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1.
Controlled trial of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower): Effectiveness analysis.
Sousa, P, Martinho, R, Reis, CI, Dias, SS, Gaspar, PJS, Dixe, MDA, Luis, LS, Ferreira, R
Journal of advanced nursing. 2020;(4):1057-1068
Abstract
AIM: To evaluate the effectiveness on lifestyle change of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower) and to analyse the predictors of the mHealth intervention effectiveness. DESIGN This study is designed as a non-randomized controlled trial with a two-arm structure. METHODS Adolescents of 12-16-year old were recruited from three school districts, with access to the Internet and smartphone/tablet devices. The intervention group was invited to engage in the mHealth intervention (TeenPower) for 6 months in addition to a school-based intervention. The control group only followed the school-based intervention. A repeated measures factorial ANOVA was used and the main effectiveness outcome was the lifestyle change measured by the adolescent lifestyle profile. RESULTS The outcomes of the mHealth intervention (TeenPower) show a significant effect on nutrition (ƞ2 p = 0.03, p = .03), positive life perspective (ƞ2 p = 0.04, p = .01), and global lifestyle (ƞ2 p = 0.02, p = .05), with a dropout rate of 62.1%. The analysis of the effectiveness predictors of the mHealth intervention suggested that older adolescents tended to show a significant increase in the rates of stress management (r = .40; p < .05). CONCLUSIONS Although the considerable dropout rate, the mHealth intervention presented significant impact on multiple lifestyle domains, providing support for the effectiveness of mHealth interventions for health promotion as an add-on to standard interdisciplinary interventions. IMPACT Adolescents must have the necessary and appropriate knowledge for the correct and responsible decision-making regarding their health and lifestyle. Innovative strategies (mHealth intervention) were used to promote healthy behaviours. This study evaluates the effectiveness of an mHealth intervention (TeenPower) specifically designed for adolescents. We found a significant impact in several lifestyle domains such as health responsibility, nutrition, positive life perspective, and global lifestyle.
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2.
Impacts of a Standing Desk Intervention within an English Primary School Classroom: A Pilot Controlled Trial.
Sherry, AP, Pearson, N, Ridgers, ND, Johnson, W, Barber, SE, Bingham, DD, Nagy, LC, Clemes, SA
International journal of environmental research and public health. 2020;(19)
Abstract
Traditional classroom furniture dictates that children predominantly sit during class time. This study evaluated the impact of providing standing desks within a deprived UK primary school setting over 8 months using mixed-method approaches. All children within a Year 5 class (9-10-year-olds, n = 30) received an adjustable sit-stand desk, while another Year 5 class (n = 30) in a nearby school retained traditional furniture as a control classroom. At baseline, 4 months, and 8 months, activPAL monitors (PAL Technologies, Glasgow, UK) were worn for 7 days to provide time spent sitting and standing. Behavior-related mental health, musculoskeletal discomfort surveys, and a cognitive function test battery were also completed at all three timepoints. Intervention experiences from pupils and the teacher were captured using focus groups, interviews, and classroom observations. At both 4 months and 8 months, multi-level models revealed a reduction in class time sitting in the intervention group compared to the control group ((β (95%CI) 4 months -25.3% (-32.3, -18.4); 8 months -19.9% (-27.05, -12.9)). Qualitative data revealed challenges to teaching practicalities and a gradual decline in behavior-related mental health was observed (intervention vs. control: 4 months +5.31 (+2.55, +8.08); 8 months +7.92 (+5.18, +10.66)). Larger trials within similar high-priority settings are required to determine the feasibility and cost-effectiveness of providing standing desks to every child in the classroom.
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3.
GReat-Child Trial™ based on social cognitive theory improved knowledge, attitudes and practices toward whole grains among Malaysian overweight and obese children.
