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1.
BMC Public Health ; 21(1): 1630, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488691

RESUMO

BACKGROUND: IMPROVE aims to conduct a hybrid type 3 evaluation design to test the effectiveness of bundled implementation strategies on intervention fidelity of the Healthy School Start (HSS) program, while simultaneously monitoring effects on health outcomes of children and parents. The HSS is a 4-component family support program for children starting school (5-7 years of age) promoting healthy dietary habits and physical activity in the home environment to prevent childhood obesity and parents' risk of developing type 2 diabetes. METHODS: IMPROVE is a cluster-randomized controlled trial with two arms to evaluate and compare the effects of two different bundles of implementation strategies on intervention fidelity expressed as adherence and responsiveness at 12 and 24 months (primary outcomes). Thirty schools in two municipalities will participate in the study reaching about 1400 families per school year. In stakeholder workshops, key implementation determinants were identified according to the domains of the Consolidated Framework for Implementation Research. Through a consensus process with stakeholders, two bundles of implementation strategies were tailored to address context-specific determinants. Schools randomly assigned to group 1 will receive bundle 1 (Basic) and group 2 will receive bundle 1 + 2 (Enhanced). Bundle 2 consists of external facilitation, fidelity monitoring and feedback strategies. Secondary outcomes will include change in acceptability, appropriateness, feasibility, and organisational readiness as perceived by school staff. In addition, child weight status and diet, and parents' feeding practices and risk of type 2 diabetes will be monitored. Linear and ordinal regression analysis will be used to test the effect on the primary and secondary outcomes, taking clustering and covariates into consideration where needed. Process evaluation will be conducted through key stakeholder interviews to investigate experiences of the program and perceptions on sustainability. DISCUSSION: This systematic approach to investigating the effectiveness of two different bundles of implementation strategies tailored to context-specific determinants on the fidelity of the HSS intervention will provide new insight into feasible implementation strategies and external support needed for the HSS to be effective and sustainable. Results will help inform how to bridge the gap between the research on school-based health programs and routine practice in schools. TRIAL REGISTRATION: Registered prospectively at ClinicalTrials.gov ID: NCT04984421 , registered July 30, 2021.


Assuntos
Diabetes Mellitus Tipo 2 , Obesidade Pediátrica , Criança , Saúde da Criança , Promoção da Saúde , Humanos , Sobrepeso , Obesidade Pediátrica/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Serviços de Saúde Escolar , Instituições Acadêmicas
2.
MMWR Morb Mortal Wkly Rep ; 70(35): 1201-1205, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34473686

RESUMO

Colleges and universities in the United States have relied on various measures during the COVID-19 pandemic to prevent transmission of SARS-CoV-2, the virus that causes COVID-19, including implementing testing programs (1-3). These programs have permitted a safer return to campus for students by identifying infected persons and temporarily isolating them from the campus population (2,3). The University of Texas at Austin (UT Austin) implemented COVID-19 prevention measures in Fall 2020* including the following testing programs: clinic-based diagnostic testing, voluntary community screening, and targeted screening (testing of specific student populations in situations of increased transmission risk). During September 30-November 30, 2020, UT Austin students participated in tests for SARS-CoV-2, which resulted in the detection of 401 unique student cases of COVID-19 from among 32,401 tests conducted.† Among students who participated in one targeted screening program for students attending campus events, 18 (37.5%) of 48 infected students were asymptomatic at the time of their positive test result compared with 45 (23%) of 195 students identified through community testing and nine (5.8%) of 158 students identified through clinic-based testing. Targeted screening also identified a different population of students than did clinic-based and community testing programs. Infected students tested through targeted screening were more likely to be non-Hispanic White persons (chi square = 20.42; p<0.03), less likely to engage in public health measures, and more likely to have had interactions in settings where the risk for SARS-CoV-2 transmission is higher, such as restaurants, gyms, and residence halls. In addition to clinic-based SARS-CoV-2 testing at colleges and universities, complementary testing programs such as community and targeted screening might enhance efforts to identify and control SARS-CoV-2 transmission, especially among asymptomatic persons and disproportionately affected populations that might not otherwise be reached.


