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School-Based Interventions in Low Socioeconomic Settings to Reduce Obesity Outcomes among Preschoolers: A Scoping Review.

ABSTRACT: Pediatric obesity continues to grow globally, specifically in low-socioeconomic rural areas. Strategies that combat pediatric obesity have not yet been fully determined. While the implementation of some interventions in preschool (ages 2-5) populations have demonstrated successful results, others have proven to be inconclusive and less have focused specifically on low socioeconomic populations. This scoping review aims to examine the literature to study the effectiveness of the school-based interventions in low socioeconomic settings on adiposity-related outcomes among preschoolers. PubMed/MEDLINE and EBSCO (ERIC (Education Resource Information Center) and Food Science Source) were used to conduct the search strategy. A total of 15 studies were assessed that met the inclusion criteria: Studies that included school-based interventions; reported adiposity-related data; targeting preschoolers (2 to 5 years old) in rural/low socioeconomic/underserved/areas. Interventions were then described as successful or inconclusive based on the primary outcome. Nine out of the fifteen studies were labeled as successful, which had a reduction in adiposity-related outcomes (BMI (body mass index), BMI z-score, waist circumference, skinfold, percent body fat). Current evidence, although scarce, suggest that obesity outcomes can be targeted in low socioeconomic settings through school interventions with a multicomponent approach (nutrition and physical activity) and the inclusion of parents. Further research is needed to determine effective interventions, their efficacy, and their long-term outcomes.

SUBMITTER: Luybli M

PROVIDER: S-EPMC6683276 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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School-Based Interventions in Low Socioeconomic Settings to Reduce Obesity Outcomes among Preschoolers: A Scoping Review.

Luybli Megan M Schmillen Hanna H Sotos-Prieto Mercedes M

Nutrients 20190704 7

Pediatric obesity continues to grow globally, specifically in low-socioeconomic rural areas. Strategies that combat pediatric obesity have not yet been fully determined. While the implementation of some interventions in preschool (ages 2-5) populations have demonstrated successful results, others have proven to be inconclusive and less have focused specifically on low socioeconomic populations. This scoping review aims to examine the literature to study the effectiveness of the school-based inte ...[more]

PMID: 31277426

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Project description:BackgroundThe worldwide prevalence of overweight and obesity is at alarming levels. Nearly one in three children in Europe is overweight or obese. Disordered eating and body image concerns are equally widespread and increase risk for more chronic and severe weight-related problems. Research has shown that online interventions that address both healthy weight regulation and body image can reduce risk for eating disorders and obesity simultaneously and are feasible to implement in school settings. To date, evaluation and dissemination of such programs in Europe is scant.MethodsThe Healthy Teens @ School study is a multi-country cluster-randomized controlled trial (RCT) comparing the effectiveness of an unguided, online, multi-level intervention for promoting a healthy lifestyle and reducing problematic eating behavior, eating disorder and obesity risk among students aged 14 to 19 years with control condition. As part of the Horizon 2020 funded project ICare (GA No. 634757) the trial is conducted in Austria and Spain. Cluster randomization by school is used. The intervention is an adapted version of an evidence-based program developed in the USA (StayingFit). Participants of the intervention group are assigned to one of two possible program tracks based on the results of the initial online-assessment: Overweight adolescents are assigned to the "Weight Management" track emphasizing balanced eating and exercise for weight maintenance, and all other individuals are assigned to the "Healthy Habits" track which aims at promoting healthy habits related to e.g., nutrition, physical activity, sleep. The participants of both tracks work on ten modules (one 20-30 min module per week) during school hours and/or at home. Assessments are conducted at pre- and post-intervention, and at 6- and 12-months after baseline assessment. The primary outcome is intuitive eating, secondary outcomes are eating disorder symptomatology, body image concerns, body mass index, food intake, physical activity, self-esteem, stress coping, depression, and anxiety. Following the initial assessment, individuals in the control group do not have access to the prevention program but continue as normal and are only prompted to the assessments at all time points. At the end of the 12-month study they will get access to the program.DiscussionThe results from this study will add to the understanding of how to address eating and weight related problems in adolescents and will shed light on the feasibility of implementing online prevention programs in school routine in Austria and Spain. As part of the larger ICare project this RCT will determine how an adapted version of StayingFit is disseminated within Europe.

