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Fraisl D, See L, Estevez D, Tomaska N, MacFeely S. Citizen science for monitoring the health and well-being related Sustainable Development Goals and the World Health Organization's Triple Billion Targets. Front Public Health 2023; 11:1202188. [PMID: 37637808 PMCID: PMC10450341 DOI: 10.3389/fpubh.2023.1202188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/07/2023] [Indexed: 08/29/2023] Open
Abstract
Achieving the health and well-being related Sustainable Development Goals (SDGs) and the World Health Organization's (WHO) Triple Billion Targets depends on informed decisions that are based on concerted data collection and monitoring efforts. Even though data availability has been increasing in recent years, significant gaps still remain for routine surveillance to guide policies and actions. The COVID-19 crisis has shown that more and better data and strengthened health information systems are needed to inform timely decisions that save lives. Traditional sources of data such as nationally representative surveys are not adequate for addressing this challenge alone. Additionally, the funding required to measure all health and well-being related SDG indicators and Triple Billion Targets using only traditional sources of data is a challenge to achieving efficient, timely and reliable monitoring systems. Citizen science, public participation in scientific research and knowledge production, can contribute to addressing some of these data gaps efficiently and sustainably when designed well, and ultimately, could contribute to the achievement of the health and well-being related SDGs and Triple Billion Targets. Through a systematic review of health and well-being related indicators, as well as citizen science initiatives, this paper aims to explore the potential of citizen science for monitoring health and well-being and for mobilizing action toward the achievement of health and well-being related targets as outlined in the SDG framework and Triple Billion Targets. The results demonstrate that out of 58 health and well-being related indicators of the SDGs and Triple Billion Targets covered in this study, citizen science could potentially contribute to monitoring 48 of these indicators and their targets, mostly at a local and community level, which can then be upscaled at a national level with the projection to reach global level monitoring and implementation. To integrate citizen science with official health and well-being statistics, the main recommendation is to build trusted partnerships with key stakeholders including National Statistical Offices, governments, academia and the custodian agencies, which is mostly the WHO for these health and well-being related targets and indicators.
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Affiliation(s)
- Dilek Fraisl
- International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Linda See
- International Institute for Applied Systems Analysis, Laxenburg, Austria
| | | | | | - Steve MacFeely
- World Health Organization, Geneva, Switzerland
- University College Cork, Cork, Ireland
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Habib-Mourad C, Hwalla N, Maliha C, Zahr S, Antoniades K. Ajyal Salima a novel public-private partnership model for childhood obesity prevention in the Arab countries. Front Public Health 2022; 10:1012752. [PMID: 36561856 PMCID: PMC9763279 DOI: 10.3389/fpubh.2022.1012752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
The prevalence of childhood overweight and obesity among children is on the rise around the world. Meanwhile, comprehensive multi-sectorial approaches have been found to be effective in improving nutritional status among children. Ajyal Salima is a public-private partnership (PPP) school-based nutrition and physical activity intervention program implemented in six Arab countries. Its objective is to promote healthy eating and physical activity habits among 9-11-year-old students. The stakeholders, involved with the implementation of the program, comprised (1) local authorities, ministries of Education and Health, and non-governmental organizations (NGOs) as public partners, (2) The American University of Beirut (AUB) as the academic/regional scientific partner, and (3) Nestlé as the private partner. The Ajyal Salima program encompasses four coordinated educational components: classroom sessions, family involvement, food service intervention, and training of trainers. The program's educational material has been culturally adapted to each country's needs, as well as pilot tested. This paper describes the strategies used to build the PPP framework of Ajyal Salima, and the role of each stakeholder. The Ajyal Salima program is an example of a promising and sustainable comprehensive PPP program to address childhood obesity, that can be exported to other countries in the region and globally.
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Affiliation(s)
- Carla Habib-Mourad
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon,*Correspondence: Nahla Hwalla
| | - Carla Maliha
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Sarah Zahr
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
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Chrissini MK, Panagiotakos DB. Public health interventions tackling childhood obesity at European level: A literature review. Prev Med Rep 2022; 30:102068. [PMID: 36531092 PMCID: PMC9747664 DOI: 10.1016/j.pmedr.2022.102068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/15/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
Childhood obesity pandemic, a form of malnutrition including undernutrition, and other food-regime associated risks, has universally been on the rise during the chronic period of the past 4-5 decades and is now acknowledged as one of the most "toxic fuel" accounting for poor health in the majority of countries. In order to find remedies to heal this alarming issue, a corpus of European interventions have been brought to light in the recent years. Since the vague influence and effectiveness of these measures / policies is to be further identified, their evaluation screening is underlined as a pivotal necessity. Within this framework this paper aims to critically report on the development and evaluation of the implementation of the European Union, World Health Organization Regional Office for Europe, and European Union countries' national public health policy interventions and action plans in the fight against childhood obesity. Thus, this is a narrative review synthesizing the results -following a qualitative interpretation and analysis- of recent scientific epidemiological research and review studies evidence concerning European public health interventions tackling childhood obesity, through computer-assisted literature search -via PubMed, Scopus, and Google Scholar- scientific databases. According to the literature data, it is concluded that despite the unprecedented public health challenge of addressing childhood obesity, the extent to which related European policies and programs targeting healthy nutrition, increased physical activity, and healthy lifestyle ethos are truly efficacious is still under inquiry.
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Affiliation(s)
- Maria K. Chrissini
- Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Demosthenes B. Panagiotakos
- Medical Research Methods & Epidemiology, Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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Del Giudice IM, Tsai KA, Arshonsky J, Bond S, Bragg MA. Food industry donations to patient advocacy organisations focussed on non-communicable diseases. Public Health Nutr 2022; 26:1-9. [PMID: 36305342 PMCID: PMC9989705 DOI: 10.1017/s1368980022001859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 06/02/2022] [Accepted: 07/12/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study used publicly available Form 990 tax documents to quantify food industry donations to patient advocacy organisations (PAO) dedicated to supporting patients with non-communicable diseases. DESIGN Observational, cross-sectional assessment of significant national and international food industry donations to US-based non-communicable disease-focussed PAO between 2000 and 2018. Researchers recorded and categorised the: (1) frequency and value of donations; (2) reason for donation; (3) name and type of PAO recipient and (4) non-communicable disease focus of the PAO. SETTING Form 990 tax documents. PARTICIPANTS Nine food and beverage companies that donated to non-communicable disease-focussed PAO. RESULTS Adjusting for inflation, nine food and beverage companies collectively donated $10 672 093 (n 2709) to the PAO between 2001 and 2018. The largest category of donations was ‘matching gifts’ (67·9 %, median amount = $115·16), followed by ‘general operations support’ (25·8 %, median amount = $107·79). Organisations focussing on cancer received the largest number and amount of donations ($6 265 861, n 1968). Eight of the nine companies made their largest monetary value of donation to PAO focussed on cancer. CONCLUSIONS Publicly available tax data provide robust information on food industry donation practices. Our findings document the food industry’s role in supporting patient advocacy organisations and raise questions regarding conflicts of interest. Increased awareness of food industry donation practices involving PAO may generate pressure for policies mandating transparency or encourage donors and recipients to voluntarily disclose donations. If public disclosure becomes widespread, constituents, advocates, researchers and policymakers can better supervise and address potential conflicts of interest.
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Affiliation(s)
- Inés M Del Giudice
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, USA
| | - Krystle A Tsai
- Department of Population Health, NYU School of Medicine, 180 Madison Ave, 3rd Floor, New York, NY10016, USA
| | - Josh Arshonsky
- Department of Population Health, NYU School of Medicine, 180 Madison Ave, 3rd Floor, New York, NY10016, USA
| | - Sara Bond
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, USA
| | - Marie A Bragg
- Public Health Nutrition Program, School of Global Public Health, New York University, New York, NY, USA
- Department of Population Health, NYU School of Medicine, 180 Madison Ave, 3rd Floor, New York, NY10016, USA
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Jayasinghe S, Soward R, Dalton L, Holloway TP, Murray S, Patterson KAE, Ahuja KDK, Hughes R, Byrne NM, Hills AP. Domains of Capacity Building in Whole-Systems Approaches to Prevent Obesity-A "Systematized" Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10997. [PMID: 36078714 PMCID: PMC9517932 DOI: 10.3390/ijerph191710997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Despite increased awareness of its risks, for the most part, contemporary efforts for obesity prevention have been patchy at best. As such, the burgeoning interest in whole-systems approaches (WSAs) that acknowledge the complex, dynamic nature of overweight and obesity and operate across multiple levels of society is particularly timely. Many components of "community capacity building" (CB), an essential but often neglected aspect of obesity prevention, overlap with "best practice principles" in effective/optimal community-based obesity-prevention initiatives. Rhetoric urging WSAs and community CB in public health abounds although operative and efficacious contemporary examples of these approaches to reducing obesity levels are scarce. The aim of this investigation was to undertake a systematized review of the level of capacity building incorporated in published literature on WSAs targeting obesity to better understand how domains of CB have been incorporated. A PubMed search and a recently published systematic review were utilized to identify WSAs to obesity prevention between 1995-2020. A team-based approach to qualitative thematic data analysis was used to systematically assess and describe each intervention regarding explicit capacity-building practice. Despite not being specifically designed for building capacity, a significant proportion of the WSAs studied in the current report had implemented several CB domains.
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Affiliation(s)
- Sisitha Jayasinghe
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Robert Soward
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Lisa Dalton
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Timothy P. Holloway
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Sandra Murray
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Kira A. E. Patterson
- College of Arts, Law and Education, University of Tasmania, Launceston, TAS 7250, Australia
| | - Kiran D. K. Ahuja
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Nuala M. Byrne
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Andrew P. Hills
- College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
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Application of a Realistic Evaluation Approach on Three Public Health Programs Aiming at Prevention of Obesity. ADVANCES IN PUBLIC HEALTH 2022. [DOI: 10.1155/2022/3289330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Rich literature abounds concerning the clinical effectiveness of programs aiming to produce weight gain/obesity prevention outcomes. However, there is very little evidence on how these outcomes are produced, and what interplay of factors made those programs effective (or not) in the environment that produced those effects. This study aims to describe the application of realistic evaluation in the field of obesity prevention, as an approach to unravel those components that influence the capacity of a program to produce its effects and to examine its significance in an effort to understand those components. The concepts of critical realism have informed the development of an interview topic guide, while three European programs were selected as case studies after a rigorous selection process. In total, 26 in-depth semi-structured interviews were taken, paired with personal observation and secondary data research. Several grounded context-mechanisms-outcomes (CMO) configurations were described within the respective context of each location, with the mechanisms introduced from each project resulting in distinctive outcomes. This study highlights the potential of realistic evaluation as a comprehensive framework to explain in which contextual circumstances of each program’s effects are produced, how certain underlying mechanisms produce those effects, and how to explicitly connect the context and the acting mechanisms into distinct outcome patterns, which will ultimately form unique configuration sets for each of the analyzed projects.
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Effects of a Mixed Exercise Program on Overweight and Obese Children and Adolescents: A Pilot, Uncontrolled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159258. [PMID: 35954616 PMCID: PMC9368334 DOI: 10.3390/ijerph19159258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022]
Abstract
Pediatric excess weight has reached severity worldwide, affecting physical health. Decreasing weight and body mass index (BMI) after exercise intervention reduces the cardiometabolic consequences; the role of age and gender on the effectiveness of exercise in overweight youth was debated in this study. A total of 138 overweight/obese young (75 girls, 63 boys) were recruited at Perugia (Italy) University to follow an exercise program. Participants were allocated into two groups (children, n = 88 and adolescents, n = 50). The study aimed to verify the efficacy of a mixed resistance–endurance exercise program in anthropometric and physical performance measures, evaluating the influence of gender and age on two groups of young overweight/obese participants. In children, we observed a statistically significant improvement in fat mass percentage, fat-free mass, waist circumference (WC), fat mass, as well as in strength, endurance, speed, and flexibility measures. We also observed reduced WC and waist-to-height ratio (WHtR) values in girls. In the adolescents’ subgroup, results showed a statistically significant variation in fat mass percentage, BMI, WC, and WHtR, and strength of the upper and lower limbs; we also observed a weight reduction in girls. A clinical approach, with the combination of strength and dynamometric tests plus the body composition study using air plethysmography methodology, is health-effective and allows for the monitoring of the efficacy of an exercise program in overweight/obese young people.
