scholarly journals Black American and Latinx Parent/Caregiver Participation in Digital Health Obesity Interventions for Children: A Systematic Review

2021 ◽  
Vol 3 ◽  
Author(s):  
Jennifer Sanchez-Flack ◽  
Joanna Buscemi ◽  
Alexander O'Donnell ◽  
Margaret H. Clark Withington ◽  
Marian Fitzgibbon

Parents/caregivers are consistently described as integral targets given their influential role in supporting and managing behaviors such as diet and physical activity. Identifying effective obesity prevention interventions to enhance and sustain parent participation is needed. Digital obesity prevention interventions are a promising strategy to improve parent/caregiver participation. Digital health interventions demonstrate acceptable participation and retention among parents/caregivers. However, our understanding of digital obesity prevention interventions targeting Black American and Latinx parents/caregivers is limited. This systematic review aims to identify Black American and Latinx parents'/caregivers' level of participation in digital obesity prevention and treatment interventions and determine the relationship between parent/caregiver participation and behavioral and weight status outcomes. This review adheres to PRISMA guidelines and is registered in PROSPERO. Eligibility criteria include: intervention delivered by digital technology, targeted Black American and Latinx parents/caregivers of young children (2–12 years), reported parent/caregiver participation outcomes, targeted diet or physical activity behaviors, and randomized controlled trial study design. Searches were conducted in September 2020 in ERIC, PsychInfo, PubMed, and Web of Science. Initial searches returned 499 results. Four reviewers screened records against eligibility criteria and 12 studies met inclusion criteria. Across all studies, parent/caregiver participation ranged from low to high. Only half of the included studies reported significant improvements in behavioral or weight status outcomes for parents/caregivers and/or children. Of these studies, three reported high parental/caregiver participation rates, and three reported high satisfaction rates. These findings suggest that participation and satisfaction may impact behavior change and weight status. The small number of studies indicates that additional research is needed to determine whether engagement or other factors predict responsiveness to the digital health intervention. Our results lay the groundwork for developing and testing future digital health interventions with the explicit goal of parental/caregiver participation and considers the need to expand our digital health intervention research methodologies to address obesity inequities among diverse families better.

Author(s):  
Zheng Liu ◽  
Han-Meng Xu ◽  
Li-Ming Wen ◽  
Yuan-Zhou Peng ◽  
Li-Zi Lin ◽  
...  

Abstract Background Childhood obesity is a serious public health concern. School-based interventions hold great promise to combat the rising trend of childhood obesity. This systematic review aimed to assess the overall effects of school-based obesity prevention interventions, and to investigate characteristics of intervention components that are potentially effective for preventing childhood obesity. Methods We systematically searched MEDLINE, CENTRAL and Embase databases to identify randomized- or cluster randomized- controlled trials of school-based obesity interventions published between 1990 and 2019. We conducted meta-analyses and subgroup analyses to determine the overall effects of obesity prevention programs and effect differences by various characteristics of intervention components on body mass index (BMI) or BMI Z-score of children. Results This systematic review included a total of 50 trials (reported by 56 publications). Significant differences were found between groups on BMI (− 0.14 kg/m2 (95% confidence interval: − 0.21, − 0.06)) and BMI Z-score (− 0.05 (− 0.10, − 0.01)) for single-component interventions; significant differences were also found between groups on BMI (− 0.32 (− 0.54, − 0.09) kg/m2) and BMI Z-score (− 0.07 (− 0.14, − 0.001)) for multi-component interventions. Subgroup analyses consistently demonstrated that effects of single-component (physical activity) interventions including curricular sessions (− 0.30 (− 0.51, − 0.10) kg/m2 in BMI) were stronger than those without curricular sessions (− 0.04 (− 0.17, 0.09) kg/m2 in BMI); effects of single-component (physical activity) interventions were also strengthened if physical activity sessions emphasized participants’ enjoyment (− 0.19 (− 0.33, − 0.05) kg/m2 in BMI for those emphasizing participants’ enjoyment; − 0.004 (− 0.10, 0.09) kg/m2 in BMI for those not emphasizing participants’ enjoyment). The current body of evidence did not find specific characteristics of intervention components that were consistently associated with improved efficacy for multi-component interventions (P > 0.05). Conclusions School-based interventions are generally effective in reducing excessive weight gain of children. Our findings contribute to increased understandings of potentially effective intervention characteristics for single-component (physical activity) interventions. The impact of combined components on effectiveness of multi-component interventions should be the topic of further research. More high-quality studies are also needed to confirm findings of this review.


