Measurement challenges for childhood obesity research within and between Latin America and the United States.
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ABSTRACT:
SUBMITTER: Berrigan D
PROVIDER: S-EPMC8365689 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:International migration has economic and health implications. The acculturation process to the host country may be linked to childhood obesity. We use the Community Energy Balance (CEB) framework to analyze the relationship between migration and childhood obesity in Mexican households with international migrants. Using longitudinal data from the Mexican Family Life Survey (MxFLS), we examine how migrant networks affect childhood obesity in origin communities. We also review binational health programs that could be effective at tackling childhood obesity in migrant households from Mexico. Children embedded in migrant networks are at greater risk of developing overweight or obesity, suggesting a significant relationship between childhood obesity and international migration in Mexican households. Based on our search criteria, our analysis of health outreach programs shows that Ventanillas de Salud (VDS)/Health Windows has great promise to prevent childhood obesity in a culturally sensitive and trustful environment. The CEB framework is useful to understand how migration contributes to the risk of childhood overweight and obesity in migrant households. VDS is a feasible and replicable strategy with great potential to address childhood obesity among migrant families accounting for the dynamic and binational determinants of childhood obesity.
| S-EPMC8365698 | biostudies-literature
Project description:Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, and progress of PAPs across RE-AIM framework dimensions. Evidence-based advocacy along with political will and evidence of scalability and impact were key for successful launch and implementation of all PAPs. Diverse adaptations of PAP design and implementation had to be done across contexts. Stronger process and impact monitoring and evaluation systems that track equity indicators are needed to maximize the population benefits of these PAPs. Implementation science offers an important contribution toward addressing knowledge gaps, enhancing obesity policy dialogue, and producing transferable lessons across the Americas and, therefore, should be used for research and evaluation during PAP development and throughout the implementation and maintenance phases.
| S-EPMC8365637 | biostudies-literature
Project description:ObjectiveThere is evidence linking the built environment (BE) with physical activity (PA), but few studies have been conducted in Latin America (LA). State-of-the-art methods and protocols have been designed in and applied in high-income countries (HIC). In this paper, we identify key challenges and potential solutions to conducting high-quality PA and BE research in LA.MethodsThe experience of implementing the IPEN data collection protocol (IPEN: International Physical Activity Environment Network) in Curitiba, Brazil; Bogotá, Colombia; and Cuernavaca, Mexico (2010-2011); is described to identify challenges for conducting PA and BE research in LA.ResultsFive challenges were identified: lack of academic capacity (implemented solutions (IS): building a strong international collaborative network); limited data availability, access and quality (IS: partnering with influential local institutions, and crafting creative solutions to use the best-available data); socio-political, socio-cultural and socio-economic context (IS: in-person recruitment and data collection, alternative incentives); safety (IS: strict rules for data collection procedures, and specific measures to increase trust); and appropriateness of instruments and measures (IS: survey adaptation, use of standardized additional survey components, and employing a context-based approach to understanding the relationship between PA and the BE). Advantages of conducting PA and BE research in LA were also identified.ConclusionsConducting high-quality PA and BE research in LA is challenging but feasible. Networks of institutions and researchers from both HIC and LMIC play a key role. The lessons learned from the IPEN LA study may be applicable to other LMIC.
| S-EPMC4268364 | biostudies-literature
Project description:BackgroundLimited knowledge on the prevalence and distribution of risk factors impairs the planning and implementation of cardiovascular prevention programs in the Latin American and Caribbean (LAC) region.Methods and findingsPrevalence of hypertension, diabetes mellitus, abnormal lipoprotein levels, obesity, and smoking were estimated from individual-level patient data pooled from population-based surveys (1998-2007, n=31,009) from eight LAC countries and from a national survey of the United States (US) population (1999-2004) Age and gender specific prevalence were estimated and age-gender adjusted comparisons between both populations were conducted. Prevalence of diabetes mellitus, hypertension, and low high-density lipoprotein (HDL)-cholesterol in LAC were 5% (95% confidence interval [95% CI]: 3.4, 7.9), 20.2% (95% CI: 12.5, 31), and 53.3% (95% CI: 47, 63.4), respectively. Compared to LAC region's average, the prevalence of each risk factor tended to be lower in Peru and higher in Chile. LAC women had higher prevalence of obesity and low HDL-cholesterol than men. Obesity, hypercholesterolemia, and hypertriglyceridemia were more prevalent in the US population than in LAC population (31 vs. 16.1%, 16.8 vs. 8.9%, and 36.2 vs. 26.5%, respectively). However, the prevalence of low HDL-cholesterol was higher in LAC than in the US (53.3 vs. 33.7%).ConclusionsMajor cardiovascular risk factors are highly prevalent in LAC region, in particular low HDL-cholesterol. In addition, marked differences do exist in this prevalence profile between LAC and the US. The observed patterns of obesity-related risk factors and their current and future impact on the burden of cardiovascular diseases remain to be explained.
