Mobile Health Apps in Pediatric Obesity Treatment: Process Outcomes From a Feasibility Study of a Multicomponent Intervention (Preprint)

BACKGROUND Multicomponent family interventions underline current best practice in childhood obesity treatment. Mobile health (mHealth) adjuncts that address eating and physical activity behaviors have shown promise in clinical studies. OBJECTIVE This study aimed to describe process methods for applying an mHealth intervention to reduce the rate of eating and monitor physical activity among children with obesity. METHODS The study protocol was designed to incorporate 2 mHealth apps as an adjunct to usual care treatment for obesity. Children and adolescents (aged 9-16 years) with obesity (BMI ≥98th centile) were recruited in person from a weight management service at a tertiary health care center in the Republic of Ireland. Eligible participants and their parents received information leaflets, and informed consent and assent were signed. Participants completed 2 weeks of baseline testing, including behavioral and quality of life questionnaires, anthropometry, rate of eating by Mandolean, and physical activity level using a smart watch and the myBigO smartphone app. Thereafter, participants were randomized to the (1) intervention (usual clinical care+Mandolean training to reduce the rate of eating) or (2) control (usual clinical care) groups. Gender and age group (9.0-12.9 years and 13.0-16.9 years) stratifications were applied. At the end of a 4-week treatment period, participants repeated the 2-week testing period. Process evaluation measures included recruitment, study retention, fidelity parameters, acceptability, and user satisfaction. RESULTS A total of 20 participants were enrolled in the study. A web-based randomization system assigned 8 participants to the intervention group and 12 participants to the control group. Attrition rates were higher among the participants in the intervention group (5/8, 63%) than those in the control group (3/12, 25%). Intervention participants undertook a median of 1.0 training meal using Mandolean (25th centile 0, 75th centile 9.3), which represented 19.2% of planned intervention exposure. Only 50% (9/18) of participants with smart watches logged physical activity data. Significant differences in psychosocial profile were observed at baseline between the groups. The Child Behavior Checklist (CBCL) mean total score was 71.7 (SD 3.1) in the intervention group vs 57.6 (SD 6.6) in the control group, t-test P<.001, and also different among those who completed the planned protocol compared with those who withdrew early (CBCL mean total score 59.0, SD 9.3, vs 67.9, SD 5.6, respectively; t-test P=.04). CONCLUSIONS A high early attrition rate was a key barrier to full study implementation. Perceived task burden in combination with behavioral issues may have contributed to attrition. Low exposure to the experimental intervention was explained by poor acceptability of Mandolean as a home-based tool for treatment. Self-monitoring using myBigO and the smartwatch was acceptable among this cohort. Further technical and usability studies are needed to improve adherence in our patient group in the tertiary setting.

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Mobile Health Apps in Pediatric Obesity Treatment: Process Outcomes From a Feasibility Study of a Multicomponent Intervention

JMIR mhealth and uhealth ◽

10.2196/16925 ◽

2020 ◽

Vol 8 (7) ◽

pp. e16925

Author(s):

Sarah Browne ◽

M-Tahar Kechadi ◽

Shane O'Donnell ◽

Mckenzie Dow ◽

Louise Tully ◽

...

Keyword(s):

