H. Alderson, E. Kaner, Rebecca Brown, D. Howel, E. McColl, D. Smart, A. Copello, T. Fouweather, R. McGovern, Heather Brown, P. McArdle, R. Lingam
Declared competing interests of authors: Eileen Kaner sat on the Public Health Research Research Funding Board (2010–16) and reports National Institute for Health Research (NIHR) Public Health Research grants during the conduct of this study. Denise Howel was a member of NIHR Health Services and Delivery Research Commissioning Board (2012–15) and is a member of NIHR Programme Grants for Applied Research Subpanel (2017–20). Elaine McColl was a member of the NIHR Journals Library Editorial Group; she was an editor for the NIHR Programme Grants for Applied Research programme (2013–16) and was a member of the NIHR Clinical Trials Unit Standing Advisory Committee until 2016. She reports grants from NIHR Public Health Research programme during the conduct of this study and other NIHR Journals Library-funded grants outside the submitted work.
{"title":"Behaviour change interventions to reduce risky substance use and improve mental health in children in care: the SOLID three-arm feasibility RCT","authors":"H. Alderson, E. Kaner, Rebecca Brown, D. Howel, E. McColl, D. Smart, A. Copello, T. Fouweather, R. McGovern, Heather Brown, P. McArdle, R. Lingam","doi":"10.3310/PHR08130","DOIUrl":"https://doi.org/10.3310/PHR08130","url":null,"abstract":"Declared competing interests of authors: Eileen Kaner sat on the Public Health Research Research Funding Board (2010–16) and reports National Institute for Health Research (NIHR) Public Health Research grants during the conduct of this study. Denise Howel was a member of NIHR Health Services and Delivery Research Commissioning Board (2012–15) and is a member of NIHR Programme Grants for Applied Research Subpanel (2017–20). Elaine McColl was a member of the NIHR Journals Library Editorial Group; she was an editor for the NIHR Programme Grants for Applied Research programme (2013–16) and was a member of the NIHR Clinical Trials Unit Standing Advisory Committee until 2016. She reports grants from NIHR Public Health Research programme during the conduct of this study and other NIHR Journals Library-funded grants outside the submitted work.","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"8 1","pages":"1-162"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42255571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Owen, E. Limb, C. Nightingale, A. Rudnicka, B. Ram, A. Shankar, S. Cummins, D. Lewis, C. Clary, A. Cooper, A. Page, D. Procter, A. Ellaway, B. Giles-Corti, P. Whincup, D. Cook
Background Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited. Objectives The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes' Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined. Design The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment. Setting East Village, London, UK. Participants A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013-15 and followed up after 2 years. Intervention The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes' Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport. Main outcome measure Change in objectively measured daily steps from baseline to follow-up. Methods Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village. Results A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19-34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval -231 to 539 steps), more so in the intermediate sector (433 steps, 95% c
{"title":"Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study.","authors":"C. Owen, E. Limb, C. Nightingale, A. Rudnicka, B. Ram, A. Shankar, S. Cummins, D. Lewis, C. Clary, A. Cooper, A. Page, D. Procter, A. Ellaway, B. Giles-Corti, P. Whincup, D. Cook","doi":"10.3310/phr08120","DOIUrl":"https://doi.org/10.3310/phr08120","url":null,"abstract":"Background\u0000Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.\u0000\u0000\u0000Objectives\u0000The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes' Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.\u0000\u0000\u0000Design\u0000The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.\u0000\u0000\u0000Setting\u0000East Village, London, UK.\u0000\u0000\u0000Participants\u0000A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013-15 and followed up after 2 years.\u0000\u0000\u0000Intervention\u0000The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes' Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.\u0000\u0000\u0000Main outcome measure\u0000Change in objectively measured daily steps from baseline to follow-up.\u0000\u0000\u0000Methods\u0000Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.\u0000\u0000\u0000Results\u0000A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19-34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval -231 to 539 steps), more so in the intermediate sector (433 steps, 95% c","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48899416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Salway, E. Such, L. Preston, A. Booth, M. Zubair, C. Victor, R. Raghavan
