861 resultados para early intervention strategies
Resumo:
Background:
Methods:
Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan.
Results:
The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these inputs and strategies with a set of outcomes to measure the intervention's effectiveness based on the theoretical frameworks, evaluation studies, and decision-maker experiences.
Conclusion:
Documenting the design of and implementation plan for this knowledge translation intervention provides a transparent, theoretical, and practical approach to a complex intervention. It provides significant insights into how practitioners might engage with evidence in public health decision making. While this intervention model was designed for the local government context, it is likely to be applicable and generalizable across sectors and settings.
Resumo:
Initiatives to promote children’s nutrition and prevent childhood obesity are vital. Dietary patterns are a useful way to characterize whole diets, though no previous early childhood health promotion trial has assessed intervention impact using this approach. This research aimed to assess the effect on young children’s dietary patterns of a healthy eating and physical activity intervention. The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a health promotion cluster-randomized controlled trial involving 542 families. Child diets were assessed by multiple 24-hour recalls post-intervention, at approximately 18 months of age. An Obesity Protective Dietary Index was created, and dietary patterns were also assessed by principal components analysis. These outcomes were used to compare intervention and control participants to test the effectiveness of the intervention. Children in the intervention arm scored significantly higher (15.6 ± 5.9) than those in the control arm (14.5 ± 6.7) for the Obesity Protective Dietary Index (scores out of 30, p=0.01). Three dietary patterns were identified by principal components analysis, however, scores were not significantly different between intervention and control arms. In conclusion, this paper presents novel results in both the evaluation of an early childhood health promotion intervention and in the assessment of child dietary patterns. The results highlight the capacity for such an initiative to improve child diets, and the need for further research in this area.
Resumo:
Background:
Methods:
Data from 206 toddlers (53% male) participating in the Melbourne InFANT Program were collected in 2008–2010 and analysed in 2012. Mothers completed a survey of physical activity predictors when their child was 4- (T1) and 9- months old (T2). Physical activity was assessed by ActiGraph GT1M accelerometers at 19- months (T3) of age.
Results:
One infant behaviour at T1 and one maternal belief and two infant behaviours at T2 showed associations with physical activity at T3 and were included in multivariate analyses. After adjusting for the age at which the child started walking and maternal education, the time spent with babies of a similar age at 4-months (β = 0.06, 95% CI [0.02, 0.10]) and the time spent being physically active with their mother at 9-months (β = 0.06, 95% CI [0.01, 0.12]) predicted children’s physical activity at 19-months of age.
Conclusions:
Promotion of peer-interactions and maternal-child co-participation in physical activity could serve as a health promotion strategy to increase physical activity in young children. Future research is required to identify other early life predictors not assessed in this study and to examine whether these factors predict physical activity in later life stages.
Resumo:
Purpose
Two-year longitudinal follow-up data evaluated the behavioral impact of Resilient Families, a universal intervention that aimed to prevent early initiation and frequent and heavy adolescent alcohol use in secondary schools in Melbourne, Australia.
Methods
Of 24 secondary schools (62% of those approached), 12 were randomly assigned to intervention and 12 as controls. Intervention students received a social relationship curriculum; their parents received parent education handbooks and invitations to parent education events outlining strategies to encourage healthy adolescent development and reduce adolescent alcohol misuse. At Wave 1 (2004), students were in Year 7 secondary school (mean age, 12.3 years). Data were imputed for students completing at least two of three annual surveys (N = 2,354). Wave 3 (2006; mean, 14.5 years) main outcome measures for alcohol use were “any,” “frequent” (at least monthly), and “heavy” (five or more drinks in a session at least once in the prior fortnight). Multivariate logistic regression assessed intervention exposure effects, adjusting for school classroom clustering and baseline measures.
Results
Relative to controls, intervention students showed significant reductions in any lifetime use (adjusted odds ratio [AOR], .78; 95% confidence interval [CI], .62–.97), and reduced progression to frequent (AOR, .69; CI, .56–.86) and heavy use (AOR, .75; CI, .60–.94).
Conclusions
Randomized assignment to Resilient Families was associated with a significant reduction in adolescent alcohol use among families volunteering for the evaluation. Family–school-based interventions appear promising as a strategy to contribute to population reductions in currently high rates of adolescent alcohol misuse.
Resumo:
This research project is an exploration of the early childhood intervention service (ECIS) provided by Scope Southern Region. The research seeks to examine the benefits and outcomes for families and children. In doing so, the project’s emphasis is on key practices such as family centred practice and transdisciplinary practice, while examining the enablers and barriers to providing positive benefits to families and children. The central question is whether the interventions are of assistance to families and children.
Resumo:
Background
To investigate the effect of an early childhood obesity prevention intervention, incorporating a parent modelling component, on fathers’ obesity risk-related behaviours.
Methods
Cluster randomized-controlled trial in the setting of pre-existing first-time parents groups organised by Maternal and Child Health Nurses in Victoria, Australia. Participants were 460 first-time fathers mean age = 34.2 (s.d.4.90) years. Dietary pattern scores of fathers were derived using principal component analysis, total physical activity and total television viewing time were assessed at baseline (infant aged three to four months) and after 15 months.
Results
No significant beneficial intervention effect was observed on fathers’ dietary pattern scores, total physical activity or total television viewing time.
Conclusion
Despite a strong focus on parent modelling (targeting parents own diet, physical activity and television viewing behaviours), and beneficial impact on mothers’ obesity risk behaviours, this intervention, with mothers as the point of contact, had no effect on fathers’ obesity risk-related behaviours. Based on the established links between children’s obesity risk-related behaviors and that of their fathers, a need exists for research testing the effectiveness of interventions with a stronger engagement of fathers.
