings varied across churches also suggests that the relationship among an individual's obesity-related behaviors and network characteristics should be understood in the unique social context.
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Affiliation(s)
- Soohyun Nam
- School of Nursing, Yale University, Orange, Connecticut, United States of America
- * E-mail:
| | - Sunyoung Jung
- College of Nursing, Pusan National University, Pusan, Republic of Korea
| | - David Vlahov
- School of Nursing, Yale University, Orange, Connecticut, United States of America
| | - Carl Latkin
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Trace Kershaw
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Robin Whittemore
- School of Nursing, Yale University, Orange, Connecticut, United States of America
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13
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Howell CR, Juarez L, Agne AA, Nassel AF, Scarinci IC, Ayala GX, Cherrington AL. Assessing Hispanic/Latino and Non-Hispanic White Social Determinants of Obesity Among a Community Sample of Residents in the Rural Southeast US. J Immigr Minor Health 2022; 24:1469-1479. [PMID: 35174428 PMCID: PMC9980419 DOI: 10.1007/s10903-022-01334-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
Employing an ecological approach, we sought to identify social determinants of obesity among Hispanics/Latinos and non-Hispanic whites living in the Southeast US. Data on social determinants of obesity (individual, family, community and cultural/contextual) were collected from 217 participants [106 Hispanics/Latinos; 111 non-Hispanic whites]; height and weight were objectively measured. We compared prevalence of overweight and obese between ethnic groups and BMI values within each group by social determinants. Hispanics had a 1.9-fold increase (OR 1.93, 95% CI: 1.05-3.55) in overweight prevalence compared to non-Hispanic whites after adjusting for age and gender. We found positive estimates between unfavorable family-level determinants and BMI among Hispanic/Latinos. In contrast, non-Hispanic whites who reported unfavorable neighborhood characteristics had higher BMI's. Findings highlight the need for targeted approaches for the prevention and control of obesity.
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Affiliation(s)
- Carrie R Howell
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA.
| | - Lucia Juarez
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
| | - April A Agne
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
| | - Ariann F Nassel
- School of Public Health, University of Alabama at Birmingham, 1665 University Blvd, Birmingham, AL, 35233, USA
| | - Isabel C Scarinci
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
| | - Guadalupe X Ayala
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Andrea L Cherrington
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 638 Medical Towers, 1717 11th Avenue South, Birmingham, AL, 35205, USA
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14
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van der Put A, Ellwardt L. Employees' healthy eating and physical activity: the role of colleague encouragement and behaviour. BMC Public Health 2022; 22:2004. [PMID: 36319982 PMCID: PMC9628058 DOI: 10.1186/s12889-022-14394-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/04/2022] [Accepted: 10/19/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Exercising and eating healthy are not just an individual choice, but influenced by family members, friends, or neighbours. Little is known, however, about colleagues, who are another important interpersonal influence. Many people spend many hours at work, surrounded by mostly the same colleagues, who could therefore significantly shape employees’ (un)healthy choices. We studied to what extent colleagues may play a part in one another’s eating and exercise behaviours by focusing on two pathways: colleagues can encourage a healthy lifestyle or act as role models whose behaviours can be observed and copied. Methods: We used the European Sustainable Workforce Survey, with data on 4345 employees in 402 teams in 113 organisations. We used network autocorrelation models, which resemble regression models, to study to what extent employee encouragement is related to fruit and vegetable consumption, and physical activity. Specific to this type of model is the inclusion of a network correlation parameter which allows for the outcome of an employee to be directly associated with the outcomes of their colleagues. In this way we tested whether colleagues’ behaviours were related to one another. Results: We found that employees were more likely to eat fruit and vegetables as well as engage in physical activity when their colleagues encourage a healthy lifestyle. Employees’ healthy eating behaviours were positively related to their colleagues’ fruit and vegetable consumption, while we found a negative correlation concerning physical activity. Conclusion: Overall, colleagues’ encouragement and own healthy behaviours have the potential to contribute to creating a culture of health in the workplace and support all employees in making healthy choices.
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Affiliation(s)
- Anne van der Put
- grid.5477.10000000120346234Department of Sociology, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands
| | - Lea Ellwardt
- grid.6190.e0000 0000 8580 3777Institute of Sociology and Social Psychology, University of Cologne, Albert Magnus Platz, 50923 Cologne, Germany
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15
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Piombo SE, Huh J, Valente TW. Adolescent Body Mass Index and Exposure to Peers with Overweight and Obesity: A Structural Equation Model Approach to Longitudinal Network Data. Child Obes 2022; 18:445-453. [PMID: 35108122 PMCID: PMC9529305 DOI: 10.1089/chi.2021.0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: Considerable evidence has shown that social networks influence a wide variety of health behaviors. This study investigates whether having friends with overweight/obesity in one's social network (network exposure) can predict changes in body mass index (BMI) throughout high school in a diverse urban population of students. Methods: Racially and ethnically diverse students from five high schools in Los Angeles County were surveyed at four time points throughout high school from 2010 to 2013 (N = 2091). Surveys included questions on students' social networks, demographics, and health-related information. BMI and weight categories were calculated for all students who provided height and weight information (∼50%). A latent growth curve model was used to assess the growth trajectory of BMI and the time-varying effect of network exposure to friends with overweight/obesity while controlling for demographic covariates. Results: Hispanic students had a significantly higher initial BMI compared with non-Hispanic students (p < 0.01). There was a significant positive slope for time on BMI growth (p < 0.01). Greater personal network exposure to friends with overweight/obesity was associated with a significant 0.65-point average increase in BMI (p < 0.05) at the first follow-up time point (T2) and a significant 0.62-point average increase in BMI (p < 0.01) at the last follow-up (T4) while controlling for covariates. Conclusions: Using structural equation modeling to understand the relationship between BMI and social networks, we found that increased network exposure to peers with overweight/obesity is associated with higher individual BMI, demonstrating that friendships may influence adolescents' weight status over time.
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Affiliation(s)
- Sarah E. Piombo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Thomas W. Valente
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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16
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Schlicht JA, van Woudenberg TJ, Buijzen M. Arranging the fruit basket: A computational approach towards a better understanding of adolescents' diet-related social media communications. Acta Psychol (Amst) 2022; 230:103738. [PMID: 36113249 DOI: 10.1016/j.actpsy.2022.103738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/05/2022] [Accepted: 09/04/2022] [Indexed: 11/01/2022] Open
Abstract
This study investigated the contents and linguistic styles that adolescents use in their dietary communications on social media. The main aim of the study was to describe adolescents' social media communication practices with regards to diet, in order to better understand dietary social influences and how to effectively intervene in them. The current study made use of an online communication dataset (N = 72,384 messages) of adolescents in primary and secondary school (N = 1038, 9-16 y/o). We analyzed the message content using tailor-made diet- and health-related dictionaries and LDA topic modeling. The linguistic style of the messages was investigated by assessing the sentiment and underlying psychological dimensions. Further, we used multivariate linear regressions to test how each message dimension was related to message liking, which was considered as an indicator of a message's influence potential regarding peers' dietary behaviors. The results confirmed that adolescents show a preference to discuss neutral-to-unhealthy dietary items most often. No association emerged between message content (i.e., message healthiness and topics) and the number of likes that a message received, while messages with more positive sentiment and higher subjectivity received slightly more likes. Also, our findings confirm that visual dietary content is more often liked than textual descriptions alone. The findings indicate that the content and the healthiness of a message does not explain its popularity among adolescents. Rather, the way how diet-related content is formulated (i.e., in a positive and subjective tone) emerged as a more important predictor for message liking.
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Affiliation(s)
- Jonas A Schlicht
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, the Netherlands.
| | - Thabo J van Woudenberg
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, the Netherlands
| | - Moniek Buijzen
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, the Netherlands; Radboud University Nijmegen, the Netherlands
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17
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Lu H, Kandilov IT, Nie P. Heterogeneous Impact of Social Integration on the Health of Rural-to-Urban Migrants in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9999. [PMID: 36011631 PMCID: PMC9407958 DOI: 10.3390/ijerph19169999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND While several studies have found that lower levels of social integration may lead to a deterioration in the health status of migrants, previous research on the nexus between social integration and health has generally ignored the potential endogeneity of social integration. This paper examines the heterogeneous impact of social integration on the health of rural-to-urban migrants in China by exploiting plausibly exogenous, long-term, geographic variation in dialectal diversity. METHODS Drawing on nationally representative data from the 2017 China Migrants Dynamic Survey (n = 117,446), we first regressed self-reported health on social integration using ordinary least squares estimation and then used an ordered probit model as a robustness check. Additionally, to rule out the potential endogeneity of social integration, we relied mainly on an instrumental variable approach and used dialectal diversity as a source of exogenous variation for social integration. RESULTS We found that social integration has a significant positive impact on rural-to-urban migrants' health. We also detected considerable heterogeneity in the effects of social integration across gender, generation, and wage levels: the health status of women, more recent generation migrants, and migrants with wages in the middle of wage distribution are more likely to be affected by social integration. CONCLUSIONS We confirmed the beneficial impact of social integration on migrants' health, which has some important policy implications. Successful migration policies should take the fundamental issue of migrants' social integration into account.
