Optimizing nutrition and oral health for caregivers-intervention protocol.
Ontology highlight
ABSTRACT: Background
The focus of care has shifted from institutional care to home care. Family caregivers provide the majority of home care that allows an opportunity for their care recipients to live at home and avoid costly institutional care. The aim of this study is to describe the nutritional status, oral health, and quality of life of family caregivers over the age of 65 and their care recipients, and to evaluate the impact of individually tailored diet and oral health advice to their nutritional status and oral health.Methods/design
Altogether, 250 family caregivers aged 65 or over, and their care recipients are studied in this prospective randomized population-based multidisciplinary 6-month intervention study. Participants are randomly allocated to the intervention groups or the control group. Data collection is performed at three time-points: at baseline and 6 months and after a 6-month follow-up at 12 months. Caregivers' and their care recipients' nutritional and oral health status as a primary outcome, and functional ability, cognitive status, quality of life, depression symptoms, sense of coherence, morbidity, and medication of family caregivers as secondary outcomes will be measured using validated self-administered questionnaires and clinical examinations.Discussion
To our knowledge, this is the first experiment to determine whether caregivers and their care recipients benefit from individual nutritional intervention and oral health intervention in terms of nutrition status, oral health status, and quality of life.Trial registration
ClinicalTrials.gov NCT04003493 . Registered on June 28, 2019.
SUBMITTER: Nykanen I
PROVIDER: S-EPMC8444374 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:PurposeThis study examined the effectiveness of Caregivers Optimizing Achievement of Children With Hearing Loss (COACH), an intervention in which parents were taught naturalistic interaction strategies that addressed the unique linguistic input needs of their young children with hearing loss.MethodA single-subject multiple-baseline across-behaviors design was used with four caregiver-child dyads to determine the effects of COACH training on caregivers' use of the COACH language facilitation strategies and on their children's language abilities.ResultsA functional relation was demonstrated between teaching of strategies and caregivers' use of the strategies across three dyads with slower, consistent changes observed in a fourth dyad. Improvements in children's use of target-level language were observed for children in three dyads.ConclusionsCaregivers were able to implement COACH language facilitation strategies, although the pace of caregivers' learning differed across dyads. Caregivers reported high satisfaction with participating in the intervention. Future research using a randomized design and a longer intervention condition is needed for a more complete assessment of the effects of the intervention on children's language abilities.Supplemental materialhttps://doi.org/10.23641/asha.22290082.
| S-EPMC10473369 | biostudies-literature
Project description:Community resource referral systems have been implemented into care settings that serve persons with dementia but with little input from caregivers. Focus groups were conducted with African American, Hispanic, and Asian caregivers to describe their preferences for community resource referral information. Caregivers discussed the significance of a community resource list for dementia caregiving and self-care and articulated strategies for effective information delivery during a medical visit. Most caregivers acknowledged that resource needs change with progression of dementia, but no patterns emerged with regard to preference for information delivered incrementally based on disease stage or all at once. Hispanic and Asian caregivers felt that resource information should specify service providers' language and cultural capabilities. All caregivers agreed that delivery by a member of the care team with knowledge of dementia-specific resources would be most effective. Optimal delivery of community resource referrals is caregiver-centered and customizable to individual and subgroup preferences.
| S-EPMC8501155 | biostudies-literature
Project description:Caregivers' health literacy has emerged as an important determinant of young children's health care and outcomes. We examined the hypothesis that caregivers' health literacy influences children's oral-health-care-related expenditures. This was a prospective cohort study of 1,132 child/caregiver dyads (children's mean age = 19 months), participating in the Carolina Oral Health Literacy Project. Health literacy was measured by the REALD-30 (word recognition based) and NVS (comprehension based) instruments. Follow-up data included child Medicaid claims for CY2008-10. We quantified expenditures using annualized 2010 fee-adjusted Medicaid-paid dollars for oral-health-related visits involving preventive, restorative, and emergency care. We used descriptive, bivariate, and multivariate statistical methods based on generalized gamma models. Mean oral-health-related annual expenditures totaled $203: preventive--$81, restorative--$99, and emergency care--$22. Among children who received services, mean expenditures were: emergency hospital-based--$1282, preventive--$106, and restorative care--$343. Caregivers' low literacy in the oral health context was associated with a statistically non-significant increase in total expenditures (average annual difference = $40; 95% confidence interval, -32, 111). Nevertheless, with both instruments, emergency dental care expenditures were consistently elevated among children of low-literacy caregivers. These findings provide initial support for health literacy as an important determinant of the meaningful use and cost of oral health care.
