Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 26
Filter
1.
Contemporary Clinical Trials ; : 106771, 2022.
Article in English | ScienceDirect | ID: covidwho-1803647

ABSTRACT

Background Childhood obesity prevention efforts are needed in the United States, especially for families with low income. The purpose of this study is to determine whether HomeStyles-2, a nutrition education and childhood obesity prevention program for families with children in middle childhood (ages 6 to 11 years), motivates parents to re-shape their home environments and weight-related lifestyle practices to be more supportive of meeting national nutrition and physical activity recommendations and weight status of their children more so than those in the control condition. Methods A research-practice partnership with Florida's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program was formed to conduct a cluster randomized trial to evaluate the HomeStyles-2 intervention. SNAP-Ed-eligible individuals who are parents/caregivers of children aged 6–11 living in the study catchment area will be invited to enroll in the study and participate in a six-lesson series using the HomeStyles-2 program or an attention control program. The primary outcome measures related to parent weight-related behaviors will be assessed on the individual level. Linear mixed models with a hierarchical design will be used to assess outcomes of interest. Discussion This study has the potential to demonstrate the effectiveness of a new curriculum implemented in a federal nutrition education program. Because of the COVID-19 pandemic, adjustments were made to the intervention design to allow for virtual delivery of the intervention through SNAP-Ed. This unanticipated change will offer much-needed research on the effectiveness of virtual nutrition education, which may help to expand SNAP-Ed's reach across the country. Trial registration: NCT05019339.

2.
Child Obes ; 18(3): 160-167, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1806218

ABSTRACT

Background: Few studies have examined the associations of pediatric weight management interventions (PWMIs) with reduction in parental stress. We sought to examine the extent to which a PWMI reduces parental stress and whether changes in parental healthful feeding practices and support for physical activity are associated with reduction in parental stress. Methods: We analyzed data from the Clinic and Community Approaches to Healthy Weight randomized controlled trial (RCT). Parental stress change over 12 months was analyzed using a multivariate mixed linear model. We then examined associations of changes in healthful feeding practices and support for physical activity over 12 months with changes in stress using a multivariate linear model. Results: In multivariate-adjusted models, participation in a PWMI was associated with decrease in parental stress at 12 months, with a mean difference (MD) of -0.24 U [95% confidence interval (CI): -0.45, -0.04]. Increases in scores for exercising regularly [MD = -0.27 (95% CI: -0.52, -0.03)] and keeping healthy food at home [MD = -0.38 (95% CI: -0.66, -0.10)] were associated with decrease in stress. Conclusions: Participation in a PWMI was associated with decrease in parental stress. Encouraging parents of children with overweight and obesity to keep healthy food in the house and exercise regularly may represent important strategies to improve parental stress. PWMI effectiveness studies should consider parental stress as an outcome while addressing social determinants of health that may influence parental stress. Clinical Trial Registration Number: NCT03012126.


Subject(s)
Pediatric Obesity , Child , Exercise , Humans , Overweight , Parents , Pediatric Obesity/prevention & control
3.
Irish Medical Journal ; 114(9), 2021.
Article in English | EMBASE | ID: covidwho-1733356
4.
Clin Endocrinol (Oxf) ; 2022 Feb 12.
Article in English | MEDLINE | ID: covidwho-1731114