| S-EPMC3547948 | biostudies-literature
Project description:ImportancePremature death rates vary in the United States by race/ethnicity. Despite their socioeconomic disadvantages, US Latino populations have lower premature mortality rates than do US white populations, a phenomenon termed the "Latino or Hispanic paradox."ObjectiveTo investigate whether there is a broader Latin American paradox by comparing premature mortality rates in the United States according to race/ethnicity with rates in Latin America and Puerto Rico from 2001 to 2015.Design, setting, and participantsThis descriptive cross-sectional study used mortality data from the World Health Organization Mortality Database. All deaths occurring in individuals aged 20 to 64 years among US Latino, African American, white, and Puerto Rican and 12 other Latin American populations from January 2001 to December 2015 were selected. The data analysis began in October 2018.ExposuresAge, sex, race/ethnicity, and country.Main outcomes and measuresAll-cause mortality, cause-specific mortality, age-standardized mortality rates (AMSRs), and average annual percentage change in mortality rates during 2001 to 2015.ResultsDuring 2001 to 2015, 22 million deaths (8 million women and 14 million men) occurred among individuals aged 20 to 64 years in the selected populations. Among women, US Latina individuals had the lowest premature mortality rates (ASMR for 2015, 144 deaths per 100 000 population) and US African American women had the highest premature mortality rate (ASMR for 2015, 340 deaths per 100 000 population) of the 16 populations studied. Rates among US white women shifted from the sixth lowest in 2001 (ASMR, 231 deaths per 100 000 population) to the 12th lowest in 2015 (ASMR, 235 deaths per 100 000 population). Among men, Peru had the lowest premature mortality rates (ASMR for 2015, 219 deaths per 100 000 population), and Belize had the highest premature mortality rates (ASMR for 2015, 702 deaths per 100 000 population). White men in the United States shifted from the fifth lowest rates in 2001 (ASMR, 396 deaths per 100 000 population) to the eighth lowest rates in 2015 (ASMR, 394 deaths per 100 000 population). Rates for both women and men decreased in all the populations studied from 2001 to 2015 (average annual percentage change range, 0.4% to 3.8% per year) except among US white populations, for which the rate plateaued (average annual percentage change, 0.02% per year [95% CI, -0.3% to 0.2% per year] for women; -0.2% per year [95% CI, -0.4% to 0.0% per year] for men) and among Nicaraguan men, for whom the rates increased (0.6% per year [95% CI, 0.2% to 1.0% per year]). The populations with the lowest mortality rates in 2015 had lower rates from all major causes, but rates were particularly lower for heart disease (21 deaths per 100 000 population) and cancer (50 deaths per 100 000 population).Conclusions and relevancePremature mortality rates are lower for US Latino populations and several Latin American countries than for US white populations, suggesting that there may be a broader Latin American paradox. This analysis also highlights the high premature mortality rates among US African American populations, especially women, compared with many Latin American populations.
| S-EPMC8268086 | biostudies-literature
Project description:PurposeEpidermal growth factor receptor (EGFR) mutations confer sensitivity to EGFR tyrosine kinase inhibitors in patients with advanced non-small-cell lung cancer (NSCLC). There are limited and conflicting reports on the frequency of EGFR mutations in Latinos.Patients and methodsSamples from 642 patients with NSCLC from seven institutions in the United States and Latin America were assessed for EGFR mutations (exons 18 to 21) at Clinical Laboratory Improvement Amendments-certified central laboratories.ResultsEGFR mutation analysis was successfully performed in 480 (75%) of 642 patients; 90 (19%) were Latinos, 318 (66%) were non-Latino whites, 35 (7%) were non-Latino Asians, 30 (6%) were non-Latino blacks, and seven (2%) were of other races or ethnicities. EGFR mutations were found in 21 (23%) of 90 Latinos with varying frequencies according to the country of origin; Latinos from Peru (37%), followed by the United States (23%), Mexico (18%), Venezuela (10%), and Bolivia (8%). In never-smoker Latinos and Latinos with adenocarcinoma histology, EGFR mutation frequencies were 38% and 30%, respectively. There was a significant difference in the frequency of EGFR mutations among the different racial and ethnic subgroups analyzed (P < .001), with non-Latino Asians having the highest frequency (57%) followed by Latinos (23%), non-Latino whites (19%), and non-Latino blacks (10%). There was no difference between Latinos (23%) and non-Latinos (22%; P = .78) and Latinos and non-Latino whites (P = .37). Patients from Peru had an overall higher frequency of mutations (37%) than all other Latinos (17%), but this difference only exhibited a trend toward significance (P = .058).ConclusionThere was no significant difference between the frequency of EGFR mutations in NSCLC in Latinos and non-Latinos.
