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Richardson KA, Punke ELA, Dabrowski BS, Teply AL, Walker J, McKibbin CL. Parent Intention to Participate in an Online Intervention to Enhance Health Behavior Change Among Youth Treated with Psychotropic Medication Who are Overweight or Obese: An Application of the Theory of Planned Behavior. JOURNAL OF PREVENTION (2022) 2024; 45:431-450. [PMID: 38446270 DOI: 10.1007/s10935-024-00773-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/07/2024]
Abstract
Youth with mental health disorders (MHD), particularly those who take psychotropic medications, are at increased risk of being overweight or obese (OW/OB) when compared to typical youth. Parents are important resources for interventions addressing OW/OB. However, parents of youth with MHD may face challenges that require interventions designed to address their needs. Prior to investing research funding in the development of interventions for this group, research is needed to understand factors associated with parents' decisions to enroll in these programs. The theory of planned behavior (TPB) provided a framework for examining parents' salient beliefs, direct attitudes, and intention to enroll in a hypothetical online healthy lifestyle intervention for their youth (ages 11-17) with OW/OB and treated with psychotropic medication. Parents who were enrolled in the study (n = 84) completed demographic questionnaires and a TPB questionnaire which was constructed for this study. A confirmatory factor analysis (CFA) of the direct attitude (i.e., attitude toward the behavior, subjective norm, perceived behavioral control) questions generally supported the three-factor model (i.e., RMSEA = .07, 90% CI .03-.11, p = .18; CFI = .96, SRMR = .06). Results from a multiple regression analysis demonstrated that direct attitudes predicted parent intention to participate in an online healthy lifestyle intervention for this sample of youth accounting for 84% of variance. In this preliminary study, the TPB appears to be a promising framework for understanding direct attitudes associated with parent intentions toward intervention participation in this population of youth. Interventions for parents of youth with OW/OB who are prescribed psychotropic medication should consider addressing these direct attitudes to improve intention.
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Affiliation(s)
| | | | | | - Abby L Teply
- Department of Psychology, University of Wyoming, Laramie, WY, 82072, USA
| | - Johnathan Walker
- Department of Psychology, University of Wyoming, Laramie, WY, 82072, USA
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Moore WS, Maldonado-Molina MM, Mobley AR, Shelnutt KP, McVay MA. Parental Factors Associated With Intentions to Initiate a Family-Based Pediatric Weight Management Program. Child Obes 2024; 20:270-278. [PMID: 37366662 DOI: 10.1089/chi.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Background: Childhood obesity can be addressed through family-based pediatric weight management; however, treatment enrollment in the United States is low. This study aimed to identify parental factors associated with intentions to initiate a family-based pediatric weight management program. Methods: Cross-sectional survey data were collected from an online panel of US parents with at least one 5- to 11-year-old child identified as likely to have overweight or obesity. Participants viewed a video about a hypothetical family-based pediatric weight management program, rated their 30-day initiation intentions for that program, and answered additional related questionnaires. Results: Participants (n = 158) identified as White/Caucasian (53%) or Black/African American (47%), were primarily female (61.4%) and married/cohabitating (81.6%) with children who were predominantly girls (53.2%) and, on average, 9-year-olds. Higher parents' perception of program effectiveness predicted initiation intentions (p < 0.001), while concern for their child's weight and parent depression and anxiety levels did not. Higher initiation intentions and perceived program effectiveness were reported by Black/African American participants (p < 0.01) and those with at least a bachelor's degree (p < 0.01) compared to White/Caucasian participants and those without a bachelor's degree, respectively. Initiation intentions were higher for those with greater financial security (p = 0.020) and fewer than three children in the home (p = 0.026). Participants endorsed initiation barriers of time constraints (25%), possible lack of enjoyment for the child (16.9%), and lack of family support (15%). Conclusions: Future program enrollment efforts may need to focus on strategies to increase perceived program effectiveness, although further research is needed that measures actual enrollment in real-world contexts.
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Affiliation(s)
- Wendy S Moore
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Mildred M Maldonado-Molina
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Amy R Mobley
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Karla P Shelnutt
- Department of Family, Youth, and Community Sciences, Institute of Food and Agricultural Science (IFAS), University of Florida, Gainesville, FL, USA
| | - Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
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Bryant K, Sandhu J, Nguyen J, Asonye E, Thompson D, Sisley S. Isolation in a Sea of "Experts": Identifying the Parental Struggles Caring for Children With Early-Onset Obesity. Child Obes 2023; 19:408-416. [PMID: 36112365 DOI: 10.1089/chi.2022.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Severe early-onset childhood obesity is diagnosed by having a BMI >120% of the 95th percentile before age 5 years. Treatment for early-onset obesity is frequently unsuccessful. Prior studies have shown parents of children with obesity often face stigmatization and those who experience weight bias also experience poorer medical care. Home environment influences many risk factors, and parents are crucial for intervention. Research on the parental perspective of care is lacking and greater understanding could increase the effectiveness of treatment. We sought to understand the common stressors and obstacles parents encounter caring for a child with early-onset severe obesity. Methods: Parents of children with early-onset severe obesity participated in semistructured interviews. Interviews were digitally recorded, transcribed verbatim, coded, and analyzed using hybrid thematic analysis. Results: We identified a global theme of "Isolation in a sea of 'experts'," supported by three organizing themes: (i) Facing barriers at every turn; (ii) Carrying all the burdens; and (iii) Struggling to get their child seen as an individual. Within each organizing theme, subthemes emerged that highlighted the struggles that parents encountered. These included significant conflict with others when attempting to implement dietary changes (e.g., spouses, other children, and extended family), protecting their child's self-esteem, perceived weight bias from medical staff, lack of experienced obesity clinicians, lack of access to weight management services, and judgment from others (e.g., family, friends, and strangers). Conclusions: This study highlighted that many parents of children with early-onset severe obesity felt significant struggles, both internal and external. Understanding the barriers parents face when caring for their children is critical to improving relationships and medical care.
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Affiliation(s)
- Kathleen Bryant
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Jagnoor Sandhu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Jessica Nguyen
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
| | - Elizabeth Asonye
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Deborah Thompson
- Section of Nutrition, Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
- US Department of Agriculture, Agricultural Research Center, Children's Nutrition Research Center, Houston, TX, USA
| | - Stephanie Sisley
- Texas Children's Hospital, Houston, TX, USA
- Section of Nutrition, Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
- Section of Endocrinology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Saunders LA, Jackson B, Gibson LY, Doust J, Dimmock JA, Davis EA, Price L, Budden T. 'It's been a lifelong thing for me': parents' experiences of facilitating a healthy lifestyle for their children with severe obesity. BMC Public Health 2023; 23:1176. [PMID: 37337142 DOI: 10.1186/s12889-023-15780-y] [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: 09/12/2022] [Accepted: 04/28/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE For parents and guardians, assisting children/adolescents with severe obesity to lose weight is often a key objective but a complex and difficult challenge. Our aim in this study was to explore parents' (and guardians') perspectives on the challenges they have faced in assisting their children/adolescents with severe obesity to lead a healthy lifestyle. METHODS Thirteen parents/guardians were interviewed from a pool of families who had been referred but did not engage between 2016 and 2018 (N = 103), with the Perth Children's Hospital Healthy Weight Service, a clinical obesity program for children/adolescents (parent age M = 43.2 years, children age M = 10.3 years). Using semi-structured interviews and thematic analysis, we identified 3 broad themes. RESULTS Parental weight-related factors reflected parents' own lifelong obesity narrative and its effect on their own and their families' ability to live a healthy lifestyle. Perceived inevitability of obesity in their child reflected parents' feelings that the obesity weight status of their children/adolescent was a persistent and overwhelming problem that felt 'out of control'. Lastly, parents reported challenges getting medical help stemming from co-morbid medical diagnosis in their child/adolescent, and difficulties with medical professionals. CONCLUSION This study demonstrates that parents face challenges in supporting healthy lifestyle for children/adolescents with severe obesity due to parents own internal weight biases and their negative experiences within the healthcare system when seeking help.
