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 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 Implementation of a Rapid Phenotypic Susceptibility Platform for Gram-Negative Bloodstream Infections With Paired Antimicrobial Stewardship Intervention: Is the Juice Worth the Squeeze?

2021 ◽  
Author(s):  
Evan D Robinson ◽  
Allison M Stilwell ◽  
April E Attai ◽  
Lindsay E Donohue ◽  
Megan D Shah ◽  
...  
Keyword(s):  
Median Time ◽  
Antimicrobial Stewardship ◽  
A Priori ◽  
Bloodstream Infections ◽  
Standard Of Care ◽  
Post Intervention ◽  
Gram Negative ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
The Impact

Abstract Background Implementation of the Accelerate PhenoTM Gram-negative platform (RDT) paired with antimicrobial stewardship program (ASP) intervention projects to improve time to institutional-preferred antimicrobial therapy (IPT) for Gram-negative bacilli (GNB) bloodstream infections (BSIs). However, few data describe the impact of discrepant RDT results from standard of care (SOC) methods on antimicrobial prescribing. Methods A single-center, pre-/post-intervention study of consecutive, nonduplicate blood cultures for adult inpatients with GNB BSI following combined RDT + ASP intervention was performed. The primary outcome was time to IPT. An a priori definition of IPT was utilized to limit bias and to allow for an assessment of the impact of discrepant RDT results with the SOC reference standard. Results Five hundred fourteen patients (PRE 264; POST 250) were included. Median time to antimicrobial susceptibility testing (AST) results decreased 29.4 hours (P < .001) post-intervention, and median time to IPT was reduced by 21.2 hours (P < .001). Utilization (days of therapy [DOTs]/1000 days present) of broad-spectrum agents decreased (PRE 655.2 vs POST 585.8; P = .043) and narrow-spectrum beta-lactams increased (69.1 vs 141.7; P < .001). Discrepant results occurred in 69/250 (28%) post-intervention episodes, resulting in incorrect ASP recommendations in 10/69 (14%). No differences in clinical outcomes were observed. Conclusions While implementation of a phenotypic RDT + ASP can improve time to IPT, close coordination with Clinical Microbiology and continued ASP follow up are needed to optimize therapy. Although uncommon, the potential for erroneous ASP recommendations to de-escalate to inactive therapy following RDT results warrants further investigation.

scholarly journals Examining Second Graders’ Healthy Food Choices: Through Literacy and Active Learning

2019 ◽  
Vol 12 ◽  
pp. 117863881983906
Author(s):  
Elsie Lindy Olan ◽  
Laurie O. Campbell ◽  
Shiva Jahani
Keyword(s):  
Active Learning ◽  
Health Knowledge ◽  
Food Choices ◽  
Second Graders ◽  
Healthy Food ◽  
Second Grade ◽  
Post Intervention ◽  
Literacy Environment ◽  
Second Grade Students ◽  
Alternative Approach

The purpose of this study was to investigate the implementation of a nutrition module and activities ( Go, Slow, Whoa) in a literacy environment through an active learning approach. Second graders (N = 85) from diverse socioeconomic status (SES) areas completed the 12-week program. The participants’ perceptions of healthy food choices were measured both pre- and post-intervention. Students met for 30 minutes twice a week, to complete 5-lessons from a Coordinated Approach to Child Health ( CATCH) nutrition module and activities ( Go, Slow, Whoa). Measures were taken both pre- and post-intervention ( Food Fury Quiz) to distinguishing between healthy and unhealthy foods (images). There was a statistically significant improvement ( t = 12.16, df =84, P = .000) from pretest ( M = 19.06, SD = 3.13) and posttest ( M = 23.34, SD = 0.48) scores. Administering a healthy food choice curriculum through literacy and active learning provides an alternative approach to improving health knowledge among second grade students.

scholarly journals Predictors of Weight Loss Maintenance following an Insurance-Sponsored Weight Management Program

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Christiaan G. Abildso ◽  
Olivier Schmid ◽  
Megan Byrd ◽  
Sam Zizzi ◽  
Alessandro Quartiroli ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Weight Loss Maintenance ◽  
The United States ◽  
Management Program ◽  
Weight Management Program ◽  
Post Intervention ◽  
Physically Active ◽  
Intentional Weight Loss ◽  
Predictors Of Weight Loss

