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Kim KW, Wallander JL, Wiebe D. Associations among COVID-19 Family Stress, Family Functioning, and Child Health-Related Quality of Life through Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:483. [PMID: 38671700 PMCID: PMC11049322 DOI: 10.3390/children11040483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
The COVID-19 pandemic has resulted in lasting effects on children, necessitating a thorough understanding of its impact for effective recovery planning. This study investigated the associations among COVID-19 family stress, family functioning, children's lifestyle behaviors (i.e., healthy food intake, unhealthy food intake, physical activity, and screen time), and their health-related quality of life (HRQOL). Data from a 2022 survey of parents with children aged 5 to 12 (mean age of boys: 8.36, mean age of girls: 7.76) in the United States through the online Prolific platform were analyzed using path analysis and gender-based multi-group analysis. The results showed an inverse relationship between family stressors and functioning (β = -0.39, p < 0.05). COVID-19 family stress was negatively related to child physical HRQOL (β = -0.20, p < 0.05) but not psychosocial HRQOL. Family functioning showed a positive relation with child healthy food intake (β = 0.26, p < 0.05) and a negative relation with unhealthy diet consumption (β = -0.27, p < 0.05), while no significant associations were found with child physical activity and screen time. Family functioning was indirectly associated with both types of HRQOL through the child's eating patterns. These relationships were more pronounced for girls. The findings point to a complex interplay between family stress and functioning, dietary habits, and the HRQOL of children during the COVID-19 pandemic, particularly concerning girls' food intake and well-being.
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Affiliation(s)
- Kay W. Kim
- Psychological Sciences, University of California, Merced, CA 95343, USA
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Brown V, Sheppard L, Salmon J, Arundell L, Cerin E, Ridgers ND, Hesketh KD, Daly RM, Dunstan DW, Brown H, Gatta JD, Chinapaw JMM, Moodie M. Cost-effectiveness of reducing children's sedentary time and increasing physical activity at school: the Transform-Us! intervention. Int J Behav Nutr Phys Act 2024; 21:15. [PMID: 38347579 PMCID: PMC10860323 DOI: 10.1186/s12966-024-01560-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Improving physical activity and reducing sedentary behavior represent important areas for intervention in childhood in order to reduce the burden of chronic disease related to obesity and physical inactivity in later life. This paper aims to determine the cost-effectiveness of a multi-arm primary school-based intervention to increase physical activity and/or reduce sedentary time in 8-9 year old children (Transform-Us!). METHODS Modelled cost-utility analysis, using costs and effects from a cluster randomized controlled trial of a 30-month intervention that used pedagogical and environmental strategies to reduce and break up sedentary behaviour (SB-I), promote physical activity (PA-I), or a combined approach (PA + SB-I), compared to current practice. A validated multiple-cohort lifetable model (ACE-Obesity Policy model) estimated the obesity and physical activity-related health outcomes (measured as change in body mass index and change in metabolic equivalent task minutes respectively) and healthcare cost-savings over the cohort's lifetime from the public-payer perspective, assuming the intervention was delivered to all 8-9 year old children attending Australian Government primary schools. Sensitivity analyses tested the impact on cost-effectiveness of varying key input parameters, including maintenance of intervention effect assumptions. RESULTS Cost-effectiveness results demonstrated that, when compared to control schools, the PA-I and SB-I intervention arms were "dominant", meaning that they resulted in net health benefits and healthcare cost-savings if the intervention effects were maintained. When the costs and effects of these intervention arms were extrapolated to the Australian population, results suggested significant potential as obesity prevention measures (PA-I: 60,780 HALYs saved (95% UI 15,007-109,413), healthcare cost-savings AUD641M (95% UI AUD165M-$1.1B); SB-I: 61,126 HALYs saved (95% UI 11,770 - 111,249), healthcare cost-savings AUD654M (95% UI AUD126M-1.2B)). The PA-I and SB-I interventions remained cost-effective in sensitivity analysis, assuming the full decay of intervention effect after 10 years. CONCLUSIONS The PA-I and SB-I Transform-Us! intervention arms represent good value for money and could lead to health benefits and healthcare cost-savings arising from the prevention of chronic disease in later life if intervention effects are sustained. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN83725066). Australia and New Zealand Clinical Trials Registry Number (ACTRN12609000715279).
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Affiliation(s)
- Vicki Brown
- Deakin University, Deakin Health Economics, Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation (IHT), Geelong, Australia.
| | - Lauren Sheppard
- Deakin University, Deakin Health Economics, Institute for Health Transformation, Geelong, Australia
| | - Jo Salmon
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Lauren Arundell
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Ester Cerin
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Nicola D Ridgers
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia; Deakin University, Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Kylie D Hesketh
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Robin M Daly
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | | | - Helen Brown
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Jacqueline Della Gatta
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - J M M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, Netherlands
| | - Marj Moodie
- Deakin University, Deakin Health Economics, Institute for Health Transformation, Geelong, Australia
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Tian J, Blizzard L, Campbell JA, Gall S, Dwyer T, Venn A. Association of body mass index from childhood to mid-adulthood with health-related quality of life in mid-adulthood. Qual Life Res 2023; 32:3349-3358. [PMID: 37668925 PMCID: PMC10624736 DOI: 10.1007/s11136-023-03497-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Most studies regarding the association of obesity with health-related quality of life (HRQoL) have assessed obesity at only one or two time points. We aimed to examine the associations of life course body mass index (BMI) from childhood with health-related quality of life (HRQoL) in mid-adulthood. METHODS Data were from a cohort study of Australian children (n = 2254, mean baseline age 12.0 (2.0) years in 1985, 46.8% male). Weight and height were measured at baseline and measured or self-reported on average 20, 25, and 30 years later. Age and sex-standardised BMI-z score was calculated at each time point. Physical and mental HRQoL and health state utilities (HSUs) were measured by SF-12 and SF-6D at the last adult follow-up. Linear regression was used to examine the associations adjusting for age, sex, and childhood health status. RESULTS Higher BMI-z score in childhood (βadjusted - 1.39, 95% CI - 1.73 to - 1.05) and increasing BMI-z score from childhood to young adulthood (βadjusted - 1.82, 95% CI - 2.17 to - 1.46) and from young to mid-adulthood (βadjusted - 1.77, 95% CI - 2.28 to - 1.26) were associated with lower physical HRQoL in mid-adulthood. Similar results were found for mid-adulthood HSUs (βadjusted ranged - 0.006 to - 0.014, all P < 0.05). Only increasing BMI-z score from young to mid-adulthood significantly related to poorer mental HRQoL (βadjusted - 0.74, 95% CI - 1.29 to - 0.19) in mid-adulthood. CONCLUSION High BMI from childhood to mid-adulthood had only modest associations with HRQoL and HSUs, with effects on physical HRQoL most apparent.
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Affiliation(s)
- Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Julie A Campbell
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
- The George Institute for Global Health, University of Oxford, Wellington Square, Oxford, UK
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
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Huse O, Backholer K, Nguyen P, Calibo A, Guirindola M, Desnacido JP, Sacks G, Bell AC, Peeters A, Angeles-Agdeppa I, Ananthapavan J. A comparative analysis of the cost-utility of the Philippine tax on sweetened beverages as proposed and as implemented. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100912. [PMID: 37780636 PMCID: PMC10534259 DOI: 10.1016/j.lanwpc.2023.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
Background In response to increasing overweight and obesity, the Philippine government introduced a tax on sweetened beverages (SBs) in 2018. Evidence suggests that the beverage industry influenced the final tax design, making it more favourable for industry than the initially proposed bill. This study aimed to compare the relative health and economic benefits of the proposed SB tax with the implemented SB tax. Methods Philippine dietary consumption data were combined with price elasticity data from Mexico and data from Australia adapted to the Philippine context to estimate reductions in SB purchases and changes in body mass index (BMI) following the implementation of the tax. A multi-state, multiple-cohort Markov model was used to estimate the change in health-adjusted life years (HALYs) due to reduction in the epidemiology of obesity-related diseases, healthcare cost savings and government taxation revenue, resulting from both the proposed and implemented tax policies, over the lifetime of the 2018 Philippine population. Findings The proposed and implemented taxes were modelled to be dominant (cost-saving and improving health). Intervention costs were modelled to be PHP305.2 million (M) (approximately US$6M). Compared to the proposed tax, the implemented tax was modelled to result in a 43.0% smaller reduction in targeted beverage intake (51.1 ml/person/day vs. 89.7 ml/person/day), a 43.5% smaller reduction in BMI (0.35 kg/m2 vs. 0.62 kg/m2), 39.7% fewer HALYs gained (2,503,118 vs. 4,149,030), 39.9% fewer healthcare cost savings (PHP16.4 billion (B) vs. PHP27.3B), and 27.7% less government taxation revenue (PHP426.3B vs. PHP589.4B). Interpretation While the implemented tax in the Philippines will benefit population health, it is likely to yield less benefit than the proposed tax. The influence of the food and beverage industry on policy processes has the potential to lessen the benefits of population NCD prevention policies. Funding OH was supported to conduct this research by an Australian Government Research Training Program Stipend Scholarship. The funding body had no role in data collection and analysis, or manuscript preparation.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Phuong Nguyen
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anthony Calibo
- Child Health Division, Department of Health, Medical Specialist IV, Disease Prevention and Control Bureau, Manila (2011-2020), Philippines
- Institute of Pediatrics and Child Health, St. Luke's Medical Center, Quezon City, Philippines
| | - Mildred Guirindola
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Josie P. Desnacido
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Gary Sacks
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Andrew Colin Bell
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Jaithri Ananthapavan
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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Duzel H, Ergin I, Durusoy R. How do determinants of health relate to children's quality of life? A cross-sectional study in Izmir, Turkey. Prim Health Care Res Dev 2023; 24:e54. [PMID: 37705285 PMCID: PMC10539745 DOI: 10.1017/s1463423623000397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 09/15/2023] Open
Abstract
AIM This study aims to determine health-related quality of life (QoL) and the related factors from the perspective of social determinants of health among children. BACKGROUND Childhood is the most intense period of life, and environmental factors surrounding children, as well as individual lifestyle factors, are related to the child's physical and mental well-being. To our knowledge, there is a lack of studies evaluating the relationship between determinants of health and the QoL of healthy children in general. METHODS This cross-sectional study was executed in the Bayrakli district of Izmir city. Stratified clustered sampling was used including 24 schools and 3367 7th-grade children, and 1284 students were targeted (50% prevalence, 95% CI, %5 margins of error, 2.25 design effect, and 20% replacement). The response rate was 84.9% (n = 1090). The Turkish KID-KINDL Health-Related Quality of Life Questionnaire for Children was used to assess QoL. Independent variables were examined in four layers using Dahlgren's Determinants of Health Model: basic characteristics, lifestyle factors, family characteristics, and life conditions. RESULTS The mean QoL score was 71.3 ± 12.6. Our study explained 31.7% of the variance in QoL. Higher QoL scores were associated with better health status, perceived academic achievement, normal/thin body perception, physical activity (PA), and adequate sleep duration. Living with both parents and having fewer siblings positively influenced QoL. Moreover, the presence of structural problems in the household and poorer health perceptions were associated with lower QoL scores (P < 0.05) This study highlighted the multifaceted nature of QoL in Turkish children, revealing the importance of various determinants of health. The results show that in order to improve the general well-being of this population, interventions and policies are required that concentrate on elements including health status, academic accomplishment, body perception, physical activity, family structure, and living situations.
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Affiliation(s)
- Hilal Duzel
- Department of Public Health, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
- Department of Public Health, Ege University Faculty of Medicine, Izmir, Turkey
| | - Isil Ergin
- Department of Public Health, Ege University Faculty of Medicine, Izmir, Turkey
| | - Raika Durusoy
- Department of Public Health, Ege University Faculty of Medicine, Izmir, Turkey
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Grant V, Gachupin FC. Sleep Time, Physical Activity, and Screen Time among Montana American Indian Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6658. [PMID: 37681797 PMCID: PMC10487368 DOI: 10.3390/ijerph20176658] [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] [Received: 06/27/2023] [Revised: 08/02/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
The purpose of this study is to describe sleep, PA, and screen time behaviors among rural American Indian (AI) youth, stratified by sex and grade, to better understand how to address these health behaviors in AI youth. Body composition, a screen time survey, and demographic information were collected from 65 AI youth. Accelerometers were worn for 7 days. Sixty percent were overweight or obese. Sleep did not differ by sex or grade, with an actigraphy-based total sleep time (aTST) of 7.8 h per night. Boys had significantly more light PA (p = 0.002) and vigorous PA (p = 0.01) compared to girls. Screen time did differ by sex but not by grade, with girls in the sixth and seventh grades reporting more screen time than boys, but boys in the eighth grade reporting more screen time than girls. Despite sex differences in screen time, high levels of screen time and obesity and low levels of PA and sleep are a concern in this population.
