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Agung FH, Sekartini R, Sudarsono NC, Hendarto A, Werdhani RA, Pudjiati SR, Hanum L, Naufal A, Sawyer SM. Development and validation of the adolescent behavioural change Counselling Assessment Tool in Indonesia. BMC Health Serv Res 2024; 24:257. [PMID: 38419005 PMCID: PMC10900824 DOI: 10.1186/s12913-024-10582-3] [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: 06/02/2023] [Accepted: 01/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Primary care provides an important context to engage adolescents and their families in healthy lifestyles with the goal of reducing future behaviour-related health problems. Developing a valid tool to assess health professionals' skills in behavioural change counselling is integral to improving the quality of clinical care provided to adolescents in Indonesia. METHODS This work was nested within a project to develop a training program to enhance the behaviour-change counselling of adolescents and their parents by Indonesian primary care professionals. Initial item development was based on the content of the training module and the domain structure of the Behavioral Change Counselling Index (BECCI), a commonly used tool to assess counselling quality in healthcare settings. Expert panels were used to test content validity, while face validity was assessed by a group of trained psychologists. Inter-rater agreement was calculated prior to tests of construct validity and reliability, which involved psychologists rating 125 audio-taped counselling sessions between the health professional and adolescent patients, together with a parent. RESULTS An initial 13-item tool was developed using a 1-5 Likert scale. Validity and reliability testing resulted in the decision to use a 14-item tool with a 0-3 Likert scale. The scale was found to have a Cronbach's α coefficient of 0.839 (internal consistency), and there was strong inter-rater agreement (0.931). CONCLUSION The assessment tool known as the Adolescent Behavioural Change Counselling Assessment Tool, is a valid and reliable instrument to measure Indonesian health professionals' behavioural-change counselling skills with adolescent patients. The tool provides an evaluation framework for future interventions that aim to improve health professionals' skills in addressing adolescent behaviour-related health problems.
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Affiliation(s)
- Fransisca Handy Agung
- Faculty of Medicine, Universitas Pelita Harapan, Jl. Jend. Sudirman No.20, Bencongan, Kelapa Dua, 15810, Tangerang, Banten, Indonesia.
| | - Rini Sekartini
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Nani Cahyani Sudarsono
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Aryono Hendarto
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Retno Asti Werdhani
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Sri Retno Pudjiati
- Faculty of Psychology, Universitas Indonesia, Kampus UI, Depok, West Java, Indonesia
| | - Lathifah Hanum
- Faculty of Psychology, Universitas Indonesia, Kampus UI, Depok, West Java, Indonesia
| | - Affan Naufal
- Balaraja Distric Hospital, Jl. Rumah Sakit No 88, Balaraja, Tangerang, Banten, Indonesia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital and Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, 50 Flemington Rd, 3052, Parkville, VIC, Australia
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Agung FH, Sekartini R, Sudarsono N, Hendarto A, Werdhani RA, Dhamayanti M, Pudjiati R, Hanum L, Naufal A, Sawyer SM. Development of an internet-based intervention to improve health professionals' counseling skills around adolescent weight management in Indonesia. PLoS One 2023; 18:e0294986. [PMID: 38060485 PMCID: PMC10703284 DOI: 10.1371/journal.pone.0294986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Obesity is a growing public health and clinical concern, worldwide. In many countries, including Indonesia, health professionals lack the capacity to promote behavior change around obesity prevention and management, especially with adolescents for whom a wider set of communication skills are required. This study describes the theoretical basis, approach to development of content, use and satisfaction of an internet-based educational intervention designed to improve the quality of health professional weight management counseling with adolescents in Indonesia. METHODS This study is part of an exploratory sequential mixed methods design which was undertaken from 2020 to 2022. Following a needs analysis, an internet-based training resource was developed, informed by constructive alignment theory and active learning principles. Using both synchronous and asynchronous approaches over a four-week pilot study, a weekly interactive session was held online, using multifaceted training materials housed on a website (https://ramahremaja.id). The training resource was then tested in a two-arm study involving health professionals from 17 of 34 provinces across Indonesia. RESULTS Sixty-four primary health professionals were recruited for the two-arm study. The completion rate for reviewing all materials and assignments on the website was 72% and the online meeting participation rate was 78%. Participants were highly positive about the clarity of the training material and the appropriateness of the delivery methods. The main challenges related to poor internet literacy and interrupted internet connectivity. CONCLUSION Designed to support weight management in adolescents, this internet-based training program shows potential for enhancing Indonesian health professional behavior-change counseling skills.
