scholarly journals Testing the effect of summer camp on excess summer weight gain in youth from low-income households: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
E. Whitney Evans ◽  
Rena R. Wing ◽  
Denise F. Pierre ◽  
Whitney C. Howie ◽  
Morgan Brinker ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Energy Intake ◽  
Low Income ◽  
Summer Camp ◽  
Controlled Trial ◽  
Group Differences ◽  
Randomized Controlled ◽  
School Year ◽  
Low Income Households

Abstract Background Children from racial and ethnic minority groups, low-income households, and those with overweight or obesity gain more weight during the summer than the school year. Summer day camps, which offer routine opportunities for physical activity and regular meal and snack times, have potential to mitigate excess weight gain. This randomized controlled trial was done to determine the feasibility and preliminary effectiveness of summer camp in preventing excess summer weight gain among youth from low-income households. Methods Children, ages 6 to 12 years, were randomized to attend 8-weeks of summer day camp (CAMP) or to experience an unstructured summer as usual (SAU) in 2017–2018. Primary feasibility outcomes included retention, engagement and completion of midsummer measures. Secondary outcomes included changes in BMIz, engagement in moderate to vigorous physical activity (MVPA) and sedentary behavior, and diet quality and energy intake from the school year to summer. Multivariable linear mixed models were used to assess group differences. Results Ninety-four participants were randomized to CAMP (n = 46) or SAU (n = 48), of whom 93.0 and 91.6% completed end of school and end of summer assessments, respectively. While CAMP participants attended only 50% of camp days offered, on average, they lost − 0.03 BMIz units while those in SAU gained 0.07 BMIz units over the summer (b = 0.10; p = .02). Group differences in change in energy intake from the school year to summer were borderline significant, as energy intake remained relatively unchanged in CAMP participants but increased among participants in SAU (p = 0.07). Conclusions Randomizing children to attend summer day camp or experience an unstructured summer as usual was effective in this low-income sample. Our findings support the potential for summer camps in mitigating excess summer weight gain. A larger randomized trial is needed explore efficacy, cost-effectiveness and longer-term effects of attending summer camp on weight and weight-related behaviors. Trial registration ClinicalTrials.gov Registration: NCT04085965 (09/2019, retrospective registration).

Abstract 070: Community-based, Cluster Randomized Controlled Trial Increases Physical Activity In Diverse, Low Income Older Adults Over 2-year Period

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Katie Crist ◽  
Fatima Tuz Zahra ◽  
Kelsie M Full ◽  
Marta M Jankowska ◽  
Loki Natarajan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Randomized Controlled Trial ◽  
Depressive Symptoms ◽  
Low Income ◽  
Controlled Trial ◽  
Community Based ◽  
Randomized Controlled ◽  
Income Status ◽  
Cluster Randomized

Objective: Older adults are the least active population group in the U.S. Low income and ethnically diverse communities have fewer physical activity (PA) related resources and facilities, which contributes to lower PA levels and disparities in cardiovascular (CVD) risk factors and disease outcomes. This study assessed the hypothesis that low income and diverse older adults participating in the multilevel Peer Empowerment Program 4 Physical Activity (PEP4PA) would increase moderate-to-vigorous PA (MVPA), improve blood pressure (BP), perceived quality of life (PQoL), and depressive symptoms to a greater extent than older adults receiving usual senior center programming. Methods: In a cluster-randomized controlled trial (RCT) in 12 senior centers, 476 older adults (mean age 71.4 years, 76% female, 60% low income, 38% minority) were assigned to a PA intervention (n=267) or control (n=209) condition. The peer-led intervention included individual self-monitoring and counseling, group walks and social support, and community advocacy to improve walking conditions. Outcomes included minutes of MVPA per day (7-day accelerometer), systolic and diastolic BP (automatic cuff), PQoL (PQoL-20) and depressive symptoms (CES-D 10) at baseline, 6, 12, 18 and 24 months. To account for multiple measurement days and clustering of participants within senior centers, mixed effects regression models with random effects estimated the intervention effects on all outcomes between groups over time. Models were adjusted for imbalanced baseline covariates. A three-way interaction term assessed whether intervention effects differed by income status. Results: Compared to the control group, intervention participants significantly increased MVPA from baseline at 6, 12, 18 and 24 months by 8, 11, 9 and 9 minutes/day respectively (p<0.001), with increases remaining statistically significant across the 2-year period. The intervention group significantly increased mean PQoL scores from 7.2 at baseline to 7.6 (p<0.001), 7.8 (p=0.008) and 7.7 (p<0.001) at 12, 18 and 24 months, compared to control participants. No significant effects were observed for BP or depressive symptoms. Low income participants decreased minutes of MVPA, compared to higher income participants, at 12 and 24 months (β=-7.9, p=0.008 and β=-10.8, p=0.001). Conclusions: The multilevel RCT achieved sustained increases in MVPA and QoL in a diverse cohort of older adults across 2 years of follow up. The peer-led, community-based intervention provides a sustainable model to improve health behaviors related to CVD in an at-risk and often difficult to reach aging population. Further exploration is needed to understand what components of the intervention may be modified to address the differential effects by income status.