ABSTRACT

OBJECTIVE: To assess the influence of longitudinal weight gain from 0 to 4 years old on dehydroepiandrosterone sulphate (DHEAS) levels at 7 years old. DESIGN: DHEAS levels were measured at 7 years old in a subsample of 587 children from the Generation XXI birth cohort. Weight trajectories (0-4 years of age) were identified using model-based clustering and categorized as "normal weight gain," "weight gain during infancy," "weight gain during childhood" and "persistent weight gain." MEASUREMENTS: Differences in DHEAS levels at age 7 between the four weight trajectories were analysed through analysis of covariance (ANCOVA), adjusted for birth weight (BW) and body mass index (BMI). RESULTS: In the crude analysis, compared with the "normal weight gain" trajectory (5.53 (95% CI: 5.10-5.98] µmol/L), DHEAS levels were significantly higher in children in the "persistent weight gain" (8.75 [95% CI: 7.23-10.49] µmol/L, p < .001] and in children in the "weight gain during infancy" trajectories (7.68 [95% CI: 6.22-9.49] µmol/L, p = .021] and marginally significantly higher in children in the "weight gain during childhood" trajectory (6.89 (95% CI: 5.98-8.00) µmol/L; p = .052). In BW- and BMI-adjusted model, a statistically significant difference in DHEAS levels was found between the "persistent weight gain" (7.93 [95% CI: 6.43-9.86] µmol/L) and the "normal weight gain" trajectories ([5.75 [95% CI: 5.32-6.23] µmol/L; p = .039). CONCLUSION: Higher DHEAS levels are found in 7-year-old children following a trajectory of persistent weight gain from 0 to 4 years, independently of their BW or current BMI, highlighting the impact of exposure to overweight in the first years of life on prepubertal adrenal androgen production.

5.
Journal of Investigative Medicine ; 70(2):538, 2022.
Article in English | EMBASE | ID: covidwho-1701808

ABSTRACT

Purpose of Study Prior to the COVID-19 pandemic, we initiated a randomized clinical trial for childhood obesity. The trial consented 131 and randomized 104;6-12 year old patients who reside in rural regions in 4 member states (DE, NE, SC, and WV) of the ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) Approximately 6 weeks into the 10-week recruitment period, the trial was forced to pause all study activity due to the COVID-19 pandemic. This pause necessitated a substantial revision in recruitment and study methods to using virtual procedures. This descriptive paper outlines ways to recruit and manage clinical trial participants using technology to obtain informed consent, obtain height and weight measurements by video, and maintain participant engagement throughout the duration of the trial. Methods Used We reviewed multiple data sources to describe the transition to virtual study procedures. These include research electronic data capture (REDCap) surveys conducted both during the pause and at the completion of the study to identify readiness for each site to conduct virtual recruitment and other study procedures as well as at the end of the study to identify issues that each site encountered during the virtual phase of the project. We also reviewed meeting notes and study enrollment figures. Summary of Results The IRB approved study changes allowed for variability between clinical sites in terms of virtual communication platforms and methods for participant consent and height/weight assessment. Identified advantages of the study included ability to conduct visits during all times of the day or evening, and reduced travel requirements. Challenges included poor Internet reliability in some rural areas;additional participant contacts for consent and eligibility screening;shipping delays of materials;reliance on family to perform height and weight measures;increased costs for materials and shipping. Despite the added challenges, all sites were able to meet the study enrollment objectives. Flexibility was key in implementation of virtual procedures given the variations in site resources. Conclusions While each study site had certain challenges unique to their location during the pandemic, we also identified several common issues with the transition to remote procedures. Lessons learned from this study can assist other study groups in navigating challenges, especially when recruiting and implementing studies with a difficult to reach rural and underserved populations or during challenging events like the pandemic.

6.
Search-Journal of Media and Communication Research ; 13(3):141-156, 2021.
Article in English | Web of Science | ID: covidwho-1695960

ABSTRACT

Childhood obesity and its associated risks in Malaysia remains a major health concern where at least one in five of children are affected. Media engagement with the public on the outbreak of Covid-19 had since overshadowed these health issues. Measures for social distancing and containment through the Movement Control Order (MCO) presented challenges for parents in making healthy food choices and dealing with unforeseen sedentary lifestyles. The study examined perceptions of parents towards health communication, how parents ensure their children abide by healthy eating habits, and how they seek information on childhood obesity intervention during this period. The positive deviance (PD) approach argues that champions of innovative ideas on maintaining good health are found within the communities rather than a change agency's prescription. The study obtained input from parents in the Klang Valley through semi-structured interviews. Thematic analysis findings show that parents from M40 and B40 communities have insufficient information on nutrition for childhood development and prioritize convenience over long-term effects due to their hectic routines and household income. Positive deviant (PD) T20 groups are found to be more efficient in managing and applying knowledge due to their higher health literacy and communication within their social groups. This outlines the gap on effective communication strategies to improve health literacy of the public.