Project description:BackgroundIt is estimated that 20-50% of all radiological examinations are of low value. Many attempts have been made to reduce the use of low-value imaging. However, the comparative effectiveness of interventions to reduce low-value imaging is unclear. Thus, the objective of this systematic review was to provide an overview and evaluate the outcomes of interventions aimed at reducing low-value imaging.MethodsAn electronic database search was completed in Medline - Ovid, Embase-Ovid, Scopus, and Cochrane Library for citations between 2010 and 2020. The search was built from medical subject headings for Diagnostic imaging/Radiology, Health service misuse or medical overuse, and Health planning. Keywords were used for the concept of reduction and avoidance. Reference lists of included articles were also hand-searched for relevant citations. Only articles written in English, German, Danish, Norwegian, Dutch, and Swedish were included. The Mixed Methods Appraisal Tool was used to appraise the quality of the included articles. A narrative synthesis of the final included articles was completed.ResultsThe search identified 15,659 records. After abstract and full-text screening, 95 studies of varying quality were included in the final analysis, containing 45 studies found through hand-searching techniques. Both controlled and uncontrolled before-and-after studies, time series, chart reviews, and cohort studies were included. Most interventions were aimed at referring physicians. Clinical practice guidelines (n = 28) and education (n = 28) were most commonly evaluated interventions, either alone or in combination with other components. Multi-component interventions were often more effective than single-component interventions showing a reduction in the use of low-value imaging in 94 and 74% of the studies, respectively. The most addressed types of imaging were musculoskeletal (n = 26), neurological (n = 23) and vascular (n = 16) imaging. Seventy-seven studies reported reduced low-value imaging, while 3 studies reported an increase.ConclusionsMulti-component interventions that include education were often more effective than single-component interventions. The contextual and cultural factors in the health care systems seem to be vital for successful reduction of low-value imaging. Further research should focus on assessing the impact of the context in interventions reducing low-value imaging and how interventions can be adapted to different contexts.

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Project description:Background:In democracies, voting is an important action through which citizens engage in the political process. Although elections are only one aspect of political engagement, voting sends a signal of support or dissent for policies that ultimately shape the social determinants of health. Social determinants subsequently influence who votes and who does not. Our objective is to examine the existing research on voting and health and on interventions to increase voter participation through healthcare organizations. Methods:We conducted a scoping review to examine the existing research on voting, health, and interventions to increase voter participation through healthcare organizations. We carried out a search of the indexed, peer-reviewed literature using Ovid MEDLINE (1946-present), PsychINFO (1806-present), Ebsco CINAHL, Embase (1947-present), Web of Science, ProQuest Sociological Abstracts, and Worldwide Political Science Abstracts. We limited our search to articles published in English. Titles and abstracts were reviewed, followed by a full-text review of eligible articles and data extraction. Articles were required to focus on the connection between voting and health, or report on interventions that occurred within healthcare organizations that aimed to improve voter engagement. Results:Our search identified 2041 citations, of which 40 articles met our inclusion criteria. Selected articles dated from 1991-2018 and were conducted primarily in Europe, the USA, and Canada. We identified four interrelated areas explored in the literature: (1) there is a consistency in the association between voting and health; (2) differences in voter participation are associated with health conditions; (3) gaps in voter participation may be associated with electoral outcomes; and (4) interventions in healthcare organizations can increase voter participation. Conclusion:Voting and health are associated, namely people with worse health tend to be less likely to engage in voting. Differences in voter participation due to social, economic, and health inequities have been shown to have large effects on electoral outcomes. Research gaps were identified in the following areas: long-term effects of voting on health, the effects of other forms of democratic engagement on health, and the broader impact that health providers and organizations can have on voting through interventions in their communities.

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School-Based Interventions in Low Socioeconomic Settings to Reduce Obesity Outcomes among Preschoolers: A Scoping Review.

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School-Based Interventions in Low Socioeconomic Settings to Reduce Obesity Outcomes among Preschoolers: A Scoping Review.

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