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Affiliation(s)
- Vernon Grant
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT 59718, USA
| | - Francine C. Gachupin
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85716, USA;
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Grant V, Mekiana D, Philip J. Physical Activity, Sleep, and Demographic Patterns in Alaska Native Children and Youth Living in Anaktuvuk Pass. YOUTH (BASEL, SWITZERLAND) 2023; 3:321-334. [PMID: 38084312 PMCID: PMC10712412 DOI: 10.3390/youth3010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Physical activity (PA), sleep, and weight are important factors for youth health. However, data about these factors are unknown in youth living in isolated Alaska Native communities. This study aims to assess PA, sleep, height and weight in elementary through high school students living in Anaktuvuk Pass. Fourteen children (<12) and 24 youths (12-20) volunteered to participate in this study. PA and sleep data were collected with actigraphy. Height and weight were assessed with standard procedures. Demographics were collected via survey. Results show that 10.53% and 18.42% of participants were overweight and obese, respectively. Average bedtime was 00:15 am and wake time 08:23 am. Total sleep time was 498.21 min. Participants averaged 477.64 min in sedentary activity, 297.29 min in light activity, 150.66 min in moderate activity, and 18.05 min in vigorous activity. Adjusted models suggest that high school students engage in significantly more sedentary activity, and significantly less light, moderate, and vigorous activity compared to those in middle and elementary school. All students engaged in less moderate and vigorous activity on the weekend compared to the weekday. Data suggest that as children age they become more sedentary. Future studies should focus on increasing daily PA in high school students while considering other obesogenic factors.
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Affiliation(s)
- Vernon Grant
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT 59717, USA
| | - Deborah Mekiana
- Alaska Native Studies, University of Alaska, Fairbanks, AK 99775, USA
| | - Jacques Philip
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK 99775, USA
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Juton C, Berruezo P, Rajmil L, Lerin C, Fíto M, Homs C, Según G, Gómez SF, Schröder H. Prospective Association between Adherence to the Mediterranean Diet and Health-Related Quality of Life in Spanish Children. Nutrients 2022; 14:nu14245304. [PMID: 36558466 PMCID: PMC9780882 DOI: 10.3390/nu14245304] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
Health-Related Quality of Life (HRQoL) is gaining attention in children and adolescents because it is an important outcome of their health status and well-being. Therefore, it is important to identify determinants for HRQoL. Currently, there is scarce and mainly cross-sectional evidence on the relationship between adherence to the Mediterranean diet and HRQoL in children and adolescents. Therefore, the objective of the present study was to assess the prospective association between adherence to the Mediterranean diet and HRQoL in Spanish children. The study was carried out in 1371 children aged 8 to 10 from different Catalan elementary schools with a medium follow-up of 15 months. The KidMed and KIDSCREEN-10 questionnaires were used to assess the relationship between diet and HRQoL, respectively. The KidMed score at baseline was positively associated with HRQoL (β = 0.320; 95% CI 0.101−0.540) after adjusting for confounders. Additionally, the logistic regression analysis showed positive associations between baseline consumption of fruit, vegetables, pulses, and high adherence to the Mediterranean diet and HRQoL at follow-up (p < 0.05 for all) while the consumption of fast-food, pasta or rice, baked good or pastries, and sweets were negatively correlated (p < 0.05 for all) with HRQoL at follow-up. In conclusion, adherence of the Mediterranean diet was predictive for HRQoL in Spanish children, but further prospective studies are needed to confirm this result.
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Affiliation(s)
- Charlotte Juton
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
| | - Paula Berruezo
- Gasol Foundation Europe, 08330 Sant Boi de Llobregat, Spain
| | - Luis Rajmil
- Pediatric and Public Health, 08023 Barcelona, Spain
| | - Carles Lerin
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Montserrat Fíto
- Cardiovascular Risk and Nutrition Research Group, IMIM Hospital del Mar Medical Research Institut, 08003 Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Clara Homs
- Gasol Foundation Europe, 08330 Sant Boi de Llobregat, Spain
- Global Research on Wellbeing (GRoW), Blanquerna Faculty of Health Sciences, Ramon Llull University, 08022 Barcelona, Spain
| | - Genís Según
- Gasol Foundation Europe, 08330 Sant Boi de Llobregat, Spain
| | - Santiago F. Gómez
- Gasol Foundation Europe, 08330 Sant Boi de Llobregat, Spain
- Cardiovascular Risk and Nutrition Research Group, IMIM Hospital del Mar Medical Research Institut, 08003 Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25008 Lleida, Spain
- Correspondence: (S.F.G.); (H.S.)
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group, IMIM Hospital del Mar Medical Research Institut, 08003 Barcelona, Spain
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25008 Lleida, Spain
- Correspondence: (S.F.G.); (H.S.)
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The importance of eating patterns for health-related quality of life among children aged 10-11 years in Alberta of Canada. Sci Rep 2022; 12:20885. [PMID: 36463245 PMCID: PMC9719497 DOI: 10.1038/s41598-022-23707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/03/2022] [Indexed: 12/04/2022] Open
Abstract
Children with unhealthy eating behaviours are more likely to experience poor physical and mental health. Few studies have investigated the importance of eating patterns for health-related quality of life (HRQoL) among children. This study aimed to identify common eating patterns, and their associations with HRQoL among Canadian children. Data were collected from 9150 grade five students (aged 10-11 years) in repeat cross-sectional population-based surveys in Alberta, Canada. Students' eating behaviours were analyzed using latent class analysis to identify the eating patterns. We applied multilevel multivariable logistic regression to examine the association of the eating patterns with HRQoL. We identified three groups of children with distinct eating patterns: eating healthy (52%), less healthy (31%) and unhealthy (17%). The first group had a higher proportion of students engaged in healthy eating behaviours. The unhealthy pattern group (third group) included a higher proportion of students with poor eating behaviours. Students' eating behaviours in the second group were healthier than the third group but less healthy than the first group. Children with unhealthy and less healthy patterns were more likely to experience lower HRQoL than children with the healthy pattern. Health promotion programs effective in improving healthy eating patterns may not only reduce the risk for chronic diseases in the long term, but also improve the HRQoL in the short term.
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Shi J, Wang X, Wu Q, Qin Z, Wang N, Qiao H, Xu F. The joint association of physical activity and sedentary behavior with health-related quality of life among children and adolescents in Mainland China. Front Public Health 2022; 10:1003358. [PMID: 36276385 PMCID: PMC9583141 DOI: 10.3389/fpubh.2022.1003358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/14/2022] [Indexed: 01/27/2023] Open
Abstract
Objectives The objective of this study was to investigate the joint association of physical activity (PA) and sedentary behavior (SB) with health-related quality of life (HRQoL) among children in Mainland China. Methods Children were randomly recruited from primary, junior, and senior high schools (graders 4-12) in Nanjing municipality of China in this cross-sectional survey in 2018. The outcome variable, HRQoL, was assessed using the validated Chinese version of Child Health Utility 9D (CHU9D-CHN) instrument. PA and SB were measured using a validated Physical Activity Scale and Food Frequency Questionnaire for Chinese school-aged children. The associations of PA and SB with HRQoL were assessed using mixed-effects linear regression models and reported as mean difference (MD) and 95% confidence interval (CI). Results Totally, 4,388 participants completed the survey (response rate = 97.6%). After adjustment for potential confounders and class-level clustering effects, relative to those with insufficient PA and prolonged SB, students with insufficient PA and shortened SB (MD = 0.054, 95%CI = 0.018, 0.089), or children with sufficient PA and prolonged SB (MD = 0.034, 95%CI = -0.030, 0.098), or students with sufficient PA and shortened SB (MD = 0.083, 95%CI = 0.045, 0.120), respectively, reported increased HRQoL scores. Conclusion PA was positively associated with HRQoL, and SB was in negative relation to HRQoL. Furthermore, sufficient PA and shortened SB might exert additive influence on HRQoL among children and adolescents in China. This study has public health implications that PA promotion and SB reduction are encouraged to be considered simultaneously for the purpose to maximally improve HRQoL in population-based behavior intervention campaigns among children and adolescents.
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Affiliation(s)
- Jun Shi
- Department of Emergency, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaorong Wang
- Department of Emergency, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qiong Wu
- Nanjing Municipal Health Institute for Primary and High School, Nanjing, China
| | - Zhenzhen Qin
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Na Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Huifen Qiao
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China,*Correspondence: Huifen Qiao
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China,Fei Xu
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Anthropometric, Lifestyle Characteristics, Adherence to the Mediterranean Diet, and COVID-19 Have a High Impact on the Greek Adolescents’ Health-Related Quality of Life. Foods 2022; 11:foods11182726. [PMID: 36140853 PMCID: PMC9497909 DOI: 10.3390/foods11182726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/20/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: The study aimed at analyzing the relationship between anthropometric characteristics, lifestyle, and dietary habits, as well as the burden of the pandemic on the health-related quality of life among Greek pupils. Research methods and procedures: On the whole, 2088 adolescents aged 12–18 years from Attica, Greece, were enlisted in this school-based cross-sectional study that took place in May–December 2021. Health-related quality of life was estimated through the KIDSCREEN-27 questionnaire, adherence to the Mediterranean diet—through the KIDMED test. For the empirical and econometric analyses, the Mann–Whitney U and Kruskal–Wallis means comparison tests were utilized; multiple linear regression was used accordingly. Results: The present study provides evidence to the fact that boys, younger adolescents, adolescents living with both parents and with highly educated mothers had a better health-related quality of life. Concerning their eating practices, positive predictors were consuming a better-quality breakfast, having all five meals daily, consuming lunch and dinner with parents, and higher adherence to the Mediterranean diet. Moreover, sufficient night sleep time, fewer hours spent on screen viewing, more frequent walks, and having hobbies were linked to the health-related quality of life with a positive sign. In contrast, negative predictors were higher body mass index and everyday life difficulties due to the COVID-19 pandemic crisis. Conclusions: Greek adolescents’ anthropometric characteristics, BMI, lifestyle and sedentary habits, eating habits, and adherence to the Mediterranean diet were significantly related to their perceived health-related quality of life during the pandemic.
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Chi S, Ko MS, Lee JH, Yi HS, Lee MS. Smartphone Usage and Sleep Quality in Korean Middle School Students During the COVID-19 Pandemic. Psychiatry Investig 2022; 19:722-728. [PMID: 36202107 PMCID: PMC9536879 DOI: 10.30773/pi.2022.0032] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/07/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study evaluated the quality of sleep and smartphone addiction in Korean adolescents during the coronavirus disease 19 pandemic and analyzed their effects on perceived quality of life. METHODS An online survey system provided by the Gwangmyeong City Health Center located in Gyeonggi-do, Korea, was completed by 1,678 local middle school students from April 1 to June 30, 2021. We measured quality of life using the KIDSCREEN-27 health-related quality of life questionnaire, quality of sleep using the Korean version of the Pittsburgh Sleep Quality Index, and smartphone addiction using the Smartphone Addiction Self-Diagnosis Scale. Bed times, wake times, and total sleep hours were also recorded. RESULTS Sleep quality and quantity were directly associated with smartphone addiction. The results indicated that lower quality of life was associated with lower sleep quality, delayed onset of sleep, shorter total sleep time, and higher smartphone addiction. Female students reported lower quality of life, lower sleep quality, delayed sleep phases, shorter total sleep hours, and higher smartphone addiction scores than did male students. CONCLUSION Our results suggest that adolescents' quality of life is threatened by poor sleep, which in turn could be due to unhealthy smartphone usage. Girls were more heavily affected by this trend than were boys. Preparations to intervene for further mental health issues that might follow are necessary.