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Bartha K, Csengeri L, Lichthammer A, Erdélyi A, Kubányi J, Szűcs Z. Impact of the first COVID–19 lockdown on the lifestyle of elementary school children. ACTA ALIMENTARIA 2022. [DOI: 10.1556/066.2022.00056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
COVID-19 lockdown affects people's daily routine and has an impact on their lifestyle. Recent studies documented associations between body weight changes and children's lifestyle during social isolation. Childhood obesity is associated with a higher risk of COVID-19 severity and mortality. Our aim was to assess the effects of lockdown due to the COVID-19 pandemic on children's sleep, screen time, physical activity, and eating habits. 387 parents of five elementary school students between 16 and 26 June 2020 were interviewed through an online questionnaire. Physical activity level decreased (63.8%), sleep (60.9%) and screen (5.64 ± 3.05 h/day) times and food intake (39.8%) increased. 80.6% of parents reported changes in children's diet: increased consumption of fruits and vegetables (32.4%), breakfast (15.5%), water and sugar-free beverages (17.6%), snacks (40.4%), sugary drinks (9.9%) was observed. Body weight increased in 44.4% of children. The results of the survey conducted under GYERE®-Children's Health Program are in line with the international literature findings: body weight change during the quarantine is significantly associated with food intake, snacking, sugary drinks, and we also found association with fruit and vegetable consumption and lack of breakfast. Effective strategies and electronic health interventions are needed to prevent sedentary lifestyle and obesity during lockdown.
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Affiliation(s)
- K.O. Bartha
- Doctoral School of Health Sciences, Semmelweis University, Üllői út 26, H-1085, Budapest, Hungary
| | - L. Csengeri
- Endocare Endocrinology Center, Bokor utca 17–21, H-1037, Budapest, Hungary
| | - A. Lichthammer
- Faculty of Health Sciences, Semmelweis University, Vas utca 17, H-1088, Budapest, Hungary
| | - A. Erdélyi
- Hungarian Dietetic Association, Kerék utca 80, H-1035, Budapest, Hungary
| | - J. Kubányi
- Hungarian Dietetic Association, Kerék utca 80, H-1035, Budapest, Hungary
| | - Zs. Szűcs
- Doctoral School of Health Sciences, Semmelweis University, Üllői út 26, H-1085, Budapest, Hungary
- Hungarian Dietetic Association, Kerék utca 80, H-1035, Budapest, Hungary
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González-Mares MO, Aradillas-García C, Márquez-Mireles LE, Monsiváis-Nava CD, Bernal-Medina JE, Vargas-Morales JM, Portales-Pérez DP, Cubillas-Tejeda AC. Implementation and evaluation of an educational intervention to prevent risk factors for the development of non-communicable diseases in Mexican families of suburban communities. EVALUATION AND PROGRAM PLANNING 2022; 92:102075. [PMID: 35349946 DOI: 10.1016/j.evalprogplan.2022.102075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/30/2021] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
Non-communicable diseases (NCD), are not transmitted from person to person, are long-lasting and usually of slow evolution. Worldwide cause 71% deaths, in Mexico during 2016 were the cause of 80% of registered deaths; population in socioeconomic disadvantage is more vulnerable. It is urgent to develop strategies that can prevent NCD, thus, the objective of this study was to design, implement and evaluate an educational intervention strategy (EI), to prevent and control risk factors for the development NCD in families of two vulnerable communities. The research design was mixed, the stages were developed based on a risk communication (RC) model and was performed in three stages: 1) EI Design, 2) Implementation and 3) Evaluation of the intervention. In the contextualization, risk factors were found in the participants who were integrated in the design of the educational strategy. The EI implemented was effective in increasing knowledge about NCD and practice of healthy habits, such as increasing the consumption of fruits and vegetables. Additionally, the guidance of EI at the family level has the advantage of creating a support network for these changes. However, pending issues remain, such as the design of effective strategies to reduce the consumption of sugars and sugary drinks.
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Affiliation(s)
- Mariana Odemaris González-Mares
- Multidisciplinary Postgraduate Programs in Environmental Sciences, Environmental Agenda. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 201, Zona Universitaria, 78210 San Luis Potosí, Mexico
| | - Celia Aradillas-García
- Faculty of Medicine, Center for Applied Research in Environment and Health. Universidad Autónoma de San Luis Potosí, Av. Sierra Leona #550, Col. Lomas 2a. Sección, 78210 San Luis Potosí, Mexico
| | - Leonardo Ernesto Márquez-Mireles
- Faculty of Social Sciences and Humanities. Universidad Autónoma de San Luis Potosí, Av. Industrias 101-A Fracc. Talleres, 78399 San Luis Potosí, Mexico
| | - Claudia Davinia Monsiváis-Nava
- Multidisciplinary Postgraduate Programs in Environmental Sciences, Environmental Agenda. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 201, Zona Universitaria, 78210 San Luis Potosí, Mexico
| | - Jesús Eduardo Bernal-Medina
- Multidisciplinary Postgraduate Programs in Environmental Sciences, Environmental Agenda. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 201, Zona Universitaria, 78210 San Luis Potosí, Mexico
| | - Juan Manuel Vargas-Morales
- Faculty of Chemical Sciences. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, Zona Universitaria, 78210, San Luis Potosí, Mexico
| | - Diana Patricia Portales-Pérez
- Faculty of Chemical Sciences. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, Zona Universitaria, 78210, San Luis Potosí, Mexico
| | - Ana Cristina Cubillas-Tejeda
- Faculty of Chemical Sciences. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, Zona Universitaria, 78210, San Luis Potosí, Mexico.
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Vanhelst J, Deken V, Boulic G, Duhamel A, Romon M. A feasible and reliable self-administered parental assessment of children’s lifestyle (SAPLACL): an ancillary study based on the VIF program. BMC Res Notes 2022; 15:179. [PMID: 35570308 PMCID: PMC9107754 DOI: 10.1186/s13104-022-06069-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/05/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives In children, achieving an acceptable degree of accuracy from dietary or physical activity (PA) assessments remains a challenge. Children tend to overestimate their time spent in daily PA and underestimate their dietary intake of fat and sugar. Because parents play a key role in family lifestyle decisions, including children’s food choices and PA levels, it is important to investigate the responses of parents regarding their children’s lifestyle habits. We aimed to develop a Self-Administered Parental Assessment of Children’s Lifestyle (SAPLACL) questionnaire and test its feasibility and reliability in 191 parents (29 fathers and 162 mothers). Results For each part of the questionnaire, the rate of missing or improper responses ranged from 0 to 24%. The highest proportion of problems in understanding was reported for the dietary intake dimension, especially for snacking in front of the TV. Some difficulty was also found regarding the question on leisure PA. Test–retest agreement was observed in 54.7–100% of the respondents. Overall, the kappa coefficients were favorable. Thus, the parent self-report questionnaire is a valid and accurate tool for analyzing children’s lifestyle habits in France.
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Huiberts I, Singh A, van Lenthe FJ, Chinapaw M, Collard D. Evaluation proposal of a national community-based obesity prevention programme: a novel approach considering the complexity perspective. Int J Behav Nutr Phys Act 2022; 19:31. [PMID: 35331266 PMCID: PMC8943931 DOI: 10.1186/s12966-022-01271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Community-based obesity prevention programmes are considered an important strategy to curb the obesity epidemic. The JOGG (Youth At a Healthy Weight) approach is a large-scale community-based programme for childhood obesity prevention in the Netherlands that has been implemented over the past ten years. Practice-based development of the programme, both at the national and local level, increasingly poses challenges for its evaluation. One considerable challenge is the increasing acknowledgement of the complexity in the JOGG-approach, characterized by (a) objectives that vary locally, (b) adaptions to the programme over time in response to a community's shifting needs, challenges and opportunities, and (c) emergent outcomes and non-linear causality.We propose an evaluation framework that highlights elements of the complex local practice, including the local programme theory, implementation, adaption, the influence of context and feedback loops and intended as well as emergent and unintended outcomes. By studying each of these elements in practice, we hope to learn about principles that guide effective obesity prevention across contexts. The results of the proposed evaluation will inform both practice and research.Considering complexity in evaluation is a relatively new challenge in public health and therefore an emergent research area. The proposed framework for complex evaluations allows to retrospectively evaluate a programme that was implemented and developed in practice, and enables us to learn from practice-based experiences. Following the ISBNPA Dare2Share initiative, we kindly invite other researchers in the field to share their ideas and experiences regarding integration of complexity in evaluation.
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Affiliation(s)
- Irma Huiberts
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands. .,Mulier Instituut, Utrecht, The Netherlands.
| | - Amika Singh
- Mulier Instituut, Utrecht, The Netherlands.,Center for Physically Active Learning, Faculty of Education, Arts and Sports. Western, Norway University of Applied Sciences, Sogndal, Norway
| | - Frank J van Lenthe
- Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.,Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
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Kone J, Bartels IM, Valkenburg-van Roon AA, Visscher TLS. Parents' perception of health promotion: What do parents think of a healthy lifestyle in parenting and the impact of the school environment? A qualitative research in the Netherlands. J Pediatr Nurs 2022; 62:e148-e155. [PMID: 34556369 DOI: 10.1016/j.pedn.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed at gaining insight into parents' perceptions towards health behaviour in parenting and the impact of the school environment. Healthcare professionals experience barriers to discuss health behaviour in families where levels of overweight and obesity are elevated. There is a need to understand parents' perception and perceived significance of health behaviour. DESIGN AND METHODS Sixty-three semi-structured interviews were conducted with parents of children from three primary schools located in two different neighbourhoods in Zwolle, the Netherlands. Parents were asked to formulate their top three priority goals in parenting, additionally supplemented with 15 predetermined goals, including a health behaviour related goal. Parents ranked the goals in order of importance and gave an explanation. Finally, parents shared their opinions regarding the school environment in promoting health behaviour, according to the EnrG framework. RESULTS In 8 out of 63 interviews, health was reported in the top three self-formulated goals. Other goals considered important were happiness and being respectful to others. When health was ranked as less important in parenting, routine of health behaviour, own beliefs and religion were given as explanations. The physical school environment and teachers were mentioned as important factors in promoting health behaviour. CONCLUSIONS Parents indicate health behaviour as a key-element in parenting, even when health behaviour is not considered as the most important priority. PRACTICE IMPLICATIONS Since school is perceived as a logical and powerful environment, healthcare professionals should collaborate with school staff to empower their own, teachers' and parents' roles to address health promotion.
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Affiliation(s)
- Jordy Kone
- Windesheim University of Applied Sciences, Research Group Healthy Cities, Zwolle, the Netherlands; Windesheim University of Applied Sciences, School of Nursing, Zwolle, the Netherlands; Hanze University of Applied Sciences, School of Health Care Studies, Groningen, the Netherlands.
| | - Ine-Marije Bartels
- Windesheim University of Applied Sciences, Research Group Healthy Cities, Zwolle, the Netherlands
| | | | - Tommy L S Visscher
- Hanze University of Applied Sciences, Research and Education, Groningen, the Netherlands
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Kobes A, Kretschmer T, Timmerman MC. Prevalence of overweight among Dutch primary school children living in JOGG and non-JOGG areas. PLoS One 2021; 16:e0261406. [PMID: 34919583 PMCID: PMC8682899 DOI: 10.1371/journal.pone.0261406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022] Open
Abstract
Background One of the most influential integrated approaches towards reducing childhood obesity is EPODE, a program that has been translated to over 20 different countries worldwide. Aim The goal of this study was to explore how JOGG–the Dutch EPODE adaptation–might reduce overweight prevalence among children. Methods To compare whether overweight prevalence was different in JOGG areas vs. non-JOGG areas, in long-term JOGG areas vs. short-term JOGG areas, and in low SES JOGG areas vs. middle/high SES JOGG areas, secondary anthropometric and personal data of 209,565 Dutch children were mapped onto publicly available JOGG data. Results Findings showed that overweight prevalence decreased from 25.17% to 16.08% in JOGG-areas, and from 32.31% to 18.43% in long-term JOGG areas. However, when taking into account SES, the decrease in prevalence was mainly visible in low SES long-term JOGG areas. Conclusion JOGG appeared to be successful in targeting areas where overweight was most prevalent. Low SES areas that had implemented JOGG for a longer period of time, i.e., six years, appeared to be successful in decreasing overweight prevalence.