scholarly journals Exercise to Reduce Mobility Disability and Prevent Falls After Fall-Related Leg or Pelvic Fracture: RESTORE Randomized Controlled Trial

2020 ◽  
Vol 35 (10) ◽  
pp. 2907-2916 ◽  
Author(s):  
Catherine Sherrington ◽  
Nicola Fairhall ◽  
Catherine Kirkham ◽  
Lindy Clemson ◽  
Anne Tiedemann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Pelvic Fracture ◽  
Lower Limb ◽  
Fall Risk ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Group Differences ◽  
Randomized Controlled ◽  
The Impact

Abstract Background Disability and falls are common following fall-related lower limb and pelvic fractures. Objective To evaluate the impact of an exercise self-management intervention on mobility-related disability and falls after lower limb or pelvic fracture. Design Randomized controlled trial. Participants Three hundred thirty-six community dwellers aged 60+ years within 2 years of lower limb or pelvic fracture recruited from hospitals and community advertising. Interventions RESTORE (Recovery Exercises and STepping On afteR fracturE) intervention (individualized, physiotherapist-prescribed home program of weight-bearing balance and strength exercises, fall prevention advice) versus usual care. Main Measures Primary outcomes were mobility-related disability and rate of falls. Key Results Primary outcomes were available for 80% of randomized participants. There were no significant between-group differences in mobility-related disability at 12 months measured by (a) Short Physical Performance Battery (continuous version, baseline-adjusted between-group difference 0.08, 95% CI − 0.01 to 0.17, p = 0.08, n = 273); (b) Activity Measure Post Acute Care score (0.18, 95% CI − 2.89 to 3.26, p = 0.91, n = 270); (c) Late Life Disability Instrument (1.37, 95% CI − 2.56 to 5.32, p = 0.49, n = 273); or in rate of falls over the 12-month study period (incidence rate ratio 0.96, 95% CI 0.69 to 1.34, n = 336, p = 0.83). Between-group differences favoring the intervention group were evident in some secondary outcomes: balance and mobility, fall risk (Physiological Profile Assessment tool), physical activity, mood, health and community outings, but these should be interpreted with caution due to risk of chance findings from multiple analyses. Conclusions No statistically significant intervention impacts on mobility-related disability and falls were detected, but benefits were seen for secondary measures of balance and mobility, fall risk, physical activity, mood, health, and community outings. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12610000805077

scholarly journals Research Design, Protocol, and Participant Characteristics of COLEAFS: A Cluster Randomized Controlled Trial of a Childcare Garden Intervention

2021 ◽  
Vol 18 (24) ◽  
pp. 13066
Author(s):  
Nilda Graciela Cosco ◽  
Nancy M. Wells ◽  
Muntazar Monsur ◽  
Lora Suzanne Goodell ◽  
Daowen Zhang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Research Design ◽  
Low Income ◽  
Controlled Trial ◽  
Childcare Centers ◽  
Randomized Controlled ◽  
Diet And Physical Activity ◽  
Cluster Randomized ◽  
Design Protocol ◽  
To Receive

Childcare garden interventions may be an effective strategy to increase fruit and vegetable (FV) consumption and physical activity among young children. The objective of this paper is to describe the research design, protocol, outcome measures, and baseline characteristics of participants in the Childcare Outdoor Learning Environments as Active Food Systems (“COLEAFS”) study, a cluster randomized controlled trial (RCT) examining the effect of a garden intervention on outcomes related to diet and physical activity. Fifteen childcare centers in low-income areas were randomly assigned to intervention (to receive garden intervention in Year 1), waitlist control (to receive garden intervention in Year 2), and control group (no intervention). The garden intervention comprised six raised beds planted with warm-season vegetables and fruits, and a garden activity booklet presenting 12 gardening activities. FV knowledge and FV liking were measured using a tablet-enabled protocol. FV consumption was measured by weighing FV before and after a snack session. Physical activity was measured using Actigraph GT3x+ worn by children for three consecutive days while at the childcare center. Of the 543 eligible children from the 15 childcare centers, 250 children aged 3–5 years received parental consent, assented, and participated in baseline data collection. By employing an RCT to examine the effect of a garden intervention on diet and physical activity among young children attending childcare centers within low-income communities, this study offers compelling research design and methods, addresses a critical gap in the empirical literature, and is a step toward evidence-based regulations to promote early childhood healthy habits.

