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Dennaoui N, Guagliano JM, Kolt GS, Jammal M, George ES. A systematic review of culturally adapted physical activity interventions for culturally and linguistically diverse children and adolescents. Prev Med 2024; 183:107979. [PMID: 38697226 DOI: 10.1016/j.ypmed.2024.107979] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/01/2024] [Accepted: 04/29/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE Limited evidence shows culturally and linguistically diverse (CALD) children and adolescents are less active, compared to the general population. It is unclear, how physical activity interventions have been adapted for CALD children and adolescents to enhance engagement. This study aimed to review culturally adapted physical activity interventions targeting CALD children and adolescents. METHODS All studies recruited children and adolescents (i.e., aged ≥5 to <18 years old) from CALD backgrounds, targeted physical activity, and included cultural adaptations. Cultural adaptations were defined as surface structures (i.e., observable characteristics of a targeted population) or deep structures (i.e., rooted in core ethnic values derived from individual cultures. RESULTS Twenty studies were included. Ten studies used a combination of surface and deep structure adaptations. Of these 10 studies, 3 found a significant between-group difference in physical activity favouring the intervention group. Among studies (n = 6) that used surface structure adaptations (e.g., language adjustments to information sheets, consent forms, and resources), 1 found a significant intervention effect on physical activity. With studies (n = 4) that used deep structure adaptations (e.g., incorporating traditional songs and dances relevant to cultural groups), 1 study found a significant intervention effect on physical activity. CONCLUSION A small number of studies found significant changes to increase physical activity levels. We found there is a lack of consistent evidence indicating that incorporating surface and/or deep structure adaptations result in significant changes in physical activity. Future research should focus on establishing higher quality methodology when developing culturally adapted interventions for CALD populations.
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Affiliation(s)
- Nariman Dennaoui
- School of Health Sciences, Western Sydney University, Sydney, Australia.
| | - Justin M Guagliano
- School of Health Sciences, Western Sydney University, Sydney, Australia; Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia
| | - Gregory S Kolt
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Melissa Jammal
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Emma S George
- School of Health Sciences, Western Sydney University, Sydney, Australia; Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia
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Tranby BN, Sia IG, Clark MM, Novotny PJ, Lohr AM, Pardo LS, Patten CA, Iteghete SO, Zeratsky KA, Rieck TM, Molina L, Capetillo GP, Ahmed Y, Drie H, Wieland ML. Negative Mood is Associated with Sociobehavioral Factors Contributing to Cardiovascular Risk in an Immigrant Population. Res Sq 2024:rs.3.rs-3934645. [PMID: 38559259 PMCID: PMC10980105 DOI: 10.21203/rs.3.rs-3934645/v1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Immigrants to the United States, on average, accumulate cardiovascular risk after resettlement, including obesity. There is a need to co-create interventions to address these disparities, and mood may be an important mediating factor. Methods The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered "negative", while ratings of good, very good, or excellent were considered "positive". Results A total of 449 HIC participants (268 Hispanic/Latino and 181 Somali) with complete baseline measures and were included in this analysis. Participants endorsing negative mood compared to those endorsing positive mood had lower scores for healthy eating (p = 0.02) and physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood also reported receiving less social support from their family and friends to eat healthy (p = < 0.001) and be physically active (p = 0.01), and less often accessed community resources for healthy eating (p = 0.001) and physical activity (p = < 0.01) compared to participants reporting positive mood. Conclusions Negative mood was associated with less healthy nutrition, lower confidence in eating healthy, sedentary lifestyle, and perceived lack of belonging to the community. Integrating mood management and self-efficacy strategies may enhance the effectiveness of lifestyle interventions among immigrants who report negative mood. ClinicalTrialsgov registration NCT05136339; April 23, 2022.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Hana Drie
- Rochester Healthy Community Partnership
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3
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Wieland ML, Molina L, Goodson M, Capetillo GP, Osman A, Ahmed Y, Elmi H, Nur O, Iteghete SO, Torres-Herbeck G, Dirie H, Clark MM, Lohr AM, Smith K, Zeratsky K, Rieck T, Herrin J, Valente TW, Sia IG. Healthy immigrant community study protocol: A randomized controlled trial of a social network intervention for cardiovascular risk reduction among Hispanic and Somali adults. Contemp Clin Trials 2024; 138:107465. [PMID: 38309526 PMCID: PMC10923143 DOI: 10.1016/j.cct.2024.107465] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/18/2023] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Immigrants to the United States face structural barriers that contribute to rising cardiovascular risk factors and obesity after immigration. This manuscript describes the development of the Healthy Immigrant Community protocol and baseline measures for a stepped wedge cluster randomized trial to test the effectiveness of a social network intervention for cardiovascular risk reduction among two immigrant populations. METHODS We developed a social network-informed, community-based, participatory research-derived health promotion intervention with Hispanic and Somali immigrant communities in Minnesota consisting of mentoring, educational and motivational sessions, group activities, and a community toolkit for healthy weight loss delivered by culturally concordant health promoters (HPs) to their social networks. Using a stepped wedge cluster randomized design, social network-based groups were randomly assigned to receive the intervention either immediately or after a delay of one year. Outcomes, measured at baseline, 6 months, 12 months, and 24 months, were derived from the American Heart Association's "Life's Simple 7": BMI and waist circumference, blood pressure, fasting blood glucose, total cholesterol, physical activity level, and dietary quality. RESULTS A total of 51 HPs were enrolled and randomized (29 Hispanic; 22 Somali). There were 475 participants enrolled in the study, representing a mean social network group size of 8 (range, 5-12). The mean BMI of the sample (32.2) was in the "obese" range. CONCLUSION Processes and products from this Healthy Immigrant Community protocol are relevant to other communities seeking to reduce cardiovascular risk factors and negative health behaviors among immigrant populations by leveraging the influence of their social networks.
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Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership.
| | | | - Miriam Goodson
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership; Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Ahmed Osman
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Yahye Ahmed
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | - Hindi Elmi
- Rochester Healthy Community Partnership; Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Omar Nur
- Rochester Healthy Community Partnership; Somali American Social Service Association, Rochester, MN, USA
| | | | - Gloria Torres-Herbeck
- Rochester Healthy Community Partnership; Alliance for Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | | | - Matthew M Clark
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA; Rochester Healthy Community Partnership
| | | | - Katherine Zeratsky
- Rochester Healthy Community Partnership; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Thomas Rieck
- Rochester Healthy Community Partnership; Department of Integrative Medicine and Health, Mayo Clinic, Rochester, MN, USA
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Thomas W Valente
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Irene G Sia
- Rochester Healthy Community Partnership; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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Baumeister A, Aldin A, Chakraverty D, Hübner C, Adams A, Monsef I, Skoetz N, Kalbe E, Woopen C. Interventions for improving health literacy in migrants. Cochrane Database Syst Rev 2023; 11:CD013303. [PMID: 37963101 PMCID: PMC10645402 DOI: 10.1002/14651858.cd013303.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Health literacy (HL) is a determinant of health and important for autonomous decision-making. Migrants are at high risk for limited HL. Improving HL is important for equitable promotion of migrants' health. OBJECTIVES To assess the effectiveness of interventions for improving HL in migrants. To assess whether female or male migrants respond differently to the identified interventions. SEARCH METHODS We ran electronic searches to 2 February 2022 in CENTRAL, MEDLINE, Embase, PsycInfo and CINAHL. We also searched trial registries. We used a study filter for randomised controlled trials (RCTs) (RCT classifier). SELECTION CRITERIA We included RCTs and cluster-RCTs addressing HL either as a concept or its components (access, understand, appraise, apply health information). DATA COLLECTION AND ANALYSIS We used the methodological procedures recommended by Cochrane and followed the PRISMA-E guidelines. Outcome categories were: a) HL, b) quality of life (QoL), c) knowledge, d) health outcomes, e) health behaviour, f) self-efficacy, g) health service use and h) adverse events. We conducted meta-analysis where possible, and reported the remaining results as a narrative synthesis. MAIN RESULTS We included 28 RCTs and six cluster-RCTs (8249 participants), all conducted in high-income countries. Participants were migrants with a wide range of conditions. All interventions were adapted to culture, language and literacy. We did not find evidence that HL interventions cause harm, but only two studies assessed adverse events (e.g. anxiety). Many studies reported results for short-term assessments (less than six weeks after total programme completion), reported here. For several comparisons, there were also findings at later time points, which are presented in the review text. Compared with no HL intervention (standard care/no intervention) or an unrelated HL intervention (similar intervention but different information topic) Self-management programmes (SMP) probably improve self-efficacy slightly (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.50; 2 studies, 333 participants; moderate certainty). SMP may improve HIV-related HL (understanding (mean difference (MD) 4.25, 95% CI 1.32 to 7.18); recognition of HIV terms (MD 3.32, 95% CI 1.28 to 5.36)) (1 study, 69 participants). SMP may slightly improve health behaviours (3 studies, 514 participants), but may have little or no effect on knowledge (2 studies, 321 participants) or subjective health status (MD 0.38, 95% CI -0.13 to 0.89; 1 study, 69 participants) (low certainty). We are uncertain of the effects of SMP on QoL, health service use or adverse events due to a lack of evidence. HL skills building courses (HLSBC) may improve knowledge (MD 10.87, 95% CI 5.69 to 16.06; 2 studies, 111 participants) and any generic HL (SMD 0.48, 95% CI 0.20 to 0.75; 2 studies, 229 participants), but may have little or no effect on depression literacy (MD 0.17, 95% CI -1.28 to 1.62) or any health behaviour (2 studies, 229 participants) (low certainty). We are uncertain if HLSBC improve QoL, health outcomes, health service use, self-efficacy or adverse events, due to very low-certainty or a lack of evidence. Audio-/visual education without personal feedback (AVE) probably improves depression literacy (MD 8.62, 95% CI 7.51 to 9.73; 1 study, 202 participants) and health service use (MD -0.59, 95% CI -1.11 to -0.07; 1 study, 157 participants), but probably has little or no effect on health behaviour (risk ratio (RR) 1.07, 95% CI 0.91 to 1.25; 1 study, 135 participants) (moderate certainty). AVE may improve self-efficacy (MD 3.51, 95% CI 2.53 to 4.49; 1 study, 133 participants) and may slightly improve knowledge (MD 8.44, 95% CI -2.56 to 19.44; 2 studies, 293 participants) and intention to seek depression treatment (MD 1.8, 95% CI 0.43 to 3.17), with little or no effect on depression (SMD -0.15, 95% CI -0.40 to 0.10) (low certainty). No evidence was found for QoL and adverse events. Adapted medical instruction may improve understanding of health information (3 studies, 478 participants), with little or no effect on medication adherence (MD 0.5, 95% CI -0.1 to 1.1; 1 study, 200 participants) (low certainty). No evidence was found for QoL, health outcomes, knowledge, health service use, self-efficacy or adverse events. Compared with written information on the same topic SMP probably improves health numeracy slightly (MD 0.7, 95% CI 0.15 to 1.25) and probably improves print literacy (MD 9, 95% CI 2.9 to 15.1; 1 study, 209 participants) and self-efficacy (SMD 0.47, 95% CI 0.3 to 0.64; 4 studies, 552 participants) (moderate certainty). SMP may improve any disease-specific HL (SMD 0.67, 95% CI 0.27 to 1.07; 4 studies, 955 participants), knowledge (MD 11.45, 95% CI 4.75 to 18.15; 6 studies, 1101 participants) and some health behaviours (4 studies, 797 participants), with little or no effect on health information appraisal (MD 1.15, 95% CI -0.23 to 2.53; 1 study, 329 participants) (low certainty). We are uncertain whether SMP improves QoL, health outcomes, health service use or adverse events, due to a lack of evidence or low/very low-certainty evidence. AVE probably has little or no effect on diabetes HL (MD 2, 95% CI -0.15 to 4.15; 1 study, 240 participants), but probably improves information appraisal (MD -9.88, 95% CI -12.87 to -6.89) and application (RR 1.51, 95% CI 1.29 to 1.77) (1 study, 608 participants; moderate certainty). AVE may slightly improve knowledge (MD 8.35, 95% CI -0.32 to 17.02; low certainty). No short-term evidence was found for QoL, depression, health behaviour, self-efficacy, health service use or adverse events. AVE compared with another AVE We are uncertain whether narrative videos are superior to factual knowledge videos as the evidence is of very low certainty. Gender differences Female migrants' diabetes HL may improve slightly more than that of males, when receiving AVE (MD 5.00, 95% CI 0.62 to 9.38; 1 study, 118 participants), but we do not know whether female or male migrants benefit differently from other interventions due to very low-certainty or a lack of evidence. AUTHORS' CONCLUSIONS Adequately powered studies measuring long-term effects (more than six months) of HL interventions in female and male migrants are needed, using well-validated tools and representing various healthcare systems.