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Affiliation(s)
- Fransisca Handy Agung
- Faculty of Medicine, Universitas Pelita Harapan, Bencongan, Kelapa Dua, Tangerang, Banten, Indonesia
| | - Rini Sekartini
- Faculty of Medicine Universitas Indonesia, Department of Child Health, Jakarta, Indonesia
| | - Nani Sudarsono
- Faculty of Medicine Universitas Indonesia, Department of Community Medicine, Jakarta, Indonesia
| | - Aryono Hendarto
- Faculty of Medicine Universitas Indonesia, Department of Child Health, Jakarta, Indonesia
| | - Retno Asti Werdhani
- Faculty of Medicine Universitas Indonesia, Department of Community Medicine, Jakarta, Indonesia
| | - Meita Dhamayanti
- Faculty of Medicine Universitas Padjajaran, Department of Child Health, Pasteur, Bandung, West Java, Indonesia
| | - Retno Pudjiati
- Faculty of Psychology Universitas Indonesia, Kampus UI, Depok, West Java, Indonesia
| | - Lathifah Hanum
- Faculty of Psychology Universitas Indonesia, Kampus UI, Depok, West Java, Indonesia
| | - Affan Naufal
- Balaraja District Hospital, Tangerang, Banten, Indonesia
| | - Susan M. Sawyer
- Institute and Department of Paediatrics, Centre for Adolescent Health, Royal Children’s Hospital, Murdoch Children’s Research, University of Melbourne, Parkville VIC, Australia
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Maynard MJ, Orighoye O, Apekey T, Simpson E, van Dijk M, Atherton E, Blackshaw J, Ells L. Improving adult behavioural weight management services for diverse UK Black Caribbean and Black African ethnic groups: a qualitative study of insights from potential service users and service providers. Front Public Health 2023; 11:1239668. [PMID: 38074747 PMCID: PMC10701265 DOI: 10.3389/fpubh.2023.1239668] [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: 06/16/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Background A significantly higher proportion of UK Black ethnic adults live with overweight or obesity, compared to their White British counterparts. The role of obesity in excess infection rates and mortality from COVID-19 has increased the need to understand if weight management interventions are appropriate and effective for Black ethnic groups. There is a paucity of existing research on weight management services in Black populations, and whether anticipated or experienced institutional and interpersonal racism in the healthcare and more widely affects engagement in these services. Understanding the lived experience of target populations and views of service providers delivering programmes is essential for timely service improvement. Methods A qualitative study using semi-structured interviews was conducted in June-October 2021 among 18 Black African and Black Caribbean men and women interested in losing weight and 10 weight management service providers. Results The results highlighted a positive view of life in the United Kingdom (UK), whether born in the UK or born abroad, but one which was marred by racism. Weight gain was attributed by participants to unhealthy behaviours and the environment, with improving appearance and preventing ill health key motivators for weight loss. Participants relied on self-help to address their overweight, with the role of primary care in weight management contested as a source of support. Anticipated or previously experienced racism in the health care system and more widely, accounted for some of the lack of engagement with services. Participants and service providers agreed on the lack of relevance of existing services to Black populations, including limited culturally tailored resources. Community based, ethnically matched, and flexibly delivered weight management services were suggested as ideal, and could form the basis of a set of recommendations for research and practice. Conclusion Cultural tailoring of existing services and new programmes, and cultural competency training are needed. These actions are required within systemic changes, such as interventions to address discrimination. Our qualitative insights form the basis for advancing further work and research to improve existing services to address the weight-related inequality faced by UK Black ethnic groups.