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Affiliation(s)
- Suhyuk Chi
- Department of Psychiatry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Min-Soo Ko
- Department of Psychiatry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jong-Ha Lee
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Hyun-Suk Yi
- Gwangmyeong City Health Center, Gwangmyeong, Republic of Korea
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University Guro Hospital, Seoul, Republic of Korea.,Department of Life Sciences, Korea University, Seoul, Republic of Korea
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Magiera A, Pac A. Determinants of Quality of Life among Adolescents in the Małopolska Region, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148616. [PMID: 35886469 PMCID: PMC9316009 DOI: 10.3390/ijerph19148616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 12/10/2022]
Abstract
Knowledge about predictors associated with quality of life (QoL) in adolescents is important for public health. The aim of the study was to indicate determinants of the different dimensions of QoL in the fields of demographic, socio-economic factors, general health and lifestyle in a sample of Polish adolescents. The cross-sectional study was carried out in a southern region of Poland among 804 schoolchildren from junior high schools and upper secondary schools. The quality of life was measured using the Polish version of the KIDSCREEN-52 questionnaire. The author’s questionnaire concerning determinants of the adolescents’ quality of life was also used. In the analysis of the quality of life, standardized results on the European population (T-score) and categorization on the low, average and high quality of life were taken into account. Defining the possible determinants of the adolescents’ quality of life was made by the multivariate logistic regression models. The highest prevalence of low QoL was observed in the school environment (53.4%) and the psychological well-being (51.6%) dimensions of the KIDSCREEN-52. The factors that increased the risk of the low assessment of the quality of life were, inter alia, female sex for physical well-being, psychological well-being, self-perception, autonomy, parent relation and home life, and financial resources, higher school year for physical well-being, psychological well-being, moods and emotions (2nd grade of upper secondary school only), self-perception, social support and peers, and school environment, and dissatisfaction in appearance for physical well-being, psychological well-being, moods and emotions, self-perception, school environment, social acceptance and bullying.
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Papadaki S, Carayanni V. Health-related quality of life, Mediterranean diet, physical activity and socioeconomic factors of Greek adolescents during COVID-19: A cross sectional study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-220008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND: Health related quality of life of the adolescents during quarantine and social isolation potentially decreases, with significant alteration on physical activities and nutrition behaviour. OBJECTIVE: The present study investigates the relationship between Greek adolescents’ health related quality of life and socioeconomic factors, lifestyle and dietary characteristics, along with their adherence to the Mediterranean Diet immediately after the lockdown period in Greece. METHODS: A total sample of 459 students aged 12–16 years old were recruited from secondary schools in the area of Athens. The KIDSCREEN-27 questionnaire for children and adolescents, the KIDMED test, the Godin and Shephard Leisure Time Physical Activity Questionnaire and the Family Affluence Scale III, were used for the statistical analysis. T-tests, Kruskal Wallis, Chi-square, Anova tests and multiple regression analyses were employed. RESULTS: Econometric analysis reveals that adolescents’ health related quality of life is higher among boys, adolescents who live with both parents, tend to sleep more during night and do not spend many hours on screen viewing. Also, adolescents with higher family affluence level, being physically active and with a high adherence to the Mediterranean Diet have higher health related quality of life. CONCLUSIONS: Adolescents’ adherence to the Mediterranean Diet, physical activity, socioeconomic characteristics and life style behaviors are highly correlated with perceived health related quality of life during COVID-19 period.
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Affiliation(s)
- Stamatina Papadaki
- Department of Public and Community Health, University of West Attica, Athens, Greece
| | - Vilelmine Carayanni
- Department of Public and Community Health, University of West Attica, Athens, Greece
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15
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Niestrój-Jaworska M, Dębska-Janus M, Polechoński J, Tomik R. Health Behaviors and Health-Related Quality of Life in Female Medical Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073896. [PMID: 35409579 PMCID: PMC8997715 DOI: 10.3390/ijerph19073896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023]
Abstract
The aim of this study was to evaluate the relationship between the intensity of health behaviors and health-related quality of life in female mid-level medical staff. The study group consisted of 153 female mid-level medical staff members. The intensity of health behaviors was examined with the Polish version of Health Behavior Inventory. Health-related quality of life was verified with the Short Form Health Survey questionnaire (SF 36v2). Among the participants, 33% had low, 39% average, and 28% high intensity of health behaviors. The mental component of health-related quality of life was rated higher (83.3 ± 15.3 points) compared to the physical one. The lowest health-related quality of life was observed in the domain of “bodily pain”, while the highest was found for the domain of “social functioning”. Both the physical and mental components of health-related quality of life were significantly positively correlated with health behavior prevalence in all its categories. The post-hoc tests revealed the variation in physical and mental components of HRQoL according to the level of health behavior intensity.
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Affiliation(s)
- Maria Niestrój-Jaworska
- Department of Health-Related Physical Activity and Tourism, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland; (M.N.-J.); (R.T.)
| | - Małgorzata Dębska-Janus
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland;
- Correspondence:
| | - Jacek Polechoński
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland;
| | - Rajmund Tomik
- Department of Health-Related Physical Activity and Tourism, The Jerzy Kukuczka Academy of Physical Education in Katowice, 40-065 Katowice, Poland; (M.N.-J.); (R.T.)
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Onyimadu O, Violato M, Astbury NM, Jebb SA, Petrou S. Health Economic Aspects of Childhood Excess Weight: A Structured Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:461. [PMID: 35455505 PMCID: PMC9028108 DOI: 10.3390/children9040461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022]
Abstract
An economic perspective is crucial to understand the broad consequences of childhood excess weight (CEW). These can manifest in the form of elevated health care and societal costs, impaired health status, or inefficiencies in the allocation of resources targeted at its prevention, management, or treatment. Although existing systematic reviews provide summaries of distinct economic research strands covering CEW, they have a restricted focus that overlooks relevant evidence. The overarching aim of this structured review was to update and enhance recent key reviews of four strands of economic evidence in this area, namely, (1) economic costs associated with CEW, (2) health utilities associated with CEW, (3) economic evaluations of interventions targeting CEW, and (4) economic determinants and broader consequences of CEW. Our de novo searches identified six additional studies for the first research strand, five studies for the second, thirty-one for the third, and two for the fourth. Most studies were conducted in a small number of high-income countries. Our review highlights knowledge gaps across all the research strands. Evidence from this structured review can act as data input into future economic evaluations in this area and highlights areas where future economic research should be targeted.
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Affiliation(s)
- Olu Onyimadu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (O.O.); (N.M.A.); (S.A.J.)
| | - Mara Violato
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK;
| | - Nerys M. Astbury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (O.O.); (N.M.A.); (S.A.J.)
| | - Susan A. Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (O.O.); (N.M.A.); (S.A.J.)
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (O.O.); (N.M.A.); (S.A.J.)
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Zanganeh M, Adab P, Li B, Pallan M, Liu WJ, Rong L, Liu W, Martin J, Cheng KK, Frew E. Relationship Between Weight Status and Health-Related Quality of Life in School-age Children in China. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2022; 9:75-81. [PMID: 35342771 PMCID: PMC8901243 DOI: 10.36469/jheor.2022.32414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Abstract
Background: Some studies from high-income countries suggest that overweight and/or obesity in children are negatively associated with health-related quality of life (HRQOL). However, the relationship between weight status and HRQOL is not well established in China, where obesity trends follow a different pattern compared with high-income countries. The risk of obesity is greater in children from higher socioeconomic backgrounds and higher in boys compared with girls. Objective: The aim of this study was to examine the relationship between weight status and HRQOL in children between 6 and 7 years old in this unique country context. Methods: Baseline HRQOL and demographic data were collected from children recruited to the CHIRPY DRAGON obesity prevention trial in China. HRQOL was measured using the Chinese version of the Child Health Utility-9D (CHU-9D-CHN) and the Pediatric Quality of Life Inventory™ (PedsQL™) instruments. CHU-9D-CHN utility scores were generated using 2 scoring algorithms (UK and Chinese tariffs). Height and weight measures were taken at school by trained researchers using standardized methods, and BMI z scores were calculated using the World Health Organization 2007 growth charts. The relationship between HRQOL and weight status was examined using multivariable analyses, adjusting for age, gender, and socioeconomic status. Results: Full data were available for 1539 children (mean age, 6 years). In both unadjusted and adjusted analyses, HRQOL, using both the CHU-9D-CHN and the PedsQL™, was marginally higher in children who were overweight or living with obesity compared with children with healthy weight, although this difference did not reach statistical significance. Separate analyses and models by gender showed that the relationship between weight status and HRQOL scores was similar in boys and girls. Conclusions: Our results suggest no statistically significant difference in HRQOL between children with overweight/obesity compared with those with healthy weight. These results have implications for the methods of economic evaluation for obesity treatment and prevention interventions within this population cohort and country setting, as there appears to be no discernible consequences on children's HRQOL from living with overweight and obesity.
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Affiliation(s)
- Mandana Zanganeh
- Centre for Health Economics, Warwick Medical School, University of Warwick
| | - Peymané Adab
- Institute of Applied Health Research, University of Birmingham
| | - Bai Li
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol
| | - Miranda Pallan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham
| | - Wei J Liu
- School Health Unit, Centre for Disease Control and Prevention, Guangzhou, China
| | - Lin Rong
- School Health Unit, Centre for Disease Control and Prevention, Guangzhou, China
| | - Wei Liu
- School Health Unit, Centre for Disease Control and Prevention, Guangzhou, China
| | - James Martin
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham
| | - Kar K Cheng
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham
| | - Emma Frew
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham
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18
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Qiao H, Wang X, Qin Z, Wang N, Zhang N, Xu F. The relationship between health literacy and health-related quality of life among school-aged children in regional China. Health Qual Life Outcomes 2021; 19:262. [PMID: 34823540 PMCID: PMC8620561 DOI: 10.1186/s12955-021-01895-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/16/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives To examine the association between health literacy (HL) and health-related quality of life (HRQoL) among primary and high school students in Nanjing, China. Methods A cross-sectional study was conducted among randomly selected primary (graders 4–6), junior (graders 7–9) and senior (graders 10–12) high school students in 2018 in Nanjing Municipality of China. HRQoL, the outcome variable, was assessed with the validated Chinese version of Child Health Utility 9D (CHU9D) and used as continuous variable, while HL, our independent variable, was measured with the validated Chinese Students’ Health literacy Assessment Scale and treated as categorical variable (“adequate” or “inadequate”) in the analysis. Mixed-effects linear regression models were introduced to calculate mean difference and 95% confidence interval (CI) for examining the association between HL and HRQoL. Results Totally, 4388 of 4498 students completed the survey. Among these responders, the mean score of CHU9D was 0.78 ± 0.17, and the proportion of participants with adequate HL was 85.8% (95% CI = 84.7%, 86.8%). After adjustment for potential confounders and class-level clustering effects, participants who had adequate HL were observed having, on average, an elevated HRQoL score of 0.08 (95% CI = 0.06, 0.11) units compared to their counterparts with inadequate HL. Such a positive HL-HRQoL association was also identified among each stratum of participants’ age, gender and residence. Conclusions HL was positively associated with HRQoL score among primary and high school students in China. It has public health implications that HRQoL may be improved through school-based health literacy intervention among children and adolescents in China.
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Affiliation(s)
- Huifen Qiao
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, 210029, Nanjing, China
| | - Xiaorong Wang
- Department of Pediatric Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Zhenzhen Qin
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Na Wang
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, 210029, Nanjing, China.
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China. .,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
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19
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Buckell J, Mei XW, Clarke P, Aveyard P, Jebb SA. Weight loss interventions on health-related quality of life in those with moderate to severe obesity: Findings from an individual patient data meta-analysis of randomized trials. Obes Rev 2021; 22:e13317. [PMID: 34374197 DOI: 10.1111/obr.13317] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
The relationship between BMI and health-related quality of life (HRQoL) critically affects regulatory approval of interventions for weight loss, but evidence of the association is inconsistent. A higher standard of evidence than that available was sought with an IPD meta-analysis of 10,884 people enrolled in five randomized controlled trials of intentional weight loss interventions. Cross-sectional and longitudinal associations of BMI and HRQoL were estimated in mixed effects models specifying a latent variable for HRQoL. Spline regressions captured nonlinear associations across the range of BMI. In cross-sectional spline regressions, BMI was not associated with HRQoL for people with a BMI < 30 kg/m2 but was for those with a higher BMI. In longitudinal spline regressions, decreases in BMI were positively associated with HRQoL for people with a BMI ≥ 25 kg/m2 . The impact of change in BMI was larger for people with higher BMIs than for those with BMIs under 30 kg/m2 . Lower BMI and decreases in BMI were related to higher HRQoL for people living with obesity but not in the population without excess weight. HRQoL gains from weight loss are greater for more severe obesity. Commissioners should use these estimates for future decision making.