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Affiliation(s)
- Annika Baumeister
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
| | - Angela Aldin
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Digo Chakraverty
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Constanze Hübner
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christiane Woopen
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
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McAuley EA, MacLaughlin HL, Hannan-Jones MT, King N, Ross LJ. Effectiveness of diet quality indices in measuring a change in diet quality over time: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2023; 81:361-383. [PMID: 36102824 DOI: 10.1093/nutrit/nuac063] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
CONTEXT Diet quality indices (DQIs) were developed to score and rank adherence to dietary patterns in observational studies, but their use to measure changes in diet quality in intervention trials is becoming common in the literature. OBJECTIVE This systematic review and meta-analysis aimed to assess the effectiveness of DQIs to measure change in diet quality in intervention trials. DATA SOURCES MEDLINE, CINAHL, Embase, and the Cochrane Central Register of Controlled Trials databases were searched from January 1994 to June 2020. Two reviewers independently completed full-text screening. Eligible studies were randomized controlled trials that used validated a priori DQIs to measure change in diet quality in adults. DATA EXTRACTION Data were extracted by an independent reviewer and reviewed by the research team. Risk of bias was assessed by the Cochrane Collaboration's Risk of Bias 2.0 tool. DATA ANALYSIS The 34 included studies (52% of reviewed studies, 0.6% of initially identified studies) used 10 different DQIs, 7 of which were able to measure significant change in diet quality. Meta-analyses of pooled results demonstrated change in the Healthy Eating Index (MD 5.35; 95%CI, 2.74-7.97; P < 0.001) and the Mediterranean Dietary Adherence Screener (MD 1.61; 95%CI, 1.00-2.23; P < 0.001) scores. DQIs were more likely to measure change in diet quality if they reflected the diet pattern being implemented, if the intervention was significantly different from the baseline and control diets, and if the study was adequately powered to detect change. CONCLUSION DQIs are responsive to change in diet quality in intervention trials when the index used reflects the dietary changes made and the study is adequately powered. The appropriate selection of a DQI to suitably match dietary changes and study populations is important for future dietary intervention trials. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020181357.
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Affiliation(s)
- Erynn A McAuley
- are with the School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,are with the Department of Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Helen L MacLaughlin
- are with the School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,are with the Department of Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Mary T Hannan-Jones
- are with the School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,are with the Department of Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Neil King
- are with the School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Lynda J Ross
- are with the School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,are with the Department of Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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6
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Valenzuela R, Morales A, Sheen J, Rangel S, Salinas JJ. The Implementation of Evidence-Based Obesity Education Curricula to Prevent Cancer in a Predominantly Mexican-American Community on the U.S.-Mexico Border. J Cancer Educ 2023; 38:215-224. [PMID: 34623603 PMCID: PMC8498764 DOI: 10.1007/s13187-021-02101-3] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 05/03/2023]
Abstract
Although cancer is the leading cause of death among Mexican-Americans, few community-based programs target obesity reduction as a way to reduce the prevalence of obesity-related cancer in underserved populations. Evidence suggests that obesity correlates with 13 types of cancer. The objective is to provide an overview of evaluation and selection of evidence-based content; details of the implementation process; modifications needed to tailor education programs to specific needs of different target audiences; and demonstrate challenges of implementing a community-based prevention program intended to reduce cancer incidence and mortality in Mexican-Americans. We used the Social Cognitive Theory (SCT) to develop a 10-topic menu of educational classes using elements of multiple evidence-based curricula. Outcome measures for physical activity and nutrition were determined using the International Physical Activity Questionnaire (IPAQ) and the Dietary Screener Questionnaire (DSQ). Weight status was determined using weight, body fat, and body mass index (BMI). To date, 2845 adults received wellness education from our program. Multiple delivery models were used to reach a larger audience; they included a 4-week model, 5-week model, employer model, low-income housing, 1- and 2-h sessions, and clinic encounters. Individuals were given education at multiple community locations including senior centers (14%), churches (0.6%), employers (17.6%), low-income housing (8.2%), community centers (16.6%), clinics (11.5%), and schools (32.5%). Our study indicates that our delivery model is feasible and can disseminate evidence-based obesity education. Further investigation is necessary to assess long-term behavioral change and to assess the most effective model for delivery.
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Affiliation(s)
- Roy Valenzuela
- Center of Emphasis in Cancer, Texas Tech University Health Sciences Center, 5001 El Paso Dr El Paso, El Paso, TX, 79905-2827, USA
| | - Alma Morales
- Center of Emphasis in Cancer, Texas Tech University Health Sciences Center, 5001 El Paso Dr El Paso, El Paso, TX, 79905-2827, USA
| | - Jon Sheen
- Center of Emphasis in Cancer, Texas Tech University Health Sciences Center, 5001 El Paso Dr El Paso, El Paso, TX, 79905-2827, USA
| | - Sylvia Rangel
- Center of Emphasis in Cancer, Texas Tech University Health Sciences Center, 5001 El Paso Dr El Paso, El Paso, TX, 79905-2827, USA
| | - Jennifer J Salinas
- Center of Emphasis in Cancer, Texas Tech University Health Sciences Center, 5001 El Paso Dr El Paso, El Paso, TX, 79905-2827, USA.
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Wieland ML, Njeru JW, Weis JA, Lohr A, Nigon JA, Goodson M, Osman A, Molina L, Ahmed Y, Capetillo GP, Nur O, Sia IG. Rochester Healthy Community Partnership: Then and now. Front Public Health 2023; 10:1090131. [PMID: 36703848 PMCID: PMC9871468 DOI: 10.3389/fpubh.2022.1090131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Community-engaged research partnerships promote health equity through incorporation of regional contexts to inform partnership dynamics that shape research and interventions that reflect community voice and priorities. Long-term partnerships build trusted relationships and promote capacity building among community and academic partners, but there are many structural barriers to sustaining long-term partnerships. Here we describe lessons learned from sustaining Rochester Healthy Community Partnership (RHCP), an 18-year community-based participatory research (CBPR) partnership in Southeast Minnesota. RHCP collaborates with immigrant and refugee populations to co-create interventions that promote health equity for community health priorities. Challenges to sustainability include a tension between project-based funding and the needs of long-term community-based research infrastructure. These challenges can be met with a focus on shared CBPR principles, operating norms, partnership dynamics, and governance. RHCP began in 2004 through identification of a community health priority, defining the community, and establishment of CBPR principles. It grew through identification of broader community health priorities, capacity building for community and academic partners, and integration of diverse learners. We describe the capacity for RHCP to respond to new societal contexts, the importance of partnership dynamics as a barometer for partnership health, and lessons learned about sustainability of the CBPR partnership.
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Affiliation(s)
- Mark L. Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States,*Correspondence: Mark L. Wieland ✉
| | - Jane W. Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Jennifer A. Weis
- Rochester Healthy Community Partnership, Rochester, MN, United States,Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Abby Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Julie A. Nigon
- Rochester Healthy Community Partnership, Rochester, MN, United States,Hawthorne Education Center, Rochester, MN, United States
| | - Miriam Goodson
- Rochester Healthy Community Partnership, Rochester, MN, United States,Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, United States
| | - Ahmed Osman
- Rochester Healthy Community Partnership, Rochester, MN, United States,Intercultural Mutual Assistance Association, Rochester, MN, United States
| | - Luz Molina
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Yahye Ahmed
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Omar Nur
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Irene G. Sia
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
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8
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Alsubhi M, Epton T, Goldthorpe J, Peters S. A qualitative investigation of the health behaviours of young children from refugee families using photo elicitation interviews. Health Psychol Behav Med 2022; 10:1086-1109. [PMID: 36388870 PMCID: PMC9645284 DOI: 10.1080/21642850.2022.2141245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives To explore the experiences and perspectives of refugee parents regarding health behaviour changes among their children (i.e. changes in diet, levels of physical activity) and the impact of these changes on the health of their children aged 2–12 years. Design A qualitative approach using semi-structured interviews supported by photo-elicitation. Methods Parents of 2–12 years old children who had relocated to the UK within the past three or more years were recruited from two refugee organisations in the UK. Semi-structured face-to-face interviews and photo-elicitation were used to stimulate face-to-face in-depth discussions with participants. Data were analysed using an inductive and latent thematic analysis approach. Results Twenty-seven parent refugees were recruited. Participants were primarily mothers (85%) and from Syria (70%). Other countries of origin were Sudan, Eritrea, Iraq, Kuwait, Libya and Tunisia. Twenty-six interviews were conducted in Arabic and one in English. The analysis identified three themes: (1) Reflection on acculturation, (2) Changed parental role, and (3) Environmental barriers to being healthy. Participants described facing substantial changes to their lifestyle and personal context, including a restricted living space, restricted neighbourhood/community and inclement weather. These differences in the environment required parents to adjust their roles, and practices around their own and their child’s eating habits. These changes influenced refugee children’s health behaviours. Of particular concern to parents were increased sedentary behaviour and consumption of unhealthy snacks. Conclusions Multiple factors were identified relating to changes in family circumstances and environments that influenced refugee children’s health behaviours. Targeting these behaviours in tailored interventions may help improve refugee children’s health.
