scholarly journals Logical Model of a Program to Combat Child and Adolescent Obesity in Supplementary Health

2021 ◽  
Vol 25 (272) ◽  
pp. 135-145
Author(s):  
Valéria Cristina de Faria ◽  
Júlio César Piedade de Medeiros dos Santos Rocha ◽  
Larissa Quintão Guilherme ◽  
Leomarques da Silveira Queiroz ◽  
Guilherme Lopes de Oliveira ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Childhood And Adolescence ◽  
Private Institutions ◽  
Logical Model ◽  
Public And Private ◽  
Intervention Models ◽  
Medical Evaluation ◽  
Physical Educator ◽  
Multiprofessional Approach

Actions to combat obesity in childhood and adolescence in the context of supplementary health are necessary and there is a scarcity in the literature of intervention models that address this theme. The aim of this study was to describe the intervention and the model of a program to combat obesity, by a health care operator. The Espaço MultiDiversão program is a modality offered by the Agros Service of Physical Activity and Health (Espaço Movimento), a partnership between the Federal University of Viçosa - Campus Florestal (UFV-CAF) and your health plan operator, which aims to serve the beneficiaries of 6 to 15 years of age residing in Florestal-MG. This program is developed in Florestal, Minas Gerais, Brazil, at UFV-CAF. The data presented in this study refer to the first class selected in September 2017. The interested are subject to physical evaluation and medical evaluation. The intervention happens under the coordination of a physical educator, and has a multiprofessional approach of the physical education, nutrition and psychology. In this logical model highlights the partnership of public and private institutions, which enabled the necessary resources for this intervention, and data are presented that justify the investment in programs in primary care.

The impact of participant pathways on the effectiveness of a community-based physical activity intervention grounded in motivational interviewing

2020 ◽  
Author(s):  
Matthew Wade ◽  
Nicola Brown ◽  
James Steele ◽  
Steven Mann ◽  
Bernadette Dancy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Motivational Interviewing ◽  
Social Action ◽  
Multilevel Models ◽  
Physical Activity Intervention ◽  
Mental Wellbeing ◽  
Community Based ◽  
The Impact ◽  
Time Point

Background: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental wellbeing after a motivational interviewing (MI) community-based PA intervention and the impact of signposting [SP] and Social Action [SA] (i.e. weekly group support) pathways. Methods: Participants (n=2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental wellbeing data were collected at baseline (following an initial 30-minute MI appointment), 12-weeks, six-months, and 12-months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models were used to derive point estimates and 95%CIs for outcomes at each time point and change scores. Results: Participants increased PA and mental wellbeing at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12-weeks, but the SP pathway retained more participants at six-months and 12-months. Conclusions: Both pathways produced similar improvements in PA and mental wellbeing, suggesting the effectiveness of MI based PA interventions. However, due to lower resources required yet similar effects, SP pathways are recommended over SA to support PA in primary care settings.

Experiences in physical activity promotion in health care settings for primary prevention in the UK

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Controlled Trial ◽  
Full Range ◽  
Tertiary Care ◽  
Physical Activity Promotion ◽  
Community Based ◽  
Activity Promotion ◽  
Randomised Controlled

In addition to the delivery of primary care services, recent changes to the NHS in the United Kingdom have placed increasing responsibility on GPs for the commissioning of the full range of health services from prevention through to clinical interventions and rehabilitation. Whilst historically there has always been an expectation that primary care professionals were ideally placed to provide support for prevention as well as treatment, their active engagement in the promotion of physical activity has remained largely superficial. With notable exceptions where individuals have a personal interest or commitment, the majority of health professionals tend to limit themselves to peremptory non-specific advice at best, or frequently don’t broach the subject at all. There are a number of reasons for this including increasing time pressures, a general lack of knowledge, limited evidence and concerns about litigation in the event of an adverse exercise induced event. However in the 1990s there was a surge of interest in the emerging “Exercise on Prescription” model where patients could be referred to community based exercise instructors for a structured “prescription” of exercise in community leisure centres. Despite the continuing popularity of the model there remain problems particularly in getting the active support of health professionals who generally cite the same barriers as previously identified. In an attempt to overcome some of these problems Wales established a national exercise referral scheme with an associated randomised controlled trial. The scheme evaluated well and had subsequently evolved with new developments including integration with secondary and tertiary care pathways, accredited training for exercise instructors and exit routes into alternative community based exercise opportunities.

