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Peña A, Olson ML, Hooker E, Ayers SL, Castro FG, Patrick DL, Corral L, Lish E, Knowler WC, Shaibi GQ. Effects of a Diabetes Prevention Program on Type 2 Diabetes Risk Factors and Quality of Life Among Latino Youths With Prediabetes: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2231196. [PMID: 36094502 PMCID: PMC9468887 DOI: 10.1001/jamanetworkopen.2022.31196] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Latino youths are disproportionately impacted by prediabetes and type 2 diabetes (T2D). Lifestyle intervention is the first-line approach for preventing or delaying T2D among adults with prediabetes. OBJECTIVE To assess the efficacy of a diabetes prevention program among Latino youths aged 12 to 16 years with prediabetes. DESIGN, SETTING, AND PARTICIPANTS This 2-group parallel randomized clinical trial with 2:1 randomization assessed a lifestyle intervention against usual care among Latino youths with prediabetes and obesity with 6- and 12-month follow-up. The study was conducted at YMCA facilities in Phoenix, Arizona from May 2016 to March 2020. INTERVENTION Participants were randomized to lifestyle intervention (INT) or usual care control (UCC). The 6-month INT included 1 d/wk of nutrition and health education and 3 d/wk of physical activity. UCC included 2 visits with a pediatric endocrinologist and a bilingual, bicultural registered dietitian to discuss diabetes risks and healthy lifestyle changes. MAIN OUTCOMES AND MEASURES Insulin sensitivity, glucose tolerance, and weight-specific quality of life (YQOL-W) at 6- and 12-month follow-up. RESULTS A total of 117 Latino youths (mean [SD] age, 14 [1] years; 47 [40.1%] girls) were included in the analysis. Overall, 79 were randomized to INT and 38 to UCC. At 6 months, the INT led to significant decreases in mean (SE) 2-hour glucose (baseline: 144 [3] mg/dL; 6 months: 132 [3] mg/dL; P = .002) and increases in mean (SE) insulin sensitivity (baseline: 1.9 [0.2]; 6 months: 2.6 [0.3]; P = .001) and YQOL-W (baseline: 75 [2]; 6 months: 80 [2]; P = .006), but these changes were not significantly different from UCC (2-hour glucose: mean difference, -7.2 mg/dL; 95% CI, -19.7 to 5.3 mg/dL; P for interaction = .26; insulin sensitivity: mean difference, 0.1; 95% CI, -0.7 to 0.9; P for interaction = .79; YQOL-W: mean difference, 6.3; 95% CI, -1.1 to 13.7; P for interaction = .10, respectively). Both INT (mean [SE], -15 mg/dL [4.9]; P = .002) and UCC (mean [SE], -15 mg/dL [5.4]; P = .005) had significant 12-month reductions in 2-hour glucose that did not differ significantly from each other (mean difference, -0.3; 95% CI, -14.5 to 14.1 mg/dL; P for interaction = .97). At 12 months, changes in mean (SE) insulin sensitivity in INT (baseline: 1.9 [0.2]; 12 months: 2.3 [0.2]; P = .06) and UCC (baseline: 1.9 [0.3]; 12 months: 2.0 [0.2]; P = .70) were not significantly different (mean difference, 0.3; 95% CI, -0.4 to 1.0; P for interaction = .37). At 12 months, YQOL-W was significantly increased in INT (basline: 75 [2]; 12 months: 82 [2]; P < .001) vs UCC (mean difference, 8.5; 95% CI, 0.8 to 16.2; P for interaction = .03). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, both INT and UCC led to similar changes in T2D risk factors among Latino youths with diabetes; however, YQOL-W was improved in INT compared with UCC. Diabetes prevention interventions that are effective in adults also appeared to be effective in high risk youths. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02615353.
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Affiliation(s)
- Armando Peña
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix
| | - Micah L. Olson
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
| | - Elva Hooker
- Ivy Center for Family Wellness, The Society of St Vincent de Paul, Phoenix, Arizona
| | - Stephanie L. Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix
| | | | | | | | - Elvia Lish
- Ivy Center for Family Wellness, The Society of St Vincent de Paul, Phoenix, Arizona
| | - William C. Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
| | - Gabriel Q. Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
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The association between weight loss and long term development in quality-of-life among children living with obesity: a pragmatic descriptive intervention study. Ital J Pediatr 2022; 48:135. [PMID: 35908012 PMCID: PMC9338673 DOI: 10.1186/s13052-022-01326-2] [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: 02/22/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Childhood obesity is associated with impaired Quality-of-Life (QoL), increased stigmatization and higher risk of development of depression compared to their peers. This report describes the long-term development in QoL for cohort of children with obesity after a sustainable weight reduction. Methods This pragmatic descriptive intervention study enrolled 120 children with obesity, age 5–17 years, in a multifactorial lifestyle intervention. The intervention was an across sectors collaboration between a department of pediatrics and community health care workers. QoL was assessed yearly throughout the intervention and evaluated by a 6-item Visual Analogue Scale (VAS). For analyzing changes in VAS, as function BMI-SDS, regression models were used, while ANOVA and Wilcoxon test were applied for normal and not-normal distributed data. 95% confidence interval not containing 0 and p-value < 0.05 was considered statistically significant. Results After 26.4 months (13.9 SD) an overall decrease in bullying (0.6 vs. 0.0 median) and motivation (10.0 vs. 9.6) was observed. QoL increased in children with a BMI-SDS reduction (0.65 (2.49 SD)) opposite children with no-change or increasing BMI-SDS who reported reduced QoL (-0.36 (1.55 SD) and -0.96 (2.27 SD)). A significant inverse relationship was observed for Joy of Life, QoL and body perception as a function of BMI-SDS per year. Conclusion Weight reduction causes improvement in QoL for children with obesity and an inverse relationship for QoL and changing BMI-SDS / year was establish.