| S-EPMC3706176 | biostudies-other
Project description:BackgroundChoking is one of the leading causes of death among unintentional injuries in young children. Food choking represents a considerable public health burden, which might be reduced through increased effective preventative education programs. We present a protocol for a community intervention trial termed CHOP (CHOking Prevention project) that aimed to teach Italian families how to prevent food choking injuries and increase knowledge relating to nutrition.MethodsItalian educational facilities were enrolled. Stratified randomization blocked by geographical area was performed. Each stratum was randomized to one of three different intervention strategies or to a control group. Educational intervention was delivered in the schools by experts and certified trainers as per the following three intervention strategies: directly to families (Strategy A); to teaching staff only, who subsequently delivered the same educational intervention to families (Strategy B); to health service staff only, who then delivered the educational intervention to teaching staff, who subsequently delivered the intervention to families (Strategy C). Participants completed a questionnaire about their knowledge on the topics presented during the educational interventions (pre-, post-, and follow-up of intervention). Information from the questionnaires was synthetized into 6 indicators in order to measure how effective each intervention strategy was.DiscussionThe issue of food choking injuries in children is relevant to public health. The protocol we present provides an opportunity to progress towards overcoming such challenges through a working model that can be implemented also in other countries.Trial registrationClinicalTrials.gov NCT03218618. The study was registered on 14 July 2017.
| S-EPMC6704497 | biostudies-literature
Project description:BackgroundOral anticoagulants (OACs) are very commonly prescribed for prevention of serious vascular events, but are also associated with serious medication-related bleeding. Mitigation of harm is believed to require high-quality OAC management. This study aimed to identify barriers and facilitators for optimal OAC management from the perspective of patients, caregivers and healthcare providers.MethodsUsing a qualitative descriptive study design, we conducted five focus groups, three with patients and caregivers and two with health care providers, in two health regions in Southwestern Ontario. An expert facilitator led the discussions using a semi-structured interview guide. Each session was digitally recorded, transcribed verbatim and anonymized. Transcripts were analyzed in duplicate using conventional content analysis.ResultsForty-two (19 patients, 7 caregivers, and 16 providers including physicians, nurses and pharmacists) participated. More than half of the patients received OAC for the treatment of venous thromboembolism (57.9%) and the majority (94.7%) were on chronic therapy (defined as >3 years). Data analysis organized codes describing barriers and facilitators into 4 main themes-medication-related, patient-related, provider-related, and system-related. Barriers highlighted were problems with medication access due to cost, patient difficulties with adherence, knowledge and adjusting their lifestyles to OAC therapy, provider expertise, time for adequate communication amongst providers and their patients, and health care system inadequacies in supporting communications and monitoring. Facilitators identified generally addressed these barriers.ConclusionsMany barriers to optimal OAC management exist even in the era of DOACs, many of which are amenable to facilitators of improved care coordination, patient education, and adherence monitoring.
| S-EPMC8480846 | biostudies-literature
Project description:Achieving optimal health is an aspirational goal for the population, yet the definition of health remains unclear. The role of nutrition in health has evolved beyond correcting malnutrition and specific deficiencies and has begun to focus more on achieving and maintaining 'optimal' health through nutrition. As such, the Council for Responsible Nutrition held its October 2022 Science in Session conference to advance this concept. Here, we summarize and discuss the findings of their Optimizing Health through Nutrition - Opportunities and Challenges workshop, including several gaps that need to be addressed to advance progress in the field. Defining and evaluating various indices of optimal health will require overcoming these key gaps. For example, there is a strong need to develop better biomarkers of nutrient status, including more accurate markers of food intake, as well as biomarkers of optimal health that account for maintaining resilience-the ability to recover from or respond to stressors without loss to physical and cognitive performance. In addition, there is a need to identify factors that drive individualized responses to nutrition, including genotype, metabotypes, and the gut microbiome, and to realize the opportunity of precision nutrition for optimal health. This review outlines hallmarks of resilience, provides current examples of nutritional factors to optimize cognitive and performance resilience, and gives an overview of various genetic, metabolic, and microbiome determinants of individualized responses.
