scholarly journals Parental Activation and Obesity-Related Health Behaviors Among a Racially and Ethnically Diverse Population of Low-Income Pediatric Patients: Protocol for a Cross-Sectional Survey Study (Preprint)

2017 ◽  
Author(s):  
Nakiya N Showell ◽  
Corinna Koebnick ◽  
Lisa R DeCamp ◽  
Margo Sidell ◽  
Tatiahna Rivera Rodriguez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Health Behaviors ◽  
Health Systems ◽  
Low Income ◽  
Screen Time ◽  
Aged Patients ◽  
Cross Sectional ◽  
Primary Care Settings

BACKGROUND Despite a recent decline in the obesity prevalence among preschool-aged children, obesity remains disproportionately high among children from low-income racial or ethnic minority families. Promoting healthy lifestyles (eg, obesity-preventative behaviors) in primary care settings is particularly important for young children, given the frequency of preventative health visits and parent-provider interactions. Higher adoption of specific health behaviors is correlated with increased patient activation (ie, skill, confidence, and knowledge to manage their health care) among adults. However, no published study, to date, has examined the relationship between parental activation and obesity-related health behaviors among young children. OBJECTIVE The goal of this study is to measure parental activation in low-income parents of preschoolers in 2 large health systems and to examine the association with diet, screen-time, and physical activity behaviors. METHODS We will conduct a cross-sectional study of parents of preschool-aged patients (2-5 years) receiving primary care at multiple clinic sites within 2 large health care systems. Study participants, low-income black, Hispanic, and white parents of preschool-aged patients, are being recruited across both health systems to complete orally administered surveys. RESULTS Recruitment began in December 2017 and is expected to end in May 2018. A total of 267 low-income parents of preschool-aged children have been enrolled across both clinic sites. We are enrolling an additional 33 parents to reach our goal sample size of 300 across both health systems. The data analysis will be completed in June 2018. CONCLUSIONS This protocol outlines the first study to fully examine parental activation and its relationship with parent-reported diet, physical activity, and screen-time behaviors among low-income preschool-aged patients. It involves recruitment across 2 geographically distinct areas and resulting from a partnership between researchers at 2 different health systems with multiple clinical sites. This study will provide new knowledge about how parental activation can potentially be incorporated as a strategy to address childhood obesity disparities in primary care settings. INTERNATIONAL REGISTERED REPOR RR1-10.2196/9688

scholarly journals Evaluation of a Primary Care Weight Management Program in Children Aged 2–5 years: Changes in Feeding Practices, Health Behaviors, and Body Mass Index

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 498 ◽  
Author(s):  
Jared Tucker ◽  
Renee DeFrang ◽  
Julie Orth ◽  
Susan Wakefield ◽  
Kathleen Howard
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Body Mass Index ◽  
Health Behaviors ◽  
Body Mass ◽  
Screen Time ◽  
Feeding Habits ◽  
Feeding Practices ◽  
Care Intervention ◽  
The Impact

Background: Primary care offers a promising setting for promoting parenting practices that shape healthy eating and physical activity behaviors of young children. This study assessed the impact of a parent-based, primary care intervention on the feeding habits, health behaviors, and body mass index (BMI) of 2–5 year olds with elevated or rapidly-increasing BMI. Methods: Four private pediatric offices in West Michigan were assigned as control (n = 2) or intervention (n = 2) sites based on patient load and demographics. Treatment families were recruited at well-child visits to receive physician health-behavior counseling and four visits with a registered dietitian nutritionist (RDN) over a 6-month period. Intervention outcomes were age- and sex-specific BMI metrics, including BMI z-scores and percent of the 95th percentile (%BMIp95), the Family Nutrition and Physical Activity survey (FNPA), and the Feeding Practices and Structure Questionnaire (FPSQ). Results: Of 165 enrolled families, 127 completed follow-up measures (77% retention). Mean (±SD) FNPA scores improved in treatment vs. control (4.6 ± 4.6 vs. 0.1 ± 4.2; p < 0.001), and screen time (h/day) decreased (−0.9 ± 1.8 vs. 0.3 ± 1.1; p < 0.001). Non-responsive feeding practices (i.e., reward for behavior (p = 0.006) and distrust in appetite (p < 0.015)) and structure-related feeding practices (structured meal timing (p < 0.001)) improved in treatment parents vs. controls. Reductions in child BMI measures did not differ between groups. Conclusions: Families with preschool children participating in a low-intensity, primary care intervention improved obesogenic health behaviors, parent feeding habits, and child screen time, but not child adiposity. Future research should assess the sustainability of these family lifestyle improvements, and evaluate their future impact on the health and development of the children.

scholarly journals Characteristics of physical activity programs in the Brazilian primary health care system

2014 ◽  
Vol 30 (10) ◽  
pp. 2155-2168 ◽  
Author(s):  
Grace Angélica de Oliveira Gomes ◽  
Eduardo Kokubun ◽  
Grégore Iven Mieke ◽  
Luiz Roberto Ramos ◽  
Michael Pratt ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Intervention Program ◽  
Physical Activity Intervention ◽  
Primary Health Care System ◽  
Health Unit ◽  
Cross Sectional ◽  
Physical Activity Programs ◽  
Care System