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Mozzillo E, Zito E, Calcaterra V, Corciulo N, Di Pietro M, Di Sessa A, Franceschi R, Licenziati MR, Maltoni G, Morino G, Predieri B, Street ME, Trifirò G, Gallè F, Franzese A, Valerio G. Poor Health Related Quality of Life and Unhealthy Lifestyle Habits in Weight-Loss Treatment-Seeking Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179355. [PMID: 34501945 PMCID: PMC8431705 DOI: 10.3390/ijerph18179355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022]
Abstract
Obesity is associated with unhealthy lifestyle behaviors and poor Health Related Quality of Life (HRQOL). The cumulative effect of lifestyle behaviors on HRQOL has been demonstrated in chronically ill adolescents, but not in adolescents with obesity. The present study aimed to assess the association between HRQOL and adherence to the Mediterranean Diet (MD) and/or low levels of physical activity (PA) in a large sample of outpatient adolescents with overweight or obesity seeking weight loss treatment. Four-hundred-twenty participants were enrolled from 10 Italian outpatient clinics. The demographics and anthropometric features, KIDMED scores, and exercise levels of the participants were collected, together with parental features. The HRQOL was assessed by the Pediatric Quality of Life Inventory (PedsQL™), Adolescents Version 4.0. PedsQL total score and functioning subscales were lower in adolescents who reported one or two unhealthy habits. Compared with the high/intermediate groups, the risk of low HRQOL was twice as high for each unit increase in BMI SDS, while the percentage was reduced by 12.2% for every unit increase in the KIDMED score and by 32.3% for each hour increase of exercise. The clustering of these two unhealthy behaviors conferred a 120% higher risk of low HRQOL. Similarly, adolescents displaying better diet quality and/or a physically more active lifestyle have better physical and psychological functioning. Further studies are needed to disclose whether these characteristics may be predictive of better adherence to weight loss treatment.
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Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Eugenio Zito
- Department of Social Sciences, University of Naples Federico II, 80138 Naples, Italy;
| | - Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Nicola Corciulo
- Unit of Auxology and Pediatric Endocrinology, Sacred Heart of Jesus Hospital, Gallipoli, 73014 Lecce, Italy;
| | | | - Anna Di Sessa
- Department of Woman, Child, and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | | | - Maria Rosaria Licenziati
- Obesity and Endocrine Disease Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy;
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Giuseppe Morino
- Research Unit for Multifactorial Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy;
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults—Pediatric Unit University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Maria Elisabeth Street
- Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Giuliana Trifirò
- Endocrinology and Metabolism Division, IRCCS Policlinico San Donato, 20097 Milan, Italy;
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
- Correspondence:
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Soltero EG, Ayers SL, Avalos MA, Peña A, Williams AN, Olson ML, Konopken YP, Castro FG, Arcoleo KJ, Keller CS, Patrick DL, Jager J, Shaibi GQ. Theoretical Mediators of Diabetes Risk and Quality of Life Following a Diabetes Prevention Program for Latino Youth With Obesity. Am J Health Promot 2021; 35:939-947. [PMID: 33949215 DOI: 10.1177/08901171211012951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This study tested self-efficacy and social support for activity and dietary changes as mediators of changes in type 2 diabetes related outcomes following a lifestyle intervention among Latino youth. SETTING AND INTERVENTION Latino adolescents (14-16 years) with obesity (BMI% = 98.1 ± 1.4) were randomized to a 3-month intervention (n = 67) that fostered self-efficacy and social support through weekly, family-centered sessions or a comparison condition (n = 69). MEASURES Primary outcomes included insulin sensitivity and weight specific quality of life. Mediators included self-efficacy, friend, and family social support for health behaviors. Data was collected at baseline, 3-months, 6-months, and 12-months. ANALYSIS Sequential path analysis was used to examine mediators as mechanisms by which the intervention influenced primary outcomes. RESULTS The intervention had a direct effect on family (β = 0.33, P < .01) and friend social support (β = 0.22, P < .001) immediately following the intervention (3-months). Increased family social support mediated the intervention's effect on self-efficacy at 6-months (β = 0.09, P < .01). However, social support and self-efficacy did not mediate long-term changes in primary outcomes (P > .05) at 12-months. CONCLUSIONS Family social support may improve self-efficacy for health behaviors in high-risk Latino youth, highlighting the important role of family diabetes prevention. Fostering family social support is a critical intervention target and more research is needed to understand family-level factors that have the potential to lead to long-term metabolic and psychosocial outcome in vulnerable youth.
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Affiliation(s)
- Erica G Soltero
- Children's Nutrition Research Center, Department of Pediatrics, 3989Baylor College of Medicine, Houston, TX, USA
| | - Stephanie L Ayers
- Southwest Interdisciplinary Research Center, 7864Arizona State University, Phoenix, AZ, USA
| | - Marvyn A Avalos
- Southwest Interdisciplinary Research Center, 7864Arizona State University, Phoenix, AZ, USA
| | - Armando Peña
- Center for Health Promotion and Disease Prevention, 7864Arizona State University, Phoenix, AZ, USA
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, 7864Arizona State University, Phoenix, AZ, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, 7864Arizona State University, Phoenix, AZ, USA.,Department of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Yolanda P Konopken
- Family Wellness Program, St. Vincent De Paul Medical and Dental Clinic, Phoenix, AZ, USA
| | - Felipe G Castro
- Center for Health Promotion and Disease Prevention, 7864Arizona State University, Phoenix, AZ, USA
| | | | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, 7864Arizona State University, Phoenix, AZ, USA
| | - Donald L Patrick
- Department of Health Services, 49462School of Public Health, University of Washington, Seattle, WA, USA
| | - Justin Jager
- Southwest Interdisciplinary Research Center, 7864Arizona State University, Phoenix, AZ, USA.,T. Denny Sanford School of Social and Family Dynamics, 7864Arizona State University, Tempe, AZ, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, 7864Arizona State University, Phoenix, AZ, USA
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5
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Arévalo Avalos MR, Ayers SL, Patrick DL, Jager J, Castro FG, Konopken YP, Olson ML, Keller CS, Soltero EG, Williams AN, Shaibi GQ. Familism, Self-Esteem, and Weight-Specific Quality of Life Among Latinx Adolescents With Obesity. J Pediatr Psychol 2021; 45:848-857. [PMID: 32632446 DOI: 10.1093/jpepsy/jsaa047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 04/03/2020] [Accepted: 05/17/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Obesity is a critical public health condition affecting Latinx adolescents and contributes to health disparities across the lifespan. Childhood and adolescent obesity is associated with reduced quality of life (QoL) and decreased self-esteem. The purpose of this study is to examine the role of cultural (e.g., familism) and psychosocial (e.g., self-esteem) factors as predictors of weight-specific QoL among Latinx adolescents with obesity. METHODS Baseline data from 160 Latinx adolescents (ages 14-16 years) with obesity (BMI > 95th percentile for age and sex) who were recruited for a diabetes prevention intervention were used. Structural equation modeling tested the relationships between four latent constructs (familism, positive self-esteem, self-deprecation, and weight-specific QoL). RESULTS The model tested paths from familism to positive self-esteem, self-deprecation, and weight-specific QoL, and paths from positive self-esteem and self-deprecation to weight-specific QoL. Higher familism was positively associated with positive self-esteem but not self-deprecation. In turn, positive self-esteem was positively associated with higher weight-specific QoL, whereas self-deprecation was negatively associated. Furthermore, there was an indirect effect of familism on QoL via positive self-esteem. CONCLUSIONS These data shed light into specific cultural and psychosocial constructs that influence QoL among Latinx adolescents with obesity. This study suggests that familism and positive self-esteem can operate as protective factors associated with higher weight-specific QoL in Latinx adolescents with obesity; whereas self-deprecation may operate as a risk factor for lower weight-specific QoL.