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Affiliation(s)
- Maha Alsubhi
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Tracy Epton
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Joanna Goldthorpe
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
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Hodder RK, O'Brien KM, Lorien S, Wolfenden L, Moore TH, Hall A, Yoong SL, Summerbell C. Interventions to prevent obesity in school-aged children 6-18 years: An update of a Cochrane systematic review and meta-analysis including studies from 2015-2021. EClinicalMedicine 2022; 54:101635. [PMID: 36281235 PMCID: PMC9581512 DOI: 10.1016/j.eclinm.2022.101635] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Childhood obesity remains a global public health priority due to the enormous burden it generates. Recent surveillance data suggests there has been a sharp increase in the prevalence of childhood obesity during the COVID-19 pandemic. The Cochrane review of childhood obesity prevention interventions (0-18 years) updated to 2015 is the most rigorous and comprehensive review of randomised controlled trials (RCTs) on this topic. A burgeoning number of high quality studies have been published since that are yet to be synthesised. METHODS An update of the Cochrane systematic review was conducted to include RCT studies in school-aged children (6-18 years) published to 30 June 2021 that assessed effectiveness on child weight (PROSPERO registration: CRD42020218928). Available cost-effectiveness and adverse effect data were extracted. Intervention effects on body mass index (BMI) were synthesised in random effects meta-analyses by setting (school, after-school program, community, home), and meta-regression examined the association of study characteristics with intervention effect. FINDINGS Meta-analysis of 140 of 195 included studies (183,063 participants) found a very small positive effect on body mass index for school-based studies (SMD -0·03, 95%CI -0·06,-0·01; trials = 93; participants = 131,443; moderate certainty evidence) but not after-school programs, community or home-based studies. Subgroup analysis by age (6-12 years; 13-18 years) found no differential effects in any setting. Meta-regression found no associations between study characteristics (including setting, income level) and intervention effect. Ten of 53 studies assessing adverse effects reported presence of an adverse event. Insufficient data was available to draw conclusions on cost-effectiveness. INTERPRETATION This updated synthesis of obesity prevention interventions for children aged 6-18 years, found a small beneficial impact on child BMI for school-based obesity prevention interventions. A more comprehensive assessment of interventions is required to identify mechanisms of effective interventions to inform future obesity prevention public health policy, which may be particularly salient in for COVID-19 recovery planning. FUNDING This research was funded by the National Health and Medical Research Council (NHMRC), Australia (Application No APP1153479).
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Affiliation(s)
- Rebecca K. Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Longworth Avenue, Wallsend, NSW 2287, Australia
- College of Health Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, 29 Kookaburra Drive, New Lambton Heights, NSW 2305, Australia
- Corresponding author at: C/- Hunter New England Population Health, Locked Bag 10, Wallsend NSW 2287 Australia.
| | - Kate M. O'Brien
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Longworth Avenue, Wallsend, NSW 2287, Australia
- College of Health Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, 29 Kookaburra Drive, New Lambton Heights, NSW 2305, Australia
| | - Sasha Lorien
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Longworth Avenue, Wallsend, NSW 2287, Australia
- College of Health Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, 29 Kookaburra Drive, New Lambton Heights, NSW 2305, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Longworth Avenue, Wallsend, NSW 2287, Australia
- College of Health Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, 29 Kookaburra Drive, New Lambton Heights, NSW 2305, Australia
| | - Theresa H.M. Moore
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol National Health Service Foundation Trust, Whitefriars, Lewins Mean, Bristol, BS1 2NT, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Beacon House, Queens Road, Bristol, United Kingdom
| | - Alix Hall
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Longworth Avenue, Wallsend, NSW 2287, Australia
- College of Health Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, 29 Kookaburra Drive, New Lambton Heights, NSW 2305, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Longworth Avenue, Wallsend, NSW 2287, Australia
- College of Health Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- National Centre of Implementation Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, 29 Kookaburra Drive, New Lambton Heights, NSW 2305, Australia
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Burwood, VIC 3125, Australia
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Stockton Road, Durham DH1 3LE, United Kingdom
- Fuse, The NIHR Centre for Translational Research in Public Health, United Kingdom
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Kim Y, Lee H, Chung ML. Living labs for a mobile app-based health program: effectiveness of a 24-week walking intervention for cardiovascular disease risk reduction among female Korean-Chinese migrant workers: a randomized controlled trial. Arch Public Health 2022; 80:181. [PMID: 35927769 PMCID: PMC9351079 DOI: 10.1186/s13690-022-00941-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background The risk of Cardiovascular disease (CVDs) among adult populations is influenced by environmental factors, and immigrant populations tend to be more vulnerable. This study examined the effectiveness of a 24-week walking program based on social-cognitive determinants through mobile app for CVD risk reduction among female Korean-Chinese middle-aged workers. Methods This study used a parallel randomized controlled trial. Participants were recruited by distributing posters and flyers and randomly assigned to either the standard treatment (ST, n = 22) or enhanced treatment group (ET, n = 28). Participants were provided with a mobile app linked to Fitbit Alta for 24 weeks and instructed to walk at least 30 minutes five times a week and moderate-intensity physical activity. The ET group had additional interventions that enhanced social-cognitive determinants such as self-efficacy, social support. All participants were guided to voluntary physical activity during the 12-week maintenance period. Data were analyzed by the Mann Whitney U-test and a generalized estimating equation. Results There were significant between-group differences regarding the number of steps (B = 1.295, P < .001) and moderate physical activity time (OR = 6.396, P = .030) at week 12. ET group had significant changes in high-density lipoprotein cholesterol (B = 10.522, P = .007), low-density lipoprotein cholesterol (B = -16.178, P = .024), total cholesterol (B = -20.325, P = .039), fasting blood sugar (B = − 8.138, P = -.046). In addition, there was a significant reduction of 10-year CVD risk for the ET group over 12 weeks compared to the ST group (B = -0.521, P<. 001). Conclusions Long-term studies are needed to reduce the risk of cardiovascular disease in large-scale migrant workers and to confirm the direct and insdirect effects of social-cognitive determinants on health outcomes. Trial registration The trial was retrospectively registered in WHO ICTRP (KCT0006467) August 19th, 2021. (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0006467,
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11
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Mirza S, Kandasamy S, de Souza RJ, Wahi G, Desai D, Anand SS, Ritvo P. Barriers and facilitators to healthy active living in South Asian families in Canada: a thematic analysis. BMJ Open 2022; 12:e060385. [PMID: 36368751 PMCID: PMC9660572 DOI: 10.1136/bmjopen-2021-060385] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The study objective was to understand the barriers and facilitators to healthy active living in South Asian families living in Canada. DESIGN Semi-structured interviews of 30-60-minute duration with South Asian women with young families, and analysed using a thematic analytical approach. SETTING Community-dwelling South Asian women interviewed in the home environment or by phone. PARTICIPANTS Fifteen married South Asian women (mean age=34.2 years) living in the Peel region of Ontario, Canada, with at least 1 child under the age of 5 years. The majority of women had immigrated to Canada (13/15), during a 5-10-year interval preceding interviews. RESULTS 57 different codes were derived from 18 interview hours, and further evaluated through member checking. The top three barriers to healthy eating were: (1) not having enough time for healthy food preparation, (2) lack of knowledge about what is healthy eating and (3) viewing healthy eating as a matter of engaging in time limited dieting. These barriers were addressed with: (1) knowledge and awareness of healthy eating, (2) clear goal setting, (3) access to fresh vegetables and fruits and (4) better arrangements and more time for food preparation. The top five barriers to physical activity were: (1) not enough time and energy, (2) competing priorities, (3) lack of childcare, (4) lack of family-engaging exercise and (5) limited access to interesting exercise programming. These barriers were addressed by: (1) experiencing exercise as enjoyable and stress releasing, (2) commitments to walking exercise, (3) use of an electronic exercise-tracking device, (4) offspring exercise supported by spouse and family and (5) success stories about exercise from others. CONCLUSIONS Barriers to healthy active living in South Asian women with young families can be addressed with facilitators that stimulate clear goal setting and healthy food preparation skills, and exercise formats that engage mothers and offspring, with or without exercise tracking.