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Affiliation(s)
- Liz A Saunders
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia.
- Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia.
- Paediatric Consultation Liaison Program, Child and Adolescent Mental Health Service, Perth Children's Hospital, Western, Australia.
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
| | - Lisa Y Gibson
- Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western, Australia
| | - Justine Doust
- Paediatric Consultation Liaison Program, Child and Adolescent Mental Health Service, Perth Children's Hospital, Western, Australia
- Healthy Weight Service, Department of Endocrinology and Diabetes, Perth Children's Hospital, Western, Australia
| | - James A Dimmock
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Elizabeth A Davis
- Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
- Healthy Weight Service, Department of Endocrinology and Diabetes, Perth Children's Hospital, Western, Australia
| | - Lyndsey Price
- Healthy Weight Service, Department of Endocrinology and Diabetes, Perth Children's Hospital, Western, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Australia
- Telethon Kids Institute, The University of Western Australia, Subiaco, WA, Australia
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Parents’ mHealth App for Promoting Healthy Eating Behaviors in Children: Feasibility, Acceptability, and Pilot Study. J Med Syst 2022; 46:70. [DOI: 10.1007/s10916-022-01860-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 08/26/2022] [Indexed: 11/26/2022]
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Richardson KA, McKibbin CL, Dabrowski BS, Punke ELA, Hartung CM. Parent Intention to Enroll in an Online Intervention to Enhance Health Behavior Change among Youth Treated with Psychotropic Medication Who Are Overweight or Obese: An Elicitation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138057. [PMID: 35805722 PMCID: PMC9266077 DOI: 10.3390/ijerph19138057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
Youth who are prescribed psychotropic medication are disproportionally affected by overweight/obesity (OW/OB), yet few interventions have been tailored to their needs. To develop new interventions, it is important to address the needs, preferences, and intentions of target users. Qualitative methods within the theory of planned behavior (TPB) framework were used in this study to identify salient beliefs which may influence attitudes associated with parents’ intentions to participate in a future online intervention designed to develop behavioral health coaching skills among parents and guardians. Twenty parents and guardians of youth with OW/OB who were taking psychotropic medications, and were eligible for the study, were recruited through TurkPrime. Parents and guardians identified key salient beliefs consistent with the theory of planned behavior including behavioral beliefs (e.g., access and convenience), normative beliefs (e.g., family), and control beliefs (e.g., cost) that may influence their decision to enroll in a future, parent-oriented intervention. The results of this study suggest important salient beliefs which may be included in future research, as well as specific preferences which may be used to guide the development of a future intervention. Future work should focus on the creation of a salient belief quantitative measure and assess the relationships of these beliefs to attitudinal constructs and behaviors.
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Canfell OJ, Littlewood R, Wright ORL, Walker JL. "We'd be really motivated to do something about it": a qualitative study of parent and clinician attitudes towards predicting childhood obesity in practice. Health Promot J Austr 2022; 34:398-409. [PMID: 35504851 DOI: 10.1002/hpja.611] [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: 06/09/2021] [Revised: 01/25/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED In Australia, one-in-four (24.9%) children live with overweight or obesity (OW/OB). Identifying infants at-risk of developing childhood OW/OB is a potential preventive pathway but its acceptability is yet to be investigated in Australia. This study aimed to (1) investigate acceptability of predicting childhood OW/OB with parents of infants (aged 0-2 years) and clinicians and (2) explore key language to address stigma and maximise the acceptability of predicting childhood OW/OB in practice. METHODS Cross-sectional and qualitative design, comprising individual semi-structured interviews. Participants were multidisciplinary paediatric clinicians (n=18) and parents (n=13) recruited across public hospitals and health services in Queensland, Australia. Data were analysed under the Framework Method using an inductive, thematic approach. RESULTS Five main themes were identified: (1) Optimism for prevention and childhood obesity prediction (2) Parent dedication to child's health (3) Adverse parent response to risk for childhood obesity (4) Language and phrasing for discussing weight and risk (5) Clinical delivery. Most participants were supportive of using a childhood OW/OB prediction tool in practice. Parents expressed dedication to their child's health that superseded potential feelings of judgment or blame. When discussing weight in a clinical setting, the use of sensitive (i.e. 'overweight', 'above average', 'growth' versus 'obesity') and positive, health-focused language was mostly supported. CONCLUSIONS Multidisciplinary paediatric clinicians and parents generally accept the concept of predicting childhood OW/OB in practice in Queensland, Australia. SO WHAT?: Clinicians, public health and health promotion professionals and policymakers can act now to implement sensitive communication strategies concerning weight and obesity risk.
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Affiliation(s)
- Oliver J Canfell
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, South Brisbane, QLD, Australia.,Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.,UQ Business School, Faculty of Business, Economics and Law, The University of Queensland, St Lucia, QLD, Australia.,Health and Wellbeing Queensland, Queensland Government, The State of Queensland, Milton QLD, Australia
| | - Robyn Littlewood
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, South Brisbane, QLD, Australia.,Health and Wellbeing Queensland, Queensland Government, The State of Queensland, Milton QLD, Australia
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Health and Wellbeing Queensland, Queensland Government, The State of Queensland, Milton QLD, Australia
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Gadaire CB, Armstrong LM, Levens SM. Development and validation of the Child Weight Risk Questionnaire. Eat Weight Disord 2022; 27:525-534. [PMID: 33860465 DOI: 10.1007/s40519-021-01181-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 03/24/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The study objective was to develop and validate a measure of parent perception of child weight-related risk, the Child Weight Risk Questionnaire (CWRQ), among a sample of US parents. METHODS A cross-sectional survey was conducted in a sample of 216 parents of 6- to 12-year-old children who were overweight. The CWRQ was used to assess parent beliefs about their child's susceptibility to physical, social-emotional, and behavioral health problems due to weight. RESULTS Confirmatory factor analysis supported the three-factor structure of the CWRQ and acceptable fit was achieved. The internal consistency of the measure was excellent. Convergent, discriminant, and incremental validity analyses provided initial evidence for CWRQ validity. CONCLUSION The CWRQ is a reliable and valid instrument for assessing parent perception of child weight-related risk. This measure could be utilized in research and applied settings to capture the multifaceted nature of parent risk perception and support efforts to tailor family weight interventions in ways that align with parent beliefs. LEVEL OF EVIDENCE Level V, cross-sectional, descriptive study.
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Affiliation(s)
- Cecily B Gadaire
- Department of Psychological Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA. .,Health Psychology Ph.D. Program, University of North Carolina at Charlotte, Charlotte, NC, USA.
| | - Laura Marie Armstrong
- Department of Psychological Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA. .,Health Psychology Ph.D. Program, University of North Carolina at Charlotte, Charlotte, NC, USA.
| | - Sara M Levens
- Department of Psychological Science, University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA.,Health Psychology Ph.D. Program, University of North Carolina at Charlotte, Charlotte, NC, USA
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Razi M, Nasiri A. Concerns of parents about children's overweight and obesity during the COVID-19 pandemic: A qualitative study. J Pediatr Nurs 2022; 63:111-116. [PMID: 34801324 PMCID: PMC8596191 DOI: 10.1016/j.pedn.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Since the end of 2019, the world has been dealing with a new crisis caused by the widespread and global outbreak of the coronavirus that has affected various aspects of life. The stay-at-home orders issued to prevent the virus from spreading have caused many problems for families, such as obesity and overweight, particularly among children. As parents play a key role in the prevention of childhood obesity, the present qualitative study aimed to examine the experiences of parents regarding the obesity or overweight of their children during the outbreak of coronavirus. DESIGN AND METHODS This study was performed using a qualitative descriptive approach. The sampling method was purposeful, and the required data were collected through in-depth, unstructured, and face-to-face interviews with 16 parents of children with obesity or overweight. The interviews were digitally recorded, transcribed verbatim, and analyzed using Graneheim and Lundman conventional content analysis approach. RESULTS The findings were divided into five main themes, including overeating while stuck at home, leading to the sedentary life, disturbed sleep-wake rhythm of the children, indifference of the children towards their appearance, and the inability of parents to control the obesity of their children. CONCLUSIONS The COVID-19 pandemic has affected families of children with obesity in various ways. The experiences of such parents provide new insight into parental struggles around managing their child's obesity particularly during such stressful times. IMPLICATIONS An in-depth study of the experiences of the parents and perception of their challenges and concerns about childhood obesity during the COVID-19 pandemic can lead to the development of useful and effective strategies for the control of childhood obesity.