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Affiliation(s)
| | - Stephanie L Ayers
- Southwest Interdisciplinary Research Center, Arizona State University
| | | | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University
| | | | | | - Micah L Olson
- Center for Health Promotion and Disease Prevention, Arizona State University.,Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital
| | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, Arizona State University
| | - Erica G Soltero
- Center for Health Promotion and Disease Prevention, Arizona State University
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, Arizona State University
| | - Gabriel Q Shaibi
- Southwest Interdisciplinary Research Center, Arizona State University.,Center for Health Promotion and Disease Prevention, Arizona State University.,Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital
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Dewberry L, Khoury J, Schmiege S, Jenkins T, Boles R, Inge T. Gastrointestinal symptoms in relation to quality of life after metabolic surgery in adolescents. Surg Obes Relat Dis 2020; 16:554-561. [PMID: 32122816 DOI: 10.1016/j.soard.2019.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/22/2019] [Accepted: 12/25/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Adolescent obesity is associated with significant co-morbidities, including decreased quality of life (QOL). QOL improves after metabolic and bariatric surgery (MBS), but recent studies have demonstrated that certain gastrointestinal symptoms (GIS) worsen after surgery, including reflux symptoms, nausea, bloating, and diarrhea. OBJECTIVE The aim of this study was to evaluate QOL and the effect of these symptoms on QOL after bariatric surgery. SETTING Five academic centers that perform adolescent MBS in the United States. METHODS We prospectively studied 228 adolescents undergoing MBS using the Teen-Longitudinal Assessment of Bariatric Surgery cohort. GIS and QOL scores were assessed before surgery, at 6 months, and yearly to 5 years after surgery. Analysis involved linear models examining QOL and the association between GIS and QOL adjusting for a priori determined covariates. RESULTS Adjusting for body mass index change over time, the physical component score (PCS) of the Short Form-36 (SF-36) increased after surgery from 44.2 at baseline to 54.4 at 5 years (P < .0001). The mental component score did not significantly change over time. The SF-36 domains that showed the biggest increase after surgery were physical functioning, physical role functioning, and general health. The SF-36 PCS decreased significantly over time post surgery in those with GIS of reflux, nausea, and diarrhea but remained higher than baseline SF-36 PCS. There was no statistically significant change in mental component score or impact of weight on quality of life-KIDS scores in those with or without GIS. CONCLUSION QOL, specifically the SF-36 PCS, increases after MBS. Reflux symptoms, nausea, and diarrhea reduce the degree of improvement in QOL in adolescents after MBS. Patients should be monitored and treated for these symptoms to address this decreased QOL.
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Affiliation(s)
- Lindel Dewberry
- Department of Surgery, University of Colorado, Aurora, Colorado.
| | - Jane Khoury
- Department of Statistics, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Sarah Schmiege
- Department of Biostatistics, University of Colorado, Aurora, Colorado
| | - Todd Jenkins
- Department of Statistics, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Richard Boles
- Department of Psychology, Children's Hospital Colorado, Aurora, Colorado
| | - Thomas Inge
- Department of Surgery, Children's Hospital Colorado, Aurora, Colorado
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Flores YN, Contreras ZA, Ramírez-Palacios P, Morales LS, Edwards TC, Gallegos-Carrillo K, Salmerón J, Lang CM, Sportiche N, Patrick DL. Increased Prevalence of Psychosocial, Behavioral, and Socio-Environmental Risk Factors among Overweight and Obese Youths in Mexico and the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1534. [PMID: 31052211 PMCID: PMC6539776 DOI: 10.3390/ijerph16091534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/22/2019] [Accepted: 04/27/2019] [Indexed: 01/22/2023]
Abstract
The aim of this study was to examine various psychosocial, behavioral, and socio-environmental factors in a multiethnic sample of healthy-weight, overweight, and obese youths in the United States (US) and Mexico and determine differences by sex. We conducted a cross-sectional analysis of 633 youths aged 11-18 years who completed a self-reported questionnaire. Height and weight were measured to determine body mass index (BMI). Overweight and obese youth in both countries were significantly more likely to report a higher body image dissatisfaction (Odds Ratio (OR) = 1.67 and OR= 2.95, respectively), depressive symptoms (OR = 1.08 and OR = 1.12, respectively), perceive themselves as overweight (OR = 2.57) or obese (OR = 5.30), and a lower weight-specific quality of life (OR = 0.97 and OR = 0.95, respectively) than healthy-weight youth. Obese youth have lower healthy lifestyle priorities (OR = 0.75) and are less likely to be physically active (OR = 0.79) and eat breakfast (OR = 0.47) than healthy-weight youth. Additionally, overweight and obese youth are more likely to engage in weight control behaviors (OR = 5.19 and OR = 8.88, respectively) and restrained eating than healthy-weight youth. All the aforementioned results had a p-value of <0.05, which was considered statistically significant. The association between these factors and overweight or obesity remained significant after controlling for age, sex, race/ethnicity, and country. In conclusion, obesity was associated with a range of psychosocial, behavioral, and socio-environmental risk factors in both countries. Our findings support the need for multifactorial approaches when developing interventions to address the growing problem of obesity among youth in the US and Mexico.
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Affiliation(s)
- Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, Mexico.