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Affiliation(s)
- Annita Kobes
- Faculty of Behavioural and Social Sciences, Department of Pedagogical and Educational Sciences, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Tina Kretschmer
- Faculty of Behavioural and Social Sciences, Department of Pedagogical and Educational Sciences, University of Groningen, Groningen, The Netherlands
| | - Margaretha C. Timmerman
- Faculty of Behavioural and Social Sciences, Department of Pedagogical and Educational Sciences, University of Groningen, Groningen, The Netherlands
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14
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Hall J, Bingham DD, Seims A, Dogra SA, Burkhardt J, Nobles J, McKenna J, Bryant M, Barber SE, Daly-Smith A. A whole system approach to increasing children's physical activity in a multi-ethnic UK city: a process evaluation protocol. BMC Public Health 2021; 21:2296. [PMID: 34922508 PMCID: PMC8684063 DOI: 10.1186/s12889-021-12255-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engaging in regular physical activity requires continued complex decision-making in varied and dynamic individual, social and structural contexts. Widespread shortfalls of physical activity interventions suggests the complex underlying mechanisms of change are not yet fully understood. More insightful process evaluations are needed to design and implement more effective approaches. This paper describes the protocol for a process evaluation of the JU:MP programme, a whole systems approach to increasing physical activity in children and young people aged 5-14 years in North Bradford, UK. METHODS This process evaluation, underpinned by realist philosophy, aims to understand the development and implementation of the JU:MP programme and the mechanisms by which JU:MP influences physical activity in children and young people. It also aims to explore behaviour change across wider policy, strategy and neighbourhood systems. A mixed method data collection approach will include semi-structured interview, observation, documentary analysis, surveys, and participatory evaluation methods including reflections and ripple effect mapping. DISCUSSION This protocol offers an innovative approach on the use of process evaluation feeding into an iterative programme intended to generate evidence-based practice and deliver practice-based evidence. This paper advances knowledge regarding the development of process evaluations for evaluating systems interventions, and emphasises the importance of process evaluation.
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Affiliation(s)
- Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK. .,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.
| | - Daniel D Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Amanda Seims
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Sufyan Abid Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Jan Burkhardt
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - James Nobles
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol National Health Service Foundation Trust, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jim McKenna
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - Maria Bryant
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.,The Hull York Medical School, University of York, York, YO10 5DD, UK
| | - Sally E Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | - Andy Daly-Smith
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK.,Faculties of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK.,Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
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15
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Exploring Factors Contributing to the Implementation of Ontario's Healthy Kids Community Challenge: Surveys and Key Stakeholder Interviews with Program Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111108. [PMID: 34769628 PMCID: PMC8583105 DOI: 10.3390/ijerph182111108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 12/04/2022]
Abstract
(1) Background: To explore factors contributing to the Healthy Kids Community Challenge (HKCC) program implementation; (2) Methods: Data were collected through a quantitative survey (n = 124) and in-depth telephone interviews (n = 16) with program providers. Interviews were recorded and transcribed for thematic analysis using NVivo; (3) Results: Provincial funding and in-kind support from community partners were key. Initiatives were feasible to implement, and key messages were well-received by communities. Specific practices and process were commonly discussed, and strong local program leadership was crucial to implementation; (4) Conclusions: Results have implications for planning and implementing future multi-component, community-based health promotion programs that include similar partnerships.
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16
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Bassi S, Bahl D, Arora M, Tullu FT, Dudeja S, Gupta R. Food environment in and around schools and colleges of Delhi and National Capital Region (NCR) in India. BMC Public Health 2021; 21:1767. [PMID: 34583672 PMCID: PMC8477491 DOI: 10.1186/s12889-021-11778-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 09/13/2021] [Indexed: 11/21/2022] Open
Abstract
Background Food policies and environment (availability, accessibility, affordability, marketing) in and around educational institutes can influence food choices and behaviours of children and adolescents. Methods Cross-sectional, mixed-methods study was implemented in schools (n = 9; Private = 6, Public = 3) and colleges (n = 4) from Delhi and National Capital Region (India). The data was collected from students of schools (n = 253) and colleges (n = 57), parents of school students (n = 190), teachers (n = 12, schools = 9, colleges = 3) and canteen operators of Private schools and colleges (n = 10; schools = 6, and colleges = 4). The primary and secondary data was collected to: 1) identify the strengths and weaknesses of the existing guidelines and directives (desk review); 2) examine food environment, existing policies and its implementation (structured observations, in-depth interviews, surveys, focus group discussions), and; 3) assess food choices, behaviours of students (focus group discussions). The thematic analysis was used for qualitative data and descriptive analysis for quantitative data. Results The available food and beverage options, in and around the participating educational institutes were either high in fat, salt and sugar (HFSS), despite government and educational institute guidelines on restricting the availability and accessibility of HFSS foods. The healthy food and beverage options were expensive compared to HFSS foods both inside and outside educational institutes. In total, 37 vendors (Private = 27; Public:10) were observed outside schools at dispersal and twelve at lunchtime. Around colleges, vendors (n = 14) were seen throughout the day. Students from all Private schools (n = 6) and colleges (n = 2) were exposed to food and beverage advertisements either HFSS (Private schools = 1–3 and colleges = 0–2 advertisements), whereas no advertisements were observed around Public schools. Conclusion It is imperative to implement food policies to improve the food environment in and around educational institutes to ensure the availability of healthy foods to establish and sustain healthy eating behaviours among students. Thus, the study findings emphasise stringent implementation, regular monitoring and surveillance of recently introduced Food Safety and Standards (Safe food and balanced diets for children in school) Regulation 2020, ensuring its compliance through effective enforcement strategies. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11778-6.
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Affiliation(s)
- Shalini Bassi
- Public Health Foundation of India, Plot No. 47, Sector 44, Gurgaon, Haryana, 122002, India.
| | - Deepika Bahl
- Public Health Foundation of India, Plot No. 47, Sector 44, Gurgaon, Haryana, 122002, India
| | - Monika Arora
- Public Health Foundation of India, Plot No. 47, Sector 44, Gurgaon, Haryana, 122002, India
| | - Fikru Tesfaye Tullu
- World Health Organization, Country Office for India, RK Khanna Tennis Stadium, Safdarjung Enclave, New Delhi, India
| | - Sakshi Dudeja
- Public Health Foundation of India, Plot No. 47, Sector 44, Gurgaon, Haryana, 122002, India
| | - Rachita Gupta
- World Health Organization, Country Office for India, RK Khanna Tennis Stadium, Safdarjung Enclave, New Delhi, India
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17
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Pereira AR, Oliveira A. Dietary Interventions to Prevent Childhood Obesity: A Literature Review. Nutrients 2021; 13:nu13103447. [PMID: 34684448 PMCID: PMC8537925 DOI: 10.3390/nu13103447] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/04/2022] Open
Abstract
Several dietary interventions have been conducted to prevent/reduce childhood obesity, but most of them are known to have failed in tackling the obesity epidemic. This study aimed to review the existing literature on dietary interventions for the prevention of childhood obesity and their effectiveness. A literature search was conducted using PubMed Central®. Only articles published between 2009 and 2021, written in English, conducted in humans, and including children and/or adolescents (<18 years old) were considered. The majority of studies were school-based interventions, with some addressing the whole community, and including some interventions in the food sector (e.g., taxation of high fat/sugar foods, front-of-pack labelling) and through mass media (e.g., restrictions on food advertising for children) that directly or indirectly could help to manage childhood obesity. Most of the programs/interventions conducted focus mainly on person-based educational approaches, such as nutrition/diet education sessions, allied to the promotion of physical activity and lifestyles to students, parents, and school staff, and less on environmental changes to offer healthier food choices. Only a few trials have focused on capacity building and macro-policy changes, such as the adaptation of the built environment of the school, serving smaller portion sizes, and increasing the availability and accessibility of healthy foods and water in schools, and restricting the access to vending machines, for example. Overall, most of the intervention studies showed no consistent effects on changing the body mass index of children; they have only reported small weight reductions, clinically irrelevant, or no effects at all. Little is known about the sustainability of interventions over time.
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Affiliation(s)
- Ana Rita Pereira
- Faculty of Health Sciences (Nutrition Sciences), University Fernando Pessoa, Rua Carlos da Maia 296, 4200-150 Porto, Portugal;
| | - Andreia Oliveira
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto (Institute of Public Health of the University of Porto), Rua das Taipas 135, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Correspondence: ; Tel.: +351-222-061-820
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18
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Trofholz A, Shanafelt A, Adamek M, Grannon K, Loth K, Caspi C, Berge JM. Integration as a Tool for Interprofessional Work: A Synthesis of the Literature Regarding How to Use Integrative Strategies to Address Complex Public Health Problems. ACTA ACUST UNITED AC 2021; 21. [PMID: 34485708 DOI: 10.1016/j.xjep.2020.100383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background and Purpose There has been limited success addressing complex public health problems using "siloed" approaches. A next important step in addressing persistent public health problems is adopting an "integrative" approach-intentional collaboration across the domains of research, clinical practice, community, and policy. This synthesis of the literature aggregates and synthesizes the diffuse and multi-disciplinary integration literature base to describe key concepts, aspects of praxis, and challenges and successes to help guide interprofessional practice. Methods A three-step approach was used: 1) a wide-ranging search for articles on integration theory/praxis; 2) a more focused search in the health literature bases; 3) a snowball strategy to identify additional studies. Discussion/Conclusions Identified themes included elements of successful integration; characteristics of an effective integrator; and dynamics between stakeholders in integration praxis. Results of this synthesis of the integration literature provide a deeper understanding of integration and points to clear and exciting next steps for integration praxis and inquiry.
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Affiliation(s)
- Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Amy Shanafelt
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | | | - Katherine Grannon
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Caitlin Caspi
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis
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19
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Lozano-Chacon B, Suarez-Lledo V, Alvarez-Galvez J. Use and Effectiveness of Social-Media-Delivered Weight Loss Interventions among Teenagers and Young Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168493. [PMID: 34444239 PMCID: PMC8393626 DOI: 10.3390/ijerph18168493] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022]
Abstract
Obesity is a risk factor that exponentially increases morbidity and mortality in the world. Today, new health strategies are being implemented based on the use of social media but the use and effectiveness for these interventions needs to be assessed. The objective of this systematic review is to assess the impact of social-media-delivered weight loss interventions among teenagers and young adults. We searched PubMed, Scopus, Google Scholar, PsycINFO, and OVID to identify articles that focused on this topic. Fourteen studies were included in the final review. The commitment of the participants was found to be fundamental factor when assessing the impact of social-media-delivered weight loss interventions, but also the social context in which the interventions were carried out. Our study highlights the potential of social media platforms to address weight loss interventions among younger groups. The works evaluated showed the usefulness of social media for the adequate monitoring and control in these groups. Finally, the current variety of study designs in this field highlights the need for greater homogeneity in their methodology and applications, which is a fundamental step before these tools could be considered a suitable tool for overweight management in clinical practice.
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Affiliation(s)
- Blanca Lozano-Chacon
- Computational Social Science DataLab (CS2 DataLab), University Institute for Social Sustainable Development (INDESS), University of Cadiz, 11003 Cádiz, Spain; (B.L.-C.); (V.S.-L.)
| | - Victor Suarez-Lledo
- Computational Social Science DataLab (CS2 DataLab), University Institute for Social Sustainable Development (INDESS), University of Cadiz, 11003 Cádiz, Spain; (B.L.-C.); (V.S.-L.)
- Department of Biomedicine, Biotechnology, and Public Health, University of Cadiz, Avda. Ana de Viya, 52, 11009 Cádiz, Spain
| | - Javier Alvarez-Galvez
- Computational Social Science DataLab (CS2 DataLab), University Institute for Social Sustainable Development (INDESS), University of Cadiz, 11003 Cádiz, Spain; (B.L.-C.); (V.S.-L.)