7.
Community Practitioner ; 94(6):34-39, 2021.
Article in English | ProQuest Central | ID: covidwho-1668644

ABSTRACT

With some of the world's higher rates of obesity in adults and children, rising levels of type 2 diabetes, a growing mental health epidemic--particularly among young people--and widening social inequalities, the UK population was not ideally placed to weather the storm when Covid-19 struck. In fact, research by a team from the Centre for Longitudinal Studies at the University College London Institute of Education revealed that of a cohort born in 1970, a third (33.8%) of the population had already been diagnosed with two or more chronic health problems by 46 to 48 years of age. Cancer care is one area where the damage of delayed appointments and screening is being felt, while difficulties in getting primary care appointments or patients not wanting to burden the NHS at a time of crisis are also having a big impact. Research by the Institute for Public Policy Research (2021) has estimated that missed referrals mean 19,500 people who should have been diagnosed with cancer have not been.

8.
Revista Espanola De Nutricion Humana Y Dietetica ; 25:25, 2021.
Article in Spanish | Web of Science | ID: covidwho-1622862

ABSTRACT

Introduction: School closures due to the COVID-19 pandemic represent a risk factor for the development of childhood obesity, due to the increase in unhealthy behaviors. Online lifestyle interventions in schoolchildren could help to mitigate this problem. However, to our knowledge, no randomized controlled trials have been conducted to prevent obesity in schoolchildren during COVID-19. The aim of this study is to evaluate the effect of a 4-month online lifestyle intervention on the BMI Z-score of Mexican schoolchildren during the COVID-19 pandemic in an intervention group compared to a control group. Material and Methods: This is a protocol for an outcome assessor-blinded pilot randomized controlled trial. Schoolchildren from a public elementary school in Hermosillo, Sonora, Mexico will be invited to participate. Participants will be randomized to an intervention group (online lifestyle intervention) or a control group. The intervention will include online sessions of nutrition education and physical activity (60 minutes per session, 30 minutes for nutrition education and 30 minutes for physical activity) and nutrition information for parents. The control group will receive a digital brochure with nutrition recommendations at the beginning of the study and access to the program materials at the end of the study. The measurements will be performed at baseline and at 4 months. The primary outcome will be the BMI Z-score. Secondary outcomes will be waist circumference, body fat percentage, nutrition knowledge, lifestyle parameters, participation, retention and acceptance of the intervention. The changes on the outcomes will be analyzed using an intention to treat analysis. The protocol was approved by the Research Ethics Committee of the University of Sonora Nursing Department and registered in Clinical Trials. Conclusion: To our knowledge, the study will provide the first evidence of the evaluation of online interventions for the prevention of obesity in schoolchildren derived from a randomized controlled trial, which could be useful in the fight against childhood obesity.