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Affiliation(s)
- Maria J. Maynard
- School of Health, Leeds Beckett University, Leeds, United Kingdom
- Obesity Institute, Leeds Beckett University, Leeds, United Kingdom
| | - Oritseweyinmi Orighoye
- Bradford Institute for Health Research, University of Bradford, Bradford, United Kingdom
| | - Tanefa Apekey
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Ellouise Simpson
- School of Health, Leeds Beckett University, Leeds, United Kingdom
| | - Margie van Dijk
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, United Kingdom
| | - Elizabeth Atherton
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, United Kingdom
| | - Jamie Blackshaw
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, United Kingdom
| | - Louisa Ells
- School of Health, Leeds Beckett University, Leeds, United Kingdom
- Obesity Institute, Leeds Beckett University, Leeds, United Kingdom
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Nicastro HL, Vorkoper S, Sterling R, Korn AR, Brown AGM, Maruvada P, Oh AY. Opportunities to advance implementation science and nutrition research: a commentary on the Strategic Plan for NIH Nutrition Research. Transl Behav Med 2023; 13:1-6. [PMID: 36370119 PMCID: PMC10091491 DOI: 10.1093/tbm/ibac066] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Despite population-wide recommendations by the U.S. Dietary Guidelines for Americans and others to encourage health-promoting dietary patterns, the proportion of Americans following dietary recommendations remains low. The gaps in the adoption and integration of evidence-based dietary interventions, practices, programs, and policies (EBIs) into community and clinical settings signal the need to strengthen efforts in implementation science (IS) in nutrition research to understand and alleviate barriers to adopting and sustaining healthy dietary behaviors and practices. Equally important is the translation of this research into practice in a variety of settings and across the diversity of populations. Recognizing this need, the U.S. National Institutes of Health (NIH) 2020-2030 Strategic Plan for NIH Nutrition Research calls for the expansion of IS as a key opportunity to advancing nutrition research. This commentary highlights three scientific opportunities to stimulate IS in nutrition research and provides examples for each opportunity. These include: (a) Advance consideration of implementation and dissemination early in the design of interventions to facilitate opportunities for equitable scale-up and sustainability of EBIs, (b) Develop and test strategies for equitable implementation of nutrition and diet EBIs in health care and community settings, and (c) Build and strengthen the infrastructure, capacity, and expertise needed to increase use of IS in clinical and community nutrition research to swiftly move the research into practice. By advancing the three opportunities identified in this commentary, the scientific community has the potential to advance the field of nutrition research and IS with the ultimate goal of improving public health.
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Affiliation(s)
- Holly L Nicastro
- Office of Nutrition Research, National Institutes of Health, Bethesda, MD, USA
| | - Susan Vorkoper
- Division of International Science Policy, Planning and Evaluation, Fogarty International Center, Bethesda, MD, USA
| | - Rene Sterling
- Division of Genomics and Society, National Human Genome Research Institute, Bethesda, MD, USA
| | - Ariella R Korn
- Cancer Prevention Fellowship Program, Rockville, MD, USA.,Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Alison G M Brown
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Padma Maruvada
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - April Y Oh
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Expanding Integrated Competency-Focused Health Worker Curricula for Maternal Infant and Young Child Nutrition. EDUCATION SCIENCES 2022. [DOI: 10.3390/educsci12080518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Maternal, infant, and young child nutrition (MIYCN) is important for health, survival, productivity, and development. Knowledgeable, skilled health workers are vital to provide quality care, improve health outcomes, and meet global nutrition targets. When nutrition is not adequately addressed in pre-service curricula, health workers may not be equipped with the knowledge, skills and confidence required to deliver nutrition services and accurate information free of commercial influence. Curriculum review, revision, and competency structuring provides an opportunity to benchmark course topics and content to global standards, to increase focus on learner outcomes, and to facilitate mutual recognition of qualifications across countries and regions. This paper discusses a multistage process to map an existing curriculum, analyse expected competencies, and recognize broader factors when developing a competency-focused curriculum in pre-service education that includes MIYCN. Examples of tools are provided which can be used for review and discussion of curricula and competency at local and national level and to integrate skills such as communication and counselling.
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Barnett I, Meeker J, Roelen K, Nisbett N. Behaviour change communication for child feeding in social assistance: A scoping review and expert consultation. MATERNAL & CHILD NUTRITION 2022; 18:e13361. [PMID: 35502622 PMCID: PMC9218306 DOI: 10.1111/mcn.13361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
To increase the effectiveness of social assistance on child nutrition, programmes are increasingly combined with behaviour change communication for improved infant and young child feeding (BCC for IYCF). Unfortunately, there is limited knowledge about which BCC strategies are most effective when combined with social assistance. A systematic scoping review and an expert consultation was conducted to (1) describe the landscape of BCC for IYCF strategies used in social assistance within low‐ and middle‐income countries and (2) to examine the effects of these BCC strategies on IYCF practices and child nutrition. Ten quantitative, three qualitative and four mixed methods studies were reviewed and complemented by 12 expert consultations carried out between August and October 2020. In most of the studies attendance in BCC for IYCF was conditional for receiving social assistance, although experts agreed that this conditionality may be counterproductive. A variety of BCC strategies were used with two being most common—group sessions with pre‐determined topics and individual counselling. Context‐specific adaptation, interactive delivery and building on existing IYCF knowledge emerged as crucial but was perceived as economically infeasible in social assistance programmes. Given the variety of BCC strategies and inconsistency in outcomes, it is impossible to draw conclusions regarding effectiveness. Nevertheless, tentative evidence suggests that the promotion of existing nutrition services, educational group sessions and individual counselling may be effective in improving IYCF. BCC for IYCF can make social assistance more beneficial, but may increase costs, demands on beneficiaries, and deviate from the original focus of the programmes. Findings suggest that integrating BCC for IYCF in social assistance programmes can be beneficial for young children, however, it may increase the costs of the programme, create additional demands on beneficiaries and may deviate the original focus of the programme. Most BCC for IYCF in social assistance programmes used two different behaviour change strategies (with group session with pre‐determined topics and individual nutrition counselling being most common). However, there is limited evidence on what BCC strategies (as part of social assistance) change behaviours most effectively. Formative research is important for the design and implementation of context‐specific BCC that builds on existing IYCF knowledge but can be time‐and resource‐consuming to develop and may thus be economically infeasible within social assistance programmes.
