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Parenting support to prevent overweight during regular well-child visits in 0-3 year old children (BBOFT+ program), a cluster randomized trial on the effectiveness on child BMI and health behaviors and parenting.
Vlasblom, E, van Grieken, A, Beltman, M, L'Hoir, MP, Raat, H, Boere-Boonekamp, MM
PloS one. 2020;(8):e0237564
Abstract
BACKGROUND Prevention of overweight during early childhood seems promising. OBJECTIVE To evaluate the effectiveness of the parenting-based BBOFT+ overweight prevention program on child BMI, child health behavior and parenting behavior among 0-36 month old children. BBOFT+ is an acronym for the key healthy lifestyle behaviors that are targeted in the BBOFT+ intervention: breastfeeding (B), daily breakfast (B), daily going outdoors (O), limiting sweet beverages (in Dutch, F) and minimal TV or computer time (T), complemented with healthy sleep behavior and improvement of parenting skills (+). METHODS A cluster randomized controlled trial in newborn children visiting well-baby clinics, comparing the BBOFT+ intervention (N = 901) with care as usual (CAU) (N = 1094). In both groups, parents received regular well-child visits (±11 visits in the first 3 years). In the intervention group, care was supplemented with the BBOFT+ program, which focuses on improving parenting skills from birth onwards to increase healthy behavior. Questionnaires were filled in at child's age 2-4 weeks, 6, 14 and 36 months. In multivariate analyses we corrected for child's birthweight, age, ethnic background, mother's educational level and BMI. RESULTS No differences were found in weight status at 36 months between intervention and control group children. At 6 months, BBOFT+ parents reported their child drinking less sweet beverages than control parents (48% vs 54%;p = .027), and going outdoors daily with their child less often (57% vs 62%;p = .03). At 14 months, more BBOFT+ parents than control parents reported to have breastfed for six months or longer (32% vs 29%;p = .022). At 36 months, more BBOFT+ parents than control parents reported their child going outside daily (78% vs 72%;p = .011) and having less TV/computer time on week- (38% vs 46%;p = .001) and weekend days (48% vs 56%;p = .002). Also, BBOFT+ parents reported having more parental control than control parents (3.92 vs 3.89;p = .02). No significant differences were found for daily breakfast, sleep duration and parenting practices in adjusted analyses. CONCLUSION The BBOFT+ overweight prevention program showed small improvements in parent-reported child health behaviors, compared to care as usual; no effect was observed on child BMI. The identified modifiable elements are potentially relevant for interventions that aim to prevent overweight.
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"Exercise during hemodialysis and health promoting behaviors: a clinical trial".
Dashtidehkordi, A, Shahgholian, N, Attari, F
BMC nephrology. 2019;(1):96
Abstract
BACKGROUND Health promoting behaviors are among the determinants of health. Hemodialysis causes significant changes in the lives of patients and affects their health promoting behaviors. Accordingly, this study aimed at investigating the effect of exercise during hemodialysis on health promotion behaviors in patients undergoing hemodialysis. METHODS This study was a two-stage (before and after) clinical trial. The sample of the study consisted of 60 hemodialysis patients in two hospitals in Isfahan who were selected randomly and divided into two groups of control and intervention using random allocation method. A 8-week exercise program by stationary bicycles (Mini-bike) was designed for the intervention group, while the control group underwent a 10-min limbering exercise for 8 weeks. Data were collected using demographic questionnaire and the Health Promoting Lifestyle Profile II (HPLP-II) questionnaire before and after the intervention and were analyzed using SPSS21 software. RESULTS Based on the independent t-test results, no significant difference was observed between the mean score of health promoting behaviors and its areas before the intervention (P > 0.05). However, the results of this test showed that the mean score of health promoting behaviors and its areas, except for the areas of responsibility (P = 0.052) and spirituality (P = 0.211), was significantly different between the two groups after the intervention (p < 0.05). CONCLUSIONS The results of this study showed that exercise with stationary bicycle during hemodialysis could promote health promoting behaviors. Thus, this exercise is recommended to be considered as part of the therapeutic protocol of these patients in hemodialysis departments. TRIAL REGISTRATION The clinical trial was found to be in accordance to the ethical principles and the national norms and standards for conducting medical research in Iran. IRCT registration number: IRCT20150116020675N3 . Registration date: 2019-01-18, 1397/10/28 Approval ID: IR.MUI. RESEARCH REC.1397.014 Approval Date: 2018-07-01 Evaluated by: Vice-Chancellor in Research Affairs -Medical University of Isfahan.
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Psychosocial predictors of weight loss by race and sex.