Physical Activity ◽

Mobile Health ◽

User Satisfaction ◽

Clinical Care ◽

Intervention Group ◽

Obesity Treatment ◽

T Test ◽

Activity Level ◽

Control Group ◽

Management Service

Background Multicomponent family interventions underline current best practice in childhood obesity treatment. Mobile health (mHealth) adjuncts that address eating and physical activity behaviors have shown promise in clinical studies. Objective This study aimed to describe process methods for applying an mHealth intervention to reduce the rate of eating and monitor physical activity among children with obesity. Methods The study protocol was designed to incorporate 2 mHealth apps as an adjunct to usual care treatment for obesity. Children and adolescents (aged 9-16 years) with obesity (BMI ≥98th centile) were recruited in person from a weight management service at a tertiary health care center in the Republic of Ireland. Eligible participants and their parents received information leaflets, and informed consent and assent were signed. Participants completed 2 weeks of baseline testing, including behavioral and quality of life questionnaires, anthropometry, rate of eating by Mandolean, and physical activity level using a smart watch and the myBigO smartphone app. Thereafter, participants were randomized to the (1) intervention (usual clinical care+Mandolean training to reduce the rate of eating) or (2) control (usual clinical care) groups. Gender and age group (9.0-12.9 years and 13.0-16.9 years) stratifications were applied. At the end of a 4-week treatment period, participants repeated the 2-week testing period. Process evaluation measures included recruitment, study retention, fidelity parameters, acceptability, and user satisfaction. Results A total of 20 participants were enrolled in the study. A web-based randomization system assigned 8 participants to the intervention group and 12 participants to the control group. Attrition rates were higher among the participants in the intervention group (5/8, 63%) than those in the control group (3/12, 25%). Intervention participants undertook a median of 1.0 training meal using Mandolean (25th centile 0, 75th centile 9.3), which represented 19.2% of planned intervention exposure. Only 50% (9/18) of participants with smart watches logged physical activity data. Significant differences in psychosocial profile were observed at baseline between the groups. The Child Behavior Checklist (CBCL) mean total score was 71.7 (SD 3.1) in the intervention group vs 57.6 (SD 6.6) in the control group, t-test P<.001, and also different among those who completed the planned protocol compared with those who withdrew early (CBCL mean total score 59.0, SD 9.3, vs 67.9, SD 5.6, respectively; t-test P=.04). Conclusions A high early attrition rate was a key barrier to full study implementation. Perceived task burden in combination with behavioral issues may have contributed to attrition. Low exposure to the experimental intervention was explained by poor acceptability of Mandolean as a home-based tool for treatment. Self-monitoring using myBigO and the smartwatch was acceptable among this cohort. Further technical and usability studies are needed to improve adherence in our patient group in the tertiary setting.

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Efficacy of an E-Mail Intervention for the Promotion of Physical Activity and Nutrition Behavior in the Workplace Context

American Journal of Health Promotion ◽

10.4278/0890-1171-19.6.422 ◽

2005 ◽

Vol 19 (6) ◽

pp. 422-429 ◽

Cited By ~ 82

Author(s):

Ronald C. Plotnikoff ◽

Linda J. McCargar ◽

Philip M. Wilson ◽

Constantinos A. Loucaides

Keyword(s):

Physical Activity ◽

Mode Of Delivery ◽

Intervention Group ◽

Activity Level ◽

Self Report ◽

Control Group ◽

Nutrition Behavior ◽

Nutrition Messages ◽

Mail Address ◽

E Mail

Purpose. The purpose of this study was to evaluate a 12-week workplace e-mail intervention designed to promote physical activity and nutrition behavior. Design. A pre- and post-test design was conducted to compare the effects of e-mail messages between intervention and control groups. Setting. Five large workplaces in Alberta, Canada. Subjects. Employees with access to a personal e-mail address (N = 2121) were randomly assigned to an intervention (n = 1566) or a control group (n = 555). Intervention. Physical activity and nutrition messages were based on social-cognitive theories. The intervention group received one physical activity and one parallel nutrition message per week for 12 weeks. The control group received no weekly messages. Measures. Each participant completed self-report measures of physical activity and nutrition related to knowledge, attitudes, and behaviors 1 week before (time 1) and 1 week after (time 2) the intervention. Results. The intervention group was more efficacious at time 2 on measures of self-efficacy, pros, cons, intentions, and behavior related to physical activity. This group also reported more favorable changes in practicing healthy eating, balancing food intake with activity level, cooking meals with techniques to reduce fat, and avoiding eating high-fat foods. Effect sizes for all significant differences were small. Conclusion. E-mail is a promising mode of delivery for promoting physical activity and nutrition in the workplace. Further theoretically driven studies are needed.

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Motivating Diabetic and Hypertensive Patients to Increase Physical Activity: The Use of Photos and Group Dynamics

10.20944/preprints201809.0028.v1 ◽

2018 ◽

Author(s):

Angela Yee Man Leung ◽

Pui Hing Chau ◽

Isaac Leung ◽

Michael Tse ◽

Perick Lai Choi Wong ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Lower Limb ◽

