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- Duberg, Anna, 1976-, et al.
(författare)
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Influencing self-rated health among adolescent girls with dance intervention : a randomized controlled trial
- 2013
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Ingår i: JAMA pediatrics. - Chicago, USA : American Medical Association. - 2168-6203 .- 2168-6211. ; 167:1, s. 27-31
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether dance intervention influenced self-rated health for adolescent girls with internalizing problems.Design: Randomized controlled intervention trial with follow-up measures at 8, 12, and 20 months after baseline.Setting: A Swedish city with a population of 130 000.Participants: Girls aged 13 to 18 years with internalizing problems, ie, stress and psychosomatic symptoms. A total of 59 girls were randomized to the intervention group and 53 were randomized to the control group.Intervention: The intervention comprised dance classes twice weekly during 8 months. Each dance class lasted 75 minutes and the focus was on the joy of movement, not on performance.Main Outcome Measures: Self-rated health was the primary outcome; secondary outcomes were adherence to and experience of the intervention.Results: The dance intervention group improved their self-rated health more than the control group at all follow-ups. At baseline, the mean score on a 5-point scale was 3.32 for the dance intervention group and 3.75 for the control group. The difference in mean change was 0.30 (95% CI, −0.01 to 0.61) at 8 months, 0.62 (95% CI, 0.25 to 0.99) at 12 months, and 0.40 (95% CI, 0.04 to 0.77) at 20 months. Among the girls in the intervention group, 67% had an attendance rate of 50% to 100%. A total of 91% of the girls rated the dance intervention as a positive experience.Conclusions: An 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention
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- Fottrell, Edward, et al.
(författare)
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The effect of increased coverage of participatory women's groups on neonatal mortality in Bangladesh : A cluster randomized trial
- 2013
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Ingår i: JAMA pediatrics. - : American Medical Association. - 2168-6211 .- 2168-6203. ; 167:9, s. 816-25
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: Community-based interventions can reduce neonatal mortality when health systems are weak. Population coverage of target groups may be an important determinant of their effect on behavior and mortality. A women's group trial at coverage of 1 group per 1414 population in rural Bangladesh showed no effect on neonatal mortality, despite a similar intervention having a significant effect on neonatal and maternal death in comparable settings.OBJECTIVE: To assess the effect of a participatory women's group intervention with higher population coverage on neonatal mortality in Bangladesh.DESIGN: A cluster randomized controlled trial in 9 intervention and 9 control clusters.SETTING: Rural Bangladesh.PARTICIPANTS: Women permanently residing in 18 unions in 3 districts and accounting for 19 301 births during the final 24 months of the intervention.INTERVENTIONS: Women's groups at a coverage of 1 per 309 population that proceed through a participatory learning and action cycle in which they prioritize issues that affected maternal and neonatal health and design and implement strategies to address these issues.MAIN OUTCOMES AND MEASURES: Neonatal mortality rate.RESULTS: Analysis included 19 301 births during the final 24 months of the intervention. More than one-third of newly pregnant women joined the groups. The neonatal mortality rate was significantly lower in the intervention arm (21.3 neonatal deaths per 1000 live births vs 30.1 per 1000 in control areas), a reduction in neonatal mortality of 38% (risk ratio, 0.62 [95% CI, 0.43-0.89]) when adjusted for socioeconomic factors. The cost-effectiveness was US $220 to $393 per year of life lost averted. Cause-specific mortality rates suggest reduced deaths due to infections and those associated with prematurity/low birth weight. Improvements were seen in hygienic home delivery practices, newborn thermal care, and breastfeeding practices.CONCLUSIONS AND RELEVANCE: Women's group community mobilization, delivered at adequate population coverage, is a highly cost-effective approach to improve newborn survival and health behavior indicators in rural Bangladesh.TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN01805825.
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- Hinkley, T., et al.
(författare)
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Early Childhood Electronic Media Use as a Predictor of Poorer Well-being A Prospective Cohort Study
- 2014
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Ingår i: JAMA pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 168:5, s. 485-492
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Identifying associations between preschool-aged children's electronic media use and their later well-being is essential to supporting positive long-term outcomes. OBJECTIVE To investigate possible dose-response associations of young children's electronic media use with their later well-being. DESIGN, SETTING, AND PARTICIPANTS The IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants) study is a prospective cohort study with an intervention component. Data were collected at baseline from September 1, 2007, through June 30, 2008, and at follow-up from September 1, 2009, through May 31, 2010, in 8 European countries participating in the IDEFICS study. This investigation is based on 3604 children aged 2 to 6 years who participated in the longitudinal component of the IDEFICS study only and not in the intervention. MAIN OUTCOMES AND MEASURES The following 6 indicators of well-being from 2 validated instruments were used as outcomes at follow-up: Peer problems and Emotional problems subscales from the Strengths and Difficulties Questionnaire and Emotional well-being, Self-esteem, Family functioning, and Social networks subscales from the KINDLR (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents-Revised Version). Each scale was dichotomized to identify those children at risk for poorer outcomes. Indicators of electronic media use (weekday and weekend television and electronic game [e-game]/computer use) from baseline were used as predictors. RESULTS Associations varied between boys and girls; however, associations suggested that increased levels of electronic media use predicted poorer well-being outcomes. Television viewing on weekdays or weekends was more consistently associated with poorer outcomes than e-game/computer use. Across associations, the likelihood of adverse outcomes in children ranged from a 1.2- to 2.0-fold increase for emotional problems and poorer family functioning for each additional hour of television viewing or e-game/computer use depending on the outcome examined. CONCLUSIONS AND RELEVANCE Higher levels of early childhood electronic media use are associated with children being at risk for poorer outcomes with some indicators of well-being. Further research is required to identify potential mechanisms.
