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Moore WS, Maldonado-Molina MM, Mobley AR, Shelnutt KP, McVay MA. Parental Factors Associated With Intentions to Initiate a Family-Based Pediatric Weight Management Program. Child Obes 2024; 20:270-278. [PMID: 37366662 DOI: 10.1089/chi.2023.0033] [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: 06/28/2023]
Abstract
Background: Childhood obesity can be addressed through family-based pediatric weight management; however, treatment enrollment in the United States is low. This study aimed to identify parental factors associated with intentions to initiate a family-based pediatric weight management program. Methods: Cross-sectional survey data were collected from an online panel of US parents with at least one 5- to 11-year-old child identified as likely to have overweight or obesity. Participants viewed a video about a hypothetical family-based pediatric weight management program, rated their 30-day initiation intentions for that program, and answered additional related questionnaires. Results: Participants (n = 158) identified as White/Caucasian (53%) or Black/African American (47%), were primarily female (61.4%) and married/cohabitating (81.6%) with children who were predominantly girls (53.2%) and, on average, 9-year-olds. Higher parents' perception of program effectiveness predicted initiation intentions (p < 0.001), while concern for their child's weight and parent depression and anxiety levels did not. Higher initiation intentions and perceived program effectiveness were reported by Black/African American participants (p < 0.01) and those with at least a bachelor's degree (p < 0.01) compared to White/Caucasian participants and those without a bachelor's degree, respectively. Initiation intentions were higher for those with greater financial security (p = 0.020) and fewer than three children in the home (p = 0.026). Participants endorsed initiation barriers of time constraints (25%), possible lack of enjoyment for the child (16.9%), and lack of family support (15%). Conclusions: Future program enrollment efforts may need to focus on strategies to increase perceived program effectiveness, although further research is needed that measures actual enrollment in real-world contexts.
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Affiliation(s)
- Wendy S Moore
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Mildred M Maldonado-Molina
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Amy R Mobley
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Karla P Shelnutt
- Department of Family, Youth, and Community Sciences, Institute of Food and Agricultural Science (IFAS), University of Florida, Gainesville, FL, USA
| | - Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
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Abstract
Background: A physician or health care provider (HCP) referral is usually needed for children to access multidisciplinary health services for obesity management; however, offering families the option to self-refer can enhance equity and access to care. Methods: We completed a retrospective medical record review to explore patient characteristics and program engagement of children with obesity who were self- (n = 18) or HCP-referred (n = 120) for obesity management. Results: Our descriptive data suggested that children who were self-referred presented with a healthier clinical profile and missed fewer appointments than their peers referred by HCPs. Conclusions: Prospective research is needed to examine whether health services and treatment outcomes differ between self- and HCP-referred children in obesity management.
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Affiliation(s)
- Laura McGeown
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Aislin R Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
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Gehring ND, Kebbe M, Rathwell S, Perez A, Peng C, Zendher E, Ho J, Ball GDC. Physician-related predictors of referral for multidisciplinary paediatric obesity management: a population-based study. Fam Pract 2021; 38:576-581. [PMID: 33755099 DOI: 10.1093/fampra/cmab019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND It is recommended that primary care-based physicians refer children with overweight and obesity to multidisciplinary paediatric obesity management, which can help to improve weight and health. OBJECTIVE To determine predictors of referral to multidisciplinary paediatric obesity management. METHODS This retrospective, population-level study included physicians who could refer 2-17 years old with a body mass index ≥85th percentile to one of three multidisciplinary paediatric obesity management clinics in Alberta, Canada. Physician demographic and procedural data were obtained from Practitioner Claims and Provider Registry maintained by Alberta Health from January 2014 to December 2017. Physician characteristics were compared based on whether they did or did not refer children for obesity management. Univariable and multivariable logistic regression models analysed associations between physician characteristics and referral making. RESULTS Of the 3863 physicians (3468 family physicians, 395 paediatricians; 56% male; 49.3 ± 12.2 years old; 22.3 ± 12.6 years since graduation) practicing during the study period, 1358 (35.2%) referred at least one child for multidisciplinary paediatric obesity management. Multivariable regression revealed that female physicians (versus males) [odds ratio (OR): 1.68, 95% confidence interval (CI): 1.46-1.93; P < 0.0001], paediatricians (versus family physicians) (OR: 4.89, 95% CI: 3.85-6.21; P < 0.0001) and urban-based physicians (versus non-urban-based physicians) (OR: 2.17, 95% CI: 1.79-2.65; P < 0.0001) were more likely to refer children for multidisciplinary paediatric obesity management. CONCLUSIONS Approximately one-third of family physicians and paediatricians referred children for multidisciplinary paediatric obesity management. Strategies are needed to improve referral practices for managing paediatric obesity, especially among male physicians, family physicians and non-urban-based physicians as they were less likely to refer children.