| S-EPMC10509435 | biostudies-literature
Project description:BackgroundThe majority of stroke survivors return to their homes and need assistance from family caregivers to perform activities of daily living. These increased demands coupled with the lack of preparedness for their new roles lead to a high risk for caregivers developing depressive symptoms and other negative outcomes. Follow-up home support and problem-solving interventions with caregivers are crucial for maintaining stroke survivors in their homes. Problem-solving interventions are effective but are underused in practice because they require large amounts of staff time to implement and are difficult for caregivers logistically.ObjectiveThe aim of this study is to test a problem-solving intervention for stroke caregivers that can be delivered over the telephone during the patient's transitional care period (time when the stroke survivor is discharged to home) followed by 8 asynchronous online sessions.MethodsThe design is a two-arm parallel randomized clinical trial with repeated measures. We will enroll 240 caregivers from eight Veterans Affairs (VA) medical centers. Participants randomized into the intervention arm receive a modified problem-solving intervention that uses telephone and web-based support and training with interactive modules, fact sheets, and tools on the previously developed and nationally available Resources and Education for Stroke Caregivers' Understanding and Empowerment Caregiver website. In the usual care group, no changes are made in the information, discharge planning, or care the patients who have had a stroke normally receive, and caregivers have access to existing VA resources (eg, caregiver support line, self-help materials). The primary outcome is a change in caregiver depressive symptoms at 11 and 19 weeks after baseline data collection. Secondary outcomes include changes in stroke caregivers' burden, knowledge, positive aspects of caregiving, self-efficacy, perceived stress, health-related quality of life, and satisfaction with care and changes in stroke survivors' functional abilities and health care use. The team will also determine the budgetary impact, facilitators, barriers, and best practices for implementing the intervention. Throughout all phases of the study, we will collaborate with members of an advisory panel.ResultsStudy enrollment began in June 2015 and is ongoing. The first results are expected to be submitted for publication in 2021.ConclusionsThis is the first known study to test a transitional care and messaging center intervention combined with technology to decrease caregiver depressive symptoms and to improve the recovery of stroke survivors. If successful, findings will support an evidence-based model that can be transported into clinical practice to improve the quality of caregiving post stroke.Trial registrationClinicalTrials.gov NCT01600131; https://www.clinicaltrials.gov/ct2/show/NCT01600131.International registered report identifier (irrid)DERR1-10.2196/21799.
| S-EPMC7688383 | biostudies-literature
Project description:AimPrevious studies have shown that children of caregivers with low oral health literacy (OHL) had more untreated caries than children of caregivers with adequate OHL. However, there is a paucity of information on this relationship among children and youth with special health care needs (CYSHCN). Accordingly, this study aims to assess the association between the caregivers' OHL and the oral health status of CYSHCN.MethodsThis cross-sectional study was conducted in four schools dedicated for CYSHCN. A 48-item questionnaire gathered information about the demographic and socioeconomic factors, the child/adolescent's medical condition, dental characteristics, caregiver self-efficacy and the child's dental attitude. The Comprehensive Measure of Oral Health Knowledge (CMOHK) questionnaire was used to assess the caregivers' OHL. The Löe & Silness gingival index (GI) and the Silness & Löe plaque index (PI) were used to assess gingival health and plaque levels, respectively. Directed acyclic graphs (DAGs) were utilized for the selection of the appropriate set of confounding variables for regression analysis. The mean score differences and 95% confidence intervals (CI) were estimated to quantify the associations of the various covariates with oral health outcome variables.ResultsThis study included 214 child/caregiver dyads. Most participants were physically disabled (56.1%) followed by children with hearing difficulty (9.8%) and congenital anomalies/syndromes (7.9%). The mean PI and GI of the children was 1.26±0.52 and 1.30±0.47, respectively. The median CMOHK score was 12 and the respondents were dichotomized based on the median value. Low caregiver oral health conceptual knowledge was significantly associated with higher PI scores (β [95% CI] = -0.26 [-0.41, -0.13]; p<0.001. Older participants (12-21-year-olds) had significantly higher plaque scores compared with younger participants (6-12-year-olds) (β [95% CI] = 0.33 [0.18, 0.51]; p<0.001). Participants who brushed their teeth twice or more daily had significantly lower (β [95% CI] = -0.15 [-0.43, -0.01]; p = 0.046). Conceptual knowledge score was not significantly associated with GI.ConclusionThis study found lower caregiver OHL levels to be associated with higher plaque scores for their child.