Assuntos
Teste para COVID-19 , COVID-19/prevenção & controle , Programas de Rastreamento , SARS-CoV-2/isolamento & purificação , Estudantes/estatística & dados numéricos , Universidades , Adolescente , Adulto , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Quarentena , Texas/epidemiologia , Adulto Jovem
3.
Rev Esp Salud Publica ; 952021 Sep 03.
Artigo em Espanhol | MEDLINE | ID: mdl-34477180

RESUMO

OBJECTIVE: Research has uncovered a global pandemic of physical inactivity and schools have been signaled as possible "agents" to modify these negative scores, since all children spend many hours a day there. The aim was to evaluate if it is possible to increase the physical activity levels of a whole school using a multifactorial, self-regulated intervention program during recess. METHODS: A cross-sectional study was conducted involving all the students (N=50) of a rural public school located in northern Spain (grades 1-6). The study followed an ABA case study research design (changes in the experimentation conditions and data collection after each one: week 1 no intervention, weeks 2-3 intervention, week 4 no intervention) and mixed quantitative-qualitative methodology which included the use of accelerometers (each participant wore one during the whole school day and the school week), field notes (researcher) and focus groups (teachers). Normality tests, descriptive and inferential statistics (ANOVAs) were conducted in the quantitative data obtained, while thematic content and constant comparison analyses in the qualitative data. RESULTS: Quantitative results showed that there was a significant increase to 67.15 ± 13.95 minutes/day of moderate-to-vigorous physical activity (MVPA) in week 2. Boys reached significantly higher scores than girls: 72.1 ± 12.12. Unfortunately, these scores went back to almost normal in the second week of implementation of the program (58.21 ± 12.88; boys= 62.75 ± 10.86). From the joined analysis of the researcher field notes and the teachers' focus groups 4 themes emerged: intensity change, dominance change, interactions change and self-regulation. CONCLUSIONS: It is possible to increase the physical activity levels of a whole school with a multifactorial, self-regulated program, but it is necessary to acknowledge that novelty "wears out" to avoid losing efficacy with time.


Assuntos
Exercício Físico , Serviços de Saúde Escolar , Acelerometria , Criança , Estudos Transversais , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Autocontrole , Espanha
4.
Artigo em Inglês | MEDLINE | ID: mdl-34444462

RESUMO

Correctional officers (COs) are exposed to a number of occupational stressors, and their health declines early in their job tenure. Interventions designed to prevent early decline in CO health are limited. This article describes the development, implementation, and evaluation of a one-year peer health mentoring program (HMP) guided by Total Worker Health® principles and using a participatory action research to collectively address worker safety, health, and well-being of newly hired COs. The HMP aimed to provide new COs with emotional and tangible forms of support during their first year of employment, including peer coaching to prevent early decline in physical fitness and health. The development and implementation of the HMP occurred across five main steps: (1) participatory design focus groups with key stakeholders; (2) adaptation of an existing mentoring handbook and training methods; (3) development of mentor-mentee recruitment criteria and assignment; (4) designing assessment tools; and (5) the initiation of a mentor oversight committee consisting of union leadership, corrections management, and research staff. Correctional employee engagement in the design and implementation process proved to be efficacious in the implementation and adaptation of the program by staff. Support for the HMP remained high as program evaluation efforts continued.


Assuntos
Tutoria , Humanos , Mentores , Grupo Associado , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Recursos Humanos
5.
Afr Health Sci ; 21(Suppl): 25-28, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34447420

RESUMO

Background: Health care workers (HWs) support HIV positive children and adolescents with detectable HIV viral loads on the intensive adherence counselling (IAC) program to achieve viral suppression through individual adherence counselling. Low re-suppression rates of 23% showed low program effectiveness in fifteen public health facilities. Objectives: We set out to determine the knowledge and perceptions of HWs that support this program to improve its effectiveness. Methods: We conducted a qualitative study where five HWs that oversee clinical care for children on ART were interviewed about the program. Data on their knowledge of the program, and perceptions on why it was not effective was collected. Thematic analysis using the inductive approach was used. Transcripts were read, coded and emergent themes determined. Results: Five HWs participated and all were knowledgeable about the program. Two themes emerged as barriers to IAC program effectiveness, patient factors and health system factors. Patient factors were failure to attend appointments, failure to change adherence practices, and lack of consent. Health system factors were work overload, delay in getting results and drug stock outs. Conclusions: HWs are knowledgeable about the IAC program and client specific barriers should be addressed to improve viral suppression for children.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Adesão à Medicação , Adolescente , Adulto , Criança , Aconselhamento , Feminino , Grupos Focais , Infecções por HIV/psicologia , Humanos , Percepção , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Uganda
6.
Afr Health Sci ; 21(Suppl): 39-43, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34447422

