Background: Youth in rural areas are disproportionally affected by pediatric obesity. Given the unique barriers rural populations face, tailoring and increasing access to obesity interventions is ...necessary. This study evaluated the effectiveness of a family-based pediatric obesity intervention delivered to rural children via televideo to a participant's home (iAmHealthy). Methods: Participating schools (n = 18) were randomly assigned to iAmHealthy or a newsletter control group. iAmHealthy is a family-based obesity intervention consisting of biweekly individual health coaching and 8 weekly group sessions followed by six monthly group sessions. Child height/weight and physical activity (MVPA) were assessed at baseline, post-treatment (8 months) and follow-up (20 months). Multi-level modeling accounting for the study's nested design estimated the effect of treatment on outcomes at both timepoints. Results: 148 youth (Mage = 8.9; 56.8% female; 87.1% White) were randomized to iAmHealthy (n = 64) or the control group (n = 84). For child BMIz change, the control group had a marginally significant increase, F (1,130) = 3.82, p = 0.053, from baseline to post and a significant increase, F(1,121) = 12.88, p < 0.001, from baseline to follow-up. The iAmHealthy group had no significant changes in BMIz from baseline to post or follow-up. For average daily MVPA, no differences were observed from baseline to post in either group; however, from baseline to follow-up a significant decrease was observed in the control group (F (1,97) = 20.59, p < 0.001), while iAmHealthy had no significant changes. Conclusions: This trial extends previous pediatric obesity work in an innovative direction by increasing convenience (moving the mHealth intervention into rural family homes) and dose of treatment. Results at follow-up suggest improved BMIz trajectories and long-term health behaviors for youth in the iAmHealthy group compared to the control group.
Dinesh Shetty
Angewandte Chemie International Edition,
March 21, 2022, Letnik:
61, Številka:
13
Journal Article
Recenzirano
Odprti dostop
“My favorite place on earth is my hometown (Koodlu, Karnataka) in India, a beautiful countryside village with loads of human values … I chose my current career path because it surprises me daily by ...tossing new challenges and excitements …” Find out more about Dinesh Shetty in his Introducing … Profile.
Abstract
This article discusses the rural areas of the Yamalo-Nenets Autonomous Okrug, their features, current state and development opportunities. The author identifies a list of the main ...environmental problems that arise as a result of production activities, and suggests ways to solve them.
Background: Pediatric obesity interventions of 26 or more contact hours may be more effective than those with fewer contact hours, but research is inconclusive. Disagreement may be due to the lack of ...uniformity in reporting dose. To remedy this issue experts recommend reporting dose intended, dose delivered, and dose received. Also, very little is known about the accumulation of dose in rural populations, and no information has been published regarding the accumulation of dose in the time of COVID 19. The purpose of the current abstract is to describe the accumulation of dose in a fourstate pediatric obesity intervention trial that was conducted in the IDeA States Pediatric Clinical Trials Network. Methods: Rural medical clinics located in four states participated. Each clinic targeted recruitment of 28 children from rural areas who were 6-11 years of age with a BMI%ile>85th and their primary caregivers who (after consent/assent) were randomly assigned to a monthly newsletter only condition or to the iAmHealthy mHealth intervention, which was composed of 12 weekly and 3 monthly one hour group sessions and 11 hours of individual family health coaching. The 6-month intervention period began on August 24, 2020 and completed on February 7, 2021 when the impact of the COVID 19 pandemic was high in participating sites. Results: 52 of the 104 randomized participants were assigned to iAmHealthy; 87% (n = 45) of these participants were retained through the final measurement. Dose intended was 26 contact hours (15 hours of group sessions and 11 hours of health coaching sessions), with a goal for families to receive 80% of these hours (20.8 hours). Dose delivered by the intervention team included 15 hours of group sessions and up to 17 hours for health coaching sessions. Dose received varied widely for both group (0.73-16.78; X = 10.65) and health coaching sessions (0.45-16.85; X = 8.21). Therefore, total accumulated contact hours varied as well (2.4531.13; X = 18.86). Two thirds of the retained participants met the a priori dose goal of 20.8 contact hours. Conclusions: Dose intended and dose received were highly concordant, but dose received varied widely by participant. Future research should continue to explore these measures of dose, especially in underserved populations, and whether these factors are related to health behavior outcomes and body mass changes.
Background: Individuals living in rural areas have higher obesity and obesity related co-morbidities than their urban counterparts. Understanding rural-urban differences associated with weight ...management may inform the development of effective weight management interventions for adults living in rural areas. Methods: The International Weight Control Registry (IWCR) is an online registry designed to assess factors contributing to successes and challenges with weight loss and weight loss maintenance across the world. We examined demographics, weight history and weight management strategies in a sample of urban and rural residents in the Midwestern U.S. (IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI). Participants were classified as rural or urban by the Rural-Urban Commuting Area Code. Analyses included Chi-square tests for proportions and independent t-test and Wilcoxon rank sum test for continuous variables. Results: The sample was 45% rural (n = 78 of a total N = 174) with a mean age of 50.3 years. Rural residents were more likely to be white, non-college graduates, and have lower family income compared with urban areas (p < 0.05). Rural and urban residents reported similar weight histories and strategies for weight management. Workrelated physical activity was higher and weekday sitting time was lower in rural compared to urban residents (p < 0.01). These data could potentially be impacted by the relative number of residents working from home during COVID-19 (Urban: 59% vs. Rural: 37%, p < 0.05). Rural residents were more likely to report a lack of neighborhood walkability (p < 0.01) and healthy food availability (p < 0.05) compared with urban residents. Conclusions: These data suggest rural-urban differences in demographic characteristics, opportunity for leisure time physical activity, and the availability of heathy foods should be considered in the development of weight management interventions. The consistency of the observed findings will be evaluated at the regional, national and international levels as the size of the available sample in the IWCR increases.
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