- UCLA Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA.
| | - Zuelma A Contreras
- UCLA Department of Epidemiology, Fielding School of Public Health, Los Angeles, CA 90095, USA.
| | - Paula Ramírez-Palacios
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, Mexico.
| | - Leo S Morales
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA.
| | - Todd C Edwards
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA.
| | - Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, Mexico.
| | - Jorge Salmerón
- Universidad Nacional Autónoma de México, Centro de Investigación en Políticas, Población y Salud. Ciudad Universitaria, Ciudad de México 04510, Mexico.
| | - Cathy M Lang
- UCLA Department of Community Health Sciences, Fielding School of Public Health, Los Angeles, CA 90095, USA.
| | - Noémie Sportiche
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, Mexico.
| | - Donald L Patrick
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA.
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8
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Soltero EG, Olson ML, Williams AN, Konopken YP, Castro FG, Arcoleo KJ, Keller CS, Patrick DL, Ayers SL, Barraza E, Shaibi GQ. Effects of a Community-Based Diabetes Prevention Program for Latino Youth with Obesity: A Randomized Controlled Trial. Obesity (Silver Spring) 2018; 26:1856-1865. [PMID: 30426694 PMCID: PMC6249045 DOI: 10.1002/oby.22300] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/26/2018] [Accepted: 07/18/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study examined the short- and long-term effects of a community-based lifestyle intervention among Latino youth with obesity. METHODS Latino adolescents (14-16 years old) were randomized to a 3-month lifestyle intervention (n = 67) or comparison control (n = 69) and followed for 12 months. The intervention included weekly nutrition and health classes delivered to groups of families and exercise sessions (3 days/week) delivered to groups of adolescents. Comparison youth received laboratory results and general health information. Primary outcomes included insulin sensitivity and weight-specific quality of life (QoL) with secondary outcomes of BMI percentile (BMI%), waist circumference, and percent body fat. RESULTS At 3 months, youth in the intervention group exhibited significant increases in insulin sensitivity (P < 0.05) and weight-specific QoL (P < 0.001), as well as reductions in BMI%, waist circumference, and percent body fat compared with controls. Increases in weight-specific QoL and reductions in BMI% and percent body fat remained significant at 12 months (P < 0.001), while changes in insulin sensitivity did not. In a subsample of youth with prediabetes at baseline, insulin sensitivity (P = 0.01), weight-specific QoL (P < 0.001), and BMI% (P < 0.001) significantly improved at 3 months. CONCLUSIONS Lifestyle intervention can improve cardiometabolic and psychosocial health in a vulnerable population of Latino adolescents at high risk for developing type 2 diabetes.
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Affiliation(s)
- Erica G Soltero
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona, USA
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
| | - Yolanda P Konopken
- Family Wellness Program, St. Vincent de Paul Medical and Dental Clinic, Phoenix, Arizona, USA
| | - Felipe G Castro
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | | | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Donald L Patrick
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Stephanie L Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
| | - Estela Barraza
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
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9
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Ho TJH, Lee CCS, Wong SN, Lau Y. Internet-based self-monitoring interventions for overweight and obese adolescents: A systematic review and meta-analysis. Int J Med Inform 2018; 120:20-30. [PMID: 30409343 DOI: 10.1016/j.ijmedinf.2018.09.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/11/2018] [Accepted: 09/24/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Internet-based self-monitoring intervention offers accessibleand convenient weight management. This review aimed to systematically review the evidence on the effectiveness of internet-based self-monitoring intervention for overweight and obese adolescents. METHOD PubMed, CINAHL, Cochrane Library, EMBASE, ProQuest, PsycINFO and SCOPUS were systematically searched for randomised controlled trials (RCTs) from inception until December 13, 2017. The risk of bias and strength of evidence was assessed using the Cochrane Collaboration Risk of Bias Tool and the Grading of Recommendations, Assessment, Development and Evaluations criteria. Meta-analysis was performed on the RevMan software using a random effects model. The overall effect was assessed using effect size (Cohen'sd)and heterogeneity was evaluated using Cochrane Q and I2 values. PROSPERO database #CRD42016050089. RESULTS A total of 6841 records were identified. Six RCTs in 10 articles were selected amongst 505 adolescents across three countries who were overweight and obese. The meta-analysis revealed a small effect on the reduction of body mass index (BMI) and BMI z-scores (d = 0.30, 95% CI: -0.48 to -0.12). Subgroup analyses suggest the use of daily multicomponent self-monitoring, specified goal setting, face-to-face counselling and parental involvement. The overall quality of evidence was low due to the risk of bias and imprecision. CONCLUSION Internet-based self-monitoring intervention is a possible approach for overweight and obese adolescents to reduce their BMI. Further well-designed RCTs with follow-up data and large sample sizes are needed to ensure the robustness of the evidence.
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Affiliation(s)
| | - Cindy Ching Siang Lee
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Suei Nee Wong
- National University of Singapore Libraries, National University of Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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10
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Summer Healthy-Lifestyle Intervention Program for Young Children Who Are Overweight: Results from a Nonrandomized Pilot Trial. J Dev Behav Pediatr 2018; 38:723-727. [PMID: 28914727 DOI: 10.1097/dbp.0000000000000499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To examine initial outcomes of an 8-week Healthy-Lifestyle Intervention Program (HIP) which included children's participation in a daily summer camp along with parents' participation in a parenting program focused on overweight/obesity. METHODS Using a nonrandomized pilot trial design, 16 children (M child age = 6.42 yr; 81% male; 100% Latino) classified as overweight/obese and their mothers completed 3 assessments (baseline, posttreatment, and 6-8 mo follow-up). RESULTS Children who completed HIP experienced significant decreases in their body mass index z-scores (primary outcome) from baseline to posttreatment (d = -1.11) with such decreases being moderately maintained at follow-up (d = -0.64). In terms of secondary outcomes, HIP was effective in improving and maintaining healthy habits in both children and mothers and children's nutritional knowledge and fitness. Objective food data showed that children's dietary intake during HIP improved. High attendance and satisfaction were reported for families who completed HIP. CONCLUSION This pilot treatment development study shows that a family lifestyle intervention conducted in a summer camp setting that targets both children and parents is a promising option for addressing pediatric obesity in young children.