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Affiliation(s)
- Mahdiye Razi
- Student Research Committee, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Nasiri
- Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran.
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Sherrard A, Tan CC. Feeding coparenting: Associations with coercive control, structure-based, and autonomy-promoting food parenting. Appetite 2021; 170:105879. [PMID: 34942283 DOI: 10.1016/j.appet.2021.105879] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022]
Abstract
Feeding coparenting refers to how two parents work together in the child feeding domain. However, little is known about feeding coparenting in relation to food parenting. The current study seeks to examine 1) whether parent demographics (i.e., sex, age, BMI, and employment status) and parent concern about child weight are related to feeding coparenting (i.e., Shared Views, Active Engagement, Solo Parenting) and 2) whether feeding coparenting is related to food parenting (i.e., coercive control feeding, structure-based feeding, autonomy-promoting feeding). Parents (n = 160) of 3- to 5-year old children completed an online survey. Parents' sex, employment status, and concern about child weight were related to feeding coparenting (Shared Views, Active Engagement, Solo Parenting). After controlling for those variables, feeding coparenting was related to structure-based (Shared Views and Active Engagement) and autonomy-promoting feeding (Active Engagement). However, none of the feeding coparenting variables were associated with coercive control feeding. These findings illuminate the importance of understanding how parents' feeding coparenting relationship plays a part in food parenting.
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Affiliation(s)
- Adelyn Sherrard
- Department of Psychology, The University of Toledo, Toledo, OH, 43606, USA.
| | - Cin Cin Tan
- Department of Psychology, The University of Toledo, Toledo, OH, 43606, USA
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Sari DK, Ichwan M, Masyithah D, Dharmajaya R, Khatib A. The Incidence of Adult Obesity is Associated with Parental and Adolescent Histories of Obesity in North Sumatra, Indonesia: A Cross-Sectional Study. J Multidiscip Healthc 2021; 14:2437-2444. [PMID: 34511927 PMCID: PMC8423409 DOI: 10.2147/jmdh.s324774] [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: 06/14/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Obesity that occurs in adulthood is influenced by various factors, not only energy balance, especially concerning the amount of energy consumed, but also heredity. The hereditary factors of obese parents on childhood obesity have been studied, but what about adulthood? This study examines the relationship between a history of obesity in adolescence, and maternal and paternal incidences of adult obesity. Patients and Methods This study was a cross-sectional study that included adult men and women aged 20–60 years old. The subjects had no chronic or metabolic disease. This research was conducted from April to November, 2020, in North Sumatra Province, Indonesia. The parameters studied were demographics, daily food intake, anthropometry and a history of obesity in adolescence, and for the participants’ fathers and mothers. The statistical test used was the chi-squared test/Fisher test. Results This study included 136 research subjects, 60 male and 76 female; based on the results of the study, 47.8% were found to be obese, but food intake showed a low intake (96.2%). There was a significant relationship between a history of obesity in adolescence and incidences of obesity (≥30 kg/m2) in the mother and father, with significance values of p=0.01, p=0.004, and p=0.001, respectively. Conclusion This study found that there was a significant relationship between a history of obesity in adolescence and incidences of adult obesity (≥ 30kg/m2) in parents, but not with the level of food intake per day. The risk of obesity will increase further with a history of obesity in parents and obesity in adolescence, and this can be used to understand and prevent obesity. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/xQs0Dh_2jKE
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Affiliation(s)
- Dina Keumala Sari
- Department of Nutrition, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - M Ichwan
- Department of Pharmacology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dewi Masyithah
- Department of Parasitology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Ridha Dharmajaya
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Alfi Khatib
- Kulliyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Malaysia
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Paediatric teams in front of childhood obesity: A qualitative study within the STOP project. An Pediatr (Barc) 2021; 95:174-185. [PMID: 34362718 DOI: 10.1016/j.anpede.2020.11.004] [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] [Received: 05/07/2020] [Accepted: 11/13/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Understanding the underlying factors that influence the approach to overweight and obesity in children is basic to best support families searching a solution to this important public health problem. OBJECTIVE To assess attitudes and feelings of paediatric staff in addressing overweight and childhood obesity to parents, exploring perceived barriers and facilitators, for an effective care. PARTICIPANTS AND METHOD Qualitative study by means of individual semi-structured questionnaires of paediatric staff (paediatricians and paediatrician nurses; n = 57; 68% female) of primary health care centres and hospitals in Mallorca. Thematic analysis was done. RESULTS Three themes emerged from the data: "Parents' attitude in childhood obesity" (sub-themes "The conscience of parents", "The parents ask for help"), "Paediatric staff and childhood obesity" (sub-themes "Approaching to the problem: The interview with parents", "Looking together for the solution"), and "System barriers" (sub-themes "Improving teamwork and health policy", "Family participation in addressing childhood obesity"). CONCLUSIONS Paediatric staffs know how to treat childhood obesity, but demand training on motivation. Effectivity on therapy of childhood obesity will be obtained after parents/carers recognize the problem and establish a trustful relationship with paediatric staff. The health system is still a barrier to the activity of paediatric personnel.
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Serban CL, Putnoky S, Ek A, Eli K, Nowicka P, Chirita-Emandi A. Making Childhood Obesity a Priority: A Qualitative Study of Healthcare Professionals' Perspectives on Facilitating Communication and Improving Treatment. Front Public Health 2021; 9:652491. [PMID: 34336760 PMCID: PMC8321411 DOI: 10.3389/fpubh.2021.652491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 06/21/2021] [Indexed: 01/02/2023] Open
Abstract
In Romania, one in four children has excess weight. Because childhood obesity is a sensitive topic, many healthcare professionals find it difficult to discuss children's excess weight with parents. This study aims to identify barriers and facilitators in childhood obesity-related communication, as perceived by healthcare professionals in Romania. As part of the STOP project, healthcare professionals (family physicians, pediatricians, and dieticians) who treat children with excess weight were invited to a telephone interview. The semi-structured questions were translated from a questionnaire previously used at the Swedish study site of the STOP project. Interviews were transcribed and then used for thematic analysis. Fifteen doctors and three dieticians (16 females and 2 males), with average 18.2 ± 10.1 years of experience, were interviewed. Four main themes were identified. Professionals reported that when children began experiencing obesity-related stigma or comorbidities, this became the tipping point of weight excess, where parents felt motivated to begin treatment. Barriers in communication were part of several layers of distrust, recognized as tension between professionals and caregivers due to conflicting beliefs about excess weight, as well as lack of trust in medical studies. Most respondents felt confident using models of good practice, consisting of a gentle approach and patient-centered care. Nonetheless, professionals noted systemic barriers due to a referral system and allocation of clinical time that hinder obesity treatment. They suggested that lack of specialized centers and inadequate education of healthcare professional conveys the system does not prioritize obesity treatment and prevention. The interviewed Romanian doctors and dieticians identified patient-centered care as key to treating children with obesity and building trust with their caregivers. However their efforts are hindered by healthcare system barriers, including the lack of specialized centers, training, and a referral system. The findings therefore suggest that, to improve childhood obesity prevention and treatment, systemic barriers should be addressed. Trial Registration:ClinicalTrials.gov, NCT03800823; 11 Jan 2019.
