Caregiver involvement in interventions for improving children's dietary intake and physical activity behaviors.
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ABSTRACT:
SUBMITTER: Morgan EH
PROVIDER: S-EPMC6956675 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundEvidence suggests that unhealthy lifestyle behaviours are modifiable risk factors for postoperative complications. Digital behaviour change interventions (DBCIs), for instance text messaging programs and smartphone apps, have shown promise in achieving lifestyle behaviour change in a wide range of clinical populations, and it may therefore be possible to reduce postoperative complications by supporting behaviour change perioperatively using digital interventions. This scoping review was conducted in order to identify existing research done in the area of perioperative DBCIs for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation.Main textThis scoping review included eleven studies covering a range of surgeries: bariatric, orthopaedic, cancer, transplantation and elective surgery. The studies were both randomised controlled trials and feasibility studies and investigated a diverse set of interventions: one game, three smartphone apps, one web-based program and five text message interventions. Feasibility studies reported user acceptability and satisfaction with the behaviour change support. Engagement data showed participation rates ranged from 40 to 90%, with more participants being actively engaged early in the intervention period. In conclusion, the only full-scale randomised controlled trial (RCT), text messaging ahead of bariatric surgery did not reveal any benefits with respect to adherence to preoperative exercise advice when compared to a control group. Two of the pilot studies, one text message intervention, one game, indicated change in a positive direction with respect to alcohol and tobacco outcomes, but between group comparisons were not done due to small sample sizes. The third pilot-study, a smartphone app, found between group changes for physical activity and alcohol, but not with respect to smoking cessation outcomes.ConclusionThis review found high participant satisfaction, but shows recruitment and timing-delivery issues, as well as low retention to interventions post-surgery. Small sample sizes and the use of a variety of feasibility outcome measures prevent the synthesis of results and makes generalisation difficult. Future research should focus on defining standardised outcome measures, enhancing patient engagement and improving adherence to behaviour change prior to scheduled surgery.
| S-EPMC8258960 | biostudies-literature
Project description:BackgroundThe aims of this systematic review were to study the effectiveness of primary school-based physical activity, sedentary behavior and nutrition interventions with direct parental involvement on children's BMI or BMI z-score, physical activity, sedentary behavior and nutrition behavior and categorize intervention components into targeted socio-cognitive determinants and environmental types using the Environmental Research framework for weight Gain prevention.MethodsIn March 2018, a systematic search was conducted in four electronic literature databases. Articles written in English about effectiveness studies on school-based interventions with direct parental involvement targeting 4-12 year olds were included. Interventions with indirect parental involvement, interventions not targeting the school environment, and pilot studies were excluded. Study and intervention characteristics were extracted. Study quality and study effectiveness were assessed and effect sizes (Cohen's d) were calculated for the outcome measures. Types of socio-cognitive factors and environmental types targeted were distinguished.ResultsIn total, 25 studies were included. Most studies on BMI or BMI z-score, physical activity and sedentary behavior found favorable results: 61.1%, 81.1% and 75%, respectively. Results regarding nutrition behavior were inconclusive. Methodological study quality varied. All interventions targeted multiple environmental types in the school and family environment. Five targeted socio-cognitive determinants (knowledge, awareness, attitude, self-efficacy and intrinsic motivation) of the children were identified. No consistent pattern was found between either type of environment targeted, number of type of environment targeted, or the child's targeted socio-cognitive determinants and intervention effectiveness.DiscussionSchool-based interventions with direct parental involvement have the potential to improve children's weight status, physical activity and sedentary behavior. Based on the results, it is recommended that school-based interventions with direct parental involvement target more than one EBRB, last at least one year, and focus particularly on the physical and social environment within both the school and the family environment.
| S-EPMC6160096 | biostudies-literature
Project description:Many adolescents have poor diet and physical activity behaviors, which can lead to the development of noncommunicable diseases in later life. Digital platforms offer inexpensive means of delivering health interventions, but little is known about their effectiveness. This systematic review was conducted to synthesize evidence on the effectiveness of digital interventions to improve diet quality and increase physical activity in adolescents, to effective intervention components and to assess the cost-effectiveness of these interventions. Following a systematic search, abstracts were assessed against inclusion criteria, and data extraction and quality assessment were performed for included studies. Data were analyzed to identify key features that are associated with significant improvement in behavior. A total of 27 studies met inclusion criteria. Most (n = 15) were Web site interventions. Other delivery methods were text messages, games, multicomponent interventions, emails, and social media. Significant behavior change was often seen when interventions included education, goal setting, self-monitoring, and parental involvement. None of the publications reported cost-effectiveness. Due to heterogeneity of studies, meta-analysis was not feasible.It is possible to effect significant health behavior change in adolescents through digital interventions that incorporate education, goal setting, self-monitoring, and parental involvement. Most of the evidence relates to Web sites and further research into alternate media is needed, and longer term outcomes should be evaluated. There is a paucity of data on the cost-effectiveness of digital health interventions, and future trials should report these data.