9.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617058

ABSTRACT

Introduction: Childhood overweight and obesity remain serious public health problem. In the Republic of Kazakhstan, few studies have quantified overweight rates among children. To assess overweight and obesity in primary school children based on measured intercountry comparable data, a cross-sectional survey was implemented in 2020 based on the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) protocol. Material and Methods: The study was conducted on a national representative sample of 6851 children of 2-3 grades in October-December 2020. The anthropometric variables were measured by standardized equipment to calculate body mass index. Prevalence of overweight and obesity was determined for 6-9-year-old children by gender using WHO growth reference 2007. The prevalence of weight categories was compared for 8-year-olds with the 2015 COSI survey. Results: 20,6% of children aged 6-9 years old were overweight, and 6,6% were obese. Among boys, the prevalence of overweight and obesity was higher, 23,6% and 8,7%, respectively, compared to girls 17,6% and 4,6%, respectively (p <0.001). The prevalence of overweight among children living in urban areas was 23.1%, significantly higher than children from rural areas-17.5% (p <0.001). The same trend is observed for obesity both by gender and by place of residence. The prevalence of obese children is higher in urban areas (8.0%) compared with the proportion of obese children in rural areas (5.2%). During the period between two surveys (2015-2020) the prevalence of overweight among 8-year-old boys increased from 18.7% in 2015 to 24.2% in 2020 and for obesity from 6.6% in 2015 to 9.6% in 2020, although non-significantly. No changes in these indicators were found in girls. Conclusion: Thus, one-fifth of Kazakhstan children 6-9 years of age were overweight or obese. The results of the child surveys from 2015 and 2020 demonstrate the trend for a plateau in overweight and obesity prevalence. The survey results demonstrate the need for actions to mobilize policy and society to tackle the childhood obesity epidemic and the need for continuous monitoring trends to better understand the progression of childhood overweight and obesity.

10.
Obesity Medicine ; 30, 2022.
Article in English | EMBASE | ID: covidwho-1616683

ABSTRACT

Background: The prevalence of obesity continued to increase and has doubled in more than 70 countries since 1980. The online search traffic pattern analysis has been used to determine the effectiveness of public health programs, early disease detection, prevention, and management. However, this analysis has not yet been applied for obesity. Aims: This study investigated the pattern of online search traffic and determined the possible factors associated with online interest in obesity. Methods: Global online search interest for obesity was measured using the Google Trends™ database. We used the search term "obesity". We limited the results from 2004 until 2021 from all countries. Correlation between country-specific characteristics and search volume index was determined using Spearman's rank-order correlation. Results: This study showed a significant decrease in global online interest in obesity from 2004 to 2021. People searching for the term “obesity” also searched for the different classifications of obesity, childhood obesity, diabetes, and COVID. The top countries where the search term “obesity” was most popular included Jamaica, New Zealand, Australia, the United States, and the United Kingdom. The population was shown to be negatively correlated with online interest in obesity (p = 0.015). Conclusions: This study showed a significant decrease in online search traffic for obesity. This may serve as a proxy measure of the public's decreased awareness and health-seeking behavior for obesity. This study emphasizes the need for more health education campaigns and programs to control and prevent obesity worldwide.

11.
Obesity ; 29(SUPPL 2):80, 2021.
Article in English | EMBASE | ID: covidwho-1616086

ABSTRACT

Background: Childhood obesity is highly prevalent in the US and disproportionately impacts minorities;these disparities have worsened during the COVID-19 pandemic. Adoption of effective pediatric weight management interventions (PWMI) that have been evaluated among low-income minority populations is needed. Connect for Healthy Weight, a package co-developed by the AAP and MGH, helps federally qualified health centers (FQHC) establish multidisciplinary healthy weight clinics based on previous effective RCTs. We sought to identify the determinants to successful adoption of Connect for Healthy Weight in pre-and post-implementation sites. Methods: We interviewed 19 stakeholders, 10 from two FQHCs in MS where Connect for Healthy Weight will be piloted and 9 from health centers that have previously implemented it. Separate interview guides informed by the Consolidated Framework for Implementation Research were developed. Qualitative data analysis was conducted using the immersion-crystallization method. Results: In pre-implementation sites, an inner setting facilitator mentioned was a positive learning climate. Characteristics of individuals that can facilitate adoption include staff willingness to learn, valuing evidence-based care for childhood obesity, and culturally and weight-sensitive staff. In terms of patient needs and resources (outer setting), social determinants of health are barriers to adoption, but creative solutions were suggested to mitigate these. Other facilitators related to the intervention included its multidisciplinary model and adaptability. Similar themes were elicited from post-implementation sites;adaptations brought on by the pandemic, such as telehealth visits and content modification to align with distancing guidelines and the effects of social isolation were also described. Conclusions: Understanding the determinants to adoption of an evidence-based PWMI allows for necessary adaptations to be made to facilitate adoption and nationwide dissemination.