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11
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Hoedjes M, Makkes S, Halberstadt J, Noordam H, Renders CM, Bosmans JE, van der Baan-Slootweg OH, Seidell JC. Health-Related Quality of Life in Children and Adolescents with Severe Obesity after Intensive Lifestyle Treatment and at 1-Year Follow-Up. Obes Facts 2018; 11:116-128. [PMID: 29631271 PMCID: PMC5981677 DOI: 10.1159/000487328] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 01/31/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To examine changes in generic and weight-related, health-related quality of life (HRQoL) in children and adolescents with severe obesity participating in intensive lifestyle treatment, and to examine whether changes in SDS-BMI were associated with changes in HRQoL. METHODS In this prospective observational study, a referred sample of 120 children and adolescents (8-19 years) with severe obesity (SDS-BMI ≥ 3.0, or ≥ 2.3 in combination with obesity-related comorbidity) received an intensive 1-year lifestyle treatment with an inpatient period in a specialized childhood obesity center. A weight-related (IWQOL-Kids) and three generic (KIDSCREEN-52, PedsQL 4.0, and EuroQol) HRQoL questionnaires were administered at baseline (T0), after treatment (T1), and 1 year later (T2). Generalized Linear Mixed Models and partial correlations were used to analyze changes in HRQoL and associations with changes in SDS-BMI. RESULTS Statistically significant improvements in generic and weight-related HRQoL overall and domain scores were observed at T1and at T2 in comparison with T0, despite partial weight regain from T1 to T2. Larger weight loss at T2 was correlated with larger improvements in physical HRQoL domains. CONCLUSION Children and adolescents with severe obesity experienced long-term improvements in generic and weight-related HRQoL after participating in intensive lifestyle treatment, despite partial weight regain.
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Affiliation(s)
- Meeke Hoedjes
- Amsterdam Public Health Research Institute, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Sabine Makkes
- Amsterdam Public Health Research Institute, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jutka Halberstadt
- Amsterdam Public Health Research Institute, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hanneke Noordam
- Amsterdam Public Health Research Institute, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Carry M. Renders
- Amsterdam Public Health Research Institute, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Judith E. Bosmans
- Amsterdam Public Health Research Institute, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Jacob C. Seidell
- Amsterdam Public Health Research Institute, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- *Prof. Dr. Jacob C. Seidell, Department of Health Sciences, Faculty of Earth and Life Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands,
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12
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Subjective evaluation of psychosocial well-being in children and youths with overweight or obesity: the impact of multidisciplinary obesity treatment. Qual Life Res 2017; 26:3279-3288. [PMID: 28762099 DOI: 10.1007/s11136-017-1667-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the effects of a multidisciplinary childhood obesity treatment programme on subjective evaluations of psychosocial well-being and quality of life. METHODS This longitudinal observational study included 1291 children, adolescents and young adults, 6-22 years of age, with overweight or obesity. At entry and after 2-82 months of obesity treatment, the patients evaluated the following domains of psychosocial well-being on a visual analogue scale: quality of life, mood, appetite, bullying, motivation for weight loss and body image satisfaction. The degree of overweight was calculated using a body mass index (BMI) standard deviation score (SDS) at each visit. RESULTS At entry, the mean BMI SDS was 2.81 (range: 1.35-6.65, 95% confidence interval (95% CI): 2.44-3.18). After a median of 14 months of treatment, the median reduction in BMI SDS was 0.29 (95% CI: 0.26-0.31, p < 0.0001). Improvements were observed in the domains of quality of life, mood, appetite, bullying and body image satisfaction (p < 0.0001). Larger reductions in BMI SDS were associated with greater improvements in the domains of quality of life (p = 0.001), mood (p = 0.04) and body image satisfaction (p < 0.0001), independent of BMI SDS at entry. However, improvements in psychosocial well-being were also observed in those increasing their BMI SDS (n = 315). CONCLUSIONS In a large group of children and youths, psychosocial well-being improved during a multidisciplinary childhood obesity treatment programme, irrespective of the degree of obesity at treatment entry. Greater reductions in BMI SDS were associated with greater improvements in psychosocial well-being, but even in the group increasing their BMI SDS improvements were observed.
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13
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Soltero EG, Konopken YP, Olson ML, Keller CS, Castro FG, Williams AN, Patrick DL, Ayers S, Hu HH, Sandoval M, Pimentel J, Knowler WC, Frick KD, Shaibi GQ. Preventing diabetes in obese Latino youth with prediabetes: a study protocol for a randomized controlled trial. BMC Public Health 2017; 17:261. [PMID: 28302101 PMCID: PMC5353870 DOI: 10.1186/s12889-017-4174-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/04/2017] [Indexed: 12/12/2022] Open
Abstract
Background Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes. Methods Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance. Discussion The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth. Trial Registration NCT02615353, registered on June 8, 2016.
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Affiliation(s)
- Erica G Soltero
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA
| | - Yolanda P Konopken
- Family Wellness Program, Virginia G. Piper, St. Vincent de Paul Medical and Dental Clinic, 1730 E. Monroe Street, Phoenix, AZ, 85034, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA.,Division of Endocrinology and Diabetes, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA
| | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA
| | - Felipe G Castro
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA.,Southwest Interdisciplinary Research Center, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA
| | - Donald L Patrick
- Seattle Quality of Life Group, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, USA
| | - Stephanie Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA
| | - Houchun H Hu
- Department of Radiology, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA
| | - Matthew Sandoval
- Valley of the Sun YMCA, 350 N. 1st Avenue, Phoenix, AZ, 85003, USA
| | - Janiel Pimentel
- Division of Endocrinology and Diabetes, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA
| | - William C Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Phoenix, AZ, 85016, USA
| | - Kevin D Frick
- Johns Hopkins Carey Business School, 100 International Drive, Baltimore, MD, 21202, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA. .,Division of Endocrinology and Diabetes, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA. .,Southwest Interdisciplinary Research Center, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA.
