Telemedicine screening adolescent metabolic syndrome in Greek schools

Abstract

Background Using telemedicine in the school setting in Greece, we screened a representative adolescent sample for MetS (International Diabetes Federation criteria) and explored its associations with anthropometric, sociodemographic and behavioural parameters. Materials and methods Cross‐sectional data were obtained from 12‐ to 17‐year‐old high school students. Results The prevalence of MetS in 1578 adolescents (mean age ± SD 14.4 ± 1.7 years) was 2.6% (3.4% among males; 2.0% among females), highest (4.3%) at age 13 years and lowest (1.3%) at 16 years. Adolescents with MetS had significantly higher mean body mass index (BMI) ± SD than those without MetS (30.2 ± 4.2 vs 21.3 ± 3.2 kg/m2, respectively; P < 0.001); among participants with obesity, 31.6% had MetS. Abdominal obesity, elevated triglycerides, low HDL‐cholesterol, impaired fasting blood glucose (FBG) and elevated blood pressure (BP) were detected in 9.5%, 2.3%, 10.7%, 25.9% and 21.8% of participants, respectively. Additional analysis (modified NCEP:ATPIII youth criteria) demonstrated similar overall prevalence of MetS (2.9%). Statistically significant correlations were found between most anthropometric and MetS characteristics, with the exception of FBG, which was correlated only with systolic BP. BMI was strongly correlated with waist and hip circumferences (r = 0.818, P < 0.001; r = 0.825, P < 0.001, respectively). Single parenthood and older maternal age (>60 years) were risk factors for MetS. Although counterintuitive, body image distortion, body dissatisfaction and bullying about weight were more prevalent in normal weight girls. Conclusions The overall prevalence of MetS was low but 12‐fold higher when obesity was taken into account. Impaired FBG and elevated BP were the most prevailing features. Telemedicine services were used effectively in Greek schools for screening youth MetS.

Adolescent Self-Efficacy for Diet and Exercise Following a School-Based Multicomponent Lifestyle Intervention

“…Adolescents’ behavioral changes were accompanied by improvements in their abdominal obesity indices—WC, WHtR, and WHR—post-intervention. These changes were translated into a decrease in adolescents’ abdominal obesity from 10.4% to 9.0%, which, although statistically non-significant, can still be considered as a meaningful outcome in view of the high prevalence of abdominal obesity in Greek adolescents [ 29 , 48 ]. Although beneficial changes in abdominal obesity indices from baseline values were observed for all participants following the intervention, the impact was even more apparent and significant in the adolescents with overweight/obesity.…”

“…The study was part of a European-Union-funded “program for health promotion, prevention and screening for characteristics of metabolic syndrome in adolescents attending high schools in three municipalities (Palaio Faliro, Aghios Dimitrios, Alimos) in the Attica region in Greece, with the use of portable telemedicine”, as described in previous studies [ 27 , 28 , 29 ]. Adolescents were screened in the school setting for general and abdominal obesity and other metabolic syndrome characteristics, as well as for their dietary and exercise self-efficacy, at baseline and following a 6-month multi-component, multi-level intervention endorsing healthy nutrition, body image and physical activity.…”

Nursing Practice and Telehealth in School Health Services: A Scoping Review

“…(a) Hearing screenings and speech and communication problems in five studies (15.62%) [48,60,66,72,74]; (b) Promoting healthy habits and lifestyles, with a focus on healthy eating and physical activity in four studies (12.5%) [49,53,55,61]; (c) Promoting mental health and emotion management in four studies (12.5%) [45,52,70,73]; (d) Prevention and management of respiratory problems, especially asthma, in four studies (12.5%) [50,59,67,69]; (e) Oral health screening and hygiene in three studies (9.37%) [51,56,65]; (f) Prevention of tobacco, alcohol, and other substance use in two studies (6.25%) [57,76]; (g) Reproductive health and pregnancy prevention in two studies (6.25%) [54,63]; (h) Screening and monitoring of mental health problems in two studies (6.25%) [46,75]; (i) Care and behaviour in one study (3.12%) [68]; (j) Prevention of psychosocial problems in one study (3.12%) [56]; (k) Autism assessment in one study (3.12%) [47]; (l) Diagnosis and management of skin scabies in one study (3.12%) [71]; (m) Prevention of skin cancer and photoaging in one study (3.12%) [64]; (n) Screening for metabolic syndrome in one study (3.12%) [58].…”

“…Intervention strategies across these studies comprised tele-education using customised information content in capsule format in fifteen studies (46.87%) [46,49,[51][52][53][54]57,[61][62][63][64]69,73,75,76]; telediagnosis or telemonitoring using wearable devices to detect signs, improve treatment adherence, and prevent complications in eight studies (25%) [48,55,56,58,65,66,72,74]; and teleconsultation (telehealth) in nine studies (28.12%) [45,47,50,59,60,67,68,70,71]. Notably, all these interventions were implemented within the context of school health services or school settings.…”

“…In the detection and follow-up of hearing problems, they coordinated with primary care staff in the implementation of the Tele-Health-Kids (THK) programme and collaborated in follow-ups via telemedicine [74]. They coordinated and executed the biochemical analyses (blood draw) and anthropometric tests for metabolic syndrome screening via telemedicine [58].…”