Koo, HC, Poh, BK, Ruzita, AT
BMC public health. 2019;(1):1574
Abstract
BACKGROUND Studies have reported that improvement of dietary habits through increased whole grain foods consumption at an early age has the potential to lead to betterment in lifelong health and wellness. The GReat-Child Trial™ was a 12-week quasi-experimental study with 6 months follow-up investigating a multi-component whole grain intervention, which consisted of behavioral, personal and environmental factors based on Social Cognitive Theory (SCT). This study aimed to evaluate the feasibility and acceptability of the GReat-Child Trial™, as well as to determine the changes in knowledge, attitudes and practices (KAP) of whole grains consumption among overweight/obese children. METHODS Two schools in Kuala Lumpur with similar socio-demographic characteristics were assigned as intervention (IG) and control (CG), respectively. Inclusion criteria were healthy Malaysian overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming whole grain foods in their 3-day diet-recall during recruitment were excluded. A total of 63 children (31 IG; 32 CG) completed the intervention. KAP questionnaire was self-administered at baseline [T0] and post intervention (at 3rd [T1] and 9th month [T2]). The baseline differences between the IG and CG across socio-demographics and scores of KAP toward whole grains were determined using chi-square and t-test, respectively. ANCOVA was performed to determine the effect of the GReat-Child Trial™ on KAP towards whole grains at post-intervention and follow-up. Baseline variables were considered as covariates. RESULTS The IG attained significantly higher scores in knowledge (mean difference = 4.23; 95% CI: 3.82, 4.64; p < 0.001), attitudes (mean difference = 7.39; 95% CI: 6.36, 8.42; p < 0.001) and practice (mean difference = 6.13; 95% CI: 4.49, 7.77; p < 0.001) of whole grain consumption compared to the CG, after adjusting for confounders. The IG reported significantly higher scores in knowledge (mean difference = 6.84; 95% CI: 6.53, 7.15; p < 0.001), attitudes (mean difference = 9.16; 95% CI: 8.08, 10.24; p < 0.001) and practice (mean difference = 8.03; 95% CI: 5.34, 10.73; p < 0.001) towards whole grains at T2 compared to T0. CONCLUSIONS These findings indicate that this intervention made a positive impact on improving children's KAP on whole grains. We anticipate the GReat-Child Trial™ to be a program that could be incorporated into school interventions to improve whole grain consumption among Malaysian children for obesity prevention.
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4.
The Effects of a Comprehensive, Integrated Obesity Prevention Intervention Approach (SuperFIT) on Children's Physical Activity, Sedentary Behavior, and BMI Z-Score.
van de Kolk, I, Gerards, SMPL, Harms, LSE, Kremers, SPJ, Gubbels, JS
International journal of environmental research and public health. 2019;(24)
Abstract
SuperFIT is a comprehensive, integrated intervention approach aimed at promoting healthy energy balance-related behaviors in 2- to 4-year-old children in the preschool and home settings. A quasi-experimental research design was adopted to evaluate the effects of SuperFIT on physical activity (PA), sedentary behavior (SB) and Body Mass Index (BMI) z-score. Children could participate in the preschool-based and family-based component (full intervention) or only in the preschool-based component (partial intervention). Children's PA levels and SB were assessed with accelerometers and observations, and height and weight were measured for the BMI z-score. Measurements were performed at baseline and two follow-up time points. Effectiveness was evaluated using linear mixed-model analyses, correcting for relevant covariates. Healthy changes in PA levels occurred within all study groups over time. No significant differences were found in overall PA levels between the intervention groups and control group at both follow-ups. Nevertheless, sedentary behavior decreased more in the full intervention group (effect size (ES): -0.62), and moderate-to-vigorous PA (ES: 0.85) and counts per minute (ES: 0.45) increased more compared to the control group on preschool days at the first follow-up. No effects were found for BMI z-score. The integrated approach of SuperFIT may induce changes in PA of young children, although the effects were small.
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5.
Promoting healthy teenage behaviour across three European countries through the use of a novel smartphone technology platform, PEGASO fit for future: study protocol of a quasi-experimental, controlled, multi-Centre trial.
Puigdomenech, E, Martin, A, Lang, A, Adorni, F, Gomez, SF, McKinstry, B, Prinelli, F, Condon, L, Rashid, R, Caon, M, et al
BMC medical informatics and decision making. 2019;(1):278
Abstract
BACKGROUND Behaviour change interventions targeting physical activity, diet, sleep and sedentary behaviour of teenagers show promise when delivered through smartphones. However, to date there is no evidence of effectiveness of multicomponent smartphone-based interventions. Utilising a user-centred design approach, we developed a theory-based, multi-dimensional system, PEGASO Fit For Future (PEGASO F4F), which exploits sophisticated game mechanics involving smartphone applications, a smartphone game and activity sensors to motivate teenagers to take an active role in adopting and maintaining a healthy lifestyle. This paper describes the study protocol to assess the feasibility, usability and effectiveness (knowledge/awareness and behavioural change in lifestyle) of the PEGASO system. METHODS We are conducting a quasi-experimental controlled cluster trial in 4 sites in Spain, Italy, and UK (England, Scotland) over 6 months. We plan to recruit 525, in a 2:1 basis, teenagers aged 13-16 years from secondary schools. The intervention group is provided with the PEGASO system whereas the comparison group continues their usual educational routine. Outcomes include feasibility, acceptance, and usability of the PEGASO system as well as between and within group changes in motivation, self-reported diet, physical activity, sedentary and sleeping behaviour, anthropometric measures and knowledge about a healthy lifestyle. DISCUSSION PEGASO F4F will provide evidence into the cross-cultural similarities and differences in the feasibility, acceptability and usability of a multi-dimensional smartphone based behaviour change intervention for teenagers. The study will explore facilitating factors, challenges and barriers of engaging teenagers to adapt and maintain a healthy lifestyle when using smartphone technology. Positive results from this ICT based multi component intervention may have significant implications both at clinical level, improving teenagers health and at public health level since it can present an influential tool against the development of chronic disease during adulthood. TRIAL REGISTRATION https://clinicaltrials.gov Registration number: NCT02930148, registered 4 October 2016.