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Affiliation(s)
- John Buckell
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xue W Mei
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Philip Clarke
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Aveyard
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
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Health Promotion through Movement Behaviors and Its Relationship with Quality of Life in Spanish High School Adolescents: A Predictive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147550. [PMID: 34299997 PMCID: PMC8303880 DOI: 10.3390/ijerph18147550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/04/2021] [Accepted: 07/13/2021] [Indexed: 12/12/2022]
Abstract
A growing number of studies have highlighted the health benefits of high physical activity, low screen time, and optimal sleep duration among school-age children and adolescents. Objective: The present study proposes to examine the individual and combined association between movement behaviors (physical activity, screen time, and sleep time) and quality of life in boys and girls. Method: A total of 319 Spanish primary and secondary school students participated in the study. Physical activity, screen time, sleep duration, and quality of life were evaluated. Results: Descriptive, correlation, and regression analyses were carried out in order to improve knowledge about health-related behaviors for all participants. The results found significant positive associations between physical activities and sleep time with quality of life. Finally, the regression models showed that physical activity scores predict quality of life, especially in children. It is concluded that movement behaviors are important in association with quality of life. Likewise, the impact of physical activity on the quality of life is highlighted as the main behavior in the prediction of the quality of life for a population of school adolescents.
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21
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Martins E, Fernandes R, Mendes F, Magalhães C, Araújo P. Food intake, physical activity and quality of life among children and youth. Work 2021; 69:475-484. [PMID: 34120928 DOI: 10.3233/wor-213492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The health-related quality of life construct (QoL) implies a relationship with eating habits (EA) and physical activity (PA). Sociodemographic and anthropometric variables (gender, age and Body Mass Index - BMI) are highlighted in the definition of healthy lifestyle habits promotion strategies. OBJECTIVE We aim to characterize and relate PA, EA and QoL in children/youth and explore gender, age and BMI influences. METHODS It is a non-experimental study, with 337 children/youth, ages between 8 and 17 years (12.61±2.96), mostly from the rural inland of Portugal. In data collection we used a sociodemographic and anthropometric questionnaire, a weekly register table of EA and Kid-Kindl (QoL). Statistical analysis (p < 0.05) were performed in SPSS-IBM 25. RESULTS Lower BMI was associated with better EA (p < 0.001), PA (p < 0.05) and self-esteem (p < 0.01) and worse scores on family subscale of QoL. Female showed higher fruit intake (p < 0.05). The older has shown better results. PA is positively correlated with QoL (p < 0.01) and EA (p < 0.05). CONCLUSIONS It is important to explore other relevant social and family dimensions, to promote intervention programs with parents, school and community, as well as healthy practices policies. The intervention in these age groups is critical for a longer-term impact in improving healthy life habits.
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Affiliation(s)
| | | | | | | | - Patrícia Araújo
- Ipam/Universidade Europeia -Laureate International Universities, Lisbon, Portugal
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22
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Shearer NJ, Gillespie AN, Olds TS, Mensah FK, Edwards B, Fernando JW, Wang Y, Wake M, Lycett K. Insights into adolescent well-being from computerised analysis of written language. Acta Paediatr 2021; 110:1880-1889. [PMID: 33608941 DOI: 10.1111/apa.15813] [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: 05/27/2020] [Revised: 01/12/2021] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
AIM To examine associations between patterns of language use and early adolescent well-being. METHODS Participants were 1763 Australian 11- to 12-year-olds in the Child Health CheckPoint. Six patterns of language use were identified from a writing activity using Linguistic Inquiry and Word Count and factor analysis: Acting in the present and future, Positive emotion, Gender and relationships, Self-aware, Inquisitive and time focused, and Confident. Well-being measures represented a spectrum from negatively to positively framed psychosocial health. Associations between language use and well-being were estimated using linear regression adjusted for age, sex and social disadvantage. RESULTS Positive emotion (high emotional tone, positive emotion) was associated with better general well-being (standardised regression coefficient (SRC) 0.05; 95% confidence interval 0.00 to 0.11; p = 0.04), life satisfaction (0.06; 0.01 to 0.11; p = 0.03), psychosocial health (0.07; 0.02 to 0.12; p = 0.01) and quality of life (QoL) (0.06; 0.01 to 0.11; p = 0.02). Similarly, Self-aware (high first person singular pronouns, authentic, low clout) was associated with better general well-being, life satisfaction and psychosocial health (SRC 0.05, 0.09, 0.08), but Confident (high clout, first person plural pronouns, affiliation) was associated with worse life satisfaction, psychosocial health and QoL (SRC -0.06, -0.09, -0.06). CONCLUSION If replicated in 'real-world' settings (e.g., social media), language patterns could provide naturalistic insights into early adolescents' well-being.
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Affiliation(s)
- Natalie J. Shearer
- Royal Children's Hospital Melbourne Victoria Australia
- Deakin University Melbourne Victoria Australia
- Murdoch Children's Research Institute Melbourne Victoria Australia
| | - Alanna N. Gillespie
- Murdoch Children's Research Institute Melbourne Victoria Australia
- Department of Paediatrics The University of Melbourne Melbourne Victoria Australia
| | - Tim S. Olds
- Murdoch Children's Research Institute Melbourne Victoria Australia
- Alliance for Research in Exercise, Nutrition and Activity University of South Australia Adelaide South Australia Australia
| | - Fiona K. Mensah
- Royal Children's Hospital Melbourne Victoria Australia
- Murdoch Children's Research Institute Melbourne Victoria Australia
- Department of Paediatrics The University of Melbourne Melbourne Victoria Australia
| | - Ben Edwards
- Centre for Social Research and Methods The Australian National University Canberra Australian Capital Territory Australia
| | | | - Yichao Wang
- Murdoch Children's Research Institute Melbourne Victoria Australia
- Department of Paediatrics The University of Melbourne Melbourne Victoria Australia
| | - Melissa Wake
- Murdoch Children's Research Institute Melbourne Victoria Australia
- Department of Paediatrics The University of Melbourne Melbourne Victoria Australia
- The Liggins Institute The University of Auckland Auckland New Zealand
| | - Kate Lycett
- Deakin University Melbourne Victoria Australia
- Murdoch Children's Research Institute Melbourne Victoria Australia
- Department of Paediatrics The University of Melbourne Melbourne Victoria Australia
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Wong CKH, Wong RS, Cheung JPY, Tung KTS, Yam JCS, Rich M, Fu KW, Cheung PWH, Luo N, Au CH, Zhang A, Wong WHS, Fan J, Lam CLK, Ip P. Impact of sleep duration, physical activity, and screen time on health-related quality of life in children and adolescents. Health Qual Life Outcomes 2021; 19:145. [PMID: 33980245 PMCID: PMC8117552 DOI: 10.1186/s12955-021-01776-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/21/2021] [Indexed: 11/26/2022] Open
Abstract
Background Existing studies on health-related quality of life (HRQoL) mainly covered single growth stages of childhood or adolescence and did not report on the trends in the relationships of HRQoL with sleep duration, physical activity, and screen time. This study aimed to establish the population norm of HRQoL in children and adolescents aged 6–17 years and examine the associations of screen time, sleep duration, and physical activity with HRQoL in this population. Methods We conducted a large-scale cross-sectional population-based survey study of Hong Kong children and adolescents aged 6 to 17 years. A representative sample of students were interviewed to assess their HRQoL using PedsQL and EQ-5D-Y-5L. Multivariable homoscedastic Tobit regression with linear form or restricted cubic spline of predictors was used to analyze the associations between screen time, sleep duration, and HRQoL. Multiple imputation by chained equations was performed to deal with missing data. Results A total of 7555 respondents (mean age 11.5, SD 3.2; 55.1% female) were sampled. Their EQ VAS scores, PedsQL physical summary scores, and psychosocial summary scores were positively correlated with sleep duration and moderate/vigorous activity but was negatively correlated with screen time. Conclusions Children and adolescents who had longer exposure to screen, shorter sleep duration, and lower physical activity levels appeared to have poorer HRQoL as assessed by PedsQL and EQ-5D-Y-5L. Advice and guidance on screen time allocation for children and adolescents should be provided at the levels of school, community, and family.
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Affiliation(s)
- Carlos K H Wong
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.,Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Rosa S Wong
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Room 115, 1/F, New Clinical Building, 102 Pokfulam Road, Queen Mary Hospital, Hong Kong, SAR, China
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Keith T S Tung
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Room 115, 1/F, New Clinical Building, 102 Pokfulam Road, Queen Mary Hospital, Hong Kong, SAR, China
| | - Jason C S Yam
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Michael Rich
- Center on Media and Child Health, BCH3186, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - King-Wa Fu
- Journalism and Media Studies Centre, The University of Hong Kong, Hong Kong, China
| | - Prudence W H Cheung
- Department of Orthopaedics and Traumatology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Chi Ho Au
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Ada Zhang
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Wilfred H S Wong
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Room 115, 1/F, New Clinical Building, 102 Pokfulam Road, Queen Mary Hospital, Hong Kong, SAR, China
| | - Jiang Fan
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Cindy L K Lam
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Room 115, 1/F, New Clinical Building, 102 Pokfulam Road, Queen Mary Hospital, Hong Kong, SAR, China.
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Qin Z, Wang N, Ware RS, Sha Y, Xu F. Lifestyle-related behaviors and health-related quality of life among children and adolescents in China. Health Qual Life Outcomes 2021; 19:8. [PMID: 33407589 PMCID: PMC7788787 DOI: 10.1186/s12955-020-01657-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/21/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To investigate associations of five typical lifestyle-related behavioral risk factors (insufficient physical activity, prolonged screen viewing, deprived sleeping, consumption of fast food and sugar-sweetened beverage) with health-related quality of life (HRQoL) among school students in China. METHODS Students aged 9-17 years (grades 4-12) were randomly selected from primary and high schools in Nanjing, China, to participate in this cross-sectional study in 2018. The outcome variable, HRQoL, was assessed using the Child Health Utility 9D (CHU9D) instrument and scored from 0 (worst) to 1 (best). Physical activity (including screen viewing and sleeping) and dietary intake were measured using a validated Physical Activity Scale and Food Frequency Questionnaire, respectively. Lifestyle-related behaviors were categorized as sufficient/insufficient or no/yes, and their associations with HRQoL were assessed using mixed-effects linear regression models. RESULTS Overall, 4388 participants completed the questionnaire (response rate = 97.6%). Students with insufficient physical activity [mean difference (MD) = - 0.03; 95% confidence interval (CI) = - 0.04, - 0.01], prolonged screen time (MD = - 0.06; 95% CI = - 0.07, - 0.04), insufficient sleeping time (MD = - 0.04; 95% CI = - 0.07, - 0.02), consumption of sugar-sweetened beverage (MD = - 0.02; 95% CI = - 0.03, - 0.01) or fast food intake (MD = - 0.03; 95% CI = - 0.04, - 0.02) reported significantly lower HRQoL scores. When considered additively, each additional lifestyle-related risk factor was associated with an average decrease of 0.03 units (95% CI: - 0.03, - 0.02) CHU9D score. CONCLUSIONS For Chinese students, HRQoL was positively associated with physical activity and sleep duration, but negatively with screen time and consumption of sugar-sweetened beverage and fast food. Moreover, lifestyle-related behaviors may have an additive effect on HRQoL.
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Affiliation(s)
- Zhenzhen Qin
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Na Wang
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Yugen Sha
- Department of Nephrology, Children's Hospital of Nanjing Medical University, 72, Guangzhou Road, Nanjing, 210008, China.
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China. .,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
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25
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Qi S, Qin Z, Wang N, Tse LA, Qiao H, Xu F. Association of academic performance, general health with health-related quality of life in primary and high school students in China. Health Qual Life Outcomes 2020; 18:339. [PMID: 33046101 PMCID: PMC7552487 DOI: 10.1186/s12955-020-01590-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To explore the association of academic performance and general health status with health-related quality of life (HRQoL) in school-aged children and adolescents in China. Methods In this cross-sectional study conducted in 2018, students (grade 4–12) were randomly chosen from primary and high schools in Nanjing, China. HRQoL, the outcome measure, was recorded using the Child Health Utility 9D, while self-rated academic performance and general health were the independent variables. Mixed-effects regression models were applied to compute mean difference (MD) and 95% confidence interval (CI) of HRQoL utility score between students with different levels of academic performance and general health. Results Totally, 4388 participants completed the study, with a response rate of 97.6%. The mean HRQoL utility score was 0.78 (SD: 0.17). After adjustment for socio-demographic attributes, physical activity, sedentary behavior, dietary patterns, body weight status and class-level clustering effects, students with fair (MD = 0.048, 95% CI 0.019, 0.078) and good (MD = 0.082, 95% CI 0.053, 0.112) self-rated academic performance reported higher HRQoL utility scores than those with poor academic performance, respectively. Meanwhile, students with fair (MD = 0.119, 95% CI 0.083, 0.154) and good (MD = 0.183, 95% CI 0.148, 0.218) self-assessed general health also recorded higher HRQoL utility scores than those with poor health, separately. Consistent findings were observed for participants by gender, school type and residential location. Conclusions Both self-rated academic performance and general health status were positively associated with HRQoL among Chinese students, and such relationships were independent of lifestyle-related behaviors and body weight status.