The Evolution of Physical Activity on Prescription (FaR) in Sweden

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Healthcare Professionals ◽  
Systems Approach ◽  
Ecological Model ◽  
Controlled Trial ◽  
Professional Associations ◽  
Successful Implementation ◽  
Surgeon General ◽  
Positive Effects

In 1996, the first Report of the US Surgeon General on Physical Activity and Health provided an extensive knowledge overview about the positive effects of physical activity (PA) on several health outcomes and PA recommendations. This contributed to an enhanced interest for PA in Sweden. The Swedish Professional Associations for Physical Activity (YFA) were appointed to form a Scientific Expert Group in the project “Sweden on the Move” and YFA created the idea of Physical Activity on Prescription (FaR) and the production of a handbook (FYSS) for healthcare professionals. In Swedish primary care, licensed healthcare professionals, i.e. physicians, physiotherapists and nurses, can prescribe PA if they have sufficient knowledge about the patient’s current state of health, how PA can be used for promotion, prevention and treatment and are trained in patient-centred counselling and the FaR method. The prescription is followed individually or by visiting local FaR providers. These include sport associations, patient organisations, municipal facilities, commercial providers such as gyms, sports clubs and walking clubs or other organisations with FaR educated staff such as health promoters or personal trainers. In clinical practice, the FaR method increases the level of PA in primary care patients, at 6 and at 12 months. Self-reported adherence to the prescription was 65% at 6 months, similar to the known compliance for medications. In a randomised controlled trial, FaR significantly improved body composition and reduced metabolic risk factors. It is suggested that a successful implementation of PA in healthcare depends on a combination of a systems approach (socio-ecological model) and the strengthening of individual motivation and capability. General support from policymakers, healthcare leadership and professional associations is important. To lower barriers, tools for implementation and structures for delivery must be readily available. Examples include handbooks such as FYSS, the FaR system and the use of pedometers.

scholarly journals The Role of Place of Delivery in Preventing Neonatal and Infant Mortality Rate in India

Geographies ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 47-62
Author(s):  
Ujjwal Das ◽  
Barkha Chaplot ◽  
Hazi Mohammad Azamathulla
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Public Hospitals ◽  
Infant Mortality Rate ◽  
Private Institutions ◽  
Public And Private ◽  
Place Of Delivery ◽  
At Home

Skilled birth attendance and institutional delivery have been advocated for reducing maternal, neonatal mortality and infant mortality (NMR and IMR). This paper examines the role of place of delivery with respect to neo-natal and infant mortality in India using four rounds of the Indian National Family Health Survey conducted in 2015–2016. The place of birth has been categorized as “at home” or “public and private institution.” The role of place of delivery on neo-natal and infant mortality was examined by using multivariate hazard regression models adjusted for clus-tering and relevant maternal, socio-economic, pregnancy and new-born characteristics. There were 141,028 deliveries recorded in public institutions and 54,338 in private institutions. The esti-mated neonatal mortality rate in public and private institutions during this period was 27 and 26 per 1000 live births respectively. The study shows that when the mother delivers child at home, the chances of neonatal mortality risks are higher than the mortality among children born at the health facility centers. Regression analysis also indicates that a professionally qualified provider′s antenatal treatment and assistance greatly decreases the risks of neonatal mortality. The results of the study illustrate the importance of the provision of institutional facilities and proper pregnancy in the prevention of neonatal and infant deaths. To improve the quality of care during and imme-diately after delivery in health facilities, particularly in public hospitals and in rural areas, accel-erated strengthening is required.

scholarly journals Long-term effectiveness of elderly health care voucher scheme strategies: a system dynamics simulation analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ka Chun Chong ◽  
Hong Fung ◽  
Carrie Ho Kwan Yam ◽  
Patsy Yuen Kwan Chau ◽  
Tsz Yu Chow ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Public Sector ◽  
System Dynamics ◽  
The Elderly ◽  
Healthcare Services ◽  
Dynamics Simulation ◽  
Public And Private ◽  
The Public ◽  
The Impact

Abstract Background The elderly healthcare voucher (EHCV) scheme is expected to lead to an increase in the number of elderly people selecting private primary healthcare services and reduce reliance on the public sector in Hong Kong. However, studies thus far have reported that this scheme has not received satisfactory responses. In this study, we examined changes in the ratio of visits between public and private doctors in primary care (to measure reliance on the public sector) for different strategic scenarios in the EHCV scheme. Methods Based on comments from an expert panel, a system dynamics model was formulated to simulate the impact of various enhanced strategies in the scheme: increasing voucher amounts, lowering the age eligibility, and designating vouchers for chronic conditions follow-up. Data and statistics for the model calibration were collected from various sources. Results The simulation results show that the current EHCV scheme is unable to reduce the utilization of public healthcare services, as well as the ratio of visits between public and private primary care among the local aging population. When comparing three different tested scenarios, even if the increase in the annual voucher amount could be maintained at the current pace or the age eligibility can be lowered to include those aged 60 years, the impact on shifts from public-to-private utilization were insignificant. The public-to-private ratio could only be marginally reduced from 0.74 to 0.64 in the first several years. Nevertheless, introducing a chronic disease-oriented voucher could result in a significant drop of 0.50 in the public-to-private ratio during the early implementation phase. However, the effect could not be maintained for an extended period. Conclusions Our findings will assist officials in improving the design of the EHCV scheme, within the wider context of promoting primary care among the elderly. We suggest that an additional chronic disease-oriented voucher can serve as an alternative strategy. The scheme must be redesigned to address more specific objectives or provide a separate voucher that promotes under-utilized healthcare services (e.g., preventive care), instead of services designed for unspecified reasons, which may lead to concerns regarding exploitation.