Intervention Group ◽

Mean Difference ◽

Regular Physical Activity ◽

Activity Level ◽

Control Group ◽

Body Strength ◽

Group Meetings

Aims: Photovoice is a strategy to allow people to express their views and concerns about health. This project aimed to promote physical activity (PA) among patients with chronic illness, identify facilitators and barriers for PA, enhance walking within the neighbourhood, and build up efficacy in doing exercise. Design: A quasi-experimental study with waitlisted control and pre-and-post measures. Setting: Community elderly centres. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either intervention group (IG) or waitlisted control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community elderly centres in which the participants freely exchanged their views about the barriers and facilitators of regular physical activity. Participants were encourage to take photos in their neighbourhood or at homes, and brought these photos for sharing in the group meetings. The photos showed the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by Garmin Accelerometer at baseline, at Week 6 and Week 10. Other measures include the 9-item Self-efficacy Scale for Exercise - Chinese version (SEE-C), the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. General linear mixed model was used to compare the outcomes between IG and CG after the intervention. Results: After the 6-week intervention, the average number of steps taken by the IG participants increased. At Week 10, there was a significant higher proportion of the IG participants who had increased at least 1,200 steps than that of the CG (Estimate=0.151, SE=0.066, p<0.05). The lower body strength of the IG participants was significantly higher than that of the CG (mean difference = 0.94, t=1.957, p<0.05) and the lower limb flexibility of the IG participants was also significantly higher than that of the CG (mean difference = 2.04, t=2.397, p<0.05) at Week 10. Conclusion: Understanding older adults’ views and thoughts about barriers to PA through photos and group discussion seemed to be a good strategy to motivate older adults with chronic illnesses to commit to regular physical activity. This photovoice intervention improved the participants’ physical activity level and physical fitness, particularly in lower limb flexibility and body strength.

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Children’s physical activity level and sedentary behaviour in Norwegian early childhood education and care: effects of a staff-led cluster-randomised controlled trial

10.21203/rs.2.20003/v4 ◽

2020 ◽

Author(s):

Eivind Andersen ◽

Steinar Øvreås ◽

Kari Anne Jørgensen ◽

Janne Borch-Jenssen ◽

Thomas Moser

Keyword(s):

Physical Activity ◽

Sedentary Time ◽

Controlled Trial ◽

Intervention Group ◽

Activity Level ◽

Control Group ◽

Education And Care ◽

Vigorous Intensity ◽

Randomised Controlled ◽

Children’S Physical Activity

Abstract Background: A growing body of evidence suggest that the children’s physical activity (PA) level in early childhood education and care (ECEC) settings are insufficient. Since most children attend ECEC settings for many hours on most days of the week, and these institutions reach children across the socioeconomic spectrum, the ECEC settings may serve as an ideal avenue for increasing physical activity level, reduce sedentary time and enhance the overall health of young children. This paper investigates the effectiveness of the “Active Kindergarten – Active Children” study to increase children’s PA level and reduce sedentary time within the ECEC setting. Methods: Accelerometers were used to asses PA and sedentary time. A total of 116 three to four-year olds took part in a randomised controlled trial in 11 ECEC settings. Participants were cluster-randomised, by ECEC setting, to either a 12 week staff-led and expert-supported intervention or a waiting list control group. Results: The intervention group increased time spent in moderate- and vigorous intensity PA by 10 min/day (95% CI = 3, 18; P=0.01), took 1909 more steps per day (95% CI = 1130, 2688; P˂0.01) and reduced sedentary time with 14min/day (95% CI = -27, -1; P=0.04) compared to the control group. The intervention group had a 2.4 higher odds (95% CI = 1.05, 5.7; P = 0.04) of meeting the PA recommendations compared to the control group at follow-up. Conclusions: Our results show that a flexible staff-led and expert-supported multicomponent PA intervention can increase total PA level, moderate- and vigorous intensity PA and reduce time spent sedentary in three to four-year old children during their stay in ECEC settings.Trial registration: The trial was retrospectively registered on September 19, 2020 and available online at ClinicalTrials.gov: No. NCT04555746

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Pedometer-based walking intervention with and without group support among sedentary adults in primary care patients in north-east Malaysia: a randomized controlled trial

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v17i1.35280 ◽

2018 ◽

Vol 17 (1) ◽

pp. 52-57

Author(s):

Nur Emilia A ◽

Lili Husniati Yaacob ◽

AK Azidah

Keyword(s):

Physical Activity ◽

Repeated Measures ◽

Intervention Group ◽

Activity Level ◽

Control Group ◽

Group Support ◽

Step Counts ◽

Walking Program ◽

North East ◽

Significant Difference

Background: Many studies have shown that pedometer is an effective motivational tool to promote walking however there is lack of evidence which combines pedometer and group support in motivating patient to increase their physical activityObjective: To determine the effectiveness of pedometer and group support versus pedometer only on physical activity level and cardiovascular risk factors among sedentary adults in north-east MalayMethods: This was a prospective randomized comparative trial. Eighty participants were randomly assigned to pedometer-based walking program plus group support ( N=40) or pedometer-based walking program only (N=40) for 12 weeks. Both groups received physical activity counselling. The intervention group had monthly group meeting for support, motivation and also walking activities. Measurements for step-counts, 7-day physical activity recall, body mass, BMI, waist and hip circumference, blood pressure, total cholesterol, HDL cholesterol and fasting blood sugar were taken at baseline and at week 12. Analyses were performed using repeated measures ANOVA and analysis of co-variance (ANCOVA).Results and Discussion: Sixty two participants completed the study. The mean age in the intervention group were 48 (4.43) years old and 47 (5.08) years old in the control group. There were significant improvements in the intervention group in terms of step-counts (p < 0.001), weight (P<0.05) and BMI (p>0.05) compared to control group. However there was no significant difference in term of other health outcome.Conclusion A pedometer-based walking program, incorporating a physical activity consultation and group support, is effective in promoting walking and improving health outcome in community based individuals. Studies of longer duration need to be done to see the sustainability of the above intervention.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.52-57