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Affiliation(s)
- Sabina Mirza
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sujane Kandasamy
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
| | - Gita Wahi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Dipika Desai
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S Anand
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Paul Ritvo
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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12
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Champion KE, Gardner LA, McCann K, Hunter E, Parmenter B, Aitken T, Chapman C, Spring B, Thornton L, Slade T, Teesson M, Newton NC. Parent-based interventions to improve multiple lifestyle risk behaviors among adolescents: A systematic review and meta-analysis. Prev Med 2022; 164:107247. [PMID: 36075490 DOI: 10.1016/j.ypmed.2022.107247] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/11/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022]
Abstract
Lifestyle risk behaviors often co-occur and are prevalent among adolescents. Parent-based interventions addressing risk behaviors concurrently have the potential to improve youth and parent outcomes. This systematic review evaluated the efficacy of parent-based interventions targeting multiple lifestyle risk behaviors among adolescents and parents. MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), Scopus, CINAHL, the Cochrane Database of Systematic Reviews (CDSR) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 2010-May 2021. Eligible studies were randomised controlled trials (RCTs) of parent-based interventions addressing 2+ risk behaviors: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviors, and poor sleep. Studies directly targeting parents, and that assessed adolescent outcomes (11-18 years) were eligible. Where possible, random-effects meta-analysis was conducted. From 11,975 identified records, 46 publications of 36 RCTs (n = 28,322 youth, n = 7385 parents) were eligible. Parent-based interventions were associated with improved adolescent moderate-to-vigorous physical activity (MVPA) [Odds Ratio (OR) = 1.82, 95% CI = 1.18, 2.81; p = 0.007], and reduced screen time (SMD = -0.39, 95% CI = -0.62, -0.16, p = 0.0009) and discretionary food intake (SMD = -0.18; 95% CI = -0.30, -0.06; p = 0.002) compared to controls. However, there was some evidence that interventions increased the odds of ever using tobacco in the medium-term (OR = 1.47, 95% CI = 0.99, 2.18, p = 0.06) and of past month tobacco use in the long-term (OR = 1.46, 95% CI = 1.12, 1.90; p = 0.005). Overall, the quality of evidence was moderate. Parent-based interventions targeting multiple risk behaviors improved adolescent MVPA, and reduced screen time discretionary food intake. Further research is needed to address sleep problems and increase intervention efficacy, particularly for alcohol and tobacco use.
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Affiliation(s)
- Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia.
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia
| | - Karrah McCann
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia
| | - Emily Hunter
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia
| | - Belinda Parmenter
- School of Health Sciences, Faculty of Medicine and Health, Wallace Wurth Building (C27), Cnr High St & Botany St, UNSW Sydney, Sydney, Australia
| | - Tess Aitken
- University of Sydney Library, University of Sydney, Sydney 2006, NSW, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr, Suite 1400, Chicago, IL 60611, United States
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia; School of Medicine and Public Health, The University of Newcastle, University Dr, Callahan NSW, 2308 Newcastle, Australia; School of Public Health and Community Medicine UNSW, UNSW Sydney, NSW 2052, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Level 6, Jane Foss Russell Building GO2, University of Sydney, Camperdown, 2006 Sydney, Australia
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13
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Patnode CD, Redmond N, Iacocca MO, Henninger M. Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2022; 328:375-388. [PMID: 35881116 DOI: 10.1001/jama.2022.7408] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Unhealthful dietary patterns, low levels of physical activity, and high sedentary time increase the risk of cardiovascular disease. OBJECTIVE To synthesize the evidence on benefits and harms of behavioral counseling interventions to promote a healthy diet and physical activity in adults without known cardiovascular disease (CVD) risk factors to inform a US Preventive Services Task Force recommendation. DATA SOURCES MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials through February 2021, with ongoing surveillance through February 2022. STUDY SELECTION Randomized clinical trials (RCTs) of behavioral counseling interventions targeting improved diet, increased physical activity, or decreased sedentary time among adults without known elevated blood pressure, elevated lipid levels, or impaired fasting glucose. DATA EXTRACTION AND SYNTHESIS Independent data abstraction and study quality rating and random effects meta-analysis. MAIN OUTCOMES AND MEASURES CVD events, CVD risk factors, diet and physical activity measures, and harms. RESULTS One-hundred thirteen RCTs were included (N = 129 993). Three RCTs reported CVD-related outcomes: 1 study (n = 47 179) found no significant differences between groups on any CVD outcome at up to 13.4 years of follow-up; a combined analysis of the other 2 RCTs (n = 1203) found a statistically significant association of the intervention with nonfatal CVD events (hazard ratio, 0.27 [95% CI, 0.08 to 0.88]) and fatal CVD events (hazard ratio, 0.31 [95% CI, 0.11 to 0.93]) at 4 years. Diet and physical activity behavioral counseling interventions were associated with small, statistically significant reductions in continuous measures of blood pressure (systolic mean difference, -0.8 [95% CI, -1.3 to -0.3]; 23 RCTs [n = 57 079]; diastolic mean difference, -0.4 [95% CI, -0.8 to -0.0]; 24 RCTs [n = 57 148]), low-density lipoprotein cholesterol level (mean difference, 2.2 mg/dL [95% CI, -3.8 to -0.6]; 15 RCTs [n = 6350]), adiposity-related outcomes (body mass index mean difference, -0.3 [95% CI, -0.5 to -0.1]; 27 RCTs [n = 59 239]), dietary outcomes, and physical activity at 6 months to 1.5 years of follow-up vs control conditions. There was no evidence of greater harm among intervention vs control groups. CONCLUSIONS AND RELEVANCE Healthy diet and physical activity behavioral counseling interventions for persons without a known risk of CVD were associated with small but statistically significant benefits across a variety of important intermediate health outcomes and small to moderate effects on dietary and physical activity behaviors. There was limited evidence regarding the long-term health outcomes or harmful effects of these interventions.
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Affiliation(s)
- Carrie D Patnode
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Megan O Iacocca
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Michelle Henninger
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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Sanz-Remacha M, Aibar A, Abós Á, Generelo-Lanaspa E, García-González L. A Community-Based Participatory Action Research with Women from Disadvantaged Populations: Strengths and Weaknesses of a Multiple Health Behaviour Change Intervention. Int J Environ Res Public Health 2022; 19:6830. [PMID: 35682413 DOI: 10.3390/ijerph19116830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 02/04/2023]
Abstract
Disadvantaged populations usually adopt risk behaviours, resulting in obesity and mental health-related disorders. Grounded in the socioecological model and self-determination theory, the aims were firstly to describe and implement a two-year multiple health behaviour change intervention, and secondly, to assess the strengths and weaknesses of the intervention. In total, 11 women from a disadvantaged population participated in this programme, which encompassed 117 sessions. Qualitative techniques were used to collect data and a thematic analysis was conducted. The variety of activities and the group-based intervention were the main strengths, and the decrease in attendance and the programme’s tight schedule were the main weaknesses. This is the first intervention in a disadvantaged population mainly comprised of Roma women. The design described in detail and its assessment provide relevant knowledge to improve their health status and decrease inequalities. The practical implications for future research are useful for replicating interventions in similar contexts.
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15
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Gagliardi AR, Morrison C, Anderson NN. The design and impact of culturally-safe community-based physical activity promotion for immigrant women: descriptive review. BMC Public Health 2022; 22:430. [PMID: 35241058 PMCID: PMC8895569 DOI: 10.1186/s12889-022-12828-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 12/23/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Immigrant women have low rates of physical activity (PA), placing them at risk for chronic diseases. Some research suggests that strategies targeting this group must be culturally-safe and community-based. This study aimed to identify the design (i.e. characteristics) and impact of culturally-safe community-based PA promotion for immigrant women. METHODS We conducted a descriptive review by searching MEDLINE, EMBASE, SPORTDiscus, CINAHL, SCOPUS, Cochrane Library and Joanna Briggs Institute Database of Systematic Reviews from inception to June 9, 2021 for English language studies that assessed community-based PA promotion strategies targeting adult immigrants and involved at least 50% women. We compiled findings in a preliminary context-mechanisms-outcomes conceptual framework. RESULTS We included 13 studies published from 2004 to 2020. Three included women-only; the remainder included a median of 63% women (range 50 to 98%). Studies included immigrants from Brazil, Dominican, Columbian, Haiti, Mexico, China, Vietnam, Bangladesh, India, Pakistan, Somalia, Sudan and Turkey. All but one study (89%) significantly improved one or more outcomes: PA knowledge, PA participation and anthropometric measures (e.g. weight, BMI, blood pressure). Most (89%) strategies were multi-faceted: in-person group educational sessions reinforced by take-home educational material and/or follow-up reminder phone calls. Single strategies (e.g. mailed educational material, group educational session) also achieved beneficial outcomes. We identified 17 culturally-safe characteristics of PA promotion strategies: language of choice, based in community settings or organizations, led by lay health workers, reflected ethno-cultural linguistic expressions and PA norms, and recognized and offered solutions to barriers of PA. Findings were captured in a preliminary theory of how contextual factors (gender, intersectionality) and mechanism (culturally-safe PA promotion) may influence PA-related outcomes (PA knowledge, self-efficacy and participation; anthropometric measures, quality of life). CONCLUSIONS This study revealed the characteristics of PA promotion strategies that significantly improved PA-related outcomes among immigrants. Given that few studies focused solely on immigrant women or reported sub-analyses, the conceptual framework generated by this study can be used in future research to more definitively establish the design and impact of culturally-safe, community-based PA promotion for immigrant women.
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Affiliation(s)
- Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, 13EN-228 200 Elizabeth Street, Toronto, ON, M5G2C4, Canada.
| | - Ciara Morrison
- Toronto General Hospital Research Institute, University Health Network, 13EN-228 200 Elizabeth Street, Toronto, ON, M5G2C4, Canada
| | - Natalie N Anderson
- Toronto General Hospital Research Institute, University Health Network, 13EN-228 200 Elizabeth Street, Toronto, ON, M5G2C4, Canada
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Wieland ML, Asiedu GB, Njeru JW, Weis JA, Lantz K, Abbenyi A, Molina L, Ahmed Y, Osman A, Goodson M, Torres-Herbeck G, Nur O, Porraz Capetillo G, Mohamed AA, Sia IG. Community-Engaged Bidirectional Crisis and Emergency Risk Communication With Immigrant and Refugee Populations During the COVID-19 Pandemic. Public Health Rep 2022; 137:352-361. [PMID: 35023414 PMCID: PMC8900245 DOI: 10.1177/00333549211065514] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study was conducted to assess an intervention that was created by a community-academic partnership to address COVID-19 health inequities. We evaluated a community-engaged bidirectional pandemic crisis and emergency risk communication (CERC) framework with immigrant and refugee populations during the COVID-19 pandemic. METHODS A 17-year community-engaged research partnership adopted a CERC framework in March 2020 to address COVID-19 prevention, testing, and socioeconomic impacts with immigrant and refugee groups in southeast Minnesota. The partnership used bidirectional communication between communication leaders and their social networks to refine messages, leverage resources, and advise policy makers. We conducted a mixed-methods evaluation for intervention acceptability, feasibility, reach, adaptation, and sustainability through multisource data, including email communications, work group notes, semistructured interviews, and focus groups. RESULTS The intervention reached at least 39 000 people in 9 months. It was implemented as intended and perceived efficacy was high. Frequent communication between community and academic partners allowed the team to respond rapidly to concerns and facilitated connection of community members to resources. Framework implementation also led to systems and policy changes to meet the needs of immigrant and refugee populations. CONCLUSIONS Community-engaged CERC is feasible and sustainable and can reduce COVID-19 disparities through shared creation and dissemination of public health messages, enhanced connection to existing resources, and incorporation of community perspectives in regional pandemic mitigation policies.
