scholarly journals Exposure to a Multilevel, Multicomponent Obesity Prevention Intervention (OPREVENT2) in Rural Native American Communities: Variability and Association with Change in Diet Quality

2021 ◽  
Vol 18 (22) ◽  
pp. 12128
Author(s):  
Michelle Estradé ◽  
Ellen J. I. van Dongen ◽  
Angela C. B. Trude ◽  
Lisa Poirier ◽  
Sheila Fleischhacker ◽  
...  
Keyword(s):  
Native American ◽  
Obesity Prevention ◽  
Diet Quality ◽  
Geographic Region ◽  
Community Action ◽  
Complex Nature ◽  
Age Group ◽  
Food Stores ◽  
Intervention Trials ◽  
Group Sex

The OPREVENT2 obesity prevention trial was a multilevel multicomponent (MLMC) intervention implemented in rural Native American communities in the Midwest and Southwest U.S. Intervention components were delivered through local food stores, worksites, schools, community action coalitions, and by social and community media. Due to the complex nature of MLMC intervention trials, it is useful to assess participants’ exposure to each component of the intervention in order to assess impact. In this paper, we present a detailed methodology for evaluating participant exposure to MLMC intervention, and we explore how exposure to the OPREVENT2 trial impacted participant diet quality. There were no significant differences in total exposure score by age group, sex, or geographic region, but exposure to sub-components of the intervention differed significantly by age group, sex, and geographical region. Participants with the highest overall exposure scores showed significantly more improvement in diet quality from baseline to follow up compared to those who were least exposed to the intervention. Improved diet quality was also significantly positively associated with several exposure sub-components. While evaluating exposure to an entire MLMC intervention is complex and imperfect, it can provide useful insight into an intervention’s impact on key outcome measures, and it can help identify which components of the intervention were most effective.

scholarly journals OPREVENT (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans): Design of a Multilevel, Multicomponent Obesity Intervention for Native American Adults and Households

2019 ◽  
Vol 3 (Supplement_2) ◽  
pp. 81-93 ◽  
Author(s):  
Leslie C Redmond ◽  
Brittany Jock ◽  
Preety Gadhoke ◽  
Dorothy T Chiu ◽  
Karina Christiansen ◽  
...  
Keyword(s):  
Native American ◽  
Obesity Prevention ◽  
Controlled Trial ◽  
Health Behavior Change ◽  
Evidence Based ◽  
Intervention Effectiveness ◽  
Food Stores ◽  
Native North Americans ◽  
North Americans ◽  
Level Data

ABSTRACT Obesity prevalence is high in Native American (NA) adults, and there is a critical need to establish and implement evidence-based social, behavioral, and policy interventions that are theoretically informed. The use of multilevel, multicomponent (MLMC) interventions has been shown to be an effective strategy for comprehensive health behavior change; however, there is little guidance available in the literature to facilitate implementation in this underserved and understudied population. To decrease obesity and related comorbidities in NA adults, an MLMC intervention called OPREVENT (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans) was implemented in 5 rural NA communities to modify the food-purchasing environment, improve diet, and increase physical activity (PA). Five NA communities across the Upper Midwest and Southwest United States were randomly assigned to Immediate (n = 3) or Delayed (n = 2) Intervention. OPREVENT was implemented in Immediate Intervention community food stores, worksites, schools, and media over 1 y. A community-randomized controlled trial was used to evaluate intervention impact in adults at the individual and institutional levels, with individual-level data being collected on diet, PA, and psychosocial variables at baseline and follow-up; and institutional-level data being collected on food stores, worksites, and schools, media, and process measures. The OPREVENT intervention was one of the first MLMC obesity interventions in this population and provides evidence-based practices for future program development. The purpose of this article is to describe the design, implementation, and evaluation of OPREVENT. This trial was registered at isrctn.com as ISRCTN76144389.

