scholarly journals Incorporating an Increase in Plant-Based Food Choices into a model of Culturally Responsive Care for Obesity in Hispanic/Latino Adults and Children

2019 ◽  
Author(s):  
Pramil Singh ◽  
Jessica Steinbach ◽  
Anna Nelson ◽  
Wendy Shih ◽  
Mary D'Avila ◽  
...  
Keyword(s):  
Pediatric Obesity ◽  
Culturally Responsive ◽  
Stakeholder Analysis ◽  
Great Promise ◽  
Post Intervention ◽  
Minimal Processing ◽  
Lifestyle Program ◽  
Important Health ◽  
Quasi Experimental ◽  
Hispanic Latinos

The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparity populations. The objective of our study was to evaluate the efficacy and scalability of the Healthy Eating Lifestyle Program (HELP) – a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino pediatric obesity patients and their families. Our evaluation methods included: 1) a quasi-experimental, one group, longitudinal study to measures changes in BMI at 0, 6, and 18 weeks of follow-up, and 2) A stakeholder analysis consisting of six key informant interviews of HELP program staff. We found a significant decrease in body mass index across all adults (-0.2 kg/m2 p=0.0047), that was much stronger in men. For children ages 5-12 years, there was also a significant decrease in BMI Z score from pre- to post- intervention (p=0.04). Program strengths were the cultural tailoring of the plant-based diet choices, and allowing a tiered approached that did not require adherence to strict vegetarianism. Our pilot study findings from HELP raise the possibility that incorporating plant-based diet choices into the treatment of pediatric obesity patients and their families can be an effective addition to a culturally responsive care model.

scholarly journals Incorporating an Increase in Plant-Based Food Choices into a Model of Culturally Responsive Care for Hispanic/Latino Children and Adults Who Are Overweight/Obese

2020 ◽  
Vol 17 (13) ◽  
pp. 4849
Author(s):  
Pramil N. Singh ◽  
Jessica Steinbach ◽  
Anna Nelson ◽  
Wendy Shih ◽  
Mary D’Avila ◽  
...  
Keyword(s):  
Weight Management ◽  
Stakeholder Analysis ◽  
Standard Of Care ◽  
Food Choices ◽  
Great Promise ◽  
Latino Children ◽  
Post Intervention ◽  
Minimal Processing ◽  
Cultural Tailoring ◽  
Hispanic Latinos

Introduction: The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparate populations. The objective of our study was to evaluate the efficacy of the Healthy Eating Lifestyle Program (HELP) for accomplishing weight management in a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino children who were overweight or obese. Methods: Our mixed methods evaluation included: (1) A one arm study to measure changes in body mass index (BMI) from pre- to post-intervention, and (2) A stakeholder analysis of the program staff. Results: For children ages 5–12 years who were overweight/obese, we found no evidence of excess weight gain evidenced by BMI Z scores (Zpost-pre = −0.02, p = 0.11). Among the parent/guardians who were overweight or obese, we found a decrease in BMI that was stronger in men (BMI post-pre = −0.75 kg/m2, p = 0.01) than in women (BMI post-pre = −0.12 kg/m2, p = 0.30). A program strength was the cultural tailoring of the plant-based diet choices. Conclusions: The evaluation raises the possibility that incorporating intervention components of HELP (plant-based food choices, family-based, cultural tailoring) into pediatric weight management can improve the standard of care.

scholarly journals Delivering the Same Intervention to Hispanic/Latinos With Pre-diabetes and Diabetes. Early Evidence of Success in a Longitudinal Mixed Method Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110555
Author(s):  
Maud Joachim-Célestin ◽  
Thelma Gamboa-Maldonado ◽  
Hildemar Dos Santos ◽  
Susanne B Montgomery
Keyword(s):  
Low Income ◽  
Mixed Method ◽  
Health Workers ◽  
Glycosylated Hemoglobin ◽  
Diabetes Prevention Program ◽  
Cost Effective ◽  
Post Intervention ◽  
Management Intervention ◽  
Quasi Experimental ◽  
Hispanic Latinos

