This document summarizes a systematic literature review on the effectiveness of technological interventions and social media platforms for weight loss. The review found that:
- Intervention programs using social media and technology effectively increased weight loss, reduced BMI, increased physical activity, and educated people on healthy eating habits. However, results plateaued in longer interventions.
- Technological interventions show promise for treating obesity as they are cost-effective, efficient, and accessible to anyone with internet access.
- Further research with longer follow-ups is still needed to make results more consistent and applicable in clinical practice. The review identified 17 studies that met criteria for evaluating the impact of technology-based interventions on weight loss.
Comparative efficacy of interventions to promote hand hygiene
in hospital: systematic review and network meta-analysis
Nantasit Luangasanatip,1, 2 Maliwan Hongsuwan,1 Direk Limmathurotsakul,1, 3 Yoel Lubell,1, 4
Andie S Lee,5, 6 Stephan Harbarth,5 Nicholas P J Day,1, 4 Nicholas Graves,2, 7 Ben S Cooper1, 4
Background: There is a global raise in the rate of fall among older adult, often than not, this fall result in severe effect such as hip fracture. Despite effort to rehabilitate this age group after hip fracture, about 50% hardly regain their pre-fracture functional state thereby impairing activity of daily living and their quality of life. Aim: This review aims at evaluating the effectiveness of different strategies of rehabilitation in the promotion of functional gait recovery after hip fracture among older adults. Data Sources: Literature searches were conducted on CINAHL, MEDLINE, SportDiscus and web of science in addition to manual search. Study Selection: Studies were selected based on the inclusion criteria by two independent reviewers. Data Extraction: Data were extracted presented on a spread sheet. Thematic approach was used in analysing the findings because of the heterogeneity of the studies. Result: It was found that 12 weeks intervention as a follow up to usual care comprising of twice a week exercise regimen conducted at home and as out-patient centre each lasting 40 to 90 minutes per session was found to be a promising strategy in rehabilitation after hip fracture among older adults. The strategy was found to improve mobility, balance and muscles strength and power. Furthermore, compliance to treatment regimen was found to be improved in short term interventional studies supervised by a trained physiotherapist. Conclusion: Based on findings, it could be concluded that outcomes were improved with the interventions. However, there is need to verify this claims in relation to appropriate exercise suitable for different cultures.
Data is an essential commodity and various organizations today unlock data to allow them to make business decisions that are highly informed. Data in open source has become highly available and U.K Government has a wide range of available open data to analyse. The paper of this report lies in information extraction from data sets of health for supporting development for wide range of food products that are healthy. The scope of this paper lies in analysing and extracting information from distinct data sets using a specific tool of data analytics that is either SAS JMP or SAS Enterprise guide or base SAS. After this analysis, results for the data will be analysed for showing the requirement for a wide range of food products that are healthy.
Comparative efficacy of interventions to promote hand hygiene
in hospital: systematic review and network meta-analysis
Nantasit Luangasanatip,1, 2 Maliwan Hongsuwan,1 Direk Limmathurotsakul,1, 3 Yoel Lubell,1, 4
Andie S Lee,5, 6 Stephan Harbarth,5 Nicholas P J Day,1, 4 Nicholas Graves,2, 7 Ben S Cooper1, 4
Background: There is a global raise in the rate of fall among older adult, often than not, this fall result in severe effect such as hip fracture. Despite effort to rehabilitate this age group after hip fracture, about 50% hardly regain their pre-fracture functional state thereby impairing activity of daily living and their quality of life. Aim: This review aims at evaluating the effectiveness of different strategies of rehabilitation in the promotion of functional gait recovery after hip fracture among older adults. Data Sources: Literature searches were conducted on CINAHL, MEDLINE, SportDiscus and web of science in addition to manual search. Study Selection: Studies were selected based on the inclusion criteria by two independent reviewers. Data Extraction: Data were extracted presented on a spread sheet. Thematic approach was used in analysing the findings because of the heterogeneity of the studies. Result: It was found that 12 weeks intervention as a follow up to usual care comprising of twice a week exercise regimen conducted at home and as out-patient centre each lasting 40 to 90 minutes per session was found to be a promising strategy in rehabilitation after hip fracture among older adults. The strategy was found to improve mobility, balance and muscles strength and power. Furthermore, compliance to treatment regimen was found to be improved in short term interventional studies supervised by a trained physiotherapist. Conclusion: Based on findings, it could be concluded that outcomes were improved with the interventions. However, there is need to verify this claims in relation to appropriate exercise suitable for different cultures.
Data is an essential commodity and various organizations today unlock data to allow them to make business decisions that are highly informed. Data in open source has become highly available and U.K Government has a wide range of available open data to analyse. The paper of this report lies in information extraction from data sets of health for supporting development for wide range of food products that are healthy. The scope of this paper lies in analysing and extracting information from distinct data sets using a specific tool of data analytics that is either SAS JMP or SAS Enterprise guide or base SAS. After this analysis, results for the data will be analysed for showing the requirement for a wide range of food products that are healthy.
Logging in 3 communities ECIL conference 2021Pamela McKinney
Presentation developed with Andrew Cox and Laura Sbaffi to summarise our quantitative research into Food and activity tracking in 3 communities of participants - people who run for leisure with Parkrun, people with type 2 diabetes who are members of the Diabetes.co.uk online community, and members of the IBS Network charity.
Integrative Health Care Shift Benefits and Challenges among Health Care Profe...ijtsrd
Nurses play an important role in supporting patients with any illness who often seek information regarding alternative therapy. Within their scope of practice, it is expected that nurses have sufficient knowledge about the safety and effective use of alternative therapies, and positive attitudes toward supporting patients who wish to use such therapies. An alternative therapy refers to the health treatments which go along with the medical care, and it is based on natural and traditional methods. It includes natural therapies, herbal medicines yoga, aromatherapy, batch flower medicines, spiritual therapies etc. They offer people the chance to try therapies outside of their standard medical care. These treatment methods are totally different from allopathic medical practices. An evaluative approach with one group pre test, post test design was used for this study. The study was conducted in selected rural areas of Tamilnadu. The samples comprised of 600 health professionals. Convenient sampling technique was used to select the samples. Data was collected using structured knowledge questionnaire before and after administering the structured health education program. The study proved their knowledge improved remarkably after administering the education. The findings of the study support the need for providing information to improve the knowledge of the health professionals regarding complementary therapies in the perspectives of integrating health care shift towards alternative therapies. So the findings have also proved that the information booklet was effective in terms of gain in knowledge scores. Dr. Pushpamala Ramaiah | Dr. Sahar Mohammed Aly | Dr. Afnan Abdulltif Albokhary ""Integrative Health Care Shift- Benefits and Challenges among Health Care Professionals"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020,
URL: https://www.ijtsrd.com/papers/ijtsrd30044.pdf
Paper Url : https://www.ijtsrd.com/medicine/nursing/30044/integrative-health-care-shift--benefits-and-challenges-among-health-care-professionals/dr-pushpamala-ramaiah
Supporting Scaled-up Option B Plus in Malawi, Africa,
It was great to work with great scientists and to be part of this publication. Congratulations Team!
Presentation by Prof. Fernando MArtin-Sanchez, Director of the Health and Biomedical Informatics Centre (HaBIC) of the University of Melbourne at at the Panel on Big Data in Health and Biomedical Research, at the annual AMIA 2013 Conference, 19th November, Washington DC
Logging in 3 communities - lightning talk festivIL 2021Pamela McKinney
Lightning talk (5 minute) presentation given at the online FestivIL conference, June 2021 about research into the information literacy of food and activity tracking in three communities, parkrunners, people with type 2 diabetes, and people with Irritable Bowel Syndrome.
INFLUENCE OF HEALTH SERVICE PROVIDER COMPETENCY ON UTILIZATION OF UNIVERSAL H...Premier Publishers
Health workers competency is very critical in realization of quality health care which is a major pillar of Universal Health Coverage. This study assessed the influence of healthcare provider competency on Universal Health Coverage utilization in Seme Sub County, Kisumu County. The study targeted community households and health facility managers. The health facilities were stratified according to their tiers and randomly sampled. The catchment population was stratified by locations and a proportionate sampling technique applied in each stratum giving a computed sample of 377 participants. The descriptive statistics were summarized using tables and charts, while logistic regression was used to determine relationship between variables. The results revealed that quite a number of health service providers are not competent enough in their departments of operation and there is no periodic training on new guidelines. This study further revealed a statistical effect on competency of health service provider on UHC (OR=2.29, 95%CI=1.02-5.15, p<0.05). Healthcare service provider competency levels have direct significant influence on utilization of UHC services by community members.
