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Bernier E, Simoneau C, Desroches S, Morisset AS, Robitaille J. Implementation of Postpartum Nutritional Interventions in Healthcare, Community and eHealth: A Systematic Review. Matern Child Health J 2024:10.1007/s10995-024-03985-5. [PMID: 39292385 DOI: 10.1007/s10995-024-03985-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVES The efficacy of interventions targeting lifestyle habits, particularly dietary habits, among postpartum women is well established. However, whether these results can be translated into tangible changes in the care and services provided to this population remains unclear. Therefore, the aim is to examine the implementation outcomes of postpartum nutritional interventions delivered in healthcare, community, or eHealth settings. METHODS A search was conducted in the MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane Library databases in July 2024, to identify all relevant studies. Included studies had to report at least 1 of the 8 implementation outcomes studied: acceptability, adoption, appropriateness, implementation cost, feasibility, fidelity, penetration, and sustainability. Study selection and data extraction were performed by two independent reviewers. Descriptive analysis of reported outcomes was performed. PROSPERO ID CRD42022351411. RESULTS Of the 8907 unique studies identified, 26 interventions (24 publications) were included.There was a great heterogeneity among interventions studied and implementation outcomes reported. Acceptability, feasibility, and fidelity were the most studied implementation outcomes. Overall, postpartum nutritional interventions were found to be acceptable and useful, but improvements were suggested by participants, such as more frequent contacts and longer programs. Recruitment, retention, participation, and penetration rates widely varied across studies. Challenges hindering the delivery of nutritional interventions were reported by participants, such as lack of time and the presence of medical conditions following delivery. CONCLUSIONS FOR PRACTICE: This review demonstrates the potential for the delivery and implementation of nutritional interventions in real-world settings during the postpartum period.
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Affiliation(s)
- Emilie Bernier
- École de nutrition, Université Laval, 2425, rue de l'Agriculture, local 1122, Québec, QC, G1V 0A6, Canada
- Centre de recherche Nutrition Santé et Société (NUTRISS) de l'Institut sur la nutrition et des aliments fonctionnels (INAF), Université Laval, Québec, Canada
- Axe Endocrinologie et Néphrologie, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Charlotte Simoneau
- École de nutrition, Université Laval, 2425, rue de l'Agriculture, local 1122, Québec, QC, G1V 0A6, Canada
- Centre de recherche Nutrition Santé et Société (NUTRISS) de l'Institut sur la nutrition et des aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Sophie Desroches
- École de nutrition, Université Laval, 2425, rue de l'Agriculture, local 1122, Québec, QC, G1V 0A6, Canada
- Centre de recherche Nutrition Santé et Société (NUTRISS) de l'Institut sur la nutrition et des aliments fonctionnels (INAF), Université Laval, Québec, Canada
| | - Anne-Sophie Morisset
- École de nutrition, Université Laval, 2425, rue de l'Agriculture, local 1122, Québec, QC, G1V 0A6, Canada
- Centre de recherche Nutrition Santé et Société (NUTRISS) de l'Institut sur la nutrition et des aliments fonctionnels (INAF), Université Laval, Québec, Canada
- Axe Endocrinologie et Néphrologie, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Julie Robitaille
- École de nutrition, Université Laval, 2425, rue de l'Agriculture, local 1122, Québec, QC, G1V 0A6, Canada.
- Centre de recherche Nutrition Santé et Société (NUTRISS) de l'Institut sur la nutrition et des aliments fonctionnels (INAF), Université Laval, Québec, Canada.
- Axe Endocrinologie et Néphrologie, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada.
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Kracht CL, Blachard CM, Downs DS, Beauchamp MR, Rhodes RE. New parents' sleep, movement, health, and well-being across the postpartum period. Behav Sleep Med 2024; 22:636-649. [PMID: 38592976 PMCID: PMC11365805 DOI: 10.1080/15402002.2024.2339815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE The aim of this study was to examine changes and the bi-directional relationship in sleep and movement, and health and well-being among new parents and differences by sex. METHODS This secondary data analysis included both conditions from a randomized control trial to improve new parents'physical activity [PA] and recruited couples. Parents (n = 181, 117 couples represented 31.5 ± 4.4 years, 51.3% women, 83.3% White) completed questionnaires on regular overnight sleep duration, PA, mental health (perceived stress), physical health (physical quality of life [PQoL]), and well-being (life satisfaction) at 2-, 4-, 6-, and 8-month postpartum. Random-intercept cross-lagged panel models were stratified by sex to examine changes in sleep and PA with health and well-being across time. RESULTS Sleep and stress were interrelated at different times for fathers (2 months), and mothers (8 months). Sleep and PQoL improved across time, with mothers reporting less sleep than fathers at 4 and 6 months. PQoL at 4 months was related to MVPA at 6-months. Life satisfaction and PA at 2 months was related to PA at 4 months. CONCLUSION Mothers and fathers experienced different sleep and stress trajectories. Mental health improved postpartum with early connections to PA. Supporting the 24-hour movement behavior cycle and mental health across the parenthood transition may benefit couples.