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Affiliation(s)
- Haiyang Lu
- Institute of Western China Economic Research, Southwestern University of Finance and Economics, Chengdu 610074, China
| | - Ivan T. Kandilov
- Department of Agricultural and Resource Economics, North Carolina State University, Raleigh, NC 27695, USA
| | - Peng Nie
- School of Economics and Finance, Xi’an Jiaotong University, Xi’an 710061, China
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany
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18
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Herr RM, De Bock F, Diehl K, Wiedemann E, Sterdt E, Blume M, Hoffmann S, Herke M, Reuter M, Iashchenko I, Schneider S. Associations of individual factors and early childhood education and care (ECEC) centres characteristics with preschoolers' BMI in Germany. BMC Public Health 2022; 22:1415. [PMID: 35883054 PMCID: PMC9317063 DOI: 10.1186/s12889-022-13814-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background The number of obese children is rising worldwide. Many studies have investigated single determinants of children’s body mass index (BMI), yet studies measuring determinants at different potential levels of influence are sparse. The aim of this study is to investigate the independent role of parental socioeconomic position (SEP), additional family factors at the micro level, as well as early childhood education and care (ECEC) centre characteristics at the meso level regarding BMI. Methods Analyses used the baseline data of the PReschool INtervention Study (PRINS) including up to 1,151 children from 53 ECEC centres. Multi-level models first estimated the associations of parental SEP indicators (parental school education, vocational training, and household income) with the children’s standard deviation scores for BMI (SDS BMI, standardised for age and gender). Second, structural (number of siblings), psychosocial (strained family relationships), and nutrition behavioural (soft-drink consumption, frequency of fast-food restaurant visits) family factors at the micro level were included. Third, characteristics of the ECEC centre at the meso level in terms of average group size, the ratio of overweight children in the group, ECEC centre type (all-day care), and the location of the ECEC centre (rural vs urban) were included. All analyses were stratified by gender and adjusted for age, migration background, and parental employment status. Results Estimates for boys and girls appeared to differ. In the full model, for boys the parental SEP indicators were not related to SDS BMI. Factors related to SDS BMI in boys were: two or more siblings; B = -.55; p = 0.045 [ref.: no sibling]), the characteristics of the ECEC centre in terms of average group size (20 – 25 children; B = -.54; p = 0.022 [ref.: < 20 children]), and the ratio of overweight children (more overweight children B = -1.39; p < 0.001 [ref.: few overweight children]). For girls the number of siblings (two and more siblings; B = .67; p = 0.027 [ref.: no sibling]) and average group size (> 25 children; B = -.52; p = 0.037 [ref.: < 20 children]) were related to SDS BMI. Conclusions The BMI of preschool children appears to be associated with determinants at the micro and meso level, however with some gender differences. The identified factors at the micro and meso level appear largely modifiable and can inform about possible interventions to reduce obesity in preschool children.
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Affiliation(s)
- Raphael M Herr
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany. .,Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Freia De Bock
- Child Health Services Unit, Clinic for General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Katharina Diehl
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany.,Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Wiedemann
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany
| | - Elena Sterdt
- Competence Centre for Early Education, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Max Herke
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Marvin Reuter
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Iryna Iashchenko
- Professorship of Health Economics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Sven Schneider
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany
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Serrano-Fuentes N, Rogers A, Portillo MC. The influence of social relationships and activities on the health of adults with obesity: A qualitative study. Health Expect 2022; 25:1892-1903. [PMID: 35748121 PMCID: PMC9327877 DOI: 10.1111/hex.13540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/21/2022] [Accepted: 05/17/2022] [Indexed: 11/26/2022] Open
Abstract
Background Obesity in adults is a leading health challenge that causes millions of deaths worldwide and represents a risk factor for developing long‐term conditions. Social relationships are one of the multiple drivers shaping obesity and obesity‐related practices. However, there is still little evidence as to the processes by which relationships influence the adoption of positive and negative obesity health‐related practices—eating, physical activity and alcohol intake. This study aims first to identify the types of relationships relevant to the adoption of practices in adults with obesity and, second, to explore the type of activities these relationships engage with or promote to produce those practices and their potential health consequences. Methods Nineteen adults who have or had a history of obesity living in the United Kingdom were interviewed between May 2020 and March 2021. Experiences were explored through semi‐structured interviews and network mapping via videoconferencing. Data were analysed using a hermeneutic phenomenology informed thematic analysis. Results Three main themes were identified: (1) everyday familial routines matter, (2) chasing healthier lifestyles: comparing, modelling and connecting emotionally with friends and (3) healthcare professionals as negative influencers. Discussion and Conclusions Findings show how different types of relationships might shape the risk of developing and losing weight. They uncover the power of informal networks (family and friends) and highlight the potentially negative impact of formal ones (healthcare professionals). Our exploration could add to arguments about the need for stakeholders confronting obesity to be aware of the relevance of everyday social relationships in health and well‐being strategies for tackling the issue, in creating collective and individual person‐centred long‐term sustainable actions. Patient and Public Contribution Feedback on the tone/content of the interview questions was provided by the two first participants. The results were checked and received feedback from one of the interviewees.
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Affiliation(s)
- Nestor Serrano-Fuentes
- NIHR ARC Wessex, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Hampshire, UK
| | - Anne Rogers
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Hampshire, UK
| | - Mari Carmen Portillo
- NIHR ARC Wessex, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Hampshire, UK
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Spread of gambling abstinence through peers and comments in online self-help chat forums to quit gambling. Sci Rep 2022; 12:3675. [PMID: 35256679 PMCID: PMC8901770 DOI: 10.1038/s41598-022-07714-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/22/2022] [Indexed: 11/08/2022] Open
Abstract
Habit formation occurs in relation to peer habits and comments. This general principle was applied to gambling abstinence in the context of online self-help forums to quit gambling. Participants in this study, conducted between September 2008 and March 2020, were 161 abstinent and 928 non-abstinent gamblers who participated in online self-help chat forums to quit gambling. They received 269,317 comments during their first 3 years of forum participation. Gamblers had an increased likelihood of 3-year continuous gambling abstinence if they had many peers in the forums. However, they had a decreased likelihood of gambling abstinence if they received rejective comments from the forums. Based on these results, online social network-based interventions may be a new treatment option for gamblers.
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Trifiletti E, Giannini M, Vezzali L, Shamloo SE, Faccini M, Cocco VM. At the core of cyberaggression: A group-based explanation. Aggress Behav 2022; 48:85-93. [PMID: 34694017 PMCID: PMC9298332 DOI: 10.1002/ab.22001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 08/20/2021] [Accepted: 10/03/2021] [Indexed: 11/27/2022]
Abstract
In this study, prototypicality of the aggressor was tested as a group‐level factor predicting social media users’ active participation in cyberaggression. Participants were exposed to a fictitious conversation, in which either a prototypical versus non‐prototypical user posted an aggressive comment as a reply to a provocative comment. In line with self‐categorization theory, we hypothesized that bystander participants would post an aggressive comment and rate the aggression as acceptable to a greater extent in the prototypical than in the non‐prototypical condition. Furthermore, we predicted that perceived normativity of aggression would mediate the effect of prototypicality. Results supported these predictions and showed that prototypical members affect the extent to which collective aggressive behaviors in online interactions are approved and enacted. These findings highlight the importance of group‐level factors in the study of cyberaggression and provide important information for understanding the psychological underpinnings of collective forms of online aggression.