| S-EPMC5493261 | biostudies-literature
Project description:BackgroundAlthough the increased prevalence of childhood obesity in the United States has been documented, little is known about its incidence. We report here on the national incidence of obesity among elementary-school children.MethodsWe evaluated data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999, a representative prospective cohort of 7738 participants who were in kindergarten in 1998 in the United States. Weight and height were measured seven times between 1998 and 2007. Of the 7738 participants, 6807 were not obese at baseline; these participants were followed for 50,396 person-years. We used standard thresholds from the Centers for Disease Control and Prevention to define "overweight" and "obese" categories. We estimated the annual incidence of obesity, the cumulative incidence over 9 years, and the incidence density (cases per person-years) overall and according to sex, socioeconomic status, race or ethnic group, birth weight, and kindergarten weight.ResultsWhen the children entered kindergarten (mean age, 5.6 years), 12.4% were obese and another 14.9% were overweight; in eighth grade (mean age, 14.1 years), 20.8% were obese and 17.0% were overweight. The annual incidence of obesity decreased from 5.4% during kindergarten to 1.7% between fifth and eighth grade. Overweight 5-year-olds were four times as likely as normal-weight children to become obese (9-year cumulative incidence, 31.8% vs. 7.9%), with rates of 91.5 versus 17.2 per 1000 person-years. Among children who became obese between the ages of 5 and 14 years, nearly half had been overweight and 75% had been above the 70th percentile for body-mass index at baseline.ConclusionsIncident obesity between the ages of 5 and 14 years was more likely to have occurred at younger ages, primarily among children who had entered kindergarten overweight. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.).
| S-EPMC4017620 | biostudies-literature
Project description:Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity-related articles published June 2015-December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity-related articles (505 from Latin America, 124 from the United States, and 17 US-Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross-border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.
| S-EPMC8365746 | biostudies-literature
Project description:Healthcare systems in Latin America are broadly heterogeneous, but all of them are burdened by a dramatic rise in liver disease. Some challenges that these countries face include an increase in patients requiring a transplant, insufficient rates of organ donation, delayed referral, and inequitable or suboptimal access to liver transplant programs and post-transplant care. This could be improved by expanding the donor pool through the implementation of education programs for citizens and referring physicians, as well as the inclusion of extended criteria donors, living donors and split liver transplantation. Addressing these shortcomings will require national shifts aimed at improving infrastructure, increasing awareness of organ donation, training medical personnel, and providing equitable access to care for all patients.
| S-EPMC10696109 | biostudies-literature
Project description:ObjectiveTo prepare Agency for Healthcare Research and Quality (AHRQ) for monitoring the impact of its own patient safety initiative, by exploring available outcomes data, assessing usability of measures, and estimating national trends in patient outcomes.Data sourcesAnnual summary data on incidence of Joint Commission Sentinel Events, MEDMARX medication error events, and MDS measures of falls and pressure ulcers in nursing home residents. HCUP National Inpatient Sample (NIS) administrative claims data.MethodsDescription and assessment of published summary data on selected safety measures. Analysis of selected Patient Safety Indicators (PSIs) and Utah–Missouri adverse event measures using HCUP NIS claims data (1994–2003).Principal findingsInterpretation of safety outcome trends requires close attention to the characteristics of underlying data sources and measures. Encounter-based measures have been affected by changes in definitions and ICD-9 coding, as well as by changes in the structure of administrative datasets like HCUP NIS. Historical trends are mixed for the safety outcome measures reviewed, with some measures showing improvement, others deterioration, and still others remaining fairly stable.ConclusionsConstructing national trends of safety outcomes is difficult because of limitations in available data sources and measures. Tracking growth in the adoption of safe practices could offer an important strategy for complementing existing safety measurement capabilities.
| S-EPMC2677038 | biostudies-literature