Background Despite nationwide efforts to address the diabetes epidemic and reduce prevalence disparities, higher rates persist among the poor, especially those with limited literacy. Currently, individuals with abnormal glycemia who have pre-diabetes and diabetes qualify for different programs. However, evidence suggests that, for low-income Hispanic/Latinos, offering a single intervention to all those with abnormal glycemia may provide a more culturally acceptable and effective approach. Our objective was to explore the feasibility of such an intervention led by community health workers (CHWs) among low-income Hispanic/Latinos with diabetes and at risk for diabetes. Methods Using a quasi-experimental mixed method design, we assessed weight, glycosylated hemoglobin, diabetes knowledge, and behavior changes of Hispanic/Latinos participants with pre-diabetes and diabetes living in Southern California. Biometric measurements, blood tests, and surveys were collected at baseline and 3 months post-intervention. Interviews and focus group discussions provided qualitative data. Results Although the program was less costly, results exceeded those reported for low-income H/L attending the National Diabetes Prevention Program and did not differ between pre-diabetes and diabetes groups. Instead, including individuals at different stages of the dysglycemic spectrum seemed to have enhanced the intervention. Physician referral and attendance of family/friends were associated with better outcomes. Conclusion Our findings indicate that a joint prevention/self-management intervention led by CHWs for low-income Hispanic/Latinos with diabetes and with pre-diabetes is feasible and cost-effective, providing results that could help reduce the success gap. Incorporating suggestions and replicating this study on a larger scale could help determine whether or not results are reproducible.

Efficacy of one-dose intramuscular rabies vaccine as pre-exposure prophylaxis in travellers

2021 ◽  
Author(s):  
Deborah J Mills ◽  
Colleen L Lau ◽  
Christine Mills ◽  
Luis Furuya-Kanamori
Keyword(s):  
Immune System ◽  
Rapid Development ◽  
Age Groups ◽  
Rabies Vaccine ◽  
Post Exposure Prophylaxis ◽  
Post Intervention ◽  
Quasi Experimental ◽  
Alternative Schedule ◽  
Insufficient Time ◽  
Exposure Prophylaxis

Abstract Background Current guidelines for rabies pre-exposure prophylaxis (PrEP) recommend multiple vaccine doses. Travellers sometimes present for pre-travel consultation with insufficient time to complete standard PrEP schedules. We investigated the efficacy of one-dose intramuscular (IM) vaccine in priming the immune system (as PrEP) by measuring antibody response to simulated post-exposure prophylaxis (PEP). Methods A quasi-experimental pre–post intervention clinical trial was conducted at a specialist travel clinic in Australia. Adults (≥18 years) without a history of rabies vaccination were included. At Visit 1, seronegative status was confirmed and one dose of 0.5 ml IM rabies vaccine (Verorab®) administered. At Visit 2 (≥60 days after Visit 1), serology was repeated and a simulated PEP dose (0.5 ml IM) given on this day and again 3 days later (Visit 3). Serology was repeated at Visit 4 (7 days after Visit 2). Results A total of 94 antibody-negative participants were included (<50 years [n = 50]; ≥50 years [n = 44]). At Visit 2, 38.0 and 31.8% of participants aged <50 and ≥50 years were antibody-positive (≥0.5 EU/ml). At Visit 4, all participants were antibody-positive; 82.0 and 47.7% of participants aged <50 and ≥50 years had antibody levels >4 EU/ml, respectively. Conclusions One-dose IM vaccine was effective as PrEP for priming the immune system in both age groups, resulting in rapid development of antibodies 7 days after commencing simulated PEP. If there is insufficient time to complete a standard PrEP schedule, one-dose IM could be considered as an alternative schedule for short trips, rather than not offering travellers any doses at all. Clinical trials registration: ACTRN12619000946112.

Effectiveness of a vancomycin dosing protocol guided by area under the concentration-time curve to minimal inhibitory concentration (AUC/MIC) with multidisciplinary team support to improve hospital-wide adherence to a vancomycin dosing protocol: A pilot study

2021 ◽  
pp. 1-6
Author(s):  
Panipak Katawethiwong ◽  
Anucha Apisarnthanarak ◽  
Kittiya Jantarathaneewat ◽  
David J. Weber ◽  
David K. Warren ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Multidisciplinary Team ◽  
Kidney Injury ◽  
University Hospital ◽  
Routine Practice ◽  
Post Intervention ◽  
Coagulase Negative Staphylococci ◽  
Time Curve ◽  
Concentration Time ◽  
Quasi Experimental