| S-EPMC8794213 | biostudies-literature
Project description:BackgroundMalnutrition is one of the crucial factors associated with poor prognosis in critical ill patients, yet a significant evidence gap surrounds the management of initial enteral feeding in severe stroke. The Optimizing Early Enteral Nutrition in Severe Stroke (OPENS) trial will compare a strategy of modified full enteral nutrition (EN) (standard full EN in conjunction with prokinetic drug) and a strategy of permissive underfeeding (40 to 60% of estimated caloric requirements) with standard full EN (advancement to target nutrition goals) in patients with severe stroke.MethodsThe OPENS trial is a multicenter randomized controlled study. A total of 600 adult patients with severe stroke will be enrolled in 12 study sites in China, and randomized to standard full EN, modified full EN, or permissive underfeeding. The primary outcome measurement is the proportion of participants with a poor outcome (modified Rankin Scale ≥3) at day 90 of enrollment. Secondary outcomes include incidence rates of complications during hospitalization, disability at hospital discharge, and the ability of activities of daily living at day 90 of enrollment. The relationship between intervention and the primary outcome will be analyzed using multivariate logistic regression adjusted for study site, demographics, and baseline characteristics.DiscussionThe OPENS trial will explore the optimum initial feeding strategy for acute severe stroke. This trial is, therefore, an important step in bridging the evidence gap surrounding the enteral feeding for patients with severe stroke during the first week of hospitalization.Trial registrationClinicalTrials.gov Identifier: NCT02982668 ; First Posted: December 5, 2016.
| S-EPMC6371599 | biostudies-literature
Project description:Sleep difficulties, particularly symptoms of insomnia and circadian disruption, are among the primary complaints of gynecologic cancer survivors before, during, and after treatment. Moreover, difficulty sleeping has been linked to poorer health-related quality of life and elevated symptom burden in this population. Although leading behavioral sleep interventions have demonstrated efficacy among cancer survivors, up to 50% of survivors are non-adherent to these treatments, likely because these interventions require labor-intensive behavior and lifestyle changes. Therefore, there is a need for more effective and acceptable approaches to diminish sleep disturbance among cancer survivors. This manuscript describes the methodology of a two-part study guided by the Multiphase Optimization Strategy (MOST) framework to identify a streamlined behavioral sleep intervention for gynecologic cancer survivors. Three candidate intervention components previously shown to decrease sleep disturbance will be evaluated, including sleep restriction, stimulus control, and systematic bright light exposure. Participants will be adult women with a history of non-metastatic gynecologic cancer who have completed primary treatment and who report current poor sleep quality. Fifteen participants will be recruited for Part 1 of the study, which will utilize qualitative methods to identify barriers to and facilitators of intervention adherence. Results will inform changes to the delivery of the candidate intervention components to promote adherence in Part 2, where 80 participants will be recruited and randomized to one of eight conditions reflecting every possible combination of the three candidate intervention components in a full factorial design. Participants will complete assessments at baseline, post-intervention, and 3-months post-intervention. Part 2 results will identify the combination of candidate intervention components that yields the most efficacious yet efficient 6-week intervention for diminishing sleep disturbance. This is the first known study to apply the MOST framework to optimize a behavioral sleep intervention and will yield a resource-efficient treatment to diminish sleep disturbance, improve health-related quality of life, and decrease symptom burden among gynecologic cancer survivors. ClinicalTrials.gov Identifier: NCT05044975.
| S-EPMC8931410 | biostudies-literature