Family systems approaches in pediatric obesity management: a scoping review.

Family-based obesity management interventions targeting child, adolescent and parental lifestyle behaviour modifications have shown promising results. Further intervening on the family system may lead to greater improvements in obesity management outcomes due to the broader focus on family patterns and dynamics that shape behaviours and health. This review aimed to summarize the scope of pediatric obesity management interventions informed by family systems theory (FST). Medline, Embase, CINAHL and PsycInfo were searched for articles where FST was used to inform pediatric obesity management interventions published from January 1980 to October 2023. After removal of duplicates, 6053 records were screened to determine eligibility. Data were extracted from 50 articles which met inclusion criteria; these described 27 unique FST-informed interventions. Most interventions targeted adolescents (44%), were delivered in outpatient hospital settings (37%), and were delivered in person (81%) using group session modalities (44%). Professionals most often involved were dieticians and nutritionists (48%). We identified 11 FST-related concepts that guided intervention components, including parenting skills, family communication, and social/family support. Among included studies, 33 reported intervention effects on at least one outcome, including body mass index (BMI) (n = 24), lifestyle behaviours (physical activity, diet, and sedentary behaviours) (n = 18), mental health (n = 12), FST-related outcomes (n = 10), and other outcomes (e.g., adiposity, cardiometabolic health) (n = 18). BMI generally improved following interventions, however studies relied on a variety of comparison groups to evaluate intervention effects. This scoping review synthesises the characteristics and breadth of existing FST-informed pediatric obesity management interventions and provides considerations for future practice and research.

Adherence to the 24-hour movement guidelines and adiposity in a cohort of at risk youth: A longitudinal analysis.

BACKGROUND: The 24-hour movement guidelines provide recommendations for physical activity, screen time and sleep duration for children. OBJECTIVES: Describe adherence to the guidelines and their cross-sectional and longitudinal associations with adiposity from childhood to adolescence. METHODS: Data are from the QUALITY Cohort. Children were followed at 8 to 10 years (childhood; n = 630), 10 to 12 years (early adolescence; n = 564) and 15 to 17 years (adolescence; n = 377). Physical activity, screen time, and sleep duration were measured by accelerometry and questionnaires. Body mass index z-scores (zBMI), waist circumference, waist-to-height ratio and percent body fat were based on clinical measurements. Multiple linear regressions estimated associations. RESULTS: In childhood, early adolescence and adolescence, 14%, 6%, and 0% of participants met the 24-hour movement guidelines, respectively. Meeting fewer guideline components was cross-sectionally associated with higher adiposity at each visit. Meeting fewer guideline components in childhood was longitudinally associated with higher adiposity at later visits. For example, those meeting none of the guideline components (vs all) in childhood had a 1.66 SD (95% CI: 0.42, 2.89) higher zBMI in early adolescence. CONCLUSION: Few participants met the guidelines. Not meeting the guidelines in childhood is associated with higher adiposity 2 and 7 years later. Interventions are needed to increase adherence to the 24-hour movement guidelines across childhood and adolescence.

Prostate Cancer Survivors' and Caregivers' Experiences Using Behavior Change Techniques during a Web-Based Self-Management and Physical Activity Program: A Qualitative Study.

Both men with prostate cancer and their caregivers report experiencing a number of challenges and health consequences, and require programs to help support the cancer patient-caregiver dyad. A tailored, web-based, psychosocial and physical activity self-management program (TEMPO), which implements behavior change techniques to help facilitate behavior change for the dyads was created and its acceptability was tested in a qualitative study. The purpose of this secondary analysis was to explore the dyads' experiences using behavior change techniques to change behavior and address current needs and challenges while enrolled in TEMPO. Multiple semi-structured interviews were conducted with 19 prostate cancer-caregiver dyads over the course of the program, resulting in 46 transcripts that were analyzed using an inductive thematic analysis. Results revealed four main themes: (1) learning new behavior change techniques, (2) engaging with behavior change techniques learned in the past, (3) resisting full engagement with behavior change techniques, and (4) experiencing positive outcomes from using behavior change techniques. The dyads' discussions of encountering behavior change techniques provided unique insight into the process of learning and implementing behavior change techniques through a web-based self-management program, and the positive outcomes that resulted from behavior changes.

Exploring the peer mentorship experiences of adults with spinal cord injury.

PURPOSE/OBJECTIVE: The purpose of this study was to understand the peer mentorship experiences of adults with spinal cord injury (SCI) through a self-determination theory (SDT) lens. Research Method/Design: Semi-structured qualitative interviews were conducted with 13 adults with SCI who received mentorship (i.e., mentees) from fellow adults with SCI (i.e., mentors) as part of an existing provincial peer mentorship program. There were two analyses conducted in this study. The first was deductive, which involved organizing relevant data as per the three basic psychological needs of self-determination theory (i.e., autonomy, competence, and relatedness). The second analysis was inductive and focused on the participants' descriptions of their experiences. RESULTS: For the SDT analysis, and concerning autonomy, mentees expressed they were able to make their own decisions and their mentors' personalized their sessions. Specific to relatedness, the mentees discussed that their mentors cared and empathized with them, which helped them connect with their mentor. In terms of competence, mentees explained that their mentors provided verbal encouragement and helped them realize they were capable of successfully completing tasks. Some mentees also highlighted how the mentors did not listen to their needs, indicating need thwarting behaviors. For the inductive analysis, mentees expressed the importance of their SCI community organization, the impact of mentoring on their families, and the positive outcomes they associated with peer mentorship, such as participation in daily and social activities. CONCLUSION/IMPLICATIONS: The present findings extend our understanding of SCI peer mentorship from the perspective of the mentee and particularly from an SDT angle. (PsycINFO Database Record (c) 2018 APA, all rights reserved).