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Affiliation(s)
- Shengxiang Qi
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Zhenzhen Qin
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Na Wang
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Lap Ah Tse
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Huifen Qiao
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, Nanjing, 210029, China.
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China. .,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
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Gall S, Walter C, du Randt R, Adams L, Joubert N, Müller I, Nqweniso S, Pühse U, Seelig H, Smith D, Steinmann P, Utzinger J, Gerber M. Changes in Self-Reported Physical Activity Predict Health-Related Quality of Life Among South African Schoolchildren: Findings From the DASH Intervention Trial. Front Public Health 2020; 8:492618. [PMID: 33102419 PMCID: PMC7555690 DOI: 10.3389/fpubh.2020.492618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/28/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: Regular physical activity is associated with multiple health benefits for children. Evidence from cross-sectional studies suggests that physical activity is positively associated with health-related quality of life (HRQoL). The promotion of physical activity, and hence HRQoL, through a school-based intervention is therefore an important endeavor, particularly in disadvantaged areas of low- and middle-income countries, including South Africa. Methods: We designed a multicomponent physical activity intervention that was implemented over a 20-week period in 2015 in eight disadvantaged primary schools of Port Elizabeth, South Africa. Overall, 758 children aged 8–13 years participated. HRQoL was measured with the 27-item KIDSCREEN questionnaire. Self-reported physical activity was assessed with a single item of the Health-Behavior of School-Aged Children test, and cardiorespiratory fitness with the 20-m shuttle run test. Post-intervention scores were predicted with mixed linear regression models, taking into consideration the clustered nature of the data. Results: Higher baseline levels as well as increasing levels of self-reported physical activity predicted all dimensions of children's HRQoL. Baseline levels and increases in cardiorespiratory fitness predicted children's self-perceived physical well-being (one of the HRQoL subscales). Participation in the multicomponent physical activity intervention did not affect children's HRQoL. Conclusion: Higher and increasing self-reported physical activity predict all assessed HRQoL dimensions, which underlines that the promotion of regular physical activity among children living in disadvantaged settings is an important public health measure. Policy makers should encourage schools to create physical activity friendly environments, while schools should implement regular physical education as proposed by the school curriculum.
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Affiliation(s)
- Stefanie Gall
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Nandi Joubert
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Danielle Smith
- Department of Human Movement Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Oswald TK, Rumbold AR, Kedzior SGE, Moore VM. Psychological impacts of "screen time" and "green time" for children and adolescents: A systematic scoping review. PLoS One 2020; 15:e0237725. [PMID: 32886665 PMCID: PMC7473739 DOI: 10.1371/journal.pone.0237725] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/31/2020] [Indexed: 12/14/2022] Open
Abstract
Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5-11 years), early adolescents (12-14 years), and older adolescents (15-18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.
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Affiliation(s)
- Tassia K. Oswald
- School of Public Health, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Alice R. Rumbold
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sophie G. E. Kedzior
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Vivienne M. Moore
- School of Public Health, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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Ananthapavan J, Sacks G, Brown V, Moodie M, Nguyen P, Veerman L, Mantilla Herrera AM, Lal A, Peeters A, Carter R. Priority-setting for obesity prevention-The Assessing Cost-Effectiveness of obesity prevention policies in Australia (ACE-Obesity Policy) study. PLoS One 2020; 15:e0234804. [PMID: 32559212 PMCID: PMC7304600 DOI: 10.1371/journal.pone.0234804] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/02/2020] [Indexed: 12/27/2022] Open
Abstract
The aim of the ACE-Obesity Policy study was to assess the economic credentials of a suite of obesity prevention policies across multiple sectors and areas of governance for the Australian setting. The study aimed to place the cost-effectiveness results within a broad decision-making context by providing an assessment of the key considerations for policy implementation. The Assessing Cost-Effectiveness (ACE) approach to priority-setting was used. Systematic literature reviews were undertaken to assess the evidence of intervention effectiveness on body mass index and/or physical activity for selected interventions. A standardised evaluation framework was used to assess the cost-effectiveness of each intervention compared to a 'no intervention' comparator, from a limited societal perspective. A multi-state life table Markov cohort model was used to estimate the long-term health impacts (quantified as health adjusted life years (HALYs)) and health care cost-savings resulting from each intervention. In addition to the technical cost-effectiveness results, qualitative assessments of implementation considerations were undertaken. All 16 interventions evaluated were found to be cost-effective (using a willingness-to-pay threshold of AUD50,000 per HALY gained). Eleven interventions were dominant (health promoting and cost-saving). The incremental cost-effectiveness ratio for the non-dominant interventions ranged from AUD1,728 to 28,703 per HALY gained. Regulatory interventions tended to rank higher on their cost-effectiveness results, driven by lower implementation costs. However, the program-based policy interventions were generally based on higher quality evidence of intervention effectiveness. This comparative analysis of the economic credentials of obesity prevention policies for Australia indicates that there are a broad range of policies that are likely to be cost-effective, although policy options vary in strength of evidence for effectiveness, affordability, feasibility, acceptability to stakeholders, equity impact and sustainability. Implementation of these policies will require sustained co-ordination across jurisdictions and multiple government sectors in order to generate the predicted health benefits for the Australian population.
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Affiliation(s)
- Jaithri Ananthapavan
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gary Sacks
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Vicki Brown
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Marj Moodie
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Phuong Nguyen
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Lennert Veerman
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Ana Maria Mantilla Herrera
- Queensland Centre for Mental Health Research, Brisbane, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Anita Lal
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Rob Carter
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
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Killedar A, Lung T, Petrou S, Teixeira-Pinto A, Hayes A. Estimating Age- and Sex-Specific Utility Values from the CHU9D Associated with Child and Adolescent BMI z-Score. PHARMACOECONOMICS 2020; 38:375-384. [PMID: 31814078 DOI: 10.1007/s40273-019-00866-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Our objective was to identify age- and sex-specific utilities for children and adolescents by body mass index (BMI) z-score. METHODS We used data from 6822 participants and 12,094 observations from two cohorts and two waves of interviews from the Longitudinal Study of Australian Children. We fit linear models using generalised estimating equations to investigate associations between Child Health Utility 9D and BMI z-score in girls and boys aged 10-17 years. We initially fit models for each sex, fully adjusted for known predictors of health-related quality of life, including socioeconomic position, long-term medical condition and maternal smoking status and also included an interaction between age and BMI z-score to examine age-specific effects. Finally, we derived a minimal model for each sex by eliminating interaction terms with P > 0.01 and predictors with P > 0.05. RESULTS Our adjusted results show different utility patterns in girls and boys. In girls, utility decrements for each unit increase in BMI z-score changed with age (P < 0.01 for interaction between age and BMI z-score). At age 10 years, the mean utility decrement for each unit increase in BMI z-score was 0.002 (95% confidence interval [CI] 0.011 decrement to 0.006 increment), but, by age 17 years, this utility decrement was 0.023 (95% CI 0.013 to 0.032). In boys, small non-significant decrements were found in utility for each unit increase in BMI z-score, with no observable change with age. CONCLUSION Our analyses demonstrated that age and sex should be considered when attributing utility values and decrements to BMI z-scores.
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Affiliation(s)
- Anagha Killedar
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Thomas Lung
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Armando Teixeira-Pinto
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
| | - Alison Hayes
- Faculty of Medicine and Health, School of Public Health, Edward Ford Building A27, University of Sydney, Sydney, NSW, 2006, Australia
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Lal A, Peeters A, Brown V, Nguyen P, Tran HNQ, Nguyen T, Tonmukayakul U, Sacks G, Calache H, Martin J, Moodie M, Ananthapavan J. The Modelled Population Obesity-Related Health Benefits of Reducing Consumption of Discretionary Foods in Australia. Nutrients 2020; 12:E649. [PMID: 32121199 PMCID: PMC7146305 DOI: 10.3390/nu12030649] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/25/2020] [Indexed: 11/16/2022] Open
Abstract
Over one third of Australians' daily energy intake is from discretionary foods and drinks. While many health promotion efforts seek to limit discretionary food intake, the population health impact of reductions in the consumption of different types of discretionary foods (e.g., sugar-sweetened beverages (SSBs), confectionery, sweet biscuits) has not been quantified. This study estimated the potential reductions in body weight, obesity-related disease incidence, and healthcare cost savings associated with consumption of one less serving per week of different discretionary foods. Reductions in the different types of discretionary food were modelled individually to estimate the impact on energy consumption and population body weight by 5-year age and sex groups. It was assumed that one serving of discretionary food each week was replaced with either a serving of fruit or popcorn, and a serving (375 mL) of SSBs was replaced with coffee, tea, or milk. Proportional multi-state multiple-cohort Markov modelling estimated likely resultant health adjusted life years (HALYs) gained and healthcare costs saved over the lifetime of the 2010 Australian population. A reduction of one serving of SSBs (375 mL) had the greatest potential impact in terms of weight reduction, particularly in ages 19-24 years (mean 0.31 kg, 95% UI: 0.23 kg to 0.37 kg) and overall healthcare cost savings of AUD 793.4 million (95% UI: 589.1 M to 976.1 M). A decrease of one serving of sweet biscuits had the second largest potential impact on weight change overall, with healthcare cost savings of $640.7 M (95% CI: $402.6 M to $885.8 M) and the largest potential weight reduction amongst those aged 75 years and over (mean 0.21 kg, 95% UI: 0.14 kg to 0.27 kg). The results demonstrate that small reductions in discretionary food consumption are likely to have substantial health benefits at the population level. Moreover, the study highlights that policy responses to improve population diets may need to be tailored to target different types of foods for different population groups.
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Affiliation(s)
- Anita Lal
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Anna Peeters
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Vicki Brown
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Phuong Nguyen
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Huong Ngoc Quynh Tran
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Tan Nguyen
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Utsana Tonmukayakul
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Hanny Calache
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Jane Martin
- Obesity Policy Coalition, Cancer Council Victoria, Melbourne, VIC 3004, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia
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Gu X, Zhang T, Chen S, Keller MJ, Zhang X. School-Based Sedentary Behavior, Physical Activity, and Health-Related Outcomes among Hispanic Children in the United States: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041197. [PMID: 32069928 PMCID: PMC7068440 DOI: 10.3390/ijerph17041197] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 01/18/2023]
Abstract
The main purpose of this study was to examine the relationships between school-based sedentary behavior, physical activity, and health-related outcomes, including cardiorespiratory fitness, weight status, and health-related quality of life (HRQOL) among Hispanic children. The participants were 374 children (192 boys, 182 girls; Mage = 9.64) recruited from four elementary schools from 3rd grade through to 5th grade. Sedentary behavior and physical activity behaviors (light physical activity [LPA] and moderate-to-vigorous physical activity (MVPA)) during school were measured by accelerometers. Cardiorespiratory fitness and weight status were measured using the FITNESSGRAM®, while HRQOL was measured using the PedsQL 4.0TM Spanish version, a validated questionnaire. Sedentary behavior was negatively correlated with cardiorespiratory fitness and HRQOL but positively associated with weight status. MVPA was positively correlated with cardiorespiratory fitness and HRQOL, but negatively associated with weight status and sedentary behavior. Multiple regressions demonstrated that sedentary behavior significantly predicted cardiorespiratory fitness and weight status, whereas MVPA significantly predicted HRQOL. With the current public health priority aiming to reduce health disparities in minority populations, the findings of this study provide important insights. Educators, health care providers, or other professionals working with Hispanic children are encouraged to focus on reducing sedentary behavior and promoting physical activity to improve their health-related outcomes.
