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Sivaramakrishnan H, Davis E, Obadimeji L, Valentine J, Wood F, Shetty V, Finlay-Jones A. Behavior Change Techniques Involved in Physical Activity Interventions for Children With Chronic Conditions: A Systematic Review. Ann Behav Med 2024; 58:527-538. [PMID: 38917474 DOI: 10.1093/abm/kaae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Behavior change techniques (BCTs) have been extensively used in physical activity interventions for children, however, no systematic reviews have synthesized their effects. PURPOSE The present review aimed to identify the most promising BCTs used in physical activity interventions associated with (i) increased physical activity behavior and (ii) positive psychosocial outcomes in children with chronic conditions. METHODS A systematic search of 6 databases identified 61 articles as eligible for inclusion. Data, including BCTs, were extracted from these studies and analyzed descriptively. Due to the heterogeneity of interventions, chronic conditions, and outcome measures, a meta-analysis was not conducted. RESULTS Social support (unspecified), graded tasks, generalization of target behavior, and credible source were the most commonly reported and most promising (i.e., present in 2+ studies evidencing significant effects) BCTs across all studies. These BCTs were found to be especially relevant to improving psychosocial outcomes in the short- and long-term and improving physical activity behaviors in the long-term. Meanwhile, to improve short-term physical activity behaviors, in addition to social support (unspecified), action planning, goal setting (behavior), and problem solving were found to be promising BCTs. CONCLUSIONS The BCTs identified in this review may be relevant to incorporate when planning future interventions to support physical activity and psychosocial outcomes for children with chronic conditions.
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Affiliation(s)
- Hamsini Sivaramakrishnan
- Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Elizabeth Davis
- Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
- Perth Children's Hospital, Nedlands, Australia
| | | | - Jane Valentine
- Telethon Kids Institute, Nedlands, Australia
- Perth Children's Hospital, Nedlands, Australia
| | - Fiona Wood
- School of Biomedical Sciences, University of Western Australia, Crawley, Australia
- Burns Service of Western Australia, Fiona Stanley Hospital, Perth Children's Hospital, Australia
- Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Australia
| | - Vinutha Shetty
- Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
- Perth Children's Hospital, Nedlands, Australia
| | - Amy Finlay-Jones
- Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
- School of Population Health, Curtin University, Bentley, Australia
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Bogatan S, Shugar A, Wasim S, Ball S, Schmidt C, Chitayat D, Shuman C, Cytrynbaum C. Development of a storytelling communication facilitation tool (SCFT) to facilitate discussion of complex genetic diagnoses between parents and their children: A pilot study using 22q11.2 deletion syndrome as a model condition. PEC INNOVATION 2023; 2:100115. [PMID: 37214507 PMCID: PMC10194326 DOI: 10.1016/j.pecinn.2022.100115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 05/24/2023]
Abstract
Objective To develop and evaluate a storytelling communication facilitation tool designed to help parents overcome barriers to discussing a complex multisystem genetic diagnosis with their affected children, using 22q11.2 deletion syndrome (22q11DS) as an exemplar condition. Methods A story telling communication facilitation tool (SCFT), entitled 22q and Me, was developed for a target audience of children with 22q11DS aged 9 to 12. The SCFT was evaluated by 14 parents to assess usability and utility by comparing responses to survey questions before and after viewing the SCFT, using a Likert scale. Results After viewing 22q and Me, parents reported that barriers to discussion were mitigated. Participants indicated they felt more comfortable and better prepared to talk to their children about 22q11DS and worried less that the diagnosis would affect their children's self-esteem. Parents described 22q and Me as engaging and able to address parental concerns. Conclusion 22q and Me was found to be an effective tool for increasing parental comfort and ability to talk to their children about their diagnosis of 22q11DS. Innovation This novel storytelling communication facilitation tool can serve as a model for the development of other educational tools geared at facilitating disclosure and discussion of other genetic conditions.
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Affiliation(s)
- Simina Bogatan
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - Andrea Shugar
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
- Department of Genetic Counseling, The Hospital for Sick Children, Toronto, Canada
| | - Syed Wasim
- Fred A. Litwin Family Centre in Genetic Medicine, University Health Network and Mount Sinai Hospital, Toronto, Canada
| | - Susan Ball
- AboutKidsHealth, SickKids Learning Institute, The Hospital for Sick Children, Toronto, Canada
| | - Cathryn Schmidt
- AboutKidsHealth, SickKids Learning Institute, The Hospital for Sick Children, Toronto, Canada
| | - David Chitayat
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Canada
| | - Cheryl Shuman
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
- Department of Genetic Counseling, The Hospital for Sick Children, Toronto, Canada
| | - Cheryl Cytrynbaum
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
- Department of Genetic Counseling, The Hospital for Sick Children, Toronto, Canada
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Finlay-Jones AL, Parkinson A, Sirois F, Perry Y, Boyes M, Rees CS. Web-Based Self-Compassion Training to Improve the Well-Being of Youth With Chronic Medical Conditions: Randomized Controlled Trial. J Med Internet Res 2023; 25:e44016. [PMID: 37703081 PMCID: PMC10534292 DOI: 10.2196/44016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/04/2023] [Accepted: 06/26/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Up to one-third of young people live with chronic physical conditions (eg, diabetes, asthma, and autoimmune disease) that frequently involve recurrent pain, fatigue, activity limitations, stigma, and isolation. These issues may be exacerbated as young people transition through adolescence. Accordingly, young people with chronic illness are at a high risk of psychological distress. Accessible, evidence-based interventions for young people with chronic illnesses are urgently needed to improve well-being, support adaptation, and enhance daily functioning. Self-compassion, which is an adaptive means of relating to oneself during times of difficulty, is a promising intervention target for this population. OBJECTIVE This study aims to test the efficacy of a 4-week, self-guided, web-based self-compassion training program for improving well-being among young Australians (aged 16-25 years) living with a chronic medical condition. The primary outcomes were self-compassion, emotion regulation difficulties, and coping; the secondary outcomes were well-being, distress, and quality of life. We also sought to test whether changes in primary outcomes mediated changes in secondary outcomes and gather feedback about the strengths and limitations of the program. METHODS We conducted a single-blind, parallel-group, randomized controlled trial comparing a 4-week, fully automated, web-based self-compassion training program with a waitlist control. Participants were recruited via the internet, and outcomes were self-assessed at 4 (T1) and 12 weeks (T2) after the baseline time point via a web-based survey. A mixed methods approach was used to evaluate the program feedback. RESULTS Overall, 151 patients (age: mean 21.15, SD 2.77 years; female patients: n=132, 87.4%) were randomized to the intervention (n=76, 50.3%) and control (n=75, 49.7%) groups. The loss-to-follow-up rate was 47.4%, and program use statistics indicated that only 29% (22/76) of young people in the experimental group completed 100% of the program. The main reported barrier to completion was a lack of time. As anticipated, treatment effects were observed for self-compassion (P=.01; partial η2=0.05; small effect); well-being (P≤.001; partial η2=0.07; medium effect); and distress (P=.003; partial η2=0.054; small-medium effect) at the posttest time point and maintained at follow-up. Contrary to our hypotheses, no intervention effects were observed for emotion regulation difficulties or maladaptive coping strategies. Improvements in adaptive coping were observed at the posttest time point but were not maintained at follow-up. Self-compassion, but not emotion regulation difficulties or coping, mediated the improvements in well-being. CONCLUSIONS Minimal-contact, web-based self-compassion training can confer mental health benefits on young people with chronic conditions. This group experiences substantial challenges to participation in mental health supports, and program engagement and retention in this trial were suboptimal. Future work should focus on refining the program content, engagement, and delivery to optimize engagement and treatment outcomes for the target group. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry 12619000572167; https://tinyurl.com/5n6hevt. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-020-8226-7.
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Affiliation(s)
- Amy Louise Finlay-Jones
- Youth Mental Health Team, Telethon Kids Institute, Nedlands, Australia
- School of Population Health, Curtin University, Bentley, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Asha Parkinson
- Youth Mental Health Team, Telethon Kids Institute, Nedlands, Australia
- School of Population Health, Curtin University, Bentley, Australia
| | - Fuschia Sirois
- Department of Psychology, Durham University, Durham, United Kingdom
| | - Yael Perry
- Youth Mental Health Team, Telethon Kids Institute, Nedlands, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Mark Boyes
- School of Population Health, Curtin University, Bentley, Australia
| | - Clare S Rees
- School of Population Health, Curtin University, Bentley, Australia
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Yang L, Ji J, Tang P, Jiang Y, Yang H, Sun X, Yang J, Lu Q. Age and sex differences in social support among children and adolescents with epilepsy. Epilepsy Behav 2022; 130:108680. [PMID: 35413662 DOI: 10.1016/j.yebeh.2022.108680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/09/2022] [Accepted: 03/22/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study aimed to explore what differences exist in the perceived frequency of social support and the importance of social support according to age and sex among children and adolescents with epilepsy. METHOD We employed an explorative cross-sectional design to examine a sample of 320 children and adolescents with epilepsy using the child and adolescent social support scale (CASSS). RESULT There is a significant relationship between sex and age and the importance of support from classmates and friends. For the dependent variables that were not affected by the age-sex interaction, we analyzed the main effects of these dependent variables of sex and age separately. We discovered that girls with epilepsy received a higher level of support from their parents and classmates than boys. Besides, compared with adolescents, children with epilepsy consider parental support more valuable. Also, children with epilepsy attach more importance to support from their teachers than adolescents. In contrast, adolescents with epilepsy receive a higher level of support from their friends than children. CONCLUSION Social support varies by age and sex in children and adolescents with epilepsy. Understanding the social support of children with epilepsy at various developmental stages and for different sexes can help provide a healthier environment for children and adolescents to grow up in. The results of this study provide a basis for formulating corresponding intervention programs for children and adolescents with epilepsy according to age and sex.
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Affiliation(s)
- Liling Yang
- School of Nursing, Shanghai Jiao Tong University, No. 227 Chongqing South Road, Shanghai, China
| | - Jianlin Ji
- School of Nursing, Shanghai Jiao Tong University, No. 227 Chongqing South Road, Shanghai, China
| | - Ping Tang
- Emergency Outpatient Clinic, Children's Hospital of Shanghai, No. 355 Luding Road, Shanghai, China
| | - Yan Jiang
- Neonatal Intensive Care Unit, Children's Hospital of Shanghai, No. 355 Luding Road, Shanghai, China
| | - Hanlin Yang
- School of Nursing, Shanghai Jiao Tong University, No. 227 Chongqing South Road, Shanghai, China
| | - Xiaomin Sun
- Department of Neurology, Children's Hospital of Shanghai, No. 355 Luding Road, Shanghai, China
| | - Jie Yang
- Department of Neurology, Children's Hospital of Shanghai, No. 1400 West Beijing Road, Shanghai, China
| | - Qunfeng Lu
- Nursing Department, Children's Hospital of Shanghai, No. 355 Luding Road, Shanghai, China.
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Zelihić D, Williamson H, Kling J, Feragen KB. "It's tough because I see that it's upsetting her…": A qualitative exploration of parents' perceptions of talking with their adolescents about having a visible difference. Body Image 2021; 38:306-316. [PMID: 34052591 DOI: 10.1016/j.bodyim.2021.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Many adolescents live with a visible difference that affects their lives in profound ways, but studies investigating parents' perceptions of raising appearance issues during conversations with their adolescent are lacking. As part of a larger study exploring the effectiveness of a web-based intervention (YP Face IT), semi-structured interviews were conducted with 18 parents of adolescents with a visible difference. Thematic analysis revealed four overarching themes: (1) Conversational settings; (2) Understanding adolescents' feelings and thoughts; (3) Providing parental guidance and encouragement; and (4) When the dialogue becomes difficult. Results showed that parents resorted to specific settings when instigating conversations about appearance, such as when their adolescents expressed a need for emotional care, were perceived to be upset, or whilst managing their condition. The choice of setting was also important as some parents generally felt uncomfortable raising appearance issues with their adolescent, for fear of fueling appearance concerns. Results further suggest that open communication can enable parents to stay informed about their adolescent's psychosocial adjustment to a visible difference. These results stress the need to make available support to facilitate open communication about appearance-related topics between parents and adolescents.
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Affiliation(s)
- Deniz Zelihić
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway.
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Johanna Kling
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
| | - Kristin B Feragen
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
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What is QOL in children and adolescents with physical disabilities? A thematic synthesis of pediatric QOL literature. Qual Life Res 2021; 30:1233-1248. [PMID: 33550543 DOI: 10.1007/s11136-021-02769-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE Many neuromotor conditions affect children from a young age through to adulthood, impacting their quality of life (QOL). For QOL to be accurately measured in these children, pediatric QOL must first be conceptualized. Some theoretical models and definitions have been proposed to understand QOL, but they were not developed for the pediatric population. The purpose of this review is to build on existing frameworks of QOL and develop a framework and definition of pediatric QOL for measurement purposes, by integrating the findings of multiple qualitative studies involving children and adolescents with physical disabilities. METHODS A systematic search was conducted on four databases. Inclusion criteria were qualitative studies with participants with common neurological and neuromuscular conditions. The content of studies had to involve the lived experiences of children and adolescents with disabilities. Thematic synthesis was conducted. RESULTS 48 studies were included. Results generated a schema of the causes and the mitigators of QOL. This consisted of casual indicators of QOL, mitigators, and components of QOL. Themes under QOL included thoughts and feelings, fitting in, self-image, about the future, and independence. A new framework and definition of pediatric QOL were proposed. CONCLUSIONS In conclusion, pediatric QOL for children with disabilities is formed by their thoughts and feelings, being accepted by society, being able to forge an identity that is beyond their disability, having autonomy, and having a hope for the future. The resulting QOL framework proposed here can also aid future development of QOL measures in children with physical disabilities.
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O'Toole S, Gallagher P, Benson A, Shahwan A, Austin JK, Lambert V. Exploring the relationship between parent-child communication about epilepsy and psychosocial well-being. J Health Psychol 2019; 26:1207-1221. [PMID: 31448626 DOI: 10.1177/1359105319871642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study examined the relationship between parent-child communication and psychosocial well-being of 47 children living with epilepsy and 72 parents of children living with epilepsy. Open communication was associated with positive illness attitude, positive self-perception and greater health-related quality of life for children living with epilepsy; positive response to illness for parents; and more perceived social support and less need for epilepsy-related support for children living with epilepsy and parents. By contrast, closed communication was associated with poorer psychosocial well-being in children living with epilepsy and parents. Healthcare professionals should provide guidance for families living with childhood epilepsy on the importance of open communication in promoting greater psychosocial well-being.
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Affiliation(s)
| | | | | | - Amre Shahwan
- Children's Health Ireland at Temple Street, Ireland
| | - Joan K Austin
- Indiana University-Purdue University Indianapolis, USA
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Ostendorf AP, Gedela S. Effect of Epilepsy on Families, Communities, and Society. Semin Pediatr Neurol 2017; 24:340-347. [PMID: 29249514 DOI: 10.1016/j.spen.2017.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The effect of epilepsy extends beyond those with the diagnosis and impacts families, communities and society. Caregiver and sibling quality of life is often negatively affected by frequent seizures, comorbid behavioral and sleep disorders and stigma surrounding the diagnosis. Furthermore, the negative effects can be magnified by individual coping styles and resources available to families of those with epilepsy. Beyond the family and immediate caregivers, epilepsy affects local communities by drawing additional resources from education systems. The direct costs of caring for an individual with epilepsy and the indirect costs associated with decreased productivity place financial strain on individuals and health care systems throughout the world. This review details factors affecting family and caregiver quality of life and provides several approaches through which health care providers may address these concerns. Furthermore, we examine the financial effect of epilepsy on society and review emerging strategies to lessen health care use for individuals with epilepsy.
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Affiliation(s)
- Adam P Ostendorf
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
| | - Satyanarayana Gedela
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH
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