Intentional weight loss among overweight and obese adults (body mass index ≥ 25 kg/m2) is associated with numerous health benefits, but weight loss maintenance (WLM) following participation in weight management programming has proven to be elusive. Many individuals attempting to lose weight join formal programs, especially women, but these programs vary widely in focus, as do postprogram weight regain results. We surveyed 2,106 former participants in a community-based, insurance-sponsored weight management program in the United States to identify the pre, during, and post-intervention behavioral and psychosocial factors that lead to successful WLM. Of 835 survey respondents (39.6% response rate), 450 met criteria for inclusion in this study. Logistic regression analyses suggest that interventionists should assess and discuss weight loss and behavior change perceptions early in a program. However, in developing maintenance plans later in a program, attention should shift to behaviors, such as weekly weighing, limiting snacking in the evening, limiting portion sizes, and being physically active every day.

scholarly journals Sex Differences in the Effects of Repeated Taste Exposure to the Mediterranean Diet: A 6-month Follow-up Study

2016 ◽  
Vol 77 (3) ◽  
pp. 125-132 ◽  
Author(s):  
Alexandra Bédard ◽  
Louise Corneau ◽  
Sylvie Dodin ◽  
Simone Lemieux
Keyword(s):  
Body Weight ◽  
Sex Differences ◽  
Weight Management ◽  
Mediterranean Diet ◽  
Food Groups ◽  
Post Intervention ◽  
Time Interaction ◽  
The Mediterranean ◽  
Taste Exposure

Purpose: To determine whether an intervention based mainly on exposure to the Mediterranean diet (MedDiet), along with recommendations and tools for encouraging healthy eating, lead to different effects on dietary adherence and body weight management six months post-intervention in Canadian men and women. Methods: Thirty-eight males and 32 premenopausal females (all aged 24–53 years) were exposed to the same 4-week experimental MedDiet during which all foods were provided to participants. Participants also received some recommendations and tools to adhere to a healthy way of eating, with no other contact until the 6-month follow-up visit. Results: Compared with baseline, the Mediterranean score (MedScore) increased at the end of the 6-month follow-up (time effect P = 0.003), with no sex difference (sex-by-time interaction P = 0.97). With regard to MedScore components, sex differences were observed with males reporting changes in more dietary food groups than females. Although the intervention was not focused on body weight management, compared with baseline, BMI decreased during the intervention in both males and females; however, only females maintained the lower BMI 6 months after the intervention. Conclusions: Exposure to the MedDiet for a short duration promotes the adherence to this food pattern in both sexes and helps in the management of body weight, especially in females.

Abstract P140: The Association of Common Genetic Loci with Childhood Obesity in 1,612 Hispanic/Latino Children and Adolescents From Across the United States and Mexico

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Lindsay Fernández-Rhodes ◽  
Mariaelisa Graff ◽  
Jonathan Bradfield ◽  
Yujie Wang ◽  
Esteban J Parra ◽  
...  
Keyword(s):  
United States ◽  
Childhood Obesity ◽  
Children And Adolescents ◽  
Risk Allele ◽  
The United States ◽  
Latino Children ◽  
European Descent ◽  
Genome Wide ◽  
A Genome ◽  
Hispanic Latinos

Childhood obesity is a global health concern due to its potential to increase cardiometabolic risk across the life course. In the United States (US) the burden of childhood obesity is highest among Hispanic/Latinos, in particular children or adolescents of Mexican descent. Although the genetic epidemiology of childhood obesity has been studied previously, the potential for novel childhood obesity loci in Hispanic/Latinos and the generalizability of previously reported loci to Hispanic/Latino children and adolescents are still unknown. Thus we aimed to conduct a genome-wide association study of childhood obesity in 1,612 Hispanic/Latino children and adolescents (2-18 years) collected as part of one Mexican (n=794 Mexico City Study) and two US (n=362 Children’s Hospital of Philadelphia; n=456 Viva La Familia Study) studies, and to generalize 11 previously reported childhood obesity loci from European descent samples to our Hispanic/Latino samples. Obesity cases and controls were defined by BMI-for-age percentiles based on the Centers for Disease Control and Prevention smoothed and sex-specific growth curves from 2000, wherein cases had percentiles ≥95 th and controls had percentiles ≤85 th . Each study performed a genome-wide logistic regression analysis of single nucleotide polymorphism (SNPs) after adjusting for sex, population stratification and relatedness, as applicable. We combined study results for SNPs >10 minor allele counts and imputation quality ≥0.5 using fixed-effect inverse-variance weighted meta-analysis. A priori, we estimated that in our sample (n effective =1,498) we would have >80% power to detect common SNPs (>15% minor allele frequency) across the genome (p<5x10 -8 ) that increase the odds of childhood obesity of 55% per risk allele. Generalizability at 11 known childhood obesity loci was defined as p<0.05 and directional consistency with the previously reported obesity-increasing allele. We found 5 suggestive childhood obesity loci (p<4x10 -6 ), including a SNP that associated with an increased odds of childhood obesity of 54% per risk allele (73% frequent) at ARHGAP21, which is expressed in an enhancer region in brain, muscle and adipose tissues and has been previously implicated with trunk fat mass in Viva la Familia at another SNP (r 2 <0.08). Of the 11 known childhood obesity loci, 9 were directionally consistent (binomial p=0.03). SEC16B and TMEM18 generalized to Hispanic/Latinos (p≤0.01), corresponding to a 27% and 40% increased odds of obesity per risk allele (22-88% frequency). These preliminary results suggest the presence of novel loci for childhood obesity and the generalizability of genetic loci discovered in samples of European descent to Hispanic/Latinos, albeit with stronger effect sizes. Future work will attempt to identify additional Hispanic/Latino obesity cases and controls to replicate the suggestive associations.

