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Updated: 16 hours 20 min ago

Weight management in rural health clinics: The Midwest diet and exercise trial.

16 hours 20 min ago
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Weight management in rural health clinics: The Midwest diet and exercise trial.

Contemp Clin Trials. 2018 Feb 14;:

Authors: Gorczyca AM, Washburn RA, Ptomey L, Mayo MS, Sullivan DK, Gibson CA, Lee R, Stolte S, Donnelly JE

Abstract
Obesity prevalence is higher in rural compared to urban residents. Rural health clinics offer a potential venue for delivery of weight management. However, traditional programs require travel to attend on-site meetings which is impractical or inconvenient for rural residents. Clinic staff in most rural settings are unlikely to be trained to provide effective weight management. Remote delivery using group phone conferences (GP) or individual phone calls (IP), by staff associated with rural clinics eliminates the need for travel to attend on-site meetings. The effectiveness of these approaches will be the focus of this trial. Staff at five primary care clinics, serving primarily rural residents, will be trained to deliver GP and IP interventions and an enhanced usual care (EUC), (i.e., individual face-to-face meetings (~45 min) at clinic site, four times across 18 mos.). Two hundred overweight/obese adults (BMI ≥ 25.0-45.0 kg/m2, age ≥ 21 yrs.) will be recruited through each clinic and randomized to GP (n = 80), IP (n = 80), or EUC (n = 40) to compare weight loss (0-6 mos.), weight maintenance (7-18 mos.), and weight change during a 6 mo. no contact follow-up (19-24 mos.) between intervention arms. The GP and IP interventions will be identical in lesson plan content, diet, and physical activity. The only difference between groups will be the delivery format (group vs. individual) and session duration (GP ~45 min/session; IP ~15 min/session). Primary (body weight) and secondary outcomes (waist circumference, energy/macronutrient intake, physical activity) will be assessed at baseline, 6, 12, 18 and 24 mos. Cost and contingent valuation analyses will also be completed.
NCT REGISTRATION: NCT02932748.

PMID: 29454140 [PubMed - as supplied by publisher]

Impact of Three Years of Classroom Physical Activity Bouts on Time-on-Task Behavior.

Thu, 02/01/2018 - 01:18
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Impact of Three Years of Classroom Physical Activity Bouts on Time-on-Task Behavior.

Med Sci Sports Exerc. 2017 Nov;49(11):2343-2350

Authors: Szabo-Reed AN, Willis EA, Lee J, Hillman CH, Washburn RA, Donnelly JE

Abstract
Participation in classroom physical activity (PA) may improve time-on-task (TOT); however, the influence of sustained moderate-to-vigorous PA (MVPA) on TOT is unknown.
PURPOSE: To explore the influence of classroom PA delivered with academic lessons on TOT, determine if the relationship between classroom PA and TOT differs by age, sex, race/ethnicity, weight or baseline fitness, and identify the influence of MVPA on TOT when controlling for demographic variables.
METHODS: Teachers in intervention schools were asked to deliver two 10-min PA lessons per day, 5 d·wk. PA was observed in both intervention and control schools to determine the amount and intensity of PA. Time-on-task was observed before and immediately after PA. Anthropometrics and fitness were assessed at baseline and end of the school year for 3 yr. Multilevel modeling was used to estimate overall group difference, change over the study, and group difference in change while accounting for covariates.
RESULTS: Students who participated in PA lessons engaged in significantly more MVPA than those in the control schools in all 3 yr (all P < 0.001). There was a significant linear increase in the percent of TOT before PA lessons for both control and intervention groups over the 3-yr period (P < 0.001), with no group difference. The intervention group spent significantly more TOT (P = 0.01) after PA than the control group. The percent of time spent in MVPA was significantly associated with the percent of TOT (P < 0.01).
CONCLUSIONS: Results indicate that children who received PA lessons participated in significantly more MVPA than those who did not and that PA was significantly associated with more TOT. These findings provide support for classroom PA as a means of increasing TOT in elementary age children.

PMID: 28614194 [PubMed - indexed for MEDLINE]

Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

Wed, 12/13/2017 - 22:15
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Weight management for adolescents with intellectual and developmental disabilities: Rationale and design for an 18month randomized trial.