Abstract Background: Limited data are available on the implementation of an area under the concentration-time curve (AUC)–based dosing protocol with multidisciplinary team (MT) support to improve adherence with vancomycin dosing protocol. Objective: To evaluate the effectiveness of an AUC-based dosing protocol with MT support intervention with adherence to a hospital-wide vancomycin dosing protocol at Thammasat University Hospital. Method: We conducted a quasi-experimental study in patients who were prescribed intravenous vancomycin. The study was divided into 2 periods; (1) the preintervention period when the vancomycin dosing protocol was already applied in routine practice and (2) the post-intervention period when the implementation of an AUC-based dosing protocol with MT support was added to the existing vancomycin dosing protocol. The primary outcome was the rate of adherence, and the secondary outcomes included acute kidney injury events, vancomycin-related adverse events, and 30-day mortality rate. Results: In total, 240 patients were enrolled. The most common infections were skin and soft-tissue infections (24.6%) and bacteremia (24.6%). The most common pathogens were coagulase-negative staphylococci (19.6%) and Enterococcus spp (15.4%). Adherence with the vancomycin dosing protocol was significantly higher in the postintervention period (90.8% vs 55%; P ≤ .001). By multivariate analysis, an AUC-based dosing protocol with MT support was the sole predictor for adherence with the vancomycin dosing protocol (adjusted odds ratio, 10.31; 95% confidence interval, 4.54–23.45; P ≤ .001). The 30-day mortality rate was significantly lower during the postintervention period (8.3% vs 20%; P = .015). Conclusions: AUC-based dosing protocol with MT support significantly improved adherence with vancomycin dosing protocol and was associated with a lower 30-day mortality rate.

scholarly journals Effects and Responsiveness of a Multicomponent Intervention on Body Composition, Physical Fitness and Leptin in Overweight/Obese Adolescents

2021 ◽  
Vol 18 (14) ◽  
pp. 7267
Author(s):  
Leticia Borfe ◽  
Caroline Brand ◽  
Letícia Schneiders ◽  
Jorge Mota ◽  
Claudia Cavaglieri ◽  
...  
Keyword(s):  
Body Composition ◽  
Physical Fitness ◽  
Intervention Group ◽  
Interleukin 10 ◽  
Control Group ◽  
Post Intervention ◽  
Necrosis Factor Alpha ◽  
Obese Adolescents ◽  
Quasi Experimental ◽  
Multicomponent Program

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.

scholarly journals 1346. Implementation of a Multidisciplinary 48 Hour Antibiotic Timeout in a Pediatric Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S684-S684
Author(s):  
Victoria Konold ◽  
Palak Bhagat ◽  
Jennifer Pisano ◽  
Natasha N Pettit ◽  
Anish Choksi ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Intervention Group ◽  
Post Intervention ◽  
Days Of Therapy ◽  
New Antibiotics ◽  
Core Elements ◽  
Quasi Experimental ◽  
Empirical Antibiotics ◽  
The Impact

Abstract Background To meet the core elements required for antimicrobial stewardship programs, our institution implemented a pharmacy-led antibiotic timeout (ATO) process in 2017 and a multidisciplinary ATO process in 2019. An antibiotic timeout is a discussion and review of the need for ongoing empirical antibiotics 2-4 days after initiation. This study sought to evaluate both the multidisciplinary ATO and the pharmacy-led ATO in a pediatric population, compare the impact of each intervention on antibiotic days of therapy (DOT) to a pre-intervention group without an ATO, and to then compare the impact of the pharmacy-led ATO versus multidisciplinary ATO on antibiotic days of therapy (DOT). Methods This was a retrospective, pre-post, quasi-experimental study of pediatric patients comparing antibiotic DOT prior to ATO implementation (pre-ATO), during the pharmacy-led ATO (pharm-ATO), and during the multidisciplinary ATO (multi-ATO). The pre-ATO group was a patient sample from February-September 2016, prior to the initiation of a formal ATO. The pharmacy-led ATO was implemented from February-September 2018. This was followed by a multidisciplinary ATO led by pediatric residents and nurses from February-September 2019. Both the pharm-ATO and the multi-ATO were implemented as an active non-interruptive alert added to the electronic health record patient list. This alert triggered when new antibiotics had been administered to the patient for 48 hours, at which time, the responsible clinician would discuss the antibiotic and document their decision via the alert workspace. Pediatric patients receiving IV or PO antibiotics administered for at least 48 hours were included. The primary outcome was DOT. Secondary outcomes included length of stay (LOS) and mortality. Results 1284 unique antibiotic orders (n= 572 patients) were reviewed in the pre-ATO group, 868 (n= 323 patients) in the pharm-ATO and 949 (n= 305 patients) in the multi-ATO groups. Average DOT was not significantly different pre vs post intervention for either methodology (Table 1). Mortality was similar between groups, but LOS was longer for both intervention groups (Table 1). Impact of an ATO on DOT, Mortality and LOS Conclusion An ATO had no impact on average antibiotic DOT in a pediatric population, regardless of the ATO methodology. Disclosures All Authors: No reported disclosures

