scholarly journals Changes in Self-Efficacy and Outcome Expectations From Child Participation in Bicycle Trains for Commuting to and From School

2018 ◽  
Vol 45 (5) ◽  
pp. 748-755 ◽  
Author(s):  
Cathy Huang ◽  
Andrew L. Dannenberg ◽  
Wren Haaland ◽  
Jason A. Mendoza

Background. Active commuting to school (ACS) is associated with increased physical activity and lowered risk of obesity. In observational studies, ACS was associated with child self-efficacy, parent self-efficacy, and parent outcome expectations, although few experiments have assessed changes in these behavioral constructs. Aim. This study examined the effects of a bicycle train intervention (BTI) on child self-efficacy, parent self-efficacy, and parent outcome expectations in a diverse, low socioeconomic status population. Method. Data were from a 2014 BTI pilot randomized controlled trial (RCT) on fourth to fifth graders aged 9 to 12 years, n = 54, from four schools serving low-income populations in Seattle, Washington. The BTI was a group of children and study staff who cycled together to/from school daily, while controls received no intervention. Responses to validated child self-efficacy, parent self-efficacy, and parent outcome expectations questionnaires ranged from 1 to 3. Adjusted linear mixed effects models estimated standardized coefficients for child self-efficacy, parent self-efficacy, and parent outcome expectations comparing intervention and controls from Time 1 (preintervention) to Time 2 (final 4-6 weeks of intervention). Results. The intervention group had increases in child self-efficacy of 0.84 standard deviations (95% confidence interval [CI] [0.37, 1.31]), parent self-efficacy of 0.46 standard deviations (95% CI [0.05, 0.86]), and parent outcome expectations of 0.47 standard deviations (95% CI [0.17, 0.76]) compared with controls from Times 1 to 2 (all ps <.05). Conclusion. A BTI improved child self-efficacy, parent self-efficacy, and parent outcome expectations, which warrants a larger RCT to examine long-term changes to these behavioral constructs and ACS.

Author(s):  
Nicole Cramer ◽  
Miriam J. Haviland ◽  
Chuan Zhou ◽  
Jason A. Mendoza

Background: A walking school bus (WSB) consists of students and adults walking to and from school and promotes active commuting to school. Self-efficacy (SE) and outcome expectations (OE) are behavioral constructs associated with active commuting to school. The authors sought to assess the impact of a WSB program on child SE, and parent SE, and OE. Methods: The authors conducted a cluster randomized controlled trial of a WSB intervention from 2012 to 2016 among 22 elementary schools serving racially diverse, low-income populations in Houston, TX and Seattle, WA. Surveys collected data from third- to fifth-grade students and their parents, (n = 418) child-parent dyads, before school randomization and at the school year’s end. Child surveys included 16 SE items, while parent surveys included 15 SE items and 14 OE items. Scores were averaged from responses ranging from 1 to 3. The authors compared changes in SE and OE between groups over time and accounted for clustering using linear mixed-effects models. Results: The intervention group had increases in child SE of 0.12 points (P = .03), parent SE of 0.11 points (P = .048), and parent OE of 0.09 points (P = .02) compared to controls over time. Conclusions: As hypothesized, the WSB improved child SE, parent SE, and parent OE related to active commuting to school.


2020 ◽  
Vol 30 (6) ◽  
pp. 587-596 ◽  
Author(s):  
Philip Young P. Hong ◽  
Sangmi Choi ◽  
Rana Hong

Purpose: This randomized controlled trial (RCT) study examined the efficacy of the Transforming Impossible into Possible (TIP) program for low-income, low-skilled jobseekers in the Self-Sufficiency Program (SSP) in South Korea. Method: A total of 169 participants in SSP regional centers were randomly assigned to the intervention group (104 participants) and the wait-list control group (65 participants). Employment hope, perceived employment barriers, economic self-sufficiency (ESS), self-esteem and self-efficacy were measured at two time points, and data were analyzed using a paired sample t-test and an analysis of covariance (ANCOVA). Results: The TIP intervention group showed statistically significant increase in employment hope, ESS, self-esteem, and self-efficacy. The ANCOVA result indicated significant pre–post score differences in these variables between the TIP and the control groups. Discussion: TIP program can be effective in increasing psychological capital for low-income and low-skilled jobseekers. Further research ought to replicate the current RCT study to determine its application to other populations.


PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1069-1075
Author(s):  
Janet R. Serwint ◽  
Modena E. H. Wilson ◽  
Judith W. Vogelhut ◽  
John T. Repke ◽  
Henry M. Seidel

Background. Prenatal pediatric visits have been recommended by the American Academy of Pediatrics to allow the pediatrician to counsel parents on infant care issues, establish a supportive relationship, and provide pediatric practice information to parents. We hypothesized that prenatal pediatric visits would have an impact on breastfeeding decisions, health care behaviors, health care utilization, and the doctor-patient relationship. Methods. We conducted a randomized controlled trial of prenatal pediatric visits for urban, low-income families to measure the impact on breastfeeding decisions, infant car safety seat use, circumcision, health maintenance, and emergency room visits and the pediatrician's perception that he/she would know the mother better. Pregnant women were recruited prenatally from the obstetrics clinic. Outcomes were measured by maternal interview prenatally and when the infant was 2 months old, in addition to review of the nursery record. Physicians were interviewed after the 2-month visit. Health care utilization was measured by chart review at 7 months. Results. A total of 156 pregnant women were enrolled and randomized, 81 to the intervention group and 75 to the control group. Of mothers who breastfed, 45% in the intervention group changed their mind in favor of breastfeeding after enrollment compared with 14% in the control group. Mothers in the intervention group compared with the control group were more likely to make fewer emergency room visits, 0.58 compared with 1.0. Pediatricians were more likely to think that they knew mothers in the intervention group well, 54% versus 29% in the control group, yet 67% of mothers in both groups agreed their pediatrician knew them well. There were no differences between groups in initiation or duration of breastfeeding at 30 or 60 days, infant car safety seat use, circumcision, or health maintenance visits. Conclusions. Prenatal pediatric visits have potential impact on a variety of health care outcomes. Among urban, low-income mothers, we found beneficial effects on breastfeeding decisions, a decrease in emergency department visits, and an initial impact on the doctor-patient relationship. We suggest urban practices actively promote prenatal pediatric visits.


2017 ◽  
Vol 42 ◽  
pp. 103-110 ◽  
Author(s):  
C.I. Mahlke ◽  
S. Priebe ◽  
K. Heumann ◽  
A. Daubmann ◽  
K. Wegscheider ◽  
...  

AbstractBackgroundOne-to-one peer support is a resource-oriented approach for patients with severe mental illness. Existing trials provided inconsistent results and commonly have methodological shortcomings, such as poor training and role definition of peer supporters, small sample sizes, and lack of blinded outcome assessments.MethodsThis is a randomised controlled trial comparing one-to-one peer support with treatment as usual. Eligible were patients with severe mental illnesses: psychosis, major depression, bipolar disorder or borderline personality disorder of more than two years’ duration. A total of 216 patients were recruited through in- and out-patient services from four hospitals in Hamburg, Germany, with 114 allocated to the intervention group and 102 to the control group. The intervention was one-to-one peer support, delivered by trained peers and according to a defined role specification, in addition to treatment as usual over the course of six months, as compared to treatment as usual alone. Primary outcome was self-efficacy measured on the General Self-Efficacy Scale at six-month follow-up. Secondary outcomes included quality of life, social functioning, and hospitalisations.ResultsPatients in the intervention group had significantly higher scores of self-efficacy at the six-month follow-up. There were no statistically significant differences on secondary outcomes in the intention to treat analyses.ConclusionsThe findings suggest that one-to-one peer support delivered by trained peer supporters can improve self-efficacy of patients with severe mental disorders over a one-year period. One-to-one peer support may be regarded as an effective intervention. Future research should explore the impact of improved self-efficacy on clinical and social outcomes.


2020 ◽  
Author(s):  
Ameer Muhammad ◽  
Yasir Shafiq ◽  
M Imran Nisar ◽  
Benazir Baloch ◽  
Amna Tanweer Yazdani ◽  
...  

Abstract BackgroundGlobally, 45% of under-five deaths are, directly or indirectly, attributable to malnutrition, most of these deaths are in low- and middle-income countries (LMICs). Children in the first 6 months of life are particularly vulnerable. An estimated 4.7 million infants under the age of 6 months are moderately wasted whereas 3.8 million are severely wasted. Despite the increased risk to a child of a mother with nutritional decompensation, there are discrepancies in guidance in this area. MethodsThis is a community-based, open-label factorial randomized controlled trial, using parallel assignment with 1:1:1 allocation ratio, in low-income squatter settlements of urban Karachi, Pakistan. In the control group (Arm A), women are randomized to standard counseling only; whereas in the first intervention group (Arm B), lactating women receive two sachets of balanced energy-protein (BEP) supplementation per day from enrollment till the infant reaches six months of age, in the second intervention group (Arm C), lactating women receive same BEP as in intervention Arm B while their babies also receive a single stat dose (20mg/kg orally) of azithromycin at 42 days. The primary outcome is relative length velocity from 0 to 6 months by the limb of allocation. The primary analysis will be Intention-to-treat analysisTrial registrationRegistration of the trial is done at ClinicalTrials.gov. NCT03564652, registered on June 21, 2018. Trial registration data is available through https://clinicaltrials.gov/ct2/show/NCT03564652


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1289-1289
Author(s):  
Hayford Avedzi ◽  
Allison Soprovich ◽  
Stephanie Ramage ◽  
Abdulrhman Alghamdi ◽  
Kate Storey ◽  
...  