Background To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people. Objectives The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives. Data sources Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants. Review methods Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness. Results The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal le
背景到目前为止，对移民和少数民族人群孤独感的原因和解决方案的研究很少。目标目标是综合现有证据，并产生与旨在解决这些人群孤独感的举措相关的新见解，以及这些举措的逻辑、功能和效果。数据来源进行了电子数据库搜索（MEDLINE、应用社会科学索引、文摘和社会科学引文索引，通过Web of Science-不受日期限制）、灰色文献搜索以及引文和参考文献搜索。数据是通过九个研讨会生成的，其中三个咨询小组涉及34名公共贡献者，一个从业者研讨会涉及50名参与者。审查方法在“系统思维”的指导下，将理论驱动的综合与有效性审查相结合，以整合关于孤独的性质和原因、干预类型和计划理论以及干预实施和有效性的证据。结果理论综述表明，在关注移民和少数民族人群时，“孤独”的常见概念可以有效地扩展到识别四个直接决定因素：积极的社会联系和互动、消极的社会联系与互动、自我价值和对现有联系的评价。共纳入170项干预措施。制定了八项干预措施的类型。为三种常见的干预类型开发了详细的逻辑模型：交友、共享身份的社会支持团体和跨文化接触。前两种类型的模型通常得到了经验数据的有力支持；第三种则更具试探性。干预过程和结果的评估受到研究内容和质量的限制。来自19项定性和6项定量研究的证据表明，社会支持团体对参与者的孤独感有积极影响。来自九项定性和三项定量研究的证据表明，交友对孤独感有积极影响。然而，交友模式的不一致成就意味着一些举措是无效的。很少有关于跨文化接触的研究报告了相关结果，尽管有四项提供了一些定性证据，三项提供了改善的定量证据。纵观干预类型，有证据表明，针对直接决定因素的举措——尤其是提高自我价值——比那些不这样做的举措更有效。没有任何证据表明任何举措会产生长期影响。英国干预（n = 41）和不干预（n = 65）的研究，加上咨询小组研讨会的数据，有助于系统过程的叙述性综合。在个人、家庭、社区、组织和更广泛的社会层面运作的连锁因素增加了孤独的风险，并破坏了干预措施的获取和影响。种族主义在整个系统中以各种方式运作，增加了孤独的风险。局限性缺乏高质量的定量研究，也没有长期随访的研究。英国的证据非常有限。针对在社区和社会层面运作的上游决定因素的研究并没有与个人结果指标挂钩。搜索方法的某些元素可能意味着相关文献被忽视了。结论关于移民和少数民族人群孤独感的原因和干预措施的作用的理论得到了有益的发展。共享身份的社会支持团体对孤独感产生积极影响的证据最强。数量证据不足。英国的证据基础极其有限。迫切需要英国在这一领域的未来研究。优先事项是与移民和少数民族共同制定干预办法，并评估现有的社区举措。研究注册本研究注册为PROSPERO CRD42017077378。
{"title":"Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis","authors":"S. Salway, E. Such, L. Preston, A. Booth, M. Zubair, C. Victor, R. Raghavan","doi":"10.3310/phr08100","DOIUrl":"https://doi.org/10.3310/phr08100","url":null,"abstract":"Background \u0000 \u0000To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people. \u0000 \u0000 \u0000 \u0000Objectives \u0000 \u0000The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives. \u0000 \u0000 \u0000 \u0000Data sources \u0000 \u0000Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants. \u0000 \u0000 \u0000 \u0000Review methods \u0000 \u0000Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness. \u0000 \u0000 \u0000 \u0000Results \u0000 \u0000The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal le","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"8 1","pages":"1-246"},"PeriodicalIF":0.0,"publicationDate":"2020-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42474328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.5923/J.PHR.20201001.03
M. Buheji
Many countries differed in its way of response and management to the fierce infectious COVID-19 outbreak. Almost all the world countries agreed on the adequate verification and traceability of the suspected infected contacts, besides followed strict measures for containment and isolation. However, life has to go on towards regular routines at a certain point, to fulfil many of the demanding socio-economic needs. The literature does not have enough methods on how to do go back smoothly to life routines. In contrast, the infected individuals or those who have a probability of spreading infections will not go without being identified. This work focus on selective traceability that would be like a default system that would ensure the availability of sustainable community preparedness model. Therefore, this paper focuses on developing a simple. Yet, robust implementable scale and framework that help any public health authority, or organizations to take appropriate decision when to quarantine, direct for self-isolate, or consider the case to be safe; afterlife starts to go back to normal. The framework helps to sustain the testing without disrupting the people life, based on evidence-based selective sampling. The paper concludes with recommending the sustainable traceability framework be added to post-surveillance strategy as active case-finding technique. The main implication of this paper is that it raises the competence of the community in mitigating the risks of virus tsunami, similar to the COVID-19, and closes its future vulnerability to any new outbreak. The paper concludes with limitations and future research recommendations.