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Affiliation(s)
- Inka Barnett
- Institute of Development Studies (IDS) University of Sussex Brighton UK
| | - Jessica Meeker
- Institute of Development Studies (IDS) University of Sussex Brighton UK
| | - Keetie Roelen
- Institute of Development Studies (IDS) University of Sussex Brighton UK
| | - Nick Nisbett
- Institute of Development Studies (IDS) University of Sussex Brighton UK
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7
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Xavier CR, Silva JGR, Duarte GR, Carvalho IA, Vieira VDF, Goliatt L. An island-based hybrid evolutionary algorithm for caloric-restricted diets. EVOLUTIONARY INTELLIGENCE 2021. [DOI: 10.1007/s12065-021-00680-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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8
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Salvo D, Parra DC, Jáuregui A, Resendiz E, Garcia-Olvera A, Velazquez D, Aguilar-Farias N, Colón-Ramos U, Hino AA, Bill Kohl HW, Pratt M, Varela AR, Ramirez-Zea M, Rivera JA. [Capacidad de investigación en obesidad infantil en Latinoamérica y en las poblaciones latinas de Estados Unidos: estado de la investigación, problemas, oportunidades y líneas de trabajo para el futuro]. Obes Rev 2021; 22 Suppl 5:e13346. [PMID: 34708537 DOI: 10.1111/obr.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, San Luis, Misuri, EE. UU
| | - Diana C Parra
- Prevention Research Center, Brown School, Washington University in St. Louis, San Luis, Misuri, EE. UU
| | - Alejandra Jáuregui
- Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Eugen Resendiz
- Prevention Research Center, Brown School, Washington University in St. Louis, San Luis, Misuri, EE. UU
| | - Armando Garcia-Olvera
- Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Daniel Velazquez
- Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Nicolas Aguilar-Farias
- Departamento de Educación Física, Deportes y Recreación, Grupo de investigación UFRO Actívate, Universidad de la Frontera, Temuco, Chile
| | - Uriyoán Colón-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington D.C., EE. UU
| | - Adriano A Hino
- Programa de Pós-Graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Harold W Bill Kohl
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, EE. UU
| | - Michael Pratt
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, California, EE. UU
| | | | - Manuel Ramirez-Zea
- Centro de Investigación del INCAP para la Prevención de las Enfermedades Crónicas, Instituto de Nutrición de Centro América y Panamá, Ciudad de Guatemala, Guatemala
| | - Juan A Rivera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
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An Assessment of Government Capacity Building to Restrict the Marketing of Unhealthy Food and Non-Alcoholic Beverage Products to Children in the Region of the Americas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168324. [PMID: 34444077 PMCID: PMC8394636 DOI: 10.3390/ijerph18168324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
The Pan American Health Organization (PAHO) Strategic Plan 2020–2025 committed to reduce children’s consumption of energy-dense nutrient-poor food and beverage products high in fat, sugar and salt (HFSS) and promote healthy eating patterns to reduce malnutrition in all forms. This paper describes the capacity-building needs in PAHO’s Member States to restrict the marketing of HFSS food and beverages to children. We asked Ministries of Health officials or national institutes/departmental representatives (n = 35) to complete a 28-item web-based survey (January to July 2020). Capacity-building needs were assessed using an adapted version of the World Health Organization’s government capacity-building framework with three modules: public health infrastructure, policies and information systems. Notable achievements for the PAHO’s Plan of Action were identified. State representatives reported strong infrastructure and information systems; however, policy improvements are needed to increase comprehensive national responses. These include using a constitutional health and human rights approach within the policies, policies that document conflict of interest from non-state actors, and strengthening regulatory oversight for digital media platforms. These findings provide baseline data and we suggest priorities for further action to strengthen national governments’ capacity-building and to accelerate the development, implementation, and monitoring systems to restrict the marketing of HFSS food and non-alcoholic beverages to children in the region of the Americas.