RESUMO

Background: In 2011, 3.4 million children were living with HIV worldwide1. Objectives: Describe the characteristics of pediatric patients enrolled into the HIV program at the Kibera community health center between January 2012 and March 2013. Determine the proportion of enrolled paediatric patients lost to follow up. Determine the correlates associated with retention and loss to follow up. Methods: The study was a retrospective cohort study of program data of all pediatric patients enrolled into the HIV program in the facility between January 2012 and March 2013. The data was analyzed using SPSS. Results: Of the 100 pediatric patients enrolled during the study period, 79 and 21 were HIV negative and positive respectively. Only 4 (5%) of the HIV exposed Infants and 11 (52%) of the HIV positive children were started on ART within the study period. The retention rate of the children at 3 months was 87% while the retention at both 12 and 15 months was 79%. There was an association between the mother or guardian disclosing their status and the retention of the child (p-value 0.026). Conclusion: The disclosure of the HIV status by parent/guardian to the child was associated with better retention of the children in the program.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Retenção nos Cuidados/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Centros Comunitários de Saúde , Feminino , Infecções por HIV/diagnóstico , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas , Masculino , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos
7.
Afr Health Sci ; 21(Suppl): 59-63, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34447425

RESUMO

Background: Early Infant Male Circumcision (EIMC) is part of sustainable HIV prevention strategies in Kenya. The goals of the national EIMC program are to circumcise at least 40% of all newborn male infants delivered at hospitals offering the service and keep the rate of moderate and adverse events below 2%. Objectives: To determine the proportion of early male infants (age less than 60 days) born at hospitals in four counties of western Kenya who got circumcised and document the prevalence of adverse events (AEs) among those circumcised. Methods: A retrospective descriptive study involving all records for EIMC from 1st March 2014 through 31st March 2018 in four counties of western Kenya. Data analysis was done using EXEL to document proportion of facilities offering EIMC and compare EIMC uptake and outcomes in the four counties against the national goals for the program. Results: A mean of 4.3% of total health facilities offer EIMC in the region. Siaya had the highest proportion of facilities offering EIMC while Migori had the lowest proportion. Uptake of EIMC was low at 17.4% for all male infants born, far less than the anticipated target of 40%. Average adverse event rates were 0.3%. Conclusion: EIMC uptake remains low in this region of Kenya due to small number of health facilities offering the service. The proportion of circumcised early male infants born at the target health facilities is below the national target of 40% even though the rate of adverse events among those circumcised is acceptable.


Assuntos
Circuncisão Masculina/efeitos adversos , Circuncisão Masculina/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Quênia , Masculino , Avaliação de Programas e Projetos de Saúde/métodos , Estudos Retrospectivos
8.
Commun Biol ; 4(1): 945, 2021 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362999

RESUMO

Two challenges that the global wheat industry is facing are a lowering nitrogen-use efficiency (NUE) and an increase in the reporting of wheat-protein related health issues. Sulphur deficiencies in soil has also been reported as a global issue. The current study used large-scale field and glasshouse experiments to investigate the sulphur fertilization impacts on sulphur deficient soil. Here we show that sulphur addition increased NUE by more than 20% through regulating glutamine synthetase. Alleviating the soil sulphur deficiency highly significantly reduced the amount of gliadin proteins indicating that soil sulphur levels may be related to the biosynthesis of proteins involved in wheat-induced human pathologies. The sulphur-dependent wheat gluten biosynthesis network was studied using transcriptome analysis and amino acid metabolomic pathway studies. The study concluded that sulphur deficiency in modern farming systems is not only having a profound negative impact on productivity but is also impacting on population health.


