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Promoting health equity in European children: design and methodology of the prospective EPHE (Epode for the Promotion of Health Equity) evaluation study.

ABSTRACT: BACKGROUND: Reducing health inequalities is a top priority of the public health agendas in Europe. The EPHE project aims to analyse the added value of a community-based interventional programme based on EPODE methodology, adapted for the reduction of socio-economic inequalities in childhood obesity. The interventions that will be implemented by this project focus on four energy balance-related behaviours (fruit and vegetable consumption, tap water intake, physical inactivity, sleep duration) and their determinants. This article presents the design of the effect evaluation of the EPHE project. METHODS/DESIGN: This is a prospective two-year follow-up evaluation study, which will collect data on the energy balance-related behaviours and potential environmental determinants of 6-8 year olds, depending on the socio-economic status of the parents. For this purpose a parental self-reported questionnaire is constructed. This assesses the socio-economic status of the parents (5 items) and the dietary (12 items), sedentary (2 items) and sleeping (4 items) behaviour of the child. Alongside potential family-environmental determinants are assessed. The EPHE parental questionnaire will be disseminated in schools of a selected medium-sized city in seven European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands). DISCUSSION: This study will evaluate the effects of the EPHE community-based interventional programmes. Furthermore, it will provide evidence for children's specific energy balance-related behaviours and family environmental determinants related to socio-economic inequalities, in seven European countries.

SUBMITTER: Mantziki K

PROVIDER: S-EPMC3997816 | biostudies-other | 2014

REPOSITORIES: biostudies-other

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Promoting health equity in European children: design and methodology of the prospective EPHE (Epode for the Promotion of Health Equity) evaluation study.

Mantziki Krystallia K Vassilopoulos Achilleas A Radulian Gabriella G Borys Jean-Michel JM du Plessis Hugues H Gregório Maria João MJ Graça Pedro P de Henauw Stefaan S Handjiev Svetoslav S Visscher Tommy L S TL Seidell Jacob C JC

BMC public health 20140402

<h4>Background</h4>Reducing health inequalities is a top priority of the public health agendas in Europe. The EPHE project aims to analyse the added value of a community-based interventional programme based on EPODE methodology, adapted for the reduction of socio-economic inequalities in childhood obesity. The interventions that will be implemented by this project focus on four energy balance-related behaviours (fruit and vegetable consumption, tap water intake, physical inactivity, sleep durati ...[more]

PMID: 24690078

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Project description:IntroductionIndigenous youth participation in decision-making is internationally recognised as a pathway to promote health equity, decolonisation and social inclusion. Hearing Indigenous youth voices and actively involving them in decisions that affect their lives and their communities has the potential to address disproportionate health and social challenges they encounter. Yet the existing evidence-base on participatory approaches remains fragmented and vast leading to a lack of integration.Methods and analysisAn integrative review methodology will be used to conduct a comprehensive, multidisciplinary review of the literature about Indigenous youth participation in health equity promotion. The literature search is anticipated to be carried out in July-August 2022. We will search online databases Scopus, Ovid MEDLINE, Embase and PsycINFO along with several interdisciplinary databases indexed in EBSCOhost and ProQuest. Key Indigenous research journals not consistently indexed in the online databases will be examined to identify additional journal articles. We will employ a blinded, dual-reviewer two-step selection process with established inclusion/exclusion criteria and limit data to English-language publications related to Indigenous populations in Canada, USA, Aotearoa New Zealand and Australia. Focusing on qualitative empirical and theoretical studies, they will undergo quality appraisal and Covidence software will be used to manage the review. Data will be sorted, extracted and analysed. We will codify data for descriptive reporting and conduct a narrative synthesis to identify a common conceptualisation for Indigenous youth participatory approaches across disciplines, its barriers and facilitators, and knowledge gaps.Ethics and disseminationEthical review is not required for the integrative review. The review will be shared through various publication and non-academic platforms as well as our university and community research networks. Findings will have broad relevance for those seeking to involve Indigenous youth to be active decision-makers across a range of fields, but with specific implications for health equity.

Project description:BackgroundThe COordinated Oral health Promotion (CO-OP) Chicago trial will test the efficacy of a community health worker (CHW) intervention to improve oral health behaviors for children at high risk for early childhood caries. Before implementing the cluster-randomized controlled trial, we conducted a formative assessment to determine the final design. We used qualitative methods to assess the feasibility and acceptability of the proposed recruitment, data collection, and intervention plan.MethodsKey informant interviews (N = 37) and site observations were conducted at 10 pediatric primary care clinics and 10 Special Supplemental Nutrition Program for Women Infant and Children (WIC) centers to gain insight from providers and administrators at the locations where recruitment and intervention will occur. Eight focus groups (N = 68) were conducted with caregivers of children to capture the parent perspective. Conceptual coding methods from grounded theory were applied to organize the data into the final themes.ResultsFamilies, clinics, and WIC centers were all very interested in additional supports for oral health and were enthusiastic about CHWs. Challenges included competing family priorities that might interfere in study enrollment and intervention efficacy. Physical space for enrollment and intervention delivery was a major barrier for some sites. Home visits for data collection and intervention delivery would be unacceptable for some families. These challenges and barriers prompted us to make major changes in our trial design. We opened the option for data collection to occur in multiple locations. We eliminated the home-only arm of the trial. Clinics and WIC centers that are randomized to the non-intervention arm will now have CHWs available at the study conclusion. Finally, we aligned the CHW oral health topics to the needs of families.ConclusionsWe conducted this comprehensive formative assessment to determine the feasibility and acceptability of the CO-OP Chicago trial. While overall acceptance of the trial was high, the results highlighted specific issues with the proposed trial implementation plan and led to several critical design changes. This type of formative work requires a significant upfront investment but we expect it will translate into savings through better recruitment, retention, intervention implementation and adherence, and result dissemination.

Dataset Information

Promoting health equity in European children: design and methodology of the prospective EPHE (Epode for the Promotion of Health Equity) evaluation study.

Publications

Promoting health equity in European children: design and methodology of the prospective EPHE (Epode for the Promotion of Health Equity) evaluation study.

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