IntroductionFew interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose).MethodsThis pre–post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes.ResultsNo significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than $25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P < .001).ConclusionBy incorporating design features that attended to the HL needs of parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.
This article aims to document the use of multisensory stimulation environments and its related perceptions, concerning ludic content, play and the computer-mediated ludic activity, from the perspective of professionals organizing and delivering therapeutic activities in these spaces with children with developmental disabilities, in Portugal. Face-to-face open interviews with 12 professionals working in multisensory stimulation environments, selected by convenience criteria, were individually recorded, transcribed and submitted to content analysis. Three main themes emerged from the data: multisensory stimulation environments offer multiple possibilities for intervention, play is part of the intervention in multisensory environments and the computer-mediated ludic experience is perceived as useful for intervention. Data suggest that multisensory stimulation environments are used as versatile spaces, both considered and explored by the interviewed professionals in its ludic potential. This fact can renew the interest in multisensory environments, in particular for the area of play in Occupational Therapy, in which the use of the computer-mediated ludic experience is a recognized possibility. Limitations of this study are associated to the level of representativeness of the interviews in relation to the diverse universe of professionals using multisensory environments. The method for collecting data is also highly sensitive to the influence of the interviewer.
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RESUMOIntrodução: A inclinação posterior da pelve (IPP) pode levar à perda da curvatura lombar fisiológica normal, predispondo o indivíduo a lesões. A bandagem elástica (BE) tem sido utilizada em disfunções musculoesquelé-ticas, podendo fornecer aos músculos um feedback para manter e perceber o alinhamento postural adequado. Não foram encontrados estudos sobre a influência do uso da bandagem na IPP. Objetivo: Avaliar o efeito da BE na ativação do músculo tensor da fáscia lata em indivíduos com IPP. Métodos: Trata-se de um ensaio clínico randomizado em que foi realizada uma avaliação do posicionamento da pelve de 20 homens com idade entre 18 e 28 anos. Os indivíduos foram divididos em dois grupos de forma aleatória; no grupo bandagem (GB), a bandagem foi aplicada com tensionamento no músculo tensor da fáscia lata e do trato iliotibial, e no grupo placebo (GP) foi aplicado o mesmo material, porém sem tensionamento, por um período de 72 horas. Os grupos foram reavaliados 30 minutos e 72 horas após a intervenção. Resultados: Houve diminuição significativa da IPP no GB (p = 0,002) quando comparado com o GP (p = 0,146). A resposta mais significativa da inclinação no GB foi observada no período imediato em comparação com 72 horas depois. Conclusão: Os achados deste estudo demonstram que a técnica da BE pode auxiliar na diminuição da IPP. São necessários mais estudos que avaliem a ativação muscular e a repercussão do uso da BE em indivíduos com IPP.Descritores: pelve; bandagens; força muscular; fascia lata.
ABSTRACT
Introduction: The posterior pelvic tilt (PPT) may lead to loss of the normal physiologic lumbar curve, predisposing the subject to injury. Elastic bandage (EB) has been used in musculoskeletal disorders
Limited research has reported the economic feasibility—from both a research and practice perspective—of efforts to recruit and enroll an intended audience in evidence-based approaches for disease prevention. We aimed to retrospectively assess and estimate the costs of a population health management (PHM) approach to identify, engage, and enroll patients in a Type 1 Hybrid Effectiveness-Implementation (HEI), diabetes-prevention trial. We used activity-based costing to estimate the recruitment costs of a PHM approach integrated within an HEI trial. We took the perspective of a healthcare system that may adopt, and possibly sustain, the strategy in the typical practice. We also estimated replication costs based on how the strategy could be applied in healthcare systems interested in referring patients to a local diabetes prevention program from a payer perspective. The total recruitment and enrollment costs were $360,424 to accrue 599 participants over approximately 15 months. The average cost per screened and enrolled participant was $263 and $620, respectively. Translating to the typical settings, total recruitment costs for replication were estimated as $193,971 (range: $43,827–$210,721). Sensitivity and scenario analysis results indicated replication costs would be approximately $283–$444 per patient enrolled if glucose testing was necessary, based on the Medicare-covered services. From a private payer perspective, and without glucose testing, per-participant assessed costs were estimated at $31. A PHM approach can be used to accrue a large number of participants in a short period of time for an HEI trial, at a comparable cost per participant.
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