scholarly journals Wastewater Surveillance for SARS-CoV-2 on College Campuses: Initial Efforts, Lessons Learned, and Research Needs

2021 ◽  
Vol 18 (9) ◽  
pp. 4455
Author(s):  
Sasha Harris-Lovett ◽  
Kara L. Nelson ◽  
Paloma Beamer ◽  
Heather N. Bischel ◽  
Aaron Bivins ◽  
...  
Keyword(s):  
Information Needs ◽  
Community Dynamics ◽  
The United States ◽  
Lessons Learned ◽  
Future Research ◽  
Private Institutions ◽  
Community Members ◽  
Public And Private ◽  
College And University ◽  
University Systems

Wastewater surveillance for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging approach to help identify the risk of a coronavirus disease (COVID-19) outbreak. This tool can contribute to public health surveillance at both community (wastewater treatment system) and institutional (e.g., colleges, prisons, and nursing homes) scales. This paper explores the successes, challenges, and lessons learned from initial wastewater surveillance efforts at colleges and university systems to inform future research, development and implementation. We present the experiences of 25 college and university systems in the United States that monitored campus wastewater for SARS-CoV-2 during the fall 2020 academic period. We describe the broad range of approaches, findings, resources, and impacts from these initial efforts. These institutions range in size, social and political geographies, and include both public and private institutions. Our analysis suggests that wastewater monitoring at colleges requires consideration of local information needs, sewage infrastructure, resources for sampling and analysis, college and community dynamics, approaches to interpretation and communication of results, and follow-up actions. Most colleges reported that a learning process of experimentation, evaluation, and adaptation was key to progress. This process requires ongoing collaboration among diverse stakeholders including decision-makers, researchers, faculty, facilities staff, students, and community members.

A telehealth intervention to promote weight loss and physical activity in overweight primary care patients

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 100509
Author(s):  
Ian Hurst ◽  
Paul J. Bixenstine ◽  
Carlos Casillas ◽  
Anna Rasmussen ◽  
Sondra Grossman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Weight Loss ◽  
Promote Weight Loss ◽  
Telehealth Intervention ◽  
Primary Care Patients

scholarly journals Household Chores or Play Outdoors? The Intersecting Influence of Gender and School Type on Physical Activity Among Indian Adolescents

2020 ◽  
Vol 47 (5) ◽  
pp. 682-691
Author(s):  
Ilana G. Raskind ◽  
Shailaja S. Patil ◽  
Nikhil Tandon ◽  
Sharanya Thummalapally ◽  
Michael R. Kramer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Private School ◽  
Rate Ratio ◽  
School Type ◽  
School Students ◽  
Public And Private ◽  
Active Time ◽  
Public School Students ◽  
Indian Adolescents

Most Indian adolescents, particularly girls and private school students, do not engage in sufficient physical activity (PA). Current understanding of these sociodemographic differences is limited by a focus on exercise, which may not fully capture PA in developing countries. We examined how gender and school type are associated with multiple PA domains and whether associations with gender differ by school type. We randomly selected an equal number of girls and boys (ages 13-16 years) from public and private schools in Southern India ( n = 395). Cross-sectional 24-hour time-use surveys measured PA, which was categorized into three domains: chores, errands, and work; play; and transportation. Negative binomial and logistic regression modeled relative differences in domain-specific PA minutes and the probability of engaging in ≥60 minutes of moderate-to-vigorous PA (MVPA), respectively, in the prior 24 hours. Girls and boys were equally likely to meet MVPA recommendations. However, girls spent twice as much active time completing chores, errands, and work (rate ratio = 1.98, 95% confidence interval = [1.32, 2.98]), while boys spent twice as much active time playing (rate ratio = 2.11, 95% confidence interval = [1.23, 3.62]). Public and private school girls spent more active time in chores, errands, and work than boys; however, gender differences were greater among public school students ( p value for interaction <.05). Although comparable MVPA levels for girls and boys are beneficial for physical health, girls may gain fewer cognitive, social, and emotional benefits associated with play. Additional research may clarify why the gendered burden of household responsibilities was greater among public school students. School-based programs to engage girls in active play may help reduce inequities.

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