Assuntos
Agricultura/métodos , Fertilizantes/análise , Gliadina/metabolismo , Nitrogênio/metabolismo , Solo/química , Enxofre/administração & dosagem , Triticum/efeitos dos fármacos , Avaliação de Programas e Projetos de Saúde , Triticum/crescimento & desenvolvimento
9.
Lancet Public Health ; 6(9): e648-e660, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34454642

RESUMO

BACKGROUND: The workplace offers a unique opportunity for effective health promotion. We aimed to comprehensively study the effectiveness of multicomponent worksite wellness programmes for improving diet and cardiometabolic risk factors. METHODS: We did a systematic literature review and meta-analysis, following PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library, Web of Science, and Education Resources Information Center, from Jan 1, 1990, to June 30, 2020, for studies with controlled evaluation designs that assessed multicomponent workplace wellness programmes. Investigators independently appraised the evidence and extracted the data. Outcomes were dietary factors, anthropometric measures, and cardiometabolic risk factors. Pooled effects were calculated by inverse-variance random-effects meta-analysis. Potential sources of heterogeneity and study biases were evaluated. FINDINGS: From 10 169 abstracts reviewed, 121 studies (82 [68%] randomised controlled trials and 39 [32%] quasi-experimental interventions) met the eligibility criteria. Most studies were done in North America (57 [47%]), and Europe, Australia, or New Zealand (36 [30%]). The median number of participants was 413·0 (IQR 124·0-904·0), and median duration of intervention was 9·0 months (4·5-18·0). Workplace wellness programmes improved fruit and vegetable consumption (0·27 servings per day [95% CI 0·16 to 0·37]), fruit consumption (0·20 servings per day [0·11 to 0·28]), body-mass index (-0·22 kg/m2 [-0·28 to -0·17]), waist circumference (-1·47 cm [-1·96 to -0·98]), systolic blood pressure (-2·03 mm Hg [-3·16 to -0·89]), and LDL cholesterol (-5·18 mg/dL [-7·83 to -2·53]), and to a lesser extent improved total fat intake (-1·18% of daily energy intake [-1·78 to -0·58]), saturated fat intake (-0·70% of daily energy [-1·22 to -0·18]), bodyweight (-0·92 kg [-1·11 to -0·72]), diastolic blood pressure (-1·11 mm Hg [-1·78 to -0·44]), fasting blood glucose (-1·81 mg/dL [-3·33 to -0·28]), HDL cholesterol (1·11 mg/dL [0·48 to 1·74]), and triglycerides (-5·38 mg/dL [-9·18 to -1·59]). No significant benefits were observed for intake of vegetables (0·03 servings per day [95% CI -0·04 to 0·10]), fibre (0·26 g per day [-0·15 to 0·67]), polyunsaturated fat (-0·23% of daily energy [-0·59 to 0·13]), or for body fat (-0·80% [-1·80 to 0·21]), waist-to-hip ratio (-0·00 ratio [-0·01 to 0·00]), or lean mass (1·01 kg [-0·82 to 2·83]). Heterogeneity values ranged from 46·9% to 91·5%. Between-study differences in outcomes were not significantly explained by study design, location, population, or similar factors in heterogeneity analyses. INTERPRETATION: Workplace wellness programmes are associated with improvements in specific dietary, anthropometric, and cardiometabolic risk indicators. The heterogeneity identified in study designs and results should be considered when using these programmes as strategies to improve cardiometabolic health. FUNDING: National Heart, Lung, and Blood Institute.


Assuntos
Promoção da Saúde , Saúde do Trabalhador , Comportamento Alimentar/psicologia , Humanos , Síndrome Metabólica/prevenção & controle , Sobrepeso/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Lancet Glob Health ; 9(9): e1262-e1272, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34363766

