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1
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Koo TH, Leong XB, Ng JK, Tan NKB, Mohamed M. Emerging Trends in Telehealth and AI-Driven Approaches for Obesity Management: A New Perspective. Malays J Med Sci 2025; 32:26-34. [PMID: 40417205 PMCID: PMC12097168 DOI: 10.21315/mjms-08-2024-614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Accepted: 11/07/2024] [Indexed: 05/27/2025] Open
Abstract
One in eight people globally, prevalent mainly in some ethnic groups and those from low socioeconomic backgrounds, is a critical global health challenge of obesity. The telehealth system would be valuable in arresting obesity, with better access to care and a supporting digital community that encourages regular practice of physical activities, healthy diets, and health monitoring, all within reach and at affordable prices. Digital health interventions such as telehealth, mHealth applications, and wearable devices are new modalities for the treatment of obesity that increase monitoring of energy expenditure, physical activity level, and caloric intake. These technologies enhance the possibilities of therapy against barriers, such as maintaining motivation and improving the diet. This review summarises current evidence regarding digital health interventions for obesity management by considering and evaluating various global digital strategies to reduce obesity. The literature emphasises the effectiveness of eHealth interventions toward weight loss and maintenance. Furthermore, artificial intelligence (AI) and Information and Communications Technology (ICT) can predict and prevent paediatric obesity. By contrast, virtual reality (VR) applications can determine real-world behaviour in clinical practice. These digital interventions could increase the reach and efficacy of traditional weight management programmes by becoming more embedded in clinical practice. However, because of their broad implementation across different clinical settings, concerns regarding the security and privacy of these technologies must be addressed.
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Affiliation(s)
- Thai Hau Koo
- Division of Endocrinology, Department of Internal Medicine, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Xue Bin Leong
- Division of Endocrinology, Department of Internal Medicine, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Jet Kwan Ng
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | | | - Mafauzy Mohamed
- Division of Endocrinology, Department of Internal Medicine, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
- School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
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Vaidya V, Gupta P, Chawla V, Singh M, Arya S, Yadav RK, Sharma R, Jain V. Smartphone Applications-Based Intervention to Reduce Body Mass Index and Improve Health-Related Behavior Among Children with Overweight/Obesity: A Pilot Clinical Trial. Indian J Pediatr 2025:10.1007/s12098-024-05402-9. [PMID: 39832043 DOI: 10.1007/s12098-024-05402-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Accepted: 12/16/2024] [Indexed: 01/22/2025]
Abstract
OBJECTIVES To assess changes in body mass index (BMI), diet and physical activity (PA) of 8-15-y-old children with overweight/ obesity, following a smartphone applications-based intervention; and to understand facilitators and barriers for BMI reduction. METHODS Children were enrolled through online sessions on childhood obesity for students, parents and teachers at five private schools in Delhi, and requesting parents who perceived their children as having obesity to contact the study team. Eligibility was confirmed through home visit by a technician. Questionnaires regarding diet, PA, attitude and practices were filled by participants and parents, followed by online intervention of three-month duration (weekly counselling; yoga classes 3 d/wk, sharing of resources on healthy eating, and goal setting), and repeat anthropometry by home visit. RESULTS Twenty-six children (16 boys) aged 11.6 ± 2.3 y were enrolled. Mean BMI (kg/m2) decreased from 25.4 ± 4.3 to 24.6 ± 4.1, p < 0.001. Any reduction in BMI was seen in 19 (73.1%) children, and reduction > 1 kg/m2 in 11 (42.3%), mediated by increase in the duration of PA and improvement in eating habits. The most cited barriers by parents were unhealthy eating when there were guests (by 69.2%); and problems with compliance due to conflicts between parent and child (by 38.5%). CONCLUSIONS Smartphone applications-based online intervention was effective in improving diet and physical activity, and reducing BMI in children with overweight/ obesity.
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Affiliation(s)
- Vedant Vaidya
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Gupta
- Pediatric Endocrine Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Veenu Chawla
- Senior Nutritionist and Director, FAB Life Program, Delhi, India
| | - Monika Singh
- Dietician, Pediatric Endocrine Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Suvercha Arya
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Raj Kumar Yadav
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajni Sharma
- Pediatric Endocrine Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Vandana Jain
- Pediatric Endocrine Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Graff K, Choi YJ, Silveira L, Smith C, Abuogi L, DeCamp LR, Jarjour J, Friedman C, Ware MA, Kaar JL. Lessons learned for preventing health disparities in future pandemics: the role of social vulnerabilities among children diagnosed with severe COVID-19 early in the pandemic. AIMS Public Health 2025; 12:124-136. [PMID: 40248413 PMCID: PMC11999811 DOI: 10.3934/publichealth.2025009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 09/09/2024] [Accepted: 11/12/2024] [Indexed: 04/19/2025] Open
Abstract
Background Hispanic ethnicity is associated with an increased risk for severe disease in children with COVID-19. Identifying underlying contributors to this disparity can lead to improved health care utilization and prevention strategies. Methods This is a retrospective cohort study of children 2-20 years of age with positive SARS-CoV-2 testing from March-October 2020. Univariable and multivariable logistic regression models were fitted to identify demographic, comorbid health conditions, and social vulnerabilities as predictors of severe COVID-19 (need for hospital admission or respiratory support). Results We included 1572 children with COVID-19, of whom 45% identified as Hispanic. Compared to non-Hispanic children, patients who identified as Hispanic were more often obese (28% vs. 14%, p < 0.0001), preferred a non-English language (31% vs. 3%, p < 0.0001), and had Medicaid or no insurance (79% vs. 33%, p < 0.0001). In univariable analyses, children who identified as Hispanic were more likely to require hospital admission (OR 2.4, CI: 1.57-3.80) and respiratory support (OR 2.4, CI: 1.38-4.14). In multivariable analyses, hospital admission was associated with obesity (OR 1.9, CI: 1.15-3.08), non-English language (OR 2.4, CI: 1.35-4.23), and Medicaid insurance (OR 2.0, CI: 1.10-3.71), but ethnicity was not a significant predictor of severe disease. Conclusions and Relevance The high rates of severe COVID-19 observed in Hispanic children early in the pandemic appeared to be secondary to underlying co-morbidities and social vulnerabilities that may have influenced access to care, such as language and insurance status. Pediatric providers and public health officials should tailor resource allocation to better target this underserved patient population.
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Affiliation(s)
- Kelly Graff
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ye Ji Choi
- University of Colorado School of Public Health, Aurora, CO, USA
| | - Lori Silveira
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Christiana Smith
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Lisa Abuogi
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Lisa Ross DeCamp
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Jane Jarjour
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Chloe Friedman
- University of Colorado School of Public Health, Aurora, CO, USA
| | - Meredith A. Ware
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jill L Kaar
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
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Choque GAH, Rodriguez MR, Soltani D, Baltaci A, Nagao-Sato S, de Davila SA, Monardez J, Peralta Reyes AO, Reicks M. Mixed-Methods Evaluation of Father Participation in an Adolescent Obesity Prevention Program With Multiple Delivery Methods. Health Promot Pract 2024; 25:997-1008. [PMID: 37300243 PMCID: PMC10830123 DOI: 10.1177/15248399231177300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Padres Preparados, Jóvenes Saludables was a Latino family-based obesity prevention intervention implemented from 2017 to 2020 across eight programs in-person only, in a blended format (online/in-person), and online only. The intervention aimed to enhance father parenting skills to improve adolescent diet and activity behaviors. Mothers were encouraged to attend. Factors associated with participation were explored using a mixed-methods, qualitative (focus group/individual interviews by Zoom) and quantitative (process evaluation) design. Eleven focus group and 24 individual interviews were completed after participation with 24 fathers, 27 mothers, and 40 adolescents with responses not sorted by delivery method before analysis. Binomial logistic regression models examined associations between fathers' program completion and predictor variables of delivery characteristics, father demographic characteristics, and family attendance patterns. Parents were married (96% fathers, 76% mothers), had low income, a high school education or less (68% fathers, 81% mothers), and had lived in the United States a mean of 19 years. Parents were motivated to participate to improve health, and to be involved with and improve communication with their child. Common barriers to participation were work and life priorities and programmatic factors including scheduling conflicts and technological issues. Participation was greater for fathers attending sessions in-person compared with online only (OR = 11.6). Fathers were more likely to participate if they attended sessions with family members vs. not attending with family members (OR = 7.2). To maximize participation, findings suggest involving multiple parents/caregivers and adolescents, addressing contextual and programmatic barriers, and promoting benefits of better health and relations with family members.
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Affiliation(s)
| | | | | | | | | | - Silvia Alvarez de Davila
- University of Minnesota Extension, St. Paul, MN, USA
- Robert J. Jones Urban Research and Outreach-Engagement Center, Minneapolis, MN, USA
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Gansterer A, Moliterno P, Neidenbach R, Ollerieth C, Czernin S, Scharhag J, Widhalm K. Effect of a Web-Based Nutritional and Physical Activity Intervention With Email Support (the EDDY Program) on Primary School Children's BMI Z-Score During the COVID-19 Pandemic: Intervention Study. JMIR Pediatr Parent 2024; 7:e50289. [PMID: 39298741 PMCID: PMC11426922 DOI: 10.2196/50289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/31/2024] [Accepted: 06/11/2024] [Indexed: 09/22/2024] Open
Abstract
Background COVID-19 mitigation measures enhanced increases in children's weight and BMI due to decreased physical activity and increased energy intake. Overweight and obesity were major worldwide problems before the pandemic, and COVID-19 increased their severity even more. High BMI directly correlates with health disadvantages including cardiovascular diseases, musculoskeletal disorders, and mental health diseases. Therefore, it is vitally important to develop counteracting interventions to maintain children's health during exceptional situations like pandemics. However, worldwide data from such interventions are limited, and to our knowledge, no suitable study has been carried out during the pandemic in Austria. Objective This study was conducted to examine a 15-week web-based intervention with email support, the EDDY (Effect of Sports and Diet Trainings to Prevent Obesity and Secondary Diseases and to Influence Young Children's Lifestyle) program and the effect of nutritional education and physical activity on children's BMI z-score during the COVID-19 pandemic in Vienna, Austria. Methods The intervention consisted of 3 weekly videos-2 physical activity and 1 nutritional education video, respectively-and a biweekly email newsletter for the parents. This study was conducted in a Viennese primary school from February to June 2021 by a team of physicians, nutritionists, and sports scientists, including both professionals and students. The study population included an intervention group (who received web-based nutritional and physical activity training) and a control group (who received no intervention), comprising in total 125 children aged 8 to 11 years. Due to COVID-19 mitigation measures, the control group was a comparative group observed during the prior school year (2019-2020). Anthropometric measurements were obtained before and after the intervention in both groups. Results Due to a high dropout rate (n=57, 45.6%) because of the mitigation measures, there were 41 children in the intervention group and 27 in the control group. At baseline, the BMI z-score was 1.0 (SD 1.1) in the intervention group and 0.6 (SD 1.2) in the control group (P=.17). After the study period, the BMI z-score decreased by 0.06 (SD 0.21) in the intervention group, whereas it increased by 0.17 (SD 0.34) in the control group (P<.001). Comparing the change in BMI z-scores within BMI categories in the intervention group and control group revealed a statistically significant difference in the normal-weight children (P=.006). Further results showed that the decrease in BMI z-score was significant in the intervention group among both boys (P=.004) and girls (P=.01). Conclusions A web-based intervention with combined nutritional education and physical activity training might be an adequate tool to lessen the enhanced increase in body weight during a pandemic. Therefore, additional studies with greater sample sizes and different locations are needed. As the implementation of such intervention programs is essential, further studies need to be established rapidly.