Abstract Objectives Rigorous evidence is needed to support uptake of recommendations to include low glycemic index (GI) foods in daily meal planning as an effective dietary self-care strategy for people with type 2 diabetes (T2D). We evaluated the effectiveness of a 12-week web-based GI-targeted nutrition education intervention on dietary intakes and GI-related knowledge among adults with T2D. Methods Participants were randomized to a control group (n = 34) that received standard printed copies of Canada's Food Guide and Diabetes Canada's GI resources or an intervention group (n = 33) that received those same materials, plus an online platform with six self-directed learning modules and supplementary print material. Each module consisted of a customized video, links to reliable websites, chat rooms, and quizzes. Evidence-based GI concept information included GI values of foods and advice for low-GI shopping, recipes, and cooking tips by a Registered Dietitian. Preferred supports through email, text messaging, phone calls, or postal mail to reinforce participants’ learning were also provided. The primary outcome, average daily dietary GI intake, was assessed using 3-day food records. Additional measures including GI knowledge and self-efficacy, glycated hemoglobin A1c, lipids, systolic blood pressure, body mass index, waist circumference, and computer proficiency, were assessed at baseline and at three months post-intervention. Results Participants (N = 67) were 64% men; mean (standard deviation [SD]) age 69.5 (9.3) years, with mean diabetes duration of 19.0 (13.7) years, BMI 30.1 (5.7) kg/m2 and A1c 7.1 (1.2)% at baseline. Mean daily GI intake decreased in the intervention group by 2.79 (7.77) compared to a 0.76 (6.48) increase in the control group (adjusted mean difference [95% CI]; −3.77 [−6.95, −0.58]). Mean GI knowledge 2.14 [0.59, 3.69], understanding of GI concept 1.65 [0.85, 2.44] and self-efficacy for consuming low-GI foods 1.29 [0.51, 2.07] increased among the intervention group (P &lt; 0.01) compared with the control group. Conclusions Web-based GI-targeted education program improved the quality of carbohydrate consumption among adults with T2D and may have been mediated through increases in knowledge and self-efficacy. Web-based nutrition education may be an effective alternative in this population. Funding Sources Canadian Foundation for Dietetic Research.


2020 ◽  
Vol 23 (13) ◽  
pp. 2424-2433 ◽  
Author(s):  
Carolina Martins dos Santos Chagas ◽  
Giselle Rhai-Sa Melo ◽  
Raquel Braz Assunção Botelho ◽  
Natacha Toral

AbstractObjective:The study aimed to assess the impact of a game-based nutritional intervention on food consumption, nutritional knowledge and self-efficacy in the adoption of healthy eating practices.Design:This cluster randomised controlled trial included both male and female high school students from private schools in the Federal District, Brazil. Four schools were randomly selected for each group. Investigated variables were age, sex, monthly family income, maternal education level, dietary perceptions and practices, nutritional knowledge and self-efficacy in the adoption of healthy eating practices.Setting:Intervention group participants were instructed to play Rango Cards, a digital game developed for the study, on their own, for a period of 7–17 d, while the control group was not provided with any game or material during the study.Participants:The study included 319 adolescents (mean age = 15·8 (sd 0·7) years).Results:Significant reductions were observed in the intervention group compared with the control group for the following variables: habit of eating while watching TV or studying and having meals at fast food restaurants. The intervention group showed increased knowledge of the effects of fruit and vegetable consumption as well as improved self-efficacy in the adoption of healthy eating practices such as reducing Na intake and preparing healthy meals.Conclusions:The design of Rango Cards is potentially capable of effecting positive changes. Therefore, the digital game promotes autonomy and self-care among adolescents with regard to healthy eating.