RESUMO

BACKGROUND: Quality of care is consistently shown to be inadequate in health-care settings in many low-income and middle-income countries, including in private facilities, which are rapidly growing in number but often do not have effective quality stewardship mechanisms. The SafeCare programme aims to address this gap in quality of care, using a standards-based approach adapted to low-resource settings, involving assessments, mentoring, training, and access to loans, to improve clinical quality and facility business performance. We assessed the effect of the SafeCare programme on quality of patient care in faith-based and private for-profit facilities in Tanzania. METHODS: In this cluster-randomised controlled trial, health facilities were eligible if they were dispensaries, health centres, or hospitals in the faith-based or private for-profit sectors in Tanzania. We randomly assigned facilities (1:1) using computer-generated stratified randomisation to receive the full SafeCare package (intervention) or an assessment only (control). Implementing staff and participants were masked to outcome measurement and the primary outcomes were measured by fieldworkers who had no knowledge of the study group allocation. The primary outcomes were health worker compliance with infection prevention and control (IPC) practices as measured by observation of provider-patient interactions, and correct case management of undercover standardised patients at endline (after a minimum of 18 months). Analyses were by modified intention to treat. The trial is registered with ISRCTN, ISRCTN93644888. FINDINGS: Between March 7 and Nov 30, 2016, we enrolled and randomly assigned 237 health facilities to the intervention (n=118) or control (n=119). Nine facilities (seven intervention facilities and two control facilities) closed during the trial and were not included in the analysis. We observed 29 608 IPC indications in 5425 provider-patient interactions between Feb 7 and April 5, 2018. Health facilities received visits from 909 standardised patients between May 3 and June 12, 2018. Intervention facilities had a 4·4 percentage point (95% CI 0·9-7·7; p=0.015) higher mean SafeCare standards assessment score at endline than control facilities. However, there was no evidence of a difference in clinical quality between intervention and control groups at endline. Compliance with IPC practices was observed in 8181 (56·9%) of 14 366 indications in intervention facilities and 8336 (54·7%) of 15 242 indications in control facilities (absolute difference 2·2 percentage points, 95% CI -0·2 to -4·7; p=0·071). Correct management occurred in 120 (27·0%) of 444 standardised patients in the intervention group and in 136 (29·2%) of 465 in the control group (absolute difference -2·8 percentage points, 95% CI -8·6 to -3·1; p=0·36). INTERPRETATION: SafeCare did not improve clinical quality as assessed by compliance with IPC practices and correct case management. The absence of effect on clinical quality could reflect a combination of insufficient intervention intensity, insufficient links between structural quality and care processes, scarcity of resources for quality improvement, and inadequate financial and regulatory incentives for improvement. FUNDING: UK Health Systems Research Initiative (Medical Research Council, Economic and Social Research Council, UK Department for International Development, Global Challenges Research Fund, and Wellcome Trust).


Assuntos
Certificação , Instalações de Saúde/normas , Controle de Infecções/normas , Melhoria de Qualidade/organização & administração , Qualidade da Assistência à Saúde/estatística & dados numéricos , Organizações Religiosas , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Guias de Prática Clínica como Assunto , Setor Privado , Avaliação de Programas e Projetos de Saúde , Tanzânia
12.
Cien Saude Colet ; 26(8): 3005-3018, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34378693

RESUMO

The SHAHRP program was effective reducing drinking and alcohol - harms in Australia, but cross-cultural adaptation is required before replication. This study aimed at assessing the feasibility of SHAHRP in Brazil focused on implementation and acceptability. A mixed-methodsdesign was used: quantitative for implementing the program and evaluation and qualitative for acceptability. The quantitative design was a pilot of a randomized controlled trial. Private schools were randomly divided into four intervention (n=160) and four control (n=188) schools. Student's mean age was 12.7 years. The fidelity of implementation and likely outcome measures were assessed. Qualitative data on acceptability were provided by students and teachers. The percentage of implementation varied from 62.5% to 87.5%. Behaviours such as alcohol-harms requires a larger cohort and longer follow-up to be adequately evaluated. The risk reduction approach and activities had good acceptability from students and teachers. Quantitative and qualitative outcomes on knowledge and decision-making indicated possible improvement in SHAHRP schools. The program is feasible and well accepted in a Brazilian setting, opening the way for a more comprehensive evaluation and dissemination.


Assuntos
Instituições Acadêmicas , Estudantes , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Brasil , Criança , Estudos de Viabilidade , Humanos , Avaliação de Programas e Projetos de Saúde , Serviços de Saúde Escolar
13.
Cien Saude Colet ; 26(8): 3099-3110, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34378701

RESUMO

This article aims to identify studies that developed quality indicator for the management of the National School Feeding Program (PNAE, in Brazilian context) and to critically appraise the properties of their instruments. Systematic review using Scopus, Lilacs, Pubmed and Web of Science for data collection. The search was limited to studies between 2009 and 2019. The search strategy included search terms related to school feeding, program evaluation, and indicator. The indicators were evaluated using the Appraisal of Indicators through Research and Evaluation instrument. The search identified 1,355 studies, of which 14 were potentially relevant records and 10 met the inclusion criteria. Most studies used a literature review with consensus techniques in the development of the instrument and a frame work format to evaluate the PNAE. None of them presented evidence of validity of the instrument. The highest level was achieved on the domain 'Purpose, relevance and organizational context', followed by 'Stakeholder involvement', 'Additional evidence, formulation and usage', and 'Scientific evidence'. This review found gaps in the methodology of studies that had developed quality indicators for the management of PNAE. Future development of these instruments should include validity evidence.