Contemp Clin Trials. 2016 Nov;51:88-95

Authors: Donnelly JE, Ptomey LT, Goetz JR, Sullivan DK, Gibson CA, Greene JL, Lee RH, Mayo MS, Honas JJ, Washburn RA

Abstract
Adolescents with intellectual and developmental disabilities (IDD) are an underserved group in need of weight management. However, information regarding effective weight management for this group is limited, and is based primarily on results from small, non-powered, non-randomized trials that were not conducted in accordance with current weight management guidelines. Additionally, the comparative effectiveness of emerging dietary approaches, such as portion-controlled meals (PCMs) or program delivery strategies such as video chat using tablet computers have not been evaluated. Therefore, we will conduct an 18month trial to compare weight loss (6months) and maintenance (7-18months) in 123 overweight/obese adolescents with mild to moderate IDD, and a parent, randomized to a weight management intervention delivered remotely using FaceTime™ on an iPad using either a conventional meal plan diet (RD/CD) or a Stop Light diet enhanced with PCMs (RD/eSLD), or conventional diet delivered during face-to-face home visits (FTF/CD). This design will provide an adequately powered comparison of both diet (CD vs. eSLD) and delivery strategy (FTF vs. RD). Exploratory analyses will examine the influence of behavioral session attendance, compliance with recommendations for diet (energy intake), physical activity (min/day), self-monitoring of diet and physical activity, medications, and parental variables including diet quality, physical activity, baseline weight, weight change, and beliefs and attitudes regarding diet and physical activity on both weight loss and maintenance. We will also complete a cost and contingent valuation analysis to compare costs between RD and FTF delivery.

PMID: 27810602 [PubMed - indexed for MEDLINE]

The Feasibility of Group Video Conferencing for Promotion of Physical Activity in Adolescents With Intellectual and Developmental Disabilities.

Wed, 11/15/2017 - 19:12
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The Feasibility of Group Video Conferencing for Promotion of Physical Activity in Adolescents With Intellectual and Developmental Disabilities.

Am J Intellect Dev Disabil. 2017 Nov;122(6):525-538

Authors: Ptomey LT, Willis EA, Greene JL, Danon JC, Chumley TK, Washburn RA, Donnelly JE

Abstract
Physical activity (PA) rates of adolescents with intellectual and developmental disabilities (IDD) are low and effective strategies for increasing PA are limited. The purpose of this study was to assess the feasibility of a group-based PA intervention that was delivered remotely to adolescents with IDD. Participants attended 30-min group PA sessions 3 times a week. PA sessions were delivered in their homes by video conferencing on a tablet computer. Thirty-one participants enrolled and 29 completed the 12-week intervention. Participants attended 77.2% ± 20.8% of scheduled sessions and averaged 26.7 ± 2.8 min of PA/session, with 11.8 ± 4.8 min at moderate- to vigorous intensity. Group-based PA delivered remotely may be a feasible approach for the promotion of PA in adolescents with IDD.

PMID: 29115872 [PubMed - in process]

Predicting resting energy expenditure in young adults.

Wed, 11/08/2017 - 19:11
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Predicting resting energy expenditure in young adults.

Obes Res Clin Pract. 2016 May-Jun;10(3):304-14

Authors: Willis EA, Herrmann SD, Ptomey LT, Honas JJ, Bessmer CT, Donnelly JE, Washburn RA

Abstract
PURPOSE: To develop and validate a REE prediction equation for young adults.
METHODS: Baseline data from two studies were pooled (N=318; women=52%) and randomly divided into development (n=159) and validation samples (n=159). REE was measured by indirect calorimetry. Stepwise regression was used to develop an equation to predict REE (University of Kansas (KU) equation). The KU equation and 5 additional REE prediction equations used in clinical practice (Mifflin-St. Jeor, Harris-Benedict, Owens, Frankenfield (2 equations)) were evaluated in the validation sample.
RESULTS: There were no significant differences between predicted and measured REE using the KU equation for either men or women. The Mifflin-St. Jeor equation showed a non-significant mean bias in men; however, mean bias was statistically significant in women. The Harris-Benedict equation significantly over-predicted REE in both men and women. The Owens equation showed a significant mean bias in both men and women. Frankenfield equations #1 and #2 both significantly over-predicted REE in non-obese men and women. We found no significant differences between measured REE and REE predicted by the Frankenfield #2 equations in obese men and women.
CONCLUSION: The KU equation, which uses easily assessed characteristics (age, sex, weight) may offer better estimates of REE in young adults compared with the 5 other equations. The KU equation demonstrated adequate prediction accuracy, with approximately equal rates of over and under-prediction. However, enthusiasm for recommending any REE prediction equations evaluated for use in clinical weight management is damped by the highly variable individual prediction error evident with all these equations.

PMID: 26210376 [PubMed - indexed for MEDLINE]


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