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Martínez-González MA, Kim HS, Prakash V, Ramos-Lopez O, Zotor F, Martinez JA. Personalised, population and planetary nutrition for precision health. BMJ Nutr Prev Health 2021; 4:355-358. [PMID: 34308147 PMCID: PMC8258037 DOI: 10.1136/bmjnph-2021-000235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/18/2021] [Indexed: 12/18/2022] Open
Affiliation(s)
- Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.,Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Hyun-Sook Kim
- Department of Food and Nutrition, Sookmyung Women's University, Yongsan-gu, Seoul, The Republic of Korea
| | - Vish Prakash
- Nutritional and Nutraceutical Research Centre, Ramaiah University of Applied Sciences, Bangalore, India
| | - Omar Ramos-Lopez
- Medicine and Psychology School, Autonomous University of Baja California, Tijuana, Mexico
| | - Francis Zotor
- School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - J Alfredo Martinez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute, Madrid, Spain.,Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
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11
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Salvo D, Parra DC, Jáuregui A, Reséndiz E, Garcia-Olvera A, Velazquez D, Aguilar-Farias N, Colón-Ramos U, Hino AA, Kohl HWB, Pratt M, Ramirez Varela A, Ramirez-Zea M, Rivera JA. Capacity for childhood obesity research in Latin American and US Latino populations: State of the field, challenges, opportunities, and future directions. Obes Rev 2021; 22 Suppl 3:e13244. [PMID: 33825321 PMCID: PMC8365746 DOI: 10.1111/obr.13244] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/25/2022]
Abstract
Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity-related articles published June 2015-December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity-related articles (505 from Latin America, 124 from the United States, and 17 US-Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross-border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.
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Affiliation(s)
- Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Diana C Parra
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Alejandra Jáuregui
- Department of Physical Activity and Healthy Lifestyles, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Eugen Reséndiz
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Armando Garcia-Olvera
- Department of Physical Activity and Healthy Lifestyles, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Daniel Velazquez
- Department of Physical Activity and Healthy Lifestyles, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, UFRO Activate Research Group, University of the Frontier, Temuco, Chile
| | - Uriyoán Colón-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Adriano A Hino
- Health Technology Graduate Program, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Harold W Bill Kohl
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, USA
| | - Michael Pratt
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, California, USA
| | | | - Manuel Ramirez-Zea
- INCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Juan A Rivera
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Tramontt CR, Maia TDM, Baraldi LG, Jaime PC. Dietary guidelines training may improve health promotion practice: Results of a controlled trial in Brazil. Nutr Health 2021; 27:347-356. [PMID: 33781125 DOI: 10.1177/0260106021996924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The double burden of malnutrition points to an urgent need to develop strategies to promote healthy diets. Health professionals are key elements for health promotion and must be prepared to deal with these issues in health services. AIM This study aimed to evaluate the impact of an educational intervention based on Brazilian Dietary Guidelines in the practice of multidisciplinary teams working in primary health care. METHODS A controlled trial comprising pre- and post-tests was conducted with four multidisciplinary healthcare teams. The intervention group received 16 hours of training on the Brazilian Dietary Guidelines. The professionals' practices were evaluated by direct observation, before and after the intervention, for two months at each timepoint. Data on dietary counselling were collected using a previously validated scale. The Kruskal-Wallis test was used for intragroup comparison at T0 versus T1, and the intergroup effects of the intervention were estimated by generalized linear regression analysis with a 95% confidence interval. RESULTS The regression with the interaction term between the intervention group and time showed a positive effect of the educational intervention on professionals' practices in the intervention group in the crude and adjusted models (coefficient = 1.36 and p = 0.020). Brazilian Dietary Guidelines application significantly increased in non-nutritionist professionals' practices (p = 0.007) and in activities not related to nutrition (p = 0.028) in the intervention group over time (T1-T0). No significant differences were found in the control group. CONCLUSION The intervention proved to be effective in promoting changes in health professionals' practices, demonstrating the strength of the strategy for dissemination of nutrition guidelines in primary health care.
