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Stea TH, Vettore MV, Øvrebø B, Abildsnes E. Changes in dietary habits and BMI z-score after a 6-month non-randomized cluster-controlled trial among 6-12 years old overweight and obese Norwegian children. Food Nutr Res 2023; 67:9617. [PMID: 38187797 PMCID: PMC10770647 DOI: 10.29219/fnr.v67.9617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background Effective prevention programs to address the high prevalence of childhood overweight and obesity and the concomitant health consequences have been warranted. Objective To improve dietary habits and weight status among Norwegian children with overweight/obesity in the primary care setting. Design A 6-month non-randomized cluster-controlled intervention among 137 children, aged 6-12 years, with overweight/obesity and their parents. Intervention and control groups were recruited by public health nurses and followed-up by 12 Healthy Life Centers across Norway. The intervention group received individual family counseling and participated in nutrition courses and physical activity groups. A frequency questionnaire assessing sociodemographic characteristics and dietary habits was completed by the parents. Trained public health nurses measured height and weight using standardized methods to calculate body mass index (BMI) and BMI z-scores. Results The intervention resulted in an increased odds of consuming evening meals (OR: 3.42), a decreased availability of salty snacks (β = -0.17), a decreased intake of salty snacks (-0.18), an increased consumption of water (β = 0.20), and a decreased estimated total intake of energy (β = -0.17), carbohydrates (β = -0.17), mono- and disaccharides (β = -0.21), sucrose (β = -0.24), and saturated fatty acids (β = -0.17). The intervention directly predicted lower BMI z-score (β = -0.17), and post-treatment levels of energy (β = -0.65), saturated fat (β = 0.43), and total carbohydrates (β = 0.41) were directly linked to BMI z-score after intervention. Age and sex were indirectly associated with BMI after intervention through energy and saturated fat intake. Conclusions The intervention had a beneficial impact on nutrient intake and weight status among children with overweight/obesity. These findings provide support for implementing complex intervention programs tailored to local primary care settings. Trial registration Clinicaltrials.gov, NCT02290171. Registered 13. November 2014, https://clinicaltrials.gov/ct2/show/NCT02290171.
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Affiliation(s)
- Tonje Holte Stea
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Mario Vianna Vettore
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Bente Øvrebø
- Department of Health and Inequalities, Norwegian Institute of Public Health, Oslo, Norway
| | - Eirik Abildsnes
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
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Deepradit S, Powwattana A, Lagampan S, Thiangtham W. Effectiveness of a family-based program for post-stroke patients and families: A cluster randomized controlled trial. Int J Nurs Sci 2023; 10:446-455. [PMID: 38020842 PMCID: PMC10667323 DOI: 10.1016/j.ijnss.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To examine the effectiveness of a family-based program for post-stroke patients and their families. Methods A cluster randomized controlled trial design was used. Participants were randomly selected in the experimental group (3 districts) and the comparison group (3 districts), with 62 families recruited. Sixty-two persons with new stroke and families (family caregivers and family members) who met the inclusion criteria were assigned to two groups, 31 in each group. Using the Neuman System Model as a framework, we implemented the stressors assessment and family-based intervention into the program. Participants in the comparison group received usual care, and those in the experimental group underwent a stressors assessment and received the family-based program. Measurement of functional status, depression, and complications in post-stroke patients and family function in family caregivers and family members, as well as caregiver burden and caregiver stress in family caregivers, were assessed at baseline, 4 weeks, and 12 weeks after enrollment. Data analysis included descriptive statistics, the chi-square test, Bonferroni test, and repeated measures analysis of variance. Results After participating in a 12-week family-based program, post-stroke patients in the experimental group showed statistically significant improvements in their functional status and decreased depression compared to the comparison group (P < 0.05). The family function of the experimental group was significantly improved, and caregivers' burden and stress were decreased compared to the comparison group (P < 0.05). Three patients in the experimental group and seven in the comparison group experienced complications. Conclusions The study findings suggest that the present family-based program improved family function in family caregivers and family members and decreased caregiver burden and stress in family caregivers. The program also improved functional status and reduced depression in post-stroke patients. It is suggested the duration of the program be extended to assess its sustainable effectiveness.