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Affiliation(s)
- Chelsea L Kracht
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Danielle Symons Downs
- The Pennsylvania State University, Department of Kinesiology, College of Health and Human Development, University Park, Pennsylvania and Department of Obstetrics & Gynecology, College of Medicine, Hershey, Pennsylvania USA
| | | | - Ryan E. Rhodes
- University of Victoria, School of Exercise Science, Physical and Health Education, Victoria, Canada
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Yi L, Habre R, Mason TB, Xu Y, Cabison J, Rosales M, Chu D, Chavez TA, Johnson M, Eckel SP, Bastain TM, Breton CV, Wilson JP, Dunton GF. Smartphone GPS-Based Exposure to Greenspace and Walkability and Accelerometer-Assessed Physical Activity During Pregnancy and Early Postpartum-Evidence from the MADRES Cohort. J Urban Health 2024:10.1007/s11524-024-00903-6. [PMID: 39145858 DOI: 10.1007/s11524-024-00903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/16/2024]
Abstract
A growing number of studies have associated walkability and greenspace exposure with greater physical activity (PA) in women during pregnancy. However, most studies have focused on examining women's residential environments and neglected exposure in locations outside the home neighborhood. Using 350 person-days (N = 55 participants) of smartphone global positioning system (GPS) location and accelerometer data collected during the first and third trimesters and 4-6 months postpartum from 55 Hispanic pregnant women from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study, we examined the day-level effect of women's exposure to walkability and greenspace on their PA outcomes during pregnancy and in the early postpartum period. Moderate-to-vigorous physical activity [MVPA] minutes per day was assessed using accelerometers. Walkability and greenspace were measured using geographic information systems (GIS) within women's daily activity spaces (i.e., places visited and routes taken) recorded using a smartphone GPS and weighted by time spent. We used a generalized linear mixed-effects model to estimate the effects of daily GPS-derived environmental exposures on day-level MVPA minutes. Results showed that women engaged in 23% more MVPA minutes on days when they had some versus no exposure to parks and open spaces in activity spaces (b = 1.23; 95%CI: 1.02-1.48). In addition, protective effects of daily greenspace and walkability exposure on MVPA were stronger in the first and third trimesters, among first-time mothers, and among women who had high pre-pregnancy body mass index (BMI) and lived in least-safe neighborhoods. Our results suggest that daily greenspace and walkability exposure are important for women's PA and associated health outcomes during pregnancy and early postpartum.
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Affiliation(s)
- Li Yi
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA.
| | - Rima Habre
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Daniel Chu
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Thomas A Chavez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - John P Wilson
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Departments of Civil & Environmental Engineering, Computer Science, and Sociology, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Yi L, Xu Y, O'Connor S, Cabison J, Rosales M, Chu D, Chavez TA, Johnson M, Mason TB, Eckel SP, Bastain TM, Breton CV, Wilson JP, Dunton GF, Habre R. GPS-derived environmental exposures during pregnancy and early postpartum - Evidence from the madres cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 918:170551. [PMID: 38336080 DOI: 10.1016/j.scitotenv.2024.170551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
The built and natural environment factors (e.g., greenspace, walkability) are associated with maternal and infant health during and after pregnancy. Most pregnancy studies assess exposures to environmental factors via static methods (i.e., residential location at a single point in time, usually 3rd trimester). These do not capture dynamic exposures encountered in activity spaces (e.g., locations one visits and paths one travels) and their changes over time. In this study, we aimed to compare daily environmental exposure estimates using residential and global positioning systems (GPS)-measured activity space approaches and evaluated potential for exposure measurement error in the former. To do this, we collected four days of continuous geolocation monitoring during the 1st and 3rd trimesters of pregnancy and at 4-6 months postpartum in sixty-two pregnant Hispanic women enrolled in the MADRES cohort. We applied residential and GPS-based methods to assess daily exposures to greenspace, access to parks and transit, and walkability, respectively. We assessed potential for exposure measurement error in residential vs GPS-based estimates using Pearson correlations for each measure overall and by study period. We found residential and GPS-based estimates of daily exposure to total areas of parks and open spaces were weakly positively correlated (r = 0.31, P < .001) across pregnancy and postpartum periods. Residential estimates of %greenspace (r = 0.52, P < .001) and tree cover (r = 0.55, P < .001) along walkable roads were moderately correlated with GPS-based estimates. Residential and GPS-based estimates of public transit proximity, pedestrian-oriented intersection density, and walkability index score were all highly positively correlated (r > 0.70, P < .001). We also found associations between residential and GPS-based estimates decreased among participants with greater daily mobility. Our findings suggest the popular approach that assessing the built and natural environment exposures using residential methods at one time point may introduce exposure measurement error in pregnancy studies. GPS-based methods, to the extent feasible, are recommended for future studies.
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Affiliation(s)
- Li Yi
- Spatial Sciences Institute, University of Southern California, United States of America.
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, United States of America
| | - Sydney O'Connor
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Daniel Chu
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Thomas A Chavez
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, United States of America
| | - John P Wilson
- Spatial Sciences Institute, University of Southern California, United States of America; Department of Population and Public Health Sciences, University of Southern California, United States of America; Departments of Civil & Environmental Engineering, Computer Science, and Sociology, University of Southern California, United States of America
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, University of Southern California, United States of America; Department of Psychology, University of Southern California, United States of America
| | - Rima Habre
- Spatial Sciences Institute, University of Southern California, United States of America; Department of Population and Public Health Sciences, University of Southern California, United States of America
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Edney S, Goh CM, Chua XH, Low A, Chia J, S Koek D, Cheong K, van Dam R, Tan CS, Müller-Riemenschneider F. Evaluating the Effects of Rewards and Schedule Length on Response Rates to Ecological Momentary Assessment Surveys: Randomized Controlled Trials. J Med Internet Res 2023; 25:e45764. [PMID: 37856188 PMCID: PMC10623229 DOI: 10.2196/45764] [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: 01/16/2023] [Revised: 05/31/2023] [Accepted: 07/28/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Ecological momentary assessments (EMAs) are short, repeated surveys designed to collect information on experiences in real-time, real-life contexts. Embedding periodic bursts of EMAs within cohort studies enables the study of experiences on multiple timescales and could greatly enhance the accuracy of self-reported information. However, the burden on participants may be high and should be minimized to optimize EMA response rates. OBJECTIVE We aimed to evaluate the effects of study design features on EMA response rates. METHODS Embedded within an ongoing cohort study (Health@NUS), 3 bursts of EMAs were implemented over a 7-month period (April to October 2021). The response rate (percentage of completed EMA surveys from all sent EMA surveys; 30-42 individual EMA surveys sent/burst) for each burst was examined. Following a low response rate in burst 1, changes were made to the subsequent implementation strategy (SMS text message announcements instead of emails). In addition, 2 consecutive randomized controlled trials were conducted to evaluate the efficacy of 4 different reward structures (with fixed and bonus components) and 2 different schedule lengths (7 or 14 d) on changes to the EMA response rate. Analyses were conducted from 2021 to 2022 using ANOVA and analysis of covariance to examine group differences and mixed models to assess changes across all 3 bursts. RESULTS Participants (N=384) were university students (n=232, 60.4% female; mean age 23, SD 1.3 y) in Singapore. Changing the reward structure did not significantly change the response rate (F3,380=1.75; P=.16). Changing the schedule length did significantly change the response rate (F1,382=6.23; P=.01); the response rate was higher for the longer schedule (14 d; mean 48.34%, SD 33.17%) than the shorter schedule (7 d; mean 38.52%, SD 33.44%). The average response rate was higher in burst 2 and burst 3 (mean 50.56, SD 33.61 and mean 48.34, SD 33.17, respectively) than in burst 1 (mean 25.78, SD 30.12), and the difference was statistically significant (F2,766=93.83; P<.001). CONCLUSIONS Small changes to the implementation strategy (SMS text messages instead of emails) may have contributed to increasing the response rate over time. Changing the available rewards did not lead to a significant difference in the response rate, whereas changing the schedule length did lead to a significant difference in the response rate. Our study provides novel insights on how to implement EMA surveys in ongoing cohort studies. This knowledge is essential for conducting high-quality studies using EMA surveys. TRIAL REGISTRATION ClinicalTrials.gov NCT05154227; https://clinicaltrials.gov/ct2/show/NCT05154227.