{"title":"Mitigating the Tsunami of COVID-19 through Sustainable Traceability","authors":"M. Buheji","doi":"10.5923/J.PHR.20201001.03","DOIUrl":"https://doi.org/10.5923/J.PHR.20201001.03","url":null,"abstract":"Many countries differed in its way of response and management to the fierce infectious COVID-19 outbreak. Almost all the world countries agreed on the adequate verification and traceability of the suspected infected contacts, besides followed strict measures for containment and isolation. However, life has to go on towards regular routines at a certain point, to fulfil many of the demanding socio-economic needs. The literature does not have enough methods on how to do go back smoothly to life routines. In contrast, the infected individuals or those who have a probability of spreading infections will not go without being identified. This work focus on selective traceability that would be like a default system that would ensure the availability of sustainable community preparedness model. Therefore, this paper focuses on developing a simple. Yet, robust implementable scale and framework that help any public health authority, or organizations to take appropriate decision when to quarantine, direct for self-isolate, or consider the case to be safe; afterlife starts to go back to normal. The framework helps to sustain the testing without disrupting the people life, based on evidence-based selective sampling. The paper concludes with recommending the sustainable traceability framework be added to post-surveillance strategy as active case-finding technique. The main implication of this paper is that it raises the competence of the community in mitigating the risks of virus tsunami, similar to the COVID-19, and closes its future vulnerability to any new outbreak. The paper concludes with limitations and future research recommendations.","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49647902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Bick, Cath Taylor, V. Bhavnani, A. Healey, P. Seed, Sarah Roberts, M. Zasada, A. Avery, Victoria Craig, Nina Khazaezadah, S. McMullen, Sheila O’Connor, Bimpe Oki, E. Oteng-Ntim, L. Poston, M. Ussher
Background: Increasing numbers of UK women have overweight or obese BMIs when they become pregnant, or gain excessive weight in pregnancy, increasing their risk of adverse outcomes. Failure to manage postnatal weight is linked to smoking, non-healthy dietary choices, lack of regular exercise, and poorer longer-term health. Women living in areas of higher social deprivation are more likely to experience weight management problems postnatally. Objectives: To assess feasibility of conducting a definitive RCT to determine effectiveness of lifestyle information and access to a commercial weight management group focusing on self-monitoring, goal setting and motivation to achieve dietary change commencing 8 to 16 weeks postnatally to achieve and maintain weight management and positive lifestyle behaviours. Design: A randomised two arm feasibility trial, with a nested mixed-methods process evaluation. Setting: A single centre in an inner city setting in the south of England Participants: Women with BMIs>25kg/m2 at antenatal booking and women with normal BMIs (18.5kg/m2) at antenatal booking who developed excessive gestational weight gain as assessed at 36 weeks gestation. Feasibility objectives: Recruitment, retention, acceptability of study processes and identification of relevant economic data. The proposed primary outcome was difference between groups in weight 12 months postnatally, expressed as % weight change and weight loss from antenatal booking. Other proposed outcomes included assessment of diet, physical activity, smoking, alcohol, body image, maternal esteem, mental health, infant feeding and NHS costs. Results: Most objectives were achieved. 193 women were recruited, 98 allocated to the intervention and 95 to the control. High follow up rates (>80%) were achieved to 12 months. A possible 8.8% benefit in weight change at 12 months compared with booking BMI was found among intervention women, compared with control (4.2% compared to 13.0% p=0.062) , 47% of whom attended at least one weight management session, with low risk of contamination between groups. Greatest benefit was among women who attended 10+ sessions. Barriers to attending sessions included opportunity, capability and motivation issues. Data collection tools were appropriate to support economic evaluation in a definitive trial, and economic modelling is feasible to quantify resource impacts and outcomes not directly measurable within a trial. Limitations: The study only recruited from one site. It was not possible to recruit women with normal BMIs who developed excessive pregnancy weight gain. Conclusion: It was feasible to recruit and retain women with overweight or obese BMIs at pregnancy commencement to a trial of postnatal weight management plus standard care compared to standard care only, and collect relevant data to assess outcomes. Approaches to recruit women with normal BMIs who gain excessive gestational weight need to be considered. Commercial weight management groups co