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14
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Soltero EG, Konopken YP, Olson ML, Keller CS, Castro FG, Williams AN, Patrick DL, Ayers S, Hu HH, Sandoval M, Pimentel J, Knowler WC, Frick KD, Shaibi GQ. Preventing diabetes in obese Latino youth with prediabetes: a study protocol for a randomized controlled trial. BMC Public Health 2017. [PMID: 28302101 DOI: 10.1186/s12889‐017‐4174‐2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes. METHODS Participants will be randomized to a lifestyle intervention or usual care group. Participants in the intervention group will attend weekly nutrition and wellness sessions and physical activity sessions twice a week for six months, followed by three months of booster sessions. The overall approach of the intervention is framed within a multilevel Ecodevelopmental model that leverages community, family, peer, and individual factors during the critical transition period of adolescence. The intervention is also guided by Social Cognitive Theory and employs key behavioral modification strategies to enhance self-efficacy and foster social support for making and sustaining healthy behavior changes. We will test intervention effects on quality of life, explore the potential mediating effects of changes in body composition, total, regional, and organ fat on improving glucose tolerance and increasing insulin sensitivity, and estimate the initial incremental cost effectiveness of the intervention as compared with usual care for improving glucose tolerance. DISCUSSION The proposed trial builds upon extant collaborations of a transdisciplinary team of investigators working in concert with local community agencies to address critical gaps in how diabetes prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent type 2 diabetes in this and other populations of high-risk youth. TRIAL REGISTRATION NCT02615353, registered on June 8, 2016.
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Affiliation(s)
- Erica G Soltero
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA
| | - Yolanda P Konopken
- Family Wellness Program, Virginia G. Piper, St. Vincent de Paul Medical and Dental Clinic, 1730 E. Monroe Street, Phoenix, AZ, 85034, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA.,Division of Endocrinology and Diabetes, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA
| | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA
| | - Felipe G Castro
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA
| | - Allison N Williams
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA.,Southwest Interdisciplinary Research Center, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA
| | - Donald L Patrick
- Seattle Quality of Life Group, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, USA
| | - Stephanie Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA
| | - Houchun H Hu
- Department of Radiology, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA
| | - Matthew Sandoval
- Valley of the Sun YMCA, 350 N. 1st Avenue, Phoenix, AZ, 85003, USA
| | - Janiel Pimentel
- Division of Endocrinology and Diabetes, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA
| | - William C Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Phoenix, AZ, 85016, USA
| | - Kevin D Frick
- Johns Hopkins Carey Business School, 100 International Drive, Baltimore, MD, 21202, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85013, USA. .,Division of Endocrinology and Diabetes, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ, 85016, USA. .,Southwest Interdisciplinary Research Center, Arizona State University, 411 N. Central Avenue, Suite 720, Phoenix, AZ, 85004-0693, USA.
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15
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Williams AN, Konopken YP, Keller CS, Castro FG, Arcoleo KJ, Barraza E, Patrick DL, Olson ML, Shaibi GQ. Culturally-grounded diabetes prevention program for obese Latino youth: Rationale, design, and methods. Contemp Clin Trials 2017; 54:68-76. [PMID: 28104469 DOI: 10.1016/j.cct.2017.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/13/2017] [Accepted: 01/14/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. OBJECTIVES To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14-16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. CONCLUSIONS The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations.
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Affiliation(s)
- Allison N Williams
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States; Southwest Interdisciplinary Research Center, Arizona State University, United States
| | - Yolanda P Konopken
- Family Wellness Program, Virginia G. Piper, St. Vincent de Paul Medical and Dental Clinic, United States
| | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States
| | - Felipe Gonzalez Castro
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States
| | | | - Estela Barraza
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States
| | - Donald L Patrick
- Seattle Quality of Life Group, Department of Health Services, School of Public Health and Community Medicine, University of Washington, United States
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States; Division of Endocrinology and Diabetes, Phoenix Children's Hospital, United States
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, United States; Southwest Interdisciplinary Research Center, Arizona State University, United States; Division of Endocrinology and Diabetes, Phoenix Children's Hospital, United States.
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16
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Dalton AG, Smith C, Dalton WT, Slawson DL. Examining General Versus Condition-Specific Health-Related Quality of Life Across Weight Categories in an Adolescent Sample. J Pediatr Health Care 2015; 29:453-62. [PMID: 25935587 PMCID: PMC4550568 DOI: 10.1016/j.pedhc.2015.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 03/03/2015] [Accepted: 04/02/2015] [Indexed: 11/15/2022]
Abstract
This study examined health-related quality of life (HRQoL) across weight categories in adolescents using both a general and a condition-specific measure sensitive to fatigue symptoms. Participants (N = 918) completed the Pediatric Quality of Life (PedsQL) Inventory and PedsQL Multidimensional Fatigue Scale measures. Actual height and weight were used to calculate body mass index for age and sex percentiles and assign weight categories. No interaction effects between total HRQoL and weight category and gender were found; however, main effects were found for both weight category and gender. Future research should examine the impact of using different measures to assess HRQoL outcomes across weight categories.
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Affiliation(s)
- Autumn G. Dalton
- Niswonger Children’s Hospital, Mountain States Health Alliance, 400 N State of Franklin Road, Johnson City, TN, 37604, USA;
| | - Courtney Smith
- Department of Psychology, East Tennessee State University, PO Box 70649, Johnson City, TN, 37614, USA;
| | - William T. Dalton
- Department of Psychology, East Tennessee State University, PO Box 70649, Johnson City, TN, 37614, USA;
| | - Deborah L. Slawson
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, PO Box 70674, Johnson City, TN, 37614, USA;
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17
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Shaibi GQ, Konopken YP, Nagle-Williams A, McClain DD, Castro FG, Keller CS. Diabetes Prevention for Latino Youth: Unraveling the Intervention "Black Box". Health Promot Pract 2015; 16:916-24. [PMID: 26324123 DOI: 10.1177/1524839915603363] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The translation of research findings into sustainable health promotion and disease prevention programs in community settings remains a challenge. This report describes the process of substantiating a community-developed diabetes prevention program for Latino youth through research. Included are design considerations, measurement strategies, and the context through which the project is culturally grounded for relevance and fit within a local community. The process included (1) refining the program to include salient, stakeholder-identified behavioral components; (2) refining the collaborative effort to embrace the capacity for facilitating relevant behavior change on targeted health-related outcomes to enhance intervention effectiveness; and (3) including the accurate assessment of intervention efficacy via precise assessment of diabetes-related health outcomes. We explain the process of collaborating with community partners to enhance the cultural relevance and sustainability of intervention effects on both individuals and communities. We discuss the rationale for empirical support for academic-community collaborations that function in both a "top-down" and a "bottom-up" manner to advance the science and practice of sustainable and efficacious community health promotion.