Doctoralia Report on Health and the Internet 2015Doctoralia
How do Internet users behave in the field of online heath? The answer to this and other questions can be found in the first Doctoralia Report on Health and the Internet 2015.
Exploring the use of routinely-available, retrospective data to study the ass...HFG Project
Country-level evidence on the impact of malaria control on micro-economic outcomes is vital for mobilizing domestic and donor resources for malaria control. Using routinely available survey data could facilitate this investigation in a cost-efficient way. The authors of this study used Malaria Indicator Surveys (MIS) and Living Conditions Monitoring Survey (LCMS) data from 2006 to 2010 for all 72 districts in Zambia to relate malaria control scale-up with household food spending (proxy for household well-being), educational attainment and agricultural production.
The authors used two quasi-experimental designs: (1) a generalized propensity score for a continuous treatment variable (defined as coverage from owning insecticide-treated bed nets and/or receipt of indoor residual spraying); and, (2) a district fixed effects model to assess changes in the outcome relative to changes in treatment pre-post scale-up. The unit of analysis was at district level. The authors also conducted simulations post-analysis to assess statistical power.
Linking political exposures to child and maternal health outcomes a realist r...Araz Taeihagh
Background: Conceptual and theoretical links between politics and public health are longstanding. Internationally comparative systematic review evidence has shown links between four key political exposures – the welfare state, political tradition, democracy and globalisation – on population health outcomes. However, the pathways through which these influences may operate have not been systematically appraised. Therefore, focusing on child and maternal health outcomes, we present a realist re-analysis of the dataset from a recent systematic review.
Methods: The database from a recent systematic review on the political determinants of health was used as the data source for this realist review. Included studies from the systematic review were re-evaluated and those relating to child and/or maternal health outcomes were included in the realist synthesis. Initial programme theories were generated through realist engagement with the prior systematic review. These programme theories were adjudicated and refined through detailed engagement with the evidence base using a realist re-synthesis involving two independent reviewers. The revised theories that best corresponded to the evidence base formed the final programme theories.
Results: Out of the 176 included studies from the systematic review, a total of 67 included child and/or maternal health outcomes and were included in the realist re-analysis. Sixty-three of these studies were ecological and data were collected between 1950 and 2014. Six initial programme theories were generated. Following theory adjudication, three theories in revised form were supported and formed the final programme theories. These related to a more generous welfare state leading to better child and maternal health especially in developed countries through progressive social welfare policies, left-of-centre political tradition leading to lower child mortality and low birth weight especially in developed countries through greater focus on welfare measures, and increased globalisation leading to greater child and infant mortality and youth smoking rates in LMECs through greater influence of multinational corporations and neoliberal trade organisations.
Conclusion: We present a realist re-analysis of a large systematically identified body of evidence on how four key political exposures – the welfare state, democracy, political tradition and globalisation – relate to child and maternal health outcomes. Three final programme theories were supported.
Keywords: Child health, Maternal health, Health policy, International health, Politics, Realist synthesis
Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Pra...Marion Sills
Kwan BM, Sills MR, Graham D, Hamer MK, Fairclough DL, Hammermeister KE, Kaiser A, Diaz-Perez MJ, Schilling LM. Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Practice-Based Research Network. JABFM. In Press.
Determinants of Malaria Prevalence among Children below Five Years in North W...IIJSRJournal
Background: Globally, malaria remains a major public health problem. In 2019 an estimated 229 million cases of malaria were reported, WHO African region accounted for 94% of total cases. In Kenya, malaria is a leading cause of morbidity and mortality among children under five years living in malaria endemic zones. This study investigated the factors that are associated with malaria prevalence among children under-five years living in North West Kisumu Ward, Kisumu County.
Methods: This cross-sectional study was carried out at Chulaimbo County Hospital from July 2019 to January 2020. Using a validated structured questionnaire, data were obtained from 369 randomly sampled children < 5 years who presented with signs and symptoms of malaria and had malaria positive or negative test results from the laboratory. Children with chronic illnesses such as HIV were not enrolled. Chi-square test of independence and logistic regression analysis was done using SPSS 20.0 software.
Results: Out of 369 participants, 183 (49.6%) tested positive for malaria. Child age was significantly associated with malaria (P = 0.04). There were low malaria odds among females (OR = 0.92, 95% CI 0.61-1.39) and in households where mothers (OR = 0.47, 95% CI 0.16-1.37) or fathers (OR = 0.86, 95% CI 0.31-2.35) had university education. Low malaria risk was also reported among children whose fathers had employment (OR = 0.94, 95% CI 0.49-1.80). On the contrary, high malaria risk was recorded among children whose mothers were employed (OR = 1.24, 95% CI 0.62-2.50). Children from married respondents were likely to test positive for malaria (OR = 1.07, 95% CI 0.60-1.93). Children who used bed nets were less likely to test positive for malaria (OR = 0.70, 95% CI 0.35-1.41). Surprisingly, low malaria risk was reported among severely malnourished children (OR = 0.71, 95% CI 0.42-1.20).
Conclusion: Child age and bed net use, but not nutritional status, are important determinants of malaria prevalence in children under 5 years. The Ministry of Health should promote more efforts towards protecting young children from malaria, by ensuring access and use of bed nets, and enhancing health education.
Unit 5Instructions Enter total points possible in cell C12, under.docxmarilucorr
Unit 5Instructions: Enter total points possible in cell C12, under the rubric. Next enter scores (between 0 and 4) into yellow cells only in column F.Evidence-Based Clinical Question SearchUnsatisfacotrySatisfactoryAverageExcellentScoreWeightFinal Score1234Identify your refined PICOT question.IncompleteN/AN/AComplete05%0.00Using PubMed and the Cochrane collaboration database, do a systematic review of your clinical question.IncompleteN/AN/AComplete010%0.00Describe your systematic review and include an errors analysis.IncompleteN/AN/AComplete010%0.00Determine an evidence-based quantitative article from the search that contains an evidence-based randomized control trial.IncompleteN/AN/AComplete010%0.00Summarize the case study selected.IncompleteN/AN/AComplete05%0.00Describe the study approach, sample size, and population studied.IncompleteN/AN/AComplete05%0.00Apply the evidence from this review to your practice specifically in your overview.IncompleteN/AN/AComplete010%0.00Evaluate the outcomes, identifying the validity and reliability.IncompleteN/AN/AComplete010%0.00Discuss if the study contained any bias.IncompleteN/AN/AComplete010%0.00Determine the level of evidence identified in the review.IncompleteN/AN/AComplete010%0.00LengthLess than 7 pages8 pages9 pages10 pages 05%0.00Format/StyleDid not follow APA formatMajor errors with APA formattingText, title page, and references page follow APA guidelines . Minor references and grammar errorsText, title page and references page follow APA guidelines. No grammar, word usage or punctuation errors. Overall style is consistent with professional work.010%0.00100%0.00Final Score0Percentage0.00%Total available points =2504Rubric ScoreGrade pointsPercentageLowHighLowHighLowHigh3.54.022525090%100%2.53.4920022580%89.99%1.72.4917520070%79.99%1.01.6915017560%69.99%0.01.000150059.99%Comments:
Running head: EFFECTIVE OBESITY MANAGEMENT 1
EFFECTIVE OBESITY MANAGEMENT 2
Effective Obesity Management
Kaplan University
Topic Selection 42/42
EBP Overview 48/48
Length 6/6
Format/Style 20/24
Total 116/120 Outstanding paper with APA errors.
Introduction
With this paper, I will share my research topic question, after much consideration, I came across the best way to address the question and yield evidence based practice results. My question is: is bariatric surgery effective in yielding long term success when compared to lifestyle changes, in the obese population? I will also include the use of reputable reliable search resources such as Cochrane Database. There are significant healthcare issues that can be addressed within my area of specialty, and the focus in healthcare should be to create a better environment where best healthcare decisions can be made. The understanding of these healthcare issues provides a better environment where better pr ...