scholarly journals Cost Savings Analysis of Individualized Exercise Oncology Programs

2019 ◽  
Vol 18 ◽  
pp. 153473541983946 ◽  
Author(s):  
Karen Y. Wonders ◽  
Rob Wise ◽  
Danielle Ondreka ◽  
Josh Gratsch
Keyword(s):  
Cancer Care ◽  
Cost Savings ◽  
Length Of Hospital Stay ◽  
Standard Of Care ◽  
National Standard ◽  
Cost Burden ◽  
Post Intervention ◽  
Before And After ◽  
The Impact ◽  
Exercise Oncology

Background: The physical and economic toll of cancer make it a high health priority. The rising cost of cancer care is now a primary focus for patients, payers, and providers. Escalating costs of clinical trials and national drug regulations have led the median monthly costs of cancer drugs to rise from less than $100 in 1965 to 1969, to more than $5000 in 2005 to 2009, stressing the importance of finding innovative ways to reduce cost burden. In the present study, we report the economic evaluation of an individualized exercise oncology program beginning early after diagnosis. Methods: An independent research group, ASCEND Innovations, retrospectively analyzed patient records to statistically demonstrate the impact of exercise oncology during cancer treatment. All patients completed 12 weeks of prescribed, individualized exercise that included cardiovascular, strength training, and flexibility components. The 3 primary hospital measures leveraged for statistical comparison before and after supportive care enrollment were number of encounters, number of readmissions, and average total charges, as well as emergency room visits and length of hospital stay ( P < .05). Results: The resulting dataset consisted of 1493 total hospital encounters for 147 unique patients. The results statistically demonstrate a positive effect of exercise oncology during cancer care, in terms of reductions in overall cost per patient pre- to post-intervention. Conclusions: Individualized exercise oncology programs should be employed as part of the national standard of care for individuals battling cancer, in order to improve patient outcome and reduce cost burden.

scholarly journals Differences in body dissatisfaction, weight-management practices and food choices of high-school students in the Bangkok metropolitan region by gender and school type

2016 ◽  
Vol 19 (7) ◽  
pp. 1222-1232 ◽  
Author(s):  
Pitipa Chongwatpol ◽  
Gail E Gates
Keyword(s):  
Physical Activity ◽  
Body Dissatisfaction ◽  
Weight Management ◽  
Management Practices ◽  
Food Choices ◽  
Metropolitan Region ◽  
School Type ◽  
Single Gender ◽  
Increased Risk ◽  
Mixed Gender

AbstractObjectiveThe present study aimed to compare body dissatisfaction, food choices, physical activity and weight-management practices by gender and school type.DesignA questionnaire was used to obtain height, weight, body image perception using Stunkard’s figure rating scale, food choices, physical activity and weight-management practices.SettingNine single- and mixed-gender schools located in Bangkok Metropolitan Region, Thailand.SubjectsStudents in 10th–12th grade, aged 15–18 years (n2082).ResultsOnly 18 % of females and 21 % of males did not indicate body dissatisfaction. About 66 % of females selected a thinner ideal figure than their current figure. Among males, 44 % wanted a thinner figure, but 35 % wanted a bigger figure. However, univariate analysis found differences by school type but not gender in the degree of body dissatisfaction; students in single-gender schools had more body dissatisfaction. Females reported using more weight-management practices but less physical activity, while males reported healthier food choices. Participants in single-gender schools had healthier food choices compared with those in mixed-gender schools. Adolescents who were at increased risk of a greater degree of body dissatisfaction were females, attended single-gender schools, had lower household income, higher BMI and less physical activity.ConclusionsMost participants reported being dissatisfied with their current body shape, but the type and level of dissatisfaction and use of weight-management practices differed by gender and type of school. These findings suggest that programmes to combat body dissatisfaction should address different risk factors in males and females attending single- and mixed-gender schools.