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Affiliation(s)
| | | | - Rhoia Neidenbach
- Sports Medicine, Exercise Physiology and Prevention, Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Caroline Ollerieth
- Sports Medicine, Exercise Physiology and Prevention, Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Sarah Czernin
- Austrian Academic Institute for Nutrition, Vienna, Austria
| | - Juergen Scharhag
- Sports Medicine, Exercise Physiology and Prevention, Department of Sport and Human Movement Science, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Kurt Widhalm
- Austrian Academic Institute for Nutrition, Vienna, Austria
- Department of Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
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Poon ETC, Fang Y, Chung LMY, Chan CKM, Or PPL, Sun F. A scoping review of physical activity-based interventions for obesity management in children and adolescents during the COVID-19 pandemic. Int J Obes (Lond) 2024; 48:302-314. [PMID: 38086902 DOI: 10.1038/s41366-023-01433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/10/2023] [Accepted: 11/24/2023] [Indexed: 02/28/2024]
Abstract
Overweight and obesity have emerged as global health issues among children and adolescents. Restrictions related to the COVID-19 pandemic have aggravated the threat of paediatric obesity due to the prevalent reduction in physical activity (PA) in children and adolescents. However, this has also created an opportunity for healthcare professionals to explore new strategies to address this persistent problem. A systematically conducted scoping review was performed on 15 online databases to summarise and analyse the design, efficacy, and feasibility of PA-based weight management interventions for children and adolescents during the pandemic. Finally, we reviewed 23 eligible studies that were published between 2021 and 2023. The included interventions were presented to 1938 children and adolescents and 355 parents using a virtual or virtually blended face-to-face approach during the pandemic. The intervention design included a basic PA programme with three optional components (nutritional education, sociopsychological counselling, and medication consultations). Implementation generally resulted in favourable changes in body mass index (BMI) and/or body size or composition (primary outcomes), as well as health behaviours, physical health or fitness, and individual well-being (secondary outcomes). A longer duration of exposure to the intervention, female sex, and older age were associated with a higher efficacy of the included interventions. Moreover, the interventions showed high feasibility, with medium-high participant attendance, high acceptance/satisfaction in both children and adolescents and their parents and teachers, and strong participant engagement. This may be related to the high accessibility of health information, timely social support, and enhanced self-efficacy. In conclusion, both the virtual and blended delivery of well-planned weight management interventions during the pandemic show promise for the treatment and control of paediatric obesity. The lessons learned from the pandemic may help improve the design of future interventions and inform the proper integration of new technologies that have emerged in the post-pandemic world.
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Affiliation(s)
- Eric Tsz Chun Poon
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China.
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Louisa Ming Yan Chung
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Carmen Ka Man Chan
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Peggy Pui Lai Or
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
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Iacopetta D, Catalano A, Ceramella J, Pellegrino M, Marra M, Scali E, Sinicropi MS, Aquaro S. The Ongoing Impact of COVID-19 on Pediatric Obesity. Pediatr Rep 2024; 16:135-150. [PMID: 38391001 PMCID: PMC10885050 DOI: 10.3390/pediatric16010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
In the developed world, pediatric obesity (PO) has been a major health concern since the last century, and this condition may lead to detrimental life-long physical and mental comorbidities. Currently, its prevalence has increased in low- and middle-income countries and in many high-income countries. Thus, the provision of effective and tailored care for children and their families has become vital. The social consequences of the COVID-19 pandemic are known everywhere, and among these, it has been argued that the COVID-19 pandemic has had a major impact on PO. Overall, the growth of PO over the last decade has been enhanced by the pandemic. During the COVID-19 pandemic, children, adolescents and young adults gained weight as the pediatric population dealt with sedentary lifestyles and changes in food habits. In this review, we want to highlight the impact that the COVID-19 pandemic had on PO.
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Affiliation(s)
- Domenico Iacopetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari "Aldo Moro", 70126 Bari, Italy
| | - Jessica Ceramella
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Michele Pellegrino
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Maria Marra
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Elisabetta Scali
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Maria Stefania Sinicropi
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
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Yudkin JS, Messiah SE, Allicock MA, Barlow SE. Integration of e-Health Strategies for Post-COVID-19 Pandemic Pediatric Weight Management Programs. Telemed J E Health 2024; 30:321-330. [PMID: 37552819 DOI: 10.1089/tmj.2023.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Background: The COVID-19 pandemic catalyzed a renewed urgency to address the obesity pandemic and accelerated the use of technology to treat pediatric obesity. Yet, there are significant incongruities between the existing literature on technology for obesity management and the current health care system that may lead to suboptimal outcomes and increased costs. This study reviewed the types of e-health strategies currently in use, highlighted inconsistencies and overlap in terminology, and identified future research directions in e-health for childhood obesity, including gaps in implementation science. Methods: This narrative literature review synthesized seminal articles from the literature, as well as recent articles, using PubMed and Google Scholar that focused on the use of technology in treating pediatric obesity. This inclusive strategy was intended to elucidate the heterogeneity in how different disciplines are using digital health terminology in pediatric obesity research. Results: Both the prevalence of e-health interventions and its associated terminology are increasing in the peer-reviewed literature, especially since the beginning of the COVID-19 pandemic. Yet, their definitions and usage are unstandardized, leading to a lack of cohesion in the research and between disciplines. There is a gap in implementation science outcomes, including reimbursement, that may significantly impact external validity and uptake. Conclusion: A more systematic and precise approach to researching e-health that can assess specific technologies and combinations of technologies, their short-term and long-term effect sizes, and feasibility can produce the necessary data that may lead to reimbursement policies and, ultimately, improved pediatric weight management outcomes.
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Affiliation(s)
- Joshua S Yudkin
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
| | - Sarah E Messiah
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
- Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Marlyn A Allicock
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Dallas, Texas, USA
- Center for Pediatric Population Health, School of Public Health, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
| | - Sarah E Barlow
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Children's Health, Children's Medical Center Dallas, Dallas, Texas, USA
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Evans EW, Darling KE, Egbert A, Hayes JF, Jelalian E, Warnick J, Topor LS, Goldschmidt AB. Leveraging seasonality and timing to optimize pediatric weight management interventions: Novel directions for future research. Obes Sci Pract 2023; 9:688-695. [PMID: 38090686 PMCID: PMC10712410 DOI: 10.1002/osp4.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 02/01/2024] Open
Abstract
National estimates suggest that more than 35% of American children, ages 2-19 years, are overweight or obese, which increases their risk for weight-related comorbidities including diabetes, cancer, cardiovascular disease risk factors, depression, and anxiety. While obesity prevention is most cost-effective, for youth with existing obesity, the United States Preventive Services Task Force recommends ≥26 h of comprehensive lifestyle intervention over 6-12 months. This include standard behavioral therapy, dietary counseling, and an emphasis on physical activity. Although such programs are effective in reducing weight status, there are many barriers to completing these programs. A novel consideration for both the prevention and treatment of childhood obesity is the recognition that the timing of intervention, both duration and time of the year, can impact family engagement and intervention effectiveness. This paper discusses the potential of targeting high-risk periods for weight gain and offering brief behavioral intervention, in hopes of inspiring research on novel approaches to the prevention and treatment of childhood obesity.
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Affiliation(s)
- E. Whitney Evans
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Katherine E. Darling
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Amy Egbert
- Department of Psychological SciencesUniversity of ConnecticutStorrsConnecticutUSA
| | - Jacqueline F. Hayes
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Elissa Jelalian
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Jennifer Warnick
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Lisa Swartz Topor
- Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
- Pediatric Endocrinology and Diabetes CenterHasbro Children's HospitalProvidenceRhode IslandUSA
| | - Andrea B. Goldschmidt
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
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O'Hara VM, Louder D, Johnston SV, Hastey K, Browne NT. Pediatric Obesity Care via Telemedicine: Expanding the Path Forward-A Review. Curr Obes Rep 2023; 12:546-556. [PMID: 37940835 DOI: 10.1007/s13679-023-00537-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE OF REVIEW Review latest data regarding the intersection of pediatric obesity epidemic with telemedicine expansion to meet the need of equitable obesity care in children. RECENT FINDINGS Prevalence of pediatric obesity in the USA continues to worsen particularly in rural, underserved areas. Although there is an increasing number of obesity medicine specialists over the last decade, availability varies by geographic location. Pre-pandemic centers were limited, rarely located in rural areas, and required in-person visits for reimbursement. Telemedicine changes, responding to pandemic needs, provided increase in telemedicine utilization and acceptance with similar or improved obesity care outcomes. Given pediatric obesity prevalence and need for chronic, effective obesity care, leveraging telemedicine to expand reach and decrease access barriers provides a critical and creative remedy. Data cites similar outcomes between telemedicine and in-person care. The time to reimagine a full spectrum of care delivery for pediatric obesity is now.
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Affiliation(s)
- Valerie M O'Hara
- Maine Medical Center Weight and Wellness Clinic, 41 Donald B. Dean Drive Suite A, South Portland, ME, 04106, USA.
| | - Danielle Louder
- Northeast Telehealth Resource Center, MCD Global Health, 105 Second Street, Suite 2A, Hallowell, ME, 04347, USA
| | - Starr V Johnston
- Northern Light Acadia Hospital, 268 Stillwater Ave, Bangor, ME, 04401, USA
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Simione M, Aschbrenner K, Farrar-Muir H, Luo M, Granadeno J, Caballero-Gonzalez A, Price SN, Torres C, Boudreau AA, Fiechtner L, Hambidge SJ, Sease K, Taveras EM. Adapting Connect for Health pediatric weight management program for telehealth in response to the COVID-19 pandemic. Implement Sci Commun 2023; 4:139. [PMID: 37974245 PMCID: PMC10652425 DOI: 10.1186/s43058-023-00523-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND To address the evolving needs and context changes due to the COVID-19 pandemic, we adapted Connect for Health, an evidence-based, primary care, pediatric weight management intervention. The objective of this study is to describe the planned adaptation process to ensure continued and equitable program uptake during the pandemic. METHODS Guided by adaptation frameworks, we identified the core functions and forms of Connect for Health and then adapted the intervention in response to a changing healthcare context. We engaged stakeholders and surveyed parents of children with a BMI ≥ 85th percentile and pediatric clinicians and examined their experiences using telehealth for pediatric weight management and needs and preferences. Using multivariable logistic regression, we examined the preferences of parents with limited English proficiency regarding key aspects of pediatric weight management. RESULTS We surveyed 200 parents and 43% had a primary language of Spanish. Parents wanted care to be a combination of in-person and virtual visits (80%). We found that parents with limited English proficiency had a higher odds ratio of affirming in-person visits are better than virtual visits for ensuring their child's health concern can be taken care of (OR: 2.91; 95% CI: 1.36, 6.21), feeling comfortable when discussing personal information (OR: 3.91; 95% CI: 1.82, 8.43), talking about healthy behaviors and setting goals (OR: 3.09; 95% CI: 1.39, 6.90), and talking about mental health and overall well-being (OR: 4.02; 95% CI: 1.83, 8.87) than parents without limited English proficiency. We surveyed 75 clinicians and 60% felt telehealth was a useful tool to provide care for pediatric weight management. Clinicians felt virtual visits did not pose barriers to all aspects of care. Informed by the surveys and stakeholder input, we made clinician- and family-level adaptations while retaining the program's function. CONCLUSIONS By engaging stakeholders and adapting the program for telehealth, we optimized the reach and fit of Connect for Health to ensure its continued uptake. We have provided a real-world example of how clinical innovations can evolve and how to systematically plan adaptations in response to changing healthcare contexts. TRIAL REGISTRATION Clinicaltrials.gov (NCT04042493), Registered on August 2, 2019.
