Using the RE-AIM framework to evaluate the feasibility of a parent-focused intervention targeting childhood obesity.

BACKGROUND: Childhood obesity remains a serious public health concern. Community-based childhood obesity treatment interventions have the potential to improve health behaviors and outcomes among children, but require thorough evaluation to facilitate translation of research into practice. The purpose of the current study was to determine the feasibility of a community-based, parent-focused childhood obesity intervention ("C.H.A.M.P. Families") using the RE-AIM framework, an evaluation tool for health interventions. METHODS: A single-group, non-randomized, repeated measures feasibility study was conducted. Participants (n = 16 parents/caregivers of 11 children with obesity) completed a 13-week parent-focused education intervention. The intervention consisted of three main components: (a) eight group-based (parent-only) education sessions; (b) eight home-based (family-centered) activities; and (c) two group-based follow-up support sessions for parents and children. The five dimensions of RE-AIM-reach, effectiveness, adoption, implementation, and maintenance-were assessed using various measures and data sources (e.g., child, parent/caregiver, costing, census) obtained throughout the study period. Outcome variables were measured at baseline, mid-intervention, post-intervention, and at a 6-month follow-up. RESULTS: Overall, the C.H.A.M.P. Families intervention reached approximately 0.09% of eligible families in London, Ontario. Despite the small number, participants were generally representative of the population from which they were drawn, and program participation rates were high (reach). Findings also suggest that involvement in the program was associated with improved health-related quality of life among children (effectiveness/individual-level maintenance). In addition, the intervention had high fidelity to protocol, attendance rates, and cost-effectiveness (implementation). Lastly, important community partnerships were established and maintained (adoption/setting-level maintenance). CONCLUSIONS: Based on a detailed and comprehensive RE-AIM evaluation, the C.H.A.M.P. Families intervention appears to be a promising parent-focused approach to the treatment of childhood obesity. TRIAL REGISTRATION: ISRCTN Registry, Study ID ISRCTN 10752416 . Registered 24 April 2018.

Describing the views of Canadian post-secondary students in health-related disciplines on the recognition of obesity as a chronic disease.

OBJECTIVE: This cross-sectional study examined students' perspectives on the ramifications of obesity being recognized as a chronic disease in Canada. PARTICIPANTS: Undergraduate and graduate students (n = 150) in health-related programs at a major Canadian university. METHODS: An online survey featured open-ended questions to capture student perspectives on recognizing obesity as a disease. Data were evaluated using content analysis methods. RESULTS: Positive themes identified included: (a) treatment accessibility; (b) improved healthcare provider attitudes; (c) de-stigmatization of obesity; (d) promotion of health behaviors; and (e) greater research/funding. Negative themes included potential: (a) healthcare system burdens; (b) perpetuation of obesity stigma; (c) medicalization of obesity; and (d) de-emphasis on modifiable risk factors as contributing to obesity. CONCLUSIONS: There is a need to increase students' understanding of the multifaceted nature of obesity and the prevention of obesity-related stigma within healthcare. Findings may inform post-secondary health curricula and obesity initiatives.

Impact of awareness and concerns of climate change on children's mental health: a scoping review protocol.

OBJECTIVE: The purpose of this scoping review is to identify and describe the existing literature on the impact of the overarching awareness and concerns of climate change on children's mental health and well-being. INTRODUCTION: Children are widely acknowledged as being disproportionately at risk to the effects of climate change, yet research overlooks the impact that climate change has on their mental health. Children's overarching awareness of climate change, and its global effects, may influence their mental health and well-being. INCLUSION CRITERIA: This review will include all research that addresses school-aged children's (aged 3-19) mental-health issues stemming from an awareness of climate change. It will not include research that examines direct impacts of climate change on children's mental health, such as trauma from a specific climate-related event. METHODS: Searches will be conducted across eight research databases (Cochrane Database of Systematic Reviews, CINAHL, Embase, GreenFILE, PubMed, PsycINFO, Web of Science, and Scopus) and three unpublished/gray literature databases (ProQuest Dissertations and Theses, GreyLit.org, and OpenGrey). Data will be extracted for author(s), year of publication, country of origin, purpose, population, methodology, concepts of interest, outcomes, and key findings relating to the scoping review objectives. Findings will be presented as a narrative summary.