Unit 4Instructions Enter total points possible in cell C14, under.docxmarilucorr
Unit 4Instructions: Enter total points possible in cell C14, under the rubric. Next enter scores (between 0 and 4) into yellow cells only in column F.Interpreting Statistical Output for Data Analysis PresentationUnsatisfacotrySatisfactoryAverageExcellentScoreWeightFinal Score1234Defined Key Clinical Questions Did not clearly define clinical question for research Attempted to define clinical question, without any reference necessary for database searchVaguely defined clinical question without the reference necessary for database researchClearly defined key clinical question used to search evidence-based databank (i.e, Pubmed, Medline, CINAHL, etc)020%0.00Database ReviewDid not provide a review of the evidence from a database searchProvide a brief overview of database results, not clearly linked to high levels of evidence Defined database results clearly, without generating a key clinical questionDefined database results clearly, generated from key clinical question database search results020%0.00Level 1 & 2 EvidenceOnly referenced Level 5-7 evidence, based on expert opinion andcase study reviews. Referenced research results from Level 4 and belowOnly referenced Level 3 evidenceReferenced randomized control study research and systematic review of randomized control studies (Level 1 and 2 evidence)015%0.00Intrepretation of Statistical ResultsAttemped to provide an overview of the evidence reviewed, but lacked statistically significant data. Attemped to provide a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence. But, unable to clearly intrept stength of evidence and the intrepretation was inaccurate. Attemped to provide a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence. But, unable to clearly intrept stength of evidence. Provides a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence.030%0.00LengthLess than 12 slides.NANAPresentation length 12-15.05%0.00Format/StyleDid not follow APA formatMajor errors with APA formattingText, title page, and references page follow APA guidelines . Minor references and grammar errorsText, title page and references page follow APA guidelines. No grammar, word usage or punctuation errors. Overall style is consistent with professional work.010%0.00100%0.00Final Score0PercentageERROR:#DIV/0!Total available points =4Rubric ScoreGrade pointsPercentageLowHighLowHighLowHigh3.54.00090%100%2.53.490080%89.99%1.72.490070%79.99%1.01.690060%69.99%0.01.0000059.99%
Effective obesity management
Introduction
The growing prevalence of obesity amongst adults and children is a major public health challenge both nationally and internationally.
Therefore the research aims at providing an effective understanding of effective obesity management when focusing on bariatric surgery and lifestyle changes.
...
Logging in 3 communities ECIL conference 2021Pamela McKinney
Presentation developed with Andrew Cox and Laura Sbaffi to summarise our quantitative research into Food and activity tracking in 3 communities of participants - people who run for leisure with Parkrun, people with type 2 diabetes who are members of the Diabetes.co.uk online community, and members of the IBS Network charity.
Integrative Health Care Shift Benefits and Challenges among Health Care Profe...ijtsrd
Nurses play an important role in supporting patients with any illness who often seek information regarding alternative therapy. Within their scope of practice, it is expected that nurses have sufficient knowledge about the safety and effective use of alternative therapies, and positive attitudes toward supporting patients who wish to use such therapies. An alternative therapy refers to the health treatments which go along with the medical care, and it is based on natural and traditional methods. It includes natural therapies, herbal medicines yoga, aromatherapy, batch flower medicines, spiritual therapies etc. They offer people the chance to try therapies outside of their standard medical care. These treatment methods are totally different from allopathic medical practices. An evaluative approach with one group pre test, post test design was used for this study. The study was conducted in selected rural areas of Tamilnadu. The samples comprised of 600 health professionals. Convenient sampling technique was used to select the samples. Data was collected using structured knowledge questionnaire before and after administering the structured health education program. The study proved their knowledge improved remarkably after administering the education. The findings of the study support the need for providing information to improve the knowledge of the health professionals regarding complementary therapies in the perspectives of integrating health care shift towards alternative therapies. So the findings have also proved that the information booklet was effective in terms of gain in knowledge scores. Dr. Pushpamala Ramaiah | Dr. Sahar Mohammed Aly | Dr. Afnan Abdulltif Albokhary ""Integrative Health Care Shift- Benefits and Challenges among Health Care Professionals"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020,
URL: https://www.ijtsrd.com/papers/ijtsrd30044.pdf
Paper Url : https://www.ijtsrd.com/medicine/nursing/30044/integrative-health-care-shift--benefits-and-challenges-among-health-care-professionals/dr-pushpamala-ramaiah
Supporting Scaled-up Option B Plus in Malawi, Africa,
It was great to work with great scientists and to be part of this publication. Congratulations Team!
Presentation by Prof. Fernando MArtin-Sanchez, Director of the Health and Biomedical Informatics Centre (HaBIC) of the University of Melbourne at at the Panel on Big Data in Health and Biomedical Research, at the annual AMIA 2013 Conference, 19th November, Washington DC
Logging in 3 communities - lightning talk festivIL 2021Pamela McKinney
Lightning talk (5 minute) presentation given at the online FestivIL conference, June 2021 about research into the information literacy of food and activity tracking in three communities, parkrunners, people with type 2 diabetes, and people with Irritable Bowel Syndrome.
INFLUENCE OF HEALTH SERVICE PROVIDER COMPETENCY ON UTILIZATION OF UNIVERSAL H...Premier Publishers
Health workers competency is very critical in realization of quality health care which is a major pillar of Universal Health Coverage. This study assessed the influence of healthcare provider competency on Universal Health Coverage utilization in Seme Sub County, Kisumu County. The study targeted community households and health facility managers. The health facilities were stratified according to their tiers and randomly sampled. The catchment population was stratified by locations and a proportionate sampling technique applied in each stratum giving a computed sample of 377 participants. The descriptive statistics were summarized using tables and charts, while logistic regression was used to determine relationship between variables. The results revealed that quite a number of health service providers are not competent enough in their departments of operation and there is no periodic training on new guidelines. This study further revealed a statistical effect on competency of health service provider on UHC (OR=2.29, 95%CI=1.02-5.15, p<0.05). Healthcare service provider competency levels have direct significant influence on utilization of UHC services by community members.
Doctoralia Report on Health and the Internet 2015Doctoralia
How do Internet users behave in the field of online heath? The answer to this and other questions can be found in the first Doctoralia Report on Health and the Internet 2015.
Exploring the use of routinely-available, retrospective data to study the ass...HFG Project
Country-level evidence on the impact of malaria control on micro-economic outcomes is vital for mobilizing domestic and donor resources for malaria control. Using routinely available survey data could facilitate this investigation in a cost-efficient way. The authors of this study used Malaria Indicator Surveys (MIS) and Living Conditions Monitoring Survey (LCMS) data from 2006 to 2010 for all 72 districts in Zambia to relate malaria control scale-up with household food spending (proxy for household well-being), educational attainment and agricultural production.
The authors used two quasi-experimental designs: (1) a generalized propensity score for a continuous treatment variable (defined as coverage from owning insecticide-treated bed nets and/or receipt of indoor residual spraying); and, (2) a district fixed effects model to assess changes in the outcome relative to changes in treatment pre-post scale-up. The unit of analysis was at district level. The authors also conducted simulations post-analysis to assess statistical power.
Linking political exposures to child and maternal health outcomes a realist r...Araz Taeihagh
Background: Conceptual and theoretical links between politics and public health are longstanding. Internationally comparative systematic review evidence has shown links between four key political exposures – the welfare state, political tradition, democracy and globalisation – on population health outcomes. However, the pathways through which these influences may operate have not been systematically appraised. Therefore, focusing on child and maternal health outcomes, we present a realist re-analysis of the dataset from a recent systematic review.
Methods: The database from a recent systematic review on the political determinants of health was used as the data source for this realist review. Included studies from the systematic review were re-evaluated and those relating to child and/or maternal health outcomes were included in the realist synthesis. Initial programme theories were generated through realist engagement with the prior systematic review. These programme theories were adjudicated and refined through detailed engagement with the evidence base using a realist re-synthesis involving two independent reviewers. The revised theories that best corresponded to the evidence base formed the final programme theories.
Results: Out of the 176 included studies from the systematic review, a total of 67 included child and/or maternal health outcomes and were included in the realist re-analysis. Sixty-three of these studies were ecological and data were collected between 1950 and 2014. Six initial programme theories were generated. Following theory adjudication, three theories in revised form were supported and formed the final programme theories. These related to a more generous welfare state leading to better child and maternal health especially in developed countries through progressive social welfare policies, left-of-centre political tradition leading to lower child mortality and low birth weight especially in developed countries through greater focus on welfare measures, and increased globalisation leading to greater child and infant mortality and youth smoking rates in LMECs through greater influence of multinational corporations and neoliberal trade organisations.
Conclusion: We present a realist re-analysis of a large systematically identified body of evidence on how four key political exposures – the welfare state, democracy, political tradition and globalisation – relate to child and maternal health outcomes. Three final programme theories were supported.