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Affiliation(s)
- Sarah Edney
- Physical Activity and Nutrition Determinants in Asia Programme, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Claire Marie Goh
- Physical Activity and Nutrition Determinants in Asia Programme, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Xin Hui Chua
- Physical Activity and Nutrition Determinants in Asia Programme, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Alicia Low
- Singapore Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Janelle Chia
- Singapore Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Daphne S Koek
- Singapore Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Karen Cheong
- Singapore Health Promotion Board, Singapore Government, Singapore, Singapore
| | - Rob van Dam
- Physical Activity and Nutrition Determinants in Asia Programme, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Exercise and Nutrition Sciences and Epidemiology, Milken Institute of Public Health, The George Washington University, Washington DC, VA, United States
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Physical Activity and Nutrition Determinants in Asia Programme, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Kent-Marvick J, Cloyes KG, Meek P, Simonsen S. Racial and ethnic disparities in postpartum weight retention: A narrative review mapping the literature to the National Institute on Minority Health and Health Disparities Research Framework. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231166822. [PMID: 37082834 PMCID: PMC10126608 DOI: 10.1177/17455057231166822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 04/22/2023]
Abstract
PLAIN LANGUAGE SUMMARY A Review of the Literature Using the National Institutes of Health, National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to Create a Roadmap of the Studies Investigating Racial and Ethnic Disparities in Excess Weight Retained After Pregnancy. WHY WAS THIS STUDY DONE? Three out of four people who give birth retain excess weight at 1-year post-pregnancy. This is concerning, as weight that is retained following pregnancy is associated with increased risk for the development of disease. People from racial and ethnic minority groups experience weight retention more frequently post-pregnancy. Black and Hispanic/Latina/o/x birthing people are more likely to begin pregnancy overweight or obese. They are also more likely to retain excess weight following pregnancy. Investigating these risks in people from racially/ethnically diverse backgrounds may be an important way to address disparities in excess weight retained post-pregnancy. WHAT DID THE RESEARCHERS DO? This review of the literature used a tool called the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to map the literature to date on racial and ethnic disparities in excess weight retained post-pregnancy. WHAT DID THE RESEARCHERS FIND? We used the NIMHD Research Framework as a visual guide of the existing research about excess weight retained following pregnancy. Results illustrate the levels and domains at which research has been investigated. These results reveal that efforts have been focused at the individual level, with most attention given to diet and activity. Mapping the literature to the NIMHD Research Framework sheds light on gaps in the research. WHAT DO THE FINDINGS MEAN? Mapping the literature has revealed a need for investigations that make connections between the levels and domains of the Framework, so that we may understand underlying factors that contribute to health disparities.
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Affiliation(s)
| | - Kristin G Cloyes
- College of Nursing, University of Utah, Salt Lake City, UT, USA
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Paula Meek
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Sara Simonsen
- College of Nursing, University of Utah, Salt Lake City, UT, USA
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König LM, Van Emmenis M, Nurmi J, Kassavou A, Sutton S. Characteristics of smartphone-based dietary assessment tools: a systematic review. Health Psychol Rev 2022; 16:526-550. [PMID: 34875978 DOI: 10.1080/17437199.2021.2016066] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Smartphones have become popular in assessing eating behaviour in real-life and real-time. This systematic review provides a comprehensive overview of smartphone-based dietary assessment tools, focusing on how dietary data is assessed and its completeness ensured. Seven databases from behavioural, social and computer science were searched in March 2020. All observational, experimental or intervention studies and study protocols using a smartphone-based assessment tool for dietary intake were included if they reported data collected by adults and were published in English. Out of 21,722 records initially screened, 117 publications using 129 tools were included. Five core assessment features were identified: photo-based assessment (48.8% of tools), assessed serving/ portion sizes (48.8%), free-text descriptions of food intake (42.6%), food databases (30.2%), and classification systems (27.9%). On average, a tool used two features. The majority of studies did not implement any features to improve completeness of the records. This review provides a comprehensive overview and framework of smartphone-based dietary assessment tools to help researchers identify suitable assessment tools for their studies. Future research needs to address the potential impact of specific dietary assessment methods on data quality and participants' willingness to record their behaviour to ultimately improve the quality of smartphone-based dietary assessment for health research.