scholarly journals Individually Tailored, Adaptive Intervention to Manage Gestational Weight Gain: Protocol for a Randomized Controlled Trial in Women With Overweight and Obesity (Preprint)

2017 ◽  
Author(s):  
Danielle Symons Downs ◽  
Jennifer S Savage ◽  
Daniel E Rivera ◽  
Joshua M Smyth ◽  
Barbara J Rolls ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Pregnant Women ◽  
Healthy Eating ◽  
Controlled Trial ◽  
Overweight And Obesity ◽  
Adaptive Intervention ◽  
Gestational Weight ◽  
Randomized Controlled

BACKGROUND High gestational weight gain is a major public health concern as it independently predicts adverse maternal and infant outcomes. Past interventions have had only limited success in effectively managing pregnancy weight gain, especially among women with overweight and obesity. Well-designed interventions are needed that take an individualized approach and target unique barriers to promote healthy weight gain. OBJECTIVE The primary aim of the study is to describe the study protocol for Healthy Mom Zone, an individually tailored, adaptive intervention for managing weight in pregnant women with overweight and obesity. METHODS The Healthy Mom Zone Intervention, based on theories of planned behavior and self-regulation and a model of energy balance, includes components (eg, education, self-monitoring, physical activity/healthy eating behaviors) that are adapted over the intervention (ie, increase in intensity) to better regulate weight gain. Decision rules inform when to adapt the intervention. In this randomized controlled trial, women are randomized to the intervention or standard care control group. The intervention is delivered from approximately 8-36 weeks gestation and includes step-ups in dosages (ie, Step-up 1 = education + physical activity + healthy eating active learning [cooking/recipes]; Step-up 2 = Step-up 1 + portion size, physical activity; Step-up 3 = Step-up 1 + 2 + grocery store feedback, physical activity); 5 maximum adaptations. Study measures are obtained at pre- and postintervention as well as daily (eg, weight), weekly (eg, energy intake/expenditure), and monthly (eg, psychological) over the study period. Analyses will include linear mixed-effects models, generalized estimating equations, and dynamical modeling to understand between-group and within-individual effects of the intervention on weight gain. RESULTS Recruitment of 31 pregnant women with overweight and obesity has occurred from January 2016 through July 2017. Baseline data have been collected for all participants. To date, 24 participants have completed the intervention and postintervention follow-up assessments, 3 are currently in progress, 1 dropped out, and 3 women had early miscarriages and are no longer active in the study. Of the 24 participants, 13 women have completed the intervention to date, of which 1 (8%, 1/13) received only the baseline intervention, 3 (23%, 3/13) received baseline + step-up 1, 6 (46%, 6/13) received baseline + step-up 1 + step-up 2, and 3 (23%, 3/13) received baseline + step-up 1 + step-up 2 +step-up 3. Data analysis is still ongoing through spring 2018. CONCLUSIONS This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy. Results from this study will be useful in designing a larger randomized trial to examine efficacy of this intervention and developing strategies for clinical application. REGISTERED REPORT IDENTIFIER RR1-10.2196/9220

Acceptability of a mobile-health intervention to increase physical activity among pregnant patients with overweight or obesity: A feasibility randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Tainayah Thomas ◽  
Fei Xu ◽  
Sneha Sridhar ◽  
Tali Sedgwick ◽  
Linda Nkemere ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Controlled Trial ◽  
Moderate Intensity ◽  
Moderate Intensity Physical Activity ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Intensity Physical Activity ◽  
Overweight Or Obesity