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Affiliation(s)
- Mark L. Wieland
- Division of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Gladys B. Asiedu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Jane W. Njeru
- Division of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jennifer A. Weis
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, USA
| | - Kiley Lantz
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
| | - Adeline Abbenyi
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
| | - Luz Molina
- Language Services, Mayo Clinic, Rochester, MN, USA
| | - Yahye Ahmed
- Somali American Social Services Association, Rochester, MN, USA
| | - Ahmed Osman
- Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Miriam Goodson
- Alliance of Chicanos, Hispanics and Latin Americans, Rochester, MN, USA
| | | | - Omar Nur
- Somali American Social Services Association, Rochester, MN, USA
| | | | - Ahmed A. Mohamed
- Division of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Irene G. Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
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Barragan M, Luna V, Hammons AJ, Olvera N, Greder K, Drumond Andrade FC, Fiese B, Wiley A, Teran-Garcia M, Team TACR. Reducing Obesogenic Eating Behaviors in Hispanic Children through a Family-Based, Culturally-Tailored RCT: Abriendo Caminos. Int J Environ Res Public Health 2022; 19:ijerph19041917. [PMID: 35206123 PMCID: PMC8872523 DOI: 10.3390/ijerph19041917] [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] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023]
Abstract
Family-based interventions that incorporate culturally-tailored multi-component curricula and are grounded on evidence-based information and theoretical frameworks can help reduce the prevalence of obesity among Hispanic children. Abriendo Caminos: Clearing the Path to Hispanic Health is a multi-site culturally-tailored randomized control trial that aims to reduce obesity rates in Hispanic families by delivering education on nutrition, family wellness, and physical activity. This study evaluated the effect of the Abriendo Caminos six-week intervention on dietary behaviors of Hispanic children (6–18 years). Mothers (n = 365) reported their child’s eating behavior intake using the U.S. Department of Education’s Early Childhood Longitudinal Study protocol (ECLS). Pre/post dietary changes were evaluated using separate generalized estimating equation models adjusted for site, child sex, and child age group. Findings indicate a reduction in the frequency of sugar-sweetened beverages (OR 0.55, 95% CI 0.35, 0.87, p = 0.01), French fries (OR 0.56, 95% CI 0.36, 0.86, p = 0.009), and fast food (OR 0.55, 95% CI 0.36, 0.84, p = 0.006) consumption among children in the intervention arm. Additionally, children in the intervention arm increased their frequency of vegetable consumption (OR 1.84, 95% CI 1.08, 3.12, p = 0.03). The Abriendo Caminos intervention effectively improved four of eight eating behaviors in a short-term intervention.
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Affiliation(s)
- Maribel Barragan
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (M.B.); (V.L.)
| | - Viridiana Luna
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (M.B.); (V.L.)
| | - Amber J. Hammons
- Department of Child and Family Science, California State University, Fresno, CA 93740, USA;
| | - Norma Olvera
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA;
| | - Kimberly Greder
- Department of Human Development and Family Studies, Iowa State University, Ames, IA 50011, USA;
| | | | - Barbara Fiese
- Department of Human Development and Family Studies, Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
| | - Angela Wiley
- Department of Human Development and Family Science, Auburn University, Auburn, AL 36849, USA;
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA; (M.B.); (V.L.)
- Integrated Health Disparities Programs, University of Illinois Extension, Champaign, IL 61820, USA
- Carle Illinois College of Medicine, Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Correspondence:
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Wieland ML, Njeru JW, Asiedu GB, Zeratsky KA, Clark MM, Goetze R, Patten CA, Kelpin SS, Novotny P, Lantz K, Ahmed Y, Molina L, Porraz Capetillo G, Osman A, Goodson M, Sia I. Pilot Social Network Weight Loss Intervention With Two Immigrant Populations During the COVID-19 Pandemic. Am J Health Promot 2022; 36:458-471. [PMID: 35073499 PMCID: PMC8792912 DOI: 10.1177/08901171211053450] [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] [Indexed: 11/17/2022]
Abstract
Purpose To examine the feasibility and acceptability of a social network weight loss intervention delivered by lay health promoters (HPs) to immigrant populations. Design Single-arm, non-randomized, pilot study of a social network weight loss intervention developed by a community-based participatory research partnership and delivered by HPs. Setting Community-based setting in Southeastern Minnesota, United States. Sample Somali and Hispanic immigrants to the United States: 4 social networks of adults (2 Hispanic and 2 Somali) with 39 network participants. Intervention Twelve-week behavioral weight loss intervention delivered by HPs (4 weeks in-person and then 8 weeks virtual). Measures Feasibility was assessed by recruitment and retention rates. Acceptability was assessed by surveys and focus groups with HPs and participants. Behavioral measures included servings of fruits and vegetables, drinking soda, and physical activity. Physiologic measures included weight, blood pressure, glucose, cholesterol, and triglycerides. Analysis Paired t-tests of pre- to post-intervention changes at the end of 12 weeks of treatment. Results Recruitment was feasible and post-intervention was 100%. Participants highly rated the intervention on satisfaction, motivation, and confidence to eat a healthy diet, be physically active, and lose weight. Participants were motivated by group social support and cohesion of their social networks. On average, participants lost weight (91.6 ± 15.9 to 89.7 ± 16.6 kg, P < .0001), lowered their systolic blood pressure (133.9±16.9 to 127.2 ± 15.8 mm Hg; P < .001), lowered their diastolic blood pressure (81 ± 9.5 to 75.8 ± 9.6 mm Hg; P < .0001), had more servings of vegetables per day (1.9 ± 1.2 to 2.6 ± 1.4; P < .001), and increased their physical activity (2690 ± 3231 to 6595 ± 7322 MET-minutes per week; P = .02). Conclusion This pilot study of 2 immigrant communities who participated in a peer-led weight loss social network intervention delivered during the COVID-19 pandemic demonstrated high feasibility and acceptability. Participants lost weight, improved their health status, and improved their health behaviors.
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Affiliation(s)
- Mark L Wieland
- Division of Community Internal Medicine, 6915Mayo Clinic, Rochester, MN, USA
| | - Jane W Njeru
- Division of Community Internal Medicine, 6915Mayo Clinic, Rochester, MN, USA
| | - Gladys B Asiedu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 6915Mayo Clinic, Rochester, MN, USA
| | - Katherine A Zeratsky
- Division of Endocrinology, Department of Nutrition, 6915Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, 6915Mayo Clinic, Rochester, MN, USA
| | - Rachel Goetze
- Department of Psychiatry and Psychology, 6915Mayo Clinic, Rochester, MN, USA
| | - Christi A Patten
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 6915Mayo Clinic, Rochester, MN, USA
| | - Sydney S Kelpin
- Department of Psychiatry and Psychology, 6915Mayo Clinic, Rochester, MN, USA
| | - Paul Novotny
- Health Sciences Research, Biomedical Statistics and Informatics, 6915Mayo Clinic, Rochester, MN, USA
| | - Kiley Lantz
- Division of Infectious Diseases, 6915Mayo Clinic, Rochester, MN, USA
| | - Yahye Ahmed
- Somali American Social Services Association, Rochester, MN, USA
| | - Luz Molina
- Language Services, 6915Mayo Clinic, Rochester, MN, USA
| | | | - Ahmed Osman
- Intercultural Mutual Assistance Association, Rochester, MN, USA
| | - Miriam Goodson
- Alliance of Chicanos, Hispanics and Latin Americans, Rochester, MN, USA
| | - Irene Sia
- Division of Infectious Diseases, 6915Mayo Clinic, Rochester, MN, USA
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Guerra PH, Silvestre R, Mello THTD, Carvalho ALBS, Costa FFD, Florindo AA. Effects of community health worker-based interventions on physical activity levels in children: a systematic review. ACTA ACUST UNITED AC 2021; 40:e2020232. [PMID: 34706032 PMCID: PMC8547134 DOI: 10.1590/1984-0462/2022/40/2020232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022]
Abstract
Objective: To identify the strategies and effects of interventions carried out by community health workers (CHW) on physical activity (PA) levels in children and adolescents. Data source: In August 2020, a systematic review, designed according to the PRISMA checklist items, was conducted by searches in seven electronic databases and in reference lists. Original studies were searched without restriction with regard to year of publication; they were written in Spanish, English or Portuguese and examined interventions implemented by CHW, involving theoretical and/or practical contents of PA, with a focus on children and/or adolescents between three and 19 years of age. Data synthesis: Of the 2,321 studies initially retrieved, eight were included, targeting samples with more specific characteristics (e.g., clinical, ethnic and/or socioeconomic). In all studies, CHW were trained to lead educational activities. In three non-controlled trials, positive results were observed, involving indicators such as moderate and vigorous PA and physical inactivity reduction. Also, two positive results were found in reducing sedentary behavior. Conclusions: Even though most of the interventions included did not have a significant effect on increasing PA levels, the available findings reinforce the role of CHW as an important strategy for dialogue between health services and the most vulnerable communities, and they suggest a greater articulation of these professionals in the actions developed in the school context.
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Ridgeway JL, Njeru JW, Breitkopf CR, Mohamed AA, Quirindongo-Cedeño O, Sia IG, Wieland ML. Closing the Gap: Participatory Formative Evaluation to Reduce Cancer Screening Disparities among Patients with Limited English Proficiency. J Cancer Educ 2021; 36:795-803. [PMID: 32052262 DOI: 10.1007/s13187-020-01706-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Patients with limited English proficiency (LEP) have disproportionately lower rates of cancer screening than English-proficient patients. Given the multifactorial nature of screening disparities, strategies to improve screening rates must address barriers within and outside of the clinic setting. The objectives of this study were to understand local barriers from multiple stakeholder perspectives, to identify potential multilevel intervention approaches, and to mobilize community-engaged intervention decision making and planning. This participatory formative evaluation approach employed needs assessment and user engagement in order to enhance intervention usefulness and relevance. The study took place in several stages and involved clinic and community partners in a small metropolitan area of the Midwest USA. Interviews were conducted with LEP patients (n = 9) who had not completed three recommended screenings (breast, cervical, and colorectal), primary care providers (n = 5), medical interpreter (n = 5), and community members (n = 3). These highlighted multilevel barriers including limited patient understanding of preventive health, time and cost constraints, and variable roles of language interpreters. The literature was also reviewed to identify interventions used with similar populations. Findings from this review suggest that interventions are largely focused on single population groups or address single screening barriers. Finally, a community-academic summit (n = 48 participants) was held to review results and develop recommendations for community and clinic interventions. Findings from this study indicate that it is possible to engage a diverse group of stakeholders in strategies that are responsive to health care providers and patients, including LEP patients from heterogeneous backgrounds.