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Affiliation(s)
- Meg Simione
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Kelly Aschbrenner
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Haley Farrar-Muir
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Man Luo
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Jazmin Granadeno
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Ariadne Caballero-Gonzalez
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Sarah N Price
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
| | - Carlos Torres
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- MGH Chelsea HealthCare Center, Chelsea, MA, USA
| | - Alexy Arauz Boudreau
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Lauren Fiechtner
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Simon J Hambidge
- Ambulatory Care Services, Denver Health, Denver, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kerry Sease
- Department of Pediatrics, University of South Carolina School of Medicine, Greenville, SC, USA
- Prisma Health, Greenville, SC, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children, 125 Nashua St, Suite 860, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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12
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Sierra-Velez D, Gundewar A, Persaud A, Simione M, Castro I, Perkins M, Lindros J, Salmon J, Smith JD, Taveras EM, Fiechtner L. Stakeholders' perception of factors influencing adoption of a pediatric weight management intervention: a qualitative study. Front Public Health 2023; 11:1045618. [PMID: 37900042 PMCID: PMC10613059 DOI: 10.3389/fpubh.2023.1045618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Background Childhood obesity is highly prevalent in the United States and disproportionately impacts communities of color and low-income populations; these disparities have worsened during the COVID-19 pandemic. Adoption of effective pediatric weight management interventions (PWMIs) that have been evaluated among low-income diverse populations is needed. The Healthy Weight Clinic PWMI, a package co-developed by the American Academy of Pediatrics and Massachusetts General Hospital, helps health centers establish multidisciplinary Healthy Weight Clinics based on previous randomized controlled trials which demonstrated effectiveness. We sought to identify the factors influencing successful adoption of this PWMI and understand adaptations needed prior to implementation in new sites. Methods We interviewed 20 stakeholders, 10 from two health centers in Mississippi where the Healthy Weight Clinic PWMI will be piloted (pre-implementation sites) and 10 from health centers that have previously implemented it (sites in maintenance stages). Separate interview guides informed by the Consolidated Framework for Implementation Research (CFIR) were developed for the pre-implementation sites and those in maintenance stages, including questions related to adaptations of the PWMI in response to the COVID-19 pandemic. Qualitative data analysis was conducted using directed content analysis based on CFIR constructs. Adaptations in response to the pandemic were categorized using Framework for Reporting Adaptations and Modifications-Expanded (FRAME). Results In pre-implementation sites, an inner setting facilitator mentioned was a positive learning climate. Characteristics of individuals that can facilitate adoption include staff willingness to learn, valuing evidence-based care for childhood obesity, and culturally and weight-sensitive staff. In terms of patient needs and resources (outer setting), social drivers of health are barriers to adoption, but creative solutions were suggested to mitigate these. Other facilitators related to the intervention included its multidisciplinary model and adaptability. Similar themes were elicited from sites in maintenance stages; adaptations brought on by the pandemic, such as telehealth visits and content modification to align with distancing guidelines and the effects of social isolation were also described. Conclusion Understanding the factors influencing adoption of an evidence-based PWMI informs necessary adaptations and implementation strategies required to facilitate nationwide dissemination of PWMIs, with the goal of reaching the populations most at-risk.
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Affiliation(s)
- Desiree Sierra-Velez
- Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, MA, United States
| | - Anisha Gundewar
- Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, United States
| | - Alicia Persaud
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, United States
| | - Meg Simione
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, United States
| | - Ines Castro
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, United States
| | - Meghan Perkins
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, United States
| | - Jeanne Lindros
- Institute for Healthy Childhood Weight, American Academy of Pediatrics, Itasca, IL, United States
| | - Jeremiah Salmon
- Institute for Healthy Childhood Weight, American Academy of Pediatrics, Itasca, IL, United States
| | - Justin D. Smith
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Lauren Fiechtner
- Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, MA, United States
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, United States
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13
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Slusher AL, Hu P, Samuels S, Tokoglu F, Lat J, Li Z, Alguard M, Strober J, Vatner D, Shabanova V, Caprio S. Rising NAFLD and metabolic severity during the Sars-CoV-2 pandemic among children with obesity in the United States. Obesity (Silver Spring) 2023; 31:1383-1391. [PMID: 36694381 PMCID: PMC10186584 DOI: 10.1002/oby.23728] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Nonalcoholic fatty liver disease (NAFLD), the most common liver disease among youth with obesity, precedes more severe metabolic and liver diseases. However, the impact of the Sars-CoV-2 global pandemic on the prevalence and severity of NAFLD and the associated metabolic phenotype among youth with obesity is unknown. METHODS Participants were recruited from the Yale Pediatric Obesity Clinic during the Sars-CoV-2 global pandemic (August 2020 to May 2022) and were compared with a frequency-matched control group of youth with obesity studied before the Sars-CoV-2 global pandemic (January 2017 to November 2019). Glucose metabolism differences were assessed during an extended 180-minute oral glucose tolerance test. Magnetic resonance imaging-derived proton density fat fraction (PDFF) was used to determine intrahepatic fat content in those with NAFLD (PDFF ≥ 5.5). RESULTS NAFLD prevalence increased in participants prior to (36.2%) versus during the Sars-CoV-2 pandemic (60.9%), with higher PDFF values observed in participants with NAFLD (PDFF ≥ 5.5%) during versus before the pandemic. An increase in visceral adipose tissue and a hyperresponsiveness in insulin secretion during the oral glucose tolerance test were also observed. CONCLUSIONS Hepatic health differences were likely exacerbated by environmental and behavioral changes associated with the pandemic, which are critically important for clinicians to consider when engaging in patient care to help minimize the future risk for metabolic perturbations.
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Affiliation(s)
- Aaron L. Slusher
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
| | - Pamela Hu
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
| | - Stephanie Samuels
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
| | - Fuyuze Tokoglu
- Radiology and Biomedical Imaging, Yale University School of
Medicine, New Haven, CT
| | - Jessica Lat
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
| | - Zhongyao Li
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
| | - Michele Alguard
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
| | - Jordan Strober
- Department of Internal Medicine, Yale University School of
Medicine, New Haven, CT
| | - Daniel Vatner
- Department of Internal Medicine, Yale University School of
Medicine, New Haven, CT
| | - Veronika Shabanova
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
| | - Sonia Caprio
- Department of Pediatrics, Yale University School of
Medicine, New Haven, CT
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14
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Taghizadeh S, Alesaeidi S, Jafari-Koshki T, Valizadeh-Otaghsara SM, Poursheikhali A, Tousi AZ, Abbasalizad–Farhangi M. Trend Impact Analysis (TIA) of community-based futures study for pediatric obesity in Iran. BMC Pediatr 2023; 23:66. [PMID: 36750801 PMCID: PMC9905010 DOI: 10.1186/s12887-023-03880-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Childhood obesity has been regarded as one of the main healthcare challenges in the last century, leading to critical health problems and reduced life expectancy. Many factors can play a role in its development or prevention. Using the Trend Impact Analysis (TIA), this study aimed to conduct a community-based futures study for pediatric obesity in Iran. METHODS We obtained the prevalence of overweight and obesity from the database of the Ministry of Health and Medical Education. Moreover, we reviewed 21 documents, texts, and comments from three key stakeholders in Iran and prepared a list of key experts, who were stakeholders in the field of obesity prevention of childhood in different organizations. Then, we collected the expert opinions by Delphi method. Data analysis was performed using the Excel and R software. RESULTS Fourteen experts participated in the first stage and nine experts in the second stage. We identified two positive drivers, including the prevalence of coronavirus disease 2019 (COVID-19) and the widespread expansion of online educational programs. Meanwhile, we identified five negative drivers as follows: (1) controlling and limiting obesogenic environments in the community, school, and family; (2) running annual compulsory anthropometry programs for students of all educational levels in health centers; (3) integrating nutrition education interventions in the curricula of all educational levels; (4) taxation of unhealthy and fast foods; and (5) preparing safe and appropriate sports environments for children and adolescents (on the streets, schools, parks, and sports clubs). Without considering the drivers, the prevalence of overweight and obesity is predicted to reach 29.10% in 2031. However, it is expected that the negative drivers can increase the prevalence trend from 23.40% in 2018 to 19.57% in 2031, the positive drivers to 32.61%, and the combination of all drivers to 23.07%. CONCLUSION It seems that measures such as the effective communication of policy makers, basic evaluation of the programs and policies related to the prevention of childhood obesity, and localization of the programs of international organizations for the prevention of obesity can greatly control the prevalence of childhood obesity.
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Affiliation(s)
- Shahnaz Taghizadeh
- grid.412888.f0000 0001 2174 8913Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sogol Alesaeidi
- grid.411036.10000 0001 1498 685XDepartment of Pediatric Medicine, Imam Hossein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tohid Jafari-Koshki
- grid.412888.f0000 0001 2174 8913Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Atousa Poursheikhali
- grid.412105.30000 0001 2092 9755Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ayda Zahiri Tousi
- grid.444802.e0000 0004 0547 7393Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Mahdieh Abbasalizad–Farhangi
- grid.412888.f0000 0001 2174 8913Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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15
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Fabin-Czepiel K, Pieczyńska-Chapuła K, Deja G. "The obesity pandemic" in the COVID-19 pandemic - new treatment for an old problem. Pediatr Endocrinol Diabetes Metab 2023; 29:104-111. [PMID: 37728462 PMCID: PMC10411083 DOI: 10.5114/pedm.2023.129342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/15/2023] [Indexed: 09/21/2023]
Abstract
Obesity is a worldwide problem, and the fact that it increasingly affects children and adolescents is worrying. The COVID-19 pandemic and the restrictions introduced affected the physical activity of children and adolescents, and changed their lifestyle and the amount of time spent in front of screens, which are significant factors correlated with weight gain. Due to the scale of the problem of obesity and overweight, much attention is currently paid to seeking effective forms of therapy in these different, difficult circumstances. Interventions promoting a healthy lifestyle among obese children after the COVID-19 pandemic are particularly important and necessary. This article provides a review of the literature on the recent worsening of obesity in the paediatric population, with particular emphasis on the importance of the COVID-19 pandemic. New methods of fighting obesity with the use of telemedicine and current methods of pharmacotherapy, including new drugs, are presented.
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Affiliation(s)
| | | | - Grażyna Deja
- Department of Paediatric Diabetology, Department of Paediatrics, Faculty of Medicine, Medical University of Silesia in Katowice, Poland
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16
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Welshons KF, Johnson NA, Gold AL, Reicks M. Diabetes prevention program outcomes by in-person versus distance delivery mode among ethnically diverse, primarily lower-income adults. Digit Health 2023; 9:20552076231173524. [PMID: 37188080 PMCID: PMC10176546 DOI: 10.1177/20552076231173524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
Objective Physical activity and weight loss outcomes of a diabetes prevention program were compared for ethnically diverse adults, with the majority participating in public assistance programs. Outcomes were compared for those who completed the program in person versus by distance delivery. Methods A two-group, pre-post study design compared National Diabetes Prevention Program outcomes based on in-person delivery (2018-2020 pre-COVID-19 pandemic, n = 47) and distance delivery (after March 2020, n = 31). Outcomes were measured or self-reported depending on the delivery method. Linear mixed models with a random intercept for coach and covariates were used to assess delivery mode group differences in percent weight loss and weekly physical activity minutes. Results Completion rates were similar by in-person versus distance delivery mode (57% vs. 65%). Among those who completed the program, the mean age was 58 years, the mean baseline body mass index was 33, and 39% were Hispanic. The majority were female (87%), participating in a public assistance program (63%), and living in a micropolitan area (61%). Percent weight loss was greater in the distance delivery group (7.7%) compared to the in-person group (4.7%) in the unadjusted analysis (p = 0.009) but not when adjusted for covariates. No differences were observed in adjusted weekly physical activity minutes between the in-person (219 min) versus the distance group (148 min). Conclusions No differences were observed by delivery mode in percent weight loss or weekly physical activity minutes, indicating that distance delivery does not compromise program effectiveness.