Personalized coupons for lower-calorie fast-food choices among young German adults and the influence of consumers' nutritional attitudes on promotion effectiveness

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Minh Thi Thuy Nguyen ◽  
Agnes Emberger-Klein ◽  
Klaus Menrad
Keyword(s):  
Fast Food ◽  
Food Choices ◽  
Economic Benefits ◽  
Control Treatment ◽  
Current Evidence ◽  
Future Research ◽  
Control Group ◽  
Grocery Stores ◽  
Post Intervention ◽  
Content Type

PurposePersonalized price promotion (PPP) is a marketing instrument that addresses the limitations of untargeted promotions by tailoring the offers to individual customers based on their purchase histories. Current evidence on PPP is limited to its immediate effects on buying behaviors at grocery stores and food companies' economic benefits. Moreover, little is known about the role of consumer characteristics in determining how effectively this promotional tool works. Hence, we aim to assess the effectiveness of PPP in promoting healthy fast food and which consumer-specific factors affect its performance.Design/methodology/approachThe authors conduct a laboratory experiment to examine the effects of personalized and non-personalized coupons for lower-calorie fast food menus on food and calorie selection. The coupon personalization is based on participants' menu choices, calorie needs and deal proneness. The authors additionally investigate how post-intervention changes are influenced by consumers' estimation of their selected calories, and their attitudes toward nutrition.FindingsRecipients of personalized incentives are more likely than participants in the control group to redeem the offered coupons, select more healthy items and reduce their selected calories. Such changes are less likely among participants underestimating the calorie content of their menu choices and perceiving higher barriers to healthy eating. Personalized coupons perform better even among subjects receiving lower discounting levels than the control treatment.Originality/valueAs the first to evaluate the effectiveness of PPP in encouraging healthy food choices, this study highlights the potential of this cutting-edge price intervention and provides valuable implications for future research.

scholarly journals Predictors of Attendance and Attrition Among Participants of Vidas Activas y Familias Saludables (VALÉ), a Pediatric Weight Management Program for Latino Families

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1615-1615
Author(s):  
Cindy Castro ◽  
Margaret Jones ◽  
Daisy Posada ◽  
Robyn Mehlenbeck ◽  
Sina Gallo
Keyword(s):  
Weight Management ◽  
Low Income ◽  
Management Program ◽  
Paternal Age ◽  
Latino Children ◽  
Weight Management Program ◽  
Poverty Level ◽  
Number Of Children ◽  
Pediatric Weight Management

Abstract Objectives To assess the demographic predictors of attrition and attendance among Latino children and their families participating in a family-based, culturally-adapted pediatric weight management program. Methods Latino children, ages 5–9 with a BMI-for-age ≥85th percentile were recruited from local schools and clinics serving low-income populations. Families met weekly as a group for ∼120 minutes for 10 consecutive weeks. The VALÉ program was designed to address nutrition, physical activity, and health behavior modification. The current analysis included data from four cohorts that participated in the VALÉ program between 2017 and 2019. Demographic variables were collected from families at baseline. Family attendance was recorded at each session and categorized (as ≤80% and &gt;80% of sessions attended). Attrition was defined the % of participants who returned for follow-up immediately post program completion. Differences in demographics between attendance and attrition groups were compared using X2 or T-Test and an alpha of 0.05 was used as the cutoff for significance. Results Participants (n = 88) had an average age of 7.6 years, 66% were male, and the majority of parents were born in Central America (78% of mothers, 74% of fathers). Average household size was 5.7 with 88% reported being &lt;185% of the federal poverty level. Overall, 18% attended &gt;80% of all sessions and 61% returned for follow-up. Both maternal and paternal age were significantly higher for those completed &gt;80% of sessions (P = 0.12 and 0.17, respectively) and returned for follow-up (P &lt; 0.01 and P = 0.05, respectively). The proportion of mothers who were employed was higher among those who completed &gt;80% of sessions (69%) compared with those attending fewer sessions (39%, P = 0.03). Total number of children in the household was lower among those who returned for follow-up (P = 0.04). Conclusions Among a Latino sample of children and their families participating in a pediatric weight management program, maternal and paternal age, number of children in the household, and maternal employment were important predictors of either program attendance and/or attrition. Funding Sources George Mason University, Potomac Health Foundation.

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