- Department of Biomedicine, Biotechnology, and Public Health, University of Cadiz, Avda. Ana de Viya, 52, 11009 Cádiz, Spain
- Institute of Research and Innovation in Biomedical Research of Cadiz (INIBICA), University of Cadiz, 11405 Jerez de la Frontera, Spain
- Correspondence: ; Tel.: +34-956-019-080
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20
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Dupin CM, Estaquio C, Nabi H. Theoretical conceptions of intervention research addressing cancer control issues. Health Promot Int 2021; 36:206-215. [PMID: 32243507 DOI: 10.1093/heapro/daaa032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Population health intervention research (PHIR) involves the use of scientific methods to produce knowledge about policy and program interventions that operate within or outside of the health sector and have the potential to impact health at the population level. PHIR is a relatively new research field that has gained momentum internationally. When developing PHIR, it is important to have a program theory with the potential to increase intervention success by identifying underlying mechanisms, areas of failure and unintended outcomes. Since 2010, the French National Cancer Institute (Institut National du Cancer-INCa) has supported a national, competitive, dedicated call for proposals in PHIR to tackle cancer control issues. After 5 years of activity, specific analysis of the proposals submitted for funding and/or funded (n = 63) from descriptive and analytic perspectives was called for. Analysis of the data revealed diversity in terms of targeted populations, partnerships engaged and methodological approaches. Projects were more likely to be funded (n = 15) if presented with a robust methodological approach and diversity in methodology, and/or with research objectives at different levels of action. The analysis also revealed that researchers do not explicitly describe theoretical constructs underpinning their interventions to combat cancer. PHIR still needs improvement to better incorporate social, institutional and policy approaches to cancer control. Researchers should apply a theory-driven approach to distinguish between 'program failure' and 'theory failure'. Following up the funded projects will allow successes and failures to be evaluated with respect to the use (or non-use) of theory-driven approaches.
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Affiliation(s)
- Cécile-Marie Dupin
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Faculty of Medicine and Nursing Science, Aix Marseille Université, Marseille, F-13000, France
| | - Carla Estaquio
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Strategic Evaluation and Impact Program, Institut National du Cancer, Boulogne-Billancourt F-92513, France
| | - Hermann Nabi
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Axe Oncologie, Centre de Recherche du CHU de Québec, Québec, Canada.,Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, Canada.,INSERM, Centre for Research in Epidemiology and Population Health, U1018, F-94807 Villejuif, France
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21
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VANHELST JÉRÉMY, DEKEN VALÉRIE, BOULIC GAËLLE, DUHAMEL ALAIN, ROMON MONIQUE. Feasibility and reliability of the Self Administered Children's Lifestyle Assessment (SACLA), a new tool to measure children's lifestyle behaviors: the VIF Program. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E117-E121. [PMID: 34322626 PMCID: PMC8283655 DOI: 10.15167/2421-4248/jpmh2021.62.1.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/25/2021] [Indexed: 11/21/2022]
Abstract
Objectives To develop a self-administered children health-related behaviors assessment, and to test its feasibility and reliability in a group of French children. Methods A sample of 216 children participated in the first stage of this study, dedicated to the feasibility assessment. An independent sample of 99 children participated in the assessment of reliability via questionnaire test and retest. Results Missing or inappropriate responses on different parts of the questionnaire ranged from 0 to 35%, more evident on the drink intake and sleep areas. Some questions in fact have been modified or removed. No problems were reported on the dimensions of physical activity habits and sedentary behaviors. The mean percentage of agreement in test-retest reliability for the questionnaire dimensions was 78% (47-99%). Overall, kappa coefficients were good. Conclusions This questionnaire is an acceptable and reliable instrument for assessing lifestyle habits in French children.
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Affiliation(s)
- JÉRÉMY VANHELST
- University of Lille, Inserm, CHU Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, Lille, France - Clinical Investigation Center, CHU Lille, Lille, France
- Correspondence: Jérémy Vanhelst, Antenne pédiatrique du CIC, Hôpital Jeanne de Flandre, CHU de Lille, avenue Eugène Avinée, 59000 Lille Cedex, France - Tel.: +33 3 20 44 60 58 - Fax: +33 3 20 44 66 87 - E-mail:
| | - VALÉRIE DEKEN
- University of Lille, CHU Lille, ULR 2694, METRICS: Evaluation des technologies de santé et des pratiques médicales, Lille, France
| | | | - ALAIN DUHAMEL
- University of Lille, CHU Lille, ULR 2694, METRICS: Evaluation des technologies de santé et des pratiques médicales, Lille, France
| | - MONIQUE ROMON
- Professeur émérite, University of Lille, CHU Lille, ULR 2694, METRICS: Evaluation des technologies de santé et des pratiques médicales, Lille, France
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22
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Motevalli M, Drenowatz C, Tanous DR, Khan NA, Wirnitzer K. Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021; 13:1200. [PMID: 33917383 PMCID: PMC8067342 DOI: 10.3390/nu13041200] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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Affiliation(s)
- Mohamad Motevalli
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University College of Teacher Education Upper Austria, A-4020 Linz, Austria;
| | - Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Naim Akhtar Khan
- Nutritional Physiology & Toxicology Division, INSERM UMR 1231, Université de Bourgogne, F-21000 Dijon, France;
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Department of Subject Didactics and Educational Research & Development, University College of Teacher Education Tyrol, A-6020 Innsbruck, Austria
- Life and Health Science Cluster Tirol, Subcluster Health/Medicine/Psychology, A-6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria
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23
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Management of Childhood Obesity—Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021. [DOI: 10.3390/nu13041200
expr 902416715 + 844236509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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24
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Motevalli M, Drenowatz C, Tanous DR, Khan NA, Wirnitzer K. Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients 2021; 13:1200. [PMID: 33917383 PMCID: PMC8067342 DOI: 10.3390/nu13041200&set/a 931824908+802380262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
As a major public health concern, childhood obesity is a multifaceted and multilevel metabolic disorder influenced by genetic and behavioral aspects. While genetic risk factors contribute to and interact with the onset and development of excess body weight, available evidence indicates that several modifiable obesogenic behaviors play a crucial role in the etiology of childhood obesity. Although a variety of systematic reviews and meta-analyses have reported the effectiveness of several interventions in community-based, school-based, and home-based programs regarding childhood obesity, the prevalence of children with excess body weight remains high. Additionally, researchers and pediatric clinicians are often encountering several challenges and the characteristics of an optimal weight management strategy remain controversial. Strategies involving a combination of physical activity, nutritional, and educational interventions are likely to yield better outcomes compared to single-component strategies but various prohibitory limitations have been reported in practice. This review seeks to (i) provide a brief overview of the current preventative and therapeutic approaches towards childhood obesity, (ii) discuss the complexity and limitations of research in the childhood obesity area, and (iii) suggest an Etiology-Based Personalized Intervention Strategy Targeting Childhood Obesity (EPISTCO). This purposeful approach includes prioritized nutritional, educational, behavioral, and physical activity intervention strategies directly based on the etiology of obesity and interpretation of individual characteristics.
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Affiliation(s)
- Mohamad Motevalli
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Correspondence:
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University College of Teacher Education Upper Austria, A-4020 Linz, Austria;
| | - Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
| | - Naim Akhtar Khan
- Nutritional Physiology & Toxicology Division, INSERM UMR 1231, Université de Bourgogne, F-21000 Dijon, France;
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria; (D.R.T.); (K.W.)
- Department of Subject Didactics and Educational Research & Development, University College of Teacher Education Tyrol, A-6020 Innsbruck, Austria
- Life and Health Science Cluster Tirol, Subcluster Health/Medicine/Psychology, A-6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, A-6020 Innsbruck, Austria
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Leatherdale ST, Burns KE, Qian W, Faulkner G, Carson V. Evaluating the Impact of the Healthy Kids Community Challenge (HKCC) on Physical Activity of Older Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063083. [PMID: 33802728 PMCID: PMC8002468 DOI: 10.3390/ijerph18063083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: The Healthy Kids Community Challenge (HKCC) was a community-based obesity prevention intervention funded by the Government of Ontario (Canada). (2) Methods: A quasi-experimental design was used to examine the impact of the HKCC on physical activity (PA) outcomes using both repeat cross-sectional (T1 2014-2015, n = 31,548; T2 2015-2016, n = 31,457; and T3 2016-2017, n = 30,454) and longitudinal data (n = 3906) from the COMPASS study. Grade 9-12 students in HKCC communities were placed into one of three intervention groups [T2 data collection post-HKCC finishing (IG1), T2 data collection during HKCC (IG2), and T2 data collection pre-HKCC starting (IG3)], Ontario students in non-HKCC communities were Control Group 1 (CG1) and Alberta students were Control Group 2 (CG2). (3) Results: Repeat cross-sectional results show over time the HKCC had no significant impact on PA outcomes in any of the intervention groups. Longitudinal results show a significant decrease in time spent in moderate-to-vigorous PA (IG2: -3.15 min/day) between T1 and T3 in IG2. (4) Conclusions: These results suggest the HKCC did not have an impact on improving PA outcomes among older youth in HKCC communities. Moving forward, there is a need to provide effective and sustainable interventions to promote PA among older youth.
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Affiliation(s)
- Scott T. Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (K.E.B.); (W.Q.)
- Correspondence: ; Tel.: +1-519-888-4567 (ext. 47812)
| | - Kathleen E. Burns
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (K.E.B.); (W.Q.)
| | - Wei Qian
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (K.E.B.); (W.Q.)
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada;
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Danielli S, Coffey T, Ashrafian H, Darzi A. Systematic review into city interventions to address obesity. EClinicalMedicine 2021; 32:100710. [PMID: 33681735 PMCID: PMC7910670 DOI: 10.1016/j.eclinm.2020.100710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/11/2020] [Accepted: 12/22/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Obesity threatens to undo the improvements that have been made in life expectancy over the last two centuries. It disproportionately affects lower socioeconomic and ethnic minority groups and has become one of the most important global health challenges of the 21stcentury. Whilst obesity is not confined to city populations, cities are home to more than half of the world's population with concentrated groups at high risk of obesity. Cities have also long been the forefront of social and technological change that has led to our current obesogenic environment. The aim of this study was to systematically identify city-wide interventions to address obesity, from which recommendations for policy makers, health system leaders and political leaders in cities could be made. METHODS Systematic review, conducted according to PRISMA guidelines, examining Embase, Ovid Medline, Central, Scopus, Campbell Library, CINALH, Health Business Elite; Health Management Information Consortium (HMIC), PyschINFO and Prospero. No restrictions on article type, date range or geographic location were applied. Along with classic academic sources, books and policy white papers were sought and reviewed. Studies that described a city-wide intervention to reduce obesity were included, irrespective of study design or perceived methodological quality. Only studies in English language were included. The primary outcome indicators that were sought and extracted were: reduction in obesity, reduction in weight and/or reduction in BMI. Where a primary outcome indicator was not stated, any other secondary impact measure was identified and recorded. This manuscript represents thematic analysis of a sub-set of data from the Prospero study, registration number: CRD42020166210. FINDINGS Our search yielded 42,137 original citations of which 1614 met the inclusion criteria and 96 were coded as relating to obesity. The 96 citations, ranging in year of publication 1997 to 2019, were conducted in 36 cities, with 13 citations either not stating a city or covering multiple cities, across 5 continents. The highest proportion of publications were from North America (59 / 96) and in particular the USA (56/96) and New York City (23/96). Primary outcome indicators were only stated in one quarter of the identified studies (24/96). Overall, there was heterogeneity of study design, descriptive methodologies and publication types, with a majority being descriptive texts using qualitative instruments of assessment. INTERPRETATION Multi-level and multi-component interventions, at the individual, community and city level, done in concert, are needed to address obesity. A composite of interventions that cities can utilise to address obesity is provided. These interventions will also be beneficial to the environment and make the case that personal health and planetary health are inextricably linked and should be considered as one. FUNDING None.