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Affiliation(s)
- Jennifer L Ridgeway
- Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Jane W Njeru
- Division of Community Internal Medicine, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA
| | | | - Ahmed A Mohamed
- Division of Community Internal Medicine, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA
| | | | - Irene G Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Mark L Wieland
- Division of Community Internal Medicine, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA.
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Perdew M, Liu S, Naylor PJ. Family-based nutrition interventions for obesity prevention among school-aged children: a systematic review. Transl Behav Med 2021; 11:709-723. [PMID: 32893869 DOI: 10.1093/tbm/ibaa082] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Effective evidence-informed family-based nutrition interventions for childhood obesity management are needed. (a) To assess the number and quality of published randomized controlled trials incorporating family-based nutrition interventions for childhood obesity (ages 5-18 years) management and (b) to identify intervention attributes (e.g., contact time, nutrition curricula, and behavior change strategies) used in successful interventions. Studies that met eligibility criteria were randomized controlled trials and family-based childhood obesity management interventions for children and adolescents ages 5-18 years old that included a healthy eating component and measured child dietary behaviors and/or parent dietary feeding practices. Six databases were searched: CINAHL complete, Cochrane Central Register of Controlled Trials, Health Source: Nursing/Academic Edition, MEDLINE with full text (PubMed), PsycINFO, SPORTDiscus, and ERIC (EBSCO Host). The validated Quality Assessment Tool for Quantitative Studies was used to assess study quality. Eight studies met eligibility criteria. Study quality analysis showed that blinding of the research teams (e.g., analysts, and those focused on data collection) and the use of age appropriate, valid, and reliable instruments were areas of concern. Successful nutrition interventions targeting children 5-18 years old, appear to include setting family-based goals, modifying home food environment, hands-on approaches to teaching nutrition (games, group-based activities), and fruit and vegetable vouchers. This review highlighted a limited amount of moderate to high quality evidence to suggest that family-based nutrition interventions can be successful in improving dietary behaviors and that interventions with positive outcomes had some components of nutrition curricula and strategies in common.
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Affiliation(s)
- Megan Perdew
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Sam Liu
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
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Nur HA, Atoloye AT, Wengreen H, Archuleta M, Savoie-Roskos MR, Wille C, Jewkes M. A Scoping Review and Assessing the Evidence for Nutrition Education Delivery Strategies for Refugees in High-Income Countries. Adv Nutr 2021; 12:2508-2524. [PMID: 34245153 PMCID: PMC8634542 DOI: 10.1093/advances/nmab080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/12/2021] [Accepted: 06/04/2021] [Indexed: 11/14/2022] Open
Abstract
Upon resettlement, refugees face many challenges, including limited knowledge of available food and food insecurity, that increase their risks of diet-related diseases. Nutrition education may help them better navigate the challenges of their new food environments and help them live healthier lives. This review assesses the evidence on nutrition education delivery strategies and outcomes among refugees in the United States and other high-income countries using Levac review guidelines. Multiple electronic databases were searched using combinations of the following terms: nutrition, food, cooking, or gardening; education, workshop, curriculum, class, literacy, or program; and refugee. The quality of the peer-reviewed papers was assessed using the Medical Education Research Study Quality Instrument (MERSQI) scoring method. A total of 1930 studies were identified, and 17 met the inclusion criteria. The mean MERSQI score of the peer-reviewed studies was 9.02 (SD, 3.3; range, 1-14). The key nutrition education delivery strategies included conducting a needs assessment and providing client-centered education, a collaborative approach in program design, and hands-on activities such as cooking and store visits. A refugee's literacy level, cultural, and language barriers are common challenges to nutrition education delivery. Because there is limited evidence regarding the efficacy of programs regarding changes in refugees' nutrition knowledge and diet-related behaviors, future research should include rigorously designed studies and the development and implementation of standardized assessment and training tools. The adoption of a context-specific and flexible model is important for effective nutrition education delivery among the refugee population.
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Affiliation(s)
- Habiba A Nur
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, UT, USA
| | - Abiodun T Atoloye
- Rudd Center for Food Policy and Obesity, University of Connecticut, CT, USA
| | | | - Martha Archuleta
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, UT, USA
| | | | - Celina Wille
- School of Applied Sciences, Technology, and Education, Utah State University, UT, USA
| | - Melanie Jewkes
- Home and Community Department, Utah State University, UT, USA
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23
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Atoloye AT, Nur H, Wengreen H, Archuleta M. Tackling Cultural Determinants of Health Through Nutrition Education Among Refugees. Health Equity 2021; 5:390-393. [PMID: 34104845 PMCID: PMC8182646 DOI: 10.1089/heq.2020.0109] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/30/2022] Open
Abstract
Nutrition education provides an avenue to address nutrition behavior change needs and prevents chronic disease in refugee communities. Previous studies have consistently identified cultural uniqueness as one of the barriers to meeting the needs of the refugee communities effectively. This current perspective describes the barriers and opportunities to improve nutrition education efforts among this population while taking into account the cultural context.
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Affiliation(s)
- Abiodun T. Atoloye
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, USA
| | - Habiba Nur
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, Utah, USA
| | - Heidi Wengreen
- Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, Utah, USA
| | - Martha Archuleta
- Department of Nutrition, Dietetics, and Food Sciences, Salt Lake Center, Utah State University, Logan, Utah, USA
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Suárez-Reyes M, Quintiliano-Scarpelli D, Fernandes AP, Cofré-Bolados C, Pizarro T. Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile. Int J Environ Res Public Health 2021; 18:ijerph18115855. [PMID: 34072527 PMCID: PMC8198969 DOI: 10.3390/ijerph18115855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022]
Abstract
In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p < 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p < 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.
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Affiliation(s)
- Mónica Suárez-Reyes
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago 9170020, Chile; (M.S.-R.); (C.C.-B.)
| | - Daiana Quintiliano-Scarpelli
- Carrera de Nutrición y Dietética, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile;
- Correspondence: ; Tel.: +56-2-23279525
| | - Anna Pinheiro Fernandes
- Carrera de Nutrición y Dietética, Facultad de Medicina-Clínica Alemana, Universidad del Desarrollo, Santiago 7610658, Chile;
| | - Cristian Cofré-Bolados
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago 9170020, Chile; (M.S.-R.); (C.C.-B.)
| | - Tito Pizarro
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago 9170020, Chile;
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Fisberg RM, Leme ACB, Previdelli Á, de Mello AV, Martinez AG, Hermes Sales C, Gómez G, Kovalskys I, Herrera-Cuenca M, Cortés Sanabria LY, Yépez García MC, Torres RG, Rigotti A, Fisberg M; ELANS study group. Contribution of food groups to energy, grams and nutrients-to-limit: the Latin American Study of Nutrition and Health/Estudio Latino Americano de Nutrición y Salud (ELANS). Public Health Nutr 2021; 24:2424-36. [PMID: 33843560 DOI: 10.1017/S136898002100152X] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans. DESIGN Data from the Latin American Study of Nutrition and Health (ELANS). SETTING ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. PARTICIPANTS Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15-65 years. 'What We Eat in America' food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount. RESULTS Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %). CONCLUSION Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.
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Meiers SJ, Dyce E, Wieland ML, Patten C, Clark MM, Hanza MMK, Bronars C, Nigon JA, Sia IG. Lay health worker as interventionist training: reflective writing in US family health promotion practice. Health Promot Int 2021; 36:1739-1752. [PMID: 33619566 DOI: 10.1093/heapro/daaa143] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Lay health worker-led health promotion interventions are well received within racial and ethnic minority communities. Increasing numbers of trained lay health workers will be needed to meet global health goals. The purpose of this process evaluation was to gain insights about how lay health worker as interventionists used theory-based approaches within a nutrition and physical activity health behavior change intervention in a clinical trial enrolling immigrant and refugee families. Data were comprised of ongoing reflective writing statements from four health workers about their implementation of the intervention. Using content analysis three themes emerged: (i) encouraging setting of small, family focused and relevant goals, (ii) being flexible in content delivery and (iii) being personally transformed (i.e. gained a sense of meaning from their experience). Lay health worker interventionist reflections on practice revealed they delivered the intervention within the primacy of the family partnering relationship by attending to unique family needs, and adjusting educational content and goal setting accordingly. Our results provide guidance for training and process evaluation of lay health worker intervention delivery in ethnically and racially diverse populations. Incorporating real-time reflection upon what was learned about skills of facilitating family motivation and family confidence enhanced affective learning and may be useful in future research studies and health promotion practice. The processes identified including setting small goals, flexibility and personal transformation could be considered in future lay health worker-delivered health promotion interventions.
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Affiliation(s)
- Sonja J Meiers
- Department of Graduate Nursing, Winona State University, Rochester, MN 55904, USA
| | - Evan Dyce
- Department of Graduate Nursing, Winona State University, Rochester, MN 55904, USA.,Department of Family Medicine, CentraCare, Big Lake, MN 55309, USA
| | - Mark L Wieland
- Division of Primary Care Internal Medicine, Rochester, MN 55905, USA
| | - Christi Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Carrie Bronars
- Department of Mental Health, Minneapolis Veterans Administration Health Care System, Minneapolis, MN 55417, USA
| | - Julie A Nigon
- Hawthorne Education Center, Rochester Public Schools Rochester, Rochester, MN 55902, USA
| | - Irene G Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55905, USA
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Portero de la Cruz S, Cebrino J. Trends in Diet Quality and Related Sociodemographic, Health, and Occupational Characteristics among Workers in Spain: Results from Three Consecutive National Health Surveys (2006-2017). Nutrients 2021; 13:522. [PMID: 33562746 PMCID: PMC7915096 DOI: 10.3390/nu13020522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 12/22/2022] Open
Abstract
Poor dietary practices are commonly reported in working populations from different economic sectors, resulting in increased absenteeism and a decrease in productivity. The aims of this study were to describe the frequency of food consumption and diet quality in workers aged ≥16 years from 2006 to 2017 in Spain and to evaluate the factors associated with diet quality. A nationwide cross-sectional study was carried out among workers using data from the Spanish National Health Surveys in 2006 (n = 11,068), 2011 (n = 7497) and 2017 (n = 8890). Sociodemographic, occupational, and health-related variables were used as well as diet quality data. A multiple linear regression was performed to determine the characteristics related to overall diet quality. The percentage of workers who consumed vegetables, at most, once or twice per week decreased from 2006 to 2017 (p < 0.001). A lower diet quality score was related to the consumption of tobacco and alcohol and being aged ≥25 years old, while a higher diet quality score was linked to being a woman, having Spanish nationality, receiving optimal perceived social support, being physically active in one's main occupation, doing leisure-time physical activity, and the type of contract.
