A New Model of Well-Child Care: Implications for Resource Costs and Dissemination

Ritzwoller, Debra P.; Sukhanova, Anna; Beck, Arne; Bergman, David A.

doi:10.7812/tpp/10-158

Cited by 7 publications

(2 citation statements)

References 27 publications

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“…Similar findings have been observed in other studies [55,56]. Populations with multiple behavioral risk factors are at greatest risk for chronic disease and premature death compared with people with single or no risk factors [12,57] whereas participants with CV disease were more likely to have three or more CV risk factors (32%) than those without CV diseases (9.5%) [58]. The higher levels of risk factors at younger ages in men compared to women leads to CV disease presenting 10 years later in women [11].…”

Section: Discussionsupporting

confidence: 90%

The relationships between body composition and cardiovascular risk factors in young Australian men

Liberato

Maple-Brown

Bressan

et al. 2013

Nutr J

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IntroductionCardiovascular (CV) disease is a leading cause of global mortality. Despite clear evidence of the coexistence of several risk factors in young people as children and an understanding of the importance of the health behaviors in controlling CV disease, there are limited data on the relationships between risk factors and CV disease in young people. Therefore further study is required.ObjectiveThis study aimed to investigate associations among body composition, health behaviors and CV risk factors in young Australian men.MethodsThirty five healthy men aged 18–25 years had their blood pressure (BP), blood lipids, body composition, resting metabolic rate (RMR), physical activity, dietary intake and cardiorespiratory fitness assessed.ResultsParticipants were categorised according to the percentage of body fat into two groups: lean and overweight men. There were no between-group differences in the biochemical indicators except that overweight men had lower HDL-C compared to lean men. Both groups had similar mean energy, protein, fat, carbohydrate and alcohol intake, RMR, physical activity level (PAL) and energy expenditure (EE). Most of the participants (65.7%) had LDL≥2.5 mmol/L. Other common individual risk factors were body fat≥20% (42.9%), waist circumference≥88 cm (28.6%), PAL<1.8 (22.9%) and systolic BP≥130 mmHg (20%). The mean number of CV risk factors was lower among men having a high intake of monounsaturated fatty acids (MUFA, >12% of the energy intake) regardless of whether they were overweight or lean and did not seem to differ according to the source of MUFA consumed.ConclusionsIt is a serious concern to observe such a high percentage of CV risk factors in a group of apparently healthy young men. The likelihood of multiple CV risk factors is greater among those with high body fatness and low MUFA intake. Intake of MUFA favorably affects CV risk factors regardless of the source.

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Section: Discussionsupporting

confidence: 90%

The relationships between body composition and cardiovascular risk factors in young Australian men

Liberato

Maple-Brown

Bressan

et al. 2013

Nutr J

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“…Integrated programs utilising innovative Well-child Care models have been shown to be cost-effective for obesity and injury-prevention education programs for managed health organisations in North America [939495]. Further research into the cost-effectiveness of multi-sectoral Well-child Care in different health and organisation settings are required.…”

Section: Discussionmentioning

confidence: 99%

A Realist Synthesis of Literature Informing Programme Theories for Well Child Care in Primary Health Systems of Developed Economies

2019

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Introduction: Well-child Care is the provision of preventative health care services for children and their families. The approach, however, to the universal provision of those services is contentious. Methods: We undertook a realist synthesis to enhance understanding of the theoretical mechanisms driving Well-child Care by searching for published and grey literature from multiple databases. Findings: Well-child Care is re-conceptualised as an integrated program delivered in the continuum of pregnancy, infancy and childhood. Depending on the context, Well-child Care can be a policy, a strategy, or an actual clinical practice that promotes child and family health. The main mechanisms include: role, training and continuity of health providers; administrators’ views of the return of investment on achieved outcomes; access to services by families; and the adaptation of programs to meet the dynamic needs of stakeholders. Evidence indicates that for most outcomes, Well-child Care is best delivered in partnerships between community health, social care, and early childhood education sectors. Conclusions: We conclude that Well-child Care policy and program leaders should shift their focus to the integration of: human and physical resources; policy instruments; and shared agreement on outcomes measures across health, social and education sectors. In addition, countries should work towards strengthening universal early education programs and parents’ health literacy regarding child development, health and safety.

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The Mediating Roles of Perceived Stress and Health Behaviors in the Relation Between Objective, Subjective, and Neighborhood Socioeconomic Status and Perceived Health

2014

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Background Objective, subjective, and neighborhood socioeconomic status (SES) are associated with perceived health, morbidity, and mortality. Purpose We investigated whether perceived stress and health behaviors mediated the relation between the three types of SES and perceived health. Methods Participants (N = 508) attending a public clinic completed a computerized survey assessing objective SES (income, education, employment); health behaviors; perceived stress; and perceived health. They also indicated their social standing relative to others (subjective SES) and provided their current address to determine neighborhood SES. Results In a structural equation model including all three SES types, lower objective and subjective SES were related to poorer perceived health. When mediators were included in the model, there were significant indirect effects of: (a) SES on health through stress; and (b) SES on health through stress and health compromising behaviors. Conclusions Interventions to reduce the impact of stressors could improve the health of socioeconomically disadvantaged individuals.

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A New Model of Well-Child Care: Implications for Resource Costs and Dissemination

Cited by 7 publications

References 27 publications

The relationships between body composition and cardiovascular risk factors in young Australian men

The relationships between body composition and cardiovascular risk factors in young Australian men

A Realist Synthesis of Literature Informing Programme Theories for Well Child Care in Primary Health Systems of Developed Economies

The Mediating Roles of Perceived Stress and Health Behaviors in the Relation Between Objective, Subjective, and Neighborhood Socioeconomic Status and Perceived Health

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