BMJ Nutrition, Prevention and Health最新文献

{"title":"Factors influencing the implementation of food fortification regulation among small and medium-scale corn millers in Dar es Salaam Tanzania: a qualitative study.","authors":"Dorice C Lema, Gladys Reuben Mahiti, Bruno F Sunguya","doi":"10.1136/bmjnph-2024-000940","DOIUrl":"https://doi.org/10.1136/bmjnph-2024-000940","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to explore factors influencing the implementation of food fortification regulation among corn millers in Dar es Salaam Tanzania.</p><p><strong>Methods: </strong>This phenomenological qualitative study was conducted in Dar es Salaam, Tanzania among purposely interviewed corn millers. In-depth interviews conducted with nine corn millers were analysed using thematic analysis with the aid of N-Vivo software version 12.</p><p><strong>Results: </strong>The implementation of food fortification regulation among corn millers is influenced by access to knowledge and the right information, lack of consumers' awareness, zero costs for the fortification of corn flour, and lack of punitive measures for non-compliance to the regulation.</p><p><strong>Conclusion and recommendations: </strong>Laxity in implementing food fortification as an important population-wide approach in addressing micronutrient deficiency is evident in Tanzania. This is triggered by non-punitive measures for non-compliance of