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Affiliation(s)
- Nicole D Gehring
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Maryam Kebbe
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Sarah Rathwell
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB, Canada
| | - Arnaldo Perez
- School of Dentistry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Chenhui Peng
- Pediatric Centre for Weight and Health, Stollery Children's Hospital, Alberta Health Services, Edmonton, AB, Canada
| | - Emily Zendher
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Josephine Ho
- Department of Paediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
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Peckham A, Wright JG, Marani H, Abdelhalim R, Laxer D, Allin S, Alam N, Marchildon G. Putting the Patient First: A Scoping Review of Patient Desires in Canada. Healthc Policy 2021; 16:46-69. [PMID: 34129478 PMCID: PMC8200834 DOI: 10.12927/hcpol.2021.26499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Five broad themes were identified and expressed differently across the health states, including personalized care, navigation, choice, holistic care and care continuity. Patients' perspectives must be considered to meet the diverse needs of targeted patient groups, which can inform health system planning, quality improvement initiatives and targeting of investments.
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Affiliation(s)
- Allie Peckham
- Assistant Professor, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ; North American Observatory on Health Systems and Policies, University of Toronto, Toronto, ON
| | - James G Wright
- Chief, Economics, Policy and Research, Ontario Medical Association, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public HealthUniversity of Toronto, Toronto, ON
| | - Husayn Marani
- Research Assistant, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public HealthUniversity of Toronto, Toronto, ON
| | - Reham Abdelhalim
- Research Assistant, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public HealthUniversity of Toronto, Toronto, ON
| | - Dara Laxer
- Executive Director, Health Policy and Promotion, Ontario Medical Association, Toronto, ON
| | - Sara Allin
- Director of Operations, North American Observatory on Health Systems and Policies; Assistant Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Nadia Alam
- Past President, Ontario Medical Association, Toronto, ON
| | - Greg Marchildon
- Director, North American Observatory on Health Systems and Policies; Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Farnesi BC, Perez A, Holt NL, Morrison KM, Gokiert R, Legault L, Chanoine JP, Sharma AM, Ball GDC. Continued attendance for paediatric weight management: A multicentre, qualitative study of parents' reasons and facilitators. Clin Obes 2019; 9:e12304. [PMID: 30775853 DOI: 10.1111/cob.12304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/02/2018] [Accepted: 11/06/2018] [Indexed: 11/30/2022]
Abstract
Although prolonged engagement in paediatric weight management (PWM) is associated with positive treatment outcomes, little is currently known about enablers of long-term programme attendance. The purpose of our study was to explore families' reasons for and facilitators of their continued attendance at health services for PWM. Semi-structured, individual interviews were conducted with parents of children (10-17 year old; body mass index ≥85th percentile) who completed the active phase of treatment in one of four Canadian multidisciplinary clinics for PWM. Interview data were recorded digitally, transcribed verbatim and analysed thematically. Parents' (n = 40) reasons for continued clinic attendance included ongoing concerns (eg, parental concern about their child's health), actual and expected benefits from treatment (eg, lifestyle improvements) and perceived quality of care (eg, structured, comprehensive, tailored health services). Several logistical and motivational factors contributed to continued attendance, including flexible work schedules, flexible appointment times, financial resources and children's motivation for treatment. Helping families address treatment barriers and ensuring that weight management services meet families' treatment expectations are promising strategies to enhance retention in PWM to optimize health outcomes.
