Weight Matters—Factors Influencing Eating Behaviors of Vulnerable Women

Women from low socioeconomic backgrounds are more affected by obesity than men. The influence of weight as a determinant of women’s eating behaviors has seldom been studied, especially in Latin America. In this study, we analyzed the food choices of vulnerable women according to their weight status. We conducted photo-elicitation interviews with 31 women from low-income neighborhoods in Santiago, Chile. Weight and height were measured and participants were divided into normal weight (n = 9), overweight (n = 15), and obese groups (n = 7) according to World Health Organization (WHO) body mass index (BMI) categories (p < 0.001). Quantitative and qualitative approaches were used for the analysis. Women in overweight and obese groups described more about their families, temporality, financial issues, and food perception. When weight groups were analyzed separately, more factors explaining eating behaviors were found (mental and physical health, body dissatisfaction, gender role, and obstacles for eating healthy) in the obese group. Results suggest that women with obesity or overweight based their diets on more internal and external factors than did normal weight women. This study contributes to our understanding of why changing behaviors can be difficult in women with obesity. Health care providers should consider these factors in the implementation of programs to address the need for a healthy diet for overweight and obese women.

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Maternal perceptions of 5-year-old child weight status and factors influencing perceptions: Findings from the ROLO Kids Study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001676 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Anna Gouldson ◽

Aisling Geraghty ◽

Eileen O'Brien ◽

Mary Horan ◽

Jean Donnelly ◽

...

Keyword(s):

Health Care Providers ◽

Weight Status ◽

Normal Weight ◽

Care Providers ◽

Maternal Perceptions ◽

Kappa Score ◽

Weight Category ◽

Child Weight ◽

Factors Influencing ◽

Child’S Weight

AbstractIntroductionObesity is a global condition affecting both adults and children. Mothers play an important role in identifying problems with their child's weight. However, studies are limited on the accuracy of maternal perceptions of her child's weight status in early childhood. The aim of this study was to look at maternal perceptions of her child's weight status in 5-year-old children and to investigate factors influencing this.Materials and Methods339 mother and child pairs were followed up from the ROLO Kids study in the National Maternity Hospital, Dublin, Ireland. Height and weight of the mother and the child were measured, and BMI was calculated. Demographic details were collected and questionnaires asked mothers to assign their child to a weight category and to give the reason they put their child in this particular category. KAPPA analysis and student t tests were used to analyse the data.ResultsIn this cohort over 75% of the children were normal weight, 14.7% were in the overweight category, and 8.5% in the obese category. The KAPPA score for maternal-perceived category and actual weight status was 0.037 which is a low level of agreement. Mothers were more likely to underestimate their child's weight, with 28.5% underestimating the appropriate weight category for their child compared with 2.4% who overestimated. Maternal age, education, and child sex did not influence accurate weight assessments; however, mothers with a higher BMI were more likely to inaccurately assess their child's weight (P < 0.05).DiscussionMaternal perception of their child's weight status is not an accurate indication of child weight, particularly for mothers with a raised BMI. This research highlights the important role of health care providers in assessing child weight status, rather than relying on parental reports alone, in order to appropriately intervene to reduce the incidence of childhood obesity.

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Prevalence and Documentation Rates of Obesity in Hospitalized Patients: Results of a Retrospective Cohort Study

10.20944/preprints201807.0141.v1 ◽

2018 ◽

Author(s):

Mohammad A. Hossain ◽

Ami Amin ◽

Anju Paul ◽

Huzaif Qaisar ◽

Monika Akula ◽

...