Keywords: Child health, Maternal health, Health policy, International health, Politics, Realist synthesis
Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Pra...Marion Sills
Kwan BM, Sills MR, Graham D, Hamer MK, Fairclough DL, Hammermeister KE, Kaiser A, Diaz-Perez MJ, Schilling LM. Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Practice-Based Research Network. JABFM. In Press.
Determinants of Malaria Prevalence among Children below Five Years in North W...IIJSRJournal
Background: Globally, malaria remains a major public health problem. In 2019 an estimated 229 million cases of malaria were reported, WHO African region accounted for 94% of total cases. In Kenya, malaria is a leading cause of morbidity and mortality among children under five years living in malaria endemic zones. This study investigated the factors that are associated with malaria prevalence among children under-five years living in North West Kisumu Ward, Kisumu County.
Methods: This cross-sectional study was carried out at Chulaimbo County Hospital from July 2019 to January 2020. Using a validated structured questionnaire, data were obtained from 369 randomly sampled children < 5 years who presented with signs and symptoms of malaria and had malaria positive or negative test results from the laboratory. Children with chronic illnesses such as HIV were not enrolled. Chi-square test of independence and logistic regression analysis was done using SPSS 20.0 software.
Results: Out of 369 participants, 183 (49.6%) tested positive for malaria. Child age was significantly associated with malaria (P = 0.04). There were low malaria odds among females (OR = 0.92, 95% CI 0.61-1.39) and in households where mothers (OR = 0.47, 95% CI 0.16-1.37) or fathers (OR = 0.86, 95% CI 0.31-2.35) had university education. Low malaria risk was also reported among children whose fathers had employment (OR = 0.94, 95% CI 0.49-1.80). On the contrary, high malaria risk was recorded among children whose mothers were employed (OR = 1.24, 95% CI 0.62-2.50). Children from married respondents were likely to test positive for malaria (OR = 1.07, 95% CI 0.60-1.93). Children who used bed nets were less likely to test positive for malaria (OR = 0.70, 95% CI 0.35-1.41). Surprisingly, low malaria risk was reported among severely malnourished children (OR = 0.71, 95% CI 0.42-1.20).
Conclusion: Child age and bed net use, but not nutritional status, are important determinants of malaria prevalence in children under 5 years. The Ministry of Health should promote more efforts towards protecting young children from malaria, by ensuring access and use of bed nets, and enhancing health education.
Unit 5Instructions Enter total points possible in cell C12, under.docxmarilucorr
Unit 5Instructions: Enter total points possible in cell C12, under the rubric. Next enter scores (between 0 and 4) into yellow cells only in column F.Evidence-Based Clinical Question SearchUnsatisfacotrySatisfactoryAverageExcellentScoreWeightFinal Score1234Identify your refined PICOT question.IncompleteN/AN/AComplete05%0.00Using PubMed and the Cochrane collaboration database, do a systematic review of your clinical question.IncompleteN/AN/AComplete010%0.00Describe your systematic review and include an errors analysis.IncompleteN/AN/AComplete010%0.00Determine an evidence-based quantitative article from the search that contains an evidence-based randomized control trial.IncompleteN/AN/AComplete010%0.00Summarize the case study selected.IncompleteN/AN/AComplete05%0.00Describe the study approach, sample size, and population studied.IncompleteN/AN/AComplete05%0.00Apply the evidence from this review to your practice specifically in your overview.IncompleteN/AN/AComplete010%0.00Evaluate the outcomes, identifying the validity and reliability.IncompleteN/AN/AComplete010%0.00Discuss if the study contained any bias.IncompleteN/AN/AComplete010%0.00Determine the level of evidence identified in the review.IncompleteN/AN/AComplete010%0.00LengthLess than 7 pages8 pages9 pages10 pages 05%0.00Format/StyleDid not follow APA formatMajor errors with APA formattingText, title page, and references page follow APA guidelines . Minor references and grammar errorsText, title page and references page follow APA guidelines. No grammar, word usage or punctuation errors. Overall style is consistent with professional work.010%0.00100%0.00Final Score0Percentage0.00%Total available points =2504Rubric ScoreGrade pointsPercentageLowHighLowHighLowHigh3.54.022525090%100%2.53.4920022580%89.99%1.72.4917520070%79.99%1.01.6915017560%69.99%0.01.000150059.99%Comments:
Running head: EFFECTIVE OBESITY MANAGEMENT 1
EFFECTIVE OBESITY MANAGEMENT 2
Effective Obesity Management
Kaplan University
Topic Selection 42/42
EBP Overview 48/48
Length 6/6
Format/Style 20/24
Total 116/120 Outstanding paper with APA errors.
Introduction
With this paper, I will share my research topic question, after much consideration, I came across the best way to address the question and yield evidence based practice results. My question is: is bariatric surgery effective in yielding long term success when compared to lifestyle changes, in the obese population? I will also include the use of reputable reliable search resources such as Cochrane Database. There are significant healthcare issues that can be addressed within my area of specialty, and the focus in healthcare should be to create a better environment where best healthcare decisions can be made. The understanding of these healthcare issues provides a better environment where better pr ...
Unit 4Instructions Enter total points possible in cell C14, under.docxmarilucorr
Unit 4Instructions: Enter total points possible in cell C14, under the rubric. Next enter scores (between 0 and 4) into yellow cells only in column F.Interpreting Statistical Output for Data Analysis PresentationUnsatisfacotrySatisfactoryAverageExcellentScoreWeightFinal Score1234Defined Key Clinical Questions Did not clearly define clinical question for research Attempted to define clinical question, without any reference necessary for database searchVaguely defined clinical question without the reference necessary for database researchClearly defined key clinical question used to search evidence-based databank (i.e, Pubmed, Medline, CINAHL, etc)020%0.00Database ReviewDid not provide a review of the evidence from a database searchProvide a brief overview of database results, not clearly linked to high levels of evidence Defined database results clearly, without generating a key clinical questionDefined database results clearly, generated from key clinical question database search results020%0.00Level 1 & 2 EvidenceOnly referenced Level 5-7 evidence, based on expert opinion andcase study reviews. Referenced research results from Level 4 and belowOnly referenced Level 3 evidenceReferenced randomized control study research and systematic review of randomized control studies (Level 1 and 2 evidence)015%0.00Intrepretation of Statistical ResultsAttemped to provide an overview of the evidence reviewed, but lacked statistically significant data. Attemped to provide a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence. But, unable to clearly intrept stength of evidence and the intrepretation was inaccurate. Attemped to provide a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence. But, unable to clearly intrept stength of evidence. Provides a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence.030%0.00LengthLess than 12 slides.NANAPresentation length 12-15.05%0.00Format/StyleDid not follow APA formatMajor errors with APA formattingText, title page, and references page follow APA guidelines . Minor references and grammar errorsText, title page and references page follow APA guidelines. No grammar, word usage or punctuation errors. Overall style is consistent with professional work.010%0.00100%0.00Final Score0PercentageERROR:#DIV/0!Total available points =4Rubric ScoreGrade pointsPercentageLowHighLowHighLowHigh3.54.00090%100%2.53.490080%89.99%1.72.490070%79.99%1.01.690060%69.99%0.01.0000059.99%
Effective obesity management
Introduction
The growing prevalence of obesity amongst adults and children is a major public health challenge both nationally and internationally.
Therefore the research aims at providing an effective understanding of effective obesity management when focusing on bariatric surgery and lifestyle changes.
...
Quantitative/Mixed-Methods
American InterContinental University
March 27, 2018
Running head: QUANTITATIVE/MIXED-METHODS
1
QUANTITATIVE/MIXED-METHODS
2
Quantitative/Mixed-Methods
Abstract
Case studies which are done in the field of medicine work towards improving the health of the population. There are some of the parts contained in case studies which are abstract, results, limitations of results, conclusions, and applications. The common statistical methods used in research are descriptive numerical and qualitative thematic analyses. The results of the studies show that equal participation of individuals in the health sector will help boost public health. Limitations of results are that although some strategies may work towards improving health sector, not all of them are effective.
Public health is an important sector in any country for it directly affects the economy of the nation. There need to be certain ways which should be employed with the aim of supporting and improving public health. In this paper, I am going to examine 4 contemporary peer-reviewed articles which employ quantitative or mixed-methods concerning ways on how to improve the health of the public. The interest of the paper is to aid in achieving the best impact in public health sector via using programs which will improve health outcomes drastically. Enhancement of public health will in return help to improve the well-being of populations across the world. Public health awareness on how to avoid unhealthy lifestyles should be created.