scholarly journals OPREVENT2 Community Action Component to Promote Healthy Policy, Systems, and Environments With Native American Communities: Process Evaluation and Lessons Learned

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 140-140
Author(s):  
Brittany Jock ◽  
Joel Gittelsohn
Keyword(s):  
Physical Activity ◽  
Native American ◽  
Obesity Prevention ◽  
Community Action ◽  
Health Staff ◽  
Community Members ◽  
School Teachers ◽  
Community Partners ◽  
Stakeholder Groups ◽  
To Receive

Abstract Objectives To assess the implementation of the Community Action Component (CAC) of OPREVENT2, which aimed to promote healthy food and physical activity policies, systems, and environments (PSE) with six Native American communities. Methods OPREVENT2 examined the impact of a multi-level, multi-component obesity prevention intervention in six tribal communities in the Southwest and Midwest regions of the US (Three randomly selected to receive the intervention first, three to receive second). The CAC was designed to identify and develop PSE changes in partnership with community partners. We developed the following implementation standards prior to the intervention: we aimed to hold monthly meetings that were ≥1 hour and recruited ≥10 participants representing different stakeholder groups (health staff, store employee, tribal leader, school teachers/staff, and community members). We used measures of frequency to evaluate the extent that we met established reach, dose delivered, and fidelity standards. Results CAC meetings used participatory approaches to discuss ways to use PSE changes to encourage healthy eating and physical activity in stores, schools, worksites, and communities. Overall, we achieved high dose delivered; we held one monthly meeting on average that ranged 60–120 minutes. Reach varied by community; on average we attained 64%, 101%, 479% of the participants. Meetings were attended most often by community members, health staff, and tribal leaders, with low participation from store employees or school teachers/staff. Whenever possible, CAC meetings were planned with existing meetings to enhance reach to encourage sustainability and enable collaboration with community partners. Future interventions could develop a tribal council resolution to encourage other stakeholder groups to attend and promote sustainability of intersectoral work at an earlier stage. Assessing community readiness could assist in developing strategies to promote PSE changes that are tailored to each community. Conclusions The inclusion of CAC complements community-based obesity prevention strategies in Native American communities and can achieve moderate to high reach, dose-delivered, and fidelity. Funding Sources National Heart, Lung, and Blood Institute.

scholarly journals Implementation of a multilevel, multicomponent intervention for obesity control in Native American communities (OPREVENT2): challenges and lessons learned

2020 ◽  
Vol 35 (3) ◽  
pp. 228-242
Author(s):  
J Gittelsohn ◽  
B Jock ◽  
L Poirier ◽  
C Wensel ◽  
M Pardilla ◽  
...  
Keyword(s):  
Social Media ◽  
Native American ◽  
Process Evaluation ◽  
Local Community ◽  
Community Action ◽  
Lessons Learned ◽  
Intervention Component ◽  
Food Stores ◽  
Media Component ◽  
Implementation Level

Abstract OPREVENT2 was a multilevel, multicomponent (MLMC) adult obesity prevention that sought to improve access and demand for healthier food and physical activity opportunities in six Native American communities in the Southwest and Midwest. OPREVENT2 worked with worksites, food stores, schools (grades 2–6), through social media and mailings, and with a local community action committee (CAC), in each of the three intervention communities, and was implemented in six phases. We conducted a process evaluation to assess implementation of each intervention component in terms of reach, dose delivered and fidelity. Implementation of each component was classified as high, medium or low according to set standards, and reported back at the end of each phase, allowing for improvements. The school and worksite components were implemented with high reach, dose delivered and fidelity, with improvement over time. The school program had only moderate reach and dose delivered, as did the social media component. The CAC achieved high reach and dose delivered. Overall, study reach and dose delivered reached a high implementation level, whereas fidelity was medium. Great challenges exist in the consistent implementation of MLMC interventions. The detailed process evaluation of the OPREVENT2 trial allowed us to carefully assess the relative strengths and limitations of each intervention component.