BACKGROUND Pregnant patients with overweight or obesity are at high risk of perinatal complications. Excess gestational weight gain further exacerbates this risk. Mobile health (mHealth) lifestyle interventions that leverage technology to facilitate self-monitoring and provide just-in-time feedback may motivate behavior change to reduce excess gestational weight gain, reduce intervention costs, and increase scalability by improving access. OBJECTIVE To test the acceptability and feasibility of a pilot mHealth lifestyle intervention for pregnant patients with overweight or obesity to promote moderate-intensity physical activity, encourage guideline-concordant gestational weight gain, and inform the design of a larger pragmatic cluster randomized controlled trial. METHODS We conducted a mixed-methods acceptability and feasibility randomized controlled trial among pregnant patients with a pre-pregnancy body mass index 25.0-40.0 kg/m2. Patients with singletons at 8–15 weeks’ gestation, and aged 21 years or older with Wi-Fi access were randomly assigned (1:1) to receive usual prenatal care or an mHealth lifestyle intervention. Participants in the intervention arm received wireless scales, access to an intervention website, activity trackers to receive automated feedback on weight gain and activity goals, and a monthly call from a lifestyle coach. Surveys and focus groups with intervention participants assessed intervention satisfaction and ways to improve the intervention. Physical activity outcomes were assessed using the Pregnancy Physical Activity Questionnaire and gestational weight gain was assessed using electronic health record data in both arms. RESULTS Thirty-three patients were randomly assigned to the intervention arm and 35 patients to the usual care arm. 100% of participants in the intervention arm weighed themselves at least once a week compared with 20% of participants in the usual care arm. Participants in the intervention arm wore the activity tracker 6.4 days/week, weighed themselves 5.3 times/week, and 87.9% rated the program “good to excellent.” Focus groups found participants desired more support related to nutrition to help them manage gestational weight gain and would have preferred an app instead of a website. Participants in the intervention arm had a 23.46 MET-hours greater change in total physical activity per week (95% CI:1.13, 45.8) and a 247.2-minute greater change in moderate intensity physical activity per week (95% CI: 36.2, 530.6) in unadjusted models, but these effects were attenuated in adjusted models (change in total physical activity: 15.55 MET-hours per week; 95% CI: -6.32, 37.42; change in moderate intensity physical activity: 199.6 minutes per week; 95% CI: -43.7, 442.9). We found no difference in total gestational weight gain (mean difference: 1.14 kg; 95% CI: -0.71, 3.00) compared to usual care. CONCLUSIONS A pilot mHealth lifestyle intervention was feasible, highly acceptable, and promoted self-monitoring. Refined interventions are needed to effectively impact physical activity and gestational weight gain among pregnant patients with overweight or obesity. CLINICALTRIAL ClinicalTrials.gov NCT03936283

Effectiveness of Isolated Hip Exercise, Knee Exercise, or Free Physical Activity for Patellofemoral Pain: A Randomized Controlled Trial

2019 ◽  
Vol 47 (6) ◽  
pp. 1312-1322 ◽  
Author(s):  
Alexandra Hott ◽  
Jens Ivar Brox ◽  
Are Hugo Pripp ◽  
Niels Gunnar Juel ◽  
Gøran Paulsen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Patient Education ◽  
Controlled Trial ◽  
Knee Extension ◽  
Pain Scale ◽  
Group Differences ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
Anterior Knee

Background: Exercise for patellofemoral pain (PFP) is traditionally knee focused, targeting quadriceps muscles. In recent years, hip-focused exercise has gained popularity. Patient education is likely an important factor but is underresearched. Purpose: To compare 3 treatment methods for PFP, each combined with patient education: hip-focused exercise, knee-focused exercise, or free physical activity. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A single-blind randomized controlled trial was performed with 112 patients who were 16 to 40 years old (mean, 27.6 years) and had a symptom duration >3 months (mean, 39 months) with a clinical diagnosis of PFP and no radiograph or magnetic resonance evidence of other pathology. Patients were randomized to a 6-week intervention consisting of patient education combined with isolated hip-focused exercise (n = 39), traditional knee-focused exercise (n = 37), or free physical activity (n = 36). The primary outcome was Anterior Knee Pain Scale (0-100) at 3 months. Secondary outcomes were visual analog scale for pain, Tampa Scale for Kinesiophobia, Knee Self-efficacy Scale, EuroQol, step-down, and isometric strength. Results: There were no between-group differences in any primary or secondary outcomes at 3 months except for hip abduction strength and knee extension strength. Between-group differences at 3 months for Anterior Knee Pain Scale were as follows: knee versus control, 0.2 (95% CI, –5.5 to 6.0); hip versus control, 1.0 (95% CI, –4.6 to 6.6); and hip versus knee, 0.8 (95% CI, –4.8 to 6.4). The whole cohort of patients improved for all outcomes at 3 months except for knee extension strength. Conclusion: The authors found no difference in short-term effectiveness in combining patient education with knee-focused exercise, hip-focused exercise, or free training for patients with PFP. Registration: NCT02114294 (ClinicalTrials.gov identifier).

Sign in / Sign up

Export Citation Format

Share Document