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Affiliation(s)
- Costela Lacrimioara Serban
- Functional Sciences Department, "Victor Babes" University of Medicine and Pharmacy Timişoara, Timişoara, Romania
| | - Salomeia Putnoky
- Microbiology Department, Centre for Studies in Preventive Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,School of Anthropology and Museum Ethnography, University of Oxford, Oxford, United Kingdom
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
| | - Adela Chirita-Emandi
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, Regional Center of Medical Genetics Timis, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania.,Regional Center of Medical Genetics, "Louis Turcanu" Clinical Emergency Hospital for Children, Timişoara, Romania
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14
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Argelich E, Alemany ME, Amengual-Miralles B, Argüelles R, Bandiera D, Barceló MA, Beinbrech B, Bouzas C, Capel P, Cerdà AL, Colom M, Corral H, de Sotto-Esteban D, Fleitas G, Garcias C, Juan D, Juan J, Mateos D, Martín MI, Martínez MÀ, Mínguez M, Moncada E, Nadal M, Pont JM, Puigserver B, Suñer CA, Ugarriza L, Yeste D, Yeste S, Tur JA. [Paediatric teams in front of childhood obesity: a qualitative study within the STOP project]. An Pediatr (Barc) 2021. [PMID: 33478849 DOI: 10.1016/j.anpedi.2020.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Understanding the underlying factors that influence the approach to overweight and obesity in children is basic to best support families searching a solution to this important public health problem. OBJECTIVE To assess attitudes and feelings of paediatric staff in addressing overweight and childhood obesity to parents, exploring perceived barriers and facilitators, for an effective care. PARTICIPANTS AND METHOD Qualitative study by means of individual semi-structured questionnaires of paediatric staff (paediatricians and paediatrician nurses; n=57; 68% female) of primary health care centres and hospitals in Mallorca. Thematic analysis was done. RESULTS Three themes emerged from the data: «Parents' attitude in childhood obesity» (sub-themes «The conscience of parents», «The parents ask for help»), «Paediatric staff and childhood obesity» (sub-themes «Approaching to the problem: The interview with parents», «Looking together for the solution»), and «System barriers» (sub-themes «Improving teamwork and health policy», «Family participation in addressing childhood obesity»). CONCLUSIONS Paediatric staffs know how to treat childhood obesity, but demand training on motivation. Effectivity on therapy of childhood obesity will be obtained after parents/carers recognize the problem and establish a trustful relationship with paediatric staff. The health system is still a barrier to the activity of paediatric personnel.
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Affiliation(s)
- Emma Argelich
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Grupo de investigación en Nutrición Comunitaria y Estrés Oxidativo, Universidad de las Islas Baleares & IDISBA, Palma de Mallorca, España; Hospital de Manacor, Manacor, España
| | | | | | | | | | | | | | - Cristina Bouzas
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Grupo de investigación en Nutrición Comunitaria y Estrés Oxidativo, Universidad de las Islas Baleares & IDISBA, Palma de Mallorca, España
| | | | | | | | | | | | | | | | | | | | - David Mateos
- Grupo de investigación en Nutrición Comunitaria y Estrés Oxidativo, Universidad de las Islas Baleares & IDISBA, Palma de Mallorca, España; Hospital Universitario Son Espases, Palma de Mallorca, España
| | | | | | | | | | | | | | | | | | | | | | | | - Josep A Tur
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Grupo de investigación en Nutrición Comunitaria y Estrés Oxidativo, Universidad de las Islas Baleares & IDISBA, Palma de Mallorca, España.
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15
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Kennedy BM, Davison G, Fowler LA, Rodriguez-Guzman E, Collins ML, Baker A, Cook S, Lindros J, Wilfley DE, Zebrick AJ, Staiano AE. Perceptions of a Pragmatic Family-Centered Approach to Childhood Obesity Treatment. Ochsner J 2021; 21:30-40. [PMID: 33828424 PMCID: PMC7993422 DOI: 10.31486/toj.19.0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Few studies have examined both parent and child preferences regarding family-based weight management programs (WMPs) delivered in primary care settings, especially among racial minority populations. The purpose of this study was to determine the perceptions that parents and their children/adolescents have about the components that should be included in a family-based WMP and to identify perceived preferences, benefits, and/or barriers to participation. Methods: A sample of 60 participants (30 parents and 30 children/adolescents) participated in 1 of 5 separate structured focus groups, using probing questions and the nominal group technique (NGT). Parents reported demographics for themselves and their children/adolescents. Themes from probing questions were identified using thematic analysis. Results: Parents were primarily African American (93%) and diverse in income. NGT sessions revealed that parents across all groups perceived that education on healthy eating, parental involvement, and effective program leaders are most important and have the greatest impact, while parental involvement was perceived as the easiest method to implement in a family-based WMP for childhood obesity. Children/adolescents perceived that education on healthy eating and exercise would have the greatest impact, while healthy eating and meal plans were perceived as the easiest methods to implement with a family. Parents and children/adolescents also identified improved psychological well-being (eg, decreased bullying, increased self-esteem, and motivation) as a desired program outcome. Conclusion: Parents and their children/adolescents highlighted the importance of physical and psychological health as targets in treatment. Feedback from patients can inform the design and implementation of family-based WMPs delivered in primary care settings.
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Affiliation(s)
| | - Genevieve Davison
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Lauren A. Fowler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | | | | | | | - Stephen Cook
- Department of Research, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY
| | | | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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16
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Huntington J, Dwyer JJM, Shama S, Brauer P. Registered dietitians' beliefs and behaviours related to counselling patients on physical activity and sedentary behaviour from a theory of planned behaviour perspective. BMC Nutr 2020; 6:66. [PMID: 33292838 PMCID: PMC7702673 DOI: 10.1186/s40795-020-00392-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022] Open
Abstract
Background Registered dietitians working in team-based primary care settings (e.g., family health teams [FHTs]) are positioned to counsel on physical activity and sedentary behaviour when providing nutrition-related services to promote health and prevent disease. This qualitative study explored FHT registered dietitians’ beliefs and behaviours related to counselling patients on physical activity and sedentary behaviour. Methods Twenty registered dietitians in FHTs in Ontario, Canada were interviewed in person. Theory of planned behaviour guided the development of this cross-sectional, descriptive study. Thematic analysis was used to identify themes within each of the following theoretical constructs (topics): registered dietitians’ behaviour (practice), behavioural intention, attitude, subjective norm, and perceived behavioural control related to physical activity and sedentary behaviour counselling. Results All participants counselled patients on physical activity, using some motivational interviewing strategies, and most counselled on sedentary behaviour. Many participants intended to continue their current physical activity counselling practices and increase sedentary behaviour counselling. Some participants had a positive attitude about the effectiveness of counselling on physical activity and sedentary behaviour, but their belief about effectiveness was dependent on factors such as time frame for behaviour change. Many participants felt that other health care professionals expected them to counsel on physical activity and they believed that other registered dietitians counsel on physical activity and sedentary behaviour. Facilitators to counselling included FHT dynamics and time with patients. In terms of barriers, almost all participants were confident in basic PA counselling only and contended that only this is within their scope of practice. Many participants posited that exercise prescription is outside their scope of practice. Other barriers included registered dietitians’ lack of knowledge and not having a physical activity expert on the team. Conclusions The results suggest that strategies are warranted to improve FHT registered dietitians’ knowledge, attitude, and counselling skills related to physical activity and sedentary behaviour. This study provides a strong foundation to develop a theory-based, quantitative measure to assess physical activity and sedentary behaviour counselling practices and determinants among registered dietitians. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-020-00392-1.
