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Pratt KJ, Kiser HM, Feng X, VanFossen C, Spees C, Taylor C, Noria S, Eneli I, Skelton JA. Changes in Child Weight, Behaviors, and Family Dynamics during Parental Participation in a Medical Weight Management Program: A Longitudinal Uncontrolled Pilot Study. Child Obes 2023; 19:102-111. [PMID: 35483051 DOI: 10.1089/chi.2021.0206] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: There is limited evidence of the effects of parental participation in outpatient medical weight management (MWM) programs on children. The aims of the project were to (1) identify time effects from parental participation in the MWM program on changes in child weight trajectories, healthy and unhealthy weight control practices, physical and sedentary activity, parental restrictive feeding and pressure to eat, and family functioning and communication and (2) determine differences based on child factors. Methods: A longitudinal uncontrolled pilot study was conducted, in which parent-child (ages 7-19) dyads completed assessments at parents' MWM program initiation, 3 months (mid-program), 6 months (end of program), and 12 months to determine sustained effects. Repeated measures analysis of variance (ANOVA) was completed using a mixed multilevel modeling approach using Restricted Maximum Likelihood estimation method; each outcome was additionally analyzed with child baseline weight status, age group, and sex as between-subjects factors. Results: Fifty three dyads met inclusion criteria, 23 completed the initial assessment (enrollment: 43.3%), and 13 completed the 12-month assessment (retention: 56.5%). Significant effects over time were observed for decreased parental restrictive feeding (p < 0.038) over 12 months, and group by time effects were observed for increased restrictive feeding for female compared to male children (p = 0.025) over 12 months. Marginally significant group by time effects were found for increased impaired family functioning (p = 0.054) and communication (p = 0.054) for children with overweight/obesity compared to healthy weight children over 12 months. Conclusions: Female children and children with overweight/obesity may experience increased negative family dynamics (restriction of food, family functioning, and communication) through parental MWM programs.
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Affiliation(s)
- Keeley J Pratt
- Human Development and Family Science Program, Department of Human Sciences, The Ohio State University, Columbus, OH, USA.,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Pediatrics, Nationwide Children's Hospital Center for Healthy Weight and Nutrition, The Ohio State University, Columbus, OH, USA
| | - Haley M Kiser
- Human Development and Family Science Program, Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Xin Feng
- Human Development and Family Science Program, Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Catherine VanFossen
- Human Development and Family Science Program, Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- Division of Medical Dietetics Program, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Christopher Taylor
- Division of Medical Dietetics Program, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sabrena Noria
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ihuoma Eneli
- Department of Pediatrics, Nationwide Children's Hospital Center for Healthy Weight and Nutrition, The Ohio State University, Columbus, OH, USA
| | - Joseph A Skelton
- Department of Pediatrics and Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Kiser HM, Pratt KJ, Focht BC, Wallace L, Slesnick N, Noria S, Needleman B, Pona AA. Preoperative Psychological Evaluation Outcomes, Reasoning, and Demographic and Diagnostic Correlates. Obes Surg 2023; 33:539-547. [PMID: 36538213 PMCID: PMC9765350 DOI: 10.1007/s11695-022-06414-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Little is known about associations between preoperative psychiatric, disordered eating, and substance use diagnoses with the clinical decision to require follow-up after the preoperative psychological evaluation. To determine the proportion of patients who require follow-up (no required follow-up (NFU), required follow-up (RFU), placed on hold (POH)) from the preoperative psychological evaluation, associations with diagnoses, and noted reasons for follow-up. MATERIALS AND METHODS The sample included 508 patients (77.6% female; 64.4% White) pursuing bariatric metabolic surgery with completed psychological evaluations between August 2019 and December 2020 at a Midwest medical center. Patient demographics, psychological evaluation outcome and corresponding reasoning, and psychiatric, disordered eating, and substance use diagnoses were extracted from the health record. Descriptive and bivariate analyses determined associations between demographics and diagnoses with psychological evaluation outcomes and corresponding reasoning. RESULTS The breakdown of psychological evaluation outcomes was 60.6% (n = 308) NFU, 38.4% (n = 195) RFU, and 1.0% (n = 5) POH. Demographic correlates of RFU included higher BMI, being single, lower educational attainment, unemployment, public/no insurance, and receiving multiple or any psychiatric diagnosis (all p-values < 0.05). Diagnostic correlates of RFU included anxiety, depression, not having a current trauma or stressor-related disorder, disordered eating, and substance use diagnoses (all p-values < 0.001). RFU/POH was primarily due to psychiatric (61%) reasons. CONCLUSION Higher rates of RFU were observed for patients with higher economic need and with psychiatric, disordered eating, or substance use diagnoses. Future work should establish preoperative programming to assist patients with addressing ongoing psychiatric concerns prior to bariatric metabolic surgery.