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Children’s physical activity level and sedentary behaviour in Norwegian early childhood education and care: effects of a staff-led cluster-randomised controlled trial

BMC Public Health ◽

10.1186/s12889-020-09725-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Eivind Andersen ◽

Steinar Øvreås ◽

Kari Anne Jørgensen ◽

Janne Borch-Jenssen ◽

Thomas Moser

Keyword(s):

Physical Activity ◽

Sedentary Time ◽

Controlled Trial ◽

Intervention Group ◽

Activity Level ◽

Control Group ◽

Education And Care ◽

Vigorous Intensity ◽

Randomised Controlled ◽

Children’S Physical Activity

Abstract Background A growing body of evidence suggest that the children’s physical activity (PA) level in early childhood education and care (ECEC) settings are insufficient. Since most children attend ECEC settings for many hours on most days of the week, and these institutions reach children across the socioeconomic spectrum, the ECEC settings may serve as an ideal avenue for increasing physical activity level, reduce sedentary time and enhance the overall health of young children. This paper investigates the effectiveness of the “Active Kindergarten – Active Children” study to increase children’s PA level and reduce sedentary time within the ECEC setting. Methods Accelerometers were used to asses PA and sedentary time. A total of 116 three to four-year olds took part in a randomised controlled trial in 11 ECEC settings. Participants were cluster-randomised, by ECEC setting, to either a 12 week staff-led and expert-supported intervention or a waiting list control group. Results The intervention group increased time spent in moderate- and vigorous intensity PA by 10 min/day (95% CI = 3, 18; P = 0.01), took 1909 more steps per day (95% CI = 1130, 2688; P < 0.01) and reduced sedentary time with 14 min/day (95% CI = − 27, − 1; P = 0.04) compared to the control group. The intervention group had a 2.4 higher odds (95% CI = 1.05, 5.7; P = 0.04) of meeting the PA recommendations compared to the control group at follow-up. Conclusions Our results show that a flexible staff-led and expert-supported multicomponent PA intervention can increase total PA level, moderate- and vigorous intensity PA and reduce time spent sedentary in three to four-year old children during their stay in ECEC settings. Trial registration The trial was retrospectively registered on September 19, 2020 and available online at ClinicalTrials.gov: No. NCT04555746.

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Effects of exergame training on the health promotion of young adults

Fisioterapia em Movimento ◽

10.1590/1980-5918.030.001.ao06 ◽

2017 ◽

Vol 30 (1) ◽

pp. 59-67 ◽

Cited By ~ 2

Author(s):

Audrin Said Vojciechowski ◽

Jéssica Zampier Natal ◽

Anna Raquel Silveira Gomes ◽

Elisângela Valevein Rodrigues ◽

Isabela Lúcia Pelloso Villegas ◽

...

Keyword(s):

Physical Activity ◽

Young Adults ◽

Physical Condition ◽

Intervention Group ◽

Exercise Adherence ◽

Activity Level ◽

The Self ◽

Control Group ◽

Self Perception ◽

Skeletal Muscle Function

Abstract Introduction: Training with exergames has been prescribed for health problems prevention, however, little is known about its influence on the self-perception of the physical condition and on the physical and motor skills (PMS). Objective: To investigate the effects of exergames (EXG) on the self-perception of the physical condition, level of physical activity and PMS in healthy young adults. Methods: Forty young adults, of both genders, were allocated by convenience into Control Group (CG, n = 20, 21.85 ± 0.62 years old), the individuals did not perform the physical training with exergames, and Intervention Group (IG, n = 20, 23.10 ± 0.61 years old), the subjects practiced exergames training (XBOX360 Kinect ®), in pairs, twice a week, for 12 weeks. Anthropometric measurements; self-perceived physical condition (International Fitness Scale-IFIS); International Physical Activity Questionnaire (IPAQ) and PMS (flexibility; abdominal endurance; upper limb strength and endurance, agility and velocity) were evaluated. Results: The IG presented better self-perception of the physical condition; increased physical activity level in the leisure domain and enhanced PMS after 12 weeks of intervention, compared to the CG. Conclusion: The EXG was efficient to improve skeletal muscle function, to contribute to physical exercise adherence and to promote physical health in active young adults.