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Affiliation(s)
| | - Arnaldo Perez
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Nicholas L Holt
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - Katherine M Morrison
- Department of Pediatrics and Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Rebecca Gokiert
- Faculty of Extension, University of Alberta, Edmonton, Canada
| | - Laurent Legault
- Department of Pediatrics, McGill University, Hamilton, Canada
| | - Jean-Pierre Chanoine
- Endocrinology and Diabetes Unit, British Columbia Children's Hospital, Vancouver, Canada
| | - Arya M Sharma
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Geoff D C Ball
- Department of Pediatrics, University of Alberta, Edmonton, Canada
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Understanding engagement in a family-focused, multicomponent, childhood weight management programme delivered in the community setting. Public Health Nutr 2019; 22:1471-1482. [PMID: 30724148 DOI: 10.1017/s1368980018003828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To describe public health nurses' (PHN) experiences of referring to, and families' experiences of being referred to, a multicomponent, community-based, childhood weight management programme and to provide insight into families' motivation to participate in and complete treatment. DESIGN Qualitative study using semi-structured interviews and the draw-and-write technique. SETTING Two geographical regions in the south and west of Ireland.ParticipantsNine PHN involved in the referral process, as well as ten parents and nine children who were referred to and completed the programme, participated in the present study. RESULTS PHN were afraid of misclassifying children as obese and of approaching the subject of excess weight with parents. Peer support from other PHN as well as training in how best to talk about weight with parents were potential strategies suggested to alleviate these fears. Parents recalled the anxiety provoked by the 'medical terminology' used during referral and their difficulty interpreting what it meant for the health of their child. Despite initial fears, concern for their children's future health was a major driver behind their participation. Children's enjoyment, the social support experienced by parents as well as staff enthusiasm were key to programme completion. CONCLUSIONS The present study identifies the difficulties of referring families to community weight management programmes and provides practical suggestions on how to support practitioners in making referrals. It also identifies key positive factors influencing parents' decisions to enrol in community weight management programmes. These should be maximised by staff and policy makers when developing similar programmes.
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Salahuddin M, Barlow SE, Pont SJ, Butte NF, Hoelscher DM. Development and use of an index for measuring implementation of a weight management program in children in primary care clinics in Texas. BMC FAMILY PRACTICE 2018; 19:191. [PMID: 30518321 PMCID: PMC6280362 DOI: 10.1186/s12875-018-0882-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 11/23/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND The Texas Childhood Obesity Research Demonstration study was an integrated, systems-oriented intervention that incorporated primary and secondary obesity prevention approaches targeting multiple sectors, including primary care clinics, to address childhood obesity. The primary care clinic component included the American Academy of Pediatrics' Next Steps weight management counseling materials that support brief healthy lifestyle-focused visits. The current study describes the methodology and assesses the implementation of the Next Steps program in the participating primary care clinics, as well as the association of implementation with enrollment of children with overweight and obesity in the secondary prevention intervention. METHODS The study used a serial cross-sectional study design to collect data from 11 primary care clinics in Houston (n = 5) and Austin (n = 6), Texas, in 2013-2014. Responses of primary care providers on 42 self-reported survey questions assessing acceptability, adoption, appropriateness, and feasibility of the program were utilized to create a mean standardized clinic implementation index score. Provider scores were aggregated to represent Next Steps implementation scores at the clinic level. A mixed effects logistic regression test was conducted to determine the association between program implementation and the enrollment of children in the secondary prevention. RESULTS Mean implementation index score was lower at Year 2 of implementation (2014) than Year 1 (2013) although the decrease was not significant [63.2% (12.2%) in 2013 vs. 55.3% (16.5%) in 2014]. There were no significant associations between levels of implementation of Next Steps and enrollment into TX CORD secondary prevention study. CONCLUSIONS The development of an index using process evaluation measures can be used to assess the implementation and evaluation of provider-based obesity prevention tools in primary care clinics.