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Affiliation(s)
- Laura M König
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany.,Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Miranda Van Emmenis
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Johanna Nurmi
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Aikaterini Kassavou
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Sutton
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Bi-Directional Associations of Affective States and Diet among Low-Income Hispanic Pregnant Women Using Ecological Momentary Assessment. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3040022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Affective states play a role in dietary behaviors. Yet, little research has studied within-subjects associations between affect and diet during pregnancy. We examined the acute bidirectional relationships between affect and food intake and moderation by pre-pregnancy body mass index (BMI) in low-income, Hispanic pregnant women using ecological momentary assessment (EMA). Women (N = 57) completed four days of EMA during their first trimester. Women responded to five random prompts per day about their current affect and past two-hour food intake. Higher positive affect (PA) or lower negative affect (NA) predicted greater likelihood of fruit/vegetable consumption in the next two hours in women with lower pre-pregnancy BMI and lower likelihood in women with higher pre-pregnancy BMI. Higher PA predicted less likelihood of fast food consumption in the next two hours in women with lower pre-pregnancy BMI and slightly higher likelihood in women with higher pre-pregnancy BMI. Women with lower pre-pregnancy BMI had higher PA when they reported consuming chips/fries in the past two hours, and women with higher pre-pregnancy BMI had lower PA when they reported consumption of chips/fries in the past two hours. Results showed differential relationships between affect and food intake as a function of pre-pregnancy BMI.
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Parker H, Burkart S, Reesor-Oyer L, Smith MT, Dugger R, von Klinggraeff L, Weaver RG, Beets MW, Armstrong B. Feasibility of Measuring Screen Time, Activity, and Context Among Families With Preschoolers: Intensive Longitudinal Pilot Study. JMIR Form Res 2022; 6:e40572. [PMID: 36173677 PMCID: PMC9562053 DOI: 10.2196/40572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Digital media has made screen time more available across multiple contexts, but our understanding of the ways children and families use digital media has lagged behind the rapid adoption of this technology. OBJECTIVE This study evaluated the feasibility of an intensive longitudinal data collection protocol to objectively measure digital media use, physical activity, sleep, sedentary behavior, and socioemotional context among caregiver-child dyads. This paper also describes preliminary convergent validity of ecological momentary assessment (EMA) measures and preliminary agreement between caregiver self-reported phone use and phone use collected from passive mobile sensing. METHODS Caregivers and their preschool-aged child (3-5 years) were recruited to complete a 30-day assessment protocol. Within 30-days, caregivers completed 7 days of EMA to measure child behavior problems and caregiver stress. Caregivers and children wore an Axivity AX3 (Newcastle Upon Tyne) accelerometer to assess physical activity, sedentary behavior, and sleep. Phone use was assessed via passive mobile sensing; we used Chronicle for Android users and screenshots of iOS screen time metrics for iOS users. Participants were invited to complete a second 14-day protocol approximately 3-12 months after their first assessment. We used Pearson correlations to examine preliminary convergent validity between validated questionnaire measures of caregiver psychological functioning, child behavior, and EMA items. Root mean square errors were computed to examine the preliminary agreement between caregiver self-reported phone use and objective phone use. RESULTS Of 110 consenting participants, 105 completed all protocols (105/110, 95.5% retention rate). Compliance was defined a priori as completing ≥70%-75% of each protocol task. There were high compliance rates for passive mobile sensing for both Android (38/40, 95%) and iOS (64/65, 98%). EMA compliance was high (105/105, 100%), but fewer caregivers and children were compliant with accelerometry (62/99, 63% and 40/100, 40%, respectively). Average daily phone use was 383.4 (SD 157.0) minutes for Android users and 354.7 (SD 137.6) minutes for iOS users. There was poor agreement between objective and caregiver self-reported phone use; root mean square errors were 157.1 and 81.4 for Android and iOS users, respectively. Among families who completed the first assessment, 91 re-enrolled to complete the protocol a second time, approximately 7 months later (91/105, 86.7% retention rate). CONCLUSIONS It is feasible to collect intensive longitudinal data on objective digital media use simultaneously with accelerometry and EMA from an economically and racially diverse sample of families with preschool-aged children. The high compliance and retention of the study sample are encouraging signs that these methods of intensive longitudinal data collection can be completed in a longitudinal cohort study. The lack of agreement between self-reported and objectively measured mobile phone use highlights the need for additional research using objective methods to measure digital media use. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-36240.
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Affiliation(s)
- Hannah Parker
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Layton Reesor-Oyer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Michal T Smith
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Roddrick Dugger
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - R Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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10
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Omowale SS, Gary-Webb TL, Wallace ML, Wallace JM, Rauktis ME, Eack SM, Mendez DD. Stress during pregnancy: An ecological momentary assessment of stressors among Black and White women with implications for maternal health. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221126808. [PMID: 36148967 PMCID: PMC9510975 DOI: 10.1177/17455057221126808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Stress can lead to adverse physiological and psychological outcomes. Therefore, understanding stress during pregnancy provides insight into racial disparities in maternal health, particularly Black maternal health. OBJECTIVES This study aimed to describe (1) daily exposure to self-reported stress levels during pregnancy, and (2) sources of stress among participants that identified as Black or White using data collected via ecological momentary assessment. METHODS We leveraged survey data from the Postpartum Mothers Mobile Study, a prospective longitudinal study using ecological momentary assessment data collection methods to describe patterns of stress during pregnancy. This article is descriptive and documents patterns of self-reported stress levels and sources of stress. Frequencies and percentages of stress responses were computed to describe these patterns. RESULTS The sample (n = 296) was 27% Black (n = 78) and 63% White (n = 184). Results were based on at least one measurement of that stress level during pregnancy. A similar number of Black and White participants reported no stress during pregnancy. White (85%-95%) and Black (60%-70%) participants reported low to moderate levels of stress. Black participants (38%) and White participants (35%) reported experiencing high stress. Black and White participants reported similar sources of stress: stress from a partner, too many things to do, a baby or other children, and financial concerns. White participants reported work as a top stressor, and Black participants reported financial issues as a top source of stress. CONCLUSION This study provides insight into daily exposure to stress that has implications for maternal health. We described patterns of self-reported stress and sources of stress among Black and White participants. The daily exposures to stress reported by this sample exist within a context of root causes of structural inequities in education, health care, income, wealth, and housing that must be addressed to achieve maternal health equity.
