ABSTRACT
BACKGROUND: Implementing community health nursing programs is a new field of application in the primary health sector of Germany. Hence, there is limited evidence of effective community-based and nurse-led interventions with regard to the German health care system. International research findings are mostly not transferable. The Community Health Nursing in der Stadt (CoSta; ie, "Community Health Nursing in the City") project is the first study that examines a community health nurse-led intervention for adults with chronic health conditions. OBJECTIVE: This study protocol describes the design and methods of a randomized controlled field trial that will investigate if a community health nurse-based intervention has an impact on health-related quality of life in adults with chronic conditions. METHODS: The study was designed as a randomized controlled trial that will be conducted under real-life conditions in the field. In a 4-month period, patients with at least 1 chronic International Classification of Diseases, Tenth Revision, diagnosis will be enrolled. Participants will be randomly allocated to an intervention group or a control group. The sample size was assumed based on an effect size of 0.50 with a significance level of .05, using a 2-sided (2-tailed), 2-sample unequal variance t test. The control group will be treated as usual. The intervention group will receive-in addition to the usual treatment-preventive home visits; consultations; and educative training, which will be offered by 2 community health nurses for up to 12 months. Both groups will be followed up at baseline, after 6 months, and after 12 months. The primary outcome measure is the mental component summary score from the 36-Item Short Form Health Survey after 12-months. Secondary patient outcomes will be included. The study received ethics approval from the Competence Health Center's institutional review board at the University of Applied Sciences Hamburg (procedure number: 2020-14). RESULTS: The CoSta project was funded by the Federal Ministry of Education and Research Germany (contract number: 13FH019SX8). In total, 187 participants were recruited at the beginning of August 2021. Further, 92 were excluded and 94 were randomized. Data collection will be conducted until the end of 2022. CONCLUSIONS: Our study will provide data with regard to the effectiveness of community nurse-led interventions that focus on the treatment of vulnerable adults with chronic health conditions in a community health center. In secondary analyses, the associations among influencing social factors (education, income, and employment) will be examined. We expect results that will help reduce the research-to-practice gap. TRIAL REGISTRATION: German Clinical Trials Register DRKS00026164; https://tinyurl.com/yckxc5ut. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37965.
ABSTRACT
Adolescent obesity prevention programs focusing on Latino fathers may be useful to address Latino adolescent obesity. Adolescent obesity has become an urgent issue because of the coronavirus disease 2019 pandemic, with limited ability to deliver prevention programs in-person. This study aimed to assess the feasibility of a community-based, adolescent obesity prevention program for Latino father-adolescent dyads delivered remotely, adapted from the in-person Padres Preparados, Jóvenes Saludables program. A quasi-experimental design was used to assess the feasibility of the remotely delivered program based on criteria adapted from other feasibility studies of community-based health promotion programs for Latino families. Father-adolescent dyads were recruited at two sites in a Midwestern state during 2020; mothers were also encouraged to participate. Recruitment met the feasibility criteria (65 families expressed interest between August and October) with 26 families participating in this study. The retention ratio (percentage of participants who completed a post-session survey to those who completed the baseline survey) among fathers was acceptable (77%), while a lower percentage of adolescents were retained (68%). The session attendance ratio (number of sessions attended of the eight total sessions offered) was higher among adolescents (88%) and lower among fathers (68%) compared to the criteria. Satisfaction ratings (≥88%) and completeness of data collection at both baseline and post-session survey (≥76%) were acceptable. Favorable results were obtained for parent outcomes, while adolescent outcomes were not favorably changed. This remotely delivered adolescent obesity prevention program was feasible for Latino fathers; however, additional engagement with adolescents may be needed.
Adolescent obesity became a more urgent issue because of the coronavirus disease 2019 pandemic with less physical activity under lockdown, more food insecure families and limited in-person access to programs. Our study concluded that a remotely delivered version of a community-based, adolescent obesity prevention program for Latino fatheradolescent dyads (the Padres Preparados, Jóvenes Saludables program) was feasible based on participation, satisfaction and parent outcomes. Additional engagement in activities to improve adolescent health behaviors may be needed to improve the overall effectiveness of the program.