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Affiliation(s)
- Meliha Salahuddin
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX USA
- University of Texas Health Science Center at Tyler, Tyler, TX USA
- Population Health, Office of Health Affairs, University of Texas System, Austin, TX USA
| | - Sarah E. Barlow
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX USA
- UT Southwestern Medical Center, Dallas, TX USA
| | - Stephen J. Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children’s Medical Center, University of Texas at Austin Dell Medical School, Houston, TX USA
| | - Nancy F. Butte
- USDA/ARS Children’s Nutrition Research Center; Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX USA
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Predicting Enrollment in Multidisciplinary Clinical Care for Pediatric Weight Management. J Pediatr 2018; 202:129-135. [PMID: 30025672 DOI: 10.1016/j.jpeds.2018.06.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 05/28/2018] [Accepted: 06/13/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To characterize the children who were referred, determine the proportion of referred children who enrolled, and examine factors associated with enrollment in multidisciplinary clinical care for pediatric weight management. STUDY DESIGN This cross-sectional study included the population of children (2-17 years of age; body mass index of ≥85th percentile) referred to 1 of 3 hospital-based multidisciplinary weight management clinics in Alberta, Canada, from April 2013 to April 2016. Referral and enrollment data were obtained from Alberta Health Services databases. Bivariate and multivariable logistic regression models were used to determine the independent and combined effects of predictors of enrollment. RESULTS Of the 2014 children (51.8% male; mean body mass index z-score: 3.42 ± 0.03) referred to multidisciplinary clinical care, 757 (37.6%) enrolled in care. Most referred children had severe obesity and were referred by physicians. Several factors independently predicted enrollment; however, in our most parsimonious multivariable model, only the time gap (OR, 0.94; 95% CI, 0.88-0.99; P = .03) between the attendance date of the orientation session and the booking date of initial appointment predicted enrollment for all children. Body mass index z-score (OR, 0.81; 95% CI, 0.67-0.98; P = .03) and time gap (OR, 0.92; 95% CI, 0.85-0.99; P = .02) predicted enrollment in children with severe obesity exclusively. CONCLUSIONS Fewer than 40% of referred children enrolled in multidisciplinary clinical care. Reducing the duration of enrollment and providing additional support for treatment initiation to children with severe obesity may enhance treatment uptake for pediatric weight management.
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Perez AJ, Ball GDC. Helping children and families to enrol in weight management: What can stakeholders do? Paediatr Child Health 2018; 24:15-18. [PMID: 30792594 DOI: 10.1093/pch/pxy056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Many children and their families do not benefit from multidisciplinary clinical care (MCC) for paediatric weight management because they do not enrol in (initiate) treatment. The purpose of this report was to highlight practical recommendations to enhance the enrolment of Canadian children in MCC, which were drawn from multisite Canadian studies (quantitative and qualitative) that we completed recently. Recommendations to stakeholders, including primary care providers, MCC providers and decisions makers, were organized according to opportunities, motivation and barriers to enrol. Findings from our research suggested that enrolment in MCC can be improved by increasing opportunities and motivation to enrol as well as reducing the impact of enrolment barriers.
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Affiliation(s)
- Arnaldo J Perez
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Geoff D C Ball
- Department of Pediatrics, University of Alberta, Edmonton, Alberta
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10
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Perez AJ, Kebbe M, Holt NL, Gokiert R, Chanoine JP, Legault L, Morrison KM, Sharma AM, Ball GDC. Parent Recommendations to Enhance Enrollment in Multidisciplinary Clinical Care for Pediatric Weight Management. J Pediatr 2018; 192:122-129. [PMID: 29246332 DOI: 10.1016/j.jpeds.2017.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/26/2017] [Accepted: 09/14/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To explore parents' recommendations to enhance enrollment in multidisciplinary clinical care for managing pediatric obesity. STUDY DESIGN Data for this interpretative description study were collected through individual, semistructured interviews that were audiorecorded, transcribed verbatim, and analyzed thematically. Parents (n = 79) were recruited from 4 multidisciplinary weight management clinics in Canada located in Edmonton, Hamilton, Montreal, and Vancouver. RESULTS Most interviewed parents had children with obesity (body mass index ≥95th percentile; 84.2%), were female (87.3%), had postsecondary education (69.6%), and were white (75.9%). Parents' recommendations referred to enrollment opportunities, information about obesity services, motivation for treatment, and accessibility to obesity services. Specifically, parents recommended to increase referral options and follow-up contacts with families during the enrollment process, inform referring physicians and families about the availability and characteristics of obesity services, enhance families' motivation for treatment, prevent families from getting discouraged, make services more appealing to families, and address accessibility issues (eg, offering multiple options for appointment times, providing support for transportation). CONCLUSIONS Parents' recommendations support the need for family-centered approaches to enhance enrollment; however, their feasibility, acceptability, and effectiveness remain to be tested empirically.