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Affiliation(s)
- Xiangli Gu
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA; (X.G.); (X.Z.)
| | - Tao Zhang
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, TX 76262, USA;
- Correspondence:
| | - Senlin Chen
- School of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA;
| | - M Jean Keller
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, TX 76262, USA;
| | - Xiaoxia Zhang
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA; (X.G.); (X.Z.)
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Moeijes J, van Busschbach JT, Bosscher RJ, Twisk JWR. Sports participation and health-related quality of life: a longitudinal observational study in children. Qual Life Res 2019; 28:2453-2469. [PMID: 31161332 PMCID: PMC6698265 DOI: 10.1007/s11136-019-02219-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE In this study, longitudinal associations between sports participation and health-related quality of life (HRQoL) were explored. Sports participation was operationalized as membership of a sports club, frequency of sports participation, performing individual versus team sports and performing indoor versus outdoor sports. The concept of HRQoL referred to the self-perceived enjoyment and satisfaction with one's personal health situation. METHODS Data from 618 fourth-grade primary school children were included at baseline; 10-13 months later, 417 children (response rate 67.5%) were retained. At both time points, children reported on sports participation (Move and Sports Monitor Questionnaire-youth aged 8-12 years) and health-related quality of life (KIDSCREEN-52). Because of the clustering of children in schools, data were analysed using linear mixed models. Analyses were adjusted for sex, age, BMI, household composition, SES and frequency of sports participation. RESULTS The questionnaires were fully completed by 417 children. High sports-active children showed better scores on almost all dimensions of HRQoL than moderate [difference (B) = - 1.82 (p = 0.05) to - 1.51 (p = 0.05)] or low ports-active children [difference (B) = - 3.67 (p < 0.001) to - 1.95 (p = 0.03)] and non-sports club members [difference (B) = - 5.58 (p < 0.001) to - 2.65 (p = 0.02)]. Unlike frequency, the other examined characteristics of sports participation were only to a limited extent longitudinal associated with HRQoL. CONCLUSION As frequency is more relevant than the form of sports participation, children should be encouraged to perform any kind of sports activity on a very regular base.
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Affiliation(s)
- Janet Moeijes
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Jooske T. van Busschbach
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands
| | - Ruud J. Bosscher
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, 8017 CA Zwolle, The Netherlands
| | - Jos W. R. Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Fernandez-Jimenez R, Santos-Beneit G, Tresserra-Rimbau A, Bodega P, de Miguel M, de Cos-Gandoy A, Rodríguez C, Carral V, Orrit X, Haro D, Carvajal I, Ibañez B, Storniolo C, Domènech M, Estruch R, Fernández-Alvira JM, Lamuela-Raventós RM, Fuster V. Rationale and design of the school-based SI! Program to face obesity and promote health among Spanish adolescents: A cluster-randomized controlled trial. Am Heart J 2019; 215:27-40. [PMID: 31277052 DOI: 10.1016/j.ahj.2019.03.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/28/2019] [Indexed: 12/18/2022]
Abstract
Unhealthy habits in adolescents are increasing at an alarming rate. The school offers a promising environment in which to implement effective preventive strategies to improve adolescents' lifestyle behaviors. The SI! Program is a multilevel multicomponent school-based health-promotion intervention aimed at all stages of compulsory education in Spain. We present the study design of the SI! Program for Secondary Schools, targeting adolescents aged 12 to 16 years. AIM The main goal of this study is to evaluate the impact of the SI! Program educational intervention on adolescent lifestyle behaviors and health parameters. METHODS The study was designed as a cluster-randomized controlled intervention trial and enrolled 1326 adolescents from 24 public secondary schools in Spain, together with their parents/caregivers. Schools and their students were randomly assigned to the intervention group (the SI! curriculum-based educational program over 2 or 4 academic years) or to the control group (usual curriculum). The primary endpoint will be the change from baseline at 2-year and 4-year follow-up in the composite Ideal Cardiovascular Health (ICH) score, consisting of four health behaviors (body mass index, dietary habits, physical activity, and smoking) and three health factors (blood pressure, total cholesterol, and glucose). Secondary endpoints will include 2-year and 4-year changes from baseline in ICH score subcomponents, the Fuster-BEWAT health scale, adiposity markers (waist circumference and body composition), polyphenol and carotenoid intake, and emotion management. DISCUSSION The overarching goal of the SI! Program is to instill healthy behaviors in children and adolescents that can be sustained into adulthood. The SI! Program for Secondary School is a comprehensive health-promotion intervention targeting 12-16-year-old adolescents and their immediate environment. The present study addresses the optimal timing and impact of the educational intervention on health in adolescence.
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Affiliation(s)
- Rodrigo Fernandez-Jimenez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Centro de Investigación Biomédica En Red en enfermedades CardioVasculares (CIBERCV), Madrid, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Gloria Santos-Beneit
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Pere Virgili Health Research Center, Universitat Rovira i Virgili, Reus, Spain; Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain
| | - Patricia Bodega
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Mercedes de Miguel
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Amaya de Cos-Gandoy
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Carla Rodríguez
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Vanesa Carral
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Xavier Orrit
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Domènech Haro
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Isabel Carvajal
- Foundation for Science, Health and Education (SHE), Barcelona, Spain
| | - Borja Ibañez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Centro de Investigación Biomédica En Red en enfermedades CardioVasculares (CIBERCV), Madrid, Spain; IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain
| | - Carolina Storniolo
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, XaRTA, INSA, University of Barcelona, Barcelona, Spain
| | - Mónica Domènech
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ramon Estruch
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Rosa Maria Lamuela-Raventós
- Biomedical Research Networking Center-Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Government of Spain, Madrid, Spain; Department of Nutrition, Food Science and Gastronomy, School of Pharmacy and Food Sciences, XaRTA, INSA, University of Barcelona, Barcelona, Spain.
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, United States.
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Mpundu-Kaambwa C, Chen G, Huynh E, Russo R, Ratcliffe J. Mapping the PedsQL™ onto the CHU9D: An Assessment of External Validity in a Large Community-Based Sample. PHARMACOECONOMICS 2019; 37:1139-1153. [PMID: 31161585 DOI: 10.1007/s40273-019-00808-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Mapping algorithms have been indicated as a second-best solution for estimating health state utilities for the calculation of quality-adjusted life-years within cost-utility analysis when no generic preference-based measure is incorporated into the study. However, the predictive performance of these algorithms may be variable and hence it is important to assess their external validity before application in different settings. OBJECTIVE The aim of this study was to assess the external validity and generalisability of existing mapping algorithms for predicting preference-based Child Health Utility 9D (CHU9D) utilities from non-preference-based Pediatric Quality of Life Inventory (PedsQL) scores among children and adolescents living with or without disabilities or health conditions. METHODS Five existing mapping algorithms, three developed using data from an Australian community population and two using data from a UK population with one or more self-reported health conditions, were externally validated on data from the Longitudinal Study of Australian Children (n = 6623). The predictive accuracy of each mapping algorithm was assessed using the mean absolute error (MAE) and the mean squared error (MSE). RESULTS Values for the MAE (0.0741-0.2302) for all validations were within the range of published estimates. In general, across all ages, the algorithms amongst children and adolescents with disabilities/health conditions (Australia MAE: 0.2085-0.2302; UK MAE: 0.0854-0.1162) performed worse relative to those amongst children and adolescents without disabilities/health conditions (Australia MAE: 0.1424-0.1645; UK MAE: 0.0741-0.0931). CONCLUSIONS The published mapping algorithms have acceptable predictive accuracy as measured by MAE and MSE. The findings of this study indicate that the choice of the most appropriate mapping algorithm to apply may vary according to the population under consideration.
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Affiliation(s)
- Christine Mpundu-Kaambwa
- Institute for Choice, University of South Australia Business School, Level 3 Way Lee Building, North Terrace, Adelaide, SA, 5001, Australia.
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia
| | - Elisabeth Huynh
- Department of Health Services Research and Policy, The Australian National University, Canberra, Australia
| | - Remo Russo
- Faculty of Health Sciences, School of Medicine, Flinders University, Adelaide, Australia
- Department of Paediatric Rehabilitation, Women's and Children's Hospital, Adelaide, Australia
| | - Julie Ratcliffe
- Institute for Choice, University of South Australia Business School, Level 3 Way Lee Building, North Terrace, Adelaide, SA, 5001, Australia
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Oosterhoff M, Joore MA, Bartelink NHM, Winkens B, Schayck OCP, Bosma H. Longitudinal analysis of health disparities in childhood. Arch Dis Child 2019; 104:781-788. [PMID: 30948361 DOI: 10.1136/archdischild-2018-316482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/06/2019] [Accepted: 03/08/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Combatting disparities in health outcomes among children is a major public health concern. This study focuses on two questions: (1) To what extent does socioeconomic status (SES) contribute to disparities in health outcomes? and (2) To what extent can social inequalities in health outcomes be explained by differences in children's health behaviours? DESIGN This study included 2-year follow-up data of 1259 children (4-12 years of age) who participated in the 'Healthy Primary School of the Future' project (ClinicalTrials.gov NCT02800616). SES was measured by maternal and paternal education and household income (adjusted for family size). Health outcomes were body mass index (BMI) z-score, health resource use, school absenteeism, health-related quality of life and psychosocial health, measured over 2 years of follow-up (2015-2017). Health behaviours included physical activity, and consumption of fruits, vegetables and sweetened beverages. Associations between SES and baseline health behaviours were examined, and mixed models for repeated measures were used to assess associations between SES and health outcomes over 2 years of follow-up. RESULTS A high socioeconomic background was significantly associated with better health outcomes (all outcomes). For example, children with a low SES had higher BMI z-scores (beta coefficient: 0.42, 95% CI 0.22 to 0.62) and higher consumption healthcare costs (ratio of mean costs: 2.21, 95% CI 1.57 to 3.10). Effects of SES changed very little after controlling for health behaviours. DISCUSSION Our findings strongly suggest that socioeconomic background has a pervasive impact on disparities in child health, but gives little support to the idea that social inequalities in child health can be tackled by means of lifestyle interventions.
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Affiliation(s)
- Marije Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+)/Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Manuela A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+)/Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Nina H M Bartelink
- Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Onno C P Schayck
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Wu XY, Zhuang LH, Li W, Guo HW, Zhang JH, Zhao YK, Hu JW, Gao QQ, Luo S, Ohinmaa A, Veugelers PJ. The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: a systematic review and meta-analysis. Qual Life Res 2019; 28:1989-2015. [PMID: 30875010 DOI: 10.1007/s11136-019-02162-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The association between diet quality, dietary behavior and health-related quality of life has been mostly examined in children and adolescents with specific chronic diseases. No systematic review has synthesized the influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents. The purpose of this study was to systematically review the primary studies that evaluated the association between diet quality, dietary behavior and health-related quality of life in the general population of children and adolescents and to synthesize the findings for the association. METHODS A computer search in the databases of MEDLINE, EMBASE and PSYCINFO was performed to retrieve English language studies that were published from 1946 up to April 8, 2018. We also screened the PubMed-related articles and the reference lists of the existing relevant literature to identify other eligible studies. We synthesized the association between diet quality, dietary behavior and health-related quality of life using both a qualitative method and meta-analysis. We reported the review following up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. RESULTS Seventeen studies were included in the synthesis including twelve cross-sectional studies and five longitudinal studies. We found that diet quality and dietary behavior were associated with health-related quality of life in children and adolescents. The positive effect of healthy diets on health-related quality of life was observed for multiple domains of health-related quality of life, including physical, school and emotional functioning, and psychosocial quality of life. We observed a dose-response relationship between the diet exposure and health-related quality of life, where an unhealthy dietary behavior or lower diet quality was associated with decreased health-related quality of life among children and adolescents. CONCLUSION The findings of the systematic review suggest the importance of promoting healthy diets and nutrition for good health-related quality of life among children and adolescents. Future research is needed to strengthen the evidence for prospective relationships and for the dose-response effect between diet quality, dietary behavior and health-related quality of life among children and adolescents.