{"title":"Lifestyle information and access to a commercial weight management group to promote maternal postnatal weight management and positive lifestyle behaviour: the SWAN feasibility RCT","authors":"D. Bick, Cath Taylor, V. Bhavnani, A. Healey, P. Seed, Sarah Roberts, M. Zasada, A. Avery, Victoria Craig, Nina Khazaezadah, S. McMullen, Sheila O’Connor, Bimpe Oki, E. Oteng-Ntim, L. Poston, M. Ussher","doi":"10.3310/PHR08090","DOIUrl":"https://doi.org/10.3310/PHR08090","url":null,"abstract":"Background: Increasing numbers of UK women have overweight or obese BMIs when they become pregnant, or gain excessive weight in pregnancy, increasing their risk of adverse outcomes. Failure to manage postnatal weight is linked to smoking, non-healthy dietary choices, lack of regular exercise, and poorer longer-term health. Women living in areas of higher social deprivation are more likely to experience weight management problems postnatally. Objectives: To assess feasibility of conducting a definitive RCT to determine effectiveness of lifestyle information and access to a commercial weight management group focusing on self-monitoring, goal setting and motivation to achieve dietary change commencing 8 to 16 weeks postnatally to achieve and maintain weight management and positive lifestyle behaviours. Design: A randomised two arm feasibility trial, with a nested mixed-methods process evaluation. Setting: A single centre in an inner city setting in the south of England Participants: Women with BMIs>25kg/m2 at antenatal booking and women with normal BMIs (18.5kg/m2) at antenatal booking who developed excessive gestational weight gain as assessed at 36 weeks gestation. Feasibility objectives: Recruitment, retention, acceptability of study processes and identification of relevant economic data. The proposed primary outcome was difference between groups in weight 12 months postnatally, expressed as % weight change and weight loss from antenatal booking. Other proposed outcomes included assessment of diet, physical activity, smoking, alcohol, body image, maternal esteem, mental health, infant feeding and NHS costs. Results: Most objectives were achieved. 193 women were recruited, 98 allocated to the intervention and 95 to the control. High follow up rates (>80%) were achieved to 12 months. A possible 8.8% benefit in weight change at 12 months compared with booking BMI was found among intervention women, compared with control (4.2% compared to 13.0% p=0.062) , 47% of whom attended at least one weight management session, with low risk of contamination between groups. Greatest benefit was among women who attended 10+ sessions. Barriers to attending sessions included opportunity, capability and motivation issues. Data collection tools were appropriate to support economic evaluation in a definitive trial, and economic modelling is feasible to quantify resource impacts and outcomes not directly measurable within a trial. Limitations: The study only recruited from one site. It was not possible to recruit women with normal BMIs who developed excessive pregnancy weight gain. Conclusion: It was feasible to recruit and retain women with overweight or obese BMIs at pregnancy commencement to a trial of postnatal weight management plus standard care compared to standard care only, and collect relevant data to assess outcomes. Approaches to recruit women with normal BMIs who gain excessive gestational weight need to be considered. Commercial weight management groups co","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"8 1","pages":"1-176"},"PeriodicalIF":0.0,"publicationDate":"2020-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47230327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Clemes, D. Bingham, N. Pearson, Yu-Ling Chen, C. Edwardson, R. McEachan, K. Tolfrey, Lorraine A Cale, G. Richardson, M. Fray, James Altunkaya, S. Bandelow, N. B. Jaicim, S. Barber
Background Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. The school classroom represents an ideal setting for environmental change through the provision of sit–stand desks. Objectives The aim of this study was to undertake a pilot cluster randomised controlled trial of the introduction of sit–stand desks in primary school classrooms, to inform a definitive trial. Objectives included providing information on school and participant recruitment and retention, acceptability of the intervention, and outcome measures. A preliminary estimate of the intervention’s effectiveness on the proposed primary outcome (change in weekday sitting time) for inclusion in a definitive trial was calculated, along with a preliminary assessment of potential cost-effectiveness. A full process evaluation was also undertaken. Design A two-armed pilot cluster randomised controlled trial with economic and qualitative evaluations. Schools were randomised on a 1 : 1 basis to the intervention (n = 4) or control (n = 4) trial arms. Setting Primary schools in Bradford, West Yorkshire, UK. Participants Children in Year 5 (i.e. aged 9–10 years). Intervention Six sit–stand desks replaced three standard desks (sitting six children) in the intervention classrooms for 4.5 months. Teachers were encouraged to ensure that all pupils were exposed to the