12.
Obesity ; 29(SUPPL 2):101, 2021.
Article in English | EMBASE | ID: covidwho-1616075

ABSTRACT

Background: As a result of the COVID-19 pandemic and the closure of schools across the United States(US), more children are struggling with mental health and obesity issues than ever before. KidShape, an evidence-based pediatric weight management program, had been implemented successfully across the United States as an in-person program. KidShape saw a need to reimagine the program in an online format to scale an effective family wellness program. Methods: Registered Dietitians (RD) and a health psychologist evaluated the nine-week KidShape behavioral family-based weight management intervention (totaling 26.5 contact hours over three months) to determine which evidence-based components were needed to implement the program online and meet the US Preventive Services Recommendation Statement for Obesity in Children as a comprehensive, intensive behavioral interventions (2017). An online curriculum was designed for families with children ages 7 to 13 to meet one hour twice a week for 12 weeks plus a one-hour nutrition assessment at the beginning of the program and a nutrition reassessment at the program midpoint with an RD ( = 26 contact hours). The weekly family group sessions provide tools for healthy eating, improving physical activity, limiting screen time, mindfulness, problem solving, improving self-esteem/ body image, and goal setting. The team evaluated three online platforms for implementation: Blackboard, Zoom and Outschool. Results: Virtual KidShape workshops were implemented with a combination of Outschool and Zoom platforms with the greatest success as determined by ease of use and participation. The RDs and health psychologist teaching the workshops were able to actively and positively engage with families virtually. The intervention was scalable quickly without physical space limitations. Families joined from multiple states and 100% provided positive feedback. Conclusions: Adaptation of KidShape, a comprehensive intensive behavioral intervention, to effectively address pediatric mental health and weight issues was feasible in an online virtual format. Families accessed the program accross the US regardless of geography. The evidence-based curriculum plus using technology that families were familiar with due to online school and parents working virtually because of the COVID-19 pandemic created a positive user experience.

13.
Obesity ; 29(SUPPL 2):76, 2021.
Article in English | EMBASE | ID: covidwho-1616049

ABSTRACT

Background: Pediatric obesity interventions of 26 or more contact hours may be more effective than those with fewer contact hours, but research is inconclusive. Disagreement may be due to the lack of uniformity in reporting dose. To remedy this issue experts recommend reporting dose intended, dose delivered, and dose received. Also, very little is known about the accumulation of dose in rural populations, and no information has been published regarding the accumulation of dose in the time of COVID 19. The purpose of the current is to describe the accumulation of dose in a four-state pediatric obesity intervention trial that was conducted in the IDeA States Pediatric Clinical Trials Network. Methods: Rural medical clinics located in four states participated. Each clinic targeted recruitment of 28 children from rural areas who were 6-11 years of age with a BMI%ile≥85th and their primary caregivers who (after consent/assent) were randomly assigned to a monthly newsletter only condition or to the iAmHealthy mHealth intervention, which was composed of 12 weekly and 3 monthly one hour group sessions and 11 hours of individual family health coaching. The 6-month intervention period began on August 24, 2020 and completed on February 7, 2021 when the impact of the COVID 19 pandemic was high in participating sites. Results: 52 of the 104 randomized participants were assigned to iAmHealthy;87% (n = 45) of these participants were retained through the final measurement. Dose intended was 26 contact hours (15 hours of group sessions and 11 hours of health coaching sessions), with a goal for families to receive 80% of these hours (20.8 hours). Dose delivered by the intervention team included 15 hours of group sessions and up to 17 hours for health coaching sessions. Dose received varied widely for both group (0.73-16.78;X = 10.65) and health coaching sessions (0.45-16.85;X = 8.21). Therefore, total accumulated contact hours varied as well (2.45-31.13;X = 18.86). Two thirds of the retained participants met the a priori dose goal of 20.8 contact hours. Conclusions: Dose intended and dose received were highly concordant, but dose received varied widely by participant. Future research should continue to explore these measures of dose, especially in underserved populations, and whether these factors are related to health behavior outcomes and body mass changes.