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Affiliation(s)
- Jessica Huntington
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - John J M Dwyer
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Sara Shama
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - Paula Brauer
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
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17
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Sjunnestrand M, Nordin K, Eli K, Nowicka P, Ek A. Planting a seed - child health care nurses' perceptions of speaking to parents about overweight and obesity: a qualitative study within the STOP project. BMC Public Health 2019; 19:1494. [PMID: 31706318 PMCID: PMC6842180 DOI: 10.1186/s12889-019-7852-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/28/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Nurses in child health care (CHC) centers in Sweden play a key role in the early detection and management of childhood overweight/obesity, through meeting families early, regularly and over many years. However, research focusing on CHC nurses' perceptions of their role in childhood overweight/obesity management is scarce. As part of the EU-funded project "Science and Technology in childhood Obesity Policy" (STOP), this study examines CHC nurses' perceptions of speaking to parents about children's overweight/obesity and of their role in referring children to treatment for overweight/obesity. METHODS All registered CHC nurses in Stockholm County (n = 442) received an email invitation letter explaining the study. Individual face-to-face visits (n = 15) in selected centers, and phone calls (n = 24) to nurses working in these centres were also conducted. In total, 17 CHC nurses (all female, average work experience 6.7 years (SD ± 4.9 years)) from 10 municipalities (including four of the top five municipalities with the highest prevalence of overweight and obesity) in Stockholm County were interviewed. The interviews were conducted by phone, transcribed and analyzed using thematic analysis. RESULTS Two main themes were developed through the analysis: 1) The relationship between the nurse and the parent and 2) Glitch in the system. Under the first theme, nurses reported that weight-related discussions were facilitated by building and maintaining trust with parents. However, nurses also said they were reluctant to address children's weights if this could compromise parents' trust. Under the second theme, nurses highlighted several organizational barriers to addressing a child's weight with parents, including insufficient cooperation with other healthcare providers and limited time for visits. Nurses also identified lack of sufficient knowledge about what to offer the family and lack of confidence in their communication skills as additional barriers. CONCLUSIONS We found that pediatric nurses perceive relational and organizational factors as barriers to address childhood obesity with parents. To improve care, it is necessary to provide nurses with continuing education about obesity and communication skills and organizational support to improve communication within the healthcare system. TRIAL REGISTRATION ClinicalTrials.gov NCT03800823; 11 Jan 2019, prospectively registered.
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Affiliation(s)
- My Sjunnestrand
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK.,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. .,Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden.
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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18
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Bell LK, Golley R, Moores CJ, Perry R, Hartley J, Miller M, Matwiejczyk L, Miller J, Magarey AM. Feasibility of a Group-Based, Facilitator-Directed Online Family Lifestyle Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1194-1201. [PMID: 31471067 DOI: 10.1016/j.jneb.2019.07.007] [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: 09/11/2018] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study aimed to overcome barriers to access and attendance, and improve recruitment and engagement, through delivery and evaluation of the Parenting, Eating and Activity for Child Health (PEACH) child weight management program, as a facilitated group-based online healthy lifestyle program, PEACH Lifestyle. METHODS Pre-post feasibility study of an online intervention comprising a website with 10 self-directed learning modules and 6 facilitated group-based video conferencing sessions with parents (n = 79) of children (7.9 ± 2.9 years, 25% healthy weight, 23% obese). RESULTS Three enrollees were from remote locations. Half of the parents (n = 38) attended ≥1 video conferencing session (median = 3 participants per session [Range, 0-7]). Thirty percent (n = 7 of 21) completed all 10 online modules. Technical issues, time, and family commitments were barriers to engagement. CONCLUSIONS AND IMPLICATIONS Reframing and delivering a weight management program as a healthy lifestyle program online in real-time did not address barriers to engagement in PEACH Lifestyle.
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Affiliation(s)
- Lucinda K Bell
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.
| | - Rebecca Golley
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Carly J Moores
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Rebecca Perry
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Jo Hartley
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Micelle Miller
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Louisa Matwiejczyk
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Jacqueline Miller
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia; Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Anthea M Magarey
- Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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19
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Butler ÉM, Suhag A, Hong Y, Liang L, Gong C, Xiong F, Luo F, Liu G, Chen S, Taylor RW, Cutfield WS, Fu J, Derraik JGB. Parental Perceptions of Obesity in School Children and Subsequent Action. Child Obes 2019; 15:459-467. [PMID: 31408357 DOI: 10.1089/chi.2018.0338] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Despite perceiving their child as being above a healthy weight, many parents do not intervene. Little is known about the factors influencing parental action. We assessed parental perception of child's weight status, the prevalence of mitigating parental action, and the underlying factors. Methods: We studied 20,242 children and adolescents from 6 centers across China. Anthropometry was measured by research nurses. Parents answered questionnaires, including their perception of their child's weight status, and any subsequent weight treatment. Results: A total of 3254 children had obesity (16.1%), with 63.0% correctly perceived as overweight by their parents. These children were more likely to be older (≥8 years; p < 0.0001), have severe obesity [adjusted relative risk (aRR) 1.41; p < 0.0001], and have mothers with overweight/obesity (aRR 1.15; p < 0.0001). In particular, parents of children aged <8 years were over five times more likely to perceive their child with overweight/obesity as "thin" than parents of teenagers. Conversely, girls, older children/adolescents, and urban youth were more likely to be wrongly perceived by parents as having an overweight issue. Only one in four children (27.8%) with available information received treatment for their perceived weight problem. Children with severe obesity were more likely to be treated (aRR 1.34; p < 0.0001), as were children of mothers with overweight/obesity (aRR 1.18; p = 0.002). Conclusions: Only one in four Chinese children perceived as overweight by their parents received treatment for their weight problem. Given that overweight/obesity in childhood tracks into adulthood and many parents did not intervene despite perceiving an overweight problem in their child, interventions for childhood obesity need to extend beyond parental perception of children's weight status.
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Affiliation(s)
- Éadaoin M Butler
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand
| | - Alisha Suhag
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Ye Hong
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li Liang
- First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunxiu Gong
- Beijing Children's Hospital of Capital Medical University, Beijing, China
| | - Feng Xiong
- Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Feihong Luo
- Department of Endocrinology, Children's Hospital of Shanghai Fudan University, Shanghai, China
| | - Geli Liu
- General Hospital of Tianjin Medical University, Tianjin, China
| | - Shaoke Chen
- Maternal and Children Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Rachael W Taylor
- A Better Start-National Science Challenge, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand
| | - JunFen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - José G B Derraik
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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20
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Balakumaran J, Kao YY, Wang KW, Ronen GM, MacKillop J, Thabane L, Samaan MC. Translating knowledge into action to prevent pediatric and adolescent diabesity: a meeting report. Adolesc Health Med Ther 2019; 10:91-101. [PMID: 31692573 PMCID: PMC6716568 DOI: 10.2147/ahmt.s209922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/05/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The obesity and Type 2 Diabetes Mellitus (T2DM) rates are at an all-time high globally. This diabesity epidemic is increasingly impacting children and adolescents, and there is scarce evidence of interventions with favourable long-term outcomes. PURPOSE In order to understand the determinants of diabesity and how to address them, multiple stakeholders were invited to a meeting to discuss current state of knowledge and to help design a program to prevent pediatric and adolescent diabesity. PARTICIPANTS AND METHODS The meeting was held at McMaster University on March 4th, 2015. The event involved presentations to deliver state-of-the-art knowledge about diabesity, and roundtable discussions of several domains including nutrition, physical activity, sleep, and mental health. Discussion transcripts were analyzed using NVivo. RESULTS Forty-nine participants took part in the workshop. They included clinical healthcare professionals, public health, Aboriginal Patient Navigator, research scientists, students, and patients with family members. A total of 628 reference counts from the roundtable discussions were coded under 20 emerging themes. Participants believed that the most important elements of the program involve the provision of knowledge and education, family involvement, patient motivation, location of program delivery, and use of surveys and questionnaires for outcome measurement. CONCLUSION Effective pediatric and adolescent diabesity prevention programs should be conceptualized by multidisciplinary stakeholders and embrace the complexity of diabesity with multiprong interventions. This meeting provided a framework for developing such interventions.