In the articles, samples and populations used were appropriate for it showed the real representative of the population at hand. All the samples used in the 4-contemporary peer-reviewed articles fulfilled the rule of thumb hence making them appropriate. The samples used were suitable for they were used to estimate the population parameters for it stood for the entire inhabitants. The samples used were larger but not too large to consume more resources of money and time. The larger sample has helped to produce accurate results making the samples valid and appropriate. The appropriateness of the samples used in these articles, it has been proved via usage of target variance. In using target variance an estimate to be derived from the model eventually attained.
Each article which has been used includes having results, limitations of results, conclusions, and applications. The first contemporary peer-reviewed article is entitled, Refugee women’s involvements of maternity-care facilities in Canada: a methodical review using a description synthesis written by Gina MA Higginbottom, Myfanwy Morgan, Miranda Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay and Rubina Barolia. The article was published 11 February 2015. The results show that there needs to have a healthier understanding of the aspects that produce discrepancies in availability, adequacy, and outcomes during parenthood care (Higginbottom, Morgan, Alexandre, Chiu, Forg ...
SUPPORTING LARGE-SCALE NUTRITION ANALYSIS BASED ON DIETARY SURVEY DATAhiij
While online survey systems facilitate the collection on copious records on diet, exercise and other healthrelated
data, scientists and other public health experts typically must download data from those systems
into external tools for conducting statistical analyses. A more convenient approach would enable
researchers to perform analyses online, without the need to coordinate additional analysis tools. This
paper presents a system illustrating such an approach, using as a testbed the WAVE project, which is a 5-
year childhood obesity prevention initiative being conducted at Oregon State University by health scientists
utilizing a web application called WavePipe. This web application has enabled health scientists to create
studies, enrol subjects, collect physical activity data, and collect nutritional data through online surveys.
This paper presents a new sub-system that enables health scientists to analyse and visualize nutritional
profiles based on large quantities of 24-hour dietary recall records for sub-groups of study subjects over
any desired period of time. In addition, the sub-system enables scientists to enter new food information
from food composition databases to build a comprehensive food profile. Interview feedback from novice
health science researchers using the new functionality indicated that it provided a usable interface and
generated high receptiveness to using the system in practice.
SUPPORTING LARGE-SCALE NUTRITION ANALYSIS BASED ON DIETARY SURVEY DATAhiij
While online survey systems facilitate the collection on copious records on diet, exercise and other healthrelated data, scientists and other public health experts typically must download data from those systems
into external tools for conducting statistical analyses. A more convenient approach would enable
researchers to perform analyses online, without the need to coordinate additional analysis tools. This
paper presents a system illustrating such an approach, using as a testbed the WAVE project, which is a 5-
year childhood obesity prevention initiative being conducted at Oregon State University by health scientists
utilizing a web application called WavePipe. This web application has enabled health scientists to create
studies, enrol subjects, collect physical activity data, and collect nutritional data through online surveys.
This paper presents a new sub-system that enables health scientists to analyse and visualize nutritional
profiles based on large quantities of 24-hour dietary recall records for sub-groups of study subjects over
any desired period of time. In addition, the sub-system enables scientists to enter new food information
from food composition databases to build a comprehensive food profile. Interview feedback from novice
health science researchers using the new functionality indicated that it provided a usable interface and
generated high receptiveness to using the system in practice.
SUPPORTING LARGE-SCALE NUTRITION ANALYSIS BASED ON DIETARY SURVEY DATAhiij
While online survey systems facilitate the collection on copious records on diet, exercise and other healthrelated data, scientists and other public health experts typically must download data from those systems
into external tools for conducting statistical analyses. A more convenient approach would enable
researchers to perform analyses online, without the need to coordinate additional analysis tools. This
paper presents a system illustrating such an approach, using as a testbed the WAVE project, which is a 5-
year childhood obesity prevention initiative being conducted at Oregon State University by health scientists
utilizing a web application called WavePipe. This web application has enabled health scientists to create
studies, enrol subjects, collect physical activity data, and collect nutritional data through online surveys.
This paper presents a new sub-system that enables health scientists to analyse and visualize nutritional
profiles based on large quantities of 24-hour dietary recall records for sub-groups of study subjects over
any desired period of time. In addition, the sub-system enables scientists to enter new food information
from food composition databases to build a comprehensive food profile. Interview feedback from novice
health science researchers using the new functionality indicated that it provided a usable interface and
generated high receptiveness to using the system in practice.
SUPPORTING LARGE-SCALE NUTRITION ANALYSIS BASED ON DIETARY SURVEY DATAhiij
While online survey systems facilitate the collection on copious records on diet, exercise and other healthrelated data, scientists and other public health experts typically must download data from those systems
into external tools for conducting statistical analyses. A more convenient approach would enable
researchers to perform analyses online, without the need to coordinate additional analysis tools. This
paper presents a system illustrating such an approach, using as a testbed the WAVE project, which is a 5-
year childhood obesity prevention initiative being conducted at Oregon State University by health scientists
utilizing a web application called WavePipe. This web application has enabled health scientists to create
studies, enrol subjects, collect physical activity data, and collect nutritional data through online surveys.
This paper presents a new sub-system that enables health scientists to analyse and visualize nutritional
profiles based on large quantities of 24-hour dietary recall records for sub-groups of study subjects over
any desired period of time. In addition, the sub-system enables scientists to enter new food information
from food composition databases to build a comprehensive food profile. Interview feedback from novice
health science researchers using the new functionality indicated that it provided a usable interface and
generated high receptiveness to using the system in practice.
The explosion in the number of applications (apps) designed for the medical and wellness sectors has been noted by many. Recently we have seen increased presence of truly medical apps, in addition to consumer health and wellbeing apps, designed for clinical professionals and patients with medical conditions.
Consumer based mHealth apps typically allow people to do old things in new ways, such as recording health measures digitally rather than on paper. We see this also with medical apps, where increases in the quality and efficiency of existing health care models provide clinical staff with digital tools that replace paper based documentation. In rare and exciting cases we are also seeing mHealth applications that are doing things in entirely new ways to drive real innovation in health care delivery through mobile devices.
The aim of the tutorial is to highlight real world, high impact mobile research that is relevant to the key discipline of Mobile HCI. Thus, the tutorial will be application rather than academically focused. The tutorial will highlight the wide range of mHealth applications available that go far beyond trackers and behavior change tools and encourage researchers to look beyond consumer applications in their research. Four key areas of mHealth applications will be covered including Apps for the HealthyWell, mHealth in Hospitals, Practice and Clinical Apps and Patient Apps and will cover applications for health assessment, treatment and triage, behavior change, chronic illness, mental health, adolescent health, rehabilitation and age care with a focus on the need for rigorous evaluation and efficacy analysis.
Low Functional health literacy is a problem affecting 90 million residents of the United States. Among the 90 million, 36% are adults who have “below basic” health literacy skills. Assessing health literacy is important in improving health behaviors, health outcomes, and perceived communication barriers related to health. The Patient Protection and Affordable Care Act enacted in 2010 brought about changes that demand a more coordinated approach to manage health care services. This research focused on the efforts being made to promote health literacy at Medicaid health homes such as Greater Buffalo United Accountable Healthcare Network (GBUAHN). This research consisted of observation of Patient Health Navigator interactions with patients in order to identify best practices of health literacy initiatives within GBUAHN. Results suggest best practices include promoting and establishing relationship to effectively enhance patients understanding of all their healthcare needs. This study suggests that GBUAHN should continue making use of recommendations related health literacy promotion while exploring areas of improvement as noted on scorecard. Patient Health Navigators are engaging patient in manner that will establish adherence within patients.
A Descriptive Study of Health Literacy Practices at GBUAHN
Final-SLR-MARKO-PAPUCKOVSKI
1. Marko Papuckovski 4074610
Does the use of Technological Interventions and Social Media platforms affect weight-
loss in overweight populations - a systematic review of current literature
Abstract
Background: With obesity becoming a worldwide epidemic, revolutionary technological
interventions and support through social media may prove to be an effective way in
treating and reversing the current epidemic.
Aim: To evaluate the effectiveness of technological intervention programs aimed at
reducing obesity and increasing weight loss in overweight populations.
Methods: A systematic literature review using data from databases; PubMed, Cochrane
and Web Of Science. The inclusion criteria stated that the article must be published
after the year 2004 and that subjects included are free from disease states that are
unassociated with obesity.
Results: The data showed that intervention programs through technology such as social
media prove to be effective in increasing weight loss, reducing BMI measurements,
increasing physical activity levels and educating subjects on healthy eating habits.
However, results proved to be short term and eventually started to plateau in the longer
interventions.