14.
J Pediatr Endocrinol Metab ; 35(3): 297-302, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-1561349

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has changed everyday life. The Korean government urged schools to close as a measure of social distancing, and children and adolescents seemed to gain weight due to home confinement. We aimed to investigate the trends in weight changes in children during the pandemic period. MATERIALS AND METHODS: This retrospective study included 139 children aged between 6 and 12 years who visited the pediatric endocrine clinic for regular growth follow-up for 1 year during the COVID-19 pandemic. We analyzed changes in the body mass index (BMI), BMI z-score, and proportion of children who were overweight or obese over a period of 1 year. RESULTS: The BMI and BMI z-scores of the 139 children increased significantly over the year. The increase was maximum during the first three months of the COVID-19 pandemic, with little change between the third and sixth month of the pandemic. The proportion of children who were overweight or obese increased over time, from 24.5% at the COVID-19 pandemic baseline to 38.1% 1 year later (p < 0.001). CONCLUSIONS: The COVID-19-related lockdown resulted in significant weight gain in Korean children. Changes in BMI showed different trends depending on the degree of school closure. An overall shift from normal weight to overweight or obesity was observed during the pandemic period.


Subject(s)
COVID-19/epidemiology , Pediatric Obesity/epidemiology , SARS-CoV-2 , Body Mass Index , Child , Communicable Disease Control/methods , Female , Humans , Male , Overweight/epidemiology , Republic of Korea/epidemiology , Retrospective Studies , Schools , Weight Gain
15.
JMIR Mhealth Uhealth ; 9(9): e31621, 2021 09 14.
Article in English | MEDLINE | ID: covidwho-1443996

ABSTRACT

BACKGROUND: Mobile health (mHealth) may improve pediatric weight management capacity and the geographical reach of services, and overcome barriers to attending physical appointments using ubiquitous devices such as smartphones and tablets. This field remains an emerging research area with some evidence of its effectiveness; however, there is a scarcity of literature describing economic evaluations of mHealth interventions. OBJECTIVE: We aimed to assess the economic viability of using an mHealth approach as an alternative to standard multidisciplinary care by evaluating the direct costs incurred within treatment arms during a noninferiority randomized controlled trial (RCT). METHODS: A digitally delivered (via a smartphone app) maintenance phase of a pediatric weight management program was developed iteratively with patients and families using evidence-based approaches. We undertook a microcosting exercise and budget impact analysis to assess the costs of delivery from the perspective of the publicly funded health care system. Resource use was analyzed alongside the RCT, and we estimated the costs associated with the staff time and resources for service delivery per participant. RESULTS: In total, 109 adolescents participated in the trial, and 84 participants completed the trial (25 withdrew from the trial). We estimated the mean direct cost per adolescent attending usual care at €142 (SD 23.7), whereas the cost per adolescent in the mHealth group was €722 (SD 221.1), with variations depending on the number of weeks of treatment completion. The conversion rate for the reference year 2013 was $1=€0.7525. The costs incurred for those who withdrew from the study ranged from €35 to €681, depending on the point of dropout and study arm. The main driver of the costs in the mHealth arm was the need for health professional monitoring and support for patients on a weekly basis. The budget impact for offering the mHealth intervention to all newly referred patients in a 1-year period was estimated at €59,046 using the assessed approach. CONCLUSIONS: This mHealth approach was substantially more expensive than usual care, although modifications to the intervention may offer opportunities to reduce the mHealth costs. The need for monitoring and support from health care professionals (HCPs) was not eliminated using this delivery model. Further research is needed to explore the cost-effectiveness and economic impact on families and from a wider societal perspective. TRIAL REGISTRATION: ClinicalTrials.gov NCT01804855; https://clinicaltrials.gov/ct2/show/NCT01804855.