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Affiliation(s)
- Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Allison Nagle-Williams
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Darya D McClain
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Felipe Gonzalez Castro
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Colleen S Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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18
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Lao WL, Malone DC, Armstrong EP, Voellinger D, Somers S, Jin J, Dreyer N, Globe D. Effect of adjustable gastric banding on quality of life and weight loss in the Helping Evaluate Reduction in Obesity (HERO) registry study: 2 year analysis. Curr Med Res Opin 2015; 31:1451-60. [PMID: 26154653 DOI: 10.1185/03007995.2015.1059802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This report from the Helping Evaluate Reduction in Obesity (HERO) Study investigated weight loss, health-related quality of life (HRQOL), and factors predictive of HRQOL improvement during a 2 year period following Lap-Band AP implantation (post-LBAP). RESEARCH DESIGN AND METHODS This prospective, observational study included patients with 1 and 2 year follow-up data post-LBAP (N = 585). Changes in body mass index (BMI), percentage of weight loss (%WL), excess weight loss (%EWL) and HRQOL (Impact of Weight on Quality of Life [IWQOL]-Lite measure), and differences between <30% EWL and ≥30% EWL subgroups were assessed at 1 and 2 years post-LBAP. Multiple linear regression examined association of %EWL groups with IWQOL-Lite scores controlling for age, gender, region (US vs outside US), household income, employment status, and comorbidities. RESULTS Most patients were female (80.2%) and from the US (64.8%); overall mean (SD) age was 43.6 (11.28) years and 65.8% of patients had ≥30% EWL at year 2. At 2 years post-LBAP, mean %EWL was 43.5%; %EWL was 12.4% in the <30% EWL group and 59.6% in ≥30% EWL group (P ≤ 0.0001). Changes in IWQOL total and subscores were significantly greater in ≥30% EWL versus <30% EWL patients (all P < 0.0005) at years 1 and 2; Self-Esteem and Physical subscores had the largest changes. Multiple regression analysis showed that patients with ≥30% EWL had clinically meaningful improvements in HRQOL compared with patients having <30% EWL (P ≤ 0.001). Similarly, US patients and females had a clinically significant change in IWQOL score versus their counterparts (P ≤ 0.001). Conversely, income, comorbidities and employment status were not significant predictors of change in IWQOL scores at year 2. CONCLUSIONS These results support and extend findings regarding the effectiveness of LBAP for weight loss and illustrate the importance of ≥30% EWL as a significant factor in predicting clinically significant improvement in HRQOL 1 and 2 years post-LBAP. CLINICAL TRIAL REGISTRATION NCT00953173.
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Affiliation(s)
- W-L Lao
- a a University of Arizona , Tucson , AZ , USA
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Factors influencing quality of life of obese students in Hangzhou, China. PLoS One 2015; 10:e0121144. [PMID: 25799275 PMCID: PMC4370691 DOI: 10.1371/journal.pone.0121144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 02/10/2015] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate the quality of life (QOL) of overweight and obese middle or high school students and identify relevant factors influencing their QOL scores. Methods 716 students were recruited from 6 middle or high schools in Hangzhou, China. The Chinese version of the Youth Quality of Life Instrument–Weight Module (YQOL-W) was self administered. The YQOL-W scores were compared among different BMI groups, gender, educational status, annual household income, parental education and recruitment community using t test or one-way analysis of variance. The independent association of these variables with QOL among overweight and obese students was examined using multivariable linear regression modeling. Results Overweight and obese students reported lower total scores, self, social and environment scores than their normal weight peers (all P<0.001). The QOL of overweight and obese middle and high school students was associated with BMI value, gender, educational status, parental education, and recruitment community. Girls had lower total scores, self, social and environment domain scores than boys (all P<0.001); high school students had lower total and three domain scores than middle school students (all P<0.05). Students whose fathers had higher education reported higher total scores, self and social scores than students with less educated fathers (all P<0.05). Students whose mothers had higher education reported higher environment scores than students with less educated mothers (P = 0.01). Students from migrant communities reported significantly lower total scores, self and social scores than those from rural communities (all P<0.05), but comparable scores with those from urban communities (P>0.05). Students from migrant communities reported comparable environment scores with those from rural and urban communities (P>0.05). Conclusions Overweight and obesity have negative effects on students’ quality of life. Therefore weight specific QOL could be included in weight reduction interventions as a relevant outcome.
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Perceived health status and cardiometabolic risk among a sample of youth in Mexico. Qual Life Res 2015; 24:1887-97. [PMID: 25648756 DOI: 10.1007/s11136-015-0922-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 01/02/2023]
Abstract
PURPOSE To examine differences in self-reported perceived mental and physical health status, as well as known cardiometabolic risk factors in a sample of normal weight, overweight, and obese Mexican youths. METHODS Cross-sectional analysis of 164 youths aged 11-18 years recruited in Cuernavaca, Mexico. Participants completed a self-administered questionnaire that included measures of generic and weight-specific quality of life, perceived health, physical function, depressive symptoms, and body shape satisfaction. Height, weight, and waist circumference were measured, and body mass index (BMI) was determined. Fasting blood samples from participants yielded levels of glucose, triglycerides, and cholesterol (total, HDL, and LDL). RESULTS Nearly 50 % of participants were female, 21 % had a normal BMI, 39 % were overweight, and 40 % were obese. Obese youths reported significantly lower measures of perceived health status (PHS) and showed an increase in cardiometabolic risk, compared with normal weight youths. Physical functioning, generic and weight-specific QoL were inversely associated with BMI, waist circumference, and glucose. Depressive symptoms were positively correlated with BMI, waist circumference, glucose levels, and HDL cholesterol. No correlation was found between PHS and cardiometabolic risk measures after controlling for BMI. CONCLUSIONS In this sample of Mexican youths, obesity was associated with a significantly lower PHS and increased cardiometabolic risk.