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Affiliation(s)
- Saisunee Deepradit
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Arpaporn Powwattana
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand
| | - Sunee Lagampan
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand
| | - Weena Thiangtham
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, Thailand
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Chai LK, Collins C, May C, Brain K, Wong See D, Burrows T. Effectiveness of family-based weight management interventions for children with overweight and obesity: an umbrella review. ACTA ACUST UNITED AC 2020; 17:1341-1427. [PMID: 31021970 DOI: 10.11124/jbisrir-2017-003695] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The objective of the review was to synthesize the effectiveness and strategies used in family-based behavioral childhood obesity interventions in improving child weight-related outcomes. INTRODUCTION Family-based interventions are common practice in the treatment of childhood obesity. Research suggests that direct parental involvement can improve child weight-related outcomes. However, challenges remain in assessing the effects of family-based interventions on child weight and weight-related behavior due to the lack of quality programs and diversity of treatment strategies. INCLUSION CRITERIA The review included systematic reviews and/or meta-analyses of family-based behavioral interventions in children aged ≤18 who were classified as overweight and/or obese, and which reported child weight related outcomes, such as body mass index (BMI), body fat percentage and waist circumferences. METHODS Seven databases were searched from 1990 to May 2016 to identify English language publications. Reference lists of included reviews and relevant registers were also searched for additional reviews. All included systematic reviews were critically appraised by two reviewers independently. Data extracted included characteristics of included systematic reviews and weight-related outcomes reported. Data synthesis involved categorizing the interventions into seven categories and presented findings in narrative and tabular format. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS The umbrella review included 14 systematic reviews (low to moderate methodological quality), published between 2004 and 2015, including 47 independent trials ranging from one month to seven years follow-up conducted in more than 16 countries. The majority of reviews (93%) reported weight outcomes of children aged six to 13 years. All reviews except one indicated that family-based interventions were successful in improving child weight and/or weight-related behavior. Five reviews highlighted that parent-only interventions had similar (n = 4) or greater (n = 1) effectiveness compared to parent-child interventions. Effective interventions employed parent-targeted strategies, including nutrition and physical activity education sessions, positive parenting skills, role modelling and child behavior management to encourage positive healthy eating/exercise behaviors in children and/or whole family. CONCLUSIONS Family-based interventions targeting parents, alone or with their child, are effective for child weight management. Due to the lack of high quality evidence, especially in emerging parent-only interventions, further research is warranted. Health practitioners can work with parents as agents of change and focus on fostering positive parenting skills, such as monitoring, reinforcement, role modelling, and providing a nurturing environment, in order to support health behaviors in their children. Future research needs to explore whether parent-only interventions are more cost-effective compared to parent-child interventions, and to include larger populations, longer intervention duration and follow-up.
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Affiliation(s)
- Li Kheng Chai
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Clare Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,The University of Newcastle Centre for Evidence Based Healthcare Informing Research (CEBHIR): a Joanna Briggs Institute Centre of Excellence
| | - Chris May
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia.,Family Action Centre, The University of Newcastle, Callaghan, Australia
| | - Katherine Brain
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Denise Wong See
- Department of Nutrition and Dietetics, John Hunter Children's Hospital, Newcastle, Australia
| | - Tracy Burrows
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia.,Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
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Criss S, Horhota M, Wiles K, Norton J, St Hilaire KJ, Short MA, Blomquist KK. Food cultures and aging: a qualitative study of grandparents' food perceptions and influence of food choice on younger generations. Public Health Nutr 2020; 23:221-30. [PMID: 31566158 DOI: 10.1017/S1368980019002489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore food perceptions among grandparents and understand the influence of these perceptions on food choice for the younger generations in their family. DESIGN Qualitative methodology, thematic analysis of the transcripts from fourteen focus groups. SETTING Grandparents in the southern region of the United States. SUBJECTS Participants were fifty-eight Black, Hispanic, and White grandparents, predominantly women (72%), ranging in age from 44-86 years (mean age = 65·4 (sd 9·97) years). RESULTS Grandparents' perceptions related to personal food choice were related to health issues and the media. Grandparents' perceived influence on their children's and grandchildren's food choices was described through the themes of proximity and power (level of influence based on an interaction of geographic proximity to grandchildren and the power given to them by their children and grandchildren to make food decisions), healthy v. unhealthy spoiling, cultural food tradition, and reciprocal exchange of knowledge. CONCLUSION Our results highlight areas for future research including nutrition interventions for older adults as well as factors that may be helpful to consider when engaging grandparents concerning food decisions for younger generations to promote health. Specifically, power should be assessed as part of a holistic approach to addressing dietary influence, the term 'healthy spoiling' can be used to reframe notions of traditional spoiling, and the role of cultural food tradition should be adapted differently by race.
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Schuster RC, Szpak M, Klein E, Sklar K, Dickin KL. “I try, I do”: Child feeding practices of motivated, low-income parents reflect trade-offs between psychosocial- and nutrition-oriented goals. Appetite 2019; 136:114-123. [DOI: 10.1016/j.appet.2019.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 01/02/2019] [Accepted: 01/07/2019] [Indexed: 01/08/2023]
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Fusar-Poli P, Radua J. Ten simple rules for conducting umbrella reviews. Evid Based Ment Health 2018; 21:95-100. [PMID: 30006442 PMCID: PMC10270421 DOI: 10.1136/ebmental-2018-300014] [Citation(s) in RCA: 266] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Evidence syntheses such as systematic reviews and meta-analyses provide a rigorous and transparent knowledge base for translating clinical research into decisions, and thus they represent the basic unit of knowledge in medicine. Umbrella reviews are reviews of previously published systematic reviews or meta-analyses. Therefore, they represent one of the highest levels of evidence synthesis currently available, and are becoming increasingly influential in biomedical literature. However, practical guidance on how to conduct umbrella reviews is relatively limited. METHODS We present a critical educational review of published umbrella reviews, focusing on the essential practical steps required to produce robust umbrella reviews in the medical field. RESULTS The current manuscript discusses 10 key points to consider for conducting robust umbrella reviews. The points are: ensure that the umbrella review is really needed, prespecify the protocol, clearly define the variables of interest, estimate a common effect size, report the heterogeneity and potential biases, perform a stratification of the evidence, conduct sensitivity analyses, report transparent results, use appropriate software and acknowledge the limitations. We illustrate these points through recent examples from umbrella reviews and suggest specific practical recommendations. CONCLUSIONS The current manuscript provides a practical guidance for conducting umbrella reviews in medical areas. Researchers, clinicians and policy makers might use the key points illustrated here to inform the planning, conduction and reporting of umbrella reviews in medicine.
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Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- FIDMAG Germanes Hospitalaries, CIBERSAM, Barcelona, Spain
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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