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From the Workplace to Home

Californian Journal of Health Promotion ◽

10.32398/cjhp.v14i3.2066 ◽

2016 ◽

Vol 14 (3) ◽

pp. 31-44

Author(s):

Sean Pinkerton ◽

Kathleen S. Wilson ◽

Elaine Rutkowski ◽

Clay Sherman

Keyword(s):

Physical Activity ◽

Self Efficacy ◽

Intervention Group ◽

Wellness Programs ◽

Activity Level ◽

Control Group ◽

Online Questionnaire ◽

Workplace Satisfaction ◽

Parents And Children ◽

The Impact

Background and Purpose: Improved employee health contributes to improved employer outcomes in productivity, attendance and workplace satisfaction. Wellness programs focus on the employee to improve these outcomes, but fail to offer opportunities that include the family. A focus on the employee and their child may yield greater health improvements. This pilot study explored the impact of an e-mail intervention targeting the employee and his/her child on their physical activity level, self-efficacy and social control (SC). Methods: Parent and child dyads were recruited from faculty and staff at a university and were subsequently randomized into an intervention group (family-focused activities) or a control group (employee-focused activities). Both parents and children (ndyads = 19) completed a baseline and follow-up (10 weeks later) online questionnaire that measured physical activity, self-efficacy, and SC. Results: Significant differences in parents were found in task efficacy, scheduling efficacy, and collaborative SC, where the intervention group reported higher changes for these outcomes compared to the control group (p

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Effectiveness of Medication Review Services on Diabetes Self-Care in Primary Care Patients (Preprint)

10.2196/preprints.23269 ◽

2020 ◽

Author(s):

Tay Siew Cheng Sarah ◽

Lim Jit Fan Christina ◽

Tan Soo Chieng Daphne ◽

Tan Seok Yee Maureen ◽

Chen Jieying Cordelia ◽

...

Keyword(s):

Physical Activity ◽

Primary Healthcare ◽

Medication Review ◽

Intervention Group ◽

Self Care ◽

Effective Intervention ◽

Controlled Study ◽

Control Group ◽

Dietary Control ◽

Glucose Management

BACKGROUND Diabetes is one of the most common medical conditions referred to medication review service run by pharmacists, OBJECTIVE This study aims to determine whether pharmacist-run MRS can be an effective intervention tool to improve patients’ participation in self-care of diabetes. METHODS This randomised controlled study was conducted in five public primary healthcare centres from December 2014 to October 2016. Participants were 40 to 80 years of age and had been diagnosed with type 2 diabetes. These participants were prescribed with five or more chronic medications, of which at least one was an antidiabetic medication, by the primary healthcare centres’ doctors. The participants were randomly recruited into the intervention or control arm. A self-developed questionnaire which incorporated the validated Diabetes Self-Management Questionnaire (DSMQ) was administered face-to-face by the study team to the participants prior to and after MRS. MRS was not administered to participants in the control group. RESULTS A total of 221 participants completed the follow up. There were 105 participants in the control arm and 116 in the intervention arm. The DSMQ Sum Scale score of the control group improved by 0.16 ± 1.11 (p= 0.136) while the intervention group improved by 0.40 ± 0.99 (p=0.000). Participants in the intervention group reported a better improvement in their self-care of diabetes, specifically in glucose management (0.38± 1.35, p=0.003), dietary control (0.26±1.66, p=0.096) and physical activity (0.67±2.36, p=0.003). CONCLUSIONS Pharmacist-run MRS is an effective intervention tool to improve participants’ self-care of diabetes, particularly in glucose management, dietary control and physical activity.

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Impact of The Daily Mile on children’s physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol

BMJ Open ◽

10.1136/bmjopen-2020-045879 ◽

2021 ◽

Vol 11 (5) ◽

pp. e045879

Author(s):

Bina Ram ◽

Anna Chalkley ◽

Esther van Sluijs ◽

Rachel Phillips ◽

Tishya Venkatraman ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Cohort Study ◽

Educational Attainment ◽

Primary School ◽

Primary Schools ◽

Intervention Group ◽

Control Group ◽

Physical And Mental Health ◽

School Year

IntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children’s physical and mental health and educational attainment throughout primary school.Methods and analysisiMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5–6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from ‘below expected’ to ‘above expected levels’). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings.

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