2015 ◽  
Vol 12 (9) ◽  
pp. 1280-1288 ◽  
Author(s):  
Robin DeWeese ◽  
Punam Ohri-Vachaspati

Background:Active commuting to school (ACS) increases students’ daily physical activity, but associations between student weight and ACS are inconsistent. Few studies examining ACS and weight account for distance commuted. This study examines the association between students’ weight status and ACS, taking into account distance to school.Methods:In 2009–10 a random digit-dial household survey conducted in low-income minority cities collected information about ACS for 1 randomly selected school-going student per household. Parents provided measured heights and weights. Distance commuted was obtained using geocoded home and school addresses. Multivariate regression analyses assessed associations of ACS and distance commuted with weight status.Results:36.6% of students were overweight/obese; 47.2% engaged in ACS. Distance walked/biked to school was associated with 7% lower odds of overweight/obesity (OR = 0.93, 95% CI: 0.88– 0.99). Without distance commuted in the model, ACS was not associated with students’ weight status. Compared with no ACS, ACS greater than a half-mile was associated with 65% lower odds of a student being overweight/obese (OR = 0.35, 95% CI: 0.16– 0.78); ACS less than a half-mile was not.Conclusions:ACS is significantly inversely associated with overweight/obesity among students who commute beyond a one-half mile threshold.


2017 ◽  
Vol 20 (15) ◽  
pp. 2796-2805 ◽  
Author(s):  
Patricia Markham Risica ◽  
Kristen McCausland

AbstractObjectiveThe present study aimed to describe change in feeding intentions and predictors of breast-feeding intentions during the course of pregnancy.DesignAnalysis of prospectively collected data from a larger randomized controlled trial of a health education intervention to reduce environmental smoke exposure among women during and after pregnancy.SettingParticipants were recruited from prenatal clinics, but all further communication occurred with participating women living in the community.SubjectsLow-income, adult women (n399) were interviewed during the 16th and 32nd week of pregnancy to ascertain prenatal feeding intentions and breast-feeding knowledge, attitudes and self-efficacy. Characteristics of women by infant feeding intention were assessed along with differences in intention from 16 to 32 weeks of pregnancy and feeding behaviours after delivery. Differences in psychosocial variables between women of different intention for infant feeding were measured. Women in each category of feeding intention were assessed for changes in psychosocial factors by eventual infant feeding behaviour.ResultsFeeding intention early in pregnancy was strongly, but not consistently, associated with feeding intention late in pregnancy, feeding initiation and later feeding patterns. Over one-third of women who were undecided at 16 weeks’ gestation or earlier initiated breast-feeding. Increases in knowledge and improvement in time, social factors and social support barriers were found among those who exclusively breast-fed.ConclusionsResults indicate that feeding decisions may change during pregnancy. Determining when women make feeding decisions during their pregnancy warrants more research. Interventions to increase breast-feeding intentions should target knowledge, self-efficacy and barriers.


2020 ◽  
Vol 5 ◽  
pp. 23 ◽  
Author(s):  
Maria Lazo-Porras ◽  
Antonio Bernabe-Ortiz ◽  
Alvaro Taype-Rondan ◽  
Robert H. Gilman ◽  
German Malaga ◽  
...  

Background: Novel approaches to reduce diabetic foot ulcers (DFU) in low- and middle-income countries are needed. Our objective was to compare incidence of DFUs in the thermometry plus mobile health (mHealth) reminders (intervention) vs. thermometry-only (control). Methods: We conducted a randomized trial enrolling adults with type 2 diabetes mellitus at risk of foot ulcers (risk groups 2 or 3) but without foot ulcers at the time of recruitment, and allocating them to control (instruction to use a liquid crystal-based foot thermometer daily) or intervention (same instruction supplemented with text and voice messages with reminders to use the device and messages to promote foot care) groups, and followed for 18 months. The primary outcome was time to occurrence of DFU. A process evaluation was also conducted. Results: A total of 172 patients (63% women, mean age 61 years) were enrolled; 86 to each study group. More patients enrolled in the intervention arm had a history of previous DFU (66% vs. 48%). Follow-up for the primary endpoint was complete for 158 of 172 participants (92%). Adherence to ≥80% of daily temperature measurements was 87% (103 of 118) among the study participants who returned the logbook. DFU cumulative incidence was 24% (19 of 79) in the intervention arm and 11% (9 of 79) in the control arm. After adjusting for history of foot ulceration and study site, the hazard ratio (HR) for DFU was 1.44 (95% CI 0.65, 3.22). Conclusions: In our study, conducted in a low-income setting, the addition of mHealth to foot thermometry was not effective in reducing foot ulceration. Importantly, there was a higher rate of previous DFU in the intervention group, the adherence to thermometry was high, and the expected rates of DFU used in our sample size calculations were not met. Trial registration: ClinicalTrials.gov NCT02373592 (27/02/2015)


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