Keyword(s):

Health Care Providers ◽

Weight Status ◽

Average Length ◽

Medical Center ◽

Normal Weight ◽

Hospitalized Patients ◽

Obese Patients ◽

Discharge Diagnosis ◽

Care Providers ◽

Management Interventions

While obesity is a serious chronic condition, its prevalence and documentation as a diagnosis has not been extensively studied in hospitalized patients. We conducted a retrospective chart review to investigate the prevalence and documentation of obesity as a diagnosis among patients admitted to our medical center. IRB approval was obtained for this retrospective study. Body mass index as per CDC, admission and discharge diagnosis of obesity and common comorbidities including hypertension, diabetes, hyperlipidemia and others, were recorded. Length of hospital stay was calculated. We also investigated whether counselling for weight loss was provided to obese patients. A total of 540 consecutive patients with mean age of 66 ± 6 years, were investigated, of which 182(34%) had normal weight, 188(35%) patients were overweight and 170(31%) patients were obese. Obese group included 55% female and 45% male. 100 (59%) had class I obesity, 43(25%) had class II obesity and 27(16%) class III obesity. Of the obese patients 40/170(23.5%) patients had obesity documented on the admission problem list and only 21(12%) had obesity documented as a discharge diagnosis. Only 3(2%) patients received appropriate counseling and referral for obesity management during the hospitalization. Comorbidities included hypertension (68%), diabetes (35%), hyperlipidemia (36%), coronary artery disease (18%), chronic kidney disease (17%), congestive heart failure (18%) and COPD (24%). The average length of stay in normal weight, overweight and obese patients was similar (4.5 ± 0.5 days). An overwhelming percentage never had weight status documented despite significant prevalence of obesity. Hospitalization offers health care providers a window of opportunity to identify obesity, communicate risks and initiate weight management interventions.

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

BMC Public Health ◽

10.1186/s12889-021-11395-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hannah Maria Jennings ◽

Joanna Morrison ◽

Kohenour Akter ◽

Hassan Haghparast-Bidgoli ◽

Carina King ◽

...

Keyword(s):

Quality Of Care ◽

Health Care Providers ◽

Low Income ◽

Diabetes Management ◽

Local Health ◽

Care Seeking ◽

Care Providers ◽

Structured Interviews ◽

Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

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Obesity in Children and Adolescents during COVID-19 Pandemic

Children ◽

10.3390/children8020135 ◽

2021 ◽

Vol 8 (2) ◽

pp. 135

Author(s):

Androniki Stavridou ◽

Evangelia Kapsali ◽

Eleni Panagouli ◽

Athanasios Thirios ◽

Konstantinos Polychronis ◽

...

Keyword(s):

Physical Activity ◽

Young Adults ◽

Health Care Providers ◽

Eating Behaviors ◽

Adolescents And Young Adults ◽

Care Providers ◽

Weight Changes ◽

Sugary Drinks ◽

Precautionary Measures ◽

Obesity In Children

Background: The COVID-19 pandemic has led to special circumstances and changes to everyday life due to the worldwide measures that were imposed such as lockdowns. This review aims to evaluate obesity in children, adolescents and young adults during the COVID-19 pandemic. Methods: A literature search was conducted to evaluate pertinent studies up to 10 November 2020. Results: A total of 15 articles were eligible; 9 identified 17,028,111 children, adolescents and young adults from 5–25 years old, 5 pertained to studies with an age admixture (n = 20,521) and one study included parents with children 5–18 years old (n = 584). During the COVID-19 era, children, adolescents and young adults gained weight. Changes in dietary behaviors, increased food intake and unhealthy food choices including potatoes, meat and sugary drinks were noted during the ongoing COVID-19 pandemic. Food insecurity associated with financial reasons represents another concern. Moreover, as the restrictions imposed reduced movements out of the house, physical activity was limited, representing another risk factor for weight gain. Conclusions: COVID-19 restrictions disrupted the everyday routine of children, adolescents and young adults and elicited changes in their eating behaviors and physical activity. To protect them, health care providers should highlight the risk of obesity and provide prevention strategies, ensuring also parental participation. Worldwide policies, guidelines and precautionary measures should ideally be established.

