Facilitators and barriers of children's participation in nutrition, physical activity, and obesity interventions: A systematic review

Intensive physical training in children with heritable connective tissue disorders is feasible and safe: a pilot study

PURPOSE

This pilot study assessed the feasibility, safety, and acceptability of a physical training program combined with parental meetings for children with heritable connective tissue disorders (HCTD), including Marfan syndrome (MFS), Loeys-Dietz syndrome (LDS), and Ehlers-Danlos syndromes (EDS). Secondary, it aimed to explore preliminary observations regarding the program's impact on individual training goals and physical fitness, including aerobic and anaerobic capacity, strength, agility, pain, fatigue, and disability.

MATERIALS AND METHODS

The intervention comprised functional power training (FPT) and high-intensity interval training (HIIT) conducted three times a week over 12 weeks. Data on feasibility, safety, and acceptability were collected, along with preliminary observations on physical fitness performance.

RESULTS

The intervention was feasible and safe, with no serious adverse events reported. However, acceptability was limited, with a participation rate of 27.8%. Preliminary findings revealed that 80% of participants achieved their training goals, 75% improved their aerobic capacity, and 70% showed gains in strength and agility, alongside reported reductions in pain and fatigue.

CONCLUSION

This study highlights the potential benefits of tailored physical training for children with HCTD. Despite acceptability challenges, the intervention demonstrated feasibility and safety, providing a foundation for larger-scale effectiveness studies that include systematic feedback mechanisms to enhance participant engagement.

Intervention Mapping for Refining a Sport-Based Public Health Intervention in Rural Schools

Sport-based youth development programs, delivered through campus-community partnerships, can create impactful experiences for college students, meet university objectives, and improve the health of children in under-resourced rural communities. This study aimed to pilot test intervention mapping (IM), a systematic approach to intervention development and implementation, to refine the Hoosier Sport intervention, which is a local public health initiative that utilizes the Obesity-Related Behavioral Intervention Trials (ORBITs) model to improve physical activity in middle school children. The IM process, which included a diverse IM planning and advisory group of university representatives and local schools, was guided by self-determination theory (SDT) and social cognitive theory (SCT) and followed four steps: Logic Model of the Problem, Logic Model of Change, Program Design, and Program Production. Using SDT and SCT, we identified our personal determinants as autonomy, competence, and relatedness, while our environmental determinants were role-modeling and sports equipment access. We then created change methods and practical applications for refining and implementing our intervention and gathered pilot test data to assess the feasibility of the intervention. The IM process provided a more robust and evidence-based approach to intervention design and production, while involving stakeholders to foster meaningful collaboration and increase program success. By using IM in program development, public health interventions that promote youth development through sport will likely be more easily scaled up.

A systematic review of recruitment and retention of ethnic minorities and migrants in obesity prevention randomised controlled trials

BACKGROUND

Participants' recruitment and retention into community-based interventions can be challenging, especially in research involving ethnic minorities and migrants. Despite known challenges, there are limited reviews that probe recruitment and retention strategies involving ethnic minorities and migrants in the Organisation for Economic Cooperation and Development (OECD) countries. This systematic review aimed to measure recruitment and retention rates and identify the barriers and facilitators to effective recruitment and retention of ethnic minorities and migrants in community-based obesity prevention Randomised Control Trials (RCTs) in OECD countries.

METHODS

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases (CINAHL, Cochrane, Embase, Medline and PsychInfo) were searched from January 2000 to March 2022, in addition to Google and Google Scholar. Methodological quality and risk of bias were assessed, and pooled analysis and meta-ethnographic analysis were conducted on the included studies.

RESULTS

Twenty-five studies were included in the review. The pooled analysis found a 64% rate of recruitment of ethnic minorities in RCTs, with a retention rate of 71%. Key facilitators identified were-use of multiple communication channels, incentives, recruiting community champions, participant convenience and employing culturally sensitive strategies. Key barriers to participation were limited access to study sites, time constraints, limited trust, perceived fear, and anxiety.

CONCLUSION

Findings suggest the importance of undertaking culturally appropriate recruitment and retention strategies to minimise barriers and facilitate effective recruitment and retention of low-income ethnic minorities and migrants in community-based research.

Refined Feasibility Testing of an 8-Week Sport and Physical Activity Intervention in a Rural Middle School

This study examines how the 8-week Hoosier Sport program impacts cardiovascular disease (CVD) risks by promoting physical activity (PA) among rural, low-income children. Using a human-centered participatory co-design approach, the program aimed to increase PA levels (e.g., total PA, daily steps) in at-risk children. The present study explored the feasibility of the intervention as well as physiological and psychological changes across the intervention using a hybrid type 2 design (a model that evaluates both the effectiveness of an intervention and its implementation in real-world settings). Favorable feasibility indicators like attendance, acceptability, and compliance, with a 23.3% recruitment rate and 94.3% retention rate, were observed. Moreover, participants attended over 80% of sessions across the 8 weeks. Accelerometers (AX3) tracked daily steps and total PA for 7 days before and after the intervention, revealing increased PA levels throughout. At post-intervention, notable improvements were observed in psychological factors such as autonomy, social competence, and global self-worth. This study highlights the importance of tailored PA interventions in schools, emphasizing their potential to improve PA levels among rural, low-income children.

Leverage point themes within Dutch municipalities' healthy weight approaches: A qualitative study from a systems perspective

INTRODUCTION

Despite all efforts of national and local approaches, obesity rates continue to rise worldwide. It is increasingly recognized that the complexity of obesity should be further addressed by incorporating a systems perspective when implementing approaches. Such an approach has four interconnected system levels: events, structures, goals, and beliefs, in which small changes ('leverage points') can lead to substantial changes in the functioning of the entire system. The current research examined the functioning of five Dutch municipalities' healthy weight approaches (HWAs) and the leverage point themes that can be identified in their system.

METHODS

Thirty-four semi-structured interviews were conducted with various stakeholders about the HWA, including policy advisors, care professionals, practice professionals, and citizens. An inductive thematic analysis was performed.

RESULTS

Three main themes were identified: 1) HWA organization structure, 2) collaboration between professionals, and 3) citizen participation. Across all system levels, we identified leverage point themes. The upper-levels events and structures occurred the most and were explained by underlying goals and beliefs. Leverage point themes regarding "HWA organization structure" were municipal processes, such as perceived impact; diversity of themes, activities, and tasks; network; and communication strategies, such as messages about the HWA. Leverage point themes regarding "collaboration between professionals" were linking pins, indicating central players within the network; motivation and commitment including support base; and stimulating one another to work on the HWA by spurring other professionals into action. Lastly, leverage point themes under "citizen participation" included reaching the target group, e.g., look for entry points; and citizens' motivation, including customization.

DISCUSSION

This paper provides unique insights into HWAs' leverage point themes that can lead to substantial changes in how the entire system functions and makes suggestions about underlying leverage points to help stakeholders improve their HWA. Future research could focus on studying leverage points within leverage point themes.

The positive impact of gamification in imparting nutritional knowledge and combating childhood obesity: A systematic review on the recent solutions

Objective

This paper reviews the recent gamified interventions that focus on the dietary factor to explore the effectiveness of using gaming elements in combating the prevalence of childhood obesity.

Methods

Two electronic databases were searched (PubMed and ProQuest); to identify the relevant papers published between 2018 and 2021. The keywords that use to search the entire selected databases were gamification and obesity. There were no restrictions regarding the language. Two independent reviewers screened the titles, abstracts, and keywords for relevance.

Results

407 papers were identified initially, while only 18 articles met the inclusion criteria. Most of the included articles indicated the positive impact of gamification on changing children eating behaviors. This systematic review summarizes the theories followed in developing such interventions and suggests some other theories to use and follow. Moreover, we synthesized the main findings into six recommendations that would assist in combating the global concern regarding childhood obesity if IS/IT researchers and other implement them during the development of any IT intervention.

Conclusions

Using gamification and gaming elements in imparting nutritional knowledge to children and improving their eating habits and behaviors is considered effective generally. It provides them with the needed knowledge and promotes the acquisition of better habits within enjoyable environment.

Getting them through the door: Social and behavioral determinants of uptake and engagement in an obesity intervention

Using data from a large-scale screening program (N = 19634), we aimed to prospectively identify factors predicting uptake (i.e. acceptance of the invitation) and engagement (i.e. participation in at least two sessions) in a multi-component-intensive-behavioral-intervention for obesity-management (MBIOM) intervention targeting adolescents (n = 2862; 12-14 years; BMI ≥90th percentile). Approximately one third of adolescents most in need of weight management declined the initial invitation to enter the MBIOM. Poor diet, sedentary behavior, and parental education predicted willingness to enter and stay in the intervention, however measured body mass index did not matter. Perceived family support, instead of initial motivation, facilitated engagement. Our results provide new insights on the importance of regional socio-geographical factors including trust in local authorities.

Perceptions of a family-based lifestyle intervention for children with overweight and obesity: a qualitative study on sustainability, self-regulation, and program optimization

BACKGROUND

Family-based lifestyle interventions (FBLIs) are an important method for treating childhood weight problems. Despite being recognized as an effective intervention method, the optimal structure of these interventions for children's overweight and obesity has yet to be determined. Our aim was to better understand participants' (a) implementation of behaviour strategies and long-term outcomes, (b) perceptions regarding the optimal structure of FBLIs, and (c) insights into psychological concepts that may explain the success of these programs.

METHODS

Purposive sampling was used to recruit participants. We conducted focus groups as well as one-to-one interviews with parents (n = 53) and children (n = 50; aged 7-13, M = 9.4 yr, SD = 3.1) three months following their involvement in a 10-week, multi-component, FBLI involving education and activities relating to healthy nutrition, physical activity, and behavior modification. Using an interpretivist approach, a qualitative study design was employed to examine participant experiences.

RESULTS

We identified three higher-order categories: (a) participants' program experiences and perceptions (b) lifestyle changes post-program, and (c) recommendations for optimizing family-based programs. Themes identified within these categories included (a) support and structure & content, (b) diet and physical activity, and (c) in-program recommendations and post-program recommendations.

CONCLUSIONS

We identified several challenges that can impair lasting behavior change (e.g., physical activity participation) following involvement in a FBLI. On optimizing these programs, participants emphasized fun, interactive content, interpersonal support, appropriate educational content, and behavior change techniques. Concepts rooted in motivational theory could help address calls for greater theoretical and mechanistic insight in FBLIs. Findings may support research advancement and assist health professionals to more consistently realize the potential of these interventions.