An Integrated Clinic-Community Partnership for Child Obesity Treatment: A Randomized Pilot Trial

2018 ◽  
pp. 103-116
Author(s):  
Jessica Hoffman ◽  
Leah Frerichs ◽  
Mary Story ◽  
Jason Jones ◽  
Kiah Gaskin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Clinical Care ◽  
Child Obesity ◽  
Integrated Model ◽  
Obesity Treatment ◽  
Z Score ◽  
Parks And Recreation ◽  
Child Bmi

BACKGROUND AND OBJECTIVES Effective treatment of childhood obesity remains elusive. Integration of clinical and community systems may achieve effective and sustainable treatment. However, the feasibility and effectiveness of this integrated model are unknown. METHODS We conducted a randomized clinical trial among children aged 5 to 11 presenting for obesity treatment. We randomized participants to clinical care or clinical care plus community-based programming at a local parks and recreation facility. Primary outcomes were the change in child BMI at 6 months and the intensity of the program in treatment hours. Secondary outcomes included health behaviors, fitness, attrition, and quality of life. RESULTS We enrolled 97 children with obesity, and retention at 6 months was 70%. Participants had a mean age of 9.1 years and a mean baseline BMI z score of 2.28, and 70% were living in poverty. Intervention participants achieved more treatment hours than controls (11.4 vs 4.4, SD: 15.3 and 1.6, respectively). We did not observe differences in child BMI z score or percent of the 95th percentile at 6 months. Intervention participants had significantly greater improvements in physical activity (P = .010) and quality of life (P = .008). CONCLUSIONS An integrated clinic-community model of child obesity treatment is feasible to deliver in a low-income and racially diverse population. As compared with multidisciplinary treatment, the integrated model provides more treatment hours, improves physical activity, and increases quality of life. Parks and recreation departments hold significant promise as a partner agency to deliver child obesity treatment.

Use of a mobile lifestyle intervention application as a waitlist intervention for adolescents with obesity: single arm feasibility study (Preprint)

2020 ◽  
Author(s):  
Chu Shan Elaine Chew ◽  
Eric Andrew Finkelstein ◽  
Courtney Davis
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Lifestyle Intervention ◽  
Intervention Program ◽  
Clinical Care ◽  
Mobile App ◽  
Z Score ◽  
Fat Percentage ◽  
Lifestyle Intervention Program

BACKGROUND Use of a mobile health tool as a waitlist intervention combined with in-person weight management clinic visits may increase participant engagement and be an effective treatment strategy for adolescent obesity. OBJECTIVE The aim of this study was to assess the effectiveness of and adolescent engagement with a mobile application-based lifestyle intervention program as a waitlist intervention prior to their engagement with a multidisciplinary weight management clinic METHODS This single-arm feasibility study recruited adolescents with obesity, aged 10-16 year old, to a waitlist intervention using a mobile app-based lifestyle intervention program with routine clinical care. Primary outcomes were adolescents’ engagement with the mobile application and BMI z-score at 6 months. Secondary outcomes included health behaviours, physical activity levels , quality of life and disordered eating behaviours. RESULTS We enrolled 40 adolescents with mean age of 13.8 ± 1.7 years and BMI z-score of 2.07 ± 0.30. Participants were ethnically diverse with 45% Chinese, 33% Malay, 15% Indians and 10% of other ethnicity. 83% of the participants had a household income level that was below the national median levels. 83% of the participants engaged with the mobile app-based lifestyle intervention program. There was no significant differences in the BMI z-score and disordered eating behaviours of the participants at 6 months. Participants had significant improvement in quality of life (P=0.044) and physical activity level (P=0.026) with reduction of total caloric intake (P=0.018) and fat percentage (P=0.018) at 6 months. CONCLUSIONS Use of a mobile app-based lifestyle intervention program combined with multidisciplinary clinical care is feasible strategy to provide obesity management services to a low-income and racially diverse Asian population and improves quality of life, physical activity levels and reduces fat percentage and total caloric intake. CLINICALTRIAL ClinicalTrials.gov NCT03561597

scholarly journals A Physical Activity Intervention Feasibility Study for Kidney Inpatients: A Basic Research Protocol

2021 ◽  
Vol 8 ◽  
pp. 205435812098705
Author(s):  
Kathryn Wytsma-Fisher ◽  
Stefan Mustata ◽  
Theresa Cowan ◽  
Manuel Ester ◽  
S. Nicole Culos-Reed
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Physical Function ◽  
Kidney Failure ◽  
Standard Care ◽  
Physical Activity Intervention ◽  
Clinical Care ◽  
Activity Promotion ◽  
Cardiovascular Morbidity And Mortality

Background: Low physical activity levels and poor physical functioning are strongly associated with poor clinical outcomes and mortality in adult kidney failure patients, regardless of treatment modality. Compared with the general population, individuals with chronic kidney disease are physically inactive, have reduced physical abilities and difficulties performing routine daily tasks, lower health-related quality of life, and higher cardiovascular morbidity and mortality. In addition, frail kidney failure patients have higher hospitalization and mortality rates as compared with other kidney failure patients. Evidence suggests that assessment and recommendations for physical activity should be part of standard care for kidney failure patients. Structured exercise can improve physical function and quality of life in frail older adults and may be used specifically for management of frailty in kidney failure. However, research is needed to determine best practices for implementation of physical function measurements and physical activity promotion in standard kidney failure care. Objective: The proposed Move More study will assess the feasibility of a physical activity intervention offered to the kidney failure inpatients in Calgary, Alberta. Specifically, this study is designed to examine the effects of an early physical activity/mobility intervention led by a kinesiologist, and supported by the clinical care team including physiotherapists (PT) and nurse clinicians. Methods: The Move More study is a single-arm pilot intervention examining feasibility and optimal improvement in real-world conditions. Kidney failure inpatients at the Foothills Medical Centre will be recruited to participate. Patients will receive an individualized in-hospital physical activity/mobility intervention. Frailty and physical function will be assessed at baseline and postintervention prior to hospital discharge. The goal is to recruit 24 to 36 patients. Conclusions: Evidence needed to support the inclusion of mobility and physical activity as part of standard care will be gathered, with knowledge gained used to help direct future physical activity programming for kidney failure inpatients.