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Affiliation(s)
- Janatani Balakumaran
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Yun-Ya Kao
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Gabriel M Ronen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph’s Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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21
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Esdaile E, Hernandez E, Moores CJ, Vidgen HA. Enrolment of families with overweight children into a program aimed at reducing childhood obesity with and without a weight criterion: a natural experiment. BMC Public Health 2019; 19:756. [PMID: 31200674 PMCID: PMC6570944 DOI: 10.1186/s12889-019-6894-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Difficulties engaging families with overweight children to enrol into programs aimed at reducing childhood obesity have been well documented. During the implementation of the Parenting, Eating and Activity for Child Health Program (PEACH™) over a large geographical area (Queensland (QLD), Australia), a natural experiment developed. This experiment provided an opportunity to observe if there was a difference in enrolment for families with overweight children with a weight criterion (referred to as the period with a Targeted Eligibility Criterion (TEC)) compared to when a weight criterion was removed (the period referred to as Universal Eligibility Criterion (UEC)). We also examined the eligibility criterion's relationship with attendance, parental concern about their child's weight, estimation of overweight and obesity from parent-reported data. METHODS A secondary analysis of baseline data from 926 overweight/obese children from 817 families enrolled in PEACH™ QLD was performed. Analyses were adjusted to control for the presence of clustered data. Bivariate statistics were performed using Pearson chi-square test with the second-order Rao-Scott correction, and Mann-Whitney U-test for non-parametric continuous variables. Generalized Estimating Equations (GEE) explored the association between weight status-based eligibility criteria and enrolment of overweight children. GEE were adjusted for sex, age and socioeconomic index and stratified for weight category. RESULTS Compared to obese children, overweight children were almost twice as likely to be enrolled when the program did not have weight status-based eligibility criteria (during UEC period) (OR = 1.90 (CI 95% 1.35-2.68, p < 0.001)). Parents of overweight children enrolled during the UEC period were more likely to regard their child's weight as less of a concern than during the TEC period (UEC 67% vs. TEC 45%, p = 0.036). Children whose parent-reported data underestimated their weight category were more likely to be enrolled while the program did not have weight-related eligibility criteria OR = 2.27 (CI 1.38-3.70, p < 0.01). Program session attendance did not appear to be impacted by the changes in eligibility criteria. CONCLUSIONS The omission of weight criteria for healthy lifestyle programs is a consideration for health professionals and decision-makers alike when encouraging the enrolment of children who are overweight into healthy lifestyle programs. TRIAL REGISTRATION ACTRN12617000315314 . Retrospectively registered 28 February 2017.
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Affiliation(s)
- Emma Esdaile
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland Qld 4059 Australia
| | - Emely Hernandez
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland Qld 4059 Australia
| | - Carly Jane Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 Australia
| | - Helen Anna Vidgen
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland Qld 4059 Australia
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Tanaka H. Overweight Children at a Primary School in Hirosaki City: A Longitudinal, Individualized, Observational Study. TOHOKU J EXP MED 2019; 247:209-214. [PMID: 30905900 DOI: 10.1620/tjem.247.209] [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: 11/18/2022]
Abstract
The 2015 Annual report on growth velocity and physiologic status in schoolchildren revealed that the overweight incidence among fifth grade primary school in Aomori Prefecture was higher than the countrywide average. As a pilot study, overweight fifth grade (age, 10 years) children attending the attached primary school of Hirosaki University, Faculty of Education, were recruited in 2016, after which 6-year longitudinal change in physiological status between the first (age, 6 years) and sixth grades (age, 11 years) were evaluated using somatometric data obtained from the annual health checkup conducted each Spring. Of the 80 fifth graders recruited, none of whom had any underlying diseases affecting physiologic status, 6 (7.5%, 3 boys and 3 girls) were deemed overweight. Subsequently, 20 non-overweight children (10 boys and 10 girls) of the same grade were randomly selected for comparison. We used percent degree of overweight (%DO) for evaluating overweight instead of body mass index. Accordingly, compared with controls, overweight children already exhibited significantly greater weight and %DO at the first grade. Moreover, those who remained being overweight by the fourth grade showed %DO that tended to persist thereafter. Most overweight children exhibited increased annual velocity in %DO between the first and third grades. Overweight children showed varied fluctuations in %DO status throughout 6 years of primary school, whereas non-overweight children showed almost stable %DO within the normal range. The present study indicates the importance of early and sustained health education, particularly during the period before primary school entry until at least before fourth grade.
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Affiliation(s)
- Hiroshi Tanaka
- Department of School Health Science, Faculty of Education, Hirosaki University.,Department of Pediatrics, Hirosaki University Hospital
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Davidson K, Vidgen H, Denney-Wilson E, Daniels L. How is children's weight status assessed for early identification of overweight and obesity? - Narrative review of programs for weight status assessment. J Child Health Care 2018; 22:486-500. [PMID: 29439599 DOI: 10.1177/1367493518759238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Assessment of a child's weight status is the first step in the management of childhood overweight and obesity. We reviewed routine assessment programs to inform early and routine identification of childhood overweight and obesity to address this global health issue. Twelve electronic databases were searched (Scopus, Web of Science, Wiley, ScienceDirect, PsycINFO, PsycARTICLES, PsycEXTRA, CINAHL, Primary Search, MEDLINE, ERIC, Academic Search Elite) for universal programs for weight status assessment of children aged 4-12 in Organization for Economic Co-operation and Development - countries, which included more than one assessment and parents receiving feedback. Of 1638 papers found via database searches, and 18 additional records identified through other sources, 26 were included. Reference to five countries' programs for weight status assessment was found in the results: Australia, Sweden, the Netherlands, the United Kingdom and the United States. All of these programs were implemented in a school setting. Lack of services, stakeholder collaboration, parental awareness and engagement and government funding need to be improved for this health check to be undertaken as a part of an ongoing program. This review is about the implementation of similar programs. Early identification of risk for overweight and obesity allows families that require help to connect with available health services.
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Affiliation(s)
- Kamila Davidson
- 1 School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Helen Vidgen
- 1 School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Lynne Daniels
- 1 School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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Villarosa AR, George D, Ramjan LM, Srinivas R, George A. The role of dental practitioners in addressing overweight and obesity among children: A scoping review of current interventions and strategies. Obes Res Clin Pract 2018; 12:405-415. [PMID: 30082247 DOI: 10.1016/j.orcp.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/22/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION With the growing prevalence of childhood obesity worldwide, there is a need for interventions to identify and address overweight and obesity in childhood. Although guidelines recommend general practitioners routinely screen for overweight and obesity among children, research suggests this is often not done. To address this, dental practitioners may be able to play a role in identifying and addressing overweight and obesity among children. METHODS This review aimed to explore the evidence and efficacy of existing obesity and overweight interventions targeting children in the dental setting. A systematic search of nine electronic databases was conducted to identify relevant published and grey literature. This was expanded to also include strategies for promoting oral health in the dental setting. RESULTS A total of 11 records were included in this review, which focussed on the current role and effectiveness of dental practitioners in addressing obesity among children, and the available strategies and resources. Although there was a paucity of research on the training of dental practitioners in this area and their efficacy in identifying and addressing obesity among children, evidence suggests that parents found it acceptable for dental practitioners to promote healthy practices to children who experience overweight or obesity. This review also identified screening tools and strategies for identifying and addressing overweight and obesity among children in dental practice. CONCLUSION There is a clear role for dental practitioners in addressing overweight and obesity among children, however further research is required to identify the most effective interventions to implement in dental practice.