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Affiliation(s)
| | - Marco Giannini
- Department of Human Sciences University of Verona Verona Italy
| | - Loris Vezzali
- Faculty of Medicine University of Modena and Reggio Emilia Modena Italy
| | - Soraya E. Shamloo
- Department of Human Sciences University of Verona Verona Italy
- Faculty of Medicine University of Modena and Reggio Emilia Modena Italy
| | - Martina Faccini
- Department of Human Sciences University of Verona Verona Italy
| | - Veronica M. Cocco
- Department of Humanities, Social Sciences and Cultural Industries University of Parma Parma Italy
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22
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Winkler MR, Mui Y, Hunt SL, Laska MN, Gittelsohn J, Tracy M. Applications of Complex Systems Models to Improve Retail Food Environments for Population Health: A Scoping Review. Adv Nutr 2021; 13:1028-1043. [PMID: 34999752 PMCID: PMC9340968 DOI: 10.1093/advances/nmab138] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/10/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Retail food environments (RFEs) are complex systems with important implications for population health. Studying the complexity within RFEs comes with challenges. Complex systems models are computational tools that can help. We performed a systematic scoping review of studies that used complex systems models to study RFEs for population health. We examined the purpose for using the model, RFE features represented, extent to which the complex systems approach was maximized, and quality and transparency of methods employed. The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines were followed. Studies using agent-based modeling, system dynamics, discrete event simulations, networks, hybrid, or microsimulation models were identified from 7 multidisciplinary databases. Fifty-six studies met the inclusion criteria, including 23 microsimulation, 13 agent-based, 10 hybrid, 4 system dynamics, 4 network, and 2 discrete event simulation models. Most studies (n = 45) used models for experimental purposes and evaluated effects of simulated RFE policies and interventions. RFE characteristics simulated in models were diverse, and included the features (e.g., prices) customers encounter when shopping (n = 55), the settings (e.g., restaurants, supermarkets) where customers purchase food and beverages (n = 30), and the actors (e.g., store managers, suppliers) who make decisions that influence RFEs (n = 25). All models incorporated characteristics of complexity (e.g., feedbacks, conceptual representation of multiple levels), but these were captured to varying degrees across model types. The quality of methods was adequate overall; however, few studies engaged stakeholders (n = 10) or provided sufficient transparency to verify the model (n = 12). Complex systems models are increasingly utilized to study RFEs and their contributions to public health. Opportunities to advance the use of these approaches remain, and areas to improve future research are discussed. This comprehensive review provides the first marker of the utility of leveraging these approaches to address RFEs for population health.
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Affiliation(s)
| | - Yeeli Mui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shanda L Hunt
- Health Sciences Library, University of Minnesota, Minneapolis, MN, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Joel Gittelsohn
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA
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Cofie LE, Hirth JM, Lee JGL. Social Support Networks and Foreign-Birth Status Associated With Obesity, Hypertension and Diabetes Prevalence Among 21-30 and 50-70 Year Old Adults Living in the San Francisco Bay Area. Am J Health Promot 2021; 35:1105-1113. [PMID: 34000826 PMCID: PMC9933210 DOI: 10.1177/08901171211016320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine whether social network characteristics of US-and foreign-born individuals are related to hypertension, diabetes and obesity prevalence. DESIGN Cross-sectional. SETTING Six San Francisco Bay Area counties. PARTICIPANTS N = 1153 cohorts of young and older adults (21-30 and 50-70 years). MEASURES Network structure and support measures were calculated using name elicitation and interpreter questions common in egocentric surveys. Hypertension and diabetes were self-reported, and overweight/obesity was determined using body mass index calculations. Foreign-birth status was based on country of birth. ANALYSIS Adjusted and unadjusted logistic regression models were used to examine associations between network characteristics and hypertension, diabetes and overweight/obesity. These relationships were tested for moderation by foreign-birth status, age and gender. RESULTS Higher percentages of family members (AOR = 4.16, CI: 1.61-10.76) and same-sex individuals (AOR = 3.41, CI: 1.25-9.35) in the composition of respondents' networks were associated with overweight/obesity. Higher composition of family members (AOR = 3.54, CI: 1.09-11.48) was associated with hypertension. Respondents whose networks composed of higher numbers of advice individuals (AOR = 0.88, CI: 0.77-0.99), female respondents (AOR = 0.52, CI: 0.35-0.77) and foreign-born respondents (AOR = 0.54, CI: 0.32-0.92) were less likely to report overweight/obesity. Diabetes was associated with higher composition of individuals living within 5-minutes to respondents (AOR = 5.13, CI: 1.04-25.21). CONCLUSION Family and network support members such as advice individuals could be potential targets for chronic disease prevention, particularly among older adults and immigrants.
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Affiliation(s)
- Leslie E. Cofie
- Department of Health Education and Promotion, East Carolina University,Corresponding author: East Carolina University, 2309 Belk Building, Greenville, NC 27858, 252-328-5995,
| | - Jacqueline M. Hirth
- Center for Interdisciplinary Research in Women’s Health, Department of Obstetrics & Gynecology, University of Texas Medical Branch
| | - Joseph G L Lee
- Department of Health Education and Promotion, East Carolina University
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Levy DE, Pachucki MC, O'Malley AJ, Porneala B, Yaqubi A, Thorndike AN. Social connections and the healthfulness of food choices in an employee population. Nat Hum Behav 2021; 5:1349-1357. [PMID: 33888881 PMCID: PMC8530824 DOI: 10.1038/s41562-021-01103-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 03/23/2021] [Indexed: 02/02/2023]
Abstract
Unhealthy food choice is an important driver of obesity, but research examining the relationship of food choices and social influence has been limited. We sought to assess associations in the healthfulness of workplace food choices among a large population of diverse employees whose food-related social connections were identified using passively collected data in a validated model. Data were drawn from 3 million encounters where pairs of employees made purchases together in 2015-2016. The healthfulness of food items was defined by 'traffic light' labels. Cross-sectional simultaneously autoregressive models revealed that proportions of both healthy and unhealthy items purchased were positively associated between connected employees. Longitudinal generalized estimating equation models also found positive associations between an employee's current food purchase and the most recent previous food purchase a coworker made together with the employee. These data indicate that workplace interventions to promote healthy eating and reduce obesity should test peer-based strategies.
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Affiliation(s)
- Douglas E Levy
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Mark C Pachucki
- Department of Sociology & Computational Social Science Institute, University of Massachusetts, Amherst, Amherst, MA, USA
| | - A James O'Malley
- Department of Biomedical Data Science and The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Bianca Porneala
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Awesta Yaqubi
- Boston University School of Medicine, Boston, MA, USA
| | - Anne N Thorndike
- Harvard Medical School, Boston, MA, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
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25
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Kim N, Kang SJ, Tak S. Reconstructing a COVID-19 outbreak within a religious group using social network analysis simulation in Korea. Epidemiol Health 2021; 43:e2021068. [PMID: 34607404 PMCID: PMC8654504 DOI: 10.4178/epih.e2021068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/16/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES We reconstructed a coronavirus disease 2019 (COVID-19) outbreak to examine how a large cluster at a church setting spread before being detected and estimate the potential effectiveness of complying with mask-wearing guidelines recommended by the government. METHODS A mathematical model with a social network analysis (SNA) approach was used to simulate a COVID-19 outbreak. A discrete-time stochastic simulation model was used to simulate the spread of COVID-19 within the Sarang Jeil church. A counterfactual experiment using a calibrated baseline model was conducted to examine the potential benefits of complying with a mask-wearing policy. RESULTS Simulations estimated a mask-wearing ratio of 67% at the time of the outbreak, which yielded 953.8 (95% confidence interval [CI], 937.3 to 970.4) cases and was most consistent with the confirmed data. The counterfactual experiment with 95% mask-wearing estimated an average of 45.6 (95% CI, 43.4 to 47.9) cases with a standard deviation of 20.1. The result indicated that if the church followed government mask-wearing guidelines properly, the outbreak might have been one-twentieth the size. CONCLUSIONS SNA is an effective tool for monitoring and controlling outbreaks of COVID-19 and other infectious diseases. Although our results are based on simulations and are thus limited, the precautionary implications of social distancing and mask-wearing are still relevant. Since person-to-person contacts and interactions are unavoidable in social and economic life, it may be beneficial to develop precise measures and guidelines for particular organizations or places that are susceptible to cluster outbreaks.
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Affiliation(s)
- Namje Kim
- Department of Economics, Seoul National University, Seoul, Korea
- Institute of Research in Finance and Economics, Seoul National University, Seoul, Korea
| | - Su Jin Kang
- Institute of Health and Environment, Seoul National University, Seoul, Korea
| | - Sangwoo Tak
- Institute of Health and Environment, Seoul National University, Seoul, Korea
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26
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McDaniel T, Wilson DK, Coulon MS, Sweeney AM, Van Horn ML. Interaction of Neighborhood and Genetic Risk on Waist Circumference in African-American Adults: A Longitudinal Study. Ann Behav Med 2021; 55:708-719. [PMID: 32914830 DOI: 10.1093/abm/kaaa063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Understanding determinants of metabolic risk has become a national priority given the increasingly high prevalence rate of this condition among U.S. adults. PURPOSE This study's aim was to assess the impact of gene-by-neighborhood social environment interactions on waist circumference (WC) as a primary marker of metabolic risk in underserved African-American adults. Based on a dual-risk model, it was hypothesized that those with the highest genetic risk and who experienced negative neighborhood environment conditions would demonstrate higher WC than those with fewer risk factors. METHODS This study utilized a subsample of participants from the Positive Action for Today's Health environmental intervention to improve access and safety for walking in higher-crime neighborhoods, who were willing to provide buccal swab samples for genotyping stress-related genetic pathways. Assessments were conducted with 228 African-American adults at baseline, 12, 18, and 24 months. RESULTS Analyses indicated three significant gene-by-environment interactions on WC outcomes within the sympathetic nervous system (SNS) genetic pathway. Two interactions supported the dual-risk hypotheses, including the SNS genetic risk-by-neighborhood social life interaction (b = -0.11, t(618) = -2.02, p = .04), and SNS genetic risk-by-informal social control interaction (b = -0.51, t(618) = -1.95, p = .05) on WC outcomes. These interactions indicated that higher genetic risk and lower social-environmental supports were associated with higher WC. There was also one significant SNS genetic risk-by-neighborhood satisfaction interaction (b = 1.48, t(618) = 2.23, p = .02) on WC that was inconsistent with the dual-risk pattern. CONCLUSIONS Findings indicate that neighborhood and genetic factors dually influence metabolic risk and that these relations may be complex and warrant further study. TRIAL REGISTRATION NCT01025726.