Participants' Perceptions of "C.H.A.M.P. Families": A Parent-Focused Intervention Targeting Paediatric Overweight and Obesity.

Background: Recently, our team implemented a 13-week group-based intervention for parents of children with obesity ("C.H.A.M.P. Families"). The primary objective of this study was to explore, qualitatively, parents' perspectives of their experiences in and influence of C.H.A.M.P. Families, as well as their recommendations for future paediatric obesity treatment interventions. Methods: Twelve parents (seven mothers, five fathers/step-fathers) representing seven children (four girls, three boys) with obesity participated in one of two focus groups following the intervention. Focus groups were audio recorded and transcribed verbatim and data were analyzed using inductive thematic analysis. Results: Findings showed that parents perceived their participation in C.H.A.M.P. Families to be a positive experience. Participants highlighted several positive health-related outcomes for children, families, and parents. Parents also underscored the importance and positive impact of the group environment, specific educational content, and additional program components such as free child-minding. Recommendations for future interventions were also provided, including greater child involvement and more practical strategies. Finally, parents identified several barriers including socioenvironmental issues, time constraints, and parenting challenges. Conclusions: Researchers developing family-based childhood obesity interventions should consider the balance of parent and child involvement, as well as emphasize group dynamics strategies and positive family communication.

"C.H.A.M.P. Families": Description and Theoretical Foundations of a Paediatric Overweight and Obesity Intervention Targeting Parents-A Single-Centre Non-Randomised Feasibility Study.

Childhood obesity represents a significant global health challenge, and treatment interventions are needed. The purpose of this paper is to describe the components and theoretical model that was used in the development and implementation of a unique parent-focussed paediatric overweight/obesity intervention. C.H.A.M.P. Families was a single-centre, prospective intervention offered to parents of children aged between 6⁻14 years with a body mass index (BMI) ≥85th percentile for age and sex. The intervention included: (1) eight group-based (parent-only) education sessions over 13-weeks; (2) eight home-based activities; and (3) two group-based (family) follow-up support sessions. The first section of the manuscript contains a detailed description of each intervention component, as well as an overview of ongoing feasibility analyses. The theoretical portion details the use of evidence-based group dynamics principles and motivational interviewing techniques within the context of a broader social cognitive theory foundation. This paper provides researchers with practical examples of how theoretical constructs and evidence-based strategies can be applied in the development and implementation of parent-focussed paediatric obesity interventions. Given the need for transparent reporting of intervention designs and theoretical foundations, this paper also adds to the areas of implementation science and knowledge translation research.

Barriers to Recruiting Men Into Chronic Disease Prevention and Management Programs in Rural Areas: Perspectives of Program Delivery Staff.

Chronic disease is becoming increasingly prevalent in Canada. Many of these diseases could be prevented by adoption of healthy lifestyle habits including physical activity and healthy eating. Men, especially those in rural areas, are disproportionately affected by chronic disease. However, men are often underrepresented in community-based chronic disease prevention and management (CDPM) programs, including those that focus on physical activity and/or healthy eating. The purpose of this study was to explore the experiences and perceptions of program delivery staff regarding the challenges in recruitment and participation of men in physical activity and healthy eating programs in rural communities, and suggestions for improvement. Semistructured interviews were conducted by telephone with 10 CDPM program delivery staff from rural communities in Southwest Ontario, Canada. Time and travel constraints, relying on spouses, and lack of male program leaders were cited as barriers that contributed to low participation levels by men in CDPM programs. Hiring qualified male instructors and engaging spouses were offered as strategies to increase men's participation. The results of this study highlight many of the current issues faced by rural health organizations when offering CDPM programming to men. Health care organizations and program delivery staff can use the recommendations in this report to improve male participation levels.