An Introduction to Parks, Recreation, and Public Health: Collaborative Frameworks for Promoting Physical Activity

2007 ◽  
Vol 4 (s1) ◽  
pp. S1-S13 ◽  
Author(s):  
John Librett ◽  
Karla Henderson ◽  
Geoffrey Godbey ◽  
James R. Morrow
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Physical Activity ◽  
Learning Curve ◽  
Health Professions ◽  
Health Decisions ◽  
Parks And Recreation ◽  
Knowledge Based ◽  
Missed Opportunity

The purpose of parks and recreation as well as public health is to seek the highest possible quality of life for individuals and communities. Unfortunately, little discourse has occurred between the parks and recreation and public health professions. This missed opportunity has resulted in an incomplete understanding of the spectrum of issues shared by the fields, a slow transdisciplinary learning curve, and a dearth of knowledge-based linkages between science and practice. The goal of the 2006 Cooper Institute Conference on Parks, Recreation, and Public Health: Collaborative Frameworks for Promoting Physical Activity was to highlight opportunities and advance cooperation between parks, recreation, and public health researchers and practitioners that result in collaborations that influence public health decisions at the macro (agency) and micro (individual) levels. This article introduces the discussion on scientific and practice issues in parks, recreation, and public health. By establishing a baseline of frameworks for strengthening collaboration we hope to improve the health and quality of life through parks and recreation-based physical activity.

scholarly journals A physical activity intervention feasibility study for renal inpatients: a basic research protocol

2020 ◽  
Author(s):  
Kathryn Wytsma-Fisher ◽  
Stefan Mustata ◽  
Theresa Cowan ◽  
Manuel Ester ◽  
S. Nicole Culos-Reed
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Kidney Disease ◽  
Physical Function ◽  
Standard Care ◽  
Physical Activity Intervention ◽  
Clinical Care ◽  
Activity Promotion ◽  
Cardiovascular Morbidity And Mortality

Background: Low physical activity levels and poor physical functioning are strongly associated with poor clinical outcomes and mortality in adult End Stage Kidney Disease (ESKD) patients, regardless of treatment modality. Compared to the general population, individuals with chronic kidney disease are physically inactive, have reduced physical abilities and difficulties performing routine daily tasks, lower health-related quality of life, higher cardiovascular morbidity and mortality. In addition, frail ESKD patients have higher hospitalization and mortality rates than other ESKD patients. Evidence suggests that assessment and recommendations for physical activity should be part of standard care for ESKD patients. Structured exercise can improve physical function and quality of life in frail older adults and may be used specifically for management of frailty in ESKD. However, research is needed to determine best practices for implementation of physical function measurements and physical activity promotion in standard ESKD care. Objective: The proposed Move More study will assess the feasibility of a physical activity intervention offered to the ESKD inpatients in Calgary, Alberta. Specifically, this study is designed to examine the effects of an early physical activity/mobility intervention led by a kinesiologist (KT), and supported by the clinical care team including physiotherapists (PT) and nurse clinicians.Methods: The Move More study is a single-arm pilot intervention examining feasibility and preliminary efficacy. ESKD inpatients at the Foothills Medical Centre will be recruited to participate. Patients will receive an individualized in-hospital physical activity/mobility intervention. Frailty and physical function will be assessed at baseline and post-intervention prior to hospital discharge. Conclusions: Evidence needed to support the inclusion of mobility and physical activity as part of standard care will be gathered, with knowledge gained used to help direct future physical activity programming for ESKD inpatients.

scholarly journals Understanding the Impact of Initial COVID-19 Restrictions on Physical Activity, Wellbeing and Quality of Life in Shielding Adults with End-Stage Renal Disease in the United Kingdom Dialysing at Home versus In-Centre and Their Experiences with Telemedicine

2021 ◽  
Vol 18 (6) ◽  
pp. 3144
Author(s):  
Joe Antoun ◽  
Daniel J. Brown ◽  
Daniel J. W. Jones ◽  
Nicholas C. Sangala ◽  
Robert J. Lewis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Clinical Care ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact ◽  
At Home

Early in the coronavirus-2019 (COVID-19) containment strategy, people with end-stage renal disease (ESRD) were identified as extremely clinically vulnerable and subsequently asked to ‘shield’ at home where possible. The aim of this study was to investigate how these restrictions and the transition to an increased reliance on telemedicine within clinical care of people living with kidney disease impacted the physical activity (PA), wellbeing and quality of life (QoL) of adults dialysing at home (HHD) or receiving in-centre haemodialysis (ICHD) in the UK. Individual semistructured telephone interviews were conducted with adults receiving HHD (n = 10) or ICHD (n = 10), were transcribed verbatim and, subsequently, thematically analysed. As result of the COVID-19 restrictions, PA, wellbeing and QoL of people with ESRD were found to have been hindered. However, widespread support for the continued use of telemedicine was strongly advocated and promoted independence and satisfaction in patient care. These findings highlight the need for more proactive care of people with ESRD if asked to shield again, as well as increased awareness of safe and appropriate PA resources to help with home-based PA and emotional wellbeing.

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