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Affiliation(s)
- Tyler McDaniel
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - Dawn K Wilson
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - M Sandra Coulon
- Department of Mental Health, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Allison M Sweeney
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - M Lee Van Horn
- Department of Educational Psychology, University of New Mexico, Albuquerque, NM, USA
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27
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Miller S, Bruine de Bruin W, Livings M, Wilson J, Weber K, Frazzini A, Babboni M, de la Haye K. Self-reported dietary changes among Los Angeles County adults during the COVID-19 pandemic. Appetite 2021; 166:105586. [PMID: 34217761 DOI: 10.1016/j.appet.2021.105586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 01/01/2023]
Abstract
Poor diets are historically the leading cause of morbidity and mortality in the United States (U.S.), causing over 44,000 deaths each month. Dietary patterns have likely changed during the COVID-19 pandemic due to major shifts and crises in social, economic, and food systems. This study examines self-reported dietary changes in Los Angeles (L.A.) County during COVID-19, and identifies factors associated with making healthy and unhealthy changes. Data are from the Understanding Coronavirus in America Study, an internet panel of adults representative of L.A. County households (N = 1080). Multinomial logistic regression was used to test if self-reported change in diet healthiness assessed in July 2020 was associated with socio-ecological factors known to be associated with diet, assessed between April-July 2020. More than half of L.A. County residents reported making changes to their diet: 28.3% reported eating healthier food since the beginning of the pandemic, while 24.8% reported eating less healthy food. Individuals who were significantly more likely to report healthy changes were Non-Hispanic Black or Hispanic/Latino (vs. Non-Hispanic White), had received unemployment insurance, or had larger social networks. Individuals who were significantly more likely to report unhealthy changes were younger, of mixed race, had children in their household, had transportation barriers, or had obesity. Individuals who were significantly more likely to report both healthy and unhealthy changes were Asian, had experienced food insecurity, or had challenges getting food due to store closures. The pandemic may be exacerbating diet-related disease risk in some groups, such as communities of color, and among individuals with obesity and those facing transportation barriers.
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Affiliation(s)
- Sydney Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA.
| | - Wandi Bruine de Bruin
- Sol Price School of Public Policy and Dornsife Department of Psychology, University of Southern California, USA; Schaeffer Center for Health Policy and Economics and the Center for Economic and Social Research, University of Southern California, USA
| | - Michelle Livings
- Spatial Sciences Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, USA
| | - John Wilson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA; School of Architecture; Department of Sociology, Dornsife College of Letters, Arts and Sciences, University of Southern California, USA; Departments of Civil & Environmental Engineering and Computer Science, Viterbi School of Engineering, University of Southern California, USA
| | - Kate Weber
- Dornsife Public Exchange, University of Southern California, USA
| | | | - Marianna Babboni
- Dornsife Public Exchange, University of Southern California, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
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28
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Lev-Ari S, Rolnik B, Volovitz I. Immune Responses to SARS-CoV2 Mirror Societal Responses to COVID-19: Identifying Factors Underlying a Successful Viral Response. BIOLOGY 2021; 10:biology10060485. [PMID: 34072585 PMCID: PMC8228441 DOI: 10.3390/biology10060485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 12/05/2022]
Abstract
Simple Summary The immune system was sculpted in numerous evolutionary battles to protect individuals, societies, and species from novel pathogens. During that time, it had developed highly effective strategies to cope with novel pathogenic challenges and retain immune “memory” following pathogen clearance. We found surprising parallels between person-level immune responses to the virus causing COVID-19 and the society-level responses to the COVID-19 pandemic. Similarly, the events which lead to a life-endangering immune cytokine storm, parallel those leading to a devastating socioeconomic crisis we termed a “social cytokine storm”. This new understanding may help explain why COVID-19, caused by a virus with no “exceptional” epidemiological capabilities, had inflicted such profound social and global toll. Understanding the set of events leading to an immunological and societal cytokine storms may aid scientists and policymakers to adopt more effective strategies that could reduce future disease morbidity and mortality, avert avoidable social cytokine storms, and minimize the socioeconomic toll. Abstract The adaptive immune system was sculpted to protect individuals, societies, and species since its inception, developing effective strategies to cope with emerging pathogens. Here, we show that similar successful or failed dynamics govern personal and societal responses to a pathogen as SARS-CoV2. Understanding the self-similarity between the health-protective measures taken to protect the individual or the society, help identify critical factors underlying the effectiveness of societal response to a pathogenic challenge. These include (1) the quick employment of adaptive-like, pathogen-specific strategies to cope with the threat including the development of “memory-like responses”; (2) enabling productive coaction and interaction within the society by employing effective decision-making processes; and (3) the quick inhibition of positive feedback loops generated by hazardous or false information. Learning from adaptive anti-pathogen immune responses, policymakers and scientists could reduce the direct damages associated with COVID-19 and avert an avoidable “social cytokine storm” with its ensuing socioeconomic damage.
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Affiliation(s)
- Shahar Lev-Ari
- Tel-Aviv Sourasky Medical Center, Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Correspondence: (S.L.-A.); (I.V.)
| | - Benjamin Rolnik
- Healthcare Innovation Lab, Department of Genetics, Stanford Medicine, Stanford, CA 94305, USA;
| | - Ilan Volovitz
- Tel-Aviv Sourasky Medical Center, Cancer Immunotherapy Lab, Neurosurgery Department, Tel-Aviv 64236, Israel
- Correspondence: (S.L.-A.); (I.V.)
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Asensio-Cuesta S, Blanes-Selva V, Conejero A, Portolés M, García-Gómez M. A user-centered chatbot to identify and interconnect individual, social and environmental risk factors related to overweight and obesity. Inform Health Soc Care 2021; 47:38-52. [PMID: 34032537 DOI: 10.1080/17538157.2021.1923501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study was to assess the feasibility of using a user-centered chatbotfor collecting linked data to study overweight and obesity causes ina target population. In total 980 people participated in the feasibility study organized in three studies: (1) within a group of university students (88 participants), (2) in a small town (422 participants), and (3) within a university community (470 participants). We gathered self-reported data through the Wakamola chatbot regarding participants diet, physical activity, social network, living area, obesity-associated diseases, and sociodemographic data. For each study, we calculated the mean Body Mass Index (BMI) and number of people in each BMI level. Also, we defined and calculated scores (1-100 scale) regarding global health, BMI, alimentation, physical activity and social network. Moreover, we graphically represented obesity risk for living areas and the social network with nodes colored by BMI. Students group results: Mean BMI 21.37 (SD 2.57) (normal weight), 8 people underweight, 5 overweight, 0 obesity, global health status 78.21, alimentation 63.64, physical activity 65.08 and social 26.54, 3 areas with mean BMI level of obesity, 17 with overweight level. Small town´s study results: Mean BMI 25.66 (SD 4.29) (overweight), 2 people underweight, 63 overweight, 26 obesity, global health status 69.42, alimentation 64.60, physical activity 60.61 and social 1.14, 1 area with mean BMI in normal weight; University´s study results: Mean BMI 23.63 (SD 3.7) (normal weight), 22 people underweight, 86 overweight, 28 obesity, global health status 81.03, alimentation 81.84, physical activity 70.01 and social 1.47, 3 areas in obesity level, 19 in overweight level. Wakamola is a health care chatbot useful to collect relevant data from populations in the risk of overweight and obesity. Besides, the chatbot provides individual self-assessment of BMI and general status regarding the style of living. Moreover, Wakamola connects users in a social network to help the study of O&O´s causes from an individual, social and socio-economic perspective.
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Affiliation(s)
- Sabina Asensio-Cuesta
- Instituto De Tecnologías De La Información Y Comunicaciones (ITACA), Valencia, Spain
| | - Vicent Blanes-Selva
- Instituto De Tecnologías De La Información Y Comunicaciones (ITACA), Valencia, Spain
| | - Alberto Conejero
- Instituto Universitario De Matemática Pura Y Aplicada, Valencia, Spain
| | - Manuel Portolés
- Instituto Universitario De Matemática Pura Y Aplicada. Universitat Politècnica De València, Valencia, Spain
| | - Miguel García-Gómez
- Instituto Universitario De Tecnologías De La Información Y Comunicaciones, Valencia, Spain
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30
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Social Capital on Social Networking Sites: A Social Network Perspective. SUSTAINABILITY 2021. [DOI: 10.3390/su13095147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although social capital has been researched from many approaches and attempts have been made to measure it online, the literature lacks an operational description that would allow its measurement criteria to be established from a social network perspective. Therefore, the purpose of this paper is to identify in the literature what metrics researchers use to measure social capital on social networking sites from a social network perspective. Thus, this contribution offers a theoretical description of the key elements for measuring social capital in social networking sites, which may be useful in subsequent studies.