The aim of this study was to describe the characteristics of programs that promote physical activity in the public primary care system by region of Brazil, subject to the presence or absence of multidisciplinary primary care teams (NASF). We conducted a cross sectional and population-based telephone survey of the health unit coordinators from 1,251 health care units. Coordinators were asked about the presence and characteristics of physical activity programs. Four out of ten health units reported having a physical activity intervention program, the most common involving walking groups. Most of the activities were performed in the morning, once or twice a week, and in sessions of 30 minutes or more. Physical education professionals were primarily responsible for directing the activities. Interventions occurred in the health unit itself or in adjacent community spaces. In general, these characteristics were similar between units with or without NASF, but varied substantially across regions. These findings will guide future physical activity policies and programs within primary care in Brazil.

Regular consumption of red meat and health behaviors in the Brazilian population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D de Assumpção ◽  
S M Álvares Domene ◽  
A M Pita Ruiz ◽  
P M Stolses Bergamo Francisco
Keyword(s):  
Physical Activity ◽  
Health Behaviors ◽  
Meat Consumption ◽  
Cross Sectional Study ◽  
National Health Survey ◽  
Red Meat ◽  
Alcoholic Beverages ◽  
Cross Sectional ◽  
Unhealthy Eating ◽  
Regular Consumption

Abstract Background The consumption of red meat should not surpass 500 g of cooked weight per week. Regular consumption can exceed this recommendation, increasing the risk of chronic diseases. Objective Estimate the prevalence of the regular consumption of red meat according to health behaviors in Brazilian adults (≥18 years). Methods A cross-sectional study was conducted with data from the 2013 National Health Survey, which is a household inquiry with a representative sample of the population ≥18 years of age. The regular consumption of red meat (beef, pork, goat) was defined as ≥ 5 days/week. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated according to health behaviors (healthy and unhealthy eating patterns, smoking, practice of physical activity during leisure and alcohol intake). Results A total of 60,202 adults were interviewed, 52.9% of whom were women and mean age was 42.9 years (95%CI: 42.6-43.2). The prevalence of regular red meat consumption was 36.7% (95%CI: 36.0-37.5) and was higher among those who ingested soft drinks/artificial juice (PR = 1.08) and sweets (PR = 1.05) ≥3 days/week, ingested beans (PR = 1.07) and raw vegetables (PR = 1.03) ≥5 days/week, ingested fatty meat (PR = 1.09), smokers (PR = 1.05), individuals who were inactive during leisure (PR = 1.04) and those who consumed alcohol ≥2 times/week (PR = 1.06). The prevalence was lower among those who ate fruit (PR = 0.99) and chicken (PR = 0.95) ≥5 days/week, those who ate fish (PR = 0.90) at least 1 day/week and those who drank no fat/low fat milk rather than whole milk. Conclusions The regular consumption of red meat was higher among individuals who ingested unhealthy foods more often, those who ingested fatty meat, smokers, those who ingested alcoholic beverages and those who did not practice physical activity. Actions are needed to reduce the frequency of red meat consumption. Key messages Regular consumption of red meat can exceed the recommendation of 500 g of cooked weight per week. The regular consumption of red meat was associated with the more frequent ingestion of unhealthy foods and fatty meat.

scholarly journals Prevalence and correlates of adherence to movement guidelines among urban and rural children in Mozambique: a cross-sectional study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Taru Manyanga ◽  
Joel D. Barnes ◽  
Jean-Philippe Chaput ◽  
Peter T. Katzmarzyk ◽  
Antonio Prista ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sleep Duration ◽  
Screen Time ◽  
Cross Sectional Study ◽  
Rural Children ◽  
Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract Background Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. Methods This is cross-sectional study of 9–11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. Results More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16–0.87), school location (OR: 0.21; CI: 0.09–0.52), and outdoor time (OR: 0.67; CI: 0.53–0.85) were significant correlates of meeting all three 24-h movement guidelines. Conclusions Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.

scholarly journals 660 Chronotype Associations with Insomnia, Depressive Symptoms, and Changes in Sleep and Health Behaviors during the COVID-19 Pandemic

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A258-A258
Author(s):  
Megan Petrov ◽  
Matthew Buman ◽  
Dana Epstein ◽  
Shawn Youngstedt ◽  
Nicole Hoffmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Health Behaviors ◽  
Screen Time ◽  
Online Survey ◽  
Light Exposure ◽  
Multinomial Logistic Regression ◽  
Depression Scale ◽  
Time In Bed ◽  
Significant Difference