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Affiliation(s)
- Arnaldo J Perez
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Kebbe
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Nicholas L Holt
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Rebecca Gokiert
- Community-University Partnership, Faculty of Extension, University of Alberta, Edmonton, Alberta, Canada
| | - Jean-Pierre Chanoine
- Endocrinology and Diabetes Unit, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Laurent Legault
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Katherine M Morrison
- Department of Pediatrics and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Arya M Sharma
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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The Team to Address Bariatric Care in Canadian Children (Team ABC3): Team Grant Research Proposal. BMC Res Notes 2017; 10:301. [PMID: 28992812 PMCID: PMC6389219 DOI: 10.1186/s13104-017-2506-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/16/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Severe obesity (SO) in Canadian children remains poorly understood. However, based on international data, the prevalence of SO appears to be increasing and is associated with a number of psychosocial, bio-mechanical, and cardiometabolic health risks. The purpose of our national Team to Address Bariatric Care in Canadian Children (Team ABC3) is to develop and lead a series of inter-related studies to enhance the understanding and management of SO in Canadian children and adolescents (0-18 years). METHODS/DESIGN From 2015 to 2019, Team ABC3 will conduct a series of projects at the regional, provincial, and national levels using multiple methods and study designs to respond to key knowledge gaps by (i) generating evidence on the prevalence of SO and its impact on health services utilization in children using existing Canadian data sources from primary care settings, (ii) exploring contemporary definitions of SO that link with health outcomes, (iii) comparing and contrasting health risks across the continuum of SO, (iv) understanding potential barriers to and facilitators of treatment success in children with SO, and (v) examining innovative lifestyle and behavioral interventions designed to successfully manage SO in children and their families. Furthermore, to examine the impact of innovative interventions on the management SO, we will (vi) evaluate whether adding a health coach, who provides support via text, email, and/or phone, improves children's ability to adhere to a web-based weight management program and (vii) test the feasibility and impact of a community-based weight management program for pre-school children with SO and their parents that combines group-based parenting sessions with in-home visits. DISCUSSION Our research aligns with national priorities in obesity research, brings together leading scientists, clinicians, and stakeholders from across Canada, and will inform health services delivery throughout the country to provide the best care possible for children with SO and their families.
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Kebbe M, Byrne JLS, Damanhoury S, Ball GDC. Following Suit: Using Conversation Cards for Priority Setting in Pediatric Weight Management. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:588-592.e1. [PMID: 28479009 DOI: 10.1016/j.jneb.2017.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/21/2017] [Accepted: 03/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To describe families' selections of Conversation Cards (CCs), a priority-setting tool in pediatric weight management, and examine CC-related differences based on families' anthropometric and sociodemographic characteristics. METHODS A retrospective medical record review was conducted of 2- to 17-year-olds with obesity and their families who enrolled in a pediatric weight management clinic between January, 2012 and September, 2016. RESULTS Medical records of 146 children were included. On average, families selected 10 ± 6 CCs (range, 3-32 CCs); only 50% of families (n = 73) indicated perceived readiness to make healthy changes. Adolescents (vs children) revealed less healthy eating behaviors (P = .001) and physical activity habits (P = .002). Goal setting was perceived to be a motivator across several sociodemographic characteristics (all P < .05). CONCLUSIONS AND IMPLICATIONS The CCs were useful in describing families' priorities. The diversity of issues identified by families highlighted the importance of multidisciplinary expertise in pediatric weight management.