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Affiliation(s)
- Xiu Yun Wu
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China.
| | - Li Hui Zhuang
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China.
| | - Wei Li
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Hong Wei Guo
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Jian Hua Zhang
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Yan Kui Zhao
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Jin Wei Hu
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Qian Qian Gao
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Sheng Luo
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, 350 University Terrace, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, 350 University Terrace, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada
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Catchpool M, Gold L, Grobler AC, Clifford SA, Wake M. Health-related quality of life: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:157-164. [PMID: 31273026 PMCID: PMC6624055 DOI: 10.1136/bmjopen-2018-022398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To describe the distribution of health-related quality of life (HRQL) in a national sample of Australian children aged 11-12 years and their parents, and examine associations within parent-child dyads. DESIGN The Child Health CheckPoint, a population-based cross-sectional study nested between waves 6 and 7 of the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven Australian cities and eight regional towns, or home visit; February 2015 to March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1853 children (49.0% girls) and 1863 parents (87.7% mothers) with HRQL data were included (1786 pairs). OUTCOME MEASURES HRQL was self-reported using preference-based (Child Health Utility 9Dimension, CHU9D) and non-preference-based (Pediatric Quality of Life, PedsQL V.4.0) measures for children and preference-based measures for parents (CHU9D; Assessment of Quality of Life 8 Dimension, AQoL-8D). Utility scores from preference-based measures were calculated using existing Australian algorithms to present a score on a 0-1 scale, where 1 represents full health. Parent-child concordance was assessed using Pearson's correlation coefficients and adjusted linear regression models. Survey weights and methods were applied to account for LSAC's complex sample design, stratification and clustering within postcodes. RESULTS Children's means and SD were 0.81 (SD 0.16) for CHU9D and 78.3 (SD 13.03) for PedsQL. In adults, mean HRQL for AQoL-8D and CHU9D were 0.78 (SD 0.16) and 0.89 (SD 0.10), respectively. Mean HRQL was similar for boys and girls, but slightly higher for fathers than mothers. The Pearson correlation coefficient for parent-child CHU9D values was 0.13 (95% CI 0.09 to 0.18). Percentiles and concordance are presented for both samples for males and females separately and together. CONCLUSIONS We provide Australian paediatric population values for HRQL measures, and the first national CHU9D values for mid-life adults. At age 11-12 years in this relatively healthy sample, parent-child concordance in HRQL was small.
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Affiliation(s)
- Max Catchpool
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand
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Tenjin K, Sekine M, Yamada M, Tatsuse T. Relationship Between Parental Lifestyle and Dietary Habits of Children: A Cross-Sectional Study. J Epidemiol 2019; 30:253-259. [PMID: 31155541 PMCID: PMC7217687 DOI: 10.2188/jea.je20190015] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Although parents seek the best for their children, nutrition education for parents has attracted little attention to improve their children’s dietary habits. To address this gap, this study aimed to examine the relationship between parental lifestyle factors and children’s dietary habits. Methods We used data from the questionnaire survey of the Super Shokuiku School Project conducted in January 2016. The participants consisted of 1,632 elementary school children who answered questions about their lifestyle, while their parents answered parental lifestyle questions, including Breslow’s seven health practice score (BHPS). Logistic regression analysis was performed to evaluate the strength of the relationship between parental lifestyle factors and parental dietary attitudes or children’s dietary habits. Results Compared with good maternal BHPS (scores of 6–7), poor maternal BHPS (scores of 0–3) was significantly associated with less parental interest in Shokuiku, less parental consideration of nutrient balance, and an increased rate of children eating breakfast alone (adjusted odds ratio [aOR] 2.95; 95% confidence interval [CI], 1.82–4.78, aOR 3.86; 95% CI, 2.50–5.96, and aOR 2.42; 95% CI, 1.34–4.35, respectively). There was no significant difference between parental BHPS and the following children’s dietary habits: frequency of eating breakfast, vegetable intake, and snacking. These habits of children were associated with their personal lifestyle factors. Conclusion Two types of dietary habits among children were associated with lifestyle factors of both parents and children. Nutrition education might be especially important for parents to improve their dietary attitude and children’s dietary habits. However, different nutrition education interventions would be needed to appropriately address each dietary habit.
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Affiliation(s)
- Kumi Tenjin
- Department of Epidemiology and Health Policy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Masaaki Yamada
- Department of Epidemiology and Health Policy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Takashi Tatsuse
- Department of Epidemiology and Health Policy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
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39
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Moeijes J, van Busschbach JT, Wieringa TH, Kone J, Bosscher RJ, Twisk JWR. Sports participation and health-related quality of life in children: results of a cross-sectional study. Health Qual Life Outcomes 2019; 17:64. [PMID: 30987637 PMCID: PMC6466683 DOI: 10.1186/s12955-019-1124-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 03/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background In children physical activity has been shown to be associated with health-related quality of life (HRQoL). This study further explores this association for specific characteristics of sports participation, namely membership of a sports club, frequency of sports participation, performing individual versus team sports, performing indoor versus outdoor sports, while differentiating between specific dimensions in the physical, psychological and social domain of HRQoL. Methods Cross-sectional data were collected from Dutch primary school children aged 10 to 12 years. They completed the Movement and Sports Monitor Questionnaire Youth aged 8 to 12 years (MSMQ) and the KIDSCREEN-52, an HRQoL questionnaire for children and adolescents. The data were examined using linear multilevel analyses because of the clustering of children in schools. Results The questionnaires were completed by 1876 children (response rate 81.3%). Membership of a sports club, moderate or high frequency of sports participation, and performing outdoor sports were all significantly associated with better HRQoL. These associations were largely found in the physical domain of HRQoL, to a lesser degree in the social domain, and to a limited extent in the psychological domain. Conclusion The association between sports participation and HRQoL in children depends on both characteristics of sports participation and the domain of life that is concerned. These differences offer starting points for developing tailor-made sports programs for children. Electronic supplementary material The online version of this article (10.1186/s12955-019-1124-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janet Moeijes
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands. .,Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
| | - Jooske T van Busschbach
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands.,University of Groningen, University Medical Center Groningen, University Center for Psychiatry, P.O. Box 30001, 9700, RB, Groningen, The Netherlands
| | - Thomas H Wieringa
- Department of Medical Psychology, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Jordy Kone
- School of Health Care Studies, Hanze University of Applied Sciences Groningen, P.O. Box 30030, 9700, RM, Groningen, The Netherlands.,Department of Health and Welfare, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands
| | - Ruud J Bosscher
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
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Cost-effectiveness of community-based childhood obesity prevention interventions in Australia. Int J Obes (Lond) 2019; 43:1102-1112. [PMID: 30926947 DOI: 10.1038/s41366-019-0341-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 01/13/2019] [Accepted: 03/03/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The objective of this study is to examine, from a limited societal perspective, the cost-effectiveness of community-based obesity prevention interventions (CBIs)-defined as a programme of community-level strategies to promote healthy eating and physical activity for Australian children (aged 5-18 years). METHODS The effectiveness of CBIs was determined by undertaking a literature review and meta-analysis. Commonly implemented strategies to increase physical activity and improve nutrition were costed (in 2010 Australian dollars) to determine the average cost of a generic programme. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the lifetime of the target population. Monte-Carlo simulation was used to assess second-order uncertainty of input parameters to estimate mean incremental cost-effectiveness ratios (ICER) with 95% uncertainty intervals (UIs). Scenario analyses tested variations in programme intensity, target population, and duration of effect. RESULTS The meta-analysis revealed a small but significant difference in BMI z-score (mean difference of - 0.07 (95% UI: - 0.13 to - 0.01)) favouring the CBI community compared with the control. The estimated net cost of implementing CBIs across all local government areas (LGAs) in Australia was AUD426M (95% UI: AUD3M to AUD823M) over 3 years. This resulted in 51,792 HALYs gained (95% UI: 6816 to 96,972) over the lifetime of the cohort. The mean ICER was AUD8155 per HALY gained (95% UI: AUD237 to AUD81,021), with a 95% probability of being cost-effective at a willingness to pay threshold of AUD50,000 per HALY. CONCLUSIONS CBIs are cost-effective obesity prevention initiatives; however, implementation across Australia will be (relatively) expensive when compared with current investments in preventive health.
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Pucci S, Pereira MG. The Moderator Role of Caffeine Intake in Adolescents’ Sleep and Health Behaviors. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019. [DOI: 10.1080/1067828x.2018.1561573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hoare E, Crooks N, Hayward J, Allender S, Strugnell C. Associations between combined overweight and obesity, lifestyle behavioural risk and quality of life among Australian regional school children: baseline findings of the Goulburn Valley health behaviours monitoring study. Health Qual Life Outcomes 2019; 17:16. [PMID: 30658630 PMCID: PMC6339321 DOI: 10.1186/s12955-019-1086-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/07/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Health related quality of life is a multi-dimensional construct of particular interest in determining the consequences of illness and disease. This study aimed to determine the relationships between overweight/obesity, and associated obesogenic risk behaviours with health related quality of life and physical, social, emotional and school sub-domains, among a large cohort of Australian primary school children. METHODS The data were derived from the Goulburn Valley Health Behaviours Monitoring study whereby a census-styled school recruitment process and high participatory opt-out (passive) procedure was employed. All primary schools in three Local Government Areas were invited to participate between July-September 2016 with 39/62 (62%) of schools participating and 1606/2034 (79%) students in Grade 2 (aged approx. 7-8 years), Grade 4 (aged approx. 9-10 years) and Grade 6 (aged approx. 11-12 years) participating. Measured height and weight were collected among participating students and older children (Grade 4 and 6) who also completed a self-report behavioural questionnaire, including the paediatric quality of life inventory. RESULTS Among 809 children aged 9 to 12 years, there were 219 (27.1%) classified as overweight/obese. Male children classified as overweight/obese reported significantly lower health related quality of life in the physical functioning and global functioning scores, compared to normal weight males. Significantly higher quality of life scores were observed among all children who met the physical activity recommendations on five out of the seven previous days. Significantly higher scores were observed among males adhering to the daily screen time recommendations, and among those meeting daily recommendations for fruit consumption. Among male school children, soft drink consumption was associated to lower health related quality of life. CONCLUSION Although cross-sectional, these findings highlight children with overweight/obesity and some underlying lifestyle behavioural risk factors, had significantly lower healthy-related quality of life, although this was observed most consistently among male school children. These findings have not previously been identified in young children and highlights the need to consider mental and emotional health in public health efforts to prevent obesity. TRIAL REGISTRATION ANZCTR Trial Registry: ACTRN12616000980437 retrospectively registered 26 July 2016.
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Affiliation(s)
- Erin Hoare
- Food & Mood Centre, IMPACT SRC, School of Medicine, Deakin University, 1 Gheringhap Street, Geelong, Australia
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Nicholas Crooks
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Joshua Hayward
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Steven Allender
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Claudia Strugnell
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, Australia
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Lebacq T, Dujeu M, Méroc E, Moreau N, Pedroni C, Godin I, Castetbon K. Perceived social support from teachers and classmates does not moderate the inverse association between body mass index and health-related quality of life in adolescents. Qual Life Res 2018; 28:895-905. [DOI: 10.1007/s11136-018-2079-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 11/29/2022]
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Chen G, Xu F, Huynh E, Wang Z, Stevens K, Ratcliffe J. Scoring the Child Health Utility 9D instrument: estimation of a Chinese child and adolescent-specific tariff. Qual Life Res 2018; 28:163-176. [PMID: 30374777 DOI: 10.1007/s11136-018-2032-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE To derive children and adolescents' preferences for health states defined by the Chinese version of Child Health Utility 9D (CHU9D-CHN) instrument in China that can be used to estimate quality-adjusted life years (QALYs) for economic evaluation. METHODS A profile case best-worst scaling (BWS) and a time trade-off (TTO) method were combined to derive a Chinese-specific tariff for the CHU9D-CHN. The BWS survey recruited students from primary and high schools using a multi-stage random sampling method and was administered in a classroom setting, whilst the TTO survey adopted an interviewer-administrated conventional TTO task and was administered to a convenience sample of undergraduate students. A latent class modelling framework was adopted for analysing the BWS data. RESULTS Two independent surveys were conducted in Nanjing, China, including a valid sample of 902 students (mean age 13 years) from the BWS survey and a valid sample of 38 students (mean age 18 years) from the TTO survey. The poolability of the best and the worst responses was rejected and the optimal result based on the best responses only. The optimal model suggests the existence of two latent classes. The BWS estimates were further re-anchored onto the QALY scale using the TTO generated health state values via a mapping approach. CONCLUSION This study provides further insights into the use of the BWS method to generate health state values with young people and highlights the potential different decision rules that young people may employ for determining best vs. worst choices in this context.