sit–stand desks for at least 1 hour per day, on average, using a rotation system. Schools assigned to the control arm continued with their usual practice. Main outcome measures Trial feasibility outcomes included school and participant recruitment and attrition, acceptability of the intervention, and acceptability of and compliance with the proposed outcome measures [including weekday sitting measured using activPAL™ (PAL Technologies Ltd, Glasgow, UK) accelerometers, physical activity, adiposity, blood pressure, cognitive function, musculoskeletal comfort, academic progress, engagement and behaviour]. Results Thirty-three per cent of schools approached and 75% (n = 176) of eligible children took part. At the 7-month follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63% to 97%. A preliminary estimate of intervention effectiveness, from a weighted linear regression model (adjusting for baseline sitting time and wear time) revealed a mean difference in change in sitting of –30.6 minutes per day (95% confidence interval –56.42 to –4.84 minutes per day) between the intervention and control trial arms. The process evaluation revealed that the intervention, recruitment and evaluation procedures were acceptable to teachers and children, with the exception of minor issues around activPAL attachment. A preliminary within-trial economic analysis revealed no difference between intervention and control trial arms in health and education resource use or outcomes. Long-term
{"title":"Sit–stand desks to reduce sedentary behaviour in 9- to 10-year-olds: the Stand Out in Class pilot cluster RCT","authors":"S. Clemes, D. Bingham, N. Pearson, Yu-Ling Chen, C. Edwardson, R. McEachan, K. Tolfrey, Lorraine A Cale, G. Richardson, M. Fray, James Altunkaya, S. Bandelow, N. B. Jaicim, S. Barber","doi":"10.3310/phr08080","DOIUrl":"https://doi.org/10.3310/phr08080","url":null,"abstract":"Background Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. The school classroom represents an ideal setting for environmental change through the provision of sit–stand desks. Objectives The aim of this study was to undertake a pilot cluster randomised controlled trial of the introduction of sit–stand desks in primary school classrooms, to inform a definitive trial. Objectives included providing information on school and participant recruitment and retention, acceptability of the intervention, and outcome measures. A preliminary estimate of the intervention’s effectiveness on the proposed primary outcome (change in weekday sitting time) for inclusion in a definitive trial was calculated, along with a preliminary assessment of potential cost-effectiveness. A full process evaluation was also undertaken. Design A two-armed pilot cluster randomised controlled trial with economic and qualitative evaluations. Schools were randomised on a 1 : 1 basis to the intervention (n = 4) or control (n = 4) trial arms. Setting Primary schools in Bradford, West Yorkshire, UK. Participants Children in Year 5 (i.e. aged 9–10 years). Intervention Six sit–stand desks replaced three standard desks (sitting six children) in the intervention classrooms for 4.5 months. Teachers were encouraged to ensure that all pupils were exposed to the sit–stand desks for at least 1 hour per day, on average, using a rotation system. Schools assigned to the control arm continued with their usual practice. Main outcome measures Trial feasibility outcomes included school and participant recruitment and attrition, acceptability of the intervention, and acceptability of and compliance with the proposed outcome measures [including weekday sitting measured using activPAL™ (PAL Technologies Ltd, Glasgow, UK) accelerometers, physical activity, adiposity, blood pressure, cognitive function, musculoskeletal comfort, academic progress, engagement and behaviour]. Results Thirty-three per cent of schools approached and 75% (n = 176) of eligible children took part. At the 7-month follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63% to 97%. A preliminary estimate of intervention effectiveness, from a weighted linear regression model (adjusting for baseline sitting time and wear time) revealed a mean difference in change in sitting of –30.6 minutes per day (95% confidence interval –56.42 to –4.84 minutes per day) between the intervention and control trial arms. The process evaluation revealed that the intervention, recruitment and evaluation procedures were acceptable to teachers and children, with the exception of minor issues around activPAL attachment. A preliminary within-trial economic analysis revealed no difference between intervention and control trial arms in health and education resource use or outcomes. Long-term ","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"8 1","pages":"1-126"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43561820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timea Partos, R. Hiscock, Anna B. Gilmore, J. Branston, S. Hitchman, A. McNeill