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31
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Asensio-Cuesta S, Blanes-Selva V, Conejero JA, Frigola A, Portolés MG, Merino-Torres JF, Rubio Almanza M, Syed-Abdul S, Li YCJ, Vilar-Mateo R, Fernandez-Luque L, García-Gómez JM. A User-Centered Chatbot (Wakamola) to Collect Linked Data in Population Networks to Support Studies of Overweight and Obesity Causes: Design and Pilot Study. JMIR Med Inform 2021; 9:e17503. [PMID: 33851934 PMCID: PMC8087340 DOI: 10.2196/17503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 10/05/2020] [Accepted: 02/20/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity and overweight are a serious health problem worldwide with multiple and connected causes. Simultaneously, chatbots are becoming increasingly popular as a way to interact with users in mobile health apps. OBJECTIVE This study reports the user-centered design and feasibility study of a chatbot to collect linked data to support the study of individual and social overweight and obesity causes in populations. METHODS We first studied the users' needs and gathered users' graphical preferences through an open survey on 52 wireframes designed by 150 design students; it also included questions about sociodemographics, diet and activity habits, the need for overweight and obesity apps, and desired functionality. We also interviewed an expert panel. We then designed and developed a chatbot. Finally, we conducted a pilot study to test feasibility. RESULTS We collected 452 answers to the survey and interviewed 4 specialists. Based on this research, we developed a Telegram chatbot named Wakamola structured in six sections: personal, diet, physical activity, social network, user's status score, and project information. We defined a user's status score as a normalized sum (0-100) of scores about diet (frequency of eating 50 foods), physical activity, BMI, and social network. We performed a pilot to evaluate the chatbot implementation among 85 healthy volunteers. Of 74 participants who completed all sections, we found 8 underweight people (11%), 5 overweight people (7%), and no obesity cases. The mean BMI was 21.4 kg/m2 (normal weight). The most consumed foods were olive oil, milk and derivatives, cereals, vegetables, and fruits. People walked 10 minutes on 5.8 days per week, slept 7.02 hours per day, and were sitting 30.57 hours per week. Moreover, we were able to create a social network with 74 users, 178 relations, and 12 communities. CONCLUSIONS The Telegram chatbot Wakamola is a feasible tool to collect data from a population about sociodemographics, diet patterns, physical activity, BMI, and specific diseases. Besides, the chatbot allows the connection of users in a social network to study overweight and obesity causes from both individual and social perspectives.
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Affiliation(s)
- Sabina Asensio-Cuesta
- Instituto de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, Valencia, Spain
| | - Vicent Blanes-Selva
- Instituto de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, Valencia, Spain
| | - J Alberto Conejero
- Instituto Universitario de Matemática Pura y Aplicada, Universitat Politècnica de València, Valencia, Spain
| | - Ana Frigola
- Department of Nutrition and Food Science, Universitat de València, Valencia, Spain
| | - Manuel G Portolés
- Instituto Universitario de Matemática Pura y Aplicada, Universitat Politècnica de València, Valencia, Spain
| | | | - Matilde Rubio Almanza
- Department of Endocrinology and Nutrition, Hospital La Fe, Universitat de València, Valencia, Spain
| | - Shabbir Syed-Abdul
- International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chuan Jack Li
- International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - Ruth Vilar-Mateo
- Unidad Mixta de Tic aplicadas a la reingeniería de procesos socio-sanitarios, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | | | - Juan M García-Gómez
- Instituto de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, Valencia, Spain
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32
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Lam TM, Vaartjes I, Grobbee DE, Karssenberg D, Lakerveld J. Associations between the built environment and obesity: an umbrella review. Int J Health Geogr 2021; 20:7. [PMID: 33526041 PMCID: PMC7852132 DOI: 10.1186/s12942-021-00260-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background In the past two decades, the built environment emerged as a conceptually important determinant of obesity. As a result, an abundance of studies aiming to link environmental characteristics to weight-related outcomes have been published, and multiple reviews have attempted to summarise these studies under different scopes and domains. We set out to summarise the accumulated evidence across domains by conducting a review of systematic reviews on associations between any aspect of the built environment and overweight or obesity. Methods Seven databases were searched for eligible publications from the year 2000 onwards. We included systematic literature reviews, meta-analyses and pooled analyses of observational studies in the form of cross-sectional, case–control, longitudinal cohort, ecological, descriptive, intervention studies and natural experiments. We assessed risk of bias and summarised results structured by built environmental themes such as food environment, physical activity environment, urban–rural disparity, socioeconomic status and air pollution. Results From 1850 initial hits, 32 systematic reviews were included, most of which reported equivocal evidence for associations. For food- and physical activity environments, associations were generally very small or absent, although some characteristics within these domains were consistently associated with weight status such as fast-food exposure, urbanisation, land use mix and urban sprawl. Risks of bias were predominantly high. Conclusions Thus far, while most studies have not been able to confirm the assumed influence of built environments on weight, there is evidence for some obesogenic environmental characteristics. Registration: This umbrella review was registered on PROSPERO under ID CRD42019135857.
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Affiliation(s)
- Thao Minh Lam
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands. .,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands. .,Department of Epidemiology and Data Science, Amsterdam University Medical Centers (VUmc Location), De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands.
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Dutch Health Foundation, The Hague, the Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Julius Global Health, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands
| | - Derek Karssenberg
- Department of Physical Geography, Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands
| | - Jeroen Lakerveld
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Department of Epidemiology and Data Science, Amsterdam University Medical Centers (VUmc Location), De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands
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Jessen-Winge C, Ilvig PM, Fritz H, Brandt CJ, Lee K, Christensen JR. What a weight loss programme should contain if people with obesity were asked - a qualitative analysis within the DO:IT study. BMC Public Health 2021; 21:28. [PMID: 33407271 PMCID: PMC7789717 DOI: 10.1186/s12889-020-09850-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 11/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background Currently 1.9 billion adults worldwide are estimated to be overweight or obese. In Denmark the municipalities hold the responsibility to deliver weight loss programmes to overweight and obese citizens. There is a tendency to assume that weight loss programmes that show positive effects in specialized hospital settings are directly transferrable to municipal settings. However, municipality-based weight loss programmes have not produced clinically significant reductions in body weight. One reason for this may be that much research evidence regarding obesity programming neglects the perspectives of people with obesity. The first step in developing a weight loss programme designed for municipal settings is to understand what people with obesity want and need from a programme. The aim of this study was to examine what people with obesity find important in a weight loss programme for weight loss and weight maintenance. Methods We used a qualitative, explorative, descriptive design with individual interviews. We included men and women age 17 and older with a BMI ≥ 25 kg/m2. Participants were recruited from the wait lists of 13 municipality programmes and through Facebook posts. Data were analyzed using content analysis. Results Thirty-four participants with overweight or obesity were individually interviewed (ages between 19 and 74). Findings suggest that weight loss programmes should; a) support participants in structuring days; b) consider the use of replacement activities to reduce cognitive and emotional burden; c) aide individuals to increase self-efficacy and; d) include family and friends as well as health professionals and peers in the weight loss process. Diet and exercise, while important, should be balanced with other meaningful activities in everyday life. Conclusion Participants in this study wished to balance weight loss related activities with overall everyday life as well as finding the believe in their ability to lose weight in social relations.
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Affiliation(s)
- Christina Jessen-Winge
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psycomotore therapy, University College Copenhagen, Sigurdsgade 26, 2200, Copenhagen, Denmark. .,Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark.
| | - Pia Maria Ilvig
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark
| | - Heather Fritz
- Department of Health Care sciences, Occupational Therapy Program, Wayne State University, 259 Mack Ave, Detroit, MI, 48201, USA
| | - Carl J Brandt
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark, JB Winsløwsvej 9A, 5000, Odense C, Denmark.,Department of Occupational Therapy, University College South, Degnevej 16, 6705, Esbjerg, Denmark
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Crudu F, Neri L, Tiezzi S. Family ties and child obesity in Italy. ECONOMICS AND HUMAN BIOLOGY 2021; 40:100951. [PMID: 33291005 DOI: 10.1016/j.ehb.2020.100951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 10/25/2020] [Accepted: 11/16/2020] [Indexed: 06/12/2023]
Abstract
This paper examines the impact of overweight family members on weight outcomes of Italian children aged 6-14 years. We use an original dataset matching the 2012 cross sections of the Italian Multipurpose Household Survey and the Household Budget Survey. Since the identification of within-family peer effects is known to be challenging, we implement our analysis on a partially identified model using inferential procedures recently introduced in the literature and based on standard Bayesian computation methods. We find evidence of a strong, positive effect of both overweight peer children in the family and of overweight adults on children weight outcomes. The impact of overweight peer children in the household is larger than the impact of adults. In particular, the estimated confidence sets associated to the peer children variable is positive with upper bound around one or larger, while the confidence sets for the parameter associated to obese adults often include zero and have upper bound that rarely is larger than one.