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Affiliation(s)
- Amy R Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool 1871, Australia; Western Sydney University, Penrith 2751, Australia; South Western Sydney Local Health District, NSW, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia.
| | - David George
- Western Sydney University, Penrith 2751, Australia
| | - Lucie M Ramjan
- Western Sydney University, Penrith 2751, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia; Centre for Applied Nursing Research (CANR), Liverpool 1871, Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool 1871, Australia; Western Sydney University, Penrith 2751, Australia; South Western Sydney Local Health District, NSW, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia; University of Sydney, Camperdown 2050, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), Liverpool 1871, Australia; Western Sydney University, Penrith 2751, Australia; South Western Sydney Local Health District, NSW, Australia; Ingham Institute for Applied Medical Research, Liverpool 1871, Australia; University of Sydney, Camperdown 2050, Australia
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Vidgen HA, Love PV, Wutzke SE, Daniels LA, Rissel CE, Innes-Hughes C, Baur LA. A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia. Implement Sci 2018; 13:109. [PMID: 30086782 PMCID: PMC6081901 DOI: 10.1186/s13012-018-0801-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/26/2018] [Indexed: 12/31/2022] Open
Abstract
Background The prevalence of childhood obesity poses an urgent global challenge. The World Health Organization (WHO) Commission on Ending Childhood Obesity recommends the provision of appropriate family-based, lifestyle weight management services through universal health care to support families of children with overweight or obesity; however, there are few examples of their implementation ‘at scale’. The purpose of this research was to compare and contrast the impact of system and organisational factors on the implementation of childhood obesity management services within two Australian States (New South Wales and Queensland) to comprehensively describe their influence on the achievement of the WHO recommendation. Methods Purposeful stratified sampling was used to select health service study sites (n = 16) representative of program implementation (none, discontinued, repeated) and geographic location within each State. Within each health service site, staff involved in program delivery, co-ordination and management roles participated (n = 39). An additional 11 staff involved in implementation at State level also participated. The Consolidated Framework for Implementation Research (CFIR) was used to develop interview scripts. Telephone interviews were recorded and transcribed. Transcripts were thematically coded and scored according to CFIR constructs and rating rules to identify enablers and barriers to implementation according to sample characteristics. Results New South Wales achieved ongoing implementation; Queensland did not. Enablers included a quality evidence-based program, State government recognition of the urgency of the health issue and a commitment to address it, formally appointed and funded internal implementation leaders, strong communication and reporting at all levels. Barriers included the complexity of the health issue, in particular a lack of clear roles and responsibilities for local health service delivery, inadequate ongoing funding and challenges in meeting the diverse needs of families. Conclusions This research is an important progression of the evidence base in relation to the translation of childhood obesity management trials into routine health service delivery. Understanding enablers and barriers to program implementation ‘at scale’ is imperative to inform future planning and investment by Australia and WHO member states to meet their commitment to deliver childhood weight management services as part of universal health coverage. Electronic supplementary material The online version of this article (10.1186/s13012-018-0801-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helen A Vidgen
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, 4059, QLD, Australia.
| | - Penelope V Love
- Institute of Physical Activity and Nutrition, Faculty of Health, Deakin University, Locked Bag 20001, Geelong, 3220, VIC, Australia
| | - Sonia E Wutzke
- The Australian Prevention Partnership Centre, PO Box K617, Haymarket, Sydney, 1240, NSW, Australia
| | - Lynne A Daniels
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, 4059, QLD, Australia
| | - Chris E Rissel
- NSW Office of Preventive Health, Locked Bag 7103, Liverpool BC, 1871, NSW, Australia
| | | | - Louise A Baur
- Discipline of Child and Adolescent Health, Clinical School, The Children's Hospital, University of Sydney, Locked Bag 4001, Westmead, 2145, NSW, Australia
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Zhang T, Cai L, Jing J, Ma L, Ma J, Chen Y. Parental perception of child weight and its association with weight-related parenting behaviours and child behaviours: a Chinese national study. Public Health Nutr 2018; 21:1671-1680. [PMID: 29510769 PMCID: PMC10284714 DOI: 10.1017/s136898001800006x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/23/2017] [Accepted: 01/02/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Parents commonly fail to correctly recognize the weight status of their child. Whether parental perception of child weight is associated with weight-related parenting behaviours and child behaviours is unclear. The present study aimed to investigate the distribution of parental perception of child weight and its associations with weight-related parenting behaviours and child behaviours in China. DESIGN Cross-sectional study. SETTING Seven provinces in China. SUBJECTS A total of 47 417 children aged 6-17 years and their parents were included from a national survey in 2013. Parental perception of child weight, weight-related parenting behaviours and child behaviours were self-reported. Child's weight and height were objectively measured. RESULTS A total of 30·5 % of parents underestimated and 8·7 % overestimated the child's weight. Parental underestimation was more common among younger children, boys and children with a lower BMI Z-score. Parents who perceived that their child had a healthy weight (accurately or inaccurately) were more likely to prepare breakfast for the child, exercise with him/her, set apart his/her exercise time, restrict his/her screen time, and were less likely to store soft drinks for the child. Children perceived to have a healthy weight, regardless of their actual weight status, behaved healthier on dietary intake, physical activity and homework time. CONCLUSIONS Parental underestimation of their child's weight was prominent in China, especially among younger children, boys and children with a lower BMI Z-score. Parental recognition of their child being overweight did not appear to translate into healthy changes in weight-related parenting behaviours or child behaviours.
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Affiliation(s)
- Ting Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People’s Republic of China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People’s Republic of China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People’s Republic of China
| | - Lu Ma
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People’s Republic of China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, People’s Republic of China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People’s Republic of China
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Pre–post evaluation of a weight management service for families with overweight and obese children, translated from the efficacious lifestyle intervention Parenting, Eating and Activity for Child Health (PEACH). Br J Nutr 2018; 119:1434-1445. [DOI: 10.1017/s0007114518001083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractParenting, Eating and Activity for Child Health (PEACH) is a multi-component lifestyle intervention for families with overweight and obese children. PEACH was translated from an efficacious randomised-controlled trial (RCT) and delivered at scale as PEACH Queensland (QLD) in Queensland, Australia. The aim of this study is to explore pre–post changes in parenting, and child-level eating, activity and anthropometry, in the PEACH QLD service delivery project. PEACH QLD enrolled 926 overweight/obese children (817 families). Pre-programme evaluation was completed for 752 children and paired pre–post-programme evaluation data were available for 388 children. At baseline, children with pre–post-programme data were (mean) 8·8 years old, and at follow-up were 9·3 years old, with mean time between pre–post-programme measures of 0·46 years. Outcomes reflected each domain of the PEACH programme: parenting, eating behaviour of the child and activity behaviours (means reported). Parents reported improvements in parenting self-efficacy (3·6 to 3·7, P=0·001). Children had improved eating behaviours: eating more daily serves of vegetables (2·0 to 2·6, P=0·001) and fewer non-milk sweetened beverages (0·9 to 0·6, P=0·001) and discretionary foods (2·2 to 1·5, P=0·001). Children spent more time in moderate-to-vigorous physical activity (86 to 105 min/d, P=0·001) and less time in sedentary screen-based behaviours (190 to 148 min/d, P=0·001). Consequently, there were significant improvements in mean BMIz (−0·112; P<0·001) and weight status (healthy weight/overweight/obese/morbidly obese prevalence from 0/22/33/45 % to 2/27/34/37 %, P<0·001). When delivered at scale, PEACH remains an effective family-based, multi-component, lifestyle weight management programme for overweight and obese children whose families engage in the programme.