Conclusion: Technological interventions show promise in the treatment of obesity;
interventions are cost effective, efficient and attainable to anybody with internet
access. However, further research needs to be done in order to make the results more
consistent and clinically applicable; follow up studies and longer interventions are
necessary.
Keywords: obesity, technology, social media, intervention
Introduction
“Obesity worldwide has more than doubled since 1980, in 2014, more than 1.9 billion
adults aged over the age of 18 were overweight, of which these 600 million were obese.
Furthermore, 42 million children under the age of 5 were overweight or obese in
2013.” (WHO - World Health Organization 2015). Obesity is a worldwide epidemic, in
Australia, the NHMRC (National Health and Medical Research Council) has found that
roughly 25% of children aged 2-16 years of age were overweight or obese. The NHMRC
estimates that at current rates, over two thirds of Australia's population will be
overweight by the year 2025 and a third will develop type 2 diabetes in their lifetime, a
lifestyle related disease. The world’s favorite chef, Jamie Oliver once said that “diet
2. related disease is the biggest killer in the United States, with England and Australia right
behind - we need a revolution and now is the time!”
Changing eating habits is a result of changing ones environment, when removing
unhealthy options, nutritious foods become plan A and plan B. In the WHO factsheet on
obesity and overweight diseases, it is stated that “supportive environments and
communities are fundamental in shaping people’s choices, making healthier choice of
foods and regular physical activity more prominent.”
Our environment is becoming exponentially embedded with technology and social
media, young adults in particular are more likely than any other age group to spend time
on social media platforms such as; Facebook, Twitter, Instagram, Youtube, Blogs,
Podcasts and other websites. Technology and the internet is so prevalent that the term
‘internet addiction’ has become a social norm of the current culture. Recent studies
performed in China and Korea show that roughly 18% of teenagers in Korea and 19% of
adolescents in China are classified as having internet addiction. (Li, L et al. 2015)
These figures provide an insight of how deeply rooted internet usage is in the current
generation and its culture. However, there are many advantages to social media
platforms provided by technological advances, these platforms now provide a new
environment - not physical, but virtual. Health intervention through this virtual
environment may prove to be a revolutionary and effective means of treating obesity in
current, and future populations.
Leveraging exponentially low cost technologies are affecting the way we look at health.
Leveraging technology to our advantage has provided us with ‘apps’ that can go as far as
analyzing ones genetic makeup, some apps are so extreme that you can self diagnose for
an STD, others include glucose meters to measure blood glucose and potentially send
this to your physician for examination. Moore’s Law states that computer technology is
exponentially improving, therefore it may be accurate to predict that we are moving to
a paradigm of biomedicine incorporated with information technology and wireless
communication.
A comprehensive Systematic Literature Review (SLR) was undertaken to determine
whether multidisciplinary interventions via technology and social media platforms are
effective in health interventions within overweight subjects. This review will provide an
3. Marko Papuckovski 4074610
insight in current interventions and the modifications necessary to make these
interventions more effective in increasing weight loss in overweight subjects. The SLR
will aim to determine the predisposition of future studies by reducing limitations of
current literature, save costs on research that is unnecessary or unreliable and finally it
will aim to eliminate possible bias within the research topic, offering a more precise
method for future research. It is hypothesized that health interventions via
technological platforms such as social media will provide further support and affect
weight loss in obese or overweight subjects in a positive manner. The studies will
provide an insight of behavioral tendencies associated with obesity and internet usage.
Method
A systematic literature search was performed using the following databases; PubMed,
Scopus, ScienceDirect, Cochrane and Web Of Science. The studies were limited to
intervention studies between the years of 2004 - 2015. The inclusion criteria accepted
randomized controlled trials, prospective and retrospective cohort studies, pilot studies
and time series studies. The studies must include internet based interventions on
overweight subjects over a pre-determined amount of time; this can provide measurable
parameters. The intervention must contain comparisons and show an improvement of at
least one of the following biomarkers: body weight, BMI, motivation, self efficacy, waist
circumference, physical activity, dietary changes such as reduced fat and sugar intake
and increased fruit and vegetable intake. Because technology and social media were the
core of the study, digital parameters such as ‘facebook intensity scales’, the amount of
likes, comments and shares will be used in the same sense as biomarkers to provide an
insight of active use within an intervention program. The studies included must indicate
a measurable biomarker/parameter pre intervention and post intervention. Studies that
include only social media platforms to provide a supportive environment were included.
Studies were excluded if they were published prior to 2004. The exclusion criteria also
excluded any studies in which the subject group suffered from diseases other than those
that are obesity related such as genetic predispositions to diabetes or eating disorders
such as anorexia or bulimia. The exclusion criteria were also effective in any studies
that did not include technology or social media within their intervention programs.
Systematic Literature Reviews and Meta-Analysis studies were also excluded.
4. A pilot search was undertaken using the mesh terms ‘obesity AND technolog* AND
intervention’, this initial search provided 408 articles in the Web Of Sciences database.
When categorizing the 408 articles and refining the search to only include research
articles and exclude ‘review’,‘book chapter,’ or ‘proceeding paper’, the results were
narrowed down to 309 articles. The use of Boolean search terms also further narrowed
down the results to more specific findings. These included,‘obesity prevention AND
social media’,‘overweight AND technolog* AND intervention’,‘obesity AND lifestyle
intervention studies’.
Although Systematic Literature Reviews do not require ethical approval, ethics within
the studies included should be addressed; this will be done by using the Quality Criteria
Checklist (Appendix 1) and ensuring that ethical conduct is considered within all of the
studies that were included in the review. These studies ensured that the subjects
involved had provided consent for their date and statements to be used in analysis and
discussion. The studies will be assessed on their quality based on the levels of evidence
developed by the National Health and Medical Research Council (NHMRC). Studies are
judged on their level of evidence and categorized into level I, II, III-1, III-2, III-3 or IV.
The top two highest quality studies are I - A systematic review of level II studies and II -
A randomized controlled trial in which an “independent, blinded comparison with a valid
reference standard” was performed. (NHMRC, levels of evidence, 2009, pp.6)
Furthermore, each study was assessed using the Quality Rating Checklist from the
Evidence Analysis Manual by the Academy of Nutrition and Dietetics 2012. This criterion
assessed whether the studies included had clearly addressed the issues of the inclusion
and exclusion criteria, bias, generalizability, and data collection analysis. (Appendix 1.1)
Following analysis and quality rating, each study was then collated into a summary
table. The summary table categorized the articles by
‘Author’,‘Location’,‘Year’,‘Design’,‘Level of Evidence Rating,’,Sample
Size’,‘Intervention’,‘Results/Comments’. (Appendix 1.2)
Results
A thorough database search resulted in 32 articles being tested for inclusion criteria, of
which only 17 were eligible for this review. The final articles chosen included 1 pilot
study and 16 randomised controlled trials, this proved to be a sufficient amount of
evidence to draw a conclusion regarding technological interventions and their effects on
weight loss.
5. Marko Papuckovski 4074610
Table 1: PRISMA flowchart
Results within the articles included were categorized into 3 sections;
1. Measurable biomarkers such as changes in BMI, changes in body fat and changes in
overall body weight.
2. Changes in levels of physical activity; the studies had to show either an increase or
decrease in physical activity levels in subject via minutes measure by ‘apps’ or
accelerometers, or by surveys and questionnaires.
3. Education/Motivation; articles had to indicate a change in eating patterns in the
subjects, either an increased intake of fruit and vegetables or a decreased intake of
6. saturated fats, processed sugars and snacks. Motivation levels to continue with an
intervention must also be shown via surveys or questionnaires.
The following summary table provides a breakdown of the articles included from oldest
to most recent.
Table 2: Summary table of articles included
7. Marko Papuckovski 4074610
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
Williams
on, D,
A,. et al.
United
States
2006 Random
ized
Controll
ed Trial
II 57
overweig
ht girls
African
American
girls were
randomly
assigned to
one of two
intervention
s;
1. Behavioral
internet
program
2. Internet
health
education
program
BMI, body
weight and
boy
compositions
measuremen
ts were
performed
at 6 month
intervals and
at the
completion
of the 2
years.
The internet
intervention
group lost more
body fat and the
internet
education
program group
lost more mean
body weight.
The weight loss
occurred in the
first 6 months -
at the
completion of
the study, results
at 2 years
showed no
difference in
weight loss
between the two
intervention
groups.
8. Hurling,
R,. et al.