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Affiliation(s)
- Federico Crudu
- Department of Economics and Statistics, University of Siena, Piazza San Francesco, 7/8, 53100 Siena, Italy; CRENoS, Cagliari, Italy.
| | - Laura Neri
- Department of Economics and Statistics, University of Siena, Piazza San Francesco, 7/8, 53100 Siena, Italy.
| | - Silvia Tiezzi
- Department of Economics and Statistics, University of Siena, Piazza San Francesco, 7/8, 53100 Siena, Italy.
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35
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Gore R, Patel S, Choy C, Taher M, Garcia-Dia MJ, Singh H, Kim S, Mohaimin S, Dhar R, Naeem A, Kwon SC, Islam N. Influence of organizational and social contexts on the implementation of culturally adapted hypertension control programs in Asian American-serving grocery stores, restaurants, and faith-based community sites: a qualitative study. Transl Behav Med 2020; 10:1525-1537. [PMID: 31260065 PMCID: PMC7796718 DOI: 10.1093/tbm/ibz106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Hypertension affects a third of U.S. adults and is especially high among Asian American groups. The Racial and Ethnic Approaches to Community Health for Asian AmeRicans (REACH FAR) project delivers culturally adapted, evidence-based hypertension-related programs to Bangladeshi, Filipino, Korean, and Asian Indian communities in New York and New Jersey through 26 sites: ethnic grocery stores, restaurants, and Muslim, Christian, and Sikh faith-based organizations. Knowledge of the implementation mechanisms of culturally adapted programs is limited and is critical to inform the design and execution of such programs by and in community sites. We applied four categories of the Consolidated Framework for Implementation Research-intervention and individuals' characteristics, inner and outer setting-to analyze factors influencing implementation outcomes, that is, site leaders' perceptions about adopting, adapting, and sustaining REACH FAR. We conducted semistructured interviews with 15 leaders, coded them for implementation outcomes, and recoded them to identify contextual factors. Our findings show that REACH FAR resonated in sites where leaders perceived unhealthy diet and lifestyles in their communities (intervention characteristics), sites had historically engaged in health programs as a public-service mission (inner setting), and leaders identified with this mission (individuals' characteristics). Site leaders strived to adapt programs to respond to community preferences (outer setting) without compromising core objectives (inner setting). Leaders noted that program sustainability could be impeded by staff and volunteer turnover (inner setting) but enhanced by reinforcing programs through community networks (outer setting). The findings suggest that to facilitate implementation of culturally adapted health behavior programs through community sites, interventions should reinforce sites' organizational commitments and social ties.
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Affiliation(s)
- Radhika Gore
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Shilpa Patel
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Catherine Choy
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Md Taher
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | | | | | - Sara Kim
- Korean Community Services of Metropolitan New York, New York, NY, USA
| | - Sadia Mohaimin
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Ritu Dhar
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Areeg Naeem
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Simona C Kwon
- NYU School of Medicine, Department of Population Health, New York, NY, USA
| | - Nadia Islam
- NYU School of Medicine, Department of Population Health, New York, NY, USA
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Patel JA, Badiani AA. Obesity: A Complex Process Requiring Reframing. J Prim Care Community Health 2020; 11:2150132720979142. [PMID: 33300415 PMCID: PMC7734481 DOI: 10.1177/2150132720979142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jay Anil Patel
- London School of Hygiene and Tropical Medicine, London, UK.,School of Medicine, University of Southampton, Southampton, UK
| | - Ashni Asit Badiani
- School of Medicine, University of Liverpool, Liverpool, Merseyside, UK.,University College London, London, UK
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Jessen-Winge C, Ilvig PM, Thilsing T, Lee K, Fritz H, Christensen JR. Health professionals' perceptions of weight loss programmes and recommendations for future implementation: a qualitative study. BMJ Open 2020; 10:e039667. [PMID: 33208329 PMCID: PMC7677371 DOI: 10.1136/bmjopen-2020-039667] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Obesity is an increasing public health challenge and most weight loss programmes are still inadequate to support sustainable weight loss. One reason for the continued lack of success might be the dominant biomedical, individualised approach to weight loss. Holistic approaches that focus on overall health and well-being in addition to weight loss are increasingly recommended. In Denmark, health professionals in the municipalities are responsible for developing and conducting weight loss programmes. The objective of this study was to explore what health professional's perceived as an ideal, holistic weight loss programme that could be feasibly implemented in the municipalities. DESIGN A phenomenological-hermeneutical qualitative study was performed using semistructured interviews. SETTING Thirty-two Danish municipalities were weight loss programmes are developed and conducted. PARTICIPANTS Thirty-five health professionals with experience conducting weight loss programmes. RESULTS Three themes emerged from the analysis: Support from the social network are important both during and after a weight loss, Changing the self-belief by positive discussions and doing activities, Maintaining changes through daily life. CONCLUSION Future municipal weight loss programmes should emphasise overall health and well-being instead of weight loss and adopt a holistic approach including a focus on social relationships, meaningful activities and successes as part of a balanced daily life.
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Affiliation(s)
- Christina Jessen-Winge
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
- Department of Health, University College Copenhagen, Kobenhavn, Denmark
| | - Pia Marie Ilvig
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Trine Thilsing
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Kim Lee
- Department of Public Health, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Heather Fritz
- Department of occupational therapy, Wayne State University, Detroit, Michigan, USA
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Lawlor ER, Hughes CA, Duschinsky R, Pountain GD, Hill AJ, Griffin SJ, Ahern AL. Cognitive and behavioural strategies employed to overcome "lapses" and prevent "relapse" among weight-loss maintainers and regainers: A qualitative study. Clin Obes 2020; 10:e12395. [PMID: 32767708 PMCID: PMC7116423 DOI: 10.1111/cob.12395] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 02/02/2023]
Abstract
While many behavioural weight management programmes are effective in the short-term, post-programme weight regain is common. Overcoming "lapses" and preventing "relapse" has been highlighted as important in weight-loss maintenance, but little is known on how this is achieved. This study aimed to compare the cognitive and behavioural strategies employed to overcome "lapses" and prevent "relapse" by people who had regained weight or maintained weight-loss after participating in a weight management programme. By investigating differences between groups, we intended to identify strategies associated with better weight-loss maintenance. Semi-structured interviews were conducted with 26 participants (58% female) recruited from the 5-year follow-up of the Weight Loss Referrals for Adults in Primary Care (WRAP) trial (evaluation of a commercial weight-loss programme). Participants who had lost ≥5% baseline weight during the active intervention were purposively sampled according to 5-year weight trajectories (n = 16 'Regainers', n = 10 'Maintainers'). Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Key differences in strategies were that Maintainers continued to pay attention to their dietary intake, anticipated and planned for potential lapses in high-risk situations, and managed impulses using distraction techniques. Regainers did not report making plans, used relaxed dietary monitoring, found distraction techniques to be ineffective and appeared to have difficulty navigating food within interpersonal relationships. This study is one of the longest qualitative follow-ups of a weight loss trial to date, offering unique insights into long-term maintenance. Future programmes should emphasize strategies focusing on self-monitoring, planning and managing interpersonal relationships to help participants successfully maintain weight-loss in the longer-term.
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Affiliation(s)
- Emma R Lawlor
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England
| | - Carly A Hughes
- Fakenham Medical Practice, Norfolk, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Robbie Duschinsky
- Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, England
| | | | - Andrew J Hill
- Division of Psychological & Social Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Simon J Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England
- Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, England
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, England
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Bullivant B, Mitchison D, Skromanis S, Mond J. Elucidating individuals' beliefs about the severity of eating disorders and obesity: implications for public health programs. Eat Weight Disord 2020; 25:929-938. [PMID: 31098985 DOI: 10.1007/s40519-019-00708-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 05/02/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To examine perceptions of the severity of eating disorders and obesity and the effects on these of an information manipulation while also considering the influence of potential covariates such as age, gender, physical and mental health and beliefs about the prevalence and causes of the respective conditions. METHODS Australian women and men (n = 488) aged 18-73 years were randomly assigned to one of four conditions: no information, neutral information, eating disorders emphasis and obesity emphasis. Mixed-model analysis of variance (ANOVA) was used to compare the perceived severity of eating disorders and obesity (within-subjects factor), while also testing the effect of manipulating information, i.e., selectively emphasising the occurrence and adverse effects of one condition or the other (between-subjects factor), on perceptions of severity. Correlational analysis was used to examine associations between perceptions of severity and potential covariates, those covariates for which significant associations were observed being included as covariates in the ANOVA. RESULTS Eating disorders were perceived to be a more severe condition than obesity and the information manipulation was largely ineffective. Perceptions of the severity of both eating disorders and obesity were found to be associated with several covariates, including gender, body dissatisfaction, familiarity with and beliefs about the prevalence of eating disorders and beliefs about the causes of both eating disorders and obesity. CONCLUSIONS The findings support the need for-and provide a platform for-greater collaboration between obesity and eating disorder researchers in the development of integrated prevention and health promotion programs. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Bianca Bullivant
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Macquarie University, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Skromanis
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia
| | - Jonathan Mond
- School of Medicine, Western Sydney University, Sydney, Australia.