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Affiliation(s)
- Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, Avda. Menéndez Pidal S/N, 14071 Córdoba, Spain;
| | - Jesús Cebrino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Doctor Fedriani S/N, 41009 Seville, Spain
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Kalliokoski P, Widarsson M, Rodhe N, Löfvander M. Positive impact on vitamin D related lifestyle of medical advice in pregnant Somali-born women and new mothers: a mixed method study in Swedish primary care. BMC Public Health 2021; 21:297. [PMID: 33546641 PMCID: PMC7866682 DOI: 10.1186/s12889-021-10277-y] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A previous study showed that pregnant women/new mothers especially Somali-born and some Swedish-born had extremely low vitamin D levels and poor physical performance. Our study aimed to examine vitamin D related lifestyle, attitudes and behaviour before and after brief information about vitamin D, with special long-term focus on Somali-born women. METHODS A cohort of 91 pregnant women/new mothers having serum hydroxyvitamin D (S-25-OHD) ≤ 50 nmol/L (n = 51 Somali-born with one third < 10 nmol/L of S-25-OHD) in primary health care in Sweden was targeted for intervention. Brief individual oral and visual information on vitamin D was given by doctors at baseline and after four and ten months. Questionnaires with ordinal scales on vitamin D related lifestyle of food, clothing, and outdoor activities were distributed on all occasions. Focus-group interviews with 15 women from the target-group were performed after two years. A Somali interpreter was available. RESULTS Veiled clothing, indoor living, and a low intake of milk, cheese, and fatty fish were common in the target group. Consumption pattern had increased significantly among the Somali-born women at the four-month follow-up but declined to non-significant levels at the ten-month follow-up. The focus-group interviews showed improved understanding of vitamin D deficiency, symptoms and attitudes, but varying applied behaviours related to sun exposure. Sun exposure for the children and increased fish consumption was the most evident positive results. CONCLUSIONS Vitamin D related lifestyle, attitudes and behaviour improved in a Somali-born group of pregnant women/new mothers with severe vitamin D deficiency. The preventive measures suggested in our study may have impact on public health in relation to bone and muscle strength and immunity especially in vitamin D deficiency risk groups. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02922803 . Date of registration: 28 September 2016.
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Affiliation(s)
- P Kalliokoski
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden.
| | - M Widarsson
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - N Rodhe
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden
| | - M Löfvander
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
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Kumar GS, Beeler JA, Seagle EE, Jentes ES. Long-Term Physical Health Outcomes of Resettled Refugee Populations in the United States: A Scoping Review. J Immigr Minor Health 2021; 23:813-823. [PMID: 33515162 PMCID: PMC8233239 DOI: 10.1007/s10903-021-01146-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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] [Accepted: 01/12/2021] [Indexed: 12/22/2022]
Abstract
Several studies describe the health of recently resettled refugee populations in the US beyond the first 8 months after arrival. This review summarizes the results of these studies. Scientific articles from five databases published from January 2008 to March 2019 were reviewed. Articles were included if study subjects included any of the top five US resettlement populations during 2008-2018 and if data described long-term physical health outcomes beyond the first 8 months after arrival in the US. Thirty-three studies met the inclusion criteria (1.5%). Refugee adults had higher odds of having a chronic disease compared with non-refugee immigrant adults, and an increased risk for diabetes compared with US-born controls. The most commonly reported chronic diseases among Iraqi, Somali, and Bhutanese refugee adults included diabetes and hypertension. Clinicians should consider screening and evaluating for chronic conditions in the early resettlement period. Further evaluations can build a more comprehensive, long-term health profile of resettled refugees to inform public health practice.
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Affiliation(s)
- Gayathri S Kumar
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA.
| | - Jenna A Beeler
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Emma E Seagle
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Emily S Jentes
- Immigrant, Refugee, and Migrant Health Branch, Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
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Freene N, Davey R, Sathiyakumar R, McPhail SM. Can physical activity measurement alone improve objectively-measured physical activity in primary care?: A systematic review and meta-analysis. Prev Med Rep 2020; 20:101230. [PMID: 33163332 PMCID: PMC7607506 DOI: 10.1016/j.pmedr.2020.101230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/05/2020] [Revised: 09/12/2020] [Accepted: 10/13/2020] [Indexed: 12/02/2022] Open
Abstract
Some evidence of control group increases in self-reported PA in primary care. Meta-analyses found no significant improvement in control group objectively-measured PA. 17% of studies reported increased (≥10%) objectively-measured PA in control groups. Healthy younger adults may increase objectively-measured PA with measurement alone. PA measurement using pedometers alone may be particularly useful to increase PA.
There is evidence that simply measuring physical activity alone can increase self-reported physical activity behaviour. The aim of this review was to describe changes in objectively-measured physical activity within control groups in primary care physical activity intervention studies. Five electronic databases (PubMed, MEDLINE, SPORTDiscus, PsychINFO and CINAHL) were searched from inception to February 2019. Physical activity controlled intervention studies objectively measuring physical activity in primary care with adults were included and meta-analyses were completed. Thirty studies were eligible and 22 studies were included in the meta-analysis. No statistically significant change in steps.day−1, counts.day−1 and counts.minute-1 were found in the meta-analyses within control groups. Moderate-to-vigorous physical activity minutes.day−1 significantly decreased (-3.97; 95% CI −6.31 to −1.64; P < 0.001). Sub-analyses revealed there was a trend for steps.day−1 to increase in participants < 50 years old (504; 95% CI −20 to 1029; P = 0.06). Noteworthy increases (≥10%) in objectively-measured physical activity within control groups were found in 17% of studies. Noteworthy increases were reported in studies with younger participants, one-third of the pedometer studies, one-third of studies with participants at risk of chronic disease and in studies with a shorter duration between measurements. No control group improvements were found in participants with chronic disease. Overall, no significant improvements in objectively-measured physical activity were found within control groups in primary care. Further investigation of noteworthy increases in control group physical activity levels is indicated, particularly in certain sub-groups of participants as this may effect physical activity research and interventions in these populations.
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Affiliation(s)
- Nicole Freene
- Physiotherapy, University of Canberra, Bruce, Australia.,Health Research Institute, University of Canberra, Bruce, Australia
| | - Rachel Davey
- Health Research Institute, University of Canberra, Bruce, Australia
| | | | - Steven M McPhail
- School of Public Health & Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia.,Centre for Functioning and Health Research, Metro South Health, Buranda, Australia
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Wieland ML, Njeru JW, Okamoto JM, Novotny PJ, Breen-Lyles MK, Goodson M, Porraz Capetillo GD, Molina LE, Sia IG. Association of social network factors with weight status and weight loss intentions among hispanic adults. J Behav Med 2020; 43:155-165. [PMID: 31894451 PMCID: PMC7071972 DOI: 10.1007/s10865-019-00131-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/17/2019] [Indexed: 01/02/2023]
Abstract
Hispanic adults have the highest obesity prevalence in the United States, but little is known about weight-related social network influences. A community-based sample of 610 Hispanic participants completed height/weight and a survey. The proportion of overweight or obese (OW/OB) network members was higher for OW/OB respondents compared to normal weight respondents. Participants with high weight loss intentions reported more positive social norms for weight control, social support, and social cohesion. If most or all of OW/OB participant's social contacts were trying to lose weight, the odds that they were likely to try to lose weight was four times higher than other participants. The relationship between weight loss intentions and number of social contacts trying to lose weight was strongly mediated by social norms for weight control and social support. These results suggest that social contacts and functional network characteristics may impact weight status and weight control intentions among Hispanic adults.
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Affiliation(s)
- Mark L Wieland
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Jane W Njeru
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Janet M Okamoto
- Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ, USA
| | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Miriam Goodson
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
| | - Graciela D Porraz Capetillo
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Luz E Molina
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, USA
- Department of Language Services, Mayo Clinic, Rochester, MN, USA
| | - Irene G Sia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Gallegos D, Do H, To QG, Vo B, Goris J, Alraman H. The effectiveness of living well multicultural-lifestyle management program among ethnic populations in Queensland, Australia. Health Promot J Austr 2020; 32:84-95. [PMID: 32053254 DOI: 10.1002/hpja.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/13/2019] [Accepted: 02/09/2020] [Indexed: 12/11/2022] Open
Abstract
ISSUE Some migrant groups have higher risks of deaths and chronic diseases due to barriers associated with socioeconomic disadvantage, social isolation, racism, language, poor access to health services and low levels of health literacy. However, few culturally tailored interventions have targeted ethnic groups in Australia. This study evaluated the effectiveness of the Living Well Multicultural-Lifestyle Management Program (LWM-LMP) in Queensland, Australia. METHODS The LWM-LMP was originally co-designed with the targeted communities. Participants aged ≥18 years were eligible to participate without a fee. The evaluation was a quasi-experimental design without a control group, with data collected at baseline, the end of the programme and after-programme follow-up at week 14. The programme lasted 8 weeks with one group-based session of 120 minutes delivered each week in local community venues. Each session also included time to undertake physical activity (PA). Eating and PA behaviours were self-reported. Weight, height, waist circumference and blood pressure were measured using standard protocols. RESULTS Participants were more likely to consume ≥2 servings of fruit/day, five servings of vegetable/day, low-fat milk, processed meat, fast food, hot chips/fries, salty snacks, sweet snacks, sweet beverages less than once per week and meet the PA recommendation of ≥150 minutes/wk (P < .001) at week 8. Weight, BMI, waist circumference, waist-to-height ratio and blood pressure were also improved at week 8. Many of the changes were sustained at week 14. CONCLUSIONS The LWM-LMP was effective in improving participants' lifestyle behaviours and cardiometabolic indicators. SO WHAT Engaging targeted communities in designing interventions focussed on healthy personal behaviours helps with delivery and implementation. Behavioural interventions should be culturally tailored to increase their effectiveness.