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Affiliation(s)
- Maryam Kebbe
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Jillian L S Byrne
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Samah Damanhoury
- Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, Edmonton, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
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Williams SL, Van Lippevelde W, Magarey A, Moores CJ, Croyden D, Esdaile E, Daniels L. Parent engagement and attendance in PEACH™ QLD - an up-scaled parent-led childhood obesity program. BMC Public Health 2017; 17:559. [PMID: 28599644 PMCID: PMC5466714 DOI: 10.1186/s12889-017-4466-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/25/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parenting, Eating and Activity for Child Health (PEACH™) is a multicomponent treatment program delivered over ten group sessions to parents of overweight/obese primary school-aged children. It has been shown to be efficacious in an RCT and was recently translated to a large-scale community intervention funded by the Queensland (Australia) Government. Engagement (enrolment and attendance) was critical to achieving program outcomes and was challenging. The purpose of the present study was to examine sample characteristics and mediating factors that potentially influenced program attendance. METHODS Data collected from parents who attended at least one PEACH™ Queensland session delivered between October 2013 and October 2015 (47 programs implemented in 29 discrete sites), was used in preliminary descriptive analyses of sample characteristics and multilevel single linear regression analyses. Mediation analysis examined associations between socio-demographic and parent characteristics and attendance at group sessions and potential mediation by child and parent factors. RESULTS 365/467 (78%) enrolled families (92% mothers) including 411/519 (79%) children (55% girls, mean age 9 ± 2 years) attended at least one session (mean 5.6 ± 3.2). A majority of families (69%) self-referred to the program. Program attendance was greater in: advantaged (5.9 ± 3.1 sessions) vs disadvantaged families (5.4 ± 3.4 sessions) (p < 0.05); partnered (6.1 ± 3.1 sessions) vs un-partnered parents (5.0 ± 3.1 sessions) (p < 0.01); higher educated (6.1 ± 3.0 sessions) vs lower educated parents (5.1 ± 3.3 sessions) (p = 0.02); and self-referral (6.1 ± 3.1) vs professional referral (4.7 ± 3.3) (p < 0.001). Child (age, gender, pre-program healthy eating) and parent (perceptions of child weight, self-efficacy) factors did not mediate these relationships. CONCLUSIONS To promote reach and effectiveness of up-scaled programs, it is important to identify ways to engage less advantaged families who carry higher child obesity risk. Understanding differences in referral source and parent readiness for change may assist in tailoring program content. The influence of program-level factors (e.g. facilitator and setting characteristics) should be investigated as possible alternative mediators to program engagement.
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Affiliation(s)
- Susan L. Williams
- Central Queensland University, School of Health, Medical and Applied Sciences, Building 6, Bruce Highway, Rockhampton, QLD 4702 Australia
| | - Wendy Van Lippevelde
- Department of Public Health, Ghent University, De Pintelaan 185 – 4K3 room 036, 9000 Ghent, Belgium
| | - Anthea Magarey
- Flinders University, Nutrition and Dietetics, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Sturt Road, Bedford Park, Adelaide, SA 5042 Australia
| | - Carly J. Moores
- Flinders University, Nutrition and Dietetics, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Sturt Road, Bedford Park, Adelaide, SA 5042 Australia
| | - Debbie Croyden
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children’s Health Research (CCHR), Level 6, 62 Graham St, South Brisbane, Qld 4101 Australia
| | - Emma Esdaile
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children’s Health Research (CCHR), Level 6, 62 Graham St, South Brisbane, Qld 4101 Australia
| | - Lynne Daniels
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children’s Health Research (CCHR), Level 6, 62 Graham St, South Brisbane, Qld 4101 Australia
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Dhaliwal J, Perez AJ, Holt NL, Gokiert R, Chanoine JP, Morrison KM, Legault L, Sharma AM, Ball GD. Why do parents discontinue health services for managing paediatric obesity? A multi-centre, qualitative study. Obes Res Clin Pract 2017; 11:335-343. [DOI: 10.1016/j.orcp.2016.10.285] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/30/2016] [Accepted: 10/07/2016] [Indexed: 11/26/2022]
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