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, E, Rm 003, Locked Bag 1322, Launceston, TAS, 7250, Australia.
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40
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Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review. Public Health Nutr 2020; 23:2584-2601. [PMID: 32450938 PMCID: PMC7116038 DOI: 10.1017/s1368980019005305] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objective: To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research. Design: We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro. Setting: Urban food environments in Africa. Participants: Studies involving adolescents and adults (11–70 years, male/female). Results: Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women. Conclusions: The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.
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41
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Effect of a chronotype-adjusted diet on weight loss effectiveness: A randomized clinical trial. Clin Nutr 2020; 39:1041-1048. [DOI: 10.1016/j.clnu.2019.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 04/10/2019] [Accepted: 05/10/2019] [Indexed: 11/22/2022]
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Monfared IG, Harttgen K, Vollmer S. Individual and social predictors of smoking and obesity: A panel study in Germany. SSM Popul Health 2020; 10:100558. [PMID: 32140542 PMCID: PMC7047176 DOI: 10.1016/j.ssmph.2020.100558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/08/2020] [Accepted: 02/09/2020] [Indexed: 11/25/2022] Open
Abstract
This is a longitudinal study of changes in smoking behaviour as well as becoming overweight/obese (OW/OB) and the strength of their association with personal factors such as self-control, mental health, and socioeconomic status (SES) versus their connection with the behaviour of other household members. Furthermore, we investigate that in terms of roles within a household, who is more vulnerable towards the behaviour of others. We used a hybrid model that followed individual adults (person-level fixed-effect) who participated in a national representative panel survey in Germany, SOEP, between 2008 and 2016 and answered all SF-12 items (N = 6874). The count of members in a household showing the associated adverse health behaviour was the nested random-effect. Compared with other predictors, the likelihood of a person becoming OW/OB had the strongest association with the number of cohabits who were also OW/OB and it became worse as this number increased (OR 7.18, 95% CI: 2.10-24.54 and 12.44, 95% CI: 1.53-100.85, for men and women respectively, e.g. compared with being married 2.83, 95% CI: 2.28-3.53 and 1.82, 95% CI: 1.42-2.34). However, for smoking the same rapid trend was not observed. Particularly, becoming OW/OB in female (adult) children was strongly associated with the behaviour of others (compared with household head or partner). For smoking the strongest link with others was among women who were head of the household. For both behaviours, we found neither mental health nor self-control to be strong predictors. Our findings indicate that various factors do not play equal roles in changes in health behaviour and particularly for women, becoming OW/OB is strongly connected with the behaviour of others. We further discuss the potential importance of social norms that might be helpful in developing more effective policies incorporating social connections as well as norms.
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Affiliation(s)
- Ida G. Monfared
- Centre for Modern Indian Studies & Department of Economics, University of Göttingen, Göttingen, Germany
| | | | - Sebastian Vollmer
- Centre for Modern Indian Studies & Department of Economics, University of Göttingen, Göttingen, Germany
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43
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Wieland ML, Njeru JW, Okamoto JM, Novotny PJ, Breen-Lyles MK, Goodson M, Porraz Capetillo GD, Molina LE, Sia IG. Association of social network factors with weight status and weight loss intentions among hispanic adults. J Behav Med 2020; 43:155-165. [PMID: 31894451 PMCID: PMC7071972 DOI: 10.1007/s10865-019-00131-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/17/2019] [Indexed: 01/02/2023]
Abstract
Hispanic adults have the highest obesity prevalence in the United States, but little is known about weight-related social network influences. A community-based sample of 610 Hispanic participants completed height/weight and a survey. The proportion of overweight or obese (OW/OB) network members was higher for OW/OB respondents compared to normal weight respondents. Participants with high weight loss intentions reported more positive social norms for weight control, social support, and social cohesion. If most or all of OW/OB participant's social contacts were trying to lose weight, the odds that they were likely to try to lose weight was four times higher than other participants. The relationship between weight loss intentions and number of social contacts trying to lose weight was strongly mediated by social norms for weight control and social support. These results suggest that social contacts and functional network characteristics may impact weight status and weight control intentions among Hispanic adults.
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Affiliation(s)
- Mark L Wieland
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Jane W Njeru
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Janet M Okamoto
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ, USA
| | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Miriam Goodson
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela D Porraz Capetillo
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Luz E Molina
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Irene G Sia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Smith NR, Zivich PN, Frerichs L. Social Influences on Obesity: Current Knowledge, Emerging Methods, and Directions for Future Research and Practice. Curr Nutr Rep 2020; 9:31-41. [PMID: 31960341 PMCID: PMC7033640 DOI: 10.1007/s13668-020-00302-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Individuals tend to be socially connected with those of similar weight and obesity status. To inform future research and intervention development, we reviewed recent literature examining social influences on weight with a focus on mechanisms of social influence, populations studied, and emerging analytical methods. RECENT FINDINGS Social networks appear to influence weight gain and weight loss. It remains unclear what underlying mechanisms (e.g., social norms, social comparison, behavioral modeling) drive this relationship. Stochastic actor-oriented modeling is an important method in the field, but other work has leveraged natural experiment or randomized designs to study social influence. Future networks and obesity research should examine social influence mechanisms, focus on diverse populations across the life course, and carefully consider how to adequately control for competing factors of social selection and physical environments.
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Affiliation(s)
- Natalie R Smith
- Department of Health Policy and Management, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, UNC Chapel Hill, Chapel Hill, NC, USA
| | - Paul N Zivich
- Carolina Population Center, UNC Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA
| | - Leah Frerichs
- Department of Health Policy and Management, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA.
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45
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Oladele CR, Thompson TA, Wang K, Galusha D, Tran E, Martinez-Brockman JL, Adams OP, Maharaj RG, Nazario CM, Nunez M, Nunez-Smith M. Egocentric Health Networks and Cardiovascular Risk Factors in the ECHORN Cohort Study. J Gen Intern Med 2020; 35:784-791. [PMID: 31823310 PMCID: PMC7080938 DOI: 10.1007/s11606-019-05550-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/27/2019] [Accepted: 10/30/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region. OBJECTIVE This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean. DESIGN The Eastern Caribbean Health Outcomes Research Network Cohort Study is an ongoing longitudinal cohort being conducted in the US Virgin Islands, Puerto Rico, Trinidad and Tobago, and Barbados. PARTICIPANTS Participants (n = 1989) were English or Spanish-speaking adults 40 years and older, who were residents of the island for at least 10 years, and who intended to live on-island for the next 5 years. MAIN MEASURES Logistic regression was used to examine associations between health network characteristics and CVD risk factors: physical activity, hypertension, and smoking. A baseline survey asked questions about health networks using name generator questions that assessed who participants spoke to about health matters, whose opinions on healthcare mattered, and who they would trust to make healthcare decisions on their behalf. KEY RESULTS Health networks were mainly comprised of family members and friends. Healthcare professionals comprised 7% of networks, mean network size was four, and 74% of health network contacts were perceived to be in "good" to "excellent" health. Persons with larger health networks had greater odds of being physically active compared with those with smaller networks (OR = 1.07, CI = 1.01-1.14). CONCLUSIONS Health networks may be useful to intervention efforts for CVD risk factor reduction. More studies are needed to examine health networks in Caribbean contexts and explore associations with other CVD risk factors.