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Saraiva NCG, Medeiros CCM, Araujo TLD. Serial album validation for promotion of infant body weight control. Rev Lat Am Enfermagem 2018; 26:e2998. [PMID: 29791665 PMCID: PMC5969825 DOI: 10.1590/1518-8345.2194.2998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 12/14/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: to validate the content and appearance of a serial album for children aged
from 7 to 10 years addressing the topic of prevention and control of body
weight. Method: methodological study with descriptive nature. The validation process was
attended by 33 specialists in educational technologies and/or in excess of
infantile weight. The agreement index of 80% was the minimum considered to
guarantee the validation of the material. Results: most of the specialists had a doctoral degree and a graduate degree in
nursing. Regarding content, illustrations, layout and relevance, all items
were validated and 69.7% of the experts considered the album as great. The
overall agreement validation index for the educational technology was 0.88.
Only the script-sheet 3 did not reach the cutoff point of the content
validation index. Changes were made to the material, such as title change,
inclusion of the school context and insertion of nutritionist and physical
educator in the story narrated in the album. Conclusion: the proposed serial album was considered valid by experts regarding content
and appearance, suggesting that this technology has the potential to
contribute in health education by promoting healthy weight in the age group
of 7 to 10 years.
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van Rinsum C, Gerards S, Rutten G, Philippens N, Janssen E, Winkens B, van de Goor I, Kremers S. The Coaching on Lifestyle (CooL) Intervention for Overweight and Obesity: A Longitudinal Study into Participants' Lifestyle Changes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040680. [PMID: 29617337 PMCID: PMC5923722 DOI: 10.3390/ijerph15040680] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/30/2018] [Accepted: 04/02/2018] [Indexed: 02/07/2023]
Abstract
Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents) at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, motivation, perceived barriers, lifestyle behaviours, quality of life and weight. Among children and their parents, few improvements were found regarding behaviours and quality of life. CooL has been successful in coaching adult participants towards sustained behavioural change during the intervention period. Mixed results and smaller effect sizes were found for children and their parents.
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Affiliation(s)
- Celeste van Rinsum
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Sanne Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Geert Rutten
- Faculty of Humanities and Sciences, University College Venlo, Maastricht University, P.O. Box 8, 5900 AA Venlo, The Netherlands.
| | - Nicole Philippens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Ester Janssen
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Bjorn Winkens
- Department of Methodology and Statistics, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Ien van de Goor
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands.
| | - Stef Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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Croyden DL, Vidgen HA, Esdaile E, Hernandez E, Magarey A, Moores CJ, Daniels L. A narrative account of implementation lessons learnt from the dissemination of an up-scaled state-wide child obesity management program in Australia: PEACH™ (Parenting, Eating and Activity for Child Health) Queensland. BMC Public Health 2018. [PMID: 29534700 PMCID: PMC5851159 DOI: 10.1186/s12889-018-5237-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND PEACH™QLD translated the PEACH™ Program, designed to manage overweight/obesity in primary school-aged children, from efficacious RCT and small scale community trial to a larger state-wide program. This paper describes the lessons learnt when upscaling to universal health coverage. METHODS The 6-month, family-focussed program was delivered in Queensland, Australia from 2013 to 2016. Its implementation was planned by researchers who developed the program and conducted the RCT, and experienced project managers and practitioners across the health continuum. The intervention targeted parents as the agents of change and was delivered via parent-only group sessions. Concurrently, children attended fun, non-competitive activity sessions. Sessions were delivered by facilitators who received standardised training and were employed by a range of service providers. Participants were referred by health professionals or self-referred in response to extensive promotion and marketing. A pilot phase and a quality improvement framework were planned to respond to emerging challenges. RESULTS Implementation challenges included engagement of the health system; participant recruitment; and engagement. A total of 1513 children (1216 families) enrolled, with 1122 children (919 families) in the face-to-face program (105 groups in 50 unique venues) and 391 children (297 families) in PEACH™ Online. Self-referral generated 68% of enrolments. Unexpected, concurrent and, far-reaching public health system changes contributed to poor program uptake by the sector (only 56 [53%] groups delivered by publicly-funded health organisations) requiring substantial modification of the original implementation plan. Process evaluation during the pilot phase and an ongoing quality improvement framework informed program adaptations that included changing from fortnightly to weekly sessions aligned with school terms, revision of parent materials, modification of eligibility criteria to include healthy weight children and provision of services privately. Comparisons between pilot versus state-wide waves showed comparable prevalence of families not attending any sessions (25% vs 28%) but improved number of sessions attended (median = 5 vs 7) and completion rates (43% vs 56%). CONCLUSIONS Translating programs developed in the research context to enable implementation at scale is complex and presents substantial challenges. Planning must ensure there is flexibility to accommodate and proactively manage the system changes that are inevitable over time. TRIAL REGISTRATION ACTRN12617000315314 . This trial was registered retrospectively on 28 February, 2017.
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Affiliation(s)
- Debbie L Croyden
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Helen A Vidgen
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, QLD, 4059, Australia.
| | - Emma Esdaile
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Emely Hernandez
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Anthea Magarey
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Carly J Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lynne Daniels
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, QLD, 4059, Australia
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31
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Moores CJ, Miller J, Perry RA, Chan LLH, Daniels LA, Vidgen HA, Magarey AM. CONSORT to community: translation of an RCT to a large-scale community intervention and learnings from evaluation of the upscaled program. BMC Public Health 2017; 17:918. [PMID: 29187157 PMCID: PMC5708099 DOI: 10.1186/s12889-017-4907-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 11/12/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Translation encompasses the continuum from clinical efficacy to widespread adoption within the healthcare service and ultimately routine clinical practice. The Parenting, Eating and Activity for Child Health (PEACH™) program has previously demonstrated clinical effectiveness in the management of child obesity, and has been recently implemented as a large-scale community intervention in Queensland, Australia. This paper aims to describe the translation of the evaluation framework from a randomised controlled trial (RCT) to large-scale community intervention (PEACH™ QLD). Tensions between RCT paradigm and implementation research will be discussed along with lived evaluation challenges, responses to overcome these, and key learnings for future evaluation conducted at scale. METHODS The translation of evaluation from PEACH™ RCT to the large-scale community intervention PEACH™ QLD is described. While the CONSORT Statement was used to report findings from two previous RCTs, the REAIM framework was more suitable for the evaluation of upscaled delivery of the PEACH™ program. Evaluation of PEACH™ QLD was undertaken during the project delivery period from 2013 to 2016. RESULTS Experiential learnings from conducting the evaluation of PEACH™ QLD to the described evaluation framework are presented for the purposes of informing the future evaluation of upscaled programs. Evaluation changes in response to real-time changes in the delivery of the PEACH™ QLD Project were necessary at stages during the project term. Key evaluation challenges encountered included the collection of complete evaluation data from a diverse and geographically dispersed workforce and the systematic collection of process evaluation data in real time to support program changes during the project. CONCLUSIONS Evaluation of large-scale community interventions in the real world is challenging and divergent from RCTs which are rigourously evaluated within a more tightly-controlled clinical research setting. Constructs explored in an RCT are inadequate in describing the enablers and barriers of upscaled community program implementation. Methods for data collection, analysis and reporting also require consideration. We present a number of experiential reflections and suggestions for the successful evaluation of future upscaled community programs which are scarcely reported in the literature. TRIALS REGISTRATION PEACH™ QLD was retrospectively registered with the Australian New Zealand Clinical Trials Registry on 28 February 2017 (ACTRN12617000315314).
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Affiliation(s)
- Carly Jane Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia Australia
| | - Jacqueline Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia Australia
| | - Rebecca Anne Perry
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia Australia
| | - Lily Lai Hang Chan
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia Australia
| | - Lynne Allison Daniels
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD Australia
| | - Helen Anna Vidgen
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD Australia
| | - Anthea Margaret Magarey
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia Australia
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