scholarly journals Even Pacing Is Associated with Faster Finishing Times in Ultramarathon Distance Trail Running—The “Ultra-Trail du Mont Blanc” 2008–2019

2020 ◽  
Vol 17 (19) ◽  
pp. 7074 ◽  
Author(s):  
Daniel Suter ◽  
Caio Victor Sousa ◽  
Lee Hill ◽  
Volker Scheer ◽  
Pantelis Theo Nikolaidis ◽  
...  
Keyword(s):  
General Linear Model ◽  
Performance Level ◽  
Age Group ◽  
Younger Age ◽  
Pacing Strategies ◽  
And Performance ◽  
Group Sex ◽  
The Impact ◽  
Trail Running ◽  
One Way Anova

In recent years, there has been an increasing number of investigations analyzing the effects of sex, performance level, and age on pacing in various running disciplines. However, little is known about the impact of those factors on pacing strategies in ultramarathon trail running. This study investigated the effects of age, sex, and performance level on pacing in the UTMB® (Ultra-trail du Mont Blanc) and aimed to verify previous findings obtained in the research on other running disciplines and other ultramarathon races. Data from the UTMB® from 2008 to 2019 for 13,829 race results (12,681 men and 1148 women) were analyzed. A general linear model (two-way analysis of variance (ANOVA)) was applied to identify a sex, age group, and interaction effect in pace average and pace variation. A univariate model (one-way ANOVA) was used to identify a sex effect for age, pace average, and pace variation for the fastest men and women. In our study, pace average and a steadier pace were positively correlated. Even pacing throughout the UTMB® correlated with faster finishing times. The average pace depended significantly on sex and age group. When considering the top five athletes in each age group, sex and age group also had significant effects on pace variation. The fastest women were older than the fastest men, and the fastest men were faster than the fastest women. Women had a higher pace variation than men. In male competitors, younger age may be advantageous for a successful finish of the UTMB®. Faster male runners seemed to be younger in ultramarathon trail running with large changes in altitude when compared to other distances and terrains.

scholarly journals Geographic Regional Variation in Patterns of Racial and Ethnic Disparities in Late-Life Depression

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Chirag Vyas ◽  
Charles Reynolds ◽  
David Mischoulon ◽  
Grace Chang ◽  
Olivia Okereke
Keyword(s):  
Native American ◽  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Late Life ◽  
Geographic Region ◽  
Omega 3 ◽  
Late Life Depression ◽  
Item Level ◽  
Racial Ethnic ◽  
Hispanic White

Abstract There is evidence of racial/ethnic disparities in late-life depression (LLD) burden and treatment in the US. Geographic region may be a novel social determinant; yet, limited data exist regarding the interplay of geographic region with racial/ethnic differences in LLD severity, item-level symptom burden and treatment. We conducted a cross-sectional study among 25,503 men aged 50+ years and women aged 55+ years in VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary study to the VITAL trial. Racial/ethnic groups included Non-Hispanic White, Black, Hispanic, Asian, and other groups (Native American/Alaskan Native and other/multiple/unspecified-race/ethnicity). We assessed depression status using: the Patient Health Questionnaire-8 (PHQ-8); self-reported clinician/physician diagnosis of depression; medication and/or counseling treatment for depression. In the full sample, Midwest region was significantly associated with 12% lower severity of LLD, compared to Northeast region (rate ratio (RR) (95% confidence interval (CI)): 0.88 (0.83-0.93)). However, racial/ethnic differences in LLD varied by region. For example, in the Midwest, Blacks and Hispanics had significantly higher depression severity compared to non-Hispanic Whites (RR (95% CI): for Black, 1.16 (1.02-1.31); for Hispanic, 2.03 (1.38-3.00)). Furthermore, in multivariable-adjusted logistic regression models, minority vs. non-Hispanic White adults had 2- to 3-fold significantly higher odds of several item-level symptoms across all regions, especially in the Midwest and Southwest. Finally, among those endorsing PHQ-8≥10, Blacks had 60-80% significantly lower odds of depression treatment, compared to non-Hispanic Whites, in all regions. In summary, we observed significant geographic variation in patterns of racial/ethnic disparities in LLD outcomes. This requires further longitudinal investigation.