Impact of tobacco tax increases and industry pricing on smoking behaviours and inequalities: a mixed-methods study Timea R Partoso ,1 Rosemary Hiscocko ,2 Anna B Gilmoreo ,2 J Robert Branstono ,3 Sara Hitchmano 1 and Ann McNeillo 1* 1National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK 2Department for Health, University of Bath, Bath, UK 3Centre for Governance and Regulation, School of Management, University of Bath, Bath, UK *Corresponding author ann.mcneill@kcl.ac.uk Background: Increasing tobacco prices through taxation is very effective for reducing smoking prevalence and inequalities. For optimum effect, understanding how the tobacco industry and smokers respond is essential. Tobacco taxation changes occurred in the UK over the study period, including annual increases, a shift in structure from ad valorem to specific taxation and relatively higher increases on roll-your-own tobacco than on factory-made cigarettes. Objectives: Understanding tobacco industry pricing strategies in response to tax changes and the impact of tax on smokers’ behaviour, including tax evasion and avoidance, as well as the effect on smoking inequalities. Synthesising findings to inform how taxation can be improved as a public health intervention. Design: Qualitative analysis and evidence synthesis (commercial and Nielsen data) and longitudinal and aggregate cross-sectional analyses (International Tobacco Control Policy Evaluation Project data). Setting: The UK, from 2002 to 2016. Data sources and participants: Data were from the tobacco industry commercial literature and retail tobacco sales data (Nielsen, New York, NY, USA). Participants were a longitudinal cohort (with replenishment) of smokers and ex-smokers from 10 surveys of the International Tobacco Control Policy Evaluation Project (around 1500 participants per survey). Main outcome measures: (1) Tobacco industry pricing strategies, (2) sales volumes and prices by segments over time and (3) smokers’ behaviours, including products purchased, sources, brands, consumption, quit attempts, success and sociodemographic differences. Review methods: Tobacco industry commercial literature was searched for mentions of tobacco products and price segments, with 517 articles extracted. Results: The tobacco industry increased prices on top of tax increases (overshifting), particularly on premium products, and, recently, the tobacco industry overshifted more on cheap roll-your-own tobacco than on factory-made cigarettes. Increasingly, price rises were from industry revenue generation rather than tax. The tobacco industry raised prices gradually to soften impact; this was less possible with larger tax increases. Budget measures to reduce cheap product availability failed due to new cheap factory-made products, price marking and small packs. In 2014, smokers could buy factory-made (roll-your-own tobacco) cigarettes at real prices similar to 2002. Exclusive roll-your-ow
{"title":"Impact of tobacco tax increases and industry pricing on smoking behaviours and inequalities: a mixed-methods study","authors":"Timea Partos, R. Hiscock, Anna B. Gilmore, J. Branston, S. Hitchman, A. McNeill","doi":"10.3310/phr08060","DOIUrl":"https://doi.org/10.3310/phr08060","url":null,"abstract":"Impact of tobacco tax increases and industry pricing on smoking behaviours and inequalities: a mixed-methods study Timea R Partoso ,1 Rosemary Hiscocko ,2 Anna B Gilmoreo ,2 J Robert Branstono ,3 Sara Hitchmano 1 and Ann McNeillo 1* 1National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK 2Department for Health, University of Bath, Bath, UK 3Centre for Governance and Regulation, School of Management, University of Bath, Bath, UK *Corresponding author ann.mcneill@kcl.ac.uk Background: Increasing tobacco prices through taxation is very effective for reducing smoking prevalence and inequalities. For optimum effect, understanding how the tobacco industry and smokers respond is essential. Tobacco taxation changes occurred in the UK over the study period, including annual increases, a shift in structure from ad valorem to specific taxation and relatively higher increases on roll-your-own tobacco than on factory-made cigarettes. Objectives: Understanding tobacco industry pricing strategies in response to tax changes and the impact of tax on smokers’ behaviour, including tax evasion and avoidance, as well as the effect on smoking inequalities. Synthesising findings to inform how taxation can be improved as a public health intervention. Design: Qualitative analysis and evidence synthesis (commercial and Nielsen data) and longitudinal and aggregate cross-sectional analyses (International Tobacco Control Policy Evaluation Project data). Setting: The UK, from 2002 to 2016. Data sources and participants: Data were from the tobacco industry commercial literature and retail tobacco sales data (Nielsen, New York, NY, USA). Participants were a longitudinal cohort (with replenishment) of smokers and ex-smokers from 10 surveys of the International Tobacco Control Policy Evaluation Project (around 1500 participants per survey). Main outcome measures: (1) Tobacco industry pricing strategies, (2) sales volumes and prices by segments over time and (3) smokers’ behaviours, including products purchased, sources, brands, consumption, quit attempts, success and sociodemographic differences. Review methods: Tobacco industry commercial literature was searched