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Affiliation(s)
- Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hong Do
- Chronic Disease Program, Ethnic Communities Council of Queensland, West End, QLD, Australia
| | - Quyen Gia To
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Brenda Vo
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Janny Goris
- Preventive Health Branch, Prevention Division, Queensland Department of Health, Herston, QLD, Australia
| | - Hana Alraman
- Chronic Disease Program, Ethnic Communities Council of Queensland, West End, QLD, Australia.,EACH, National Disability Insurance Scheme Partners in the Community Early Childhood Early Intervention, Ipswich, QLD, Australia
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Njeru JW, Wieland ML, Okamoto JM, Novotny PJ, Breen-Lyles MK, Osman A, Ahmed YA, Nur MA, Nur O, Sia IG. Social networks and obesity among Somali immigrants and refugees. BMC Public Health 2020; 20:238. [PMID: 32066416 PMCID: PMC7026979 DOI: 10.1186/s12889-020-8315-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 07/25/2019] [Accepted: 02/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Somali immigrants and refugees to the United States are at high risk for obesity and related cardiovascular risk. Social network factors influence health behaviors and are important contributors to the obesity epidemic. The objective of this study was to describe social networks and obesity-related characteristics among adult Somali immigrants in a Minnesota city in order to inform a community-based, participatory, research-derived, social network intervention to decrease obesity rates. METHODS Survey data (demographics, general health measures, and sociobehavioral and network measures) and height and weight measures (for calculating body mass index) were collected from adult Somali immigrants by bilingual study team members at community locations. Descriptive statistics were used to report the survey and biometric data. Logistic regression models were used to describe the basic associations of participants and network factors. Network data were analyzed to identify nodes and ties, to visualize the network, and to identify potential interventionists for a future social network intervention. RESULTS Of the 646 participants, 50% were overweight or affected by obesity. The network had 1703 nodes with 3583 ties between nodes, and modularity was high (0.75). Compared with respondents of normal weight, participants who were overweight or affected by obesity had more network members who were also overweight or obese (odds ratio [OR], 2.90; 95% CI, 1.11-7.56; P = .03); this was most notable for men (OR, 4.58; 95% CI, 1.22-17.22; P = .02) and suggestive for those 50 years or older (OR, 24.23; 95% CI, 1.55-377.83; P = .03). Weight loss intention among participants who were overweight or affected by obesity was associated with number of family members and friends trying to lose weight, enabling functional network factors (social norms for weight loss, social support for healthy eating, and social cohesion), and less favorable obesogenic social norms. CONCLUSIONS In this community sample of Somali immigrants, distinct social networks are clustered by weight status, and social contacts and functional network characteristics are related to individuals' weight loss intentions. These factors should be considered in weight loss interventions and programs. A social network intervention targeting weight loss, within a community-based participatory research framework, is feasible in this vulnerable population.
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Affiliation(s)
- Jane W Njeru
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.
| | | | | | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | | | - Ahmed Osman
- Somali Community Resettlement Services, Rochester, MN, USA
| | - Yahye A Ahmed
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mohamud A Nur
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Omar Nur
- Somalia Rebuild Organization, Rochester, MN, USA
| | - Irene G Sia
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Rhodes RE, Quinlan A, Naylor P, Warburton DER, Blanchard CM. Predicting personal physical activity of parents during participation in a family intervention targeting their children. J Behav Med 2020; 43:209-24. [DOI: 10.1007/s10865-019-00116-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/02/2019] [Indexed: 11/26/2022]
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Rhodes RE, Blanchard CM, Quinlan A, Naylor PJ, Warburton DER. Family Physical Activity Planning and Child Physical Activity Outcomes: A Randomized Trial. Am J Prev Med 2019; 57:135-44. [PMID: 31248744 DOI: 10.1016/j.amepre.2019.03.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Regular moderate-to-vigorous physical activity and high physical fitness are extremely important to the health of children and track to positive health profiles in adulthood. Family-based interventions to improve moderate-to-vigorous physical activity are essential given that children live within a structure of parental influence. The purpose of this study was to examine the effect of a parent planning skills intervention to support child physical activity on the subsequent moderate-to-vigorous physical activity (primary outcome) and fitness of their children across 26 weeks (primary endpoint). STUDY DESIGN Two-arm randomized trial with physical activity assessment at baseline 6 weeks, 13 weeks, and 26 weeks and fitness and BMI tests at baseline and 26 weeks from 2012 and 2017. SETTING/PARTICIPANTS One hundred and two children (aged 6-12 years) who were below international physical activity recommendations at baseline were recruited through advertisements. INTERVENTION Participants received a planning plus education intervention (n=52) or an education-only intervention (n=50). MAIN OUTCOME MEASURES Moderate-to-vigorous physical activity was assessed via accelerometry and fitness tests included aerobic fitness, muscular strength, flexibility. BMI was calculated by objectively assessed height and weight. RESULTS Generalized linear mixed modeling conducted in 2019 showed that the patterns varied by condition over time (β=-0.05, p<0.05), where children in the planning intervention significantly increased moderate-to-vigorous physical activity compared with the education condition at 6 weeks and 13 weeks but not at 26 weeks. Aerobic fitness (p=0.04, d=0.26) was the only significant health-related physical fitness change between the two groups and favored the planning group over the education group. CONCLUSIONS There was initial efficacy of the planning intervention, but effectiveness waned by 26 weeks. These changes appeared to be sufficient for modest changes in aerobic fitness. Future research should aim to improve the maintenance of these early positive changes and assist parents in planning for activities that also include opportunities to improve child musculoskeletal fitness. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT01882192.
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Salinas JJ, Parra-Medina D. Physical activity change after a promotora-led intervention in low-income Mexican American women residing in South Texas. BMC Public Health 2019; 19:782. [PMID: 31221117 PMCID: PMC6585106 DOI: 10.1186/s12889-019-7105-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 06/05/2019] [Indexed: 12/22/2022] Open
Abstract
Background The purpose of this study was to determine physical activity (PA) preferences associated with increases in moderate-to-vigorous physical activity (MVPA) and decrease in sedentary time in Mexican American (MA) women participating in a Promotora (community health worker)-led intervention on the U.S.-Mexico border. Methods Enlace (‘to link’ in Spanish) was a randomized clinical trial to increase PA in low-income, MA women living in South Texas on the U.S.-Mexico border. A total of 620 participants were recruited into the study. The primary outcome was increase in moderate to vigorous physical activity (MVPA) using the Actigraph GT3X 16 Mb accelerometer. A modified version of the Community Health Activities Model Program for Seniors Physical Activity (CHAMPS) instrument was used to predict MVPA. Adjusted and unadjusted logistic regression models predicted change in MVPA by change in CHAMPS activities. ANOVA analysis determined the variance explained in change in MVPA by change in time engaged in activity. Individual effect sizes were then calculated for significant activity type change on MVPA increase. Results There were significant increases in all CHAMPS activities except aerobic machines and errand walking. An increase in leisure walking (O.R. = 2.76, p = .046), errand (O.R. = 3.53, p = .051), and brisk walking (O.R. = 4.74, p = .011), dance (O.R. = 8.22, p = .003), aerobics class (O.R. = 32.7, p = .001), and light housework (O.R. = 6.75, p = .000), were associated with a decrease in sedentary time. Significant effect sizes for MVPA were observed for jogging (1.2, p = .050), general exercise (1.6, p = .024), and other exercise not specified (2.6, p = .003). Significant effect sizes for sedentary time were detected for leisure time (.031, p = .036), errands (.017, p = .022), brisk walking (.022, p = .003), dance (.042, p = .005), and aerobics class (.013, p = .009). Discussion Participants who engaged in walking and aerobic activities through this intervention significantly increased their engagement in MVPA and decreased their sedentary time. These findings are novel, since preferences have not been examined in relation to MVPA or sedentary time in MA women. Conclusion PA preferences need to be considered when aiming to promote activities that reduce sedentary time and increase PA participation among marginalized groups, such as MA women. Trial registration NCT02046343.
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Affiliation(s)
- Jennifer J Salinas
- Department of Family Medicine, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, Center of Emphasis in Cancer Research, 9849 Kenworthy St, El Paso, TX, 79924, USA.
| | - Deborah Parra-Medina
- Latino Research Initiative, The University of Texas at Austin, 210 W. 24th Street, Mailcode F9200, GWB 2.102, Austin, Texas, 78712, USA
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Snuggs S, Houston-Price C, Harvey K. Healthy eating interventions delivered in the family home: A systematic review. Appetite 2019; 140:114-133. [PMID: 31091432 DOI: 10.1016/j.appet.2019.05.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 12/13/2022]
Abstract
Unhealthy eating habits have long term health implications and can begin at a young age when children still consume the majority of their meals at home. As parents are the principal agents of change in children's eating behaviours, the home environment is the logical location for the delivery of interventions targeting healthy family eating. Despite the recent proliferation of published studies of behaviour-change interventions delivered in the home, there has been little attempt to evaluate what makes such interventions successful. This review provides a systematic evaluation of all healthy eating interventions delivered to families in the home environment to date and seeks to identify the successful elements of these interventions and make recommendations for future work. Thirty nine studies are described, evaluated and synthesised. Results show that evidence- and theory-based interventions tended to be more successful than those that did not report detailed formative or evaluative work although details of theory application were often lacking. Careful analysis of the results did not show any further systematic similarities shared by successful interventions. Recommendations include the need for more clearly theoretically driven interventions, consistent approaches to measuring outcomes and clarity regarding target populations and desired outcomes.
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Affiliation(s)
- Sarah Snuggs
- School of Psychology and Clinical Language Sciences, University of Reading, RG6 7BE, UK
| | - Carmel Houston-Price
- School of Psychology and Clinical Language Sciences, University of Reading, RG6 7BE, UK
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, RG6 7BE, UK.
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Turk MT, Kalarchian MA, Nolfi DA, Fapohunda A. Prevention and Treatment of Overweight and Obesity Among African Immigrant Populations: A Systematic Review of the Literature. Annu Rev Nurs Res 2018; 37:161-186. [PMID: 30692156 DOI: 10.1891/0739-6686.37.1.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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