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Affiliation(s)
- Haley M. Kiser
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Avenue, Columbus, OH 43210 USA
| | - Keeley J. Pratt
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Avenue, Columbus, OH 43210 USA ,Department of Surgery, The Ohio State University Medical Wexner Center, Columbus, OH 43210 USA
| | - Brian C. Focht
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Avenue, Columbus, OH 43210 USA
| | - Lorraine Wallace
- Biomedical Education and Anatomy, College of Medicine, The Ohio State University, Columbus, OH 43210 USA
| | - Natasha Slesnick
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, 1787 Neil Avenue, Columbus, OH 43210 USA
| | - Sabrena Noria
- Department of Surgery, The Ohio State University Medical Wexner Center, Columbus, OH 43210 USA
| | - Bradley Needleman
- Department of Surgery, The Ohio State University Medical Wexner Center, Columbus, OH 43210 USA
| | - Ashleigh A. Pona
- Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Columbus, OH 43210 USA
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Kiser HM, Pona AA, Focht BC, Wallace L, Slesnick N, Noria S, Needleman B, Pratt KJ. Associations between psychological evaluation outcomes, psychiatric diagnoses, and outcomes through 12 months after bariatric surgery. Surg Obes Relat Dis 2022; 19:594-603. [PMID: 36610864 DOI: 10.1016/j.soard.2022.12.018] [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] [Received: 09/02/2022] [Revised: 11/10/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is limited evidence about how patients' initial preoperative psychological evaluation outcomes (require follow-up [RFU], no required follow-up [NFU], and place on hold [POH]) and current psychiatric diagnoses associate with postoperative outcomes. OBJECTIVES To test the hypotheses that patients who receive a clinical decision of RFU versus NFU from their initial psychological evaluation will be (1) more likely to experience postoperative complications, readmissions, and emergency room visits and (2) experience less weight loss over 12-months. Specific diagnoses (any psychiatric diagnosis, depression, and anxiety) are also examined for their association with weight loss over 12 months. SETTING Midwestern medical center, United States. METHODS The sample included 322 patients (81.1% female and 64.0% White) with completed psychological evaluations between August 2019 and December 2020. Patient demographics, psychological evaluation outcomes, current diagnoses, and postoperative outcomes were extracted from the health record. Bivariate analyses determined associations between NFU/RFU and postoperative complications (yes, no), readmissions (yes, no), and emergency room visits (yes, no). Mixed multilevel models were conducted with dichotomous variables NFU/RFU, any psychiatric diagnoses (yes, no), depression diagnoses (yes, no), or anxiety diagnoses (yes, no) as the main fixed within-group factors with weight loss (weight or percent total weight loss) used as the repeated measures. Insurance and surgical procedure were included as covariates. RESULTS There were no significant differences in postoperative complications, readmissions, and emergency room visits between NFU and RFU groups. Patients who received a RFU versus an NFU had higher weights over 12 months (P = .001). CONCLUSION Hypothesis 2 was only partially supported. Patients who received an RFU versus an NFU had higher weights over 12 months, but this association was not found for percent total weight loss or any of the psychiatric within-subjects variables (i.e., psychiatric diagnoses, depression, and anxiety).
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Affiliation(s)
- Haley M Kiser
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, Columbus, Ohio
| | - Ashleigh A Pona
- Department of Psychiatry and Behavioral Health, College of Medicine, Ohio State University, Columbus, Ohio
| | - Brian C Focht
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, Columbus, Ohio
| | - Lorraine Wallace
- Department of Biomedical Education and Anatomy, College of Medicine, Ohio State University, Columbus, Ohio
| | - Natasha Slesnick
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, Columbus, Ohio
| | - Sabrena Noria
- Department of Surgery, Ohio State University Medical Wexner Center, Columbus, Ohio
| | - Bradley Needleman
- Department of Surgery, Ohio State University Medical Wexner Center, Columbus, Ohio
| | - Keeley J Pratt
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, Columbus, Ohio; Department of Surgery, Ohio State University Medical Wexner Center, Columbus, Ohio.
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Pratt KJ, Hill EB, Kiser HM, VanFossen CE, Braun A, Taylor CA, Spees C. Changes in Parent and Child Skin Carotenoids, Weight, and Dietary Behaviors over Parental Weight Management. Nutrients 2021; 13:2227. [PMID: 34209574 PMCID: PMC8308330 DOI: 10.3390/nu13072227] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 11/17/2022] Open
Abstract
(1) The objective was to determine changes in parent-child (ages 7-18) dyad skin carotenoids spanning parental participation in a medical weight management program (WMP), and associations with parent BMI, child BMIz, fruit/vegetable intake, and family meals and patterns. (2) The study design was a longitudinal dyadic observational study with assessment at WMP initiation, mid-point (3-months), and conclusion (6-months). Twenty-three dyads initiated the study, 16 provided assessments at 3 months, and 11 at program conclusion. Associations between parent and child carotenoids (dependent variables) and parent BMI, child BMIz, increases in fruit/vegetable intake, and family meals and patterns were analyzed using Pearson's correlations and independent samples t-tests. Repeated measures ANOVA assessed changes in weight status and carotenoids. (3) Parents experienced significant declines in BMI and skin carotenoid levels over 6 months. Parent and child carotenoids were correlated at each assessment. At initiation, parent BMI and carotenoids were inversely correlated, child carotenoids were associated with increased family meals, and never consuming an evening fast food or restaurant meal were associated with increased parent and child carotenoids. (4) Results demonstrate skin carotenoids are strongly correlated within dyads and may be associated with lower parental BMI and positive family meal practices.
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Affiliation(s)
- Keeley J. Pratt
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA; (H.M.K.); (C.E.V.)
- The Ohio State Wexner Medical Center, Department of Surgery, Columbus, OH 43210, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
| | - Emily B. Hill
- Divison of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (E.B.H.); (A.B.); (C.A.T.); (C.S.)
| | - Haley M. Kiser
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA; (H.M.K.); (C.E.V.)
| | - Catherine E. VanFossen
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA; (H.M.K.); (C.E.V.)
| | - Ashlea Braun
- Divison of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (E.B.H.); (A.B.); (C.A.T.); (C.S.)
| | - Christopher A. Taylor
- Divison of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (E.B.H.); (A.B.); (C.A.T.); (C.S.)
| | - Colleen Spees
- Divison of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA; (E.B.H.); (A.B.); (C.A.T.); (C.S.)
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