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Toplak H, Woodward E, Yumuk V, Oppert JM, Halford JC, Frühbeck G. 2014 EASO Position Statement on the Use of Anti-Obesity Drugs. Obes Facts 2015; 8:166-74. [PMID: 25968960 PMCID: PMC5644876 DOI: 10.1159/000430801] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 02/02/2015] [Indexed: 01/03/2023] Open
Affiliation(s)
- Hermann Toplak
- Department of Internal Medicine, Medical University, Graz, Austria
- *Univ. Prof. Dr. Hermann Toplak, Department of Medicine, Medical University Graz, Auenbruggerplatz 15, 8036 Graz, Austria,
| | - Euan Woodward
- European Association for the Study of Obesity, London, UK
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Jean-Michel Oppert
- Department of Nutrition, Pitie-Salpetriere Hospital (AP-HP); Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie, Paris, France
| | - Jason C.G. Halford
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Gema Frühbeck
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, Obesity & Adipobiology Group of the Instituto de Investigación Sanitaria de Navarra, CIBERobn, Instituto de Salud Carlos III, Pamplona, Spain
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Ligthart KAM, Paulis WD, Djasmo D, Koes BW, van Middelkoop M. Effect of multidisciplinary interventions on quality of life in obese children: a systematic review and meta-analysis. Qual Life Res 2014; 24:1635-43. [DOI: 10.1007/s11136-014-0881-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 02/03/2023]
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Imanaka M, Ando M, Kitamura T, Kawamura T. Effectiveness of web-based self-disclosure peer-to-peer support for weight loss: randomized controlled trial. J Med Internet Res 2013; 15:e136. [PMID: 23838533 PMCID: PMC3713952 DOI: 10.2196/jmir.2405] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/27/2012] [Accepted: 05/08/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity is one of the most common public health problems in the industrialized world as a cause of noncommunicable diseases. Although primarily used for one-on-one communication, email is available for uninterrupted support for weight loss, but little is known about the effects of dietitian group counseling for weight control via the Internet. OBJECTIVE We developed a Web-based self-disclosure health support (WSHS) system for weight loss. This study aims to compare the effect of weight change between those using the WSHS and those using the email health support (EHS). METHODS This study was designed as an open prospective individual randomized controlled trial. Eligible participants were aged 35 to 65 years with a body mass index (BMI) of ≥25.0 in their latest health examination. Participants were randomly assigned to either the WSHS group or the EHS group. Thirteen registered dietitians under the direction of a principal dietitian each instructed 6 to 8 participants from the respective groups. All participants in the WSHS group could receive nutritional advice and calculate their nutritive intake from a photograph of a meal on their computer screen from the Internet sent to them by their dietitian, receive supervision from the registered dietitian, and view fellow participants' weight changes and lifestyle modifications. In the EHS group, a participant could receive one-on-one nutritional advice and calculate his/her nutritive intake from the photograph of a meal on computer screen sent by email from his/her dietitian, without being able to view fellow participants' status. The follow-up period was 12 weeks for both groups. The primary outcome measure was change in body weight. The secondary outcome measure included changes in BMI and waist circumference. The intergroup comparison of the changes before and after intervention was evaluated using analysis of covariance. RESULTS A total of 193 participants were randomly assigned to either the WSHS group (n=97) or the EHS group (n=96). Ten from the WSHS group and 8 from the EHS group dropped out during the study period, and the remaining 87 in the WSHS group and 88 in the EHS group were followed up completely. Weight loss was significantly greater in the WSHS group than in the EHS group (-1.6 kg vs -0.7 kg; adjusted P=.04). However, there were few differences in waist circumference between the 2 groups. (-3.3 cm vs -3.0 cm; adjusted P=.71). CONCLUSIONS Our newly developed WSHS system using forced self-disclosure had better short-term weight loss results. Further study in a longer-term trial is necessary to determine what effects this type of intervention might have on long-term cardiovascular disease. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trial Registration (UMIN-CTR): UMIN000009147; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000010719&language=E (Archived by WebCite at http://www.webcitation.org/6HTCkhb1p).
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Affiliation(s)
- Mie Imanaka
- Health Service, Kyoto University, Kyoto, Japan
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Finne E, Reinehr T, Schaefer A, Winkel K, Kolip P. Changes in self-reported and parent-reported health-related quality of life in overweight children and adolescents participating in an outpatient training: findings from a 12-month follow-up study. Health Qual Life Outcomes 2013; 11:1. [PMID: 23281620 PMCID: PMC3547728 DOI: 10.1186/1477-7525-11-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 12/27/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) was found to improve in participants of weight management interventions. However, information on moderately overweight youth as well as on maintaining HRQoL improvements following treatment is sparse. We studied the HRQoL of 74 overweight, but not obese participants (32.4% male, mean age = 11.61 ± 1.70 SD) of a comprehensive and effective six-month outpatient training at four time-points up to 12 months after end of treatment. METHODS HRQoL was measured by self-report and proxy-report versions of the generic German KINDL-R, including six sub domains, and an obesity-specific additional module. Changes in original and z-standardized scores were analyzed by (2×4) doubly multivariate analysis of variance. This was done separately for self- and proxy-reported HRQoL, taking into account further socio-demographic background variables and social desirability. Additionally, correlations between changes in HRQoL scores and changes in zBMI were examined. RESULTS There were significant multivariate time effects for self-reported and proxy-reported HRQoL and a significant time-gender interaction in self-reports revealed (p < .05). Improvements in weight-specific HRQoL were evident during treatment (partial η² = 0.14-0.19). Generic HRQoL further increased after end of treatment. The largest effects were found on the dimension self-esteem (partial η² = 0.08-0.09 for proxy- and self-reported z-scores, respectively). Correlations with changes in weight were gender-specific, and weight reduction was only associated with HRQoL improvements in girls. CONCLUSIONS Positive effects of outpatient training on generic and weight-specific HRQoL of moderately overweight (not obese) children and adolescents could be demonstrated. Improvements in HRQoL were not consistently bound to weight reduction. While changes in weight-specific HRQoL were more immediate, generic HRQoL further increased after treatment ended. An extended follow-up may therefore be needed to scrutinize HRQoL improvements due to weight management. TRIAL REGISTRATION clinicaltrials.gov NCT00422916.
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Affiliation(s)
- Emily Finne
- Bielefeld University, School of Public Health, Bielefeld, Germany.
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Edwards TC, Patrick DL, Skalicky AM, Huang Y, Hobby AD. Perceived body shape, standardized body-mass index, and weight-specific quality of life of African-American, Caucasian, and Mexican-American adolescents. Qual Life Res 2011; 21:1101-7. [DOI: 10.1007/s11136-011-0019-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2011] [Indexed: 10/17/2022]
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