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A multi-component intervention to sit less and move more in a contact centre setting: a feasibility study.
Morris, AS, Murphy, RC, Shepherd, SO, Healy, GN, Edwardson, CL, Graves, LEF
BMC public health. 2019;(1):292
Abstract
BACKGROUND Call agents spend ~ 90% of their working day seated, which may negatively impact health, productivity, and wellbeing. This study aimed to explore the acceptability and feasibility of a multi-component workplace intervention targeting increased activity and decreased prolonged sitting in the contact centre setting prior to a full-scale effectiveness trial. METHODS An 8-week non-randomised pre-post feasibility study was conducted. Using a mixed methods approach, focus groups and interviews were thematically analysed to explore the acceptability and feasibility of key study phases, and provide context to agents' process evaluation and survey responses. The multi-component intervention, conducted in a single call centre, included height-adjustable workstations, emails, education and training sessions, and support from team leaders and a workplace champion. RESULTS Six (of 20) team leaders were recruited, with 17 of 84 call agents (78% female, 39.3 ± 11.9 years) completing baseline assessments and 13 completing follow-up. High workload influenced recruitment. Call agents perceived assessments as acceptable, though strategies are needed to enhance fidelity. Education sessions, height-adjustable workstations and emails were perceived as the most effective components; however, height-adjustable hot-desks were not perceived as feasible in this setting. CONCLUSIONS This study has identified unique, pragmatic considerations for conducting a multi-level, multi-component PA and SB intervention and associated evaluation in highly sedentary call agents in the challenging contact centre setting. The intervention was largely perceived positively, with call agents and team leaders describing numerous perceived positive effects on behavioural, health and work-related outcomes. Findings will be of value to researchers attempting to intervene in contact centres and will be used by the current authors to design a subsequent trial.
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7.
Impact of the intervention program "JolinchenKids - fit and healthy in daycare" on energy balance related-behaviors: results of a cluster controlled trial.
Steenbock, B, Buck, C, Zeeb, H, Rach, S, Pischke, CR
BMC pediatrics. 2019;(1):432
Abstract
BACKGROUND The purpose of this study was to evaluate the multi-component health promotion program, JolinchenKids - fit and healthy in daycare, designed to promote physical activity (PA), healthy eating, and mental wellbeing among 3- to 6-year-old preschoolers. METHODS For this cluster controlled trial, 62 daycare facilities (DFs) from thirteen different federal states in Germany were recruited (31 intervention, 31 control DFs). Outcome measures were children's habitual PA, fruits and vegetable consumption, consumption of unsweetened beverages and snacks with parents as raters. Study nurses assessed children's body composition and motor skills. Data was collected at baseline and 12 months later. To track adherence to the implementation of intervention modules at individual DF groups, an implementation calendar was used from baseline to follow-up. Linear mixed models were used to investigate effects for survey, group and their interaction at the individual level while accounting for clustering. RESULTS Samples of 831 (baseline) and 641 (follow-up) children aged 4.3 ± 0.8 and 5.2 ± 0.8 years were analysed. More than half of the intervention DFs chose the nutrition or PA module for the first year of implementation while an implementation level of > 50% was only achieved in less than a third. A significant intervention effect (survey × group interaction) was found for the standing long jump favouring children at intervention DFs (β = 3.08; 95% Confidence interval [CI]: (0.09; 6.07)). No significant intervention effects were found for time spent on PA, total screen time, dietary habits, and body composition, i.e. body-mass-index and percentage of body fat. CONCLUSIONS Participation in JolinchenKids - fit and healthy in daycare led to improvements in some indicators for motor skills. However, other health outcomes and behaviours were not affected by program participation over the course of 1 year. TRIAL REGISTRATION German Clinical Trials Register DRKS00011065 (Date of registration 16-09-2016).
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Baseline markers of inflammation, lipids, glucose, and Dietary Inflammatory Index scores do not differ between adults willing to participate in an intensive inflammation reduction intervention and those who do not.