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Prasetyo YB, Nursalam N, Widyawati IY, Hargono R, Ahsan A, Kumboyono K. A belief-based parenting behavior model for promoting family's ability to care for children with avoidant restrictive food intake disorder (ARFID) in Indonesia. J Public Health Res 2021; 10:1964. [PMID: 33623776 PMCID: PMC7893318 DOI: 10.4081/jphr.2021.1964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Family's ability to care for children with avoidant restrictive food intake disorder (ARFID) is a central indicator in preventing the children from worse nutritional disorders. Environmental factor, child factor, caregiving behavioral systems, and beliefs can improve the family's ability to care for children. The aim of this research was to analyze the effect of environmental factor, child factor, caregiving behavioral systems, and beliefs on the family's ability to care for children with ARFID. Design and Methods: This cross-sectional research was carried out on 245 families with children suffering from ARFID in Malang Regency, in the working area of the Health Office of Malang Regency. The population of this research was families with children suffering from ARFID within the working area of the Health Office of Malang Regency. The research sample size was computed using the rule of thumb in structural equation modeling (SEM), the sample size used was 245. Results: Results showed that the family's ability to care for children with ARFID was highly influenced by the caregiver's belief (t = 21.796; β = 0.713). Caregiver's belief became a dominant factor in the promotion of the family's ability to care for children with ARFID. A caregiver's belief was influenced by his/her behavior. Conclusions: It was concluded that the caregiver's belief serves as a primary factor in the promotion of the family's ability to care for children with ARFID. A caregiver's behavior holds a prominent role in influencing his/her belief in providing care for children suffering from ARFID.
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Affiliation(s)
- Yoyok Bekti Prasetyo
- Community Department, Department of Nursing, Faculty of Health Sciences, University of Muhammadiyah Malang, Kota Malang, Jawa Timur
| | - Nursalam Nursalam
- Department of Health Sciences, Faculty of Public Health, Airlangga University, Surabaya
| | - Ika Yuni Widyawati
- Department of Health Sciences, Faculty of Public Health, Airlangga University, Surabaya
| | - Rahmat Hargono
- Department of Health Education and Behavioural Sciences, Faculty of Public Health, Airlangga University, Surabaya
| | - Ahsan Ahsan
- Department of Nursing, Faculty of Medicine, Brawijaya University, Kota Malang, Jawa Timur, Indonesia
| | - Kumboyono Kumboyono
- Department of Nursing, Faculty of Medicine, Brawijaya University, Kota Malang, Jawa Timur, Indonesia
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Stark CM, Garner CD, Garg A, Bégin F. Building Capacity of Health Professionals in Low- and Middle-Income Countries Through Online Continuing Professional Development in Nutrition. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:63-69. [PMID: 33560042 PMCID: PMC7919702 DOI: 10.1097/ceh.0000000000000334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
ABSTRACT Continuing professional development (CPD) in low- and middle-income countries (LMICs) can build capacity of health professionals in infant and young child feeding (IYCF). However, travel to in-person workshops can be time-consuming and expensive. Thus, we developed a free online course to provide training in IYCF to health professionals globally; the course received overwhelmingly high numbers of registrations. Our aim was to conduct a program evaluation to assess course satisfaction, learning, and application using surveys administered postcourse and 9 months later. Response rates were 99% (n = 835) and 55% (n = 312), respectively. Among those who only partially completed the course, reasons for noncompletion were assessed (response rate 29%, n = 72). Data within a 1-year period were analyzed. Respondents worked in multiple settings and organizations worldwide. Nearly all (99%) reported postcourse that they learned "a lot" or "some" from all topics, and over 70% applied "a lot" of or "some" information 9 months later. In open-ended questions, respondents reported improved knowledge, skills, and competence to conduct their work; they also desired more similar training courses. Many who did not complete the course reported "not enough time" as the main reason (74%), and most (94%) wanted to continue it. The positive response to the course suggests there is an unmet need for CPD for health professionals in LMICs. Our evaluation found that online training was feasible, acceptable, and increased professionals' knowledge and application of IYCF concepts in nutrition programming. Increased use of online CPD offers the potential for global capacity-building in other health-related topics.