Assuntos
Indicadores de Qualidade em Assistência à Saúde , Instituições Acadêmicas , Brasil , Consenso , Humanos , Avaliação de Programas e Projetos de Saúde
16.
Nutrients ; 13(8)2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34444842

RESUMO

Leucocyte telomere length (LTL) is a robust marker of biological aging and is associated with obesity and cardiometabolic risk factors in childhood and adolescence. We investigated the effect of a structured, comprehensive, multidisciplinary, personalized, lifestyle intervention program of healthy diet and physical exercise on LTL in 508 children and adolescents (239 males, 269 females; 282 prepubertal, 226 pubertal), aged 10.14 ± 0.13 years. Participants were classified as obese (n = 267, 52.6%), overweight (n = 174, 34.2%), or of normal BMI (n = 67, 13.2%) according to the International Obesity Task Force (IOTF) cutoff points and were studied prospectively for one year. We demonstrated that LTL increased significantly after 1 year of the lifestyle interventions, irrespective of gender, pubertal status, or body mass index (BMI). Waist circumference was the best negative predictor of LTL at initial assessment. The implementation of the lifestyle interventions also resulted in a significant improvement in clinical (BMI, BMI z-score and waist to height ratio) and body composition indices of obesity, inflammatory markers, hepatic enzymes, glycated hemoglobin (HbA1C), quantitative insulin sensitivity check index (QUICKI), and lipid profile in all participants. These findings indicate that the increased LTL may be associated with a more favorable metabolic profile and decreased morbidity later in life.


Assuntos
Envelhecimento/genética , Leucócitos/patologia , Obesidade Pediátrica/genética , Telômero/patologia , Programas de Redução de Peso/métodos , Adolescente , Terapia Comportamental/métodos , Composição Corporal , Índice de Massa Corporal , Criança , Exercício Físico/fisiologia , Feminino , Humanos , Estilo de Vida , Masculino , Obesidade Pediátrica/sangue , Obesidade Pediátrica/terapia , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Resultado do Tratamento , Circunferência da Cintura
17.
Nutrients ; 13(8)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34444850

RESUMO

This scoping review examined intervention and sample characteristics of family-based obesity prevention interventions among Hispanic youth. This review also examined the degree to which existing interventions were culturally-adapted, acknowledged social determinants of health (SDoH), and collaborated with community stakeholders. A comprehensive search across Medline Ovid, Embase, Scopus, PsycInfo, and Pubmed was used to identify 13 studies primarily based in the U.S. (92.3%). Data was extracted by two independent reviewers. Most used a randomized control trial design (69.2%), a behavior change theory (84.6%), and reported moderate to high (≥70%) retention (69.2%). Studies targeted improvements in physical activity (69.2%) and fruit and vegetable intake (92.3%) through nutrition education, cooking demonstrations, and tastings. Younger children from low socioeconomic backgrounds (61.5%) were well represented. Most interventions were culturally-adapted (69.2%), all studies reported collaboration with stakeholders, yet only half used strategies that acknowledged SDoH (46.2%). To increase our understanding of the underlying mechanisms by which family-based approaches can reach and engage Hispanic youth and families, future studies should rigorously evaluate theoretical constructs, family processes, and SDoH that influence program participation and health behaviors. This information will guide the design and development of future interventions aimed at reducing obesity disparities among Hispanic youth.


Assuntos
Terapia Comportamental/métodos , Informação de Saúde ao Consumidor/métodos , Terapia Familiar/métodos , Hispano-Americanos/psicologia , Obesidade/prevenção & controle , Adolescente , Criança , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde Culturalmente Competente/métodos , Comportamento Alimentar/etnologia , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Promoção da Saúde/métodos , Humanos , Masculino , Obesidade/etnologia , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Determinantes Sociais da Saúde/etnologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-34360158

RESUMO

In recent years, the nutritional pattern of the Dutch adolescent has cautiously improved. However, progress can be gained if more Dutch adolescents adhere to the nutritional guidelines. School-based initiatives offer opportunities to deal with the unhealthy eating behaviours of adolescents via nutrition educational interventions. In designing and/or re-designing school-based interventions, it is important to enhance optimal context-oriented implementation adaptation by involving the complex adaptive school system. This paper elaborates on the way of dealing with the dynamic implementation context of the educational programme "Krachtvoer" (ENG: "Power food") for prevocational schools, how the programme can be adapted to each unique implementation context, and how the programme can be progressively kept up to date. Following a co-creation-guided approach with various intersectoral stakeholders within and outside the school setting, action-oriented mixed research methods (i.e., observations, semi-structured interviews, focus group interviews, programme usage monitoring, and questionnaires) constantly provide input to develop the programme and its implementation strategy via continuous micro-process cycles. Successful co-creation of school-based health promotion seems to be dependent on proper intersectoral cooperation between research and practice communities, a national partner network that can provide project-relevant insights and establish capacity building aimed at improving contextual fit, and a time-investment balance in and between sectors.