scholarly journals Trends and Rural-Urban Differences in Asthma Hospitalizations in Saskatchewan 1970-1989

1994 ◽  
Vol 1 (4) ◽  
pp. 229-234 ◽  
Author(s):  
A Senthilselvan
Keyword(s):  
Regression Models ◽  
Age Groups ◽  
Age Group ◽  
Hospitalization Rates ◽  
Rural And Urban ◽  
Asthma Hospitalization ◽  
Group Sex ◽  
Rate Ratios ◽  
Rural Dwellers

OBJECTIVE: To examine the trends in hospitalization rates for atsthma in Saskatchewan from 1970 to 1989 and to investigate the differences in asthma hospitalization rates between rural and urban dwellers.DESIGN: Asthma hospitalization rates were calculated for the age groups O to 4, 5 to 9. 10 to 14, 15 to 24. 25 to 34. 35 to 49 and 50 to 64 years for the period between 1970 and 1989. Only the first admission in each year for each person was included in the analysis. As the classification of asthma changed in 1978. trends in asthma hospitalization rates were investigated separately for the periods 1970 to 1978 and 1979 to 1989. respectively. Rate ratios were obtained for male/female and rural/urban comparisons by fitting Poisson regression models.SETTING: The hospitalization data for respiratory diseases for the province of Saskatchewan were examined by age group, sex and place or residence.RESULT: No significant increases were observed in asthma hospitalization rates lrorn 1970 to 1978. In the period 1979 to 1989. asthma hospitalization rates increased significantly among children under four years from 4.31/1000 in 1979 to 7.04/1000 in 1989. Among children under 14 years. asthma hospitalization rates were greater in boys than in girls . The converse was true for adults aged 15 and above, with women having a higher hospitalization rate for asthma than men . In adults aged 35 and above. rural dwellers had higher hospitalization rates for asthma than urban dwellers throughout the study period. In other age groups, although rural dwellers had higher asthma hospitalization rates than did urban dwellers during 1970 to 1984. the differences disappered duri ng 1985 to 1989.CONCLUSION: Further studies are required to find reasons for the increase in asthma hospitalizations among young children under four years old and for the differences between rural and urban dwellers in the age group 35 years and above.

scholarly journals Estimating, monitoring, and forecasting COVID-19 epidemics: a spatiotemporal approach applied to NYC data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vinicius V. L. Albani ◽  
Roberto M. Velho ◽  
Jorge P. Zubelli
Keyword(s):  
New York ◽  
New York City ◽  
Census Data ◽  
Age Group ◽  
Age Classes ◽  
Basic Model ◽  
Monitoring And Forecasting ◽  
Group Sex ◽  
Age Range ◽  
Spatial Locations

AbstractWe propose a susceptible-exposed-infective-recovered-type (SEIR-type) meta-population model to simulate and monitor the (COVID-19) epidemic evolution. The basic model consists of seven categories, namely, susceptible (S), exposed (E), three infective classes, recovered (R), and deceased (D). We define these categories for n age and sex groups in m different spatial locations. Therefore, the resulting model contains all epidemiological classes for each age group, sex, and location. The mixing between them is accomplished by means of time-dependent infection rate matrices. The model is calibrated with the curve of daily new infections in New York City and its boroughs, including census data, and the proportions of infections, hospitalizations, and deaths for each age range. We finally obtain a model that matches the reported curves and predicts accurate infection information for different locations and age classes.

scholarly journals Scottish Burden of Disease (SBOD) study: developments and findings of local estimates