for mentions of tobacco products and price segments, with 517 articles extracted. Results: The tobacco industry increased prices on top of tax increases (overshifting), particularly on premium products, and, recently, the tobacco industry overshifted more on cheap roll-your-own tobacco than on factory-made cigarettes. Increasingly, price rises were from industry revenue generation rather than tax. The tobacco industry raised prices gradually to soften impact; this was less possible with larger tax increases. Budget measures to reduce cheap product availability failed due to new cheap factory-made products, price marking and small packs. In 2014, smokers could buy factory-made (roll-your-own tobacco) cigarettes at real prices similar to 2002. Exclusive roll-your-ow","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"8 1","pages":"1-140"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48008146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Meiksin, J. Crichton, M. Dodd, G. Morgan, Pippa Williams, M. Willmott, E. Allen, N. Tilouche, J. Sturgess, S. Morris, C. Barter, H. Young, G. Melendez‐Torres, Bruce Taylor, H. L. Reyes, D. Elbourne, H. Sweeting, K. Hunt, R. Ponsford, R. Campbell, C. Bonell, Rebecca Meiksino, Jo Crichtono, Matthew Doddo, Gemma S Morgano, Pippa Williamso, Micky Willmotto, Elizabeth Alleno, Nerissa Tiloucheo, Joanna Sturgesso, S. Morriso, Christine Bartero, Honor Youngo, GJ Melendez-Torreso, Bruce Tayloro, H. L. McNaughton, Reyeso, Diana Elbourneo, Helen Sweetingo, Kate Hunto, Ruth Ponsfordo, Rona Campbello, Chris Bonello
Additional co-authors: H Luz McNaughton Reyes, Diana Elbourne, Helen Sweeting, Ruth Ponsford, Rona Campbell, Chris Bonell
其他合著者:H Luz McNaughton Reyes, Diana Elbourne, Helen Sweeting, Ruth Ponsford, Rona Campbell, Chris Bonell
{"title":"A school intervention for 13- to 15-year-olds to prevent dating and relationship violence: the Project Respect pilot cluster RCT","authors":"R. Meiksin, J. Crichton, M. Dodd, G. Morgan, Pippa Williams, M. Willmott, E. Allen, N. Tilouche, J. Sturgess, S. Morris, C. Barter, H. Young, G. Melendez‐Torres, Bruce Taylor, H. L. Reyes, D. Elbourne, H. Sweeting, K. Hunt, R. Ponsford, R. Campbell, C. Bonell, Rebecca Meiksino, Jo Crichtono, Matthew Doddo, Gemma S Morgano, Pippa Williamso, Micky Willmotto, Elizabeth Alleno, Nerissa Tiloucheo, Joanna Sturgesso, S. Morriso, Christine Bartero, Honor Youngo, GJ Melendez-Torreso, Bruce Tayloro, H. L. McNaughton, Reyeso, Diana Elbourneo, Helen Sweetingo, Kate Hunto, Ruth Ponsfordo, Rona Campbello, Chris Bonello","doi":"10.3310/phr08050","DOIUrl":"https://doi.org/10.3310/phr08050","url":null,"abstract":"Additional co-authors: H Luz McNaughton Reyes, Diana Elbourne, Helen Sweeting, Ruth Ponsford, Rona Campbell, Chris Bonell","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"8 1","pages":"1-338"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46232338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.5923/j.phr.20201002.02
E. Merem, Y. Twumasi, J. Wesley, D. Olagbegi, M. Crisler, C. Romorno, M. Alsarari, P. Isokpehi, A. Hines, G. S. Ochai, E. Nwagboso, S. Fageir, S. Leggett
At a time of mounting fears over the risks of tainted food and the environmental health impacts, people are embracing organic farming in record numbers. The way such alternative food items are displayed in grocery stores in every zone in the country gives credence to the growing acceptance. Since its emergence, organic farming has gained formidable foothold in the Western region where California towers above everyone and other parts of the US. Considering the reasons that originally fueled organic farming and the proliferation across the country, access to more varieties of produces are helping supplement output originating from conventional sources. Further along these lines, elements located within the organic farm structure from size of land area, cropland and food types have increased over time. While the surge in organic farmland use stems from socio-economic forces, ecology and policy factors, very little has been done in assessing the changing trends and the state of organic farm operations using a mix scale technique. Added to that, the guiding standards shaping the regulatory components of organic farm produce and the potentials are barely known. For that, this research will fill that void by focusing on organic farming activities in 10 states in the Western region with emphasis on the issues, trends and factors using secondary data under mix scale techniques of GIS and descriptive statistics. The results point to visible changes in farmland indicators from cropland, food types to output volume in organic farm operations coupled with dispersion of emergent spatial patterns highlighting the extent of organic farmland use and the evolution of other indicators across the states using GIS. Realizing that the changes surrounding organic farming activities in the study area emanate from socio-economic and physical elements, the paper offered seven suggestions to strengthen the sector. The recommendations ranged from the need for a periodic tracking of farm operations to the design of a regional organic land use and food index.