Crimarco, A, Turner-McGrievy, GM, Wirth, MD, Shivappa, N, Dunn, C, Vyas, S, Mandes, T, Hurley, TG, West, D, Hébert, JR
Nutrition and health. 2019;(1):9-19
Abstract
BACKGROUND Chronic inflammation is associated with numerous chronic diseases and can be managed with diet. AIM:: The purpose of this study was to examine differences in baseline characteristics and plasma inflammation levels between two groups of participants that participated in an intensive, lifestyle intervention or a remotely delivered intervention. This work also assessed the association between Dietary Inflammatory Index (DII)® scores and participants' inflammatory and metabolic biomarkers at baseline. METHOD Ninety-five participants (61 intervention, 34 control) chose to enroll in either a 12-month intervention consisting of a face-to-face nutrition, physical activity, and stress management intervention or a remotely-delivered intervention (control group) focusing on general cancer prevention. The intervention group met at the University of South Carolina for classes and the control group had materials emailed to them. A quantile regression was used to compare participants' high-sensitivity C-reactive protein and interleukin-6 levels. Multiple linear regression was used to determine the association between DII scores and biomarkers. RESULTS There were significant differences in age, body mass index, body fat percentage, and blood pressure between groups, but there were no differences in levels of inflammatory biomarkers. Values of interleukin-6 at the 90th percentile of its distribution were 8.31 pg/ml higher among those in DII quartile 4 compared with quartile 1 ( p = 0.02). All other outcomes were not significant. CONCLUSION Given similar levels of inflammatory biomarkers, participants opting for the control group would also have benefited from a more intensive lifestyle intervention focusing on reducing inflammation.
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9.
Effectiveness of a school-based program focusing on diet and health habits taught through physical exercise.
Pablos, A, Nebot, V, Vañó-Vicent, V, Ceca, D, Elvira, L
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2018;(4):331-337
Abstract
The global rate of obesity in childhood is becoming an epidemic and many authors have established a significant association between childhood obesity and overweight in adulthood. It is therefore necessary to seek effective strategies to reduce these levels of obesity. The aim of this study was to evaluate the impact of the Healthy Habits Program (HHP). The participants comprised 158 children from the fifth and sixth grades (intervention group, n = 82; control group, n = 76). The HHP is a school-based physical activity program focusing on promoting a healthy lifestyle. It lasted for 8 months, and measurements were taken at the beginning and end of the program. Physiological variables (total cholesterol, triglycerides, blood glucose, blood pressure, and maximal oxygen consumption), anthropometric variables (body mass index (BMI)) and behavioral variables (breakfast, quality of diet, meal frequency, physical activity, sedentary behavior, sleep, and perceived health) were evaluated. Repeated-measures ANOVA showed significant improvements (p < 0.05) after the intervention for the intervention group in triglycerides, blood glucose and maximal oxygen consumption. Significant improvements were also observed in breakfast habits and quality of diet. Finally, a significant improvement in prevalence of normal levels was observed for total cholesterol, blood pressure, and BMI. It can therefore be stated that the HHP is an innovative and useful school-based program that can help to improve diet and health in childhood.
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10.
Impact of a classroom standing desk intervention on daily objectively measured sedentary behavior and physical activity in youth.
Silva, DR, Minderico, CS, Pinto, F, Collings, PJ, Cyrino, ES, Sardinha, LB
Journal of science and medicine in sport. 2018;(9):919-924
Abstract
OBJECTIVES We investigated the impact of a standing desk intervention on daily objectively monitored sedentary behavior and physical activity in 6th grade school students. DESIGN Cluster non-randomised controlled trial. METHOD Two classes (intervention students: n=22 [aged 11.8±0.4years]; control students: n=27 [11.6±0.5years]) from a public school in Lisbon were selected. The intervention involved replacing traditional seated classroom desks for standing desks, for a total duration of 16 weeks, in addition to performing teacher training and holding education/motivation sessions with students and parents. Sedentary behavior (ActivPAL inclinometer) and physical activity (Actigraph GT3X+ accelerometer) were measured for seven days immediately before and after the intervention. RESULTS There were no differences in baseline behaviors between intervention and control groups (p>0.05). At follow-up (16 weeks), it was observed that the intervention group had decreased time spent sitting (total week: -6.8% and at school: -13.0% relative to baseline) and increased standing (total week: 16.5% and at school: 31.0%) based on inclinometer values (p-value for interaction group*time <0.05). No significant differences in activity outcomes were observed outside school time (week or weekend) between groups. CONCLUSION We conclude that a 16 week classroom standing desk intervention successfully reduced sitting time and increase standing time at school, with no observed compensatory effects outside of school time.