scholarly journals Parental Participation in a Healthy Lifestyle Program for Middle Schoolers Improves Their Family Meal Patterns and Social Support and Self-Regulation for Healthy Eating (P16-041-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Henna Muzaffar ◽  
Cassandra Nikolaus ◽  
Sharon Nickols-Richardson
Keyword(s):  
Social Support ◽  
Healthy Lifestyle ◽  
Self Regulation ◽  
Parental Participation ◽  
Post Intervention ◽  
Meal Patterns ◽  
Family Meal ◽  
Lifestyle Program ◽  
Post Assessment ◽  
Healthy Lifestyle Program

Abstract Objectives The development and dissemination of appropriate integrated curricula for parents represent a critical need and a novel approach in the obesity prevention field. Our objective was to assess if parental participation in a healthy lifestyle program (PAWS [Peer-education About Weight Steadiness] Club) for middle school students would improve parental anthropometrics, social cognitive theory (SCT) mediators of dietary behavior, and family mealtime frequency and environment. Methods A total of 42 parents participated in five weekly 1.5-hour sessions, delivered four times from 2015–2017. The sessions were led by a trained research assistant; focused on family fitness, meal planning, family mealtimes, label reading, energy balance, making healthy choices and simple recipes, self-reflection and goal setting. Data on anthropometrics, blood pressure (BP), SCT mediators (social/family support, self-efficacy, self-regulation, and outcome expectations) of eating, and family meal patterns (frequency and environment) was collected from the parents at pre-and post-intervention. Wilcoxon Signed Rank test was used to determine any changes from baseline to post assessment for SCT mediators of dietary behavior and family meal patterns. Paired t-test was used to determine any changes from pre-to post-intervention for anthropometric and BP measurements. Significance was set at P < 0.05. Results Of the 42 participants, 67% were females (mothers); 33% self-reported White and 33% self-reported African American race/ethnicity. Participants significantly improved in their self-regulation for reducing unhealthy foods (P = 0.011), social support for balancing calories (P = 0.007), and family mealtime patterns (P = 0.003) from pre- to post-assessment. No significant changes were observed for anthropometric and BP measures. Conclusions Parental participation in a healthy lifestyle program can potentially improve family mealtime environment and frequency and increase self-regulation and social support for dietary behaviors of the family. These results have implications for planning future health programs with adolescents in schools. Funding Sources Supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2012-68001-22032.

scholarly journals An evaluation of Cognitive Stimulation Therapy sessions for people with dementia and a concomitant support group for their carers

Dementia ◽  
2016 ◽  
Vol 16 (8) ◽  
pp. 985-1003 ◽  
Author(s):  
Jan Bailey ◽  
Paul Kingston ◽  
Simon Alford ◽  
Louise Taylor ◽  
Edward Tolhurst
Keyword(s):  
Support Groups ◽  
Support Group ◽  
Qualitative Data ◽  
Cognitive Stimulation ◽  
Structured Interviews ◽  
Post Intervention ◽  
Cognitive Stimulation Therapy ◽  
People With Dementia ◽  
Quasi Experimental ◽  
The Impact