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Affiliation(s)
- Kate F Welshons
- University of Minnesota
Extension, Department of Family, Health and Wellbeing, St Paul, MN,
USA
| | - Nikki A Johnson
- University of Minnesota
Extension, Department of Family, Health and Wellbeing, St Paul, MN,
USA
- Department of Health, Nutrition, and
Exercise Science, North Dakota State University Extension, Fargo, ND, USA
| | - Abby L Gold
- Department of Food Science and
Nutrition, University of Minnesota, St Paul, MN, USA
| | - Marla Reicks
- Department of Food Science and
Nutrition, University of Minnesota, St Paul, MN, USA
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17
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Capra ME, Stanyevic B, Giudice A, Monopoli D, Decarolis NM, Esposito S, Biasucci G. The Effects of COVID-19 Pandemic and Lockdown on Pediatric Nutritional and Metabolic Diseases: A Narrative Review. Nutrients 2022; 15:nu15010088. [PMID: 36615746 PMCID: PMC9823544 DOI: 10.3390/nu15010088] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
SARS-CoV-2 was the first pathogen implied in a worldwide health emergency in the last decade. Containment measures have been adopted by various countries to try to stop infection spread. Children and adolescents have been less clinically involved by COVID-19, but the pandemic and consequent containment measures have had an important influence on the developmental ages. The COVID-19 pandemic and the subsequent lockdown periods have influenced the nutrition and lifestyles of children and adolescents, playing an epigenetic role in the development of nutrition and metabolic diseases in this delicate age group. The aim of our review is to investigate the effects of the COVID-19 pandemic on nutrition and metabolic diseases in the developmental ages. Moreover, we have analyzed the effect of different containment measures in children and adolescents. An increase in being overweight, obesity and type 2 diabetes mellitus has been detected. Concerning type 1 diabetes mellitus, although a validated mechanism possibly linking COVID-19 with new onset type 1 diabetes mellitus has not been yet demonstrated, barriers to the accessibility to healthcare services led to delayed diagnosis and more severe presentation of this disease. Further studies are needed to better investigate these relationships and to establish strategies to contain the nutritional and metabolic impact of new pandemics in the developmental ages.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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18
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Siegel R, Stackpole K, Kirk S, Kharofa R. Families Chose In-Person Visits over Telehealth for Pediatric Weight Management during the COVID-19 Pandemic. Child Obes 2022; 18:572-575. [PMID: 35384747 DOI: 10.1089/chi.2022.0005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: With the onset of the coronavirus disease 2019 (COVID-19) pandemic, telehealth was implemented as a method of care delivery in many pediatric weight management programs (PWMPs). To compare patient/family preference of telehealth vs. in-person visits, we analyzed patient visits during a period when families were given the option of scheduling in-person or telehealth visits for both new and follow-up visits during the pandemic. Methods: A retrospective review was done of our center's electronic medical record of patient visits from July 1, 2020 to December 31, 2020. Results: There were 1356 completed PWMP visits, with 977 (72.1%) done in-person and 379 (27.9%) done by telehealth. Telehealth was selected more often for follow-up visits (31.4%) compared with new visits (18.8%) [odds ratio (OR) = 2.052, p = 0.008]. Black patients (30.5%) selected telehealth more often than White patients (26.1%, OR = 1.371; p = 0.03). Conclusions: Although telehealth increases flexibility and increases options to families, in-person clinic visits seem to be preferred especially for an initial visit.
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Affiliation(s)
- Robert Siegel
- The Center for Better Health and Nutrition of the Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kristin Stackpole
- The Center for Better Health and Nutrition of the Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Shelley Kirk
- The Center for Better Health and Nutrition of the Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Roohi Kharofa
- The Center for Better Health and Nutrition of the Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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19
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Grafft N, Aftosmes-Tobio A, Gago C, Lansburg K, Beckerman-Hsu J, Trefry B, Kumanyika S, Davison K. Adaptation and implementation outcomes of a parenting program for low-income, ethnically diverse families delivered virtually versus in-person. Transl Behav Med 2022; 12:1065-1075. [PMID: 36318233 PMCID: PMC9677462 DOI: 10.1093/tbm/ibac077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Driven by the COVID-19 pandemic, many in-person health behavior interventions were compelled to quickly pivot to a virtual format with little time or capacity to reflect on or examine possible equity-related implications of a format that required digital access and remote learning skills. Using a parenting program for low-income families as a case study, this paper (a) outlines the process of adapting the program from an in-person to a virtual format and (b) examines the equity-related implications of this adaptation. Parents Connect for Healthy Living (PConnect) is a 10-session empowerment-focused parenting intervention designed to promote family health for Head Start families. In 2020, PConnect was adapted over a 6-month period from an in-person to a virtual format due to the advent of the COVID-19 pandemic. Three core elements were retained in the adaptation; session content, provision of coaching support for facilitators, and the co-facilitation model. Key modifications include session length, group composition, and language of program delivery. Head Start and PConnect records provided data to compare reach, acceptability, and appropriateness of virtual and in-person PConnect. Seventy-eight parents enrolled in the in-person program and 58 in the virtual program. Participant demographics and satisfaction were similar across formats, and demographics similar to the general Head Start population. Participation was higher in the virtual format. Parents participated in the virtual program primarily via smart phones (68%). This case study supports the acceptability and appropriateness of virtual parenting programs in ethnically diverse, low-resource settings.
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Affiliation(s)
- Natalie Grafft
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | | | - Cristina Gago
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kindra Lansburg
- Action for Boston Community Development (ABCD), Boston, MA, USA
| | | | - Brooke Trefry
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | | | - Kirsten Davison
- School of Social Work, Boston College, Chestnut Hill, MA, USA
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20
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Hassapidou M, Duncanson K, Shrewsbury V, Ells L, Mulrooney H, Androutsos O, Vlassopoulos A, Rito A, Farpourt N, Brown T, Douglas P, Ramos Sallas X, Woodward E, Collins C. EASO and EFAD Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Children and Adolescents. Obes Facts 2022; 16:29-52. [PMID: 36349767 PMCID: PMC9890183 DOI: 10.1159/000527540] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This position statement on medical nutrition therapy in the management of overweight or obesity in children and adolescents was prepared by an expert committee convened by the European Association for the Study of Obesity (EASO) and developed in collaboration with the European Federation of the Associations of Dietitians (EFAD). METHODS It is based on the best evidence available from systematic reviews of randomized controlled trials on child and adolescent overweight and obesity treatment and other relevant peer-reviewed literature. RESULTS Multicomponent behavioural interventions are generally considered to be the gold standard treatment for children and adolescents living with obesity. The evidence presented in this position statement confirms that dietary interventions can effectively improve adiposity-related outcomes. Dietary strategies should focus on the reduction of total energy intake through promotion of food-based guidelines that target modification of usual eating patterns and behaviours. These should target increasing intakes of nutrient-rich foods with a lower energy density, specifically vegetables and fruits, and a reduction in intakes of energy-dense nutrient-poor foods and beverages. In addition, higher intensity, longer duration treatments, delivered by interventionists with specialized dietetic-related skills and co-designed with families, are associated with greater treatment effects. DISCUSSION Such interventions should be resourced adequately so that they can be implemented in a range of settings and in different formats, including digital or online delivery, to enhance accessibility.
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Affiliation(s)
- Maria Hassapidou
- Department of Nutritional Sciences & Dietetics, International Hellenic University, Thessaloniki, Greece
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
| | - Kerith Duncanson
- School of Medicine and Public Health, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| | - Vanessa Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| | - Louisa Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Hilda Mulrooney
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Life Sciences, Pharmacy and Chemistry, SEC Faculty, Kingston University London, Kingston upon Thames, UK
| | - Odysseas Androutsos
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Nutrition-Dietetics, University of Thessaly, Trikala, Greece
| | - Antonis Vlassopoulos
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Ana Rito
- National Institute of Health Ricardo Jorge I.P., Lisbon, Portugal
| | - Nathalie Farpourt
- Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology and Therapeutic Education, Department of Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Tamara Brown
- Applied Obesity Research Centre in the School of Health, Leeds Beckett University, Leeds, UK
| | - Pauline Douglas
- Nutrition Innovation Center for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, UK
| | | | - Euan Woodward
- European Association for the Study of Obesity, Teddington, UK
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle Australia, Callaghan, New South Wales, Australia
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21
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Hu P, Samuels S, Maciejewski KR, Li F, Aloe C, Van Name M, Savoye M, Sharifi M. Changes in Weight-Related Health Behaviors and Social Determinants of Health among Youth with Overweight/Obesity during the COVID-19 Pandemic. Child Obes 2022; 18:369-382. [PMID: 34919458 PMCID: PMC9492789 DOI: 10.1089/chi.2021.0196] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives: To assess changes in weight-related health behaviors and social determinants of health (SDoH) among youth with overweight/obesity during the coronavirus disease 2019 (COVID-19) pandemic. Methods: We assessed weight-related health behaviors (physical activity, screen time, sleep, and diet) and SDoH (food insecurity, income/childcare, and caregivers' perceived stress) before vs. during the pandemic with a survey administered August-October 2020 to caregivers of 2-17-year olds and adolescents 13-17 years old with BMI ≥85th percentile seen in clinic within 6 months prepandemic. We analyzed changes in continuous variables using paired t-tests and categorical variables with McNemar's or Fisher's exact tests, and the influence of social determinants on behavior change using multivariable regression models. Results: A total of 129 caregivers and 34 adolescents completed surveys. Compared with prepandemic, caregivers reported youth decreased moderate/vigorous physical activity (-87.4 [205.7] minutes/week, p < 0.001) and increased recreational screen time (2.5 [2.1] hours/day, p < 0.001). Fewer had regular bedtimes (before: 89% and during: 44%, p < 0.001) and more ate most meals with television (before: 16% and during: 36%, p < 0.001). Food insecurity increased from 27% to 43% (p < 0.001), 45% reported reduced household income, and caregivers with moderate/high perceived stress scale scores increased from 43% to 64% (p < 0.001). Moderate/high caregiver stress and food insecurity were associated with greater magnitudes of adverse behavior change. Conclusion: Alarming changes in health behaviors among youth with overweight/obesity, particularly among those with stressed caregivers and food insecurity, may increase prevalence of obesity-related comorbidities and exacerbate health disparities. There is an urgent need to expand access to effective interventions for overweight/obesity that address psychosocial stressors.
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Affiliation(s)
- Pamela Hu
- Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Stephanie Samuels
- Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Kaitlin R. Maciejewski
- Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Fangyong Li
- Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Carlin Aloe
- Yale University School of Public Health, New Haven, CT, USA
| | - Michelle Van Name
- Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Mary Savoye
- Section of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Mona Sharifi
- Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
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22
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Sharma A, Pruthi M, Sageena G. Adoption of telehealth technologies: an approach to improving healthcare system. TRANSLATIONAL MEDICINE COMMUNICATIONS 2022; 7:20. [PMID: 35967767 PMCID: PMC9361246 DOI: 10.1186/s41231-022-00125-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Globally, the healthcare industry is well known to be one of the strongest drivers of economic growth and development. The sector has gained substantial attention to deal with the fallout of COVID-19, leading to improvement in the quality observed in developed and developing nations. With the advent of the twenty-first century, globalization an ever-growing populace, and environmental changes prompted the more noteworthy spread of irresistible diseases, highlighting the association between wellbeing and future health security. The massive spread of COVID-19 paralyzed the global economy and took a toll on health governance and wellbeing. The present review aims to map the harrowing impacts of COVID-19 on the QoL (quality of life) observed. Particularly the post-pandemic era is likely to boot-strap the healthcare sector. Hence in post COVID era, there is a dire need to strengthen the healthcare system and understand the evolving challenges to answer calls in recovery in the wake of COVID-19. CONCLUSION There is a flurry of research highlighting the implications faced due to the rise of the pandemic, resulting in the wrecking growth and development. However, the massive potential of telehealth is still largely underexplored with scarce research on countless evolving technologies. The current crisis highlighted the need to develop emerging frameworks and facilitate multilateral cooperation. The present research can serve as the baseline for better future strategies to improve global health initiatives. Further, this can help to focus on wider health determinants, redesign strategies and policies for the healthcare industry and to mitigate/deal better with future pandemics.
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Affiliation(s)
- Arpana Sharma
- Department of Mathematics, Keshav Mahavidyalaya, University of Delhi H-4-5 Zone, Pitampura, Delhi, 110034 India
| | - Madhu Pruthi
- Principal, Keshav Mahavidyalaya, University of Delhi, H-4-5 Zone, Pitampura, Delhi, 110034 India
| | - Geetanjali Sageena
- Department of Environmental Studies, Keshav Mahavidyalaya, University of Delhi, H-4-5 Zone, Pitampura, Delhi, 110034 India
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23
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Unique Cardiovascular Disease Risk Factors in Hispanic Individuals. CURRENT CARDIOVASCULAR RISK REPORTS 2022; 16:53-61. [PMID: 35669678 PMCID: PMC9161759 DOI: 10.1007/s12170-022-00692-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/06/2022]
Abstract
Purpose of Review This review summarizes contemporary data on unique cardiovascular disease (CVD) risk factors in Hispanic individuals in the USA, and how addressing these factors is important in addressing health equity. Recent Findings Recent studies have shown high rates of traditional CVD risk factors in Hispanic individuals such as obesity, hypertension, diabetes, hyperlipidemia, and emerging CVD risk factors like hypertensive disorders of pregnancy, psychological stress, and occupational exposures. However, most studies fail to consider the significant heterogeneity in risk factor burden and outcomes in atherosclerotic CVD by Hispanic subgroup. Heart failure and rhythm disorders are less well studied in Hispanic adults, making risk assessment for these conditions difficult. High levels of CVD risk factors in Hispanic youth given an aging Hispanic population overall highlight the importance of risk mitigation among these individuals. Summary In brief, these data highlight the significant, unique burden of CVD risk among Hispanic individuals in the USA and predict a rising burden of disease among this growing and aging population. Future CVD research should focus on including robust, diverse Hispanic cohorts as well as specifically delineating results for disaggregated Hispanic groups across CVDs. This will allow for better risk assessment, prevention, and treatment decisions to promote health equity for Hispanic patients.