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Affiliation(s)
- Shaun Danielli
- Imperial College, Exhibition Rd, London, United Kingdom
- Corresponding author.
| | - Tom Coffey
- London Mayoral Health Advisor, London, United Kingdom
| | | | - Ara Darzi
- Imperial College, Exhibition Rd, London, United Kingdom
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Gadsby EW, Hotham S, Eida T, Lawrence C, Merritt R. Impact of a community-based pilot intervention to tackle childhood obesity: a 'whole-system approach' case study. BMC Public Health 2020; 20:1818. [PMID: 33256660 PMCID: PMC7708136 DOI: 10.1186/s12889-020-09694-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 10/14/2020] [Indexed: 11/24/2022] Open
Abstract
Background Go-Golborne was a three-year pilot programme to test an innovative, community-based ‘whole system’ approach to preventing overweight in children in Golborne ward, London. Whilst there is a growing interest in local whole systems approaches to obesity, understandings of what they look like in practice are newly emerging. Go-Golborne was designed, implemented and evaluated within this context. Methods The evaluation used a case-study design and theory of change approach to assess the effectiveness of the intervention. Height/weight measurements of children in the six participating primary schools were recorded annually for 4 years. For behavioural outcomes, children aged six-11 completed four annual on-line surveys (total 4331 responses). Parents were surveyed in year one and year four (177 responses). Three focus group discussions were held with children aged 10–11 (N = 21); interviews were conducted with parents (N = 11), and school representatives (N = 4). Stakeholders were surveyed twice (37 responses), and interviews were conducted with key stakeholders (N = 11). An extensive range of programme documents were reviewed and additional process data was collected from the programme team. The RE-AIM framework was used to synthesise findings and examine public health impact. Results Go-Golborne reached a diverse range of partners across Golborne. Events were attended by over 3360 local children and families and all six primary schools in the ward actively engaged in activities. The proportion of children in the above healthy weight categories remained stable over time. A number of changes in home, school and neighbourhood environments to support healthy behaviour change were evidenced. There was some qualitative evidence of positive changes in children’s behaviours, though significant or sustained changes were not evidenced by the quantitative data. Conclusions Go-Golborne helped stakeholders and parents to develop a shared commitment to improving healthy weight in children, to identify barriers to a healthy lifestyle, and to start to make changes in their services/behaviours. The campaigns and changes made at micro-level appeared to be insufficient, in the face of counteracting forces and personal factors, to achieve significant behaviour change within 3 years. This highlights the need for local initiatives to be reinforced by supporting action at regional, national and global levels. Supplementary information Supplementary information accompanies this paper at 10.1186/s12889-020-09694-2.
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Affiliation(s)
- E W Gadsby
- Centre for Health Services Studies, George Allen Wing, University of Kent, Canterbury, Kent, CT2 7NF, UK.
| | - S Hotham
- Centre for Health Services Studies, George Allen Wing, University of Kent, Canterbury, Kent, CT2 7NF, UK
| | - T Eida
- Centre for Health Services Studies, George Allen Wing, University of Kent, Canterbury, Kent, CT2 7NF, UK
| | - C Lawrence
- City of Westminster Council, Public Health Directorate, 64 Victoria Street, London, UK
| | - R Merritt
- Centre for Health Services Studies, George Allen Wing, University of Kent, Canterbury, Kent, CT2 7NF, UK
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Slot-Heijs JJ, Collard DCM, Pettigrew S, Vinck J, Edell D, Barriguete A, Visscher TLS. The training and support needs of 22 programme directors of community-based childhood obesity interventions based on the EPODE approach: an online survey across programmes in 18 countries. BMC Health Serv Res 2020; 20:870. [PMID: 32933494 PMCID: PMC7491184 DOI: 10.1186/s12913-020-05709-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 09/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tackling childhood obesity is complex and requires a community-based approach implemented in multiple environments. It is known from literature that knowledgeable and skilled professionals are essential to implement such an approach successfully. The aim of the present study was to assess the need for training and support among a global network of programme directors implementing a Community-Based Childhood Obesity Intervention (CBCOI) based on the EPODE approach, in order to assist them in optimising the implementation process. METHODS An online survey was sent to 40 programme directors representing programmes implementing a CBCOI based on the EPODE approach. The survey consisted of statements on a 5-point Likert scale and multiple-choice questions about attitude towards and usefulness of training and support, and preferences for some predefined training types and training topics. In total, 22 programme directors responded to the survey (55% response rate). Data were analysed using descriptive statistics to describe the need for support in order to improve successful implementation. RESULTS Respondents strongly agreed that continually updating skills and learning how to make their programmes more effective and sustainable at the start and during the implementation was important. On-site training was preferred most at the commencement of a programme, while a 2-day training course was most valued during implementation. Monitoring, measuring and programme evaluation was identified as the most valuable training topic. CONCLUSIONS The results indicate a continuing and significant need for support and training among programme directors implementing a CBCOI. The findings give directions regarding topics and types of training and support in order to improve the implementation process.
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Affiliation(s)
| | - Dorine C M Collard
- Mulier Institute, Herculesplein 269, NL-3584, AA, Utrecht, The Netherlands
| | - Simone Pettigrew
- The George Institute for Global Health, Level 5/ 1 King Street, Newtown, NSW, 2042, Australia
| | - Jan Vinck
- Hasselt University, Martelarenlaan 42, BE-3500, Hasselt, Belgium
| | - Dennis Edell
- EPODE Canada, 20 Gothic Ave, Toronto, M6P 1T5, Canada
| | - Armando Barriguete
- National Institute of Medical Sciences and Nutrition, Vasco Quiroga, 14080, Tlalpan, Mexico
| | - Tommy L S Visscher
- Hanze University of Applied Sciences, Zernikeplein 7, 9747, AS, Groningen, The Netherlands
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Welten M, Wijga AH, Hamoen M, Gehring U, Koppelman GH, Twisk JW, Raat H, Heymans MW, de Kroon ML. Dynamic prediction model to identify young children at high risk of future overweight: Development and internal validation in a cohort study. Pediatr Obes 2020; 15:e12647. [PMID: 32400070 PMCID: PMC7507129 DOI: 10.1111/ijpo.12647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 02/08/2020] [Accepted: 04/02/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Primary prevention of overweight is to be preferred above secondary prevention, which has shown moderate effectiveness. OBJECTIVE To develop and internally validate a dynamic prediction model to identify young children in the general population, applicable at every age between birth and age 6, at high risk of future overweight (age 8). METHODS Data were used from the Prevention and Incidence of Asthma and Mite Allergy birth cohort, born in 1996 to 1997, in the Netherlands. Participants for whom data on the outcome overweight at age 8 and at least three body mass index SD scores (BMI SDS) at the age of ≥3 months and ≤6 years were available, were included (N = 2265). The outcome of the prediction model is overweight (yes/no) at age 8 (range 7.4-10.5 years), defined according to the sex- and age-specific BMI cut-offs of the International Obesity Task Force. RESULTS After backward selection in a Generalized Estimating Equations analysis, the prediction model included the baseline predictors maternal BMI, paternal BMI, paternal education, birthweight, sex, ethnicity and indoor smoke exposure; and the longitudinal predictors BMI SDS, and the linear and quadratic terms of the growth curve describing a child's BMI SDS development over time, as well as the longitudinal predictors' interactions with age. The area under the curve of the model after internal validation was 0.845 and Nagelkerke R2 was 0.351. CONCLUSIONS A dynamic prediction model for overweight was developed with a good predictive ability using easily obtainable predictor information. External validation is needed to confirm that the model has potential for use in practice.
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Affiliation(s)
- Marieke Welten
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Alet H. Wijga
- Centre for Prevention and Health Services ResearchNational Institute for Public Health and the Environment (RIVM)BilthovenThe Netherlands
| | - Marleen Hamoen
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS)Utrecht UniversityUtrechtThe Netherlands
| | - Gerard H. Koppelman
- Groningen Research Institute for Asthma and COPDUniversity of GroningenGroningenThe Netherlands,Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's HospitalUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Jos W.R. Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Martijn W. Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Marlou L.A. de Kroon
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of Health Sciences, University Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Ayala-Marín AM, Iguacel I, Miguel-Etayo PD, Moreno LA. Consideration of Social Disadvantages for Understanding and Preventing Obesity in Children. Front Public Health 2020; 8:423. [PMID: 32984237 PMCID: PMC7485391 DOI: 10.3389/fpubh.2020.00423] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/13/2020] [Indexed: 01/22/2023] Open
Abstract
Addressing social disadvantages that lead to obesity should be a public health priority. Obesity prevalence among children and adolescents has reached a plateau in countries with high income but it continues rising in low-income and middle-income countries. In high-income countries, an elevated prevalence of obesity is found among racial and ethnic minority groups and individuals from disadvantaged socioeconomic backgrounds. In addition to classic socioeconomic status (SES) factors, like income, parental education, and occupation, recent publications have linked parental social disadvantages, such as minimal social network, non-traditional family structure, migrant status and unemployment, with obesogenic behaviors and obesity among children. Socio-ecological models of obesity in children can explain the influence of classic SES factors, social disadvantages, culture, and genes on behaviors that could lead to obesity, contributing to the elevated prevalence of obesity. Obesity is a multifactorial disease in which multilevel interventions seem to be the most effective approach to prevent obesity in children, but previous meta-analyses have found that multilevel interventions had poor or inconsistent results. Despite these results, some multilevel interventions addressing specific disadvantaged social groups have shown beneficial effects on children's weight and energy balance-related behaviors, while other interventions have benefited children from both disadvantaged and non-disadvantaged backgrounds. Considering obesity as a worldwide problem, the World Health Organization, the European Commission, and the National Institutes of Health recommend the implementation of obesity prevention programs, but the implementation of such programs without taking into consideration social disadvantages may be an unsuccessful approach. Therefore, the present publication consists of a review of the pertinent literature related to social disadvantage and its consequences for behaviors that could lead to childhood obesity. In addition, we will discuss the relationship between social disadvantages and the socio-ecological model of obesity in children. Finally, we will summarize the relevant aspects of multilevel intervention programs aiming to prevent obesity in children and provide recommendations for future research and intervention approaches to improve weight status in children with social disadvantages.
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Affiliation(s)
- Alelí M Ayala-Marín
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, España.,Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Zaragoza, España.,Departamento de Fisiatría y Enfermería, Universidad de Zaragoza, Zaragoza, España
| | - Isabel Iguacel
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, España
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Zaragoza, España.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, España
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, España.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, España.,Instituto Agroalimentario de Aragón, Universidad de Zaragoza, Zaragoza, España.,Departamento de Fisiatría y Enfermería, Universidad de Zaragoza, Zaragoza, España.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, España
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Verjans-Janssen SRB, Gerards SMPL, Kremers SPJ, Vos SB, Jansen MWJ, Van Kann DHH. Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children. Int J Behav Nutr Phys Act 2020; 17:105. [PMID: 32807194 PMCID: PMC7433155 DOI: 10.1186/s12966-020-01012-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/10/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of the current study was to evaluate the one- and two-year effectiveness of the KEIGAAF intervention, a school-based mutual adaptation intervention, on the BMI z-score (primary outcome), and energy balance-related behaviors (secondary outcomes) of children aged 7-10 years.A quasi-experimental study was conducted including eight intervention schools and three control schools located in low socioeconomic neighborhoods in the Netherlands. Baseline measurements were conducted in March and April 2017 and repeated after one and 2 years. Data were collected on children's BMI z-score, sedentary behavior (SB), physical activity (PA) behavior, and nutrition behavior through the use of anthropometric measurements, accelerometers, and questionnaires, respectively. All data were supplemented with demographics, and weather conditions data was added to the PA data. Based on the comprehensiveness of implemented physical activities, intervention schools were divided into schools having a comprehensive PA approach and schools having a less comprehensive approach. Intervention effects on continuous outcomes were analyzed using multiple linear mixed models and on binary outcome measures using generalized estimating equations. Intervention and control schools were compared, as well as comprehensive PA schools, less comprehensive PA schools, and control schools. Effect sizes (Cohen's d) were calculated.In total, 523 children participated. Children were on average 8.5 years old and 54% were girls. After 2 years, intervention children's BMI z-score decreased (B = -0.05, 95% CI -0.11;0.01) significantly compared to the control group (B = 0.20, 95% CI 0.09;0.31). Additionally, the intervention prevented an age-related decline in moderate-to-vigorous PA (MVPA) (%MVPA: B = 0.95, 95% CI 0.13;1.76). Negative intervention effects were seen on sugar-sweetened beverages and water consumption at school, due to larger favorable changes in the control group compared to the intervention group. After 2 years, the comprehensive PA schools showed more favorable effects on BMI z-score, SB, and MVPA compared to the other two conditions.This study shows that the KEIGAAF intervention is effective in improving children's MVPA during school days and BMI z-score, especially in vulnerable children. Additionally, we advocate the implementation of a comprehensive approach to promote a healthy weight status, to stimulate children's PA levels, and to prevent children from spending excessive time on sedentary behaviors.Trial registrationNetherlands Trial Register, NTR6716 ( NL6528 ), Registered 27 June 2017 - retrospectively registered.