This research aimed to ascertain the impact of a pragmatic Cognitive Stimulation Therapy course of 10 sessions on the cognitive function of people living with dementia and whether attending a concomitant carers support group was beneficial to carers. A mixed method quasi-experimental approach was adopted; data were collected pre- and post-intervention. The quantitative arm utilised three validated questionnaires rated by the carers. Qualitative data were collected via semi-structured interviews with carers regarding their perceptions of the impact of Cognitive Stimulation Therapy and the carers support group. Quantitative data analysis found no statistically significant differences within or between groups. The qualitative data demonstrated that carers perceived Cognitive Stimulation Therapy had some benefits for the people living with dementia, especially social benefits. Carers also perceived that attending the carers support group was beneficial for them in terms of gaining a better understanding of dementia, developing coping skills and having peer support. The study was limited in scale and further research with a larger sample, using direct measures of the impact of Cognitive Stimulation Therapy with people living with dementia and supplementary research exploring which characteristic of carers support groups are effective would be worthwhile.

EFEKTIFITAS WILLIAM FLEXION EXERCISE TERHADAP TINGKAT NYERI PUNGGUNG BAWAH PADA PERAWAT RUMAH SAKIT SANTA ELISABETH MEDAN TAHUN 2018

2019 ◽  
Vol 4 (1) ◽  
pp. 34-40
Author(s):  
Maria Pujiastuti Simbolon
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Design Research ◽  
Adult Population ◽  
Pain Scale ◽  
Test Results ◽  
Post Intervention ◽  
Lower Back ◽  
Quasi Experimental ◽  
Research Show

The Lower back pain is chronic pain complaints at least three months with activity limitations than caused by pain when doing the movement of mobilization Lower back pain is common musculoskeletal disorder than attacks 80% efforts of adult population. One of the made for decrease pain is William flexion exercise. Goals : The purpose of this research is to know William flexion exercise effectiveness to reducing the pain level of nurses in Santa Elisabeth hospital Medan 2014. Methods: The research method used is quasi experimental design one group (pretestpostest) design. Research conducted on 14 respondents. The analysis used in this research is paired t-test. Results: The results of research show there is an effectiveness of William flexion exercise to decrease pain scale, with William flexion exercise pre-intervention pain scale is 64,3% of moderate pain, severe pain controlled 35,7%, and post intervention score 64,3% of light pain and 35,7% of moderat pain, from the result found that Pvalue= 0,000 (P<0,05). Conclusion: Based on the result found of this study are expected to nurses, especially who having lower

Midstream social marketing intervention to influence retailers’ compliance with the minimum legal drinking age law

2016 ◽  
Vol 6 (2) ◽  
pp. 104-120 ◽  
Author(s):  
Tanja Kamin ◽  
Daša Kokole
Keyword(s):  
Social Marketing ◽  
Post Intervention ◽  
Excessive Alcohol Consumption ◽  
Content Type ◽  
The Social ◽  
Drinking Age ◽  
Quasi Experimental ◽  
Minimum Legal Drinking Age ◽  
Marketing Intervention ◽  
Marketing Approach

Purpose Alcohol availability is strongly related to excessive alcohol consumption. This study aims to examine social marketing’s response to concerns about retailers’ noncompliance with the minimum legal drinking age (MLDA) law by proposing and evaluating a social marketing intervention directed at sellers in off-premise stores. Design/methodology/approach The study is based on a non-randomized quasi-experimental design, focusing on an evaluation of the implementation of the “18 rules!” intervention in four cities in Slovenia. Two waves of underage purchase attempts were conducted pre- and post-intervention in 24 off-premise businesses, following a mystery shopping protocol. Findings The initial rate of retailers’ noncompliance with the MLDA law in off-premise establishments was high. After the social marketing intervention, an increase with compliance with the law was observed; the proportion of cashiers selling alcohol to minors after the intervention decreased from 96 to 67 per cent. Qualitative insight suggests an existence of retailers’ dilemma in complying with the MLDA. Research limitations/implications A social marketing approach could contribute to a better understanding of the social working of the MLDA law. Practical implications A social marketing approach could complement the usual enforcement strategies and contribute to a better understanding of the social working of the MLDA law, and encourage deliberate retailers’ compliance with it while developing valuable exchanges among people and stakeholders. Originality/value The paper conceptualizes retailers’ dilemma in complying with the minimal legal drinking age law and offers social marketing response to it. Results of the study show that also solely non-coercive measures have the potential in increasing retailers’ compliance with regulations.

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