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Affiliation(s)
- Christina M. Stark
- Ms. Stark: Senior Extension Associate, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Garner: Clinical Assistant Professor, Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX; Dr. Garg: Nutrition Specialist, United Nations Children's Fund (UNICEF) Headquarters, New York, NY; and Dr. Bégin: Senior Advisor, Nutrition, United Nations Children's Fund (UNICEF) Headquarters, New York, NY
| | - Christine D. Garner
- Ms. Stark: Senior Extension Associate, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Garner: Clinical Assistant Professor, Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX; Dr. Garg: Nutrition Specialist, United Nations Children's Fund (UNICEF) Headquarters, New York, NY; and Dr. Bégin: Senior Advisor, Nutrition, United Nations Children's Fund (UNICEF) Headquarters, New York, NY
| | - Aashima Garg
- Ms. Stark: Senior Extension Associate, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Garner: Clinical Assistant Professor, Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX; Dr. Garg: Nutrition Specialist, United Nations Children's Fund (UNICEF) Headquarters, New York, NY; and Dr. Bégin: Senior Advisor, Nutrition, United Nations Children's Fund (UNICEF) Headquarters, New York, NY
| | - France Bégin
- Ms. Stark: Senior Extension Associate, Division of Nutritional Sciences, Cornell University, Ithaca, NY; Dr. Garner: Clinical Assistant Professor, Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, TX; Dr. Garg: Nutrition Specialist, United Nations Children's Fund (UNICEF) Headquarters, New York, NY; and Dr. Bégin: Senior Advisor, Nutrition, United Nations Children's Fund (UNICEF) Headquarters, New York, NY
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Jacob MCM, Araújo FRD. [Competency building in Nutrition in the context of Sustainable Food Systems]. CIENCIA & SAUDE COLETIVA 2020; 25:4369-4378. [PMID: 33175046 DOI: 10.1590/1413-812320202511.31652018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 04/15/2019] [Indexed: 11/22/2022] Open
Abstract
The current discussion on the impacts of food systems on human and environmental health highlights the importance of training professionals who can work on the development of the future agenda that can incorporate the complexities of nutrition into policies, research, and the rendering of services relevant to the community. This paper presents the conclusions reached at a Brazilian event in 2018 that brought together specialists on the subject, namely students and qualified specialists in nutrition committed to understanding and identifying aspects of the training that limit professional performance. Necessary requirements were identified for the development of the workforce in nutrition, including specific knowledge, a set of specific technical skills to deal with this scenario and, lastly, the necessary dialogue with other specialized areas of knowledge. Ten recommendations on the characteristics of the curriculum and practices of the professional category that could foster the construction of the necessary skills were highlighted. The recommendations may contribute to successful training actions in nutrition in the light of the growing need for alignment with the current problems of Food and Nutrition Security and full attainment of the Sustainable Development Objectives.
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Affiliation(s)
- Michelle Cristine Medeiros Jacob
- Departamento de Nutrição, Universidade Federal do Rio Grande do Norte (UFRN). Av. Senador Salgado Filho 3000, Lagoa Nova. 59078-970 Natal RN Brasil.
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Tramontt CR, Jaime PC. Improving knowledge, self-efficacy and collective efficacy regarding the Brazilian dietary guidelines in primary health care professionals: a community controlled trial. BMC FAMILY PRACTICE 2020; 21:214. [PMID: 33087054 PMCID: PMC7580020 DOI: 10.1186/s12875-020-01245-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/11/2020] [Indexed: 11/10/2022]
Abstract
Background Capacity-building of health professionals regarding to nutrition is a strategy for qualifying public health work to promote healthy diets in primary health care (PHC) services. Objective To evaluate the effect of an intervention based on Brazilian Dietary Guidelines (BDG) on the knowledge, self-efficacy (SE) and collective efficacy (CE) of interprofessional teams working in PHC. Methods It refers to a pre-post intervention study involving 24 health professionals divided into a control group (CG) and intervention (IG). The IG received a 16-h educational workshop on the BDG, guided by a validated protocol. Knowledge, SE and CE for using the BDG were assessed via a self-administered scale, ranging from 0 to 16 and 0 to 36 points, respectively; the scale was previously validated, completed before and after 2 months of the intervention. The effects of the intervention were estimated by paired t-test for intragroup comparisons over time. Results The mean difference in the knowledge and SE scores of the IG pre- and post-intervention was 2.0 (CI 0.49–3.51) and 6.75 (CI 4.05–9.45) points, respectively. These results means the IG participants obtained 59 and 52.8% more points in knowledge and in SE in relation to CG, with significative difference (p = 0.007 and p < 0.00, respectively). There was no significant variation in the CE scores in both groups. Conclusions Considering the results presented and due to the originality of the study in question, the educational workshop was effective in increasing the knowledge and SE of professionals working in PHC in using the Dietary Guidelines in their work routines. These findings can assist other research in developing nutrition interventions with interprofessional teams.