United
Kingdo
m
2007 Random
ized
Controll
ed Trial
II 77 47
participants
were
randomized
to a test
group that
had access
to an
internet and
mobile
phone based
activity
program and
30
participants
were
assigned to
a control
group that
had no
support.
The test group
showed a greater
increase over
the baseline
than the control
group for
perceived
control and
intention to
exercise. Leisure
data indicated
that the test
group had a
greater level of
moderate
physical activity
and lost more
body fat.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
9. Marko Papuckovski 4074610
Gow, R,
W,. et al
United
States
2009 Random
ized
Controll
ed Trial
II 170 An internet
intervention
of first year
college
students
that were
randomly
assigned to
1 of 4
groups:
1. no
treatment
2. 6 week
online
interventi
on
3. 6 week
weight
and
caloric
feedback
- only via
email
4. 6 week
combine
feedback
& online
interventi
on
The combined
intervention
group showed
the lowest BMI
at the
completion of
the intervention.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
10. Liebreic
h, T et
al.
Portug
al
2009 Pilot
Study
II 49 12 week
website an
email linked
counselling
intervention
on physical
activity
behaviour
change in
individuals
with type 2
diabetes.
The intervention
group showed an
improvement in
vigorous activity.
Increased
minutes spent on
moderate
physical activity.
Pilot study shows
potential for a
larger RCT.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
11. Marko Papuckovski 4074610
McGrievy
, T,. et
al
United
States
2009 Random
ized
Controll
ed Trial
II 78 A 12 week
intervention
in which
subjects
were
separated
into two
groups that
both
received a
different
version of a
weight loss
podcast:
1. Weight
loss
podcast
(control)
2. Weight
loss
podcast
based on
social
cognitive
theory
(enhanced
)
The enhanced
group had
greater weight
loss then the
control group
and also showed
an increase in
weight loss
related
knowledge.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
12. Webber,
K, H,. et
al
United
States
2010 Random
ized
Controll
ed Trial
II 66 Initial face
to face
motivation
sessions
followed by
a 16 week
internet
program.
Motivation
increased
initially and
remained high
for those with 5%
weight loss,
however by 4
weeks,
motivation
decreased by
those who had
not seen a 5%
decrease in
weight loss.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
13. Marko Papuckovski 4074610
Cavallo,
D.N. et
al
United
States
2012 Random
ized
Controll
ed Trial
II 134 12 week
physical
activity
social
support
network to
increase
support for
physical
activity.
67 subjects
assigned to
online social
network plus
self
monitoring
and the
other 67
assigned to
education
only.
The use of an
online social
network plus self
monitoring did
not produce
greater
perception of
social support
for physical
activity when
compared to the
education only
group. The
‘Facebook
Intensity Scale’
was used to
measure overall
engagement in
intervention
group - a better
parameter of
measure may
provide greater
detail regarding
results.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
14. Taylor,
C, B,. et
al.
United
States
2012 Random
ized
Controll
ed Trial
II 118
normal
weight
subjects
& 64
overweig
ht/obese
subjects
Subjects
over their
85th
percentile of
BMI for their
age were
assigned to
the
StayingFit
program;
the program
provides
cognitive
behavioral
principles,
adolescent
weight loss
intervention
s, satiety &
hunger
awareness
skills, self
monitoring
skills, goal
setting &
emotion
regulation
skills.
Results showed
that BMI slightly
increased in the
general group
from 20.3 to
20.7 and
decreased
slightly in the
weight
maintanence
group from 27.5
to 26.6. Students
reported in
consuming more
fruit and
vegetables.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
15. Marko Papuckovski 4074610
Brindad,
E,. et al
Austra
lia
2012 Random
ized
Controll
ed Trial
II 8112 A 12 week
web based
weight loss
intervention
. 7 sites
were used,
subjects
were
separated
into 3
groups.
1. Informatio
n based
n=183
2. Supportiv
e based
n=3994
3. Personal
supportive
n=3935
Dietary
information
provided
was based
on ‘The
Wellbeing
Diet’.
Attrition was
high in the study
with 40% of
subjects
dropping out in
the first week.
Retention of
subjects was
higher in the two
support based
groups. At the
completion of
the study, 435
subjects
provided valid
weight
measurements.
The average
weight loss
overall was
2.76% with no
significant
difference in
weight loss
between the
intervention
groups.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
16. LaChauss
e, R, G,.
et al.
United
States
2012 Random
ized
Controll
ed Trial
II 320 Undergradua
te students
were
randomly
assigned to
3 separate
intervention
groups;
1. MSB
nutrition
program
2. On-
campus
weight
managem
ent
program
3. Compariso
n group
Students
performed
surveys
regarding
nutrition,
physical
activity,
stress,
attitude and
body
The MSB
nutrition group
showed an
increase in fruit
and vegetable
consumption, a
reduction in
stress levels and
increased self
efficacy -
however they
showed no
significant
change in
physical activity
or weight loss
when compared
to the other
intervention
groups.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
17. Marko Papuckovski 4074610
Genugte
n, L,. et
al.
Nether
lands
2012 Random
ized
Controll
ed Trial
II 539 A tailored
intervention
via a generic
information
website.
Anthropome
tric
measuremen
ts were
taken at
baseline and
at
completion
of the
intervention
at 6 months.
No statistically
significant
difference
between the
study groups.
Similar results
shown for waist
circumference
and skin fold
thickness.
However, the
physical activity
increased in the
intervention
group and the
intake of fatty
and sugary
snacks
decreased. The
online
intervention
resulted in
changes in the
desired
direction.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
18. Carr, L,
J,. et al.
United
States
2013 Random
ized
Controll
ed Trial
II 53 An internet
based
intervention
with an
Enhanced
Internet
group versus
a Standard
Internet
group. Five
internet
features
were
included to
increase
physical
activity;
1. PA
tracking/
logging
2. Georgraph
ic
mapping
tool
3. Discussion
forum for
social
support
4. Exercise
The Enhanced
Internet Group
showed an
increase in
physical activity
within the first 3
months when
compared to the
Standard
Internet group.
The EI group also
maintained the
increase PA over
6 months.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
19. Marko Papuckovski 4074610
Napolita
no, M,
A,. et al.
United
States
2013 Random
ized
Controll
ed Trial
II 52 Subjects
were
assigned to
one of three
groups:
1. Facebook
group
n=17
2. Facebook
plus text
group
n=18
3. Control
group
n=17
The
intervention
lasted 8
weeks.
At the
completion of
the intervention
the Facebook
plus group had
significantly
greater weight
loss than both
the Facebook
only group and
the control
group.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
20. Patrick,
K et al.
United
States
2014 Random
ized
Control
Trial
II 404 A 2 year
clinical trial
deployed via
Facebook,
Smart Phone
Apps, SMS &
other
Internet
platforms to
provide an
engaging
weight loss
program
incorporatin
g the SMART
strategy
program.
Measurements
will occur at 6,
12, 18 and 24
months. The
primary goal of
the intervention
is a 5-10% weight
loss at the
completion of
the 24 months.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
21. Marko Papuckovski 4074610
Dennison
, L et al.
Unite
Kingdo
m
2014 Random
ized
Controll
ed Trial
II 786 The
intervention
included the
POWeR Web
Based
weight
management
program.
POWeR
consisted of
weekly
online
sessions that
included self
monitoring,
goal setting
and
cognitive/
behavioral
strategies.
4. POWeR
only group
5. POWeR
plus
coaching
group
6. waiting lis
group
Participants in
the POWeR plus
coaching group
persisted with
the intervention
for longer and
were 1.61 times
more likely to
complete
sessions then
those in the
POWeR only
group. Both
intervention
groups showed
greater weight
loss than the
waiting list
control group -
the weight loss
in the POWeR
plus coaching
group was
slightly higher
then that in the
POWeR only
group.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
22. Blomfiel
d, R,. et
al
Austra
lia
2014 Random
ized
Control
Trial
II 3 separate
intervention
groups
1. Gender
tailored
weight
loss
resources
2. Online
resources
plus
website
feedback
3. Control
group
Total energy,
total fat,
saturated fat
and
carbohydrate
intake decreased
in online
intervention
group - there
was also an
increase in
percentage of
‘core’ foods.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
23. Marko Papuckovski 4074610
Li, W,.
et al.
Englan
d
2015 Random
ized
Controll
ed Trial
II 260 The
intervention
aimed to
analyze the
structural
and
functional
information
and the
neural
mechanism
underlying
internet
addiction in
healthy
young
adults.
The results
showed that
internet
addiction results
were directly
correlated with
reduced function
of inhibitory
control.