Subject(s)
Nutrition Therapy , Telemedicine , Adolescent , Child , Cost-Benefit Analysis , Exercise , Humans , Smartphone
16.
Health Aff (Millwood) ; 39(7): 1111, 2020 07.
Article in English | MEDLINE | ID: covidwho-1443863

Subject(s)
Income , Taxes , Humans
17.
J Obstet Gynaecol India ; : 1-3, 2021 Sep 10.
Article in English | MEDLINE | ID: covidwho-1410086

ABSTRACT

India is presently in the midst of a major health crisis with the second wave of corona virus spreading at an alarming rate and claiming more lives than ever before. Although the pandemic is affecting the lives of all sections of society, adolescent girls being a vulnerable group are affected in dual manner, not just by the direct effects of the virus but also by many still underrated indirect effects. The present article aims to highlight the indirect yet sinister effects of COVID-19 on physical, mental, social, sexual and reproductive and psychological health and well-being of adolescent girls and other issues like their personal safety, peer support and long-term health issues. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13224-021-01555-1.

18.
Contemp Clin Trials ; 109: 106497, 2021 10.
Article in English | MEDLINE | ID: covidwho-1347515

ABSTRACT

Family-based behavioral treatment (FBT) is an evidence-based treatment for pediatric obesity. FBT has primarily been implemented in specialty clinics, with highly trained interventionists. The goal of this study is to assess effectiveness of FBT implemented in pediatric primary care settings using newly trained interventionists who might implement FBT in pediatric practices. The goal is to randomize 528 families with a child with overweight/obesity (≥85th BMI percentile) and parent with overweight/obesity (BMI ≥ 25) across four sites (Buffalo and Rochester, New York; Columbus, Ohio; St. Louis, Missouri) to FBT or usual care and obtain assessments at 6-month intervals over 24 months of treatment. FBT is implemented using a mastery model, which provides quantity of treatment tailored to family progress and following the United States Preventive Services Task Force recommendations for effective dose and duration of treatment. The primary outcome of the trial is change in relative weight for children, and secondarily, for parents and siblings who are overweight/obese. Between group differences in the tendency to prefer small immediate rewards over larger, delayed rewards (delay discounting) and how this is related to treatment outcome is also evaluated. Challenges in translation of group-based interventions to individualized treatments in primary care settings, and in study implementation that arose due to the COVID-19 pandemic are discussed. It is hypothesized that the FBT intervention will be associated with better changes in relative weight for children, parents, and siblings than usual care. The results of this study can inform future dissemination and implementation of FBT into primary care settings.


Subject(s)
Family Therapy , Pediatric Obesity , Primary Health Care , COVID-19 , Child , Family Therapy/organization & administration , Humans , Pandemics , Parents , Pediatric Obesity/therapy
19.
JMIR Mhealth Uhealth ; 9(7): e26290, 2021 07 09.
Article in English | MEDLINE | ID: covidwho-1311339