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Affiliation(s)
| | | | - Karen Wang
- Yale University School of Medicine, New Haven, CT, USA
| | - Deron Galusha
- Yale University School of Medicine, New Haven, CT, USA
| | - Emma Tran
- Yale University School of Medicine, New Haven, CT, USA
| | | | - Oswald P Adams
- Faculty of Medical Sciences, The University of The West Indies Cave Hill Campus, Bridgetown, P.O. Box 64, Barbados
| | - Rohan G Maharaj
- Unit of Public Health and Primary Care, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | | | - Maxine Nunez
- The University of the US Virgin Islands, Charlotte Amalie, USA
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Njeru JW, Wieland ML, Okamoto JM, Novotny PJ, Breen-Lyles MK, Osman A, Ahmed YA, Nur MA, Nur O, Sia IG. Social networks and obesity among Somali immigrants and refugees. BMC Public Health 2020; 20:238. [PMID: 32066416 PMCID: PMC7026979 DOI: 10.1186/s12889-020-8315-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Somali immigrants and refugees to the United States are at high risk for obesity and related cardiovascular risk. Social network factors influence health behaviors and are important contributors to the obesity epidemic. The objective of this study was to describe social networks and obesity-related characteristics among adult Somali immigrants in a Minnesota city in order to inform a community-based, participatory, research-derived, social network intervention to decrease obesity rates. METHODS Survey data (demographics, general health measures, and sociobehavioral and network measures) and height and weight measures (for calculating body mass index) were collected from adult Somali immigrants by bilingual study team members at community locations. Descriptive statistics were used to report the survey and biometric data. Logistic regression models were used to describe the basic associations of participants and network factors. Network data were analyzed to identify nodes and ties, to visualize the network, and to identify potential interventionists for a future social network intervention. RESULTS Of the 646 participants, 50% were overweight or affected by obesity. The network had 1703 nodes with 3583 ties between nodes, and modularity was high (0.75). Compared with respondents of normal weight, participants who were overweight or affected by obesity had more network members who were also overweight or obese (odds ratio [OR], 2.90; 95% CI, 1.11-7.56; P = .03); this was most notable for men (OR, 4.58; 95% CI, 1.22-17.22; P = .02) and suggestive for those 50 years or older (OR, 24.23; 95% CI, 1.55-377.83; P = .03). Weight loss intention among participants who were overweight or affected by obesity was associated with number of family members and friends trying to lose weight, enabling functional network factors (social norms for weight loss, social support for healthy eating, and social cohesion), and less favorable obesogenic social norms. CONCLUSIONS In this community sample of Somali immigrants, distinct social networks are clustered by weight status, and social contacts and functional network characteristics are related to individuals' weight loss intentions. These factors should be considered in weight loss interventions and programs. A social network intervention targeting weight loss, within a community-based participatory research framework, is feasible in this vulnerable population.
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Affiliation(s)
- Jane W Njeru
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.
| | | | | | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Ahmed Osman
- Somali Community Resettlement Services, Rochester, MN, USA
| | - Yahye A Ahmed
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mohamud A Nur
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Omar Nur
- Somalia Rebuild Organization, Rochester, MN, USA
| | - Irene G Sia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Gallo S, Jones MT, Doig AC, Kogan K, Fields J, Wonderlich JA, Hansen A, LaCharite K, Mehlenbeck R. Feasibility of a Multidisciplinary and Culturally Adapted Pediatric Weight Management Program for Latino Families: Results From the Vidas Activas y Familias Saludables Pilot Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:55-63. [PMID: 31706793 DOI: 10.1016/j.jneb.2019.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine the feasibility of a pediatric weight management program for low-income Latino families. METHODS A pretest-posttest pilot study was conducted among 60 Latino children, aged 4-9, who were overweight/obese (body mass index-for-age ≥85th percentile). The 10-week group-based community program addressed diet, exercise, and behavior modification. Demand was assessed through recruitment and attendance, acceptability using postintervention surveys with participants, and limited efficacy testing of participant anthropometrics and cardiometabolic markers. RESULTS Overall 65% of families were retained for follow-up. All families reported feeling more confident in making healthier food choices and would participate in the program again. Pre/post intervention testing found statistically significant decreases (P < .05) in body mass index for age z score, waist circumference, and % body fat. CONCLUSIONS AND IMPLICATIONS This culturally adapted group intervention for Latino families was acceptable and shows promise for improved health status, although it needs to be replicated with a larger group and longer follow-up.
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Affiliation(s)
- Sina Gallo
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA.
| | - Margaret T Jones
- Division of Health and Human Performance, George Mason University, Fairfax, VA
| | - Amara Channell Doig
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA
| | - Kelly Kogan
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA
| | - Jennifer Fields
- Division of Health and Human Performance, George Mason University, Fairfax, VA
| | | | - Amysue Hansen
- Department of Psychology, George Mason University, Fairfax, VA
| | - Kerri LaCharite
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA
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Is Pre-operation Social Connectedness Associated with Weight Loss up to 2 Years Post Bariatric Surgery? Obes Surg 2019; 28:3524-3530. [PMID: 30043144 DOI: 10.1007/s11695-018-3378-6] [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: 01/01/2023]
Abstract
BACKGROUND To date, little attention has been paid to supportive relationships as factors contributing to weight loss from bariatric surgery. MATERIAL AND METHODS This prospective study examined whether total percentage weight loss (%TWL) at 3, 12 and 24 months post-surgery varies by distinct aspects of pre-surgery social support (received emotional and practical support and contact with friends and family) in a sample of bariatric surgery candidates (n = 182). These associations were tested with linear regression models adjusted for gender, age, ethnicity, employment status, self-esteem, mastery and time elapsed since the day of surgery. RESULTS One hundred fifty-four participants underwent a bariatric procedure, and all but seven provided weight loss data at least at one occasion. Emotional support and contact with friends were positively associated with %TWL at 3, 12 and 24 months, and the magnitude of these associations was large. For instance, in the fully adjusted models, %TWL at 24 months increased by 2.36% (SE 1.17, p = 0.048) with each increase of one standard deviation in emotional support and was higher by 9.23% (SE 4.31, p = 0.035) for participants who reported seeing 1-5 friends per month compared with those who saw none. There was some evidence for a positive association between practical support and %TWL at 3 and 12 months post-surgery. CONCLUSION Supportive relationships are important contributors to weight loss from bariatric surgery. If replicated in future studies, these findings could inform clinical care and interventions aimed at improving support systems of bariatric surgery candidates.
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Christensen KA. Emotional feeding as interpersonal emotion regulation: A developmental risk factor for binge-eating behaviors. Int J Eat Disord 2019; 52:515-519. [PMID: 30770584 DOI: 10.1002/eat.23044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 01/17/2023]
Abstract
Emotional feeding is an interpersonal emotion regulation strategy wherein people provide food to others as a means of influencing the recipient's emotional response. Parental emotional feeding has been linked to higher levels of emotional eating in children and adolescents using cross-sectional, retrospective, and prospective designs; however, there is little research on emotional feeding as a developmental risk factor for emotional eating and binge-eating behaviors in adolescence and adulthood. This Idea Worth Researching article explores the rationale for studying emotional feeding as a lifespan construct and its potential implications for understanding eating disorder pathology. Specifically, it offers suggestions for examining emotional feeding as a predictor of emotional eating and binge-eating behavior across the lifespan, assessing potential intergenerational transmission pathways, and researching similarities in feeding styles and emotional eating across a variety of relationships beyond the parent-child dyad.
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Affiliation(s)
- Kara A Christensen
- Department of Psychology, The Ohio State University, Columbus, Ohio.,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
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Dreher M, Hoffmann SW, Brendel C, Heser D, Simon P. Convenience Behavior and Being Overweight in Adults: Development and Validation of the Convenience Behavior Questionnaire. Front Public Health 2019; 7:20. [PMID: 30949463 PMCID: PMC6436074 DOI: 10.3389/fpubh.2019.00020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 01/24/2019] [Indexed: 01/09/2023] Open
Abstract
The etiology of overweight and obesity is a mixture of genetic determinants, environmental factors, and health behaviors. Especially intra- and interpersonal inactive behaviors, here termed convenience, seems to play an important role. The objective was to develop and validate the Convenience Behavior Questionnaire (CBQ) to assess convenience-related items and their association with overweight and obesity in a large population. A sample of 1233 subjects aged 18–82 years from six population groups took part in a self-administered questionnaire. Test-retest reliability was estimated and the independent association between convenience-related items and overweight and obesity was investigated. Principal component analysis revealed three factors (avoidance behaviors, social interaction behaviors and domestic environmental factors) which explained 43.4% of the variance contributing to the CBQ. Cronbach's α ranged from 0.80–0.89. Test-retest reliability using intra-class correlation was acceptable ≥ 0.70. Forward stepwise logistic regression analysis, including gender, education level, age and TV viewing on weekends showed a positive relation of convenience behavior and overweight (OR: 1.40; 95% CI: 1.01–1.96; P = 0.048), while physical activity status was not significantly associated with overweight (OR: 1.09; 95% CI: 0.77–1.54; P = 0.629). The CBQ seems to be a reliable tool which considers non-traditional behaviors related to overweight development. Interestingly our findings revealed a better relationship between convenience-related behavior with overweight and obesity than the habitual physical activity score.
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Affiliation(s)
- Matthias Dreher
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Institute of Sports Science, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sascha W Hoffmann
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Institute of Sports Science, Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Conny Brendel
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Institute of Sports Science, Johannes Gutenberg University Mainz, Mainz, Germany
| | - David Heser
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Institute of Sports Science, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Perikles Simon
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Institute of Sports Science, Johannes Gutenberg University Mainz, Mainz, Germany
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