| S-EPMC5702542 | biostudies-literature
Project description:ObjectiveInterventions that aim to improve child dietary quality and reduce disease risk often involve parents. The most effective methods to engage parents remain unclear. A systematic review of interventions designed to change child and adolescent dietary behavior was conducted to answer whether parent involvement enhanced intervention effectiveness, and what type of involvement was most effective in achieving desired outcomes.MethodIn 2008, Pub Med, Medline, Psych Info, and Cochrane Library databases were searched to identify programs designed to change child and adolescent dietary intake that also involved parents. Methods of parental involvement were categorized based on the type and intensity of parental involvement. These methods were compared against intervention design, dietary outcomes, and quality of reporting (evaluated using CONSORT checklist) for each study.ResultsThe literature search identified 1774 articles and 24 met review criteria. Four studies systematically evaluated parent involvement with inconsistent results. Indirect methods to engage parents were most commonly used, although direct approaches were more likely to result in positive outcomes. Four studies met >70% of CONSORT items.ConclusionLimited conclusions may be drawn regarding the best method to involve parents in changing child diet to promote health. However, direct methods show promise and warrant further research.
| S-EPMC2906688 | biostudies-literature
Project description:The workplace has been identified as a potential location for dietary intervention delivery due to the amount of time spent and the meals eaten in this setting. It is recommended that interventions are tailored to specific occupational groups, and to date, there is limited synthesis of the evidence relating to healthcare workers. This review characterises and evaluates the effectiveness of dietary interventions in healthcare workers to aid the design and implementation of interventions. The MEDLINE database was searched to September 2020. The reference list of an umbrella review was hand searched for additional titles against inclusion criteria. The search included i) population, ii) intervention and iii) work environment. Studies were assessed for risk of bias. Harvest plots and Forest plots were created to display study quality, direction and size of effect of selected primary (energy, fruit and vegetable and fat intake) and secondary outcomes (weight, body mass index, blood pressure and serum cholesterol levels). Thirty-nine articles assessing thirty-four interventions were eligible for inclusion. Intervention types most commonly used were environmental, educational, educational plus behavioural, and behavioural. Due to the heterogeneity in study design and intervention type, results were largely inconclusive. For dietary outcomes, interventions produced small-moderate favorable changes in fruit, vegetable and fat intake. Decreased fat intake was mainly observed in environmental interventions and increases in fruit and vegetable intake were observed when an educational or/and behavioral component was present. Interventions producing weight loss were mostly non-randomised trials involving education and physical activity. Total and low-density lipoprotein cholesterol decreased in interventions involving physical activity. Meta-analyses revealed significant decreases in energy intake, weight, blood pressure, total cholesterol, and LDL cholesterol in non-randomised trials where data were available. Much more research is needed into strategies to promote diet quality improvement in healthcare workers. Statement of significance: It is recommended that workplace dietary interventions are tailored to specific occupational groups. To our knowledge, this is the first review to examine the effects of dietary workplace interventions in healthcare professionals. Small-moderate favourable changes in fruit and vegetable intake can be achieved when an educational or/and behavioural component is included in the intervention. For weight loss, interventions involving nutrition education and physical activity in addition to a dietary component show benefit. In the studies reviewed, a high level of heterogeneity was evident and insufficient information reported to ascertain potential bias.
| S-EPMC8970821 | biostudies-literature
Project description:ObjectiveWe aimed to examine the association between food and physical activity environments in primary schools and child anthropometric, healthy eating and physical activity measures.DesignObservational longitudinal study using data from a childhood obesity prevention trial.SettingState primary schools in the West Midlands region, UK.Participants1392 pupils who participated in the WAVES (West Midlands ActiVe lifestyle and healthy Eating in School children) childhood obesity prevention trial (2011-2015).Primary and secondary outcome measuresSchool environment (exposure) was categorised according to questionnaire responses indicating their support for healthy eating and/or physical activity. Child outcome measures, undertaken at three time points (ages 5-6, 7-8 and 8-9 years), included body mass index z-scores, dietary intake (using a 24-hour food ticklist) and physical activity (using an Actiheart monitor over 5 days). Associations between school food and physical activity environment categories and outcomes were explored through multilevel models.ResultsData were available for 1304 children (94% of the study sample). At age 8-9 years, children in 10 schools with healthy eating and physical activity-supportive environments had a higher physical activity energy expenditure than those in 22 schools with less supportive healthy eating/physical activity environments (mean difference=5.3 kJ/kg body weight/24 hours; p=0.05). Children in schools with supportive physical activity environments (n=8) had a lower body mass index z-score than those in schools with less supportive healthy eating/physical activity environments (n=22; mean difference=-0.17, p=0.02). School food and physical activity promoting environments were not significantly associated with dietary outcomes.ConclusionsSchool environments that support healthy food and physical activity behaviours may positively influence physical activity and childhood obesity.Trial registration numberISRCTN97000586.