{"title":"Analyzing Organic Food Farming Trends in the US Western Region","authors":"E. Merem, Y. Twumasi, J. Wesley, D. Olagbegi, M. Crisler, C. Romorno, M. Alsarari, P. Isokpehi, A. Hines, G. S. Ochai, E. Nwagboso, S. Fageir, S. Leggett","doi":"10.5923/j.phr.20201002.02","DOIUrl":"https://doi.org/10.5923/j.phr.20201002.02","url":null,"abstract":"At a time of mounting fears over the risks of tainted food and the environmental health impacts, people are embracing organic farming in record numbers. The way such alternative food items are displayed in grocery stores in every zone in the country gives credence to the growing acceptance. Since its emergence, organic farming has gained formidable foothold in the Western region where California towers above everyone and other parts of the US. Considering the reasons that originally fueled organic farming and the proliferation across the country, access to more varieties of produces are helping supplement output originating from conventional sources. Further along these lines, elements located within the organic farm structure from size of land area, cropland and food types have increased over time. While the surge in organic farmland use stems from socio-economic forces, ecology and policy factors, very little has been done in assessing the changing trends and the state of organic farm operations using a mix scale technique. Added to that, the guiding standards shaping the regulatory components of organic farm produce and the potentials are barely known. For that, this research will fill that void by focusing on organic farming activities in 10 states in the Western region with emphasis on the issues, trends and factors using secondary data under mix scale techniques of GIS and descriptive statistics. The results point to visible changes in farmland indicators from cropland, food types to output volume in organic farm operations coupled with dispersion of emergent spatial patterns highlighting the extent of organic farmland use and the evolution of other indicators across the states using GIS. Realizing that the changes surrounding organic farming activities in the study area emanate from socio-economic and physical elements, the paper offered seven suggestions to strengthen the sector. The recommendations ranged from the need for a periodic tracking of farm operations to the design of a regional organic land use and food index.","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45943964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Clarke, J. Ingram, Debbie Johnson, G. Thomson, H. Trickey, S. Dombrowski, A. Sitch, F. Dykes, M. Feltham, C. MacArthur, T. Roberts, P. Hoddinott, K. Jolly
The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. To investigate the feasibility of delivering the ABA infant feeding intervention in a randomised controlled trial. This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group. Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding. Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention (n = 103), were recruited by researchers in antenatal clinics. Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks’ gestation and could continue until 5 months postnatally. The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial were collected via participant questionnaires. A mixed-methods process evaluation included qualitative interviews with women, infant-feeding helpers and maternity services; infant-feeding helper logs; and audio-recordings of antenatal contacts to check intervention fidelity. Of the 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months, respectively. Feeding status at 8 weeks was obtained for 95.1% of participants. Recruitment took place from February 2017 until August 2017. It was possible to recruit and train existing peer supporters to the infant-feeding helper role. The intervention was delivered to most women with relatively high fidelity. Among the 50 women in the intervention group, 39 received antenatal visits and 40 received pos
{"title":"An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT","authors":"J. Clarke, J. Ingram, Debbie Johnson, G. Thomson, H. Trickey, S. Dombrowski, A. Sitch, F. Dykes, M. Feltham, C. MacArthur, T. Roberts, P. Hoddinott, K. Jolly","doi":"10.3310/PHR08070","DOIUrl":"https://doi.org/10.3310/PHR08070","url":null,"abstract":"\u0000 \u0000 The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory.\u0000 \u0000 \u0000 \u0000 To investigate the feasibility of delivering the ABA infant feeding intervention in a randomised controlled trial.\u0000 \u0000 \u0000 \u0000 This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group.\u0000 \u0000 \u0000 \u0000 Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding.\u0000 \u0000 \u0000 \u0000 Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention (n = 103), were recruited by researchers in antenatal clinics.\u0000 \u0000 \u0000 \u0000 Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks’ gestation and could continue until 5 months postnatally.\u0000 \u0000 \u0000 \u0000 The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial were collected via participant questionnaires. A mixed-methods process evaluation included qualitative interviews with women, infant-feeding helpers and maternity services; infant-feeding helper logs; and audio-recordings of antenatal contacts to check intervention fidelity.\u0000 \u0000 \u0000 \u0000 Of the 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months, respectively. Feeding status at 8 weeks was obtained for 95.1% of participants. Recruitment took place from February 2017 until August 2017. It was possible to recruit and train existing peer supporters to the infant-feeding helper role. The intervention was delivered to most women with relatively high fidelity. Among the 50 women in the intervention group, 39 received antenatal visits and 40 received pos","PeriodicalId":32306,"journal":{"name":"Public Health Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43413649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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