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- Tiberio, Stacey S., et al.
(författare)
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Parental Monitoring of Children’s Media Consumption: The Long-term Influences on Body Mass Index in Children
- 2014
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Ingår i: JAMA pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 168:15, s. 414-421
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the potential influences of maternal and paternal monitoring of child media exposure and children’s general activities on body mass index (BMI) in middle childhood.DESIGN, SETTING, AND PARTICIPANTS: A longitudinal study, taken from a subsample of the Three Generational Study, a predominantly white, Pacific Northwest community sample (overall participation rate, 89.6%), included assessments performed from June 1998 to September 2012. Analyses included 112 mothers, 103 fathers, and their 213 children (55.4% girls) at age 5, 7, and/or 9 years. Participation rates ranged from 66.7%to 72.0% of all eligible Three Generational Study children across the 3 assessments.EXPOSURES: Parents reported on their general monitoring of their children (whereabouts and activities), specific monitoring of child media exposure, children’s participation in sports and recreational activities, children’s media time (hours per week), annual income, and educational level. Parental BMI was recorded.MAIN OUTCOMES AND MEASURES: Predictions to level and change in child BMI z scores were tested.RESULTS: Linear mixed-effects modeling indicated that more maternal, but not paternal, monitoring of child media exposure predicted lower child BMI z scores at age 7 years (95%CI, −0.39 to −0.07) and less steeply increasing child BMI z scores from 5 to 9 years (95%CI, −0.11 to −0.01). These effects held when more general parental monitoring, and parent BMI, annual income, and educational level were controlled for. The significant negative effect of maternal media monitoring on children’s BMI z scores at age 7 years was marginally accounted for by the effect of child media time. The maternal media monitoring effect on children’s BMI z score slopes remained significant after adjustment for children’s media time and sports and recreational activity.CONCLUSIONS AND RELEVANCE These findings suggest that parental behaviors related to children’s media consumption may have long-term effects on children’s BMI in middle childhood. They underscore the importance of targeting parental media monitoring in efforts to prevent childhood obesity.
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- Andersson, Ola, et al.
(författare)
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Effect of Delayed vs Early Umbilical Cord Clamping on Iron Status and Neurodevelopment at Age 12 Months A Randomized Clinical Trial
- 2014
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Ingår i: JAMA PEDIATR. - : American Medical Association (AMA). - 2168-6203. ; 168:6, s. 547-554
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Prevention of iron deficiency in infancy may promote neurodevelopment. Delayed cord clamping (DCC) can prevent iron deficiency during the first 6 months of life. However, no data are available on long-term effects on infant outcomes in relation to time for umbilical cord clamping. OBJECTIVE To investigate effects of DCC, as compared with early cord clamping (ECC), on infant iron status and neurodevelopment at age 12 months in a European setting. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 382 full-term infants born after a low-risk pregnancy at a Swedish county hospital. Follow-up at 12 months included evaluation of iron status (ferritin level, transferrin saturation, transferrin receptor level, reticulocyte hemoglobin level, and mean cell volume) and parental assessment of neurodevelopment by the Ages and Stages Questionnaire, second edition (ASQ). INTERVENTIONS Infants were randomized to DCC (>= 180 seconds after delivery) or ECC (<= 10 seconds after delivery). MAIN OUTCOMES AND MEASURES The main outcome was iron status at age 12 months; the secondary outcome was ASQ score. RESULTS In total, 347 of 382 infants (90.8%) were assessed. The DCC and ECC groups did not differ in iron status (mean ferritin level, 35.4 vs 33.6 ng/mL, respectively; P =.40) or neurodevelopment (mean ASQ total score, 229.6 vs 233.1, respectively; P =.42) at age 12 months. Predictors of ferritin levels were infant sex and ferritin in umbilical cord blood. Predictors of ASQ score were infant sex and breastfeeding within 1 hour after birth. For both outcomes, being a boy was associated with lower results. Interaction analysis showed that DCC was associated with an ASQ score 5 points higher among boys (mean [SD] score, 229 [43] for DCC vs 224 [39] for ECC) but 12 points lower among girls (mean [SD] score, 230 [39] for DCC vs 242 [36] for ECC), out of a maximum of 300 points (P =.04 for the interaction term). CONCLUSIONS AND RELEVANCE Delayed cord clamping did not affect iron status or neurodevelopment at age 12 months in a selected population of healthy term-born infants. However, it may not be possible to demonstrate minor effects on neurodevelopment with the size of the study population and the chosen method for assessment. The current data indicate that sex may influence the effects on infant development after DCC in different directions. The magnitude and biological reason for this finding remain to be investigated.
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