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Grant Wyper ◽  
Ian Grant ◽  
Eilidh Fletcher ◽  
Gerry McCartney ◽  
Diane Stockton
Keyword(s):  
Burden Of Disease ◽  
Local Population ◽  
National Policy ◽  
Years Of Life Lost ◽  
Age Group ◽  
Local Policy ◽  
Local Authorities ◽  
Life Years ◽  
Group Sex ◽  
The Right

BackgroundA criticism of Burden of Disease (BOD) estimates has been that they only provide evidence for national policy and aren’t relevant for local needs. This has led to a growing call for BOD studies to provide more granular estimates for sub-national geographies, particularly within European countries, to help support local policy makers with evidence-based decision making. AimTo develop local BOD estimates and investigate inequalities in BOD within and across local areas of Scotland. MethodsEstimates of Years Lived with Disability (YLD), Years of Life Lost (YLL), DALYs (Disability-adjusted Life Years), prevalent cases and mortality counts were developed for 68 conditions. Morbidity estimates were calculated based on a three-year average of 5-year age-group, sex and deprivation decile rates per person (from the SBOD 2016 study) which were applied to 2016 mid-year local population estimates. Mortality estimates were based on a three-year average (2014-16) sourced from the National Records of Scotland register of deaths. Direct age-standardised rates and numbers were produced for regions (3), NHS boards (14) and local authorities (32) by age-group and sex. ResultsAcross local authorities the male rate of all-cause DALYs ranged from 20,996 (per 100,000 population) to 33,442 and the female rate of all-cause DALYs ranged from 19,889 to 27,684. Inequalities in age-group (15-24; 25-44; 45-64; and 65+ years) differences between all-cause DALYs rates in the area with the highest and lowest rates ranged from 58.4% to 98.0% in males. Comparable estimates were slightly lower for females, but inequalities in rates were wider (41.4% to 87.4%). ConclusionInequalities in BOD across areas highlight the need for action at all levels. These local estimates provide a huge opportunity to work towards and beyond the 2020 vision of the Scottish Government by ensuring that we have the right workforce and services to achieve a healthier Scotland.

scholarly journals The Incidence of Surgical Site Infection in Acute Non Perforated Appendicitis

2019 ◽  
Vol 9 (2) ◽  
pp. 11-14
Author(s):  
Suraj Raj Bhattarai ◽  
Kishor Kumar Tamrakar
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Perforated Appendicitis ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Age Group ◽  
Site Infection ◽  
Cross Sectional ◽  
Significant Difference ◽  
Group Sex

Background: Appendectomy is the most commonly performed emergency  surgical procedure and has significant morbidity of surgical site infection (SSIs). Regarding this, there are conflicting reports and dilemma on use of optimal duration of antibiotics. The aim of this study was to evaluate the incidence of SSIs after three doses of perioperative prophylactic antibiot­ics (single dose before surgery and two doses postoperatively) after ap­pendectomy in acute non- perforated appendicitis (NPA). Methods: This cross sectional study was conducted in the department of General surgery, Chitwan Medical College Teaching Hospital, from May 2018 to April 2019. All the cases received single dose of antibiotics (cef­triaxone and metronidazole) during the induction of anesthesia and two doses of the same antibiotics postoperatively within 24 hours. SSIs was assessed on 2nd and followed up till 7th postoperative day. The data col­lected was analyzed using SPSS version 16. Results: In the study of 100 patients, who received perioperative three doses of antibiotics, the overall frequency of SSIs on 2nd and 3rd post-operative day were 2% (p=.840) and 6% (p=.539) respectively, which was statistically not significant. In follow up after 3rd postoperative day, there was no evidence of SSIs. Statistically there was no significant difference in the incidence and grade of SSIs between age group, sex and duration of operation. Conclusions: A combined three doses of perioperative antibiotics was ad­equate for SSIs prevention in patients of any age group and sex with acute NPA after appendectomy in usual operative time.

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