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24
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Breastfeeding, Complementary Feeding, Physical Activity, Screen Use, and Hours of Sleep in Children under 2 Years during Lockdown by the COVID-19 Pandemic in Chile. CHILDREN 2022; 9:children9060819. [PMID: 35740756 PMCID: PMC9221584 DOI: 10.3390/children9060819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
Infants and children are a risk group in terms of developing healthy habits, an important aspect if we consider that many of them were born during the COVID-19 pandemic. Our objective was to evaluate compliance with lifestyle recommendations proposed at the national and international levels in children aged 0 to 23 months during confinement due to the COVID-19 pandemic in Chile. A cross-sectional study was conducted, and 211 online questionnaires were completed with sociodemographic and lifestyle information of children. Our results show high compliance with the recommendations on breastfeeding intake (78.3% and 69.5% in 0–5-month-old and 6–23-month-old children, respectively); age of starting complementary feeding (87.4%); non-consumption of salt and sugar (80.1%), non-caloric sweeteners (90.7%), and sweet and salty snacks (68.9%); and hours of physical activity (66.8%) and sleep (65.4%). However, we observed low compliance with the recommendations on the age of introduction of dinner (58.0%), eggs (23.0%), legumes (39.2%), and fish (35.1%); low consumption of legumes (43.4%) and fish (20.5%); and low compliance with the recommendations on screen use during meals (59.2%) and daily screen hours (41.2%). In conclusion, feeding behavior, physical activity, use of screens, and hours of sleep in children were altered by confinement during the pandemic, harming the development of healthy lifestyles.
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25
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Jebeile H, Kelly AS, O'Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol 2022; 10:351-365. [PMID: 35248172 PMCID: PMC9831747 DOI: 10.1016/s2213-8587(22)00047-x] [Citation(s) in RCA: 430] [Impact Index Per Article: 143.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 01/14/2023]
Abstract
This Review describes current knowledge on the epidemiology and causes of child and adolescent obesity, considerations for assessment, and current management approaches. Before the COVID-19 pandemic, obesity prevalence in children and adolescents had plateaued in many high-income countries despite levels of severe obesity having increased. However, in low-income and middle-income countries, obesity prevalence had risen. During the pandemic, weight gain among children and adolescents has increased in several jurisdictions. Obesity is associated with cardiometabolic and psychosocial comorbidity as well as premature adult mortality. The development and perpetuation of obesity is largely explained by a bio-socioecological framework, whereby biological predisposition, socioeconomic, and environmental factors interact together to promote deposition and proliferation of adipose tissue. First-line treatment approaches include family-based behavioural obesity interventions addressing diet, physical activity, sedentary behaviours, and sleep quality, underpinned by behaviour change strategies. Evidence for intensive dietary approaches, pharmacotherapy, and metabolic and bariatric surgery as supplemental therapies are emerging; however, access to these therapies is scarce in most jurisdictions. Research is still needed to inform the personalisation of treatment approaches of obesity in children and adolescents and their translation to clinical practice.
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Affiliation(s)
- Hiba Jebeile
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Grace O'Malley
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Child and Adolescent Obesity Service, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Louise A Baur
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Weight Management Services, The Children's Hospital at Westmead, Westmead, NSW, Australia.
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26
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Eisenburger N, Friesen D, Haas F, Klaudius M, Schmidt L, Vandeven S, Joisten C. Short report: Weight management of children and adolescents with obesity during the COVID-19 pandemic in Germany. PLoS One 2022; 17:e0267601. [PMID: 35486630 PMCID: PMC9053772 DOI: 10.1371/journal.pone.0267601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this analysis was to assess the effectiveness of a juvenile outpatient weight management program during the coronavirus pandemic in Germany, which was implemented digitally during the initial lockdown and thereafter under strict hygiene rules (e.g., adapted exercise sessions). Changes in body mass index standard deviation scores (BMI SDS), physical fitness, media consumption, health-related quality of life (HRQOL), and social self-concept of 28 children and adolescents were compared to data of 30 participants before the pandemic. Adjusted mean changes from baseline to follow-up in BMI SDS (M = −0.07 ± 0.30), relative physical fitness (M = 0.0 ± 0.3 W/kg), media use (M = 0.5 ± 2.6 hours/day), HRQOL (M = −1.6 ± 15.3), and social self-concept (M = −3.8 ± 13.2) during the pandemic were not significantly different from those of the pre-pandemic participants (all p > 0.05). Therefore, the results suggest that an adjusted approach to weight management, which combined digital and adapted in-person components to meet hygiene requirements during the pandemic, was as effective as the pre-pandemic program. It could thus be a potential solution to ensure continuity of care for vulnerable children with obesity during the pandemic and the associated restrictions.
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Affiliation(s)
- Nina Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
- * E-mail:
| | - David Friesen
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Fabiola Haas
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Marlen Klaudius
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Lisa Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Susanne Vandeven
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University, Cologne, Germany
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27
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Curfman A, Hackell JM, Herendeen NE, Alexander J, Marcin JP, Moskowitz WB, Bodnar CEF, Simon HK, McSwain SD. Telehealth: Opportunities to Improve Access, Quality, and Cost in Pediatric Care. Pediatrics 2022; 149:184902. [PMID: 35224638 DOI: 10.1542/peds.2021-056035] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The use of telehealth technology to connect with patients has expanded significantly over the past several years, particularly in response to the global coronavirus disease 2019 pandemic. This technical report describes the present state of telehealth and its current and potential applications. Telehealth has the potential to transform the way care is delivered to pediatric patients, expanding access to pediatric care across geographic distances, leveraging the pediatric workforce for care delivery, and improving disparities in access to care. However, implementation will require significant efforts to address the digital divide to ensure that telehealth does not inadvertently exacerbate inequities in care. The medical home model will continue to evolve to use telehealth to provide high-quality care for children, particularly for children and youth with special health care needs, in accordance with current and evolving quality standards. Research and metric development are critical for the development of evidence-based best practices and policies in these new models of care. Finally, as pediatric care transitions from traditional fee-for-service payment to alternative payment methods, telehealth offers unique opportunities to establish value-based population health models that are financed in a sustainable manner.
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Affiliation(s)
- Alison Curfman
- Department of Pediatrics, Mercy Clinic, St Louis, Missouri.,Rubicon Founders
| | - Jesse M Hackell
- Department of Pediatrics, New York Medical College and Boston Children's Health Physicians, Pomona, New York
| | - Neil E Herendeen
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, New York
| | - Joshua Alexander
- Departments of Physical Medicine and Rehabilitation and Pediatrics, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - James P Marcin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of California Davis and University of California Davis Children's Hospital, Sacramento, California
| | - William B Moskowitz
- Division of Pediatric Cardiology, Department of Pediatrics, Children's of Mississippi and University of Mississippi Medical Center, Jackson, Mississippi
| | - Chelsea E F Bodnar
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Montana, Missoula, Montana
| | - Harold K Simon
- Departments of Pediatrics and Emergency Medicine, School of Medicine, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - S David McSwain
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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28
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Verduci E, Fiore G, Di Profio E, Zuccotti GV. The Paradox of the Mediterranean Diet in Pediatric Age during the COVID-19 Pandemic. Nutrients 2022; 14:705. [PMID: 35277063 PMCID: PMC8838277 DOI: 10.3390/nu14030705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
The outbreak of the COVID-19 pandemic, whose causative agent is Severe Acute Respiratory Syndrome Coronavirus 2, has caused a global crisis that has had a major impact on the health of the global population [...].
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Affiliation(s)
- Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (G.F.); (E.D.P.); (G.V.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Giulia Fiore
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (G.F.); (E.D.P.); (G.V.Z.)
- Department of Health, Animal Science and Food Safety, University of Milan, 20133 Milan, Italy
| | - Elisabetta Di Profio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (G.F.); (E.D.P.); (G.V.Z.)
- Department of Health, Animal Science and Food Safety, University of Milan, 20133 Milan, Italy
| | - Gian Vincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (G.F.); (E.D.P.); (G.V.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
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29
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Santiago ADS, Sabóia VM, Souza SRD, Prado GSDS, Sota FDS. AÇÕES DE PROMOÇÃO DA SAÚDE NAS UNIVERSIDADES EM FACE DA PANDEMIA DO COVID-19: SCOPING REVIEW. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0418pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: mapear na literatura as ações e estratégias de promoção da saúde das universidades no contexto da pandemia do novo coronavírus (COVID-19). Metodo: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Com base nestas perspectivas, ficou estabelecida a pergunta norteadora: quais ações e estratégias de promoção da saúde foram realizadas em universidades com a comunidade interna e seu entorno na pandemia do COVID-19? As buscas foram realizadas em março de 2021 nas bases de dados de portais de informação públicos, restritos e de literatura cinzenta. Resultados: foram selecionados 38 estudos e com base nesses foram construídas três categorias: 1) Ações e estratégias de enfrentamento do COVID-19 nas universidades 2) Ações e estratégias inclusivas e de Proteção social a grupos vulneráveis ao COVID-19 nas universidades 3) Ações e estratégias de Educação em saúde e bem-estar em face do COVID-19 nas universidades. Conclusões: o estudo evidenciou que ações e estratégias de promoção da saúde nas Universidades acontecem quando a proposta encontra apoio institucional, mobilização inter e transdisciplinar, integração com setores governamentais e iniciativa privada, além do engajamento da população acadêmica. Observaram-se diversas ações em diferentes cenários, demonstrando comprometimento social e posicionamento crítico em face do COVID-19, visando uma sociedade mais justa e sustentável pela via do conhecimento.
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30
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Corica D, Li Pomi A, Curatola S, Pepe G, Giandalia A, Tropeano A, Alibrandi A, Aversa T, Wasniewska M. Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management. Front Endocrinol (Lausanne) 2022; 13:879440. [PMID: 35860703 PMCID: PMC9289178 DOI: 10.3389/fendo.2022.879440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022] Open
Abstract
The Covid-19 pandemic drastically modified social life and lifestyle, in particular, among children and adolescents, promoting sedentary behaviors and unhealthy eating habits. The aims of this study were to assess the rate and the factors associated with outpatient drop-out in childhood obesity management, and to evaluate how the Covid-19 pandemic influenced weight status and lifestyle of children and adolescents with obesity. One hundred and forty-five children and adolescents with obesity were identified, including 80 subjects evaluated before the Covid-19 pandemic (group A) and 65 subjects in the period straddling the Covid-19 pandemic (group B). Anamnestic (family history of obesity, dietary habits, physical activity, screen time), socio-cultural (economic status, employment and schooling of parents, household composition, place of living) and clinical (weight, height, BMI, waist circumference) data were retrospectively analyzed for each subject in both groups at baseline (V0) and 12-months (V1) at in-person assessment. Glycemic and lipid profiles were assessed at V0. Drop-out rate did not differ significantly between the two groups. BMI SDS at V0 (OR=2.52; p=0.004), female sex (OR=0.41; p=0.035), and the presence of a single parent in the household (OR=5.74; p=0.033) significantly influenced drop-out in both groups. Weight loss between V0 and V1 was significantly greater among group A patients compared to group B (p=0.031). In group B, hours spent in physical activity significantly decreased from V0 to V1, being significantly lower than group A at V1; on the contrary, screen time significantly increased in the same period. The consumption of sugary drinks and snacks was significantly greater in group B than group A at V1. Our study documented that the Covid-19 pandemic, although not affecting the drop-out rate of obese children in a follow-up program, negatively influenced lifestyle and reduced the effectiveness of outpatient counseling in childhood obesity treatment.
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Affiliation(s)
- Domenico Corica
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Alessandra Li Pomi
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Selenia Curatola
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Giorgia Pepe
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Annalisa Giandalia
- Department of Clinical and Experimental Medicine , University of Messina, Messina, Italy
| | - Angelo Tropeano
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | | | - Tommaso Aversa
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
- *Correspondence: Malgorzata Wasniewska,
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31
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Santiago ADS, Sabóia VM, Souza SRD, Prado GSDS, Sota FDS. HEALTH PROMOTION ACTIONS IN UNIVERSITIES IN THE FACE OF THE COVID-19 PANDEMIC: A SCOPING REVIEW. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0418en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to map in the literature the universities' health promotion actions and strategies in the context of the new coronavirus (COVID-19) pandemic. Method: a Scoping Review, based on the procedures recommended by the Joanna Briggs Institute. Based on these perspectives, the following guiding question was established: which health promotion actions and strategies were implemented in universities with the internal community and its surroundings in the COVID-19 pandemic? The searches were carried out in March 2021 in the databases of public, restricted and gray literature information portals. Results: a total of 38 studies were selected and three categories were elaborated based on them, namely: 1) Actions and strategies for coping with COVID-19 in universities; 2) Inclusive and Social protection actions and strategies for groups vulnerable to COVID-19 in universities; and 3) Health and Well-being Education actions and strategies in the face of COVID-19 in universities. Conclusions: the study evidenced that health promotion actions and strategies in universities become a reality when the proposals find institutional support, inter- and transdisciplinary mobilization and integration with governmental sectors and private initiative, in addition to engagement of the academic population. Several actions were observed in different scenarios, showing social commitment and a critical stance in the face of COVID-19, aiming at a fairer and more sustainable society through knowledge.
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32
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Mora SJ, Sprowls M, Tipparaju VV, Wheatley-Guy CM, Kulick D, Johnson B, Xiaojun X, Forzani E. Comparative study of a novel portable indirect calorimeter to a reference breath-by-breath instrument and its use in telemedicine settings. Clin Nutr ESPEN 2021; 46:361-366. [PMID: 34857221 DOI: 10.1016/j.clnesp.2021.09.731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/18/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS Resting Energy Expenditure (REE) quantitatively describes the calories used to support body function (e.g. breathing, blood circulation, etc.) at resting condition. Assessment of the REE is essential for successful weight management and the understanding of metabolic health. REE is typically determined via indirect calorimetry. Current biomedical indirect calorimetry technologies, utilizing assessment of oxygen consumption (VO2) and carbon dioxide production (VCO2) rates (which are typically in the form factor of a metabolic cart) are bulky and require on-site calibration and/or trained professionals to operate. We introduce a novel wearable medical device with FDA clearance to determine REE accurately, portable, and user-friendly format, which can be used both by health professionals in a clinical environment and by the patient at home. Previously, we have reported the validation of Breezing Med (also named as Breezing Pro™) through Douglas Bag Method, a gold standard for gas exchange measurement, and excellent agreement has been found between the two methods for the determination of REE, VO2, and VCO2 rates (Mora et al., 2020). Now we present the validation of Breezing Med against Medical Graphics (MGC) CPX Ultima™, a FDA 510 k cleared metabolic cart, which principle is based on breath-by-breath analysis. In addition, we present Breezing Med as a tool for daily measurement of metabolic rate by the lay person at home. METHODS A) The validation study was executed via parallel measurement of 20 healthy participants under resting conditions using both the Breezing Med and the MGC Ultima CPX™ (10 min test). B) Breezing Med measurements were carried out by six subjects at home during stay-at-home order due to COVID-19 for 30 days. RESULTS A) The resulting measurements from both devices was compared with correlation slope's and R-squared coefficients close to 1. B) Results were recorded and analyzed for variability. The pilot study demonstrated the advantage of Breezing Med device to be easy-to-use at home by lay people, which make the valuable device for telemedicine applications related to weight management from home. CONCLUSIONS This result shows that the MGC Ultima CPX™ and Breezing Med are substantially equivalent for REE measurement; and an advantage of this device for metabolic assessment under the current COVID-19 pandemic situation, for people with impaired physical mobility, and for those who lives in rural areas or face impediments that limit physical access to care.
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Affiliation(s)
- S Jimena Mora
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States.
| | - Mark Sprowls
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States
| | - Vishal V Tipparaju
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States
| | | | - Doina Kulick
- Mayo Clinic, Scottsdale, Arizona, 85259, United States
| | - Bruce Johnson
- Mayo Clinic, Scottsdale, Arizona, 85259, United States
| | - Xian Xiaojun
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States
| | - Erica Forzani
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States.
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Kharofa RY, Stackpole K, Anthony C, Moorhead R, Siegel RM. Pediatric weight management amid the COVID-19 pandemic: a natural telemedicine experiment. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.2001337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Roohi Y. Kharofa
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kristin Stackpole
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Catherine Anthony
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Rebekah Moorhead
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Robert M. Siegel
- Center for Better Health and Nutrition, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Vajravelu ME, Arslanian S. Mobile Health and Telehealth Interventions to Increase Physical Activity in Adolescents with Obesity: a Promising Approach to Engaging a Hard-to-Reach Population. Curr Obes Rep 2021; 10:444-452. [PMID: 34596867 PMCID: PMC8485573 DOI: 10.1007/s13679-021-00456-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Adolescence represents a critical time to set habits for long-term health, yet adequate rates of physical activity are uncommon in this age group. Mobile technology use, however, is ubiquitous. We review advantages and challenges posed by mobile health (mHealth) and telehealth-based physical activity interventions aimed at adolescents. RECENT FINDINGS Mobile Health (mHealth) and telehealth interventions to increase physical activity in adolescents include use of wearable activity trackers, text messages or apps, and video visits with exercise specialists. Definitions and goals for physical activity differ across interventions, and methods of activity measurement also vary. User engagement is often poor, if tracked at all. No identified studies included use of behavioral economics-informed engagement strategies. Intervention designers must plan for ways to maximize engagement and to reliably measure the intended outcome. Although mHealth and telehealth interventions have advantages such as scalability and acceptability, potential pitfalls must be addressed before widespread implementation.
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Affiliation(s)
- Mary Ellen Vajravelu
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 4401 Penn Ave, Faculty Pavilion, 6th Floor, PA, 15224, Pittsburgh, USA.
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Silva Arslanian
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 4401 Penn Ave, Faculty Pavilion, 6th Floor, PA, 15224, Pittsburgh, USA
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Pecoraro P, Gallè F, Muscariello E, Di Mauro V, Daniele O, Forte S, Ricchiuti R, Liguori G, Valerio G. A telehealth intervention for ensuring continuity of care of pediatric obesity during the CoVid-19 lockdown in Italy. Nutr Metab Cardiovasc Dis 2021; 31:3502-3507. [PMID: 34728130 PMCID: PMC8496959 DOI: 10.1016/j.numecd.2021.09.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/18/2021] [Accepted: 09/23/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIMS Restriction measures adopted during the Coronavirus Disease-19 pandemic favored unhealthy behaviors. Tele-health offered the opportunity to pursue alternative ways of chronic diseases management. This retrospective study sought to determine the effects of a telehealth counselling intervention during the lockdown to children and adolescents with obesity previously engaged in a family-based secondary care program in an outpatient clinic of South Italy. METHODS AND RESULTS 117 out of 156 patients participated to the tele-health intervention. Participants underwent videocalls with each component of the multidisciplinary team to receive support in adopting adequate dietary habits and to practice exercise at home. They were included in a closed social group to watch age-adapted tutorials on healthy habits. 75 patients returned to the Center after the end of the lockdown, while only 7 patients who did not participate to the videocalls, took part to the follow-up. Body Mass Index and body composition were assessed in all these patients. BMI z score did not increase in both groups. However, a significant increase of fat mass was observed in the non-participating group (0.046), while the intervention group showed an increase of fat free mass (p < 0.000). CONCLUSION Notwithstanding the limited sample size, the telehealth intervention allowed the maintenance of baseline weight status in participants, with an increase of fat-free mass. As the CoViD-19 pandemic moves forward, the increasing adoption of the new technologies may help the continuity of care, even in pediatric obesity treatment.
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Affiliation(s)
- Pierluigi Pecoraro
- Nutrition Unit, Department of Prevention, Local Health Authority Napoli 3 Sud, Via Montedoro 47, Torre del Greco, Naples, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina 40, Naples 80133, Italy
| | - Espedita Muscariello
- Nutrition Unit, Department of Prevention, Local Health Authority Napoli 3 Sud, Via Montedoro 47, Torre del Greco, Naples, Italy
| | - Valentina Di Mauro
- Nutrition Unit, Department of Prevention, Local Health Authority Napoli 3 Sud, Via Montedoro 47, Torre del Greco, Naples, Italy
| | - Ornella Daniele
- Nutrition Unit, Department of Prevention, Local Health Authority Napoli 3 Sud, Via Montedoro 47, Torre del Greco, Naples, Italy
| | - Simone Forte
- Nutrition Unit, Department of Prevention, Local Health Authority Napoli 3 Sud, Via Montedoro 47, Torre del Greco, Naples, Italy
| | - Roberta Ricchiuti
- Nutrition Unit, Department of Prevention, Local Health Authority Napoli 3 Sud, Via Montedoro 47, Torre del Greco, Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina 40, Naples 80133, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Via Medina 40, Naples 80133, Italy.
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Bustos-Arriagada E, Fuentealba-Urra S, Etchegaray-Armijo K, Quintana-Aguirre N, Castillo-Valenzuela O. Feeding Behaviour and Lifestyle of Children and Adolescents One Year after Lockdown by the COVID-19 Pandemic in Chile. Nutrients 2021; 13:4138. [PMID: 34836396 PMCID: PMC8625155 DOI: 10.3390/nu13114138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Lockdown caused by the COVID-19 pandemic may have influenced feeding behaviour and lifestyle in children and adolescents. The purpose of this study was to analyse feeding behaviour and lifestyle in children and adolescents one year after lockdown by the COVID-19 pandemic in Chile. In this cross-sectional study an online survey was implemented in 1083 parents and caregivers regarding their children's feeding behaviour and lifestyle and sociodemographic background. The results showed that "eat breakfast daily" (89.2%), "not overnight food intake" (69.9%) and "not fast-food intake" (66.0%) were the most frequent reported feeding behaviours, particularly in pre-school children. Respondents declaring healthy feeding behaviours and lifestyle were 23.4 and 23.7%, respectively, with no significant differences by sex. In pre-school children, families with three or fewer members and parents or caregivers with an undergraduate or postgraduate degree reported a significantly better feeding behaviour and lifestyle compared to families with more than three members and parents or caregivers without an undergraduate or postgraduate degree. In conclusion, the pandemic lockdown had a negative impact in lifestyle in children and particularly in adolescents. Healthier feeding behaviour was associated with fewer family members and parents or caregivers with at least an undergraduate degree.
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Affiliation(s)
- Edson Bustos-Arriagada
- School of Nutrition and Dietetics, Faculty of Medicine, Universidad Finis Terrae, Santiago 7501015, Chile; (K.E.-A.); (N.Q.-A.); (O.C.-V.)
| | - Sergio Fuentealba-Urra
- Escuela de Educación, Facultad de Educación y Ciencias Sociales, Universidad Andres Bello, Concepción 4030000, Chile;
| | - Karina Etchegaray-Armijo
- School of Nutrition and Dietetics, Faculty of Medicine, Universidad Finis Terrae, Santiago 7501015, Chile; (K.E.-A.); (N.Q.-A.); (O.C.-V.)
| | - Nicolás Quintana-Aguirre
- School of Nutrition and Dietetics, Faculty of Medicine, Universidad Finis Terrae, Santiago 7501015, Chile; (K.E.-A.); (N.Q.-A.); (O.C.-V.)
| | - Oscar Castillo-Valenzuela
- School of Nutrition and Dietetics, Faculty of Medicine, Universidad Finis Terrae, Santiago 7501015, Chile; (K.E.-A.); (N.Q.-A.); (O.C.-V.)
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Garfan S, Alamoodi AH, Zaidan BB, Al-Zobbi M, Hamid RA, Alwan JK, Ahmaro IYY, Khalid ET, Jumaah FM, Albahri OS, Zaidan AA, Albahri AS, Al-Qaysi ZT, Ahmed MA, Shuwandy ML, Salih MM, Zughoul O, Mohammed KI, Momani F. Telehealth utilization during the Covid-19 pandemic: A systematic review. Comput Biol Med 2021; 138:104878. [PMID: 34592585 PMCID: PMC8450049 DOI: 10.1016/j.compbiomed.2021.104878] [Citation(s) in RCA: 206] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
During the coronavirus disease (COVID-19) pandemic, different technologies, including telehealth, are maximised to mitigate the risks and consequences of the disease. Telehealth has been widely utilised because of its usability and safety in providing healthcare services during the COVID-19 pandemic. However, a systematic literature review which provides extensive evidence on the impact of COVID-19 through telehealth and which covers multiple directions in a large-scale research remains lacking. This study aims to review telehealth literature comprehensively since the pandemic started. It also aims to map the research landscape into a coherent taxonomy and characterise this emerging field in terms of motivations, open challenges and recommendations. Articles related to telehealth during the COVID-19 pandemic were systematically searched in the WOS, IEEE, Science Direct, Springer and Scopus databases. The final set included (n = 86) articles discussing telehealth applications with respect to (i) control (n = 25), (ii) technology (n = 14) and (iii) medical procedure (n = 47). Since the beginning of the pandemic, telehealth has been presented in diverse cases. However, it still warrants further attention. Regardless of category, the articles focused on the challenges which hinder the maximisation of telehealth in such times and how to address them. With the rapid increase in the utilization of telehealth in different specialised hospitals and clinics, a potential framework which reflects the authors' implications of the future application and opportunities of telehealth has been established. This article improves our understanding and reveals the full potential of telehealth during these difficult times and beyond.
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Affiliation(s)
- Salem Garfan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A H Alamoodi
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia.
| | - B B Zaidan
- Future Technology Research Centre, National Yunlin University of Science and Technology, 123 University Road, Section 3, Douliou, Yunlin, 64002, Taiwan, ROC
| | | | - Rula A Hamid
- College of Business Informatics, University of Information Technology and Communications (UOITC), Baghdad, Iraq
| | - Jwan K Alwan
- Biomedical Informatics College, University of Information Technology and Communications (UOITC), Baghdad, Iraq; Faculty of Computer Science and Information Technology, University of Malaya (UM), Malaysia
| | - Ibraheem Y Y Ahmaro
- Computer Science Department, College of Information Technology, Hebron University, Hebron, Palestine
| | - Eman Thabet Khalid
- Department of Computer Sciences, College of Education for Pure Sciences, University of Basrah, Basrah, Iraq
| | - F M Jumaah
- Department of Computer and Software Engineering, Polytechnique Montréal, Canada
| | - O S Albahri
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A A Zaidan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A S Albahri
- Informatics Institute for Postgraduate Studies (IIPS), Iraqi Commission for Computers and Informatics (ICCI), Baghdad, Iraq
| | - Z T Al-Qaysi
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - M A Ahmed
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Moceheb Lazam Shuwandy
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Mahmood M Salih
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Omar Zughoul
- Computer Information System, Ahmed Bin Mohammed Military College, Al Shahaniya, Qatar
| | - K I Mohammed
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - Fayiz Momani
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
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Calcaterra V, Verduci E, Vandoni M, Rossi V, Di Profio E, Carnevale Pellino V, Tranfaglia V, Pascuzzi MC, Borsani B, Bosetti A, Zuccotti G. Telehealth: A Useful Tool for the Management of Nutrition and Exercise Programs in Pediatric Obesity in the COVID-19 Era. Nutrients 2021; 13:3689. [PMID: 34835945 PMCID: PMC8618189 DOI: 10.3390/nu13113689] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic has led to the implementation of policies that mandate various restrictions on daily life, including social distancing, the closure of public services and schools, and movement limitations. Even though these restrictive measures decreased the COVID-19 spread, they may have detrimental effects on various lifestyle components such as physical inactivity, sedentary behavior, and dietary habits, influencing the maintenance of weight and contributing to obesity among children and adolescents. The coexistence of childhood obesity and COVID-19 and changes in the bioecological environment have put children and adolescents at increased risk for developing obesity and exacerbating the severity of this disorder. The use of telehealth technology is a modern approach useful for the delivery of health care services by health care professionals, where distance is a critical factor. Telehealth is effective in promoting increased self-monitoring and behavioral change, and provides the opportunity to perform online nutritional support and exercise training programs to promote a healthy lifestyle and reduce sedentary behaviors in children and adolescents. Telehealth, including tele-exercise and tele-nutrition, has the potential to address many of the key challenges in providing health services, including in patients with obesity during the COVID-19 outbreak. This narrative review aims to describe the role of telehealth as an opportunity in the management of pediatric obesity in the COVID-19 era, and to deliver nutrition and exercise programs for the maintenance of health.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Elisabetta Di Profio
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (V.C.P.)
| | - Valeria Tranfaglia
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Martina Chiara Pascuzzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Barbara Borsani
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.V.); (V.R.); (E.D.P.); (V.T.); (M.C.P.); (B.B.); (A.B.); (G.Z.)
- Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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Tully L, Sorensen J, O'Malley G. Pediatric Weight Management Through mHealth Compared to Face-to-Face Care: Cost Analysis of a Randomized Control Trial. JMIR Mhealth Uhealth 2021; 9:e31621. [PMID: 34519665 PMCID: PMC8479601 DOI: 10.2196/31621] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) may improve pediatric weight management capacity and the geographical reach of services, and overcome barriers to attending physical appointments using ubiquitous devices such as smartphones and tablets. This field remains an emerging research area with some evidence of its effectiveness; however, there is a scarcity of literature describing economic evaluations of mHealth interventions. OBJECTIVE We aimed to assess the economic viability of using an mHealth approach as an alternative to standard multidisciplinary care by evaluating the direct costs incurred within treatment arms during a noninferiority randomized controlled trial (RCT). METHODS A digitally delivered (via a smartphone app) maintenance phase of a pediatric weight management program was developed iteratively with patients and families using evidence-based approaches. We undertook a microcosting exercise and budget impact analysis to assess the costs of delivery from the perspective of the publicly funded health care system. Resource use was analyzed alongside the RCT, and we estimated the costs associated with the staff time and resources for service delivery per participant. RESULTS In total, 109 adolescents participated in the trial, and 84 participants completed the trial (25 withdrew from the trial). We estimated the mean direct cost per adolescent attending usual care at €142 (SD 23.7), whereas the cost per adolescent in the mHealth group was €722 (SD 221.1), with variations depending on the number of weeks of treatment completion. The conversion rate for the reference year 2013 was $1=€0.7525. The costs incurred for those who withdrew from the study ranged from €35 to €681, depending on the point of dropout and study arm. The main driver of the costs in the mHealth arm was the need for health professional monitoring and support for patients on a weekly basis. The budget impact for offering the mHealth intervention to all newly referred patients in a 1-year period was estimated at €59,046 using the assessed approach. CONCLUSIONS This mHealth approach was substantially more expensive than usual care, although modifications to the intervention may offer opportunities to reduce the mHealth costs. The need for monitoring and support from health care professionals (HCPs) was not eliminated using this delivery model. Further research is needed to explore the cost-effectiveness and economic impact on families and from a wider societal perspective. TRIAL REGISTRATION ClinicalTrials.gov NCT01804855; https://clinicaltrials.gov/ct2/show/NCT01804855.
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Affiliation(s)
- Louise Tully
- Obesity Research and Care Group, Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Jan Sorensen
- Healthcare Outcomes Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Grace O'Malley
- Obesity Research and Care Group, Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland.,W82GO Child and Adolescent Weight Management Service, Children's Health Ireland at Temple Street, Dublin, Ireland
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Wang-Selfridge AA, Dennis JF. Management of Obesity Using Telemedicine During the COVID-19 Pandemic. MISSOURI MEDICINE 2021; 118:442-445. [PMID: 34658437 PMCID: PMC8504514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
IMPORTANCE During the COVID-19 pandemic, telemedicine visits increased to provide safer access to healthcare. METHODS To evaluate the role of telemedicine in obesity management during COVID-19, we conducted a systematic review to identify barriers in using this approach to patient care. CONCLUSION While necessary, the management of obesity through telemedicine was met with patient-specific and healthcare-specific barriers. Increased awareness of these barriers may allow physicians to better understand patient interactions via virtual medical visits.
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Affiliation(s)
| | - Jennifer F Dennis
- Department of Anatomy, KCUCOM. Both are at the Joplin Campus, Joplin, Missouri
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Moorman EL, Koskela-Staples NC, Mathai BB, Fedele DA, Janicke DM. Pediatric Obesity Treatment via Telehealth: Current Evidence and Future Directions. Curr Obes Rep 2021; 10:371-384. [PMID: 34302603 DOI: 10.1007/s13679-021-00446-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Telehealth delivery of pediatric weight management interventions may address time, travel, and cost barriers to in-person interventions, thus improving accessibility. This narrative review highlights findings from the past 5 years of pediatric lifestyle interventions for weight management that utilize telehealth for treatment delivery. We describe impressions and future directions. RECENT FINDINGS We identified and included 20 studies that described unique interventions from the past 5 years. The majority of reviewed studies indicated statistically significant reductions in BMI z-scores, high retention and attendance, and high satisfaction. However, mean decreases in BMI z-scores were marginal (approximately 0.10) in all but two studies. Studies did not often report effect sizes. Pediatric telehealth weight management interventions demonstrate good feasibility and acceptability. Improvement in reporting results and more rigorous research, including use of randomized designs, recruitment of larger samples, and incorporation of extended follow-up is needed to determine clinical impact and magnitude of effects.
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Affiliation(s)
- Erin L Moorman
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | | | - Babetta B Mathai
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
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Tan W. School closures were over-weighted against the mitigation of COVID-19 transmission: A literature review on the impact of school closures in the United States. Medicine (Baltimore) 2021; 100:e26709. [PMID: 34397701 PMCID: PMC8322504 DOI: 10.1097/md.0000000000026709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/28/2021] [Accepted: 06/24/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread wildly across the world. In March of 2020, almost all kindergarten through 12th grade (K-12) schools were closed in the United States in an urgent attempt to curb the pandemic in the absence of effective therapeutics or vaccination. Thirteen months since then, schools remain partially closed. Accumulated evidence suggests that children and adolescents are not the primary facilitators of transmission, limiting the restrictive effects of school closures on disease transmission. The negative effects of school closures on K-12 students need to be systematically reviewed. METHODS Following the guideline of Preferred Reporting Items for Systematic Reviews and Meta-analyzes, a comprehensive literature search from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science regarding school closures and its impact on K-12 students was conducted. The primary outcomes included the impact of school closures on the mitigation of the pandemic and the resulting public health concerns of K-12 students. RESULTS Prolonged school closures possessed negative effects on K-12 students' physical, mental, and social well-being and reduced the number of health and social workers, hindering the reopening of the country. CONCLUSIONS School closures were over-weighted against the mitigation of coronavirus disease 2019 (COVID-19) transmission. A safe reopening of all K-12 schools in the United States should be of top priority.