Referen
ce
Locati
on
Yr Design Level
of
Evid
ence
Ratin
g
Sample
Size
Intervention Results/
Comments
24. Biomarkers
Of the 16 randomised controlled trials included, 9 showed changes in measurable
biomarkers. The results consistently showed that the intervention groups had greater
weight loss, great body fat loss and a reduction in BMI.
Dennison, L,. et al performed an intervention based on weekly online sessions of self
monitoring, goal setting and cognitive/behavioral strategies. The articles were published
in 2014 and the intervention was labelled as the POWeR program. Participants were
separated into two groups, POWeR only, POWeR plus coaching and a control group. At
the completion of the study both POWeR intervention groups reported greater weight
loss than the control group. The mean difference between the POWeR plus group and
the control group was 1.97kg, and the POWeR only group 1.70kg.
Taylor, C, B,. et al studied the effects of a 10 week internet based intervention program,
118 high school students were allocated to the healthy weight regulation program and
64 to the weight maintenance program. BMI showed a decrease in the healthy weight
regulation group from 20.7 (s.d. = 2.4) to 26.6 (s.d. = 5.7).
Williamson, D, A,. et al performed an RCT to test the “efficacy of an internet-based
lifestyle behavior modification program for African-American girls over a 2 year
intervention.” A DXA scan was used to estimate the percentage of body fat lost and a
questionnaire was used to measure changes in weight loss behavior. In the first 6 months
the adolescents of the intervention group lost more body fat and the adults lost more
body weight compared to the control group. The changes in BMI and body fat were
statistically significant at 6 months (p < 0.05) but were not significant at 18 and 24
months (p > 0.05).
Brindad, E,. et al performed a large RCT with 8112 subjects. A 12 week web base
intervention was assessed. Attrition was high at 40% in the first week. 435 subjects
provided valid measurements and showed that there were no statistically significant
differences in body weight loss between the 3 intervention groups (P = .42). The overall
average weight-loss was 2.76%.
Similarly, Go, R, et al., found that a 6 week online intervention program with feedback
resulted in the lowest BMI measurement at the completion of the intervention when
compared to a control group, and an intervention only group with no feedback.
25. Marko Papuckovski 4074610
Furthermore, Nopolitano, M, et., McGrievy, T, et al., and Webber, K.H., et al., all
showed that an enhanced intervention via the internet platforms that also provided
feedback resulted in the greatest amount of weight loss when compared to control
groups.
Physical Activity
Hurling, R, et al., Genugten, L, et al., and Carr, L,J, et al., all showed that intervention
groups all showed an increase in the amount of time spent performing physical activity
when compared to a control group. The groups showed a greater intention to exercise
and a reduction in stress levels associated with exercise. Conclusively, these same
groups lost the most amount of body weight and body fat.
Education
Blomfield, R, et al., showed that over all energy intake decreased along with total
saturated fat and total carbohydrate intake also decreasing. An increase in the
percentage of ‘core’ foods resulted.
McGrievy, T, et al., performed surveys which showed that weight loss related knowledge
increased by the end of the intervention.
Discussion
The 16 randomised controlled trials all showed positive results through their
interventions. The participants enrolled in the studies were free from any genetic or
unrelated disease states and ethics were considered in the interventions. The subjects in
the studies varied from both healthy populations and overweight populations - providing
an insight on the effectiveness of the technological interventions in extreme cases and
mild cases of obesity. The wide range of subjects emphasizes the importance of
continuing study in this field and improving technological interventions that are
applicable to the majority of the population; the majority being anybody who has access
to the internet and a smart phone. However, the results from the intervention programs
plateau over time; this discredits their effectiveness, a follow up period of the studies is
necessary to determine the definite outcomes of the interventions.
Research by Morgan, J.P., et al., studied the effects of a weight loss program for
overweight and obese men. The primary aim of the study was “to evaluate the efficacy
of two relatively low intensity weight loss programs developed specifically for men (p.
26. 2).” Biomarkers of 159 overweight and obese men were measured at baseline, 3 months
and 6 months of the study. The outcomes were measured by assessors blinded to group
allocation - removing any possible bias. The following parameters were compared: body
weight, % body fat, waist circumference, blood pressure, resting heart rate, physical
activity levels, self reported dietary intake and perceived sexually healthy. The results
showed that the online group saw a decrease in energy intake, total fat intake and
carbohydrate intake (P < 0.05) - but no significant difference was seen in the control
group (P > 0.05). This is a fairly long intervention lasting half a year, the results show to
be consistent, evidence based and applicable to obese or overweight men. The study
provides strong evidence that online interventions can be effective long term. Follow
up, post intervention research will strengthen the validity of the results. This study rates
as a B on the body of evidence matrix (Table 3). A similar study by Carr, L.J, et al.,
tested the efficacy of internet intervention programs in sedentary adults (41.7 +- 10.4
years of age). After 3 month of the intervention the results showed that physical activity
increased in the intervention group when compared to the control group, however these
figures plateaud and by 6 months there was little difference between the two groups
(186.0 vs 176.8 min/wk). This study was evidence based and applicable but showed no
clinical impact and the results proved to be inconsistent, the study rates as D on the
body of evidence matrix (Table 3).
Liebreich, T, et al., analysed the effects of a 12 week website and email linked
intervention on physical activity behavior change in individuals with type 2 diabetes.
Despite being a pilot study, the intervention included 49 subjects with type 2 diabetes,
this is a significant number of subjects for a pilot study. The subjects were separated
into two groups with one receiving information based on the Social Cognitive Theory and
with one group only being provided information from the general diabetes guidelines.
The more interactive and personal approach of the intervention group resulted in an
improvement in total vigorous activity and minutes spent performing moderate physical
activity (p = 0.05). Despite only being a pilot study, the subjects were randomly assigned
to their intervention groups, removing possible bias. The results were evidence based,
applicable and showed clinical impact. When adjusted for BMI, MET minutes per week
showed a significance of (p = 0.043) and moderate to vigorous activity showed a
significance of (p = 0.010).
27. Marko Papuckovski 4074610
In younger populations such as high school and college students, results are not as
significant. Cavallo, D.N, et al., claims that the “use of an online social networking
group plus self - monitoring did not produce greater perceptions of social support or
physical activity.” LaChausse, R.B, et al., also studied the impact of intervention groups
in younger adults - specifically college students. The intervention group showed an
increase in fruit and vegetable intake and a decrease in saturated fat, sugar and total
energy intake. However, there was no significant difference seen in physical activity or
body weight between the intervention group and the control group. Similarly a study by
Taylor, C.B, et al., also saw a significant increase in fruit and vegetable intake in high
school students (p = 0.001) - but with no effect on BMI in the overweight/obese groups.
However, a study performed by Williamson, D. A, et al., showed that an internet
intervention program that included behavioral support resulted in a decrease in body fat
in adolescent subjects (- 1.12 +- 0.47% vs 0.43 +- 0.47%, p < 0.05). Parents involved in
the study also saw a significant reduction in body weight when compared to the control
group (- 2.43 +- 0.66 vs. - 0.35 +- 0.64 kg, p < 0.05). Despite the positive results in the
initial stages of the intervention, a follow up study showed that after 2 years, there was
no statistically significant difference between weight and body fat in both the
adolescents and parents in the subject and intervention groups. This demonstrates that
online interventions show promising results in early stages, but consistency needs to be
addressed.
Online interventions are also at higher risk of attrition, this is shown in a study
performed by Brindal, E, et al,. where attrition was as high as 40% in the first week. The
intervention lasted 12 weeks, and of the 8112 initial participants, only 435 provided a
valid final weight at the end of the intervention. “On average, participants lost 2.76% of
their initial body weight, with no statistically significant difference in weight loss
between groups.” (p. 2)
Despite attrition and inconsistency being a risk factor, the potential of online
interventions is demonstrated in a ranomised controlled trial performed by Dennison, L,
et al. This study addressed attrition by including a intervention plus coaching group,”
the POWeR plus coaching group was 1.61 times more likely to complete sessions than the
other two groups”. (p. 2)
Table 3: Body of evidence rating
28. Conclusion
Despite showing
promising initial
results, addressing
obesity and overweight issues via technological interventions, including social media
platforms has proven to be challenging and needs to be refined. Programs are effective
in positively impacting biomarkers such as BMI, body weight and body fat percentage,
but these results are short lived and inconsistent. Longer interventions and follow up
studies are necessary to validate the positive results shown in the initial stages of the
interventions.
NHMRC 2009 – Levels of Evidence p. 15
29. Marko Papuckovski 4074610
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