ABSTRACT

BACKGROUND: Obesity is a major public health problem globally and in Europe. The prevalence of childhood obesity is also soaring. Several parameters of the living environment are contributing to this increase, such as the density of fast food retailers, and thus, preventive health policies against childhood obesity must focus on the environment to which children are exposed. Currently, there are no systems in place to objectively measure the effect of living environment parameters on obesogenic behaviors and obesity. The H2020 project "BigO: Big Data Against Childhood Obesity" aims to tackle childhood obesity by creating new sources of evidence based on big data. OBJECTIVE: This paper introduces the Obesity Prevention dashboard (OPdashboard), implemented in the context of BigO, which offers an interactive data platform for the exploration of objective obesity-related behaviors and local environments based on the data recorded using the BigO mHealth (mobile health) app. METHODS: The OPdashboard, which can be accessed on the web, allows for (1) the real-time monitoring of children's obesogenic behaviors in a city area, (2) the extraction of associations between these behaviors and the local environment, and (3) the evaluation of interventions over time. More than 3700 children from 33 schools and 2 clinics in 5 European cities have been monitored using a custom-made mobile app created to extract behavioral patterns by capturing accelerometer and geolocation data. Online databases were assessed in order to obtain a description of the environment. The dashboard's functionality was evaluated during a focus group discussion with public health experts. RESULTS: The preliminary association outcomes in 2 European cities, namely Thessaloniki, Greece, and Stockholm, Sweden, indicated a correlation between children's eating and physical activity behaviors and the availability of food-related places or sports facilities close to schools. In addition, the OPdashboard was used to assess changes to children's physical activity levels as a result of the health policies implemented to decelerate the COVID-19 outbreak. The preliminary outcomes of the analysis revealed that in urban areas the decrease in physical activity was statistically significant, while a slight increase was observed in the suburbs. These findings indicate the importance of the availability of open spaces for behavioral change in children. Discussions with public health experts outlined the dashboard's potential to aid in a better understanding of the interplay between children's obesogenic behaviors and the environment, and improvements were suggested. CONCLUSIONS: Our analyses serve as an initial investigation using the OPdashboard. Additional factors must be incorporated in order to optimize its use and obtain a clearer understanding of the results. The unique big data that are available through the OPdashboard can lead to the implementation of models that are able to predict population behavior. The OPdashboard can be considered as a tool that will increase our understanding of the underlying factors in childhood obesity and inform the design of regional interventions both for prevention and treatment.


Subject(s)
COVID-19 , Child , Europe , Greece , Humans , SARS-CoV-2 , Sweden
20.
Child Obes ; 17(8): 497-506, 2021 12.
Article in English | MEDLINE | ID: covidwho-1290091

ABSTRACT

Background: In response to the coronavirus disease 2019 (COVID-19) pandemic, elementary and secondary schools in the United States transitioned to remote learning to slow viral spread and protect students and school officials. This move interrupted academic education and school-based health interventions focused on physical activity (PA) and healthy eating behaviors to help combat childhood obesity. Little is known on how these interventions were affected by COVID-19. Methods: This concurrent multimethodological study incorporated two independent components: qualitative descriptive semistructured interviews with public school administrators and quantitative descriptive cross-sectional needs assessment survey of public school personnel. Results: Three themes were identified from interviews with school administrators (N = 28): changes in school-based interventions addressing PA and healthy eating behaviors, changes in academic delivery affecting PA and healthy eating behaviors, and needs of school administrators. From the survey (N = 1311), 635 (48.4%) participants indicated that schools' abilities to address PA and healthy eating behaviors were negatively impacted by COVID-19. The majority (n = 876, 66.8%) of participants strongly agreed or agreed that the pandemic would affect future school-based interventions related to PA and healthy eating behaviors. Conclusions: While schools are prime locations for delivering school-based weight management interventions related to childhood obesity, participants reported the pandemic had overall negative impacts on interventions addressing PA and healthy eating behaviors. Understanding these impacts is essential to adapting school-based interventions to changes from COVID-19 so students may receive health information and access health promotion interventions in remote learning environments and during social distancing.


Subject(s)
COVID-19 , Diptera , Pediatric Obesity , Animals , Child , Cross-Sectional Studies , Humans , Pandemics/prevention & control , Pediatric Obesity/epidemiology , Pediatric Obesity/prevention & control , SARS-CoV-2 , Schools , United States/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL