Randomized Controlled Trial of a Primary Care and Home-Based Intervention for Physical Activity and Nutrition Behaviors

Patrick, Kevin; Calfas, Karen J.; Norman, Gregory J.; Zabinski, Marion F.; Sallis, James F.; Rupp, Joan W.; Covin, Jennifer; Cella, John

doi:10.1001/archpedi.160.2.128

Cited by 178 publications

(228 citation statements)

References 39 publications

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“…Using CHWs for patient navigation is a key innovative element in our project. Our results are similar to the initial findings of Patrick, et al, [10] where they employed community health educators and health behavior specialists. Hence the role of the CHWs in the present study clearly helped the research team accomplish the primary aims of the study in terms of positive health behavior change.…”

Section: Discussionsupporting

confidence: 91%

“…To date, efforts to combine clinic-based preventive care efforts with community-based programming among children and adolescents have not been carried out systematically. Recommendations from the United States Preventive Services Task Force's (USPSTF) Guide to Clinical Preventive Services (the Clinical Guide), which includes recommendations for physical activity and dietary counseling [7], and the physical activity promotion recommendations from The Guide to Community Preventive Services (the Community Guide) [8] [9], along with evidence-based assessment and counseling protocols for youth, referred to as the Patient-centered Assessment and Counseling for Exercise Plus Nutrition materials (PACE+) [10]- [13] offer the substance of an integrated intervention approach. We evaluated the feasibility and use of such evidence-based physical activity and dietary assessment and counseling protocols delivered among low-income, predominantly African-American and Latino pediatric patients (ages 10 -17 years) attending local community health clinics through the use of locally recruited and trained community health workers (CHWs).…”

Section: Introductionmentioning

confidence: 99%

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Promoting Active Living and Healthy Eating among Inner-City Youth through Community Health Workers: From Clinic to Neighborhood

Subtirelu¹,

Rincon-Subtirelu²,

Pickett³

et al. 2014

Health

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The promotion of physical activity and healthy eating to prevent obesity among youth is a pressing challenge. The current study examined the feasibility of community health workers (CHWs) conducting a physical activity (PA) and healthy eating intervention strategy with links to community supports and programs. Youth aged 10 -18 years were recruited from three clinical sites serving inner-city families. Trained CHWs conducted assessment and counseling for PA and healthy eating among youth and their families and provided customized plans and navigation to neighborhood PA and nutrition programs. Measures of daily PA by self-report, weekday and weekend day sedentary behaviors, fruit and vegetable intake, avoidance of fatty foods, and avoidance of sugary drinks were assessed at baseline and follow-up. Twenty-five patients (mean age = 12.9 years) were exposed to ~9 months of intervention from baseline. Pre-and post-assessments revealed significant changes in reported PA, sedentary behaviors on weekdays, sedentary behaviors on weekend days, fruit and vegetable intake, avoidance of fatty foods, and avoidance of sugary drinks. Results demonstrated the feasibility of having CHWs effectively influenced the PA and eating behaviors of inner-city youth. Greater success was evident when assessment and counseling for PA and healthy eating were accompanied by navigation to neighborhood resources. The use of CHWs may be a cost-effective approach impacting the PA, sedentary, and dietary behaviors of youth. * Corresponding author. M. Subtirelu et al.2343

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Promoting Active Living and Healthy Eating among Inner-City Youth through Community Health Workers: From Clinic to Neighborhood

Subtirelu¹,

Rincon-Subtirelu²,

Pickett³

et al. 2014

Health

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show abstract

“…We added selfreports of physical activity [27] and fruit/vegetable, fast food, and beverage consumption [28] using previously validated measures. Additional validated measures important to obesity were included, such as availability of fast food within a 10-min walk from home or school, food store access, school vending machine access, school lunch options, and outdoor food/ beverage advertising [29][30][31][32][33][34].…”

Section: Methodsmentioning

confidence: 99%

A pilot study evaluating the effects of a youth advocacy program on youth readiness to advocate for environment and policy changes for obesity prevention

Millstein

Woodruff

Linton

et al. 2016

Behav. Med. Pract. Policy Res.

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Youth advocacy for obesity prevention is a promising but under-evaluated intervention. The aims of this study are to evaluate a youth advocacy program's outcomes related to youth perceptions and behaviors, develop an index of youth advocacy readiness, and assess potential predictors of advocacy readiness. Youth ages 9-22 in an advocacy training program (n = 92 matched pairs) completed surveys before and after training. Youth outcomes and potential predictors of advocacy readiness were assessed with evaluated scales. All 20 groups who completed the evaluation study presented their advocacy projects to a decision maker. Two of six perception subscales increased following participation in the advocacy program: self-efficacy for advocacy behaviors (p < .001) and participation in advocacy (p < .01). Four of five knowledge and skills subscales increased: assertiveness (p < .01), health advocacy history (p < .001), knowledge of resources (p < .01), and social support for health behaviors (p < .001). Youth increased days of meeting physical activity recommendations (p < .05). In a mixed regression model, four subscales were associated with the advocacy readiness index: optimism for change (B = 1.46, 95 % CI = .49-2.44), sports and physical activity enjoyment (B = .55, 95 % CI = .05-1.05), roles and participation (B = 1.81, 95 % CI = .60-3.02), and advocacy activities (B = 1.49, 95 % CI = .64-2.32). The youth advocacy readiness index is a novel way to determine the effects of multiple correlates of advocacy readiness. Childhood obesity-related advocacy training appeared to improve youths' readiness for advocacy and physical activity.

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“…Patrick et al 26 used a randomized controlled design to compare a control intervention unrelated to obesity to a 12-month, theory-based intervention aimed at reducing sedentary behavior, promoting physical activity, and promoting healthier nutrition. The intervention was initiated in primary care but, after the initial primary care visit, was delivered by research staff by phone and mail.…”

Section: Individual/clinical Approaches To Obesity Preventionmentioning

confidence: 99%

The Role of the Pediatrician in Primary Prevention of Obesity

Daniels¹,

Hassink²,

Abrams³

et al. 2015

Pediatrics

321

248

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The adoption of healthful lifestyles by individuals and families can result in a reduction in many chronic diseases and conditions of which obesity is the most prevalent. Obesity prevention, in addition to treatment, is an important public health priority. This clinical report describes the rationale for pediatricians to be an integral part of the obesity-prevention effort. In addition, the 2012 Institute of Medicine report “Accelerating Progress in Obesity Prevention” includes health care providers as a crucial component of successful weight control. Research on obesity prevention in the pediatric care setting as well as evidence-informed practical approaches and targets for prevention are reviewed. Pediatricians should use a longitudinal, developmentally appropriate life-course approach to help identify children early on the path to obesity and base prevention efforts on family dynamics and reduction in high-risk dietary and activity behaviors. They should promote a diet free of sugar-sweetened beverages, of fewer foods with high caloric density, and of increased intake of fruits and vegetables. It is also important to promote a lifestyle with reduced sedentary behavior and with 60 minutes of daily moderate to vigorous physical activity. This report also identifies important gaps in evidence that need to be filled by future research.

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Randomized Controlled Trial of a Primary Care and Home-Based Intervention for Physical Activity and Nutrition Behaviors

Abstract: Improvements in some diet, PA, and sedentary behaviors in adolescents can be enabled through the use of a 1-year, integrated intervention using the computer, health provider counseling, mail, and telephone. The amount of intervention received may contribute to its efficacy.

Cited by 178 publications

References 39 publications

Promoting Active Living and Healthy Eating among Inner-City Youth through Community Health Workers: From Clinic to Neighborhood

Promoting Active Living and Healthy Eating among Inner-City Youth through Community Health Workers: From Clinic to Neighborhood

A pilot study evaluating the effects of a youth advocacy program on youth readiness to advocate for environment and policy changes for obesity prevention

The Role of the Pediatrician in Primary Prevention of Obesity

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