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Affiliation(s)
- Sacha R B Verjans-Janssen
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands.
| | - Sanne M P L Gerards
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands
| | - Steven B Vos
- Department of Industrial Design, Eindhoven University of Technology, 5612, AZ, Eindhoven, The Netherlands.,School of Sport Studies, Fontys University of Applied Sciences, 5644, HZ, Eindhoven, The Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health, Public Health Service South-Limburg, 6400, AA, Heerlen, The Netherlands.,Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, 6229, GT, Maastricht, The Netherlands
| | - Dave H H Van Kann
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229, HA, Maastricht, The Netherlands.,School of Sport Studies, Fontys University of Applied Sciences, 5644, HZ, Eindhoven, The Netherlands
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Bonaccorsi G, Furlan F, Scocuzza M, Lorini C. Adherence to Mediterranean Diet among Students from Primary and Middle School in the Province of Taranto, 2016-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155437. [PMID: 32731568 PMCID: PMC7432470 DOI: 10.3390/ijerph17155437] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/22/2020] [Accepted: 07/27/2020] [Indexed: 01/23/2023]
Abstract
The Mediterranean diet represents one of the healthiest dietary patterns, but nowadays it is increasingly being ignored in schools and by families. The aim of this study is to assess the adherence to the Mediterranean diet by pupils living in a small Southern Italian municipality, and whether it is a predictor of nutritional status.The degree of adherence to the Mediterranean diet, the socio-economic status and the nutritional status of 314 students (6–14 years) were tested during the 2016/2017 and 2017/2018 school years with the help of a questionnaire comprising the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) test. Multivariate logistic regression analysis was used to assess the predictive role of the KIDMED score and the other variables with respect to nutritional status. Adherence to the Mediterranean diet is high, medium and poor in, respectively, 24.8, 56.4 and 18.8% of students; it varies depending on gender and age, with females and older students showing higher values. In the multivariate logistic regression model, sex and KIDMED level are become significant predictors of nutritional status. This study highlights the need for intervention in the form of school projects—also involving families—to promote healthier eating habits in younger generations.
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Affiliation(s)
- Guglielmo Bonaccorsi
- Department of Health Science, University of Florence, 50134 Florence, Italy; (G.B.); (M.S.); (C.L.)
| | - Federica Furlan
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
- Correspondence: ; Tel.: +39-348-9213295
| | - Marisa Scocuzza
- Department of Health Science, University of Florence, 50134 Florence, Italy; (G.B.); (M.S.); (C.L.)
| | - Chiara Lorini
- Department of Health Science, University of Florence, 50134 Florence, Italy; (G.B.); (M.S.); (C.L.)
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33
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Laurent JS, Tompkins CL, Cioffredi LA, Wollenburg E, Smith D, Fontaine E. Are we underestimating overweight and obesity prevalence in children? Public Health Nurs 2020; 37:655-662. [PMID: 32686151 DOI: 10.1111/phn.12773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To objectively determine the prevalence of overweight and obesity in elementary school children in two rural counties in Vermont prior to implementing a community-based intervention. METHODS School-based objective measures of body mass index (BMI) were obtained from 1,688 public school children in first, third, and fifth grades in two Northern Vermont counties in the Fall of 2017. RESULTS Forty-one percentage of elementary school children were either overweight or obese, nearly double the estimated Vermont prevalence rate of 22.2%. Schools located in more rural areas showed higher levels of overweight and obesity in children than schools in less rural areas in these northern counties (p < .005). CONCLUSIONS Indirect and self-reported measures of BMI may be underestimating the true prevalence of overweight and obesity particularly in more rural communities. POLICY IMPLICATIONS Data presented here in which children were measured directly by trained study staff demonstrate that the prevalence of obesity among children in elementary school is alarmingly high. Accurate, ongoing BMI measurement surveillance is one tool to better understand both the current trends in childhood overweight and obesity and the effect of community and state interventions.
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Affiliation(s)
- Jennifer S Laurent
- Department of Nursing, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, USA
| | - Connie L Tompkins
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Leigh-Anne Cioffredi
- Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | | | | | - Elisabeth Fontaine
- Lifestyle Medicine & RiseVT, Northwestern Medical Center, St Albans City, VT, USA
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Constant A, Boulic G, Lommez A, Chaillou R, Guy-Grand B, Raffin S. Locally implemented prevention programs may reverse weight trajectories in half of children with overweight/obesity amid low child-staff ratios: results from a quasi-experimental study in France. BMC Public Health 2020; 20:941. [PMID: 32539822 PMCID: PMC7296681 DOI: 10.1186/s12889-020-09080-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background The aims of the present study were to assess changes in weight status between the first and last year of primary education among children with overweight/obesity in response to locally implemented school-based prevention programs, and to assess the influence of process indicators, expressed as child-staff ratios (CSRs), on these changes. Methods To meet the study objectives, a quasi-experimental design was used. Four municipalities that systematically monitored the weight status of schoolchildren and participated in the “Vivons en Forme” program agreed to provide the data available in their school medical service records. The local implementers involved in training sessions were mainly municipal staff in charge of serving midday school meals, which is compulsory in France, and those in charge of designing and facilitating creative, interactive activities at school between and after classes. CSRs were determined by occupation (school catering service/facilitator of extracurricular activities) and training session (healthy eating/physical activity) in each municipality program, and classified as low (1–5 children per adult) or moderate. Results During the 4 years of primary education, weight status improved in half of the children with overweight/obesity, and worsened in 6.6% of children with overweight/normal weight. In children who remained overweight, the BMI z-score diminished over time. Estimates of the positive 4-year weight changes were related to low CSRs in locally implemented variations of the program. Estimates increased with age and were significantly higher in low-to-moderate CSR multicomponent interventions than moderate CSR single-component intervention (reference). The moderate CSR multicomponent intervention had a similar effect as the reference. The estimated negative weight change decreased with age. Conclusions Our findings suggest that training ancillary school staff in experiential-focused interventions for healthy eating and physical activity in locally implemented school-based programs contributed positively to reducing childhood obesity during the four years of primary education without interfering with educational activities. The results also provide preliminary evidence that low CSRs could be pivotal for optimal outcomes, especially in deprived areas.
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Affiliation(s)
- Aymery Constant
- INRAE, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France. .,EHESP School of Public Health, Rennes, France.
| | - Gaëlle Boulic
- Vivons en forme Association, 474 Saint-André-Lez-Lille, France
| | - Agnes Lommez
- Vivons en forme Association, 474 Saint-André-Lez-Lille, France
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Seidell JC, Halberstadt J. National and Local Strategies in the Netherlands for Obesity Prevention and Management in Children and Adolescents. Obes Facts 2020; 13:418-429. [PMID: 32810860 PMCID: PMC7590782 DOI: 10.1159/000509588] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/01/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As in many other countries around the world, the Netherlands has a high prevalence of overweight and obesity in children. About 1 in 7 of children aged 2-19 years has either overweight or obesity. SUMMARY In this paper the national and local activities aimed at the prevention and management of obesity in children and adolescents in the Netherlands are reviewed. It is recommended to, nationally as well as locally, take an integrated-systems approach that tackles the obesogenic food environment as well as upstream and downstream determinants of obesity. Efforts should take a life course approach and be focused on promoting obesity prevention as well as improving the management of children who already have obesity. The national policies in the Netherlands rely heavily on self-regulation by stakeholders such as supermarkets, restaurants, and the food industry. Local policies and actions such as the whole-systems approach in Amsterdam are promising. Future directions include development of tools for the operationalization and evaluation of local systems approaches. Regulation by national and local governments is necessary to ensure a healthy food environment for children and their families, but health policies require intersectoral action. Key Messages: In the Netherlands many policies are in place or under development, especially at the municipal level (e.g., in Amsterdam), but more substantial action is urgently required.
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Affiliation(s)
- Jacob C Seidell
- Department of Health Sciences, Vrije Universiteit, Amsterdam, The Netherlands,
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands,
| | - Jutka Halberstadt
- Department of Health Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Vine MM, Jarvis JW, Chong E, Laxer RE, Ladak A, Manson H. An early implementation assessment of Ontario's Healthy Kids Community Challenge: results from a survey of key stakeholders. BMC Public Health 2019; 19:1568. [PMID: 31775742 PMCID: PMC6880511 DOI: 10.1186/s12889-019-7704-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Ontario Canada, the Healthy Kids Community Challenge (HKCC) is a program intended to reduce the prevalence and prevent childhood overweight and obesity through community-based initiatives to improve health behaviours. Guided by the RE-AIM framework and Durlak and DuPre's Ecological Framework for Understanding Effective Implementation, the evaluation focused on two objectives: 1) to describe the organization of the program at the community level; and, 2) to identify opportunities for improvement through an early assessment of factors contributing to implementation. METHODS Participants (n = 320) - members of the HKCC local steering committee, including the local project manager - completed a cross-sectional survey using SurveyMonkey and descriptive statistics were calculated. A sample (20%) of qualitative open-ended responses was thematically analyzed. RESULTS Results indicated strong respondent agreement that the HKCC enhanced individual knowledge of access to health-promoting programs (88.3%) and messaging regarding healthy behaviours for healthy kids, with less for its effectiveness in reducing weight (53.1%). There was a high-level of adherence to HKCC social marketing messages and overall program structure, with few Local Project Manager reports of adaptations to theme one (9.2%) and theme two messages (15.4%). Fewer Local Project Managers (50%) reported the existence of private partnerships. While most respondents agreed they had the appropriate information to complete mandatory reporting, the usefulness of the HKCC online networking platform was in question (only 47% of Local Project Managers agreed that it was useful). Results reveal sufficient funding from the province to support program implementation, with a moderate level of local political commitment (63% of respondents). CONCLUSIONS Results indicate that the HKCC was considered beneficial for enhancing access to health promoting programs, could be feasibly implemented with adherence to centrally-developed social marketing messages, and was amendable to local adaptation. Despite this, few private partnerships were reported. Going forward, there is opportunity to further evaluate factors contributing to HKCC program implementation, particularly as it relates to buy-in from intervention providers, and strategies for forming private sector partnerships to support long-term program sustainability.