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Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part I. Historical Perspective

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2018.41 ◽

2018 ◽

Vol 13 (02) ◽

pp. 109-115 ◽

Cited By ~ 1

Author(s):

Frederick M. Burkle ◽

Adam L. Kushner ◽

Christos Giannou ◽

Mary A. Paterson ◽

Sherry M. Wren ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Armed Conflict ◽

Historical Perspective ◽

Geneva Convention ◽

World Health ◽

International Humanitarian Law ◽

Humanitarian Law ◽

Care Providers ◽

The Impact

AbstractSince 1945, the reason for humanitarian crises and the way in which the world responds to them has dramatically changed every 10 to 15 years or less. Planning, response, and recovery for these tragic events have often been ad hoc, inconsistent, and insufficient, largely because of the complexity of global humanitarian demands and their corresponding response system capabilities. This historical perspective chronicles the transformation of war and armed conflicts from the Cold War to today, emphasizing the impact these events have had on humanitarian professionals and their struggle to adapt to increasing humanitarian, operational, and political challenges. An unprecedented independent United Nations–World Health Organization decision in the Battle for Mosul in Iraq to deploy to combat zones emergency medical teams unprepared in the skills of decades-tested war and armed conflict preparation and response afforded to health care providers and dictated by International Humanitarian Law and Geneva Convention protections has abruptly challenged future decision-making and deployments. (Disaster Med Public Health Preparedness. 2019;13:109–115)

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Immigrant Communities and COVID-19: Strengthening the Public Health Response

American Journal of Public Health ◽

10.2105/ajph.2021.306433 ◽

2021 ◽

Vol 111 (S3) ◽

pp. S224-S231

Author(s):

Lan N. Đoàn ◽

Stella K. Chong ◽

Supriya Misra ◽

Simona C. Kwon ◽

Stella S. Yi

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Providers ◽

Low Income ◽

Immigrant Communities ◽

Care Providers ◽

Public Health Response ◽

The Public ◽

Public Health Infrastructure ◽

Health Infrastructure

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )

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Training health workers to provide person-centred maternal and newborn health care in Burkina Faso

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v3i2.405 ◽

2013 ◽

Vol 3 (2) ◽

pp. 154-159

Author(s):

Janet Perkins ◽

Aminata Bargo ◽

Cecilia Capello ◽

Carlo Santarelli

Keyword(s):

Health Care ◽

Burkina Faso ◽

Health Care Providers ◽

Health Workers ◽

Healthcare Providers ◽

Newborn Health ◽

World Health ◽

Maternal And Newborn Health ◽

Care Providers ◽

Maternal And Newborn

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities. While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.

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Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.09070620 ◽

2020 ◽

Vol 16 (1) ◽

pp. 79-87

Author(s):

Meaghan Lunney ◽

Aminu K. Bello ◽

Adeera Levin ◽

Helen Tam-Tham ◽

Chandra Thomas ◽

...

Keyword(s):

Health Care Providers ◽

Low Income ◽

Kidney Failure ◽

Low Income Countries ◽

Multidisciplinary Teams ◽

Spiritual Support ◽

Care Providers ◽

The Status ◽

Kidney Health

Background and objectivesPeople with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality.Design, setting, participants, & measurementsThe Global Kidney Health Atlas is an ongoing initiative of the International Society of Nephrology that aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 Global Kidney Health Atlas survey, specifically addressing the availability, accessibility, and quality of conservative kidney management.ResultsRespondents from 160 countries completed the survey, and 154 answered questions pertaining to conservative kidney management. Of these, 124 (81%) stated that conservative kidney management was available. Accessibility was low worldwide, particularly in low-income countries. Less than half of countries utilized multidisciplinary teams (46%); utilized shared decision making (32%); or provided psychologic, cultural, or spiritual support (36%). One-quarter provided relevant health care providers with training on conservative kidney management delivery.ConclusionsOverall, conservative kidney management is available in most countries; however, it is not optimally accessible or of the highest quality.

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A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

Frontiers in Public Health ◽

10.3389/fpubh.2021.762784 ◽

2021 ◽

Vol 9 ◽

Author(s):

Alicia K. Matthews ◽

Karriem S. Watson ◽

Cherdsak Duang ◽

Alana Steffen ◽

Robert Winn

Keyword(s):

Health Care ◽

Smoking Cessation ◽

Health Care Providers ◽

Low Income ◽

Access To Health Care ◽

Social Determinant ◽

Evidence Based ◽

Patient Portal ◽

Care Providers ◽

Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

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