Abstract Introduction Evening chronotype (i.e., night owl preference) is associated with worse insomnia and depressive symptoms, and poorer health behaviors. The aim of this study was to examine the association between chronotype and these symptoms and health behaviors during COVID-19 pandemic quarantine. Methods An online survey, distributed internationally via social media from 5/21/2020–7/1/2020, asked adults to report sociodemographic/economic information, changes in sleep (midpoint, total sleep time, sleep efficiency, time-in-bed), and health behaviors (i.e., physical activity, sedentary screen time, and outdoor light exposure patterns) from prior to during the pandemic, chronotype preference (definitely morning [DM], rather more morning [RM], rather more evening [RE], or definitely evening [DE]), and complete the Insomnia Severity Index (ISI) and the 10-item Center for Epidemiologic Studies Depression scale (CES-D-10). Multinomial logistic regression and ANCOVA models, adjusting for age and sex, examined associations of chronotype with COVID-19 pandemic related impacts on sleep, depressive symptoms, and health behaviors. Results A subsample of 579 participants (M age: 39y, range: 18–80; 73.6% female), currently under quarantine and neither pregnant nor performing shift work, represented each chronotype evenly (~25%). Participants delayed their sleep midpoint by 72.0min (SD=111.5) during the pandemic. DE chronotypes had a greater delay than morning types (M±SD DE: 91.0±9.0 vs. RM: 55.9±9.2 & DM: 66.1±9.3; p=0.046) with no significant change in other sleep patterns relative to other chronotypes. However, DE and RE chronotypes had greater odds of reporting that their new sleep/wake schedule was still not consistent with their “body clock” preference relative to morning types (Χ2[15]=54.8, p&lt;0.001), reported greater ISI (F[3,503]=5.3, p=.001) and CES-D-10 scores (F[3,492]=7.9, p&lt;.001), and had greater odds for increased or consistently moderate-to-high sedentary screen time (Χ2[12]=22.7, p=0.03) and decreased physical activity (Χ2[12]=22.5, p=0.03) than DM chronotype. There was no significant difference in change in outdoor light exposure by chronotype (Χ2[12]=12.1, p=0.43). Conclusion In an international online sample of adults under COVID-19 pandemic quarantine, evening chronotypes, despite taking the opportunity to delay sleep to match biological clock preference, reported their sleep/wake schedules were still inconsistent with personal preference, and reported greater insomnia and depressive symptoms, and odds of engaging in poorer health behaviors than morning chronotypes. Support (if any):

Ruling out deep venous thrombosis in primary care

2005 ◽  
Vol 94 (07) ◽  
pp. 200-205 ◽  
Author(s):  
Karel G. M. Moons ◽  
Arno W. Hoes ◽  
Ruud Oudega
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Decision Rule ◽  
Cross Sectional ◽  
Diagnostic Decision ◽  
Number Of Patients ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
D Dimer

SummaryIn primary care, the physician has to decide which patients have to be referred for further diagnostic work-up. At present, only in 20% to 30% of the referred patients the diagnosis DVT is confirmed. This puts a burden on both patients and health care budgets. The question arises whether the diagnostic work-up and referral of patients suspected of DVT in primary care could be more efficient. A simple diagnostic decision rule developed in primary care is required to safely exclude the presence of DVT in patients suspected of DVT, without the need for referral. In a cross-sectional study, we investigated the data of 1295 consecutive patients consulting their primary care physician with symptoms suggestive of DVT, to develop and validate a simple diagnostic decision rule to safely exclude the presence of DVT. Independent diagnostic indicators of the presence of DVT were male gender, oral contraceptive use, presence of malignancy, recent surgery, absence of leg trauma, vein distension, calf difference and D-dimer test result. Application of this rule could reduce the number of referrals by at least 23% while only 0·7% of the patients with a DVT would not be referred. We conclude that by using eight simple diagnostic indicators from patient history, physical examination and the result of D-dimer testing, it is possible to safely rule out DVT in a large number of patients in primary care, reducing unnecessary patient burden and health care costs.

scholarly journals Prevalence and factors associated with chronic wounds in older adults in primary care

2018 ◽  
Vol 52 (0) ◽  
Author(s):  
Chrystiany Plácido de Brito Vieira ◽  
Telma Maria Evangelista de Araújo
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Primary Care ◽  
Chronic Wounds ◽  
Family Income ◽  
Family Health ◽  
Multivariate Logistic Regression Model ◽  
Cross Sectional ◽  
Diabetic Ulcer ◽  
Dietary Restrictions

ABSTRACT Objective: To analyze the prevalence of pressure injuries, diabetic and vasculogenic ulcers and associated factors in older adults attended in primary care. Method: A cross-sectional, analytical study with older adults attended in the Family Health Strategy in a Brazilian municipality. Data collection was performed from January to March 2016 using interviews and evaluations of injuries. The variables were submitted to the multivariate logistic regression model using the odds ratio, with their respective 95% confidence intervals and significance set at <0.05. Results: 339 older adults participated in the study. The mean age was 71.1 years, 67.3% were female, 44% were illiterate, 85% had low family income, 91.7% had underlying diseases, 37.2% had dietary restrictions, and 76.1% did not practice physical activity. The prevalence of pressure injury was 5.0%, diabetic ulcer 3.2%, and vasculogenic ulcer 2.9%. Not working and not regularly practicing physical activity increased the chances of presenting these injuries by 1.5 and 2.3 times, respectively. Being actively mobility and not having dietary restrictions were protective factors for not developing chronic wounds. Conclusion: The prevalence of injuries among older adults was high, and its occurrence is associated with socioeconomic and clinical characteristics.

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