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Affiliation(s)
- Michelle M Vine
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Suite 300 - 480 University Avenue, Toronto, ON, M5G 1V2, Canada. .,School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Jocelyn W Jarvis
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Suite 300 - 480 University Avenue, Toronto, ON, M5G 1V2, Canada
| | - Eunice Chong
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Suite 300 - 480 University Avenue, Toronto, ON, M5G 1V2, Canada
| | - Rachel E Laxer
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Suite 300 - 480 University Avenue, Toronto, ON, M5G 1V2, Canada
| | - Adam Ladak
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Suite 300 - 480 University Avenue, Toronto, ON, M5G 1V2, Canada
| | - Heather Manson
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Suite 300 - 480 University Avenue, Toronto, ON, M5G 1V2, Canada.,School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.,Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
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van de Kolk I, Verjans-Janssen SRB, Gubbels JS, Kremers SPJ, Gerards SMPL. Systematic review of interventions in the childcare setting with direct parental involvement: effectiveness on child weight status and energy balance-related behaviours. Int J Behav Nutr Phys Act 2019; 16:110. [PMID: 31752917 PMCID: PMC6873502 DOI: 10.1186/s12966-019-0874-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The early years are a crucial period to promote healthy energy balance-related behaviours in children and prevent overweight and obesity. The childcare setting is important for health-promoting interventions. Increasingly, attention has been paid to parental involvement in childcare-based interventions. The aim of this systematic review is to evaluate the effectiveness of these interventions with direct parental involvement on the children's weight status and behavioural outcomes. METHODS A systematic search was conducted in four electronic databases to include studies up until January 2019. Studies written in English, describing results on relevant outcomes (weight status, physical activity, sedentary behaviour and/or nutrition-related behaviour) of childcare-based interventions with direct parental involvement were included. Studies not adopting a pre-post-test design or reporting on pilot studies were excluded. To improve comparability, effect sizes (Cohen's d) were calculated. Information on different types of environment targeted (e.g., social, physical, political and economic) was extracted in order to narratively examine potential working principles of effective interventions. RESULTS A total of 22 studies, describing 17 different interventions, were included. With regard to the intervention group, 61.1% found some favourable results on weight status, 73.3% on physical activity, 88.9% on sedentary behaviour, and all on nutrition-related behaviour. There were studies that also showed unfavourable results. Only a small number of studies was able to show significant differences between the intervention and control group (22.2% weight status, 60.0% physical activity, 66.6% sedentary behaviour, 76.9% nutrition behaviour). Effect sizes, if available, were predominantly small to moderate, with some exceptions with large effect sizes. The interventions predominantly targeted the socio-cultural and physical environments in both the childcare and home settings. Including changes in the political environment in the intervention and a higher level of intensity of parental involvement appeared to positively impact intervention effectiveness. CONCLUSION Childcare-based interventions with direct parental involvement show promising effects on the children's energy balance-related behaviours. However, evidence on effectiveness is limited, particularly for weight-related outcomes. Better understanding of how to reach and involve parents may be essential for strengthening intervention effectiveness.
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Affiliation(s)
- I. van de Kolk
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - S. R. B. Verjans-Janssen
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - J. S. Gubbels
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - S. P. J. Kremers
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - S. M. P. L. Gerards
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
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Bell L, Ullah S, Leslie E, Magarey A, Olds T, Ratcliffe J, Chen G, Miller M, Jones M, Cobiac L. Changes in weight status, quality of life and behaviours of South Australian primary school children: results from the Obesity Prevention and Lifestyle (OPAL) community intervention program. BMC Public Health 2019; 19:1338. [PMID: 31640645 PMCID: PMC6805510 DOI: 10.1186/s12889-019-7710-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 09/30/2019] [Indexed: 01/30/2023] Open
Abstract
Background Childhood obesity is a serious public health concern worldwide. Community-based obesity prevention interventions offer promise due to their focus on the broader social, cultural and environmental contexts rather than individual behaviour change and their potential for sustainability and scalability. This paper aims to determine the effectiveness of a South Australian community-based, multi-setting, multi-strategy intervention, OPAL (Obesity Prevention and Lifestyle), in increasing healthy weight prevalence in 9 to 11-year-olds. Methods A quasi-experimental repeated cross-sectional design was employed. This paper reports on the anthropometric, health-related quality of life (HRQoL) and behaviour outcomes of primary school children (9–11 years) after 2–3 years of intervention delivery. Consenting children from primary schools (20 intervention communities, INT; 20 matched comparison communities, COMP) completed self-report questionnaires on diet, activity and screen time behaviours. HRQoL was measured using the Child Health Utility 9D. Body Mass Index (BMI) z-score and weight status were determined from children’s measured height and weight. A multilevel mixed-effects model, accounting for clustering in schools, was implemented to determine intervention effect. Sequential Bonferroni adjustment was used to allow for multiple comparisons of the secondary outcomes. Results At baseline and final, respectively, 2611 and 1873 children completed questionnaires and 2353 and 1760 had anthropometric measures taken. The prevalence of children with healthy weight did not significantly change over time in INT (OR 1.11, 95%CI 0.92–1.35, p = 0.27) or COMP (OR 0.85, 95%CI 0.68–1.06, p = 0.14). Although changes in the likelihood of obesity, BMI z-score and HRQoL favoured the INT group, the differences were not significant after Bonferroni adjustment. There were also no significant differences between groups at final for behavioural outcomes. Conclusions OPAL did not have a significant impact on the proportion of 9 to 11-year-olds in the healthy weight range, nor children’s BMI z-score, HRQoL and behaviours. Long-term, flexible community-based program evaluation approaches are required . Trial registration ACTRN12616000477426 (12th April 2016, retrospectively registered).
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Affiliation(s)
- Lucinda Bell
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Shahid Ullah
- Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Bedford Park, South Australia, Australia.,Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Eva Leslie
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Anthea Magarey
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Timothy Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Julie Ratcliffe
- Health Economics Unit, Repatriation General Hospital, Flinders University, Daws Park, South Australia, Australia.,Institute for Choice, UniSA Business School, Adelaide, South Australia, Australia
| | - Gang Chen
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Michelle Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Michelle Jones
- OPAL (Obesity Prevention and Lifestyle), Public Health and Clinical Systems, SA Health, Adelaide, South Australia, Australia.,Social Work, College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia, Australia
| | - Lynne Cobiac
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.,CSIRO Health and Biosecurity, Adelaide, South Australia, Australia
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Collaboration in Complex Systems: Multilevel Network Analysis for Community-Based Obesity Prevention Interventions. Sci Rep 2019; 9:12599. [PMID: 31467328 PMCID: PMC6715639 DOI: 10.1038/s41598-019-47759-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/19/2019] [Indexed: 01/06/2023] Open
Abstract
Community-based systems interventions represent a promising, but complex approach to the prevention of childhood obesity. Existing studies suggest that the implementation of multiple actions by engaged community leaders (steering committees) is of critical importance to influence a complex system. This study explores two key components of systems interventions: (1) steering committees; and (2) causal loop diagrams (CLDs), used to map the complex community-level drivers of obesity. The interactions between two components create an entangled, complex process difficult to measure, and methods to analyse the dependencies between these two components in community-based systems interventions are limited. This study employs multilevel statistical models from social network analysis to explore the complex interdependencies between steering committee collaboration and their actions in the CLD. Steering committee members from two communities engaged in obesity prevention interventions reported on their collaborative relationships with each other, and where their actions are situated in a locally developed CLD. A multilevel exponential random graph model (MERGM) was developed for each community to explore the structural configurations of the collaboration network, actions in the CLD, and cross-level interactions. The models showed the tendency for reciprocated and transitive collaboration among committee members, as well as some evidence of more complex multilevel configurations that may indicate integrated solutions and collective action. The use of multilevel network analysis represents a step toward unpacking the complexities inherent in community-based systems interventions for obesity prevention.
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Multilevel governance, public health and the regulation of food: is tobacco control policy a model? J Public Health Policy 2019; 40:147-165. [PMID: 30824824 DOI: 10.1057/s41271-019-00165-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Campaigns against risk factors for non-communicable diseases (NCDs) caused by smoking and obesity have become increasingly common on multiple levels of government, from the local to the international. Non-governmental actors have cooperated with government bodies to make policies. By analysing the policies of the World Trade Organization, the World Health Organization, the European Union, and the United Kingdom and United States governments, we identify how the struggles between public health advocates and commercial interests reached the global level, and how the relatively successful fight to 'denormalize' tobacco consumption has become a model for anti-obesity advocates. It highlights three factors important in policy change: framing the policy problem, the policymaking environment and 'windows of opportunity'-to analyse the struggle between 'harm regulation' and 'neoprohibition' approaches to an international obesity prevention regime.
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Nga VT, Dung VNT, Chu DT, Tien NLB, Van Thanh V, Ngoc VTN, Hoan LN, Phuong NT, Pham VH, Tao Y, Linh NP, Show PL, Do DL. School education and childhood obesity: A systemic review. Diabetes Metab Syndr 2019; 13:2495-2501. [PMID: 31405667 DOI: 10.1016/j.dsx.2019.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 07/08/2019] [Indexed: 01/24/2023]
Abstract
Childhood obesity prevalence is shooting up at a phenomenal rate worldwide, leading to long-term devastating consequences. A great number of studies have investigated factors contributing to the increase in BMI of children and adolescents. School-based, home-based and clinic-based solutions have been suggested as possible viable strategies, among which school-based interventions is believed to produce a noticeable effect on a massive scale. However, the question of whether school interventions, especially school education exert significant impact on childhood obesity or not, is left with mixing results. This article aims to holistically review the relationship between school education and childhood obesity. Various factors are covered, including health education, nutrition education, school nutrition, physical education, teachers' awareness, teaching practice and school stress, In all, school education is not the answer to childhood obesity but just part of it. More attempts from other stakeholders (parents, community, policy makers, researchers, etc.) should be made in order to solve this complicated puzzle.
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Affiliation(s)
- Vu Thi Nga
- Institute for Research and Development, Duy Tan University, 03 QuangTrung, Danang, Viet Nam
| | | | - Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam; School of Odonto Stomatology, Hanoi Medical University, Hanoi, Viet Nam.
| | - Nguyen Le Bao Tien
- Institute of Orthopaedics and Trauma Surgery, Viet Duc Hospital, Hanoi, Viet Nam
| | - Vo Van Thanh
- Institute of Orthopaedics and Trauma Surgery, Viet Duc Hospital, Hanoi, Viet Nam; Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
| | | | - Le Ngoc Hoan
- Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam
| | - Nguyen Thi Phuong
- NTT Hi-tech Institute, Nguyen Tat Thanh University, 300A Nguyen Tat Thanh St, Ward 13, District 4, Ho Chi Minh City, Viet Nam
| | - Van-Huy Pham
- AI Lab, Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh City, Viet Nam.
| | - Yang Tao
- College of Food Science and Technology, Nanjing Agricultural University, Nanjing 8, 210095, China
| | | | - Pau Loke Show
- Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham Malaysia Campus, JalanBroga, 43500, Semenyih, Selangor Darul Ehsan, Malaysia
| | - Duc-Lan Do
- National Centre for Sustainable Development of General Education Quality, Vietnam National Institute of Educational Sciences, Hanoi, Viet Nam
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Boelens M, Windhorst DA, Jonkman H, Hosman CMH, Raat H, Jansen W. Evaluation of the promising neighbourhoods community program to reduce health inequalities in youth: a protocol of a mixed-methods study. BMC Public Health 2019; 19:555. [PMID: 31088433 PMCID: PMC6515662 DOI: 10.1186/s12889-019-6901-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/26/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Reducing socioeconomic health inequalities among youth is a major challenge for governments around the world and reports on successful attempts are scarce. Socioecological and integral approaches with collaborative partnerships and community engagement are recommended but knowledge about the effectiveness and effective and ineffective elements is limited. The Promising Neighbourhoods program employs such an approach aiming to reduce socioeconomic inequalities in health, safety and talent development in youth. We will evaluate the process-implementation, and effectiveness of the Promising Neighbourhoods program. METHODS/DESIGN Core elements of Promising Neighbourhoods are a collaborative community programming approach with stakeholders, data-based priority setting, knowledge-, and theory-based policies and evidence-based interventions. Community stakeholders and key-leaders from the neighbourhoods are engaged in the program. For this evaluation study the program will be implemented in three intervention neighbourhoods. These neighbourhoods will be compared to three control neighbourhoods at baseline in 2018/2019 and at follow-up in 2020/2021 after full implementation of the Promising Neighbourhoods program. Intervention neighbourhoods receive a tailored intervention-package including evidence-based interventions and additional measures by community stakeholders. In control neighbourhoods, no special planning will take place thus interventions are offered as usual. A mixed-methods approach following the stages of the logic model from program is applied for this evaluation. Questionnaires, focus groups, and registration data will be collected among community stakeholders, key-leaders, and youth to evaluate the process-implementation of the program. Indicators of intermediate and ultimate outcomes will be studied among N = 818 children and N = 818 youngsters using difference-in-difference regression analysis to evaluate the effectiveness of the Promising Neighbourhoods program. DISCUSSION Hypotheses are that a collaborative community approach with stakeholders leads to clear priority-setting and better tailored interventions of better quality. We further hypothesise a decline in socioeconomic inequalities in intermediate and ultimate outcomes for health, safety and talent development in the intervention neighbourhoods in comparison to control neighbourhoods. The results add knowledge about effective and ineffective elements of collaborative community programming approaches to reduce health inequalities in youth and thus are relevant for local and national public health authorities. TRIAL REGISTRATION Netherlands National Trial Register number NL7279 . Date of registration: 26-Sept-2018.