2020 ◽  
Vol 10 (5) ◽  
pp. 1168-1176
Author(s):  
Jennifer C Sanchez-Flack ◽  
Annie Herman ◽  
Joanna Buscemi ◽  
Angela Kong ◽  
Alexis Bains ◽  
...  

Abstract Previous systematic reviews have examined the efficacy of obesity prevention interventions within early childcare/education settings. Often lacking in these reviews is reporting on external validity, which continues to be underemphasized compared to internal validity. More attention to external validity would help better translate evidence-based interventions to real-world settings. This systematic review aimed to determine the availability of data on both internal and external validity across dimensions of the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework in studies reporting on obesity prevention interventions in early childcare/education settings. Inclusion criteria included: randomized controlled trials, early childcare/education setting, targeted children 2–6 years old, addressed both diet and physical activity, collected measures of weight status and diet and/or physical activity, and published within the last 10 years. Searches were conducted in ERIC, PsychInfo, and PubMed; 23 studies met inclusion criteria. A validated RE-AIM abstraction tool was used to code studies. Most commonly reported dimensions were Reach (62.3%), Implementation (53.5%), and Efficacy/Effectiveness (48.7%). Adoption (21.7%) and Maintenance (11.6%) were less often reported. All studies reported on primary outcomes, but few reported on RE-AIM indicators of characteristics of participation and adoption, quality of life, methods used to identify staff, staff inclusion/exclusion criteria and adoption rates, implementation fidelity, measures of cost to start-up and deliver the intervention, and indicators of maintenance. This systematic review underscores the need for more focus on external validity to inform replication, dissemination, and implementation so that evidence-based early childcare/education obesity interventions can be generalized to real-world settings.


10.2196/29094 ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. e29094
Author(s):  
Matthew Mclaughlin ◽  
Tessa Delaney ◽  
Alix Hall ◽  
Judith Byaruhanga ◽  
Paul Mackie ◽  
...  


2021 ◽  
Author(s):  
Anthony Duffy ◽  
Greg Christie ◽  
Sylvain Moreno

BACKGROUND Digital Health Interventions (DHIs) are rapidly evolving the landscape of healthcare. Multiple studies have shown their propensity to extend both the quality and reach of interventions. However, failure to improve DHI development is linked to failed uptake and health outcomes. This dilemma is further conflicted by the colliding backdrops of the digital and health industries respectively, which approach, understand and involve end users differently in the framing of a DHI. OBJECTIVE The objective of this systematic review is to assess the challenges to incorporate end users in the development of digital health interventions, to identify emerging hybridised solutions, and to identify limitations and gaps for areas of future investigation. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) will be used to structure this protocol. A systematic search of the PsycInfo, PubMed (Medline), Web of Science, CINAHL and IEEE Xplore databases will be conducted. Additionally, the PerSPEcTiF guidelines for complex interventions will be consulted. Two reviewers will independently screen the titles and abstracts of the identified references and select studies according to the eligibility criteria. Any discrepancies will then be discussed and resolved. Two reviewers will independently extract and validate data from the included studies into a standardised form and conduct quality appraisal. RESULTS As of February 2020, we have completed a preliminary literature search examining challenges to incorporate end users in the development of DHI. Systematic searches, data extraction and analysis, and writing of the systematic review are expected to be completed by August 2021. CONCLUSIONS This systematic review aims to provide an effective summary of challenges to incorporate end users in the development of DHIs. Results from this review will provide an evidence base for a more harmonised approach to end users that satisfies the needs of healthcare outcomes and digital design and development respectively.


10.2196/23180 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e23180
Author(s):  
Matthew Mclaughlin ◽  
Tessa Delaney ◽  
Alix Hall ◽  
Judith Byaruhanga ◽  
Paul Mackie ◽  
...  