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Affiliation(s)
- Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Clayton, Australia
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, 2 Zizhulin, Nanjing, 210003, China. .,School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Elisabeth Huynh
- Institute for Choice, University of South Australia, Adelaide, Australia
| | - Zhiyong Wang
- Nanjing Municipal Center for Disease Control and Prevention, 2 Zizhulin, Nanjing, 210003, China
| | - Katherine Stevens
- Health Economics and Decision Science, ScHARR, University of Sheffield, Sheffield, UK
| | - Julie Ratcliffe
- Institute for Choice, University of South Australia, Adelaide, Australia
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Chatterjee A, Thompson JW, Svensson K, Tamayo Y Ortiz M, Wright R, Wright R, Tellez-Rojo M, Baccarelli A, Cantoral A, Schnaas L, Oken E. Maternal antenatal stress has little impact on child sleep: results from a prebirth cohort in Mexico City. Sleep Health 2018; 4:397-404. [PMID: 30241653 PMCID: PMC6152833 DOI: 10.1016/j.sleh.2018.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 01/28/2023]
Abstract
STUDY OBJECTIVES Maternal antenatal stress may influence offspring development and behavior, but any association with child sleep is unknown. METHODS From 2007 to 2011, we recruited pregnant women in Mexico City to the Programming Research in Obesity, Growth, Environment, and Social Stressors prebirth cohort. Mothers completed the Perceived Stress Scale (PSS, a 4-item questionnaire assessing past-month stress) and the Crisis in Family Systems measure assessing negative life events (NLEs; how many domains among the 11 assessed in which the mother experienced a stressful event in the prior 6 months)-with higher scores reflecting higher stress-and provided 5 timed salivary samples per day on 2 consecutive days, from which we derived cortisol area under the curve, slope, and awakening response. At age 4-6 years, children's sleep was estimated using accelerometry over a 7-day period. We performed secondary analysis of associations of antenatal maternal stress with child sleep duration and efficiency (time asleep/time in bed) using linear regression adjusted for maternal and child characteristics. RESULTS Among 594 mother-child dyads, mean antenatal PSS score was 5.2 (SD = 3.2) out of 16, and mean NLE was 3.2 (SD = 2) out of 11; child sleep duration was 7.7 hours (SD = 0.7), and sleep efficiency was 79% (SD = 6). There was no association between any of the stress measures-PSS, NLE, or salivary cortisol-and sleep duration or sleep efficiency in adjusted or unadjusted models. CONCLUSIONS Among mother-child dyads in a Mexico City cohort, antenatal stress was not associated with important changes in child sleep at 4-6 years.
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Affiliation(s)
- Avik Chatterjee
- Division of Global Health Equity, Department of Internal Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
| | - Jennifer W Thompson
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Suite 401E, Boston, MA 02215
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029
| | - Marcela Tamayo Y Ortiz
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México; Mexican Council for Science and Technology, National Institute of Public Health Mexico, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Robert Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029; Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Rosalind Wright
- Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029; Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Martha Tellez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Andrea Baccarelli
- Mailman School of Public Health, Columbia University, 722 W 168th St, NY, NY 10032
| | - Alejandra Cantoral
- Center for Nutrition and Health Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera CP, 62100, Cuernavaca, Morelos. México
| | - Lourdes Schnaas
- National Institute of Perinatology, Calle Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, 11000 Ciudad de México, CDMX, Mexico
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Suite 401E, Boston, MA 02215
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Oosterhoff M, Bosma H, van Schayck OCP, Evers SMAA, Dirksen CD, Joore MA. A systematic review on economic evaluations of school-based lifestyle interventions targeting weight-related behaviours among 4-12 year olds: Issues and ways forward. Prev Med 2018; 114:115-122. [PMID: 29959951 DOI: 10.1016/j.ypmed.2018.06.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/22/2018] [Accepted: 06/23/2018] [Indexed: 12/12/2022]
Abstract
Current guidelines for economic evaluations do not provide specific recommendations for the evaluation of school-based lifestyle interventions. This study examined and discussed the key aspects in the design of economic evaluations on school-based interventions targeting weight-related behaviours among 4-12 year olds. The PubMed and CRD databases (NHS EED) were searched. Grey literature was identified from reference lists and websites of relevant organizations. Full economic evaluations on school-based interventions targeting physical activity, sedentariness, or diet were selected. Key aspects included the objective, audience, intervention, comparator, population, type of analysis, perspective, costs, outcomes, and time horizon. Information was also extracted on measuring and valuing costs and outcomes, linking and extrapolating outcomes, and the maintenance of intervention effects. The 23 included studies reported on cost-effectiveness (CEAs) (N = 12), cost-utility (CUAs) (N = 9), social cost benefit (SCBA) (N = 2), and social return on investment (SROI) (N = 1) analysis. The usual practice comparator was generally not clearly defined. The SROI analysis was the single study that included outcomes in other persons than the child. Healthcare costs (N = 14), productivity costs (N = 4), and costs to the household (N = 3), or education (N = 2) sector were examined. The outcome in trial-based CEAs consisted of a variety of weight-related measures. Seven distinctive models were used to extrapolate health and/or productivity costs. To enhance the usefulness of economic evaluations on school-based lifestyle interventions in allocating public health budgets, transparent reporting on key aspects, broadening the scope of economic evaluations, and standardizing the measurement, valuation, and extrapolation of costs and outcomes should be improved. This study was conducted in Maastricht, the Netherlands.
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Affiliation(s)
- Marije Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre MUMC+/Care and Public Health Research Institute (CAPHRI), KEMTA, P. Debyelaan 25, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands.
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Social Medicine, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Onno C P van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Family Medicine, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Silvia M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Health Services Research, P.O. Box 616, 6200, MD, Maastricht, the Netherlands; Trimbos, Netherlands Institute of Mental Health and Addiction, Trimbos, P.O. Box 725, 3500, AS, Utrecht, the Netherlands
| | - Carmen D Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre MUMC+/Care and Public Health Research Institute (CAPHRI), KEMTA, P. Debyelaan 25, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands
| | - Manuela A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre MUMC+/Care and Public Health Research Institute (CAPHRI), KEMTA, P. Debyelaan 25, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands
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Tan EJ, Brown V, Petrou S, D'Souza M, Moodie ML, Wen LM, Baur LA, Rissel C, Hayes AJ. Is there an association between early weight status and utility-based health-related quality of life in young children? Qual Life Res 2018; 27:2851-2858. [PMID: 29992501 DOI: 10.1007/s11136-018-1932-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Few studies focus on the health-related quality of life (HRQoL) of preschool children with overweight or obesity. This is relevant for evaluation of obesity prevention trials using a quality-adjusted life year (QALY) framework. This study examined the association between weight status in the preschool years and HRQoL at age 5 years, using a preference-based instrument. METHODS HRQoL [based on parent proxy version of the Health Utilities Index Mark 3 (HUI3)] and weight status were measured in children born in Australia between 2007 and 2009. Children's health status was scored across eight attributes of the HUI3-vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain, and these were used to calculate a multi-attribute utility score. Ordinary least squares (OLS), Tobit and two-part regressions were used to model the association between weight status and multi-attribute utility. RESULTS Of the 368 children for whom weight status and HUI3 data were available, around 40% had overweight/obesity. After adjusting for child's sex, maternal education, marital status and household income, no significant association between weight status in the preschool years and multi-attribute utility scores at 5 years was found. CONCLUSIONS Alternative approaches for capturing the effects of weight status in the preschool years on preference-based HRQoL outcomes should be tested. The application of the QALY framework to economic evaluations of obesity-related interventions in young children should also consider longitudinal effects over the life-course. Clinical Trial Registration The Healthy Beginnings Trial was registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).
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Affiliation(s)
- Eng Joo Tan
- The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia. .,The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.
| | - Victoria Brown
- The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.,Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, VIC, 3220, Australia.,Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Stavros Petrou
- The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.,Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Mario D'Souza
- The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.,Clinical Research Centre, Sydney Local Health District, Sydney, NSW, Australia
| | - Marjory L Moodie
- The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.,Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, VIC, 3220, Australia.,Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Li Ming Wen
- The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.,The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.,Health Promotion Service, Sydney Local Health District, Sydney, Australia
| | - Louise A Baur
- The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.,The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia.,The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Chris Rissel
- The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.,The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Alison J Hayes
- The University of Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.,The NHMRC Centre of Research Excellence in The Early Prevention of Obesity in Childhood, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
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Brown V, Tan EJ, Hayes AJ, Petrou S, Moodie ML. Utility values for childhood obesity interventions: a systematic review and meta-analysis of the evidence for use in economic evaluation. Obes Rev 2018; 19:905-916. [PMID: 29356315 DOI: 10.1111/obr.12672] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/12/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Abstract
Rigorous estimates of preference-based utilities are important inputs into economic evaluations of childhood obesity interventions, yet no published review currently exists examining utility by weight status in paediatric populations. A comprehensive systematic literature review and meta-analysis was therefore undertaken, pooling data on preference-based health state utilities by weight status in children using a random-effects model. Tests for heterogeneity were performed, and publication bias was assessed. Of 3,434 potentially relevant studies identified, 11 met our eligibility criteria. Estimates of Cohen's d statistic suggested a small effect of weight status on preference-based utilities. Mean utility values were estimated as 0.85 (95% uncertainty interval [UI] 0.84-0.87), 0.83 (95% UI 0.81-0.85), 0.82 (95% UI 0.79-0.84) and 0.83 (95% UI 0.80-0.86) for healthy weight, overweight, obese and overweight/obese states, respectively. Meta-analysis of studies reporting utility values for both healthy weight and overweight/obese participants found a statistically significant weighted mean difference (0.015, 95% UI 0.003-0.026). A small but statistically significant difference was also estimated between healthy weight and overweight participants (0.011, 95% UI 0.004-0.018). Study findings suggest that paediatric-specific benefits of obesity interventions may not be well reflected by available utility measures, potentially underestimating cost-effectiveness if weight loss in childhood/adolescence improves health or well-being.
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Affiliation(s)
- V Brown
- Deakin Health Economics, Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
| | - E J Tan
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A J Hayes
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - S Petrou
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,Warwick Medical School, University of Warwick, Coventry, UK
| | - M L Moodie
- Deakin Health Economics, Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
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Magiera A, Sochacka-Tatara E, Sowa A, Jacek R, Pac A. Body weight and quality of life among adolescents in Krakow. DEVELOPMENTAL PERIOD MEDICINE 2018. [PMID: 30056403 PMCID: PMC8522893 DOI: 10.34763/devperiodmed.20182202.160170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIM The aim of this study was to assess the relationship between body weight and the quality of life among adolescents in Krakow, Poland. MATERIAL AND METHODS The study comprised 1291 pupils - 632 girls and 659 boys from 17 Krakow middle schools. Their quality of life (QoL) was assessed by means of the Polish version of the KIDSCREEN-27 questionnaire. Five dimensions of QoL were analyzed as low, average and high QoL according to Polish cut-off points. The body mass index (BMI) of the adolescents was classified as underweight, normal weight, or excessive weight according to Polish growth charts. RESULTS Low QoL was observed significantly more often in girls than in boys. Excessive weight among both girls and boys was found to be a risk factor for low QoL in the "Physical Well-being" dimension as compared to normal weight adolescents. Additionally, boys with excessive weight had a two-fold higher risk of low QoL in the "Social Support % Peers" dimension (OR=2.00; 95%CI:1.14-3.50). Underweight was associated with higher risk of low QoL in the "Physical Well-being", "Autonomy & Parents", and "Social Support % Peers" dimensions, but only among boys. CONCLUSIONS Both, underweight and excessive weight were associated with low QoL. Excessive weight in youth was linked mainly with lower physical well-being. Underweight was a predictor of low QoL only among boys in the dimensions related to physical health, as well as relations with family and peers.
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Affiliation(s)
- Agnieszka Magiera
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska
| | - Elżbieta Sochacka-Tatara
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska
| | - Agata Sowa
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska
| | - Ryszard Jacek
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska
| | - Agnieszka Pac
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska,Agnieszka Pac Katedra Epidemiologii i Medycyny Zapobiegawczej UJ CM ul. Kopernika 7a, 31-034 Kraków tel. (12) 423-10-03
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The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children. Nutrients 2018; 10:nu10050622. [PMID: 29762517 PMCID: PMC5986502 DOI: 10.3390/nu10050622] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/30/2018] [Accepted: 05/11/2018] [Indexed: 12/11/2022] Open
Abstract
Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M⁻AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m²). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372⁻25,155); total cost-savings AUD126.3M (95% UI AUD58.7M⁻196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812⁻15,679); total cost-savings AUD90.9M (95% UI AUD44.3M⁻136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP.
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