1
|
Brock DJP, Yuhas M, Porter KJ, Chow PI, Ritterband LM, Tate DF, Zoellner JM. Outcomes of a Caregiver-Focused Short Message Service (SMS) Intervention to Reduce Intake of Sugar-Sweetened Beverages in Rural Caregivers and Adolescents. Nutrients 2023; 15:1957. [PMID: 37111178 PMCID: PMC10141983 DOI: 10.3390/nu15081957] [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: 03/15/2023] [Revised: 04/07/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
This study examined enrollment, retention, engagement, and behavior changes from a caregiver short message service (SMS) component of a larger school-based sugar-sweetened beverage (SSB) reduction intervention. Over 22 weeks, caregivers of seventh graders in 10 Appalachian middle schools received a two-way SMS Baseline Assessment and four monthly follow-up assessments to report their and their child's SSB intake and select a personalized strategy topic. Between assessments, caregivers received two weekly one-way messages: one information or infographic message and one strategy message. Of 1873 caregivers, 542 (29%) enrolled by completing the SMS Baseline Assessment. Three-quarters completed Assessments 2-5, with 84% retained at Assessment 5. Reminders, used to encourage adherence, improved completion by 19-40%, with 18-33% completing after the first two reminders. Most caregivers (72-93%) selected a personalized strategy and an average of 28% viewed infographic messages. Between Baseline and Assessment 5, daily SSB intake frequency significantly (p < 0.01) declined for caregivers (-0.32 (0.03), effect size (ES) = 0.51) and children (-0.26 (0.01), ES = 0.53). Effect sizes increased when limited to participants who consumed SSB twice or more per week (caregivers ES = 0.65, children ES = 0.67). Findings indicate that an SMS-delivered intervention is promising for engaging rural caregivers of middle school students and improving SSB behaviors.
Collapse
Affiliation(s)
- Donna-Jean P. Brock
- Department of Public Health Sciences, Community-Based Health Equity Research Program, University of Virginia, Christiansburg, VA 24073, USA; (D.-J.P.B.)
| | - Maryam Yuhas
- Department of Nutrition and Food Studies, Falk College, Syracuse University, Syracuse, NY 13244, USA;
| | - Kathleen J. Porter
- Department of Public Health Sciences, Community-Based Health Equity Research Program, University of Virginia, Christiansburg, VA 24073, USA; (D.-J.P.B.)
| | - Philip I. Chow
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22908, USA; (P.I.C.)
| | - Lee M. Ritterband
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22908, USA; (P.I.C.)
| | - Deborah F. Tate
- Department of Nutrition, Communication for Health Applications and Interventions Core, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Jamie M. Zoellner
- Department of Public Health Sciences, Community-Based Health Equity Research Program, University of Virginia, Christiansburg, VA 24073, USA; (D.-J.P.B.)
| |
Collapse
|
2
|
Perspectives of Black/African American and Hispanic Parents and Children Living in Under-Resourced Communities Regarding Factors That Influence Food Choices and Decisions: A Qualitative Investigation. CHILDREN-BASEL 2021; 8:children8030236. [PMID: 33803630 PMCID: PMC8002848 DOI: 10.3390/children8030236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/17/2022]
Abstract
Families living in under-resourced communities are at risk of obesity and obesity-related chronic diseases. To develop effective interventions, it is important to identify parent and child perspectives of factors that influence food-related choices and decisions. This paper reports qualitative findings from a larger mixed method study investigating this topic. Hybrid thematic analysis was used to code and analyze the interviews. Family-generated photographs of factors influencing food choices were discussed during the interviews. Qualitative findings were organized by the socio-ecological model. Verbatim quotes and photographs were used to support themes. Thirty-six interviews were conducted (18 parents, 18 children). Findings from parents revealed personal (e.g., culture, beliefs, time), family (e.g., mother, child, father, health, finances, cohesiveness), environmental (e.g., availability, convenience, cost), and other (e.g., school food) factors influenced food choices. Similarly, child-reported influences were personal (e.g., preferences, beliefs, taste), family (e.g., mother, family encouragement, father, family time), social (e.g., school, friends), environmental (e.g., availability), and other (e.g., media, sports). The socio-ecological model provided a useful framework for identifying factors that influence food choices and decisions of families living in under-resourced communities. A deeper understanding of these factors could enhance both responsiveness and effectiveness of interventions to enhance diet and reduce obesity risk in families living in under-resourced communities.
Collapse
|
3
|
Tataw DB. Using an Integrated Conceptual Framework to Clarify Health Problems and Assess A Community Health Planning Process: A Mid-Western USA Case Study. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:392-412. [PMID: 32799632 DOI: 10.1080/19371918.2020.1802384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Within a case study design, this paper clarifies community problems, and assesses a Community Health Improvement Plan development process using a framework of explanatory models and change theories that links the macro social model, the materialistic model, social cognitive theory, theory of fundamental causes, and community organizing theory. Properties of demographic and health status artifacts are consistent with the core constructs in both the macro social and the materialistic models. The constructs in social cognitive theory and the theory of fundamental causes seem to influence program strategies even as socio-economic factors were only minimally addressed. At the organizing level, the Plan excelled in locality development and social planning but was short on social action. The findings suggest a need for social action as a model of practice in solving persistent social and health problems, and for research that investigates if social action practice can predict success in resolving these problems.