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Affiliation(s)
- Serwaa S Omowale
- California Preterm Birth Initiative,
University of California San Francisco, San Francisco, CA, USA,Department of Obstetrics, Gynecology
& Reproductive Sciences, School of Medicine, University of California San
Francisco, San Francisco, CA, USA,School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Tiffany L Gary-Webb
- Department of Epidemiology, School of
Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - John M Wallace
- School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Mary E Rauktis
- School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Shaun M Eack
- School of Social Work, University of
Pittsburgh, Pittsburgh, PA, USA
| | - Dara D Mendez
- Department of Epidemiology, School of
Public Health, University of Pittsburgh, Pittsburgh, PA, USA,Department of Behavioral and Community
Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA,
USA,Division of General Internal Medicine,
School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA,Dara D Mendez, Department of Epidemiology,
School of Public Health, University of Pittsburgh, 5130 Public Health, 130 De
Soto Street, Pittsburgh, PA 15261, USA.
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11
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Yi L, Xu Y, Eckel SP, O'Connor S, Cabison J, Rosales M, Chu D, Chavez TA, Johnson M, Mason TB, Bastain TM, Breton CV, Dunton GF, Wilson JP, Habre R. Time-activity and daily mobility patterns during pregnancy and early postpartum - evidence from the MADRES cohort. Spat Spatiotemporal Epidemiol 2022; 41:100502. [PMID: 35691658 PMCID: PMC9198358 DOI: 10.1016/j.sste.2022.100502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/07/2022] [Accepted: 03/21/2022] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Pregnant women's daily time-activity and mobility patterns determine their environmental exposures and subsequently related health effects. Most studies ignore these and assess pregnancy exposures using static residential measures. METHODS We conducted 4-day continuous geo-location monitoring in 62 pregnant Hispanic women, during pregnancy and early post-partum then derived trips by mode and stays, classified by context (indoor/outdoor, type). Generalized mixed-effect models were used to examine whether these patterns changed over time. RESULTS Women spent on average 17.3 h/day at home. Commercial and service locations were the most popular non-home destinations, while parks and open spaces were seldom visited. Women made 3.5 daily trips (63.7 min/day and approximately 25% were pedestrian-based). Women were less likely to visit commercial and services locations and make vehicle-based trips postpartum compared to the 3rd trimester. CONCLUSION Our findings suggest time-activity patterns vary across pregnancy and postpartum, thus assessing exposures at stationary locations might introduce measurement error.
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Affiliation(s)
- Li Yi
- Spatial Sciences Institute, University of Southern California, United States
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, United States
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Sydney O'Connor
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Daniel Chu
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Thomas A Chavez
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, United States
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, University of Southern California, United States; Department of Psychology, University of Southern California, United States
| | - John P Wilson
- Spatial Sciences Institute, University of Southern California, United States; Department of Population and Public Health Sciences, University of Southern California, United States; Departments of Civil & Environmental Engineering, Computer Science and Sociology, University of Southern California, United States
| | - Rima Habre
- Spatial Sciences Institute, University of Southern California, United States; Department of Population and Public Health Sciences, University of Southern California, United States.
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12
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Bell BM, Alam R, Mondol AS, Ma M, Emi IA, Preum SM, de la Haye K, Stankovic JA, Lach J, Spruijt-Metz D. Validity and Feasibility of the Monitoring and Modeling Family Eating Dynamics System to Automatically Detect In-field Family Eating Behavior: Observational Study. JMIR Mhealth Uhealth 2022; 10:e30211. [PMID: 35179508 PMCID: PMC8900902 DOI: 10.2196/30211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/28/2021] [Accepted: 12/03/2021] [Indexed: 01/02/2023] Open
Abstract
Background The field of dietary assessment has a long history, marked by both controversies and advances. Emerging technologies may be a potential solution to address the limitations of self-report dietary assessment methods. The Monitoring and Modeling Family Eating Dynamics (M2FED) study uses wrist-worn smartwatches to automatically detect real-time eating activity in the field. The ecological momentary assessment (EMA) methodology was also used to confirm whether eating occurred (ie, ground truth) and to measure other contextual information, including positive and negative affect, hunger, satiety, mindful eating, and social context. Objective This study aims to report on participant compliance (feasibility) to the 2 distinct EMA protocols of the M2FED study (hourly time-triggered and eating event–triggered assessments) and on the performance (validity) of the smartwatch algorithm in automatically detecting eating events in a family-based study. Methods In all, 20 families (58 participants) participated in the 2-week, observational, M2FED study. All participants wore a smartwatch on their dominant hand and responded to time-triggered and eating event–triggered mobile questionnaires via EMA while at home. Compliance to EMA was calculated overall, for hourly time-triggered mobile questionnaires, and for eating event–triggered mobile questionnaires. The predictors of compliance were determined using a logistic regression model. The number of true and false positive eating events was calculated, as well as the precision of the smartwatch algorithm. The Mann-Whitney U test, Kruskal-Wallis test, and Spearman rank correlation were used to determine whether there were differences in the detection of eating events by participant age, gender, family role, and height. Results The overall compliance rate across the 20 deployments was 89.26% (3723/4171) for all EMAs, 89.7% (3328/3710) for time-triggered EMAs, and 85.7% (395/461) for eating event–triggered EMAs. Time of day (afternoon odds ratio [OR] 0.60, 95% CI 0.42-0.85; evening OR 0.53, 95% CI 0.38-0.74) and whether other family members had also answered an EMA (OR 2.07, 95% CI 1.66-2.58) were significant predictors of compliance to time-triggered EMAs. Weekend status (OR 2.40, 95% CI 1.25-4.91) and deployment day (OR 0.92, 95% CI 0.86-0.97) were significant predictors of compliance to eating event–triggered EMAs. Participants confirmed that 76.5% (302/395) of the detected events were true eating events (ie, true positives), and the precision was 0.77. The proportion of correctly detected eating events did not significantly differ by participant age, gender, family role, or height (P>.05). Conclusions This study demonstrates that EMA is a feasible tool to collect ground-truth eating activity and thus evaluate the performance of wearable sensors in the field. The combination of a wrist-worn smartwatch to automatically detect eating and a mobile device to capture ground-truth eating activity offers key advantages for the user and makes mobile health technologies more accessible to nonengineering behavioral researchers.
