ABSTRACT
OBJECTIVE: The objective of the current study was to examine the feasibility of telemedicine vs. telephone for the delivery of a multidisciplinary weekly family-based behavioural group intervention to treat paediatric obesity delivered to families living in rural areas using a randomized controlled trial methodology. METHODS: 103 rural children and their families were recruited. Feasibility measures included participant satisfaction, session attendance and retention. Treatment outcome measures included child Body Mass Index z-score (BMIz), parent BMI, 24-hour dietary recalls, accelerometer data, the child behavior checklist and the behavioral pediatrics feeding assessment scale. RESULTS: Participants were highly satisfied with the intervention both via telemedicine and via telephone. Completion rates were much higher than for other paediatric obesity intervention programmes, and both methodologies were highly feasible. There were no differences in telemedicine and telephone groups on primary outcomes. CONCLUSION: Both telemedicine and telephone intervention appear to be feasible and acceptable methods of delivering paediatric obesity treatment to rural children.
Subject(s)
Behavior Therapy/methods , Family Therapy/methods , Pediatric Obesity/therapy , Rural Health Services/organization & administration , Telemedicine/methods , Telephone , Body Mass Index , Child , Child, Preschool , Cluster Analysis , Diet , Exercise , Feasibility Studies , Female , Humans , Male , Patient Compliance , Patient Satisfaction , Rural PopulationABSTRACT
OBJECTIVE: The objective of the current study was to examine the effectiveness of a multidisciplinary weekly family-based behavioral group delivered via telemedicine to rural areas, compared with a standard physician visit intervention. METHODS: A randomized controlled trial was conducted with 58 rural children and their families comparing a family-based behavioral intervention delivered via telemedicine to a structured physician visit condition. Outcome measures included child body mass index z-score (BMIz), 24-hr dietary recalls, accelerometer data, Child Behavior Checklist, Behavioral Pediatrics Feeding Assessment Scale, and feasibility and fidelity. RESULTS: Child BMIz outcomes were not statistically different between the 2 groups (F = 0.023, p = .881). Improvements in BMIz, nutrition, and physical activity were seen for both groups. CONCLUSIONS: Both telemedicine and structured physician visit may be feasible and acceptable methods of delivering pediatric obesity treatment to rural children.
Subject(s)
Family Therapy/methods , Obesity/therapy , Telemedicine/methods , Weight Reduction Programs/methods , Accelerometry , Body Mass Index , Checklist , Child , Feeding Behavior , Female , Humans , Male , Motor Activity , Rural Population , Surveys and Questionnaires , Treatment OutcomeABSTRACT
BACKGROUND: Interventions developed for improving sleep in parents of young children or in developmentally delayed children might also prove effective for persons with dementia and their caregivers. METHODS: We selectively reviewed the literature for interventions effective in improving sleep in parents of young children or in developmentally delayed children. RESULTS: Graduated extinction and adult fading have been minimally explored in dementia populations. They are fairly brief and could be administered during primary care or dementia clinic visits. Combination strategies such as extinction and sleep-enhancing medication are very effective and may be applicable for persons with dementia and their caregivers. Physical capabilities and degree of cognitive decline of patients with dementia must be considered, and medical staff and caregivers should adjust behavioral strategies to maximize the use of patients' intact cognitive abilities. CONCLUSIONS: Interventions for divergent populations prone to similar problems as those of patients with dementia might be effective and advance existing research.
Subject(s)
Caregivers/psychology , Dementia/therapy , Sleep Wake Disorders/therapy , Behavior Therapy , Combined Modality Therapy , Dementia/drug therapy , Humans , Hypnotics and Sedatives/therapeutic useABSTRACT
OBJECTIVE: To describe baseline characteristics of participants in a pediatric obesity intervention tailored specifically to rural families delivered via telemedicine. METHODS: Randomized-control trial comparing a family-based behavioral intervention to a usual care condition. Participants Fifty-eight first through fifth graders and their parents from the rural Midwest. Measures Demographic, body mass index (BMI), Actigraph activity monitor information, 24-h dietary recalls, Child Behavior Checklist, Behavioral Pediatrics Feeding Assessment Scale. RESULTS: Child mean BMI was in the 94th percentile for weight. Average daily dietary intake exceeded 2,000 kcal and children consumed over eight servings of high-calorie, low-nutrient-dense foods. Children are engaged in approximately 65 min of moderate, 12 min of vigorous and over 300 min of sedentary physical activity daily. CONCLUSIONS: Baseline data suggest children in rural areas may engage in adequate physical activity but eat many daily servings of energy-dense foods. Rural families may benefit from a comprehensive, rurally tailored obesity-related health behavior intervention.
