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Muellmann S, Gansefort D, Zeeb H, Brand T. Addressing community readiness to promote physical activity in older adults in Germany. Health Promot Int 2023; 38:daad158. [PMID: 38011398 DOI: 10.1093/heapro/daad158] [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] [Indexed: 11/29/2023] Open
Abstract
Community-based approaches are promising to promote physical activity in old age. The community readiness (CR) model offers a structured approach to assess community capacities to address a certain health topic before and after implementing an intervention. The objective of this study is to assess whether community-based capacity building for physical activity among the elderly has a lasting effect on CR. Four communities (two sub-urban and two urban) in Northwestern Germany were randomly assigned to either intervention or control group. CR was assessed at three time points (2015, 2018 and 2020) by interviewing local key informants (n = 129). Community capacity building was carried out in the two intervention communities after baseline assessment and included the development and implementation of a local physical activity action plan for elderly. Overall CR scores were calculated and random effects regression analysis was performed to analyze group-by-time interaction. At baseline, the overall CR score was 4.62 (standard deviation (SD) = 0.51) indicating that communities were in the preplanning stage of CR. CR scores in the intervention communities did not significantly increase at follow-up assessments compared to control communities [2018: 4.82, coefficient -0.03, 95% confidence interval (CI) (-0.80; 0.73); 2020: 4.54, coefficient 0.19, 95% CI: (-0.59; 0.97)]. The process evaluation indicated several factors facilitating a successful cooperation with community stakeholders. These included building on existing networks, using a structured approach for developing and implementing a local physical activity action plan for older adults, providing financial support for implementing activities and linking activities to existing community events.
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Affiliation(s)
- Saskia Muellmann
- Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany
| | - Dirk Gansefort
- Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany
- Association for Health Promotion and Academy for Social Medicine Lower Saxony Bremen, Fenskenweg 2, 30165 Hannover, Germany
| | - Hajo Zeeb
- Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany
- Health Sciences Bremen, University of Bremen, Grazer Str. 4, 28359 Bremen, Germany
| | - Tilman Brand
- Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany
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He L, Svelnis I, Ferraro A, McCrindle BW, Moon T, Salmon A, Longmuir PE. Community Readiness Assessment of the "Take TIME for Your Child's Health" Intervention. Healthcare (Basel) 2023; 11:2386. [PMID: 37685420 PMCID: PMC10487062 DOI: 10.3390/healthcare11172386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Take TIME (Tobacco-free, Injury-free, Moving daily, Eating healthy) was an early intervention strategy targeting community readiness to support healthy lifestyles for young children in Uxbridge, Canada. This study aimed to assess the effectiveness of Take TIME using the Community Readiness Model adapted for childhood obesity prevention. Six interviews were completed in Uxbridge, before and after the intervention, with purposively selected community leaders in education, political, business, religious, not-for-profit, and healthcare fields. Each interview was rated independently by two scorers. Interview content was scored (scale from 1 to 9, with 1 being no awareness and 9 being a high level of community ownership) according to the Community Readiness Model criteria on six dimensions, with overall readiness calculated as the mean score of all dimensions. T-tests compared readiness by time-point and between communities. Overall community readiness significantly improved (p = 0.03) in Uxbridge from pre-intervention (3.63 ± 1.14 vague awareness) to post-intervention (5.21 ± 0.97 preparation). Seven interviews were also completed with leaders in the matched town of Rockwood, Canada which served as the control community. Rockwood readiness was close to the Uxbridge post-intervention score (5.35 ± 1.11). Results indicated increased awareness and leadership support post-intervention in Uxbridge, but further improvements in community knowledge, formalized efforts, and additional leadership support are desired. Take TIME increased community readiness to support healthy lifestyles for young children and may be useful to other communities at similar stages, given its theoretical alignment with the community readiness model. Future research should investigate the impact of Take TIME in demographically diverse communities and appropriate interventions to move communities from the preparation to the action stage.
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Affiliation(s)
- Lisa He
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Ingrid Svelnis
- Township of Uxbridge, Uxbridge, ON L9P 1H1, Canada; (I.S.); (A.F.)
| | - Amanda Ferraro
- Township of Uxbridge, Uxbridge, ON L9P 1H1, Canada; (I.S.); (A.F.)
| | - Brian W. McCrindle
- Division of Cardiology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
| | - Tyler Moon
- Heart and Stroke Foundation, Toronto, ON M4P 1E4, Canada;
| | - Art Salmon
- Canadian Fitness and Lifestyle Research, Ottawa, ON K1B 0A9, Canada;
| | - Patricia E. Longmuir
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
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Finn EB, Whang C, Hong PH, Costa SA, Callahan EA, Huang TTK. Strategies to improve the implementation of intensive lifestyle interventions for obesity. Front Public Health 2023; 11:1202545. [PMID: 37559739 PMCID: PMC10407556 DOI: 10.3389/fpubh.2023.1202545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/04/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Emily Benjamin Finn
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Christine Whang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Peter Houlin Hong
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Sergio A. Costa
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | | | - Terry T. -K. Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
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Niknam M, Omidvar N, Eini-Zinab H, Kalantari N, Olazadeh K, Amiri P. Improving community readiness among Iranian local communities to prevent childhood obesity. BMC Public Health 2023; 23:344. [PMID: 36793004 PMCID: PMC9931445 DOI: 10.1186/s12889-023-15163-3] [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: 11/10/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Community Readiness Intervention for Tackling Childhood Obesity (CRITCO) is a theory-based intervention being developed to improve the readiness of an Iranian urban population to engage in childhood obesity prevention programs. This study aimed to explore changes in readiness of intervention and control local communities from diverse socio-economic areas of Tehran. METHODS This study was a seven-month quasi-experimental intervention implemented in four intervention communities and compared with four controls. Aligned strategies and action plans were developed around the six dimensions of community readiness. The Food and Nutrition Committee was established in each intervention community to make collaborative efforts among different sectors and assess the fidelity of the intervention. The pre-and post- readiness change was explored through interviews with 46 community key informants. RESULTS The total readiness of intervention sites increased by 0.48 units (p < 0.001) and shifted to the next higher level, from preplanning to the preparation stage. At the same time, the readiness of control communities decreased by 0.39 units (p < 0.001), although their readiness stage remained unchanged, reflecting the fourth stage. Also, a sex-dependent CR change was observed, such that the girls' schools showed a more remarkable improvement in interventions and less decline in controls. The readiness stages of interventions significantly improved for four dimensions related to community efforts, knowledge of the efforts, knowledge of childhood obesity issue, and leadership. Furthermore, the readiness of control communities significantly decreased on three of six dimensions related to community effort, knowledge of efforts, and resources. CONCLUSIONS The CRITCO successfully improved the readiness of intervention sites for addressing childhood obesity. It is hoped that the present study can be a spark for developing readiness-based childhood obesity prevention programs in Middle Eastern and other developing countries. TRIAL REGISTRATION The CRITCO intervention was registered at Iran Registry for Clinical Trials ( http://irct.ir ; IRCT20191006044997N1) on 11/11/2019.
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Affiliation(s)
- Mahdieh Niknam
- grid.411600.2Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran.
| | - Hassan Eini-Zinab
- grid.411600.2Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran
| | - Naser Kalantari
- grid.411600.2Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran
| | - Keyvan Olazadeh
- grid.411600.2Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran.
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Schröder M, Schnabel M, Hassel H, Babitsch B. Application of the Community Readiness Model for childhood obesity prevention: a scoping review. Health Promot Int 2022; 37:6680028. [PMID: 36047636 DOI: 10.1093/heapro/daac120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Community Readiness Model (CRM) provides an approach to determine community readiness (CR), which is the degree of a community's preparedness to address a health issue. This scoping review aims to characterize internationally existing applications of the CRM for childhood obesity prevention. Therefore, a systematic literature research was conducted in PubMed, Cochrane Library, LIVIVO and Google Scholar. Of 285 identified records, 17 studies met the eligibility criteria and were included in the scoping review. The CRM has already been applied to childhood obesity prevention in the USA (n = 10), Australia (n = 4), UK (n = 1), Iran (n = 1) and South Africa (n = 1). Mainly geographically defined communities (n = 12) like counties and cities were analysed but also schools (n = 4) and churches (n = 1). The scoping review revealed various methodological changes to the standard protocol of which some are particularly relevant for the application to childhood obesity prevention. The identified studies reported readiness scores in the low to mid-range of the nine-point readiness scale. To increase CR, strategies were proposed that addressed raising awareness and knowledge of childhood obesity, but also supporting connectivity in and between settings. This scoping review provides researchers and health promoters with an overview of international CR measurements and setting-specific strategies to increase CR. It highlights the potential of targeted interventions to increase readiness and shows tentative support for the assumption of a possible link between CR level and changes in obesity prevalence.
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Affiliation(s)
- Maike Schröder
- Coburg University of Applied Sciences and Arts, Department of Holistic Health Sciences, Coburg, Germany.,Osnabrück University, Department of New Public Health, Osnabrück, Germany
| | - Monika Schnabel
- Coburg University of Applied Sciences and Arts, Department of Holistic Health Sciences, Coburg, Germany
| | - Holger Hassel
- Coburg University of Applied Sciences and Arts, Department of Holistic Health Sciences, Coburg, Germany
| | - Birgit Babitsch
- Osnabrück University, Department of New Public Health, Osnabrück, Germany
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Shawky S, Kubacki K, Dietrich T, Weaven S. Is social media a panacea for social marketing communication? A scoping review. Health Mark Q 2022; 39:297-313. [PMID: 35670205 DOI: 10.1080/07359683.2022.2082136] [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: 10/18/2022]
Abstract
Recognizing the potential of social media as an integral driver of communication that facilitates two-way conversations, this scoping review seeks to identify and synthesize salient benefits and challenges of social media usage reported in social marketing communication. Following a systematic literature review procedure, 31 social marketing studies utilizing social media communications channels were identified. The findings were thematically grouped under eight main topics: targeted reach and raising awareness, continuous consumer insight, ongoing interaction and dialogue, promoting behavior change, cost and time efficiency, discussing sensitive issues, building relationships and social media challenges. Identified taxonomies inform future research.
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Affiliation(s)
- Sara Shawky
- Griffith Business School, Griffith University, Brisbane, Australia
| | - Krzysztof Kubacki
- Marketing Department, Faculty of Business, Economics and Law, Auckland University of Technology, Auckland, New Zealand
| | - Timo Dietrich
- Griffith Business School, Griffith University, Brisbane, Australia
| | - Scott Weaven
- Griffith Business School, Griffith University, Brisbane, Australia
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Mandoh M, Redfern J, Mihrshahi S, Cheng HL, Phongsavan P, Partridge SR. Shifting From Tokenism to Meaningful Adolescent Participation in Research for Obesity Prevention: A Systematic Scoping Review. Front Public Health 2022; 9:789535. [PMID: 35004591 PMCID: PMC8734426 DOI: 10.3389/fpubh.2021.789535] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/30/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Traditionally, adolescent participation in research has been tokenistic. Adolescents are rarely afforded the opportunity to influence decision-making in research designed to prevent obesity. Engaging adolescents in meaningful decision-making may enhance research translation. This review aimed to analyze the current modes and nature of adolescent participation in obesity prevention research decision-making. Methods: A systematic scoping review was conducted using Arksey and O'Malley's six-stage framework. Six major databases were searched for peer-reviewed primary research studies with adolescent participation related to obesity, physical activity, and diet. Modes of adolescent participation were categorized based on the Lansdown-UNICEF conceptual framework for measuring outcomes of adolescent participation. The framework outlines three modes of meaningful participation: (i) consultative, which involves taking opinions and needs into consideration; (ii) collaborative, where adolescents are partners in the decision-making process; and (iii) adolescent-led participation where adolescents have the capacity to influence the process and outcomes. The degree of involvement in research cycles was classified based on the National Health and Medical Research Council consumer engagement framework. Five stages of the research cycle were determined: identify, design and develop, conduct, analyze and disseminate. Results: In total, 126 papers describing 71 unique studies were identified. Of these, 69% (49/71) took place in the USA, and 85% (52/61) were conducted in minority or underserved communities, while males were more likely to be under-represented. In 49% (35/71) of studies, participation was consultative and 9% (6/71) of studies involved an adolescent-led approach. Furthermore, 87% (62/71) of studies incorporated adolescent participation in one or more of the research cycle's formative phases, which involve eliciting views, opinions and idea generation. Only 11% of studies engaged adolescents in all five stages of the research cycle where adolescents could have more influence over the research process. Conclusion: Meaningful adolescent participation in the obesity prevention research cycle is limited. Empowering and mobilizing equal partnership with adolescents should be at the forefront of all adolescent-related obesity prevention research.
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Affiliation(s)
- Mariam Mandoh
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,The George Institute for Global Health, The University of New South Wales, Camperdown, NSW, Australia
| | - Seema Mihrshahi
- Department of Health Systems and Populations, Macquarie University, Sydney, NSW, Australia.,Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Hoi Lun Cheng
- Sydney Medical School, Faculty of Medicine and Health, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, NSW, Australia.,The Children's Hospital at Westmead, Academic Department of Adolescent Medicine, Sydney, NSW, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Stephanie R Partridge
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Niknam M, Omidvar N, Amiri P, Eini-Zinab H, Kalantari N. The Action Plan and Strategy Development for the Community Readiness Improvement for Tackling Childhood Obesity (CRITCO) Study. Int J Endocrinol Metab 2022; 20:e111371. [PMID: 35432551 PMCID: PMC8994822 DOI: 10.5812/ijem.111371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/09/2021] [Accepted: 08/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Community Readiness Improvement for Tackling Childhood Obesity (CRITCO) study has been developed based on the community readiness model (CRM) to improve the readiness of targeted local communities from two diverse socioeconomic districts of Tehran for tackling childhood obesity (CO) of late primary school children (10 - 12 years of age). OBJECTIVES This study aimed to describe the rationale and process of developing the fourth phase of CRITCO study by developing an intervention package. METHODS The readiness level data was used to analyze strengths, weaknesses, opportunities, and threats (SWOT) of four intervention sites to guide proper strategies in partnership with key community members. Then, the action plan was developed as a living document to guide a 6-month quasi-experimental community-based intervention around the six dimensions of CRM. Finally, the community engagement process, outcome, and evaluation process were explained. RESULTS The current report described the action plan and strategy development of the CRITCO study. Expectedly, this study can provide valuable information to guide the public health policymakers in planning and executing relevant interventions.
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Affiliation(s)
- Mahdieh Niknam
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lilo EA, West A. "OMG, I Get Like 100 Teaspoons of Sugar a Day!" Rural Teens' Grasp of Their Beverage Consumption Habits. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 42:272684X211004928. [PMID: 33752544 DOI: 10.1177/0272684x211004928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As part of a campaign to encourage healthier beverage consumption in a rural New Mexico high school, we wanted to understand students' perceptions of their habits, and the associated health risks and benefits surrounding water and sugar-sweetened beverage consumption to influence future messaging to change behavior. We conducted a posthoc qualitative analysis of 27 student interviews from the program evaluation with both students who participated in the campaign and those who did not. Pre-campaign, students appeared largely unaware of the health risks posed by their beverage consumption habits, lacking any knowledge of nutritional recommendations, water recommendations, or of the sugar levels in products. When informed of the risks, students expressed concern for themselves, their family members, and friends, indicated a desire to make significant changes, and reported making changes for themselves, and educating others regarding the risks. Given the large amounts of money spent and concentrated efforts focused on marketing SSBs to teens, it is critically important to be educating teens and engaging them in behavior change strategies. These data can inform future strategies to improve teen health behaviors and encourage teens to become family health messengers for obesity and diabetes prevention.
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Affiliation(s)
- Emily A Lilo
- Department of Communication and Journalism, University of New Mexico, Albuquerque, New Mexico, United States
| | - Andrew West
- Department of Communication and Journalism, University of New Mexico, Albuquerque, New Mexico, United States
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Qualitative evaluation of a social media campaign to improve healthy food habits among urban adolescent females in Indonesia. Public Health Nutr 2020; 24:s98-s107. [PMID: 32907648 PMCID: PMC10071218 DOI: 10.1017/s1368980020002992] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study focuses on how adolescent girls in urban Indonesia accept technology in a social media (SM) campaign to promote healthy eating habits. DESIGN The study was a qualitative evaluation of the online campaign. In-depth interviews using semi-structured interview guidelines and focus group discussions were used to collect data. Data were analysed using a general inductive approach to provide simple and straightforward answers to our study questions. SETTINGS The study was conducted in two urban areas in Indonesia: Jakarta and Jogjakarta. PARTICIPANTS Adolescent girls aged 16-19 years. RESULTS The SM campaign was perceived as beneficial for increasing participants' knowledge. The campaign helped increase participants' awareness of healthy diets and the health risks of unhealthy diets as well as increase their motivation to change their behaviour and avoid foods containing salt, sugar and excess fat. The participants perceived information from the online campaign as complete and trustworthy. Instagram was cited as the easiest platform to use, while the website was cited as having the most complete information. YouTube provided the best viewing experience but was considered a data-heavy platform. The barriers to change were perceptions of taste, limited choices for healthy but affordable ingredients and family-related factors. CONCLUSIONS The online nutrition campaign was well accepted by Indonesian urban adolescent females and motivated them to act to protect their health. Future nutrition-related SM campaigns aimed at this demographic should focus on platforms with the greatest benefit and ease of use.
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Community Readiness for Child Maltreatment Prevention: The Challenge of a Brief Assessment. J Prim Prev 2020; 41:299-316. [PMID: 32557219 DOI: 10.1007/s10935-020-00591-3] [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: 10/24/2022]
Abstract
In this paper, we address the assessment of community readiness (CR) for the prevention of child maltreatment in the context of a community survey. A mail survey was administered to 222 service providers and 54 supervisors and managers from 35 different organizations serving children and their families in four Canadian communities. Eleven items from the short version of the Readiness Assessment for the Prevention of Child Maltreatment (RAP-CM) were used, in combination with questions assessing knowledge of family support programs offered in the community and a measure of inter-agency collaboration. Findings show that a consistent and valid indicator of "Lack of knowledge of the environment" can be derived from the RAP-CM items and used for screening key informants. Overall, CR appears mixed in the communities studied, the weakest dimensions of which are the will to address the problem and the dynamism of informal social resources. Leadership emerges as a major gap that needs to be addressed.
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School readiness to adopt a school-based adolescent nutrition intervention in urban Indonesia. Public Health Nutr 2020; 24:s72-s83. [PMID: 32375906 PMCID: PMC10071219 DOI: 10.1017/s1368980020001299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify school community readiness to adopt a school-based adolescent nutrition intervention. DESIGN Cross-sectional study: mixed-methods design. The community readiness model was used to guide instrument development and qualitative analysis. Quantitative data are presented using descriptive statistics. Each statement was rated on a seven-point Likert scale, thereby producing scores between 1 (strongly disagree) and 7 (strongly agree). SETTING Ten of the twenty current public secondary schools in Bogor, Indonesia. PARTICIPANTS Ninety teachers and ten school principals. RESULTS Eating behaviour problem awareness was present among all participants; awareness of efforts to improve eating habits was also present, but these efforts were perceived as having low efficacy; support from the City Education Authority and Health Authority was present, but the support type did not match the perceived needs; nutrition education had not been implemented across the entire school community due to competing priorities; existing nutrition policies did not provide concrete scenarios and clear guidelines for nutrition-friendly schools; the availability and accessibility of healthy foods at schools were considered to be key factors in improved adolescent nutrition; positive attitudes existed among respondents towards the implementation of various nutrition programmes, and the median and mode were seven in all types of school-based intervention. CONCLUSIONS The school community readiness level regarding school-based adolescent nutrition interventions is currently in the action phase, implying that community leaders have begun organising efforts to address issues in adolescent nutrition and are aware of their consequences. Future support should be directed towards improving existing efforts and offering concrete ideas and clear policy guidelines for implementation.
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Whelan J, Love P, Millar L, Allender S, Morley C, Bell C. A rural community moves closer to sustainable obesity prevention - an exploration of community readiness pre and post a community-based participatory intervention. BMC Public Health 2019; 19:1420. [PMID: 31666042 PMCID: PMC6820900 DOI: 10.1186/s12889-019-7644-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/20/2019] [Indexed: 11/21/2022] Open
Abstract
Background Understanding levels of community readiness can result in prevention efforts that align with communities’ ability and capacity for change and, therefore, be more effective and sustainable. Our study aimed to use baseline (pre-intervention) community readiness scores to assist with the development of obesity prevention strategies, and to assess changes in community readiness over time (pre/post- intervention), to provide evidence of intervention impact. Method Our study was located in a rural and remote area of Victoria, Australia. Community readiness was part of a broader obesity prevention intervention designed to create healthier food and physical activity environments through the combination of systems thinking and collaborative community-led solutions. Interviews were conducted using the community readiness to change tool in 2016 (pre) and 2018 (post) with a community representative sample. Baseline data informed the development of community relevant strategies and the pre/post results formed part of the overall evaluation. Results The tool generated both quantitative and qualitative (quotes) data. A final readiness score was calculated that corresponded to one of the nine stages of readiness. Four of the five domains of the community readiness to change tool showed statistically significant improvements over time (p < 0.05): knowledge of effort, knowledge of issue, community climate, and leadership. The resources domain that did not improve pre/post intervention. Conclusion Community readiness to change interviews, pre- and post- intervention, provided essential information related to the appropriate targeting and pitch of the prevention strategies, as well as providing an overall evaluation of the positive movement in the community’s readiness to implement change.
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Affiliation(s)
- Jillian Whelan
- Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, Australia.
| | - Penelope Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lynne Millar
- Adjunct Fellow, Victoria University, Melbourne, Australia
| | - Steven Allender
- Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, Australia
| | | | - Colin Bell
- Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, Australia
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Harris KJ, Brown B, Shankle L, Tryon M, Pedersen M, Panarella SK, Swaney G. Community Readiness Model for Prevention Planning: Addressing Childhood Obesity in American Indian Reservation Communities. J Racial Ethn Health Disparities 2019; 6:1144-1156. [PMID: 31332689 DOI: 10.1007/s40615-019-00616-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/03/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The community readiness model (CRM) is a stage-matched assessment protocol to assess community readiness to address a public health issue. To identify appropriate, culturally sensitive, and community-specific intervention strategies for preventing obesity in children, researchers, and community members formed a partnership to address childhood obesity within one American Indian Reservation. METHODS The CRM guided 30 interviews in five communities to direct the team's efforts in addressing obesity among children residing on the reservation. Interviews were scored across six dimensions on an anchored scale of one through nine; scores were then averaged to determine an overall readiness score for each community. A thematic analysis of interview responses aided in interpretation of the readiness scores and identified areas for prevention planning and intervention development. RESULTS The overall community readiness score for the communities was 2.9 (SD = 0.5), which falls between 2 (denial/resistance) and 3 (vague awareness) on the anchored rating scale. The thematic analysis resulted in a hierarchal classification scheme with six broad themes that corresponded to the CRM dimensions and 13 sub-themes. DISCUSSION The low readiness scores directed the team to implement corresponding strategies to increase awareness, while the thematic analysis suggested that action-based approaches might also be appropriate. The narrow range of scores suggest that community-wide assessments may be sufficient unless specific information is needed for each region of the community. The CRM may be an effective way to assess community readiness to address childhood obesity on an American Indian Reservation.
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Affiliation(s)
- Kari Jo Harris
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA.
| | - Blakely Brown
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Lindsey Shankle
- Oregon Rural Practice-Based Research Network, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Mail Code L222, Portland, OR, 97239, USA
| | - Michael Tryon
- Summit Medical Fitness Center, 205 Sunnyview Lane, Kalispell, MT, 59901, USA
| | - Maja Pedersen
- School of Public and Community Health Sciences, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | | | - Gyda Swaney
- Department of Psychology, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
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Pradeilles R, Marr C, Laar A, Holdsworth M, Zotor F, Tandoh A, Klomegah S, Coleman N, Bash K, Green M, Griffiths PL. How ready are communities to implement actions to improve diets of adolescent girls and women in urban Ghana? BMC Public Health 2019; 19:646. [PMID: 31138180 PMCID: PMC6537223 DOI: 10.1186/s12889-019-6989-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/15/2019] [Indexed: 11/16/2022] Open
Abstract
Background Ghana has reached an advanced stage of nutrition transition, contributing to an increase in nutrition-related non-communicable diseases, particularly amongst urban women. Community involvement is an important factor in the success of efforts to promote healthy eating. The readiness of populations to accept a range of interventions needs to be understood before appropriate interventions can be implemented. Therefore, this study assessed how ready urban communities are to improve diets of women of reproductive age in Ghana. Methods Using the Community Readiness Model (CRM), in-depth interviews were conducted with 24 key informants from various sectors in low income communities across two cities in Ghana: Accra and Ho. The CRM consists of 36 open questions addressing five readiness dimensions (community knowledge of efforts, leadership, community climate, knowledge of the issue and resources). Interviews were scored using the CRM protocol with a maximum of 9 points per dimension (from 1 = no awareness to 9 = high level of community ownership). Thematic analysis was undertaken to gain insights of community factors that could affect the implementation of interventions to improve diets. Results The mean community readiness scores indicated that both communities were in the “vague awareness stage” (3.35 ± 0.54 (Accra) and 3.94 ± 0.41 (Ho)). CRM scores across the five dimensions ranged from 2.65–4.38/9, ranging from denial/resistance to pre-planning. In both communities, the mean readiness score for ‘knowledge of the issue’ was the highest of all dimensions (4.10 ± 1.61 (Accra); 4.38 ± 1.81 (Ho)), but was still only at the pre-planning phase. The lowest scores were found for community knowledge of efforts (denial/resistance; 2.65 ± 2.49 (Accra)) and resources (vague awareness; 3.35 ± 1.03 (Ho)). The lack of knowledge of the consequences of unhealthy diets, misconceptions of the issue partly from low education, as well as challenges faced from a lack of resources to initiate/sustain programmes explained the low readiness. Conclusions Despite recognising that unhealthy diets are a public health issue in these urban Ghanaian communities, it is not seen as a priority. The low community readiness ratings highlight the need to increase awareness of the issue prior to intervening to improve diets. Electronic supplementary material The online version of this article (10.1186/s12889-019-6989-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rebecca Pradeilles
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK.
| | - Colette Marr
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK
| | - Amos Laar
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Michelle Holdsworth
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK
| | - Francis Zotor
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Akua Tandoh
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Senam Klomegah
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Nathaniel Coleman
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Kristin Bash
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK
| | - Mark Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - Paula L Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Cardiovascular Disease Prevention in Adolescents: eHealth, Co-Creation, and Advocacy. Med Sci (Basel) 2019; 7:medsci7020034. [PMID: 30813490 PMCID: PMC6410225 DOI: 10.3390/medsci7020034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death globally. Early atherosclerotic changes can begin to occur early in life and though adolescence. The prevalence of modifiable CVD risk factors, namely, smoking, poor diet quality, excessive alcohol intake, physical inactivity, and overweight and obesity can exacerbate the early onset of atherosclerosis. There is a need to improve modifiable risk factors during adolescence to prevent progression to CVD in later life. Electronic health (eHealth) behaviour change interventions are a potential solution for adolescents to improve CVD risk factors, given adolescents are digital frontrunners and digital technology is wide-reaching. The process of co-creating eHealth behaviour change interventions with adolescents is a promising strategy to improve intervention effectiveness and engagement. Additionally, effective youth advocacy is an emerging strategy for CVD prevention in adolescents. This narrative review evaluates published eHealth behaviour change interventions targeting cardiovascular disease risk factors in adolescents, which utilize a co-creation process, describe the emerging role of advocacy in CVD prevention for adolescents and provide recommendations for future interventions.
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Cyril S, Polonsky M, Green J, Agho K, Renzaho A. Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia. AUST HEALTH REV 2017; 41:297-307. [PMID: 27414153 DOI: 10.1071/ah16069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/23/2016] [Indexed: 11/23/2022]
Abstract
Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives. Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives. Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score=4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives. Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia. What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities' readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However, no studies in Australia have assessed disadvantaged communities' readiness to engage in obesity prevention initiatives. What does this paper add? This paper addresses the current gap in the knowledge of disadvantaged communities' level of readiness to engage in childhood obesity prevention initiatives in Australia. The study also identified the key factors responsible for low readiness of disadvantaged communities to participate in current childhood obesity prevention services. By using the Community Readiness model this study shows the readiness levels specific to the various dimensions of the model; Understanding dimension-specific readiness allows us to identify strategies that are tailored to each dimension, as guided by the model. What are the implications for practitioners? With the increasing burden of childhood obesity on disadvantaged communities, policymakers and health practitioners are facing a crisis in obesity prevention and management. Almost every year, new interventions are being planned and implemented. However if the target communities are not ready to participate in the available interventions these efforts are futile. This study exposes the key factors responsible for low readiness to participate in current obesity prevention services by disadvantaged communities. Addressing these key factors and improving readiness before designing new interventions will improve the participation of disadvantaged communities in those interventions. The study findings ultimately have the potential of reducing obesity-related disparities in Australia.
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Affiliation(s)
- Sheila Cyril
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Michael Polonsky
- Department of Marketing, Deakin Business School, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. Email
| | - Julie Green
- Murdoch Children's Research Institute, and Department of Paediatrics, The University of Melbourne, and Parenting Research Centre, 323 Victoria Parade, East Melbourne, Vic. 3002, Australia. Email
| | - Kingsley Agho
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571, Australia. Email
| | - Andre Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia. Email
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Frerichs L, Hassmiller Lich K, Young TL, Dave G, Stith D, Corbie-Smith G. Development of a Systems Science Curriculum to Engage Rural African American Teens in Understanding and Addressing Childhood Obesity Prevention. HEALTH EDUCATION & BEHAVIOR 2017; 45:423-434. [PMID: 28863266 DOI: 10.1177/1090198117726570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Engaging youth from racial and ethnic minority communities as leaders for change is a potential strategy to mobilize support for addressing childhood obesity, but there are limited curricula designed to help youth understand the complex influences on obesity. Our aim was to develop and pilot test a systems science curriculum to elicit rural African American youth perspectives on childhood obesity and enhance their understanding of and support for obesity prevention solutions. The curriculum was designed so it could be integrated with existing positive youth development curricula that help youth advocate for and implement identified solutions. We conducted four workshop sessions with youth that engaged them in systems learning activities such as guided systems diagramming activities. The participants ( n = 21) completed validated surveys presession and postsession that assessed their causal attributions of obesity and support for obesity prevention policies. The youths' perception that environmental factors cause obesity increased ( p < .05), and perceptions that individual behavior and biology cause obesity did not change. Their support for policies that addressed food access and food pricing significantly increased ( p < .05). The youths' system diagrams elucidated links between multilevel factors such as personal attitudes, social influence, and the built environment, which provides important information for designing synergistic solutions. The changes we observed in youths' perceptions of obesity and support for policy changes have important implications for youths' interest and willingness to advocate for social and environmental changes in their community. The strategies have a promising role in supporting community mobilization to address childhood obesity.
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Affiliation(s)
- Leah Frerichs
- 1 University of North Carolina at Chapel Hill, NC, USA
| | | | | | - Gaurav Dave
- 1 University of North Carolina at Chapel Hill, NC, USA
| | - Doris Stith
- 2 Community Enrichment Organization, Tarboro, NC, USA
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Anderson-Carpenter KD, Watson-Thompson J, Jones MD, Chaney L. Improving Community Readiness for Change through Coalition Capacity Building: Evidence from a Multi-Site Intervention. JOURNAL OF COMMUNITY PSYCHOLOGY 2017; 45:486-499. [PMID: 28458405 PMCID: PMC5407193 DOI: 10.1002/jcop.21860] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Often, community coalitions are facilitators of community-level changes when addressing underage drinking. Although studies have shown that enhancing coalition capacity is related to improved internal functioning, the relationship between enhanced capacity and community readiness for change is not well established. The present study used a pretest-posttest design to examine whether enhancing coalition capacity through training and technical assistance was associated with improved community readiness and coalition-facilitated community-level changes. Seven Kansas communities engaged in an intensive capacity building intervention through implementation of the Strategic Prevention Framework. The results indicated strong correlations between increased coalition capacity, changes in community readiness stages, and the number of community changes facilitated. The results suggest that strengthening coalition capacity through training and technical assistance may improve community readiness for change and enable the implementation of community-wide program and environmental changes.
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Affiliation(s)
- Kaston D Anderson-Carpenter
- Integrated Substance Abuse Programs, University of California, Los Angeles; Work Group for Community Health and Development, University of Kansas
| | | | - Marvia D Jones
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; Work Group for Community Health and Development, University of Kansas
| | - Lisa Chaney
- Southeast Kansas Education Service Center, Greenbush
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Pounds L, Fisher CM, Barnes-Josiah D, Coleman JD, Lefebvre RC. The Role of Early Maternal Support in Balancing Full-Time Work and Infant Exclusive Breastfeeding: A Qualitative Study. Breastfeed Med 2017; 12:33-38. [PMID: 27898210 DOI: 10.1089/bfm.2016.0151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Support of others is a key factor for mothers who choose to breastfeed their infants, including those who balance work outside the home and breastfeeding. However, little research has been done to understand how maternal support during the postpartum period impacts mothers' ability to later balance work and breastfeeding, in particular full-time work and exclusive breastfeeding. The results of this qualitative study indicate that the timing of support plays a key role in mothers' ability to successfully overcome barriers during the early postpartum period, thus building maternal self-efficacy in addressing problems encountered when they return to work. METHODS To understand the experience of low-income women who successfully balance full-time work and exclusive breastfeeding for the recommended 6 months, interviews were conducted with women who met study criteria for income level, work status, and exclusive breastfeeding. Breastfeeding peer counselors were also interviewed as key informants. Interviews were recorded, transcribed, and coded for themes. The results of both sets of interviews were triangulated with a focused literature review to assure the soundness of the qualitative analysis. RESULTS Timing of support included acute support, such as help establishing a successful latch needed during the first 2 weeks after delivery, to deal with breastfeeding problems that mothers perceived as being mentally and emotionally overwhelming and longer-term support needed to overcome problems perceived as being less intense. CONCLUSIONS The research invites further exploration into the relationship between breastfeeding support provided by mothers' support system, including healthcare professionals, during the postpartum period and rates of breastfeeding duration and exclusivity.
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Affiliation(s)
- Lea Pounds
- 1 Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center College of Public Health , Omaha, Nebraska
| | | | | | | | - R Craig Lefebvre
- 5 University of South Florida College of Public Health , Tampa, Florida
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Frerichs L, Ataga O, Corbie-Smith G, Tessler Lindau S. Child and youth participatory interventions for addressing lifestyle-related childhood obesity: a systematic review. Obes Rev 2016; 17:1276-1286. [PMID: 27749992 PMCID: PMC5555640 DOI: 10.1111/obr.12468] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 07/21/2016] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Abstract
A growing number of childhood obesity interventions involve children and youth in participatory roles, but these types of interventions have not been systematically reviewed. We aimed to identify child and youth participatory interventions in the peer-reviewed literature in order to characterize the approaches and examine their impact on obesity and obesity-related lifestyle behaviours. We searched PubMed/Medline, psychINFO and ERIC for quasi-experimental and randomized trials conducted from date of database initiation through May 2015 that engaged children or youth in implementing healthy eating, physical activity or weight management strategies. Eighteen studies met our eligibility criteria. Most (n = 14) trained youth to implement pre-defined strategies targeting their peers. A few (n = 4) assisted youth to plan and implement interventions that addressed environmental changes. Thirteen studies reported at least one statistically significant weight, physical activity or dietary change outcome. Participatory approaches have potential, but variation in strategies and outcomes leave questions unanswered about the mechanisms through which child and youth engagement impact childhood obesity. Future research should compare child-delivered or youth-delivered to adult-delivered health promotion interventions and more rigorously evaluate natural experiments that engage youth to implement environmental changes. With careful attention to theoretical frameworks, process and outcome measures, these studies could strengthen the effectiveness of child and youth participatory approaches.
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Affiliation(s)
- L Frerichs
- Center for Health Equity Research, University of North Carolina, Chapel Hill, USA
| | - O Ataga
- Center for Health Equity Research, University of North Carolina, Chapel Hill, USA
| | - G Corbie-Smith
- Center for Health Equity Research, University of North Carolina, Chapel Hill, USA.,Department of Social Medicine, School of Medicine, University of North Carolina, Chapel Hill, USA.,Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, USA
| | - S Tessler Lindau
- Department of Obstetrics and Gynecology and Medicine-Geriatrics, The Maclean Center on Clinical Medical Ethics, University of Chicago, Chicago, USA.,The University of Chicago Medicine Urban Health Initiative, Chicago, USA
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Gandhi KK, Baranowski T, Anderson BJ, Bansal N, Redondo MJ. Psychosocial aspects of type 1 diabetes in Latino- and Asian-American youth. Pediatr Res 2016; 80:347-55. [PMID: 27074124 DOI: 10.1038/pr.2016.87] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 02/18/2016] [Indexed: 11/09/2022]
Abstract
Latino and Asian-Americans represent the fastest growing immigrant populations in the United States. We aimed to review the current knowledge on the psychosocial factors that influence type 1 diabetes (T1D) care, education, and outcomes in Latino and Asian-American youth immigrants in the United States, as well as culturally sensitive programs to address health disparities. We conducted a narrative, conceptual review of studies on T1D in Latino and Asian-American youth and relevant studies in type 2 diabetes and adults. Approximately 50% of both Latino and Asian-American youth with T1D are in suboptimal glycemic control. Socioeconomic status, literacy, English proficiency, acculturation, access to health care, family functioning, mental health, and nutrition influence T1D care and outcomes. However, the degree to which these complex, inter-related and dynamic factors affect long-term T1D outcomes is largely unknown. Culturally sensitive programs for Latino or Asian-American youth with T1D are scarce in the United States. Research is needed among Latino and Asian-American youth with T1D so that comprehensive, culturally sensitive diabetes education, and care programs can be developed to decrease disparities in the health burden of these groups.
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Affiliation(s)
- Kajal K Gandhi
- Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Barbara J Anderson
- Division of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Nidhi Bansal
- Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas
| | - Maria J Redondo
- Division of Pediatric Endocrinology and Metabolism, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas
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Nadeau KJ, Anderson BJ, Berg EG, Chiang JL, Chou H, Copeland KC, Hannon TS, Huang TTK, Lynch JL, Powell J, Sellers E, Tamborlane WV, Zeitler P. Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges, and Priorities. Diabetes Care 2016; 39:1635-42. [PMID: 27486237 PMCID: PMC5314694 DOI: 10.2337/dc16-1066] [Citation(s) in RCA: 238] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes is a significant and increasing burden in adolescents and young adults. Clear strategies for research, prevention, and treatment of the disease in these vulnerable patients are needed. Evidence suggests that type 2 diabetes in children is different not only from type 1 but also from type 2 diabetes in adults. Understanding the unique pathophysiology of type 2 diabetes in youth, as well as the risk of complications and the psychosocial impact, will enable industry, academia, funding agencies, advocacy groups, and regulators to collectively evaluate both current and future research, treatment, and prevention approaches. This Consensus Report characterizes type 2 diabetes in children, evaluates the fundamental differences between childhood and adult disease, describes the current therapeutic options, and discusses challenges to and approaches for developing new treatments.
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Affiliation(s)
- Kristen J Nadeau
- Department of Pediatrics, University of Colorado School of Medicine, and Department of Endocrinology, Children's Hospital Colorado, Aurora, CO
| | - Barbara J Anderson
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine Education at Texas Children's Hospital, Houston, TX
| | | | | | - Hubert Chou
- Clinical Development, Daiichi Sankyo, New York, NY
| | - Kenneth C Copeland
- Department of Pediatrics and Harold Hamm Diabetes Center-Children's, The University of Oklahoma College of Medicine, Oklahoma City, OK
| | | | - Terry T-K Huang
- School of Public Health, The City University of New York, New York, NY
| | - Jane L Lynch
- The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jeff Powell
- Pediatrics and Community Health, Northern Navajo Medical Center, Navajo Area Indian Health Service, Shiprock, NM
| | - Elizabeth Sellers
- Department of Pediatrics, Health Sciences Centre Winnipeg, Winnipeg, Canada
| | - William V Tamborlane
- Department of Pediatric Endocrinology and Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, CT
| | - Philip Zeitler
- Department of Pediatrics, University of Colorado School of Medicine, and Department of Endocrinology, Children's Hospital Colorado, Aurora, CO
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Pradeilles R, Rousham EK, Norris SA, Kesten JM, Griffiths PL. Community readiness for adolescents' overweight and obesity prevention is low in urban South Africa: a case study. BMC Public Health 2016; 16:763. [PMID: 27515802 PMCID: PMC4982405 DOI: 10.1186/s12889-016-3451-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 08/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND South Africa is undergoing epidemiological and nutrition transitions with associated increases in the incidence of overweight, obesity and diet-related chronic diseases. With the emergence of the nutrition transition in South Africa, there is an urgent need for interventions to prevent overweight and obesity in children and adolescents as risk factors for chronic diseases in adolescence may track throughout later life. This research explored the potential for faith-based organisations (FBOs) to be used as community organisations for overweight and obesity prevention interventions in adolescents by assessing the readiness of religious leaders to engage in such interventions. METHODS Surveys and focus group discussions (FGDs) were conducted with 51 religious leaders in Johannesburg and Soweto. The Community Readiness Model (CRM) survey was chosen to determine the stage of readiness of this community regarding overweight and obesity prevention. Six different dimensions were assessed in the CRM (community efforts, knowledge of efforts, leadership, community climate, knowledge of the issue, resources). The surveys were scored according to the CRM protocol. The survey data were supplemented with findings from FGDs. Thematic analysis was used to analyse the FGDs. RESULTS The mean community readiness score was 2.57 ± 0.76 which equates with the "denial/resistance stage". The mean readiness score for resources was the highest of all the dimensions (3.77 ± 0.28), followed by knowledge of the issue (3.20 ± 0.51). The lowest score was seen for community knowledge of efforts (1.77 ± 1.50), followed by community climate (2.00 ± 0.64). FGDs helped interpret the CRM scores. FGDs showed that religious leaders were enthusiastic and recognised that their role was not limited solely to spiritual guidance and mentoring, but also to physical well-being. CONCLUSIONS Religious leaders recognised that they act as role models within the community and thus have a role to play in improving adolescent health. They have some knowledge about the overweight/obesity issue and some of the resources could be made available to support overweight/obesity prevention-related initiatives. However, the low community knowledge of efforts and the negative prevailing attitude of the community towards overweight and obesity highlight the need to increase awareness of this issue prior to implementing initiatives on overweight and obesity prevention.