Collapse
Affiliation(s)
- David Besong Tataw
- College of Health and Human Services, Northern Kentucky University , Highland Heights, Kentucky, USA
| |
Collapse
|
4
|
Hampton-Anderson JN, Craighead LW. Psychosociocultural Contributors to Maladaptive Eating Behaviors in African American Youth: Recommendations and Future Directions. Am J Lifestyle Med 2020; 15:621-633. [PMID: 34916883 DOI: 10.1177/1559827620936951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/29/2020] [Accepted: 06/04/2020] [Indexed: 12/15/2022] Open
Abstract
Childhood overweight and obesity disproportionately affects African Americans, and these children benefit less from standard pediatric weight management treatment programs compared to other racial/ethnic groups. Maladaptive eating behavior has been identified as a behavioral contributor to obesity and is also associated with the development of nonrestrictive eating disorders over time. Unique psychosociocultural factors have been identified that may promote higher risk for maladaptive eating behaviors in African American children beyond the effects of economic disparity. To best treat this group, it is important for practitioners to have a thorough understanding of these factors. We review several of these considerations and describe ways they may interact to contribute to the subsequent development of maladaptive eating behaviors and increased weight. Recommendations are made regarding how attention to these factors could be incorporated into current pediatric weight management treatments to better serve this population via a patient-centered care approach. Future directions will also be discussed.
Collapse
Affiliation(s)
- Joya N Hampton-Anderson
- Department of Psychiatry and Behavioral Sciences (JNHA), Emory University, Atlanta, Georgia.,Psychology Department (LWC), Emory University, Atlanta, Georgia
| | - Linda W Craighead
- Department of Psychiatry and Behavioral Sciences (JNHA), Emory University, Atlanta, Georgia.,Psychology Department (LWC), Emory University, Atlanta, Georgia
| |
Collapse
|
5
|
Ek A, Delisle Nyström C, Chirita-Emandi A, Tur JA, Nordin K, Bouzas C, Argelich E, Martínez JA, Frost G, Garcia-Perez I, Saez M, Paul C, Löf M, Nowicka P. A randomized controlled trial for overweight and obesity in preschoolers: the More and Less Europe study - an intervention within the STOP project. BMC Public Health 2019; 19:945. [PMID: 31307412 PMCID: PMC6631737 DOI: 10.1186/s12889-019-7161-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 12/15/2022] Open
Abstract
Background Childhood overweight and obesity is a serious public health issue with an increase being observed in preschool-aged children. Treating childhood obesity is difficult and few countries use standardized treatments. Therefore, there is a need to find effective approaches that are feasible for both health care providers and families. Thus, the overall aim of this study is to assess the acceptance and effectiveness of a parent support program (the More and Less, ML) for the management of overweight and obesity followed by a mobile health (mHealth) program (the MINISTOP application) in a socially diverse population of families. Methods/design A two-arm, parallel design randomized controlled trial in 300 2-to 6-year-old children with overweight and obesity from Romania, Spain and Sweden (n = 100 from each). Following baseline assessments children are randomized into the intervention or control group in a 1:1 ratio. The intervention, the ML program, consists of 10-weekly group sessions which focus on evidence-based parenting practices, followed by the previously validated MINISTOP application for 6-months to support healthy eating and physical activity behaviors. The primary outcome is change in body mass index (BMI) z-score after 9-months and secondary outcomes include: waist circumference, eating behavior (Child Eating Behavior Questionnaire), parenting behavior (Comprehensive Feeding Practices Questionnaire), physical activity (ActiGraph wGT3x-BT), dietary patterns (based on metabolic markers from urine and 24 h dietary recalls), epigenetic and gut hormones (fasting blood samples), and the overall acceptance of the overweight and obesity management in young children (semi-structured interviews). Outcomes are measured at baseline and after: 10-weeks (only BMI z-score, waist circumference), 9-months (all outcomes), 15- and 21-months (all outcomes except physical activity, dietary patterns, epigenetics and gut hormones) post-baseline. Discussion This study will evaluate a parent support program for weight management in young children in three European countries. To boost the effect of the ML program the families will be supported by an app for 6-months. If the program is found to be effective, it has the potential to be implemented into routine care to reduce overweight and obesity in young children and the app could prove to be a viable option for sustained effects of the care provided. Trial registration ClinicalTrials.gov NCT03800823; 11 Jan 2019.
Collapse
Affiliation(s)
- Anna Ek
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| | | | - Adela Chirita-Emandi
- Genetics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.,"Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara, Romania
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Cristina Bouzas
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - Emma Argelich
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain.,CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain
| | - J Alfredo Martínez
- CIBER of Physiology of Obesity and Nutrition (CIBEROBN), Instituto Carlos III, Madrid, Spain.,Department of Nutrition, Food Science, and Physiology, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IMDEA Food Precision Nutrition, Madrid, Spain
| | - Gary Frost
- Section for Nutrition Research, Department of Medicine, Imperial College London, Hammersmith Campus, London, UK
| | - Isabel Garcia-Perez
- Division of Systems and Digestive Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, South Kensington Campus, London, UK
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Campus de Montilivi, Girona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Instituto Carlos III, Madrid, Spain
| | - Corina Paul
- Pediatrics Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.,2nd Pediatrics Clinic, Clinical Emergency County Hospital Timisoara, Timisoara, Romania
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
| |
Collapse
|