scholarly journals Improving the assessment and management of obesity in UK children and adolescents: the PROMISE research programme including a RCT

2020 ◽  
Vol 8 (3) ◽  
pp. 1-264
Author(s):  
Russell M Viner ◽  
Sanjay Kinra ◽  
Deborah Christie ◽  
Tim J Cole ◽  
Silvia Costa ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Primary Care ◽  
Healthy Eating ◽  
Applied Research ◽  
Research Programme ◽  
Management Tool ◽  
Evidence Based ◽  
Obesity Drugs ◽  
Adolescent Bariatric Surgery ◽  
Lifestyle Programme

Background Five linked studies were undertaken to inform identified evidence gaps in the childhood obesity pathway. Objectives (1) To scope the impact of the National Child Measurement Programme (NCMP) (study A). (2) To develop a brief evidence-based electronic assessment and management tool (study B). (3) To develop evidence-based algorithms for identifying the risk of obesity comorbidities (study B). (4) To conduct an efficacy trial of the Healthy Eating and Lifestyle Programme (HELP) (study C). (5) To improve the prescribing of anti-obesity drugs in UK adolescents (study D). (6) To investigate the safety, outcomes and predictors of outcome of adolescent bariatric surgery in the UK (study E). Methods Five substudies – (1) a parental survey before and after feedback from the National Childhood Measurement Programme, (2) risk algorithm development and piloting of a new primary care management tool, (3) a randomised controlled trial of the Healthy Eating and Lifestyle Programme, (4) quantitative and qualitative studies of anti-obesity drug treatment in adolescents and (5) a prospective clinical audit and cost-effectiveness evaluation of adolescent bariatric surgery in one centre. Results Study A – before the National Childhood Measurement Programme feedback, three-quarters of parents of overweight and obese children did not recognise their child to be overweight. Eighty-seven per cent of parents found the National Childhood Measurement Programme feedback to be helpful. Feedback had positive effects on parental knowledge, perceptions and intentions. Study B – risk estimation models for cardiovascular and psychosocial comorbidities of obesity require further development. An online consultation tool for primary care practitioners is acceptable and feasible. Study C – the Healthy Eating and Lifestyle Programme, when delivered in the community by graduate mental health workers, showed no significant effect on body mass index at 6 months (primary outcome) when compared with enhanced usual care. Study D – anti-obesity drugs appear efficacious in meta-analysis, and their use has expanded rapidly in the last decade. However, the majority of prescriptions are rapidly discontinued after 1–3 months of treatment. Few young people described positive experiences of anti-obesity drugs. Prescribing was rarely compliant with the National Institute for Health and Care Excellence guidance. Study E – bariatric surgery appears safe, effective and highly cost-effective in adolescents in the NHS. Future work and limitations Work is needed to evaluate behaviour and body mass index change in the National Childhood Measurement Programme more accurately and improve primary care professionals’ understanding of the National Childhood Measurement Programme feedback, update and further evaluate the Computer-Assisted Treatment of CHildren (CATCH) tool, investigate delivery of weight management interventions to young people from deprived backgrounds and those with significant psychological distress and obtain longer-term data on anti-obesity drug use and bariatric surgery outcomes in adolescence. Trial registration Current Controlled Trials ISRCTN99840111. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 8, No. 3. See the NIHR Journals Library website for further project information.

Healthy eating in schools: Evidence-based interventions to help kids thrive.

2013 ◽  
Author(s):  
Catherine P. Cook-Cottone ◽  
Evelyn Tribole ◽  
Tracy L. Tylka
Keyword(s):  
Healthy Eating ◽  
Evidence Based

The psychologist’s role in ethical decision making: Adolescent bariatric surgery.

2015 ◽  
Vol 3 (4) ◽  
pp. 359-364 ◽  
Author(s):  
Karin L. Price ◽  
Margaret E. Lee ◽  
Gia A. Washington ◽  
Mary L. Brandt
Keyword(s):  
Bariatric Surgery ◽  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Adolescent Bariatric Surgery

Nonsuicidal Self-Injury Among Youth

2018 ◽  
Author(s):  
Adam Bryant Miller ◽  
Maya Massing-Schaffer ◽  
Sarah Owens ◽  
Mitchell J. Prinstein
Keyword(s):  
Risk Factors ◽  
Applied Research ◽  
Evidence Based ◽  
Prevalence Rates ◽  
Evidence Based Treatment ◽  
The Past ◽  
Self Injury ◽  
Assessment Techniques ◽  
Basic And Applied Research ◽  
Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is direct, intentional harm to one’s own body performed without the intent to die. NSSI has a marked developmental onset reaching peak prevalence in adolescence. NSSI is present in the context of multiple psychological disorders and stands alone as a separate phenomenon. Research has accumulated over the past several decades regarding the course of NSSI. While great advances have been made, there remains a distinct need for basic and applied research in the area of NSSI. This chapter reviews prevalence rates, correlates and risk factors, and leading theories of NSSI. Further, it reviews assessment techniques and provides recommendations. Then, it presents the latest evidence-based treatment recommendations and provides a case example. Finally, cutting edge research and the next frontier of research in this area are outlined.

scholarly journals Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044372
Author(s):  
Mat Nawi Zanaridah ◽  
Mohd Noor Norhayati ◽  
Zakaria Rosnani
Keyword(s):  
Primary Care ◽  
Evidence Based Medicine ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Sectional Study ◽  
Primary Care Practitioner ◽  
Cross Sectional ◽  
Primary Care Practitioners ◽  
Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

scholarly journals Engaging primary care providers in managing pediatric eating disorders: a mixed methods study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jocelyn Lebow ◽  
Cassandra Narr ◽  
Angela Mattke ◽  
Janna R. Gewirtz O’Brien ◽  
Marcie Billings ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Mixed Methods ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Care Providers ◽  
Evidence Based Treatment

Abstract Background The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders. As such, the purpose of this study was to examine in-depth primary care providers’ perspective of challenges to identifying and managing eating disorders in the primary care setting. Methods This mixed methods study surveyed 60 Pediatric and Family Medicine providers across 6 primary care practices. Sixteen of these providers were further interviewed using a qualitative, semi-structured interview. Results Providers (n = 60, response rate of 45%) acknowledged the potential of primary care as a point of contact for early identification and treatment of pediatric eating disorders. They also expressed that this was an area of need in their practices. They identified numerous barriers to successful implementation of evidence-based treatment in this setting including scarcity of time, knowledge, and resources. Conclusions Investigations seeking to build capacities in primary care settings to address eating disorders must address these barriers.

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