Background The effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. Objective This study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). Methods Four databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely sampled or recruited individuals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the individual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. Results Overall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). Conclusions The findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement; however, the associations were weak.


2021 ◽  
Author(s):  
Kieran Rustage ◽  
Alison Crawshaw ◽  
Saliha Majeed-Hajaj ◽  
Anna Deal ◽  
Laura B Nellums ◽  
...  

Objective To analyse the use of participatory approaches in research of health interventions for migrants, and how utilised approaches embody core participatory principles of democracy and power distribution. Design A systematic review of original articles. Electronic searchers were carried out in the databases MEDLINE, Embase, Global Health and PsychINFO (from inception to Nov 2020). Eligibility criteria for study selection The analysis included original peer reviewed research which reported on attempts to develop and implement a health intervention for migrants using participatory approaches. We defined migrants as foreign born individuals; studies using definitions demonstrably outside of this were excluded. Only articles reporting the full research cycle (inception, design, implementation, analysis, evaluation, dissemination) were included. Data extraction Information related to who was involved in research (migrants or other non academic stakeholders), the research stage at which they were involved (inception, design, implementation, analysis, evaluation, dissemination), and how this involvement aligned with the core principles of participatory research, categorising studies as exhibiting active, pseudo, or indirect participation of migrants. Results 1793 publication were screened of which 28 were included in our analysis. We found substantial variation in the application of participatory research approaches: across 168 individual research stages analysed across the 28 studies, we recorded 46 instances of active participation of migrants; 30 instances of proxy participation; and 24 instances of indirect participation. Whilst all studies involved at least one non-academic stakeholder group in at least one stage of the research, just two studies exhibited evidence of active participation of migrants across all research stages. Conclusions These data highlight important shortfalls in the inclusion of migrant groups in developing health interventions that affect their lives and suggest a more rigorous and standardised approach to defining and delivering participatory research is urgently needed to improve the quality of participatory research. Registration This review followed PRISMA guidelines and is registered on the Open Science Framework (osf.io/2bnz5)


2020 ◽  
Author(s):  
Matthew Mclaughlin ◽  
Tessa Delaney ◽  
Alix Hall ◽  
Judith Byaruhanga ◽  
Paul Mackie ◽  
...  

BACKGROUND The effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. OBJECTIVE This study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). METHODS Four databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely sampled or recruited individuals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the individual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. RESULTS Overall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). CONCLUSIONS The findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement; however, the associations were weak.


Author(s):  
Mandeep Sekhon ◽  
Claire White ◽  
Emma Godfrey ◽  
Aliya Amirova ◽  
Åsa Revenäs ◽  
...  

Abstract Objective The aim of this systematic review was to assess the evidence from randomised controlled trials (RCT) and cohort studies for the effectiveness of digital interventions designed to enhance adherence to physical activity (PA) for people with inflammatory arthritis (IA) and describe the intervention content using established coding criteria. Methods Six electronic databases were searched for published and unpublished studies. Independent data extraction and quality assessment (Cochrane risk of bias II or ROBIN I) were conducted by two reviewers. The primary outcome was self-reported adherence to PA post-intervention. Secondary outcomes included self-reported adherence to PA at other timepoints, level of PA or engagement with intervention at any follow-up timepoint. Intervention content was assessed using the Consensus on Exercise Reporting Template and the Behaviour Change Techniques taxonomy version 1. Results From 11,136 reports, four moderate risk of bias studies (three RCTs, one cohort study) including 1,160 participants with rheumatoid arthritis or juvenile inflammatory arthritis were identified. Due to heterogeneity of outcomes, a narrative synthesis was conducted. Only one RCT reported a small between group difference in adherence to PA [mean difference (95% confidence intervals) -0.46 (-0.82. -0.09)] in favour of the intervention. There were no between group differences in any secondary outcomes. Interventions included between 3–11 behaviour change techniques but provided minimal exercise prescription information. Conclusion There is currently limited moderate quality evidence available to confidently evaluate the effect of web-based and mobile health interventions on adherence to PA or level of PA post intervention in people with IA.


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