Jerome, GJ, Myers, VH, Young, DR, Matthews-Ewald, MR, Coughlin, JW, Wingo, BC, Ard, JD, Champagne, CM, Funk, KL, Stevens, VJ, et al
Clinical obesity. 2015;(6):342-8
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This paper examined the psychosocial predictors of weight loss among race and sex subgroups. Analyses included overweight and obese participants from the PREMIER study, a previously published randomized trial that examined the effects of two multi-component lifestyle interventions on blood pressure among pre-hypertensive and stage 1 hypertensive adults. Both intervention conditions received behavioural recommendations for weight loss and group sessions. Weight and psychosocial measures of self-efficacy and social support for diet and exercise were assessed at baseline and at 6 months. There were 157 African-American (AA) women, 46 AA men, 203 non-AA women and 182 non-AA men with an average age of 50 years and average body mass index of 34 at baseline. Multiple predictor regression models were performed individually by race and sex subgroup. Among AA women, increases in diet self-efficacy were associated with weight loss. Among AA men, increases in diet-related social support and self-efficacy, along with increases in family support to exercise, were associated with weight loss (all Ps <0.05). Among non-AA women, increases in friends' support to exercise and exercise-related self-efficacy were associated with weight loss, and among non-AA men only increases in diet self-efficacy were associated with weight loss (all Ps <0.05). These results emphasize the need for targeted interventions based on race and sex to optimize the impact of lifestyle-based weight loss programmes.
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Perceived racial discrimination and adoption of health behaviors in hypertensive Black Americans: the CAATCH trial.
Forsyth, JM, Schoenthaler, A, Ogedegbe, G, Ravenell, J
Journal of health care for the poor and underserved. 2014;(1):276-91
Abstract
BACKGROUND Few studies examine psychosocial factors influencing the adoption of healthy behaviors among hypertensive patients. The effect of discrimination on health behaviors remains untested. PURPOSE To examine the influence of discrimination on adoption of healthy behaviors among low-income Black hypertensive patients. METHODS Black patients (N = 930) in community-based primary care practices enrolled in the CAATCH trial. Mixed effects regressions examined associations between perceived discrimination and change in medication adherence, diet, and physical activity from baseline to 12 months, controlling for intervention, gender, age, income, and education. RESULTS Patients were low-income, high-school-educated, with a mean age of 57 years. Greater discrimination was associated with worse diet and lower medication adherence at baseline. Discrimination was associated with greater improvement in healthy eating behaviors over the course of the 12-month trial. CONCLUSIONS Prior exposure to discrimination was associated with unhealthy behaviors at baseline, but did not negatively influence the adoption of health behaviors over time.
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Neighborhood characteristics, adherence to walking, and depressive symptoms in midlife African American women.
Wilbur, J, Zenk, S, Wang, E, Oh, A, McDevitt, J, Block, D, McNeil, S, Ju, S
Journal of women's health (2002). 2009;(8):1201-10
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BACKGROUND African American women have more symptoms of depressed mood than white women. Adverse neighborhood conditions may contribute to these symptoms. Although reductions in depressive symptoms with physical activity have been demonstrated in white adults, little research has examined the mental health benefits of physical activity in African American women. Further, it is unknown whether physical activity can offset the effects of living in disadvantaged neighborhoods on depressive symptoms. The purpose of this study was to examine the relationships among neighborhood characteristics, adherence to a physical activity intervention, and change over time in depressive symptoms in midlife African American women. METHODS Two hundred seventy-eight women participated in a home-based, 24-week moderate-intensity walking intervention. Either a minimal treatment (MT) or enhanced treatment (ET) version of the intervention was randomly assigned to one of the two community health centers. Walking adherence was measured as the percentage of prescribed walks completed. Objective and perceived measures of neighborhood deterioration and crime were included. RESULTS Adjusting for demographics, body mass index (BMI), and depressive symptoms at baseline, walking adherence and objective neighborhood deterioration were associated with significantly lower depressive symptoms, whereas perceived neighborhood deterioration was associated with significantly higher depressive symptoms at 24 weeks. CONCLUSIONS Adherence to walking as well as aspects of the environment may influence depressive symptoms in African American women. In addition to supporting active lifestyles, improving neighborhood conditions may also promote mental health among African American women.
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Characteristics of participants in a cancer prevention intervention designed for multiethnic workers in small manufacturing worksites.
Hunt, MK, Stoddard, AM, Kaphingst, KA, Sorensen, G
American journal of health promotion : AJHP. 2007;(1):33-7
Abstract
PURPOSE To examine worker characteristics explicated in our social-contextual intervention model that might be associated with participation in a cancer prevention intervention. These characteristics included sociodemographic variables, mediating mechanisms, and modifying conditions. METHODS Randomized, controlled study in 24 small multiethnic manufacturing worksites. Analyses were conducted on an embedded cohort of 456 employees in the intervention condition, incorporating the clustering of respondents in worksites using generalized linear mixed modeling methods. The intervention was based on an inclusive, comprehensive social-contextual model targeting fruit, vegetable, and red meat consumption, multivitamin use, and physical activity. RESULTS Gender (p = .02) and self-efficacy (p < .01) were associated with participation. There were no differences in participation by race/ethnicity or occupational status. We observed no associations between participation of individual workers in intervention activities and health behavior change. CONCLUSIONS The intervention attracted workers across racial/ethnic and occupational groups. The combination of a comprehensive intervention with wide diffusion of program messages may have been more powerful in influencing participation and behavior change than characteristics of individual employees.