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Brown V, Tran H, Downing KL, Hesketh KD, Moodie M. A systematic review of economic evaluations of web-based or telephone-delivered interventions for preventing overweight and obesity and/or improving obesity-related behaviors. Obes Rev 2021; 22:e13227. [PMID: 33763956 DOI: 10.1111/obr.13227] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/01/2021] [Accepted: 02/06/2021] [Indexed: 12/16/2022]
Abstract
Obesity prevention interventions with behavioral or lifestyle-related components delivered via web-based or telephone technologies have been reported as comparatively low cost as compared with other intervention delivery modes, yet to date, no synthesized evidence of cost-effectiveness has been published. This study aimed to conduct a systematic review of economic evaluations of obesity prevention interventions with a telehealth or eHealth intervention component. A systematic search of six academic databases was conducted through October 2020. Studies were included if they reported full economic evaluations of interventions aimed at preventing overweight or obesity, or interventions aimed at improving obesity-related behaviors, with at least one intervention component delivered by telephone (telehealth) or web-based technology (eHealth). Findings were reported narratively, based on the Consolidated Health Economic Evaluation Reporting Standards. Twenty-seven economic evaluations were included from 20 studies meeting the inclusion criteria. Sixteen of the included interventions had a telehealth component, whereas 11 had an eHealth component. Seventeen interventions were evaluated using cost-utility analysis, five with cost-effectiveness analysis, and five undertook both cost-effectiveness and cost-utility analyses. Only eight cost-utility analyses reported that the intervention was cost-effective. Comparison of results from cost-effectiveness analyses was limited by heterogeneity in methods and outcome units reported. The evidence supporting the cost-effectiveness of interventions with a telehealth or eHealth delivery component is currently inconclusive. Although obesity prevention telehealth and eHealth interventions are gaining popularity, more evidence is required on their effectiveness and cost-effectiveness.
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Affiliation(s)
- Vicki Brown
- Deakin Health Economics, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia
| | - Huong Tran
- Deakin Health Economics, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia
| | - Katherine L Downing
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Marj Moodie
- Deakin Health Economics, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia
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Whitley A, Yahia N. Efficacy of Clinic-Based Telehealth vs. Face-to-Face Interventions for Obesity Treatment in Children and Adolescents in the United States and Canada: A Systematic Review. Child Obes 2021; 17:299-310. [PMID: 33926238 DOI: 10.1089/chi.2020.0347] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Childhood obesity is an ever-growing public health concern in the United States and globally. By 2030, it is estimated that 70% of the world's population of children and adolescents will be obese. Therefore, efforts to reduce childhood obesity are of utmost importance, particularly with the current coronavirus disease 2019 pandemic, as rates are expected to soar due to social distancing measures and restrictions. This systematic review aims to examine the literature regarding the effectiveness of clinic-based telehealth vs. face-to-face modalities to reduce obesity among school-aged children. Methods: An electronic database search of articles published in English over the last 10 years was undertaken in PubMed, Medline, and CINAHL. Key terms used to identify studies included school-aged children and adolescents with overweight and obesity in clinic-based weight management interventions conducted face-to-face or via telehealth, and having efficacy determined through changes in measured child BMI as primary outcomes and dietary and physical activity changes, as well as assessing feasibility and satisfaction with telehealth, as secondary outcomes. Results: Out of 1093 articles identified, 10 met the inclusion criteria. While both telehealth and face-to-face weight management interventions are effective in reducing obesity in children and adolescents, the evidence is lacking in which is more effective. Of the 10 studies, 5 showed outcome improvements when both telehealth and face-to-face interventions were combined as adjunct therapies. Conclusions: Findings support using telehealth in conjunction with face-to-face visits for obesity treatment among children and adolescents. However, more research involving telehealth weight management interventions for young children is recommended.
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Affiliation(s)
- Andrea Whitley
- Nutrition and Dietetics Program, Global Campus, School of Rehabilitation and Medical Sciences, Central Michigan University, Mt. Pleasant, MI, USA
| | - Najat Yahia
- Nutrition and Dietetics Program, Global Campus, School of Rehabilitation and Medical Sciences, Central Michigan University, Mt. Pleasant, MI, USA
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45
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Llamas-Velasco M, Ovejero-Merino E, Salgado-Boquete L. [Obesity - A Risk Factor for Psoriasis and COVID-19]. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:489-494. [PMID: 34629472 PMCID: PMC7977150 DOI: 10.1016/j.ad.2020.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 12/13/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity is a major health problem whose well-known association with psoriasis has been amply described. The importance of obesity as a risk factor for poor prognosis in the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection has recently been demonstrated. This review examines a possible relationship between obesity, psoriasis, and COVID-19, analyzing the pathophysiological links and their practical implications. On the one hand, a higher body mass index increases the risk of psoriasis and is also a factor in metabolic syndrome, which is common in patients with psoriasis and has been implicated in reducing the effectiveness of psoriasis treatments. On the other hand, obesity is a risk factor for severe COVID-19 and mortality. Obesity also promotes a proinflammatory state in the lung, where it compromises respiratory mechanics.
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Affiliation(s)
- M Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, España
| | - E Ovejero-Merino
- Servicio de Cirugía General y Digestiva, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
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Katz SF, Rodriguez F, Knowles JW. Health disparities in cardiometabolic risk among Black and Hispanic youth in the United States. Am J Prev Cardiol 2021; 6:100175. [PMID: 34327498 PMCID: PMC8315636 DOI: 10.1016/j.ajpc.2021.100175] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/10/2021] [Accepted: 03/12/2021] [Indexed: 12/18/2022] Open
Abstract
Cardiometabolic risk factors in children and adolescents track into adulthood and are associated with increased risk of atherosclerotic cardiovascular disease. The purpose of this review is to examine the pervasive race and ethnic disparities in cardiometabolic risk factors among Black and Hispanic youth in the United States. We focus on three traditional cardiometabolic risk factors (obesity, type 2 diabetes mellitus, and dyslipidemia) as well as on the emerging cardiometabolic risk factor of non-alcoholic fatty liver disease. Additionally, we highlight interventions aimed at improving cardiometabolic health among these minority pediatric populations. Finally, we advocate for continued research on effective prevention strategies to reduce cardiometabolic risk and avert further disparities in cardiovascular morbidity and mortality.
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Affiliation(s)
- Sophia Figueroa Katz
- Stanford Department of Medicine, Cardiovascular Medicine, Cardiovascular Institute, Prevention Research Center, Stanford University, Room CV273, MC 5406, 300 Pasteur Drive, Stanford, CA 94305, USA
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 9500 Euclid Avenue NA21, Cleveland, OH 44195, USA
| | - Fatima Rodriguez
- Stanford Department of Medicine, Cardiovascular Medicine, Cardiovascular Institute, Prevention Research Center, Stanford University, Room CV273, MC 5406, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Joshua W. Knowles
- Stanford Department of Medicine, Cardiovascular Medicine, Cardiovascular Institute, Prevention Research Center, Stanford University, Room CV273, MC 5406, 300 Pasteur Drive, Stanford, CA 94305, USA
- The FH Foundation, Pasadena, CA 91101, USA
- Stanford Diabetes Research Center, Stanford, CA 94305, USA
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Umano GR, Di Sessa A, Guarino S, Gaudino G, Marzuillo P, Miraglia del Giudice E. Telemedicine in the COVID-19 era: Taking care of children with obesity and diabetes mellitus. World J Diabetes 2021; 12:651-657. [PMID: 33995852 PMCID: PMC8107973 DOI: 10.4239/wjd.v12.i5.651] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/01/2021] [Accepted: 04/13/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 infection was declared a pandemic in January 2020. Since then, several measures to limit virus transmission have been imposed; among them, home confinement has been the most severe, with drastic changes in the daily routines of the general population. The "stay at home" rule has impaired healthcare service access, and patients with chronic conditions were the most exposed to the negative effects of this limitation. There is strong evidence of the worsening of obesity and diabetes mellitus in children during this period. To overcome these issues, healthcare providers have changed their clinical practice to ensure follow-up visits and medical consultation though the use of telemedicine. Telemedicine, including telephone calls, videocalls, data platforms of shared telemedicine data platforms mitigated the negative effect of pandemic restrictions. Published evidence has documented good metabolic control and weight management outcomes in centers that performed extensive telemedicine services last year during the pandemic. This review discusses studies that investigated the use of telemedicine tools for the management of pediatric obesity and diabetes.
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Affiliation(s)
- Giuseppina Rosaria Umano
- Department of Woman, Child, and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Anna Di Sessa
- Department of Woman, Child, and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Stefano Guarino
- Department of Woman, Child, and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giuseppina Gaudino
- Department of Woman, Child, and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Pierluigi Marzuillo
- Department of Woman, Child, and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Emanuele Miraglia del Giudice
- Department of Woman, Child, and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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Jorgensen LE, Barrett RE. Case Study Comparison: Limitations in Telehealth Relating to Poverty and Family Support. Semin Hear 2021; 42:158-164. [PMID: 34381299 PMCID: PMC8328545 DOI: 10.1055/s-0041-1731696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Telehealth appointments have grown in popularity due to the COVID-19 global pandemic. Three cases presented in this article show several different perspectives where telehealth was utilized. For the first patient, appointments were successfully completed via telehealth; however, the patient's family opted to continue with an unsecure internet connection at a local laundromat. For the second patient, a stable internet connection could not be obtained in his home, thus making telehealth appointments unavailable. The caregiver of this patient ended up driving to the clinic to have adjustments made in person. For the third patient, telehealth appointments were unavailable due to unstable internet connections as well as difficulty setting up video interpreting services. These cases highlight the idea that telehealth can be incredibly beneficial, when used correctly. For some, the option to attend appointments virtually gives them access to specialists that otherwise may not be available. For other patients, aspects such as access to smart devices and steady internet access must be considered to ensure a successful connection. The hope is that this article sheds light on some of the potential setbacks that can come from the use of telehealth appointments in a practice and provides discussion regarding for whom telehealth may be appropriate, even in pediatric patients. After reading this article, readers should be able to discuss ways in which there could be solutions for these barriers that may prevent some patients from utilizing these types of virtual appointments.
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Affiliation(s)
- Lindsey E. Jorgensen
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota
| | - Rachel E. Barrett
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, South Dakota
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Abstract
The pandemic caused by the new coronavirus (SARS-COV-2) has led to more than two million deaths in the world by March 2021. The worldwide call to reduce transmission is enormous. Recently, there has been a rapid growth of telemedicine and the use of mobile health (mHealth) in the context of the COVID-19 pandemic. Smartphone accessories such as a flashlight, camera, microphone, and microprocessor can measure different clinical parameters such as oxygen saturation, blood pressure, heart rate, breathing rate, fever, pulmonary auscultation, and even voice analysis. All these parameters are of great clinical importance when evaluating suspected patients of COVID-19 or monitoring infected patients admitted in various hospitals or in-home isolation. In remote medical care, the results of these parameters can be sent to a call center or a health unit for interpretation by a qualified health professional. Thus, the patient can receive orientations or be immediately referred for in-patient care. The application of machine learning and other artificial intelligence strategies assume a central role in signal processing and are gaining much space in the medical field. In this work, we present different approaches for evaluating clinical parameters that are valuable in the case of COVID-19 and we hope that soon all these parameters can be measured by a single smartphone application, facilitating remote clinical assessments.
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A literature review of 2019 novel coronavirus (SARS-CoV2) infection in neonates and children. Pediatr Res 2021; 89:1101-1108. [PMID: 32679582 DOI: 10.1038/s41390-020-1065-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/18/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023]
Abstract
At the time of writing, there are already millions of documented infections worldwide by the novel coronavirus 2019 (2019-nCoV or severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)), with hundreds of thousands of deaths. The great majority of fatal events have been recorded in adults older than 70 years; of them, a large proportion had comorbidities. Since data regarding the epidemiologic and clinical characteristics in neonates and children developing coronavirus disease 2019 (COVID-19) are scarce and originate mainly from one country (China), we reviewed all the current literature from 1 December 2019 to 7 May 2020 to provide useful information about SARS-CoV2 viral biology, epidemiology, diagnosis, clinical features, treatment, prevention, and hospital organization for clinicians dealing with this selected population. IMPACT: Children usually develop a mild form of COVID-19, rarely requiring high-intensity medical treatment in pediatric intensive care unit. Vertical transmission is unlikely, but not completely excluded. Children with confirmed or suspected COVID-19 must be isolated and healthcare workers should wear appropriate protective equipment. Some clinical features (higher incidence of fever, vomiting and diarrhea, and a longer incubation period) are more common in children than in adults, as well as some radiologic aspects (more patchy shadow opacities on CT scan images than ground-glass opacities). Supportive and symptomatic treatments (oxygen therapy and antibiotics for preventing/treating bacterial coinfections) are recommended in these patients.
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