Assuntos
Dieta Saudável , Instituições Acadêmicas , Adolescente , Promoção da Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Avaliação de Programas e Projetos de Saúde , Serviços de Saúde Escolar
19.
Adv Physiol Educ ; 45(3): 626-633, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34379488

RESUMO

The National Institute of General Medical Sciences (NIGMS) mandates that its Centers of Biomedical Research Excellence (COBRE) and Institutional Development Award Networks of Biomedical Research Excellence (INBRE) institute formal mentoring programs to promote the core program objective of junior investigator development. Despite this NIGMS requirement, and the many career-related benefits associated with mentoring, few tools exist for purposes of rigorously evaluating COBRE and INBRE mentoring programs. The purpose of this project was to develop a mentoring assessment tool to aid in the evaluation of COBRE and INBRE mentoring programs. In study 1, a list of items comprising the tool was created via a multiphase item generation process based on input received from subject matter experts within the Cognitive and Neurobiological Approaches to Plasticity Center. In study 2, feedback about this tool was solicited from 78 grant directors, mentees, and mentors representing 21 unique COBRE programs and 8 unique INBRE programs from across the United States. The results provide initial evidence that this tool possesses suitable psychometric properties, is a flexible instrument with many potential uses, and represents a valuable resource for helping evaluate COBRE and INBRE mentoring programs. Having a tool for evaluating mentoring can help promote the grant success and career development of junior investigators in COBRE and INBRE programs and help program directors develop more sustainable research centers.


Assuntos
Pesquisa Biomédica , Tutoria , Humanos , Mentores , National Institute of General Medical Sciences (U.S.) , Avaliação de Programas e Projetos de Saúde , Pesquisadores , Estados Unidos
20.
Nutrients ; 13(7)2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371862

RESUMO

Cooperative Extension is a community outreach program. Despite its large reach, there is a need for the evaluation of changes in health-related outcomes for individuals engaged with Cooperative Extension. A team-based challenge was developed using community-engaged participatory research integrated with Cooperative Extension to encourage healthy eating and physical activity behaviors through Cooperative Extension programming. Thus, the primary purpose of this secondary analysis was to (1) evaluate changes in anthropometric outcomes and (2) evaluate changes in health behavior outcomes. Associations of anthropometric changes and health behavior changes with engagement in the three-month team-based challenge were explored. Anthropometrics were measured using standard procedures, and intake of fruits and vegetables and physical activity were self-reported. Of the 145 participants in the community-engaged participatory research portion of the study, 52.4% (n = 76) had complete anthropometrics before and after the team-based challenge and were included in this study. At 3 months, there was a significant reduction in body mass index (-0.3 kg/m2, p = 0.024) and no significant change in waist circumference (p = 0.781). Fruit and vegetable intake significantly increased (+0.44 servings/day, p = 0.018). Physical activity did not significantly change based on (1) the number of days 30 or more minutes of physical activity was conducted (p = 0.765) and (2) Godin Leisure-Time Exercise Questionnaire scores (p = 0.612). Changes in anthropometrics and health behaviors were not associated with engagement in the team-based challenge. Using community-engaged participatory research with community outreach programs, such as Cooperative Extension, can improve health-related outcomes in underserved populations. However, despite a participatory approach, changes in anthropometrics and health behaviors were not associated with engagement in the developed team-based challenge.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Comportamentos Relacionados com a Saúde , Avaliação de Programas e Projetos de Saúde/métodos , Participação Social , Populações Vulneráveis/psicologia , Antropometria , Índice de Massa Corporal , Relações Comunidade-Instituição , Delaware , Dieta Saudável/psicologia , Exercício Físico/psicologia , Feminino , Frutas , Processos Grupais , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Verduras , Circunferência da Cintura
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