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Affiliation(s)
- Mirte Boelens
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Dafna A. Windhorst
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | | | - Clemens M. H. Hosman
- Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
- Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands
- Hosman Prevention and Innovation Consultancy, Berg en Dal, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Wilma Jansen
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Municipality of Rotterdam, Rotterdam, the Netherlands
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Ortega-Loubon C, Fernández-Molina M, Singh G, Correa R. Obesity and its cardiovascular effects. Diabetes Metab Res Rev 2019; 35:e3135. [PMID: 30715772 DOI: 10.1002/dmrr.3135] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/21/2022]
Abstract
Obesity is described in terms of body fat percentage or body mass index (BMI), despite the fact that these measures do not give full insight about the body fat distribution. It is presently a consistently growing universal challenge since it has tripled in the last 10 years, killing approximately 28 million people each year. In this review, we aim to clarify the different results of obesity on the working and physiology of the cardiovascular system and to reveal changes in the obesity "paradox"-a variety of cardiovascular outcomes in typical/overweight people. Central fat build-up in ordinary/overweight populaces has been related to expanded occurrences of myocardial infarction, heart failure, or all-cause mortality when contrasted with the obese populace. These discoveries are additionally clarified as the abundance and prolonged vulnerability to free fatty acids (FFAs) in obesity. This has been believed to cause the myocardial substrate to move from glucose to FFAs digestion, which causes lipid gathering in cardiomyocytes, spilling over to other lean tissues, and prompting a general atherogenic impact. This cardiomyocyte lipid aggregation has been demonstrated to cause insulin resistance and cardiovascular hypertrophy, and to lessen the heart functions in general. There is a proof backing the fact that fat tissue is not only an energy reservoir, it also coordinates hormones and proinflammatory cytokines and deals with the energy transition of the body by putting away abundant lipids in diverse tissues.
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Affiliation(s)
- Christian Ortega-Loubon
- Department of Pediatric Cardiac Surgery, Universidad Autonoma de Barcelona, Barcelona, Spain
| | | | - Gauri Singh
- Department of Medicine, University of Miami, Miller School of Medicine, Miami, Florida
| | - Ricardo Correa
- Department of Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
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Cost-effectiveness of community-based childhood obesity prevention interventions in Australia. Int J Obes (Lond) 2019; 43:1102-1112. [PMID: 30926947 DOI: 10.1038/s41366-019-0341-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 01/13/2019] [Accepted: 03/03/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The objective of this study is to examine, from a limited societal perspective, the cost-effectiveness of community-based obesity prevention interventions (CBIs)-defined as a programme of community-level strategies to promote healthy eating and physical activity for Australian children (aged 5-18 years). METHODS The effectiveness of CBIs was determined by undertaking a literature review and meta-analysis. Commonly implemented strategies to increase physical activity and improve nutrition were costed (in 2010 Australian dollars) to determine the average cost of a generic programme. A multiple cohort Markov model that simulates diseases associated with overweight and obesity was used to estimate the health benefits, measured as health-adjusted life years (HALYs) and healthcare-related cost offsets from diseases averted due to exposure to the intervention. Health and cost outcomes were estimated over the lifetime of the target population. Monte-Carlo simulation was used to assess second-order uncertainty of input parameters to estimate mean incremental cost-effectiveness ratios (ICER) with 95% uncertainty intervals (UIs). Scenario analyses tested variations in programme intensity, target population, and duration of effect. RESULTS The meta-analysis revealed a small but significant difference in BMI z-score (mean difference of - 0.07 (95% UI: - 0.13 to - 0.01)) favouring the CBI community compared with the control. The estimated net cost of implementing CBIs across all local government areas (LGAs) in Australia was AUD426M (95% UI: AUD3M to AUD823M) over 3 years. This resulted in 51,792 HALYs gained (95% UI: 6816 to 96,972) over the lifetime of the cohort. The mean ICER was AUD8155 per HALY gained (95% UI: AUD237 to AUD81,021), with a 95% probability of being cost-effective at a willingness to pay threshold of AUD50,000 per HALY. CONCLUSIONS CBIs are cost-effective obesity prevention initiatives; however, implementation across Australia will be (relatively) expensive when compared with current investments in preventive health.
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The Influence of Home and School Environments on Children's Diet and Physical Activity, and Body Mass Index: A Structural Equation Modelling Approach. Matern Child Health J 2019; 22:364-375. [PMID: 29094228 DOI: 10.1007/s10995-017-2386-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction The home and school environments play important roles in influencing children's health behaviours. However, their simultaneous influence on childhood obesity has not yet been examined. We explore the relationship of the home and school environments with childhood obesity, to determine whether this relationship is mediated by children's fruit and vegetable intake and physical behaviours. Methods This study uses baseline data from 9 to 11 year old children, their parents and school principals (matched data n = 2466) from the Obesity Prevention and Lifestyle Project. Child-reported behaviours, parent-reported home environment and principal-reported school environment data were collected via questionnaires. Trained researchers measured children's height and weight, and Body Mass Index (BMI, kg/m2) was calculated. Structural equation modelling was used to assess the relationship of the home and school environments with children's fruit and vegetable intake, physical activity behaviours, and children's BMI. Result The home diet environment was positively associated with child diet (β = 0.18, p < 0.001). The home physical activity environment had the largest inverse association with BMI (β = - 0.11, p < 0.001), indirectly through child physical activity (β = 0.28 ,p < 0.001). Schools' healthy eating policy implementation was significantly associated with child diet (β = 0.52, p < 0.05), but physical activity policy was not associated with child activity (β = - 0.007, p > 0.05). The school environment was not associated with child BMI. Discussion The home environment had a stronger association with healthier child behaviours, compared to the school environment. These findings suggest that future childhood obesity interventions targeting healthier home environments and supporting parents can promote healthier child eating and physical activity behaviours.
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Schuers M, Chapron A, Guihard H, Bouchez T, Darmon D. Impact of non-drug therapies on asthma control: A systematic review of the literature. Eur J Gen Pract 2019; 25:65-76. [PMID: 30849253 PMCID: PMC6493294 DOI: 10.1080/13814788.2019.1574742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Despite growing access to effective therapies, asthma control still needs improvement. Many non-drug factors, such as allergens, air pollutants and stress also affect asthma control and patient quality of life, but an overview of the effectiveness of non-drug interventions on asthma control was lacking. Objectives: To identify non-drug interventions likely to improve asthma control. Methods: A systematic review of the available literature in Medline and the Cochrane Library was conducted in March 2017, without any time limit. Initial searching identified 884 potentially relevant clinical trial reports, literature reviews and meta-analyses, which were screened for inclusion using criteria of quality, relevance, and reporting outcomes based on asthma control. Results: Eighty-two publications met the inclusion criteria. In general, the quality of the studies was low. Patient education programmes (22 studies) significantly improved asthma control. Multifaceted interventions (10 studies), which combined patient education programmes with decreasing exposure to indoor allergens and pollutants, significantly improved asthma control based on clinically relevant outcomes. Renovating homes to reduce exposure to allergens and indoor pollutants improved control (two studies). Air filtration systems (five studies) were effective, especially in children exposed to second-hand smoke. Most measures attempting to reduce exposure to dust mites were ineffective (five studies). Dietary interventions (eight studies) were ineffective. Promoting physical activity (five studies) tended to yield positive results, but the results did not attain significance. Conclusion: Twenty-six interventions were effective in asthma control. Simultaneously combining several action plans, each focusing on different aspects of asthma management, seems most likely to be effective.
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Affiliation(s)
- Matthieu Schuers
- a Department of General Medicine , Rouen University , Rouen , France
| | - Anthony Chapron
- b Department of General Medicine , Rennes University , Rennes , France
| | - Hugo Guihard
- a Department of General Medicine , Rouen University , Rouen , France
| | - Tiphanie Bouchez
- c Department of General Medicine , Nice University , Nice , France
| | - David Darmon
- c Department of General Medicine , Nice University , Nice , France
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Gelius P, Rütten A. Conceptualizing structural change in health promotion: why we still need to know more about theory. Health Promot Int 2019; 33:657-664. [PMID: 28334852 DOI: 10.1093/heapro/dax006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
As recently discussed in the public health literature, many questions concerning 'structural' approaches in health promotion seem to remain unanswered. We argue that, before attempting to provide answers, it is essential to clarify the underlying theoretical assumptions in order to arrive at the right questions one should ask. To this end, we introduce into the current debate an existing theoretical framework that helps conceptualize structural and individual aspects of health promotion interventions at different levels of action. Using an example from the field of physical activity promotion, we illustrate how an integrated framework can help researchers and health promoters rethink important issues and design better interventions. In particular, such an approach may help overcome perceived distinctions between different types of approaches, re-conceptualize ideas about the effectiveness of interventions, and appropriately address issues of health disparities.
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Affiliation(s)
- Peter Gelius
- Institute of Sport Science and Sport, Friedrich-Alexander University, Gebbertstraße 123b, Erlangen, Germany
| | - Alfred Rütten
- Institute of Sport Science and Sport, Friedrich-Alexander University, Gebbertstraße 123b, Erlangen, Germany
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Gillespie J, Magee E, White A, Stewart L. Eat, play, learn well—a novel approach to co-production and analysis grid for environments linked to obesity to engage local communities in a child healthy weight action plan. Public Health 2019; 166:99-107. [DOI: 10.1016/j.puhe.2018.09.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 09/17/2018] [Accepted: 09/30/2018] [Indexed: 10/27/2022]
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Igel U, Gausche R, Lück M, Lipek T, Spielau U, Garz M, Kiess W, Grande G. Challenges in doing multi-disciplinary health promotion research in Germany. Health Promot Int 2018; 33:1082-1089. [PMID: 28973359 DOI: 10.1093/heapro/dax054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Health problems such as obesity are increasingly addressed by complex intervention programmes which operate at multiple levels of influence (e.g. families, schools, neighbourhoods) involving partners from various academic, professional and cultural backgrounds. Following a complex participatory health promotion approach is challenging, because conflicting interests as well as contextual constraints may occur which are rarely discussed empirically. Process evaluations of some programmes investigate factors influencing the implementation process. However, researchers' perspectives on inter- and transdisciplinary work are mostly neglected. This paper aims at illustrating and critically analysing challenges that arose in the planning and implementation of a health promotion project in a socially deprived neighbourhood in Germany. Drawing on minutes, email conversations, and research diary entries we reflect on discrepancies and difficult interactions within the research team, with collaborating (academic) institutions (interdisciplinary work) and with the community partners (transdisciplinary work) respectively. Differences in language, interests, success criteria, professional preferences and habits as well as contextual factors are worked out and coping strategies or solutions are proposed. According to our experiences, bringing to light researchers' positions, preferences and interactions with the community is necessary to find a balance between research and practice, to develop adequate solutions for challenging situations and to evaluate the process, effectiveness and transferability of a programme. Health promotion research should report not only on the effectiveness of interventions but also on struggles, unsuccessful attempts and useful (or useless) strategies to fuel discourse on opportunities in and the efficacy and transferability of health promotion projects.
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Affiliation(s)
- Ulrike Igel
- Research and Transfer Centre, Leipzig University of Applied Sciences (HTWK Leipzig), Germany
| | - Ruth Gausche
- Hospital for Children and Adolescents, Center of Paediatric Research, University of Leipzig, Germany
| | - Martina Lück
- Hospital for Children and Adolescents, Center of Paediatric Research, University of Leipzig, Germany
| | - Tobias Lipek
- Hospital for Children and Adolescents, Center of Paediatric Research, University of Leipzig, Germany
| | | | - Maria Garz
- Hospital for Children and Adolescents, Center of Paediatric Research, University of Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, Center of Paediatric Research, University of Leipzig, Germany
| | - Gesine Grande
- Leipzig University of Applied Sciences (HTWK Leipzig), Germany
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