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Affiliation(s)
- Brooke Marie Bell
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, CT, United States.,Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Ridwan Alam
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Electrical and Computer Engineering, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - Abu Sayeed Mondol
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - Meiyi Ma
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States.,Department of Computer Science, School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Ifat Afrin Emi
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - Sarah Masud Preum
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States.,Department of Computer Science, Dartmouth College, Hanover, NH, United States
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - John A Stankovic
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - John Lach
- Department of Electrical and Computer Engineering, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States.,School of Engineering and Applied Science, The George Washington University, Washington, DC, United States
| | - Donna Spruijt-Metz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Center for Economic and Social Research, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, United States
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13
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Naya CH, Toledo-Corral CM, Chavez T, Lerner D, Lurvey N, Eckel SP, Peterson AK, Grubbs BH, Dunton GF, Breton CV, Bastain TM. Third trimester cortisol is positively associated with gestational weight gain in pregnant women with class one obesity. Int J Obes (Lond) 2022; 46:366-373. [PMID: 34718334 PMCID: PMC9012147 DOI: 10.1038/s41366-021-01009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/27/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVE Prevalence of pre-pregnancy obesity and excessive gestational weight gain (GWG) are higher among women of color with low SES. Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and its end-product, cortisol, during pregnancy is hypothesized to be associated with excessive GWG. However, past studies have produced inconsistent findings and often did not include health disparities populations. This study examined the association between pre-pregnancy body mass index (BMI), third trimester diurnal cortisol, and GWG in low-income, predominantly Hispanic women. SUBJECTS/METHODS The MADRES study is an ongoing prospective cohort study of primarily Hispanic, low-income pregnant women and their children in Los Angeles, California. Data from 176 participants were included in this study. Total cortisol secretion (area under the curve, AUC) was quantified using four salivary cortisol samples (awakening, 30 min after awakening, afternoon, and bedtime) that were collected at home on one day during the third trimester of pregnancy. Moderation of the association between total cortisol and GWG by pre-pregnancy BMI was tested using multiple linear regression with a multiplicative interaction term. RESULTS There was no association between total cortisol secretion and GWG overall (p = 0.82), but the association between total cortisol and GWG was stronger for women with class 1 pre-pregnancy obesity compared to women with normal pre-pregnancy BMI (interaction term p = 0.04). CONCLUSIONS Results suggest that obesity status before pregnancy may be exacerbating the physiological impact of cortisol on GWG.
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Affiliation(s)
- Christine H Naya
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alicia K Peterson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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14
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Reesor-Oyer L, Parker H, Burkart S, Smith MT, Dugger R, von Klinggraeff L, Weaver RG, Beets MW, Armstrong B. Measuring Micro Temporal Processes Underlying Preschoolers Screen Use and Behavioral Health: Protocol for the Tots & Tech Study (Preprint). JMIR Res Protoc 2022; 11:e36240. [PMID: 36169993 PMCID: PMC9557980 DOI: 10.2196/36240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/10/2022] [Accepted: 08/29/2022] [Indexed: 12/19/2022] Open
Abstract
Background Excessive screen time is associated with poor health and behavioral outcomes in children. However, research on screen time use has been hindered by methodological limitations, including retrospective reports of usual screen time and lack of momentary etiologic processes occurring within each day. Objective This study is designed to assess the feasibility and utility of a comprehensive multibehavior protocol to measure the digital media use and screen time context among a racially and economically diverse sample of preschoolers and their families. This paper describes the recruitment, data collection, and analytical protocols for the Tots and Tech study. Methods The Tots and Tech study is a longitudinal, observational study of 100 dyads: caregivers and their preschool-age children (aged 3-5 years). Both caregivers and children will wear an Axivity AX3 accelerometer (Axivity Ltd) for 30 days to assess their physical activity, sedentary behavior, and sleep. Caregivers will complete ecological momentary assessments (EMAs) for 1 week to measure child behavioral problems, caregiver stress, and child screen time. Results The Tots and Tech study was funded in March 2020. This study maintains rolling recruitment, with each dyad on their own assessment schedule, depending on the time of enrollment. Enrollment was scheduled to take place between September 2020 and May 2022. We aim to enroll 100 caregiver-child dyads. The Tots and Tech outcome paper is expected to be published in 2022. Conclusions The Tots and Tech study attempts to overcome previous methodological limitations by using objective measures of screen time, physical activity, sedentary behavior, and sleep behaviors with contextual factors measured by EMA. The results will be used to evaluate the feasibility and utility of a comprehensive multibehavior protocol using objective measures of mobile screen time and accelerometry in conjunction with EMA among caregiver-child dyads. Future observational and intervention studies will be able to use this study protocol to better measure screen time and its context. International Registered Report Identifier (IRRID) DERR1-10.2196/36240
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Affiliation(s)
- Layton Reesor-Oyer
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Hannah Parker
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Michal T Smith
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Roddrick Dugger
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Lauren von Klinggraeff
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - R Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
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15
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Turner A, Brokamp C, Wolfe C, Reponen T, Ryan P. Personal exposure to average weekly ultrafine particles, lung function, and respiratory symptoms in asthmatic and non-asthmatic adolescents. ENVIRONMENT INTERNATIONAL 2021; 156:106740. [PMID: 34237487 PMCID: PMC8380734 DOI: 10.1016/j.envint.2021.106740] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/27/2021] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
An increasing amount of evidence suggests ultrafine particles (UFPs) are linked to adverse health effects, especially in those with chronic conditions such as asthma, due to their small size and physicochemical characteristics. Toxicological and experimental studies have demonstrated these properties, and the mechanisms by which they deposit and translocate in the body result in increased toxicity in comparison to other air pollutants. However, current epidemiological literature is limited due to exposure misclassification and thus identifying health outcomes associated with UFPs. The objective of this study was to investigate the association between weekly personal UFP exposure with lung function and respiratory symptoms in 117 asthmatic and non-asthmatic adolescents between 13 and 17 years of age in the Cincinnati area. Between 2017 and 2019, participants collected weekly UFP concentrations by sampling for 3 h a day in their home, school, and during transit. In addition, pulmonary function was evaluated at the end of the sampling week, and respiratory symptoms were logged on a mobile phone application. Multivariable linear regression and zero-inflated Poisson (ZIP) models were used to estimate the association between personal UFP and respiratory outcomes. The average median weekly UFP exposure of all participants was 4340 particles/cm3 (p/cc). Results of fully adjusted regression models revealed a negative association between UFPs and percent predicted forced expiratory volume/forced vital capacity ratio (%FEV1/FVC) (β:-0.03, 95% CI [-0.07, 0.02]). Prediction models estimated an association between UFPs and respiratory symptoms, which was greater in asthmatics compared to non-asthmatics. Our results indicate an interaction between asthma status and the likelihood of experiencing respiratory symptoms when exposed to UFPs, indicating an exacerbation of this chronic condition. More research is needed to determine the magnitude of the role UFPs play on respiratory health.