| S-EPMC7757477 | biostudies-literature
Project description:Physical activity is important for children's health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways.ConceptualizationCurrent programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context.Evaluation designsEvaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration.Primary outcomeA collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children's physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.
| S-EPMC10133698 | biostudies-literature
Project description:OBJECTIVE:Alzheimer's disease and related dementias (ADRD) affect more than five million Americans and their family caregivers. Caregiving creates challenges, may contribute to decreased caregiver health and is associated with $9.7 billion of caregiver health care costs. The purpose of this 12 month randomized clinical trial (RCT) was to examine if the Enhancing Physical Activity Intervention (EPAI), a moderate to vigorous physical activity (MVPA) treatment group, versus the Caregiver Skill Building Intervention (CSBI) control, would have greater: (1) MVPA adherence; and (2) physical function. METHODS:Caregivers were randomly assigned to EPAI or CSBI (N=211). MVPA was assessed using a self-report measure; and physical function was objectively assessed using two measures. Intention-to-treat analyses used descriptive, categorical and generalized estimating equations (GEE), with an exchangeable working correlation matrix and a log link, to examine main effects and interactions in change of MVPA and physical function over time. RESULTS:At 12 months, EPAI significantly increased MVPA (p=<0.001) and number of steps (p=< .01); maintained stable caregiving hours and use of formal services; while CSBI increased hours of caregiving (p=<0.001) and used more formal services (p=<0.02). Qualitative physical function data indicated that approximately 50% of caregivers had difficulties completing physical function tests. CONCLUSION:The EPAI had a stronger 12 month effect on caregiver MVPA and physical function, as well as maintaining stability of caregiving hours and formal service use; while CSBI increased caregiving hours and use of formal services. A study limitation included greater EPAI versus CSBI attrition. Future directions are proposed for dementia family caregiver physical activity research.
| S-EPMC5526207 | biostudies-literature
Project description:RATIONALE:Research shows that acculturation is important to Latinas' dietary intake and related behaviors. Although evidence suggests children may also play a role, it remains unclear whether children's acculturation is related to mothers' dietary intake/behaviors. OBJECTIVES:We examined the relationship between Latino children's acculturation and mothers' dietary intake/behaviors. We also examined the mother-child acculturation gap to identify dyad characteristics associated with mothers' diet. METHODS:Baseline surveys were collected in 2010 from 314 Latino mother-child (7-13 years old) dyads of Mexican-origin enrolled in a family-based dietary intervention in Southern California, USA. Mother's daily intake of fruits, vegetables, and sugary beverages, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were assessed via self-report. Mothers' and children's bidimensional acculturation were examined using acculturation groups (e.g., assimilated, bicultural) derived from Hispanic and non-Hispanic dimensions of language. We also assessed the acculturation gap between mothers and children with the a) difference in acculturation between mothers' and children's continuous acculturation scores and b) mother-child acculturation gap typologies (e.g., traditional mothers of assimilated children). RESULTS:Findings show that having an assimilated versus a bicultural child was negatively associated with mothers' vegetable intake and positively associated with mothers' sugary beverage intake, percent of calories from fat, and frequency of away-from-home eating, regardless of mothers' acculturation. Traditional mothers of assimilated children reported more sugary beverage intake, calories from fat, and more frequent away-from-home eating than traditional mothers of bicultural children. CONCLUSION:Results suggest that children's acculturation is associated with their mothers' dietary intake/behaviors and traditional mothers of assimilated children require more attention in future research.
| S-EPMC5623112 | biostudies-literature
Project description:Paediatric trauma can result in significant levels of on-going disability. The aim of this study was to explore the restrictions on activity participation that children experience following serious injury from the perspective of their caregivers. We performed a thematic analysis of transcripts of semi-structured in-depth interviews with the caregivers of 44 seriously injured children, conducted three-years after the injury, and purposively sampled from a population-based cohort study. Both temporary and on-going restrictions on school, sport, leisure and social activities were identified, some of which were imposed by caregivers, schools, or recommended by health providers. The perceived risk of further injury, physical restrictions, emotional state and fatigue levels were important influences on degrees of activity restriction. Children who were socially less engaged, especially those who were more severely injured, had difficulty making and retaining friends, and exhibited signs of depression or social withdrawal. The activities of pre-school children were strongly regulated by their caregivers, while school age children faced obstacles with participation in aspects such as study, sport, and peer and teacher relationships, affecting learning, school attendance and enjoyment. The findings highlight the need for primary prevention and reducing the impacts of serious injury throughout the continuum of care.
| S-EPMC4962193 | biostudies-literature