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Affiliation(s)
- C R Tramontt
- Nutrition in Public Health Postgraduate Program, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, SP, 01246-904, Brazil.
| | - P C Jaime
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo, SP, 01246-904, Brazil
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Gonzalez W, Bonvecchio Arenas A, García-Guerra A, Vilar-Compte M, Villa de la Vega A, Quezada L, Rosas C, Lozada-Tequeanes AL, Hernández A. An Iterative Process for Training Design and Implementation Increased Health Workers' Knowledge for Taking Nutrition Behavior Change to Scale. J Nutr 2019; 149:2323S-2331S. [PMID: 31793649 PMCID: PMC6887730 DOI: 10.1093/jn/nxz203] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/05/2019] [Accepted: 07/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. OBJECTIVE The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. METHODS The design and implementation of training followed a 5-phase process: situation analysis, formative research, large-scale feasibility study, redesign and scale up, and evaluation. We conducted document reviews, surveys, and focus groups during the first phases to inform and refine the training, as well as a pre- and posttraining telephone survey to evaluate change in knowledge. RESULTS The initial phases of the design provided a clear understanding of the opportunities and challenges for promoting infant and young child feeding, as well as health workers' routines and practices, which informed training design. The feasibility study allowed tailoring and refinement of training. The vertical coherence and coordination between the federal and state levels during redesign and scale up facilitated compliance with training timeline and process. Evaluation results showed significant improvement in knowledge posttraining of up to 19 percentage points. CONCLUSIONS The EsIAN training component for health providers was developed using a systematic approach to consolidate and generate relevant evidence, following an iterative process to test, learn, and improve both design and implementation. This process allowed for flexibility to take advantage of new opportunities and respond to findings from iterations. Garnering and ensuring political support allowed for continuity and sustainability of actions.
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Affiliation(s)
- Wendy Gonzalez
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
| | | | | | | | | | - Laura Quezada
- Instituto Nacional de Salud Pública (INSP), Cuernavaca, México
| | - Cynthia Rosas
- División de Capacitación y Adiestramiento Técnico, Instituto Mexicanos del Seguro Social (IMSS), Alcaldía Cuauhtémoc, Ciudad de México, Mexico
| | | | - Amira Hernández
- Instituto Nacional de Salud Pública (INSP), Cuernavaca, México
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Using unfolding case studies to better prepare the public health nutrition workforce to address the social determinants of health. Public Health Nutr 2018; 22:180-183. [PMID: 30394260 DOI: 10.1017/s1368980018002811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The public health nutrition workforce has been reported to be underprepared for practice. The present study aimed to test the ability of an unfolding case study approach to support the public health nutrition workforce for the workplace, with a focus on improved access to nutritious food. DESIGN Two unfolding case studies were trialled with undergraduate students in two-hour workshops to enhance their capability to address access to nutritious food as a social determinant of health. The approach provided information about the case using a staged approach that supported learners to review and reply to information and then continue this process as the case became increasingly complex. SETTING Melbourne, Australia.ParticipantsThirty-eight undergraduate nutrition and dietetics students. RESULTS The analysis revealed that the unfolding case study approach provided a place to challenge and deepen knowledge and think about the application of theory. As the cases developed and became more challenging, students were supported to consider appropriate approaches and recognised the constant evolution and dynamic nature of practice. CONCLUSIONS This learning activity challenged students and supported deep learning about possible solutions. It may also be useful at a graduate level and for continuous education of nutritionists and/or dietitians to empower the workforce to address the social determinants of health, rather than just acknowledging them as a set of barriers that prevent people and communities from achieving optimal health. Further work is required to investigate how unfolding case studies in curricula shape preparedness for practice of public health nutrition.
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Abstract
Iron deficiency remains the largest nutritional deficiency worldwide and the main cause of anaemia. Severe iron deficiency leads to anaemia known as iron deficiency anaemia (IDA), which affects a total of 1·24 billion people, the majority of whom are children and women from resource-poor countries. In sub-Saharan Africa, iron deficiency is frequently exacerbated by concomitant parasitic and bacterial infections and contributes to over 120 000 maternal deaths a year, while it irreparably limits the cognitive development of children and leads to poor outcomes in pregnancy.Currently available iron compounds are cheap and readily available, but constitute a non-physiological approach to providing iron that leads to significant side effects. Consequently, iron deficiency and IDA remain without an effective treatment, particularly in populations with high burden of infectious diseases. So far, despite considerable investment in the past 25 years in nutrition interventions with iron supplementation and fortification, we have been unable to significantly decrease the burden of this disease in resource-poor countries.If we are to eliminate this condition in the future, it is imperative to look beyond the strategies used until now and we should make an effort to combine community engagement and social science approaches to optimise supplementation and fortification programmes.
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