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Affiliation(s)
- Ashley Turner
- Department of Environmental Health, College of Medicine, University of Cincinnati, United States.
| | - Cole Brokamp
- Department of Pediatrics, College of Medicine, University of Cincinnati, United States; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, United States
| | - Chris Wolfe
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, United States
| | - Tiina Reponen
- Department of Environmental Health, College of Medicine, University of Cincinnati, United States
| | - Patrick Ryan
- Department of Pediatrics, College of Medicine, University of Cincinnati, United States; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, United States
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16
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Cunha BCR, Rodrigues KRDH, Zaine I, da Silva EAN, Viel CC, Pimentel MDGC. Experience Sampling and Programmed Intervention Method and System for Planning, Authoring, and Deploying Mobile Health Interventions: Design and Case Reports. J Med Internet Res 2021; 23:e24278. [PMID: 34255652 PMCID: PMC8314159 DOI: 10.2196/24278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/09/2020] [Accepted: 02/25/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Health professionals initiating mobile health (mHealth) interventions may choose to adapt apps designed for other activities (eg, peer-to-peer communication) or to employ purpose-built apps specialized in the required intervention, or to exploit apps based on methods such as the experience sampling method (ESM). An alternative approach for professionals would be to create their own apps. While ESM-based methods offer important guidance, current systems do not expose their design at a level that promotes replicating, specializing, or extending their contributions. Thus, a twofold solution is required: a method that directs specialists in planning intervention programs themselves, and a model that guides specialists in adopting existing solutions and advises software developers on building new ones. OBJECTIVE The main objectives of this study are to design the Experience Sampling and Programmed Intervention Method (ESPIM), formulated toward supporting specialists in deploying mHealth interventions, and the ESPIM model, which guides health specialists in adopting existing solutions and advises software developers on how to build new ones. Another goal is to conceive and implement a software platform allowing specialists to be users who actually plan, create, and deploy interventions (ESPIM system). METHODS We conducted the design and evaluation of the ESPIM method and model alongside a software system comprising integrated web and mobile apps. A participatory design approach with stakeholders included early software prototype, predesign interviews with 12 health specialists, iterative design sustained by the software as an instance of the method's conceptual model, support to 8 real case studies, and postdesign interviews. RESULTS The ESPIM comprises (1) a list of requirements for mHealth experience sampling and intervention-based methods and systems, (2) a 4-dimension planning framework, (3) a 7-step-based process, and (4) an ontology-based conceptual model. The ESPIM system encompasses web and mobile apps. Eight long-term case studies, involving professionals in psychology, gerontology, computer science, speech therapy, and occupational therapy, show that the method allowed specialists to be actual users who plan, create, and deploy interventions via the associated system. Specialists' target users were parents of children diagnosed with autism spectrum disorder, older persons, graduate and undergraduate students, children (age 8-12), and caregivers of older persons. The specialists reported being able to create and conduct their own studies without modifying their original design. A qualitative evaluation of the ontology-based conceptual model showed its compliance to the functional requirements elicited. CONCLUSIONS The ESPIM method succeeds in supporting specialists in planning, authoring, and deploying mobile-based intervention programs when employed via a software system designed and implemented according to its conceptual model. The ESPIM ontology-based conceptual model exposes the design of systems involving active or passive sampling interventions. Such exposure supports the evaluation, implementation, adaptation, or extension of new or existing systems.
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Affiliation(s)
| | | | - Isabela Zaine
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, Brazil
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17
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Kaiser KA, Carson TL, Dhurandhar EJ, Neumeier WH, Cardel MI. Biobehavioural approaches to prevention and treatment: A call for implementation science in obesity research. Obes Sci Pract 2020; 6:3-9. [PMID: 32128237 PMCID: PMC7042105 DOI: 10.1002/osp4.384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/11/2019] [Accepted: 10/24/2019] [Indexed: 12/31/2022] Open
Abstract
Much progress has been made in the last 30 years in understanding the causes and mechanisms that contribute to obesity, yet widely available and successful strategies for prevention and treatment remain elusive at population levels. This paper discusses the biobehavioural framework and provides suggestions for applying it to enable greater progress in the science of obesity prevention and treatment, including an increased focus on implementation of science strategies. The objective is to promote a re-evaluation of current views about preventing and treating obesity within a unified biobehavioural framework. Further integration of research exploring how both behavioural and biological components interact is a critical step forward.
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Affiliation(s)
- Kathryn A. Kaiser
- Department of Health Behavior, School of Public HealthUniversity of Alabama at BirminghamBirminghamAlabama
- Nutrition Obesity Research CenterUniversity of Alabama at BirminghamBirminghamAlabama
| | - Tiffany L. Carson
- Nutrition Obesity Research CenterUniversity of Alabama at BirminghamBirminghamAlabama
- Division of Preventive Medicine, School of MedicineUniversity of Alabama at BirminghamBirminghamAlabama
| | - Emily J. Dhurandhar
- Department of Kinesiology and Sport ManagementTexas Tech UniversityLubbockTexas
| | - William H. Neumeier
- United States Army Research Institute of Environmental MedicineNatickMassachusetts
| | - Michelle I. Cardel
- Department of Health Outcomes & Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleFlorida
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18
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Maugeri A, Barchitta M. A Systematic Review of Ecological Momentary Assessment of Diet: Implications and Perspectives for Nutritional Epidemiology. Nutrients 2019; 11:nu11112696. [PMID: 31703374 PMCID: PMC6893429 DOI: 10.3390/nu11112696] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/18/2022] Open
Abstract
The ecological momentary assessment (EMA) of eating behaviors represents an innovative, detailed and valid approach to capture the complexity of food intake and to overcome limitations of traditional dietary assessment methods. Moreover, EMA studies might generate a large variety of data (e.g., dietary, behavioral, physical, sociopsychological, and contextual information), thereby enabling to examine concurrent exposures and events. Due to the increasing number of studies in this field of research, here we systematically reviewed EMA methods for the assessment of dietary intake in epidemiological studies, and discussed implications and perspectives for future research. Our study summarized several protocols and platforms that may be applied to assess diet in terms of eating frequency, choices, and habits. Nearly 38% of studies used an event-contingent strategy by asking participants to report foods and beverages consumed in real-time at each eating occasion. Instead, approximately 55% of studies used a signal-contingent prompting approach that notified the participants to record their dietary consumption. The remaining studies used a combination of event- and signal-contingent protocols to compare their accuracy or to improve the assessment of dietary data. Although both approaches might improve the accuracy and ecological validity of dietary assessment—also reducing the burden for participants—some limitations should nevertheless be considered. Despite these limitations, our systematic review pointed out that EMA can be applied in various fields of nutritional epidemiology, from the identification of determinants of dietary habits in healthy people to the management of patients with eating or metabolic disorders. However, more efforts should be encouraged to improve the validity and the reliability of EMA and to provide further technological innovations for public health research and interventions.
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Cook I. Deriving objectively-measured sedentary indices from free-living accelerometry data in rural and urban African settings: a cost effective approach. BMC Res Notes 2019; 12:573. [PMID: 31511063 PMCID: PMC6739927 DOI: 10.1186/s13104-019-4606-4] [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: 05/26/2019] [Accepted: 09/04/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives To investigate the agreement between two data reduction approaches for detecting sedentary breaks from uni-axial accelerometry data collected in human participants. Free-living, uni-axial accelerometer data (n = 318) were examined for sedentary breaks using two different methods (Healy–Matthews; MAH/UFFE). The data were cleaned and reduced using MAH/UFFE Analyzer software and custom Microsoft Excel macro’s, such that the average daily sedentary break number were calculated for each data record, for both methods. Results The Healy–Matthews and MAH/UFFE average daily break number correlated closely (R2 = 99.9%) and there was high agreement (mean difference: + 0.7 breaks/day; 95% limits of agreement: − 0.06 to + 1.4 breaks/day). A slight bias of approximately + 1 break/day for the MAH/UFFE Analyzer was evident for both the regression and agreement analyses. At a group level there were no statistically or practically significant differences within sample groups between the two methods.
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Affiliation(s)
- Ian Cook
- Physical Activity Epidemiology Laboratory, Faculty of Humanities, University of Limpopo (Turfloop Campus), P.O. Box 459, Fauna Park, Polokwane, Limpopo Province, 0787, South Africa.
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Smith KE, Juarascio A. From Ecological Momentary Assessment (EMA) to Ecological Momentary Intervention (EMI): Past and Future Directions for Ambulatory Assessment and Interventions in Eating Disorders. Curr Psychiatry Rep 2019; 21:53. [PMID: 31161276 DOI: 10.1007/s11920-019-1046-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Ambulatory assessment methods, including ecological momentary assessment (EMA), have often been used in eating disorders (EDs) to assess the type, frequency, and temporal sequencing of ED symptoms occurring in naturalistic environments. Relatedly, growing research in EDs has explored the utility of ecological momentary interventions (EMIs) to target ED symptoms. The aims of the present review were to (1) synthesize recent literature pertaining to ambulatory assessment/EMA and EMI in EDs, and (2) identify relevant limitations and future directions in these domains. RECENT FINDINGS With respect to ambulatory assessment and EMA, there has been substantial growth in the expansion of constructs assessed with EMA, the exploration of state- vs. trait-level processes, integration of objective and passive assessment approaches, and consideration of methodological issues. The EMI literature in EDs also continues to grow, though most of the recent research focuses on mobile health (mHealth) technologies with relatively minimal EMI components that adapt to momentary contextual information. Despite these encouraging advances, there remain several promising areas of ambulatory assessment research and clinical applications in EDs going forward. These include integration of passive data collection, use of EMA in treatment evaluation and design, evaluation of dynamic system processes, inclusion of diverse samples, and development and evaluation of adaptive, tailored EMIs such as just-in-time adaptive interventions. While much remains to be learned in each of these domains, the continual growth in mobile technology has potential to facilitate and refine our understanding of the nature of ED psychopathology and ultimately improve intervention approaches.
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Affiliation(s)
- Kathryn E Smith
- Center for Bio-behavioral Research, Sanford Research, Fargo, ND, USA. .,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.
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