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Affiliation(s)
- Rebecca Pradeilles
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
- MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
| | - Emily K Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanna M Kesten
- NIHR Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- NIHR Health Protection Research Unit on Evaluation of Interventions, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Paula L Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
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Hudnut-Beumler J, Po'e E, Barkin S. The Use of Social Media for Health Promotion in Hispanic Populations: A Scoping Systematic Review. JMIR Public Health Surveill 2016; 2:e32. [PMID: 27400979 PMCID: PMC4960404 DOI: 10.2196/publichealth.5579] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/06/2016] [Accepted: 06/10/2016] [Indexed: 12/31/2022] Open
Abstract
Background The Internet is an increasingly popular platform for public health interventions due to its distinct ability to communicate with, engage, and educate communities. Given the widespread use of the Internet, these interventions could be a means of equalizing access to information to address health disparities in minority populations, such as Hispanics. Hispanics are disproportionately affected by poor health outcomes, including obesity, diabetes, and human immunodeficiency virus/acquired immune deficiency syndrome. Although underserved and underrepresented, Hispanics are among the leading users of social media in the United States. Previous reviews have examined the use of social media in public health efforts, but, to our knowledge, none have focused on the Hispanic population. Objective To conduct a scoping systematic review of the published literature to capture the ways social media has been used in health interventions aimed at Hispanic populations and identify gaps in existing knowledge to provide recommendations for future research. Methods We performed a systematic review of the literature related to social media, public health, and Hispanics using the PubMed, PsycINFO, and EMBASE databases to locate peer-reviewed studies published between January 1, 2010, and December 31, 2015. Each article was reviewed for the following inclusion criteria: social media as a main component of study methodology or content; public health topic; majority Hispanic/Latino study population; English or Spanish language; and original research study. Relevant data were extracted from articles meeting inclusion criteria including publication year, location, study design, social media platform, use of social media, target population, and public health topic. Results Of the 267 articles retrieved, a total of 27 unique articles met inclusion criteria. All were published in 2012 or later. The most common study design was a cross-sectional survey, which was featured in 10 of the 27 (37%) articles. All articles used social media for at least one of the following three purposes: recruiting study participants (14 of 27, 52%), promoting health education (12 of 27, 44%), and/or describing social media users (12 of 27, 44%). All but one article used multiple social media platforms, though Facebook was by far the most popular appearing in 24 of the 27 (89%). A diverse array of Hispanic populations was targeted, and health topics featured. Of these, the most highly represented were articles on sexual health directed toward Latino men who have sex with men (12 of 27, 44%). Healthy eating and active living received the second greatest focus (4 of 27, 15%). Conclusions Social media offers a potential accessible venue for health interventions aimed at Hispanics, a group at disproportionate risk for poor health outcomes. To date, most publications are descriptive in nature, with few indicating specific interventions and associated outcomes to improve health.
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McCauley MP, Ramanadhan S, Viswanath K. Assessing opinions in community leadership networks to address health inequalities: a case study from Project IMPACT. HEALTH EDUCATION RESEARCH 2015; 30:866-881. [PMID: 26471919 PMCID: PMC4836398 DOI: 10.1093/her/cyv049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 09/11/2015] [Indexed: 06/05/2023]
Abstract
This study demonstrates a novel approach that those engaged in promoting social change in health can use to analyze community power, mobilize it and enhance community capacity to reduce health inequalities. We used community reconnaissance methods to select and interview 33 participants from six leadership sectors in 'Milltown', the New England city where the study was conducted. We used UCINET network analysis software to assess the structure of local leadership and NVivo qualitative software to analyze leaders' views on public health and health inequalities. Our main analyses showed that community power is distributed unequally in Milltown, with our network of 33 divided into an older, largely male and more powerful group, and a younger, largely female group with many 'grassroots' sector leaders who focus on reducing health inequalities. Ancillary network analyses showed that grassroots leaders comprise a self-referential cluster that could benefit from greater affiliation with leaders from other sectors and identified leaders who may serve as leverage points in our overall program of public agenda change to address health inequalities. Our innovative approach provides public health practitioners with a method for assessing community leaders' views, understanding subgroup divides and mobilizing leaders who may be helpful in reducing health inequalities.
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Affiliation(s)
- M P McCauley
- Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, WI 53226,
| | - S Ramanadhan
- Center for Community-Based Research, Dana-Farber Cancer Institute and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - K Viswanath
- Center for Community-Based Research, Dana-Farber Cancer Institute and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
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