Participatory design application in obesity prevention targeting young adults and adolescents: a mixed-methods systematic scoping review protocol

BACKGROUND

Prevention of obesity is economically and sociologically preferable to treatment, with early intervention key to preventing excess weight gain and obesity. The transition from adolescence to young adulthood is a critical intervention period. An expert-led, top-down model has dominated obesity prevention research and practice with limited success. Participatory design (PD) offers potential in transforming obesity prevention research and practice by delivering bottom-up solutions that young people value and may therefore voluntarily engage with over time. An evidence synthesis of PD application in obesity prevention targeting adolescents and young adults is currently lacking.

OBJECTIVES

Report the protocol for a mixed-methods systematic scoping review which aims to integrate and synthesise available evidence on PD application in obesity prevention targeting adolescents and young adults. Specifically, the review will address three research questions: RQ1: How is PD defined in obesity prevention interventions targeting adolescents and young adults? RQ2: To what extent is PD applied in obesity preventions interventions targeting adolescents and young adults? RQ3a: How is the utility of PD evaluated in obesity preventions interventions targeting adolescents and young adults? RQ3b: What is the utility of PD application in obesity prevention interventions targeting adolescents and young adults?

METHODS

This mixed-methods systematic scoping review protocol adheres to the PRISMA-P guidelines and is informed by the PRISMA extension for scoping reviews (PRISMA-ScR). The search strategy and eligibility criteria are informed by the sample, phenomenon of interest, design, evaluation, and research type tool. Eligible studies will be peer-reviewed literature published in English, reporting on PD application in obesity prevention interventions (including intervention development, implementation, and/or evaluation) targeting adolescents and young adults (aged 10-35 years). Study designs will include qualitative, quantitative, and mixed methods. The review will comprise a systematic literature search, eligibility screening, data extraction, quality assessment using the Mixed-Methods Appraisal Tool (MMAT), and data analysis using an iterative narrative evidence synthesis approach. Evidence on PD application will be thematically integrated in terms of who was involved, when they were involved, and how and why they were involved. Further thematic analyses will be conducted according to the MATE taxonomy and the United Kingdom Medical Research Council (UK MRC's) key functions of process evaluations. The MATE taxonomy classifies PD application in terms of methodology, agent of change, training, and engagement. The MRC describes three functions of process evaluations: implementation, mechanisms of impact, and context. Applying both in the evidence synthesis is intended to provide a more complete picture of PD application. Exploratory analyses will be conducted to assess any potential associations between PD application and effectiveness across key outcomes (weight, physical activity, sedentary time, nutrition and dietary habit, mental health, and sleep) reported within intervention evaluations.

CONCLUSIONS

Elucidating PD application is a prerequisite to establishing its utility. Through the location and synthesis of available evidence on PD application in obesity prevention targeting adolescents and young adults, this review will categorise and describe different methods of PD application and explore the utility of PD application including whether any differences may be observed between PD method applied and the effectiveness of obesity prevention interventions. Implications will be delineated from the narrative evidence synthesis to inform future research and advance practice in this context.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021268240.

Intralesional sustained-release chemotherapy with therapeutic implants for treatment of canine sun-induced squamous cell carcinoma

Squamous cell carcinoma (SCC) is the most frequently reported malignant epithelial tumour in dogs. Canine sun-induced SCC represents a useful animal model to evaluate new therapeutic modalities for possible human applications. We evaluated the safety and efficacy of treating sun-induced SCC in dogs with intralesional sustained-released chemotherapeutic gel implants that contained collagen, epinephrine (epi), and either 5-fluorouracil (5-FU) or cisplatin (CDDP). Dogs with large, single SCC or fields of multiple SCC were treated with 5-FU/epi gel for a minimum of three weekly injections. Dogs without a complete response were then treated with CDDP/epi gel for a minimum of three weekly treatments. We treated from one to 11 primary, recurrent, or refractory SCC per dog (tumour size 0.2-92.4 cm2; mean cumulative tumour area of 40.7 cm2 per dog). All dogs had at least 50% reduction in cumulative tumour area after treatment with 5-FU/epi gel. More than half (seven of 13) had complete resolution of SCC after treatment with 5-FU/epi gel or CDDP/epi gel. Minimal local tissue reactions were noted; no systemic toxicity occurred. Sustained-release chemotherapy using intralesional 5-FU/epi gel and CDDP/epi gel therapeutic implants is effective in treating canine sun-induced SCC of the skin.

Reduction of vinblastine neurotoxicity in mice utilizing a collagen matrix carrier

Vinblastine sulfate (VLB) suspended within a collagen matrix (CM) as a diffusion limiting drug delivery vehicle was examined in vitro, as well as in mouse subcutaneous and brain tumor models. Against RIF-1 and KHT subcutaneous tumors, there was enhancement of antitumor activity with intratumoral (i.t.) delivery of VLB when it was combined with CM and/or epinephrine (epi) provided as a vasoactive agent to limit diffusion of VLB away from the injection site. Furthermore, in pharmacokinetic studies an 3-fold enhancement of tumor exposure to drug (AUC) with the CM-formulation was observed relative to the administration of free VLB i.t. Craniotactic injection of VLB into mouse brain in doses from 0.2 to 2 mg/kg revealed that the CM association markedly reduced the acute toxicity of VLB in normal mouse brain. Furthermore, mice with stereotactically implanted KHT brain tumors treated with 0.2 mg/kg VLB in CM had less tumor present in the brain histologically compared to the free VLB and untreated control groups.

Lateral extracavitary approach to the spine for thoracic disc herniation: report of 23 cases

Twenty-three patients were operated upon for thoracic disc herniation between 1973 and 1982. The lateral approach to the vertebral column was used in each. Most patients had severe local pain; 13 had severe myelopathy or complete motor paralysis, including 4 who had become paraplegic after laminectomy. Eleven patients had calcified discs or osteophytic ridges. Air myelography and computed tomography were diagnostic in all cases. Postoperatively, 17 patients achieved significant relief of pain, 20 improved neurologically, and none became worse. Complications of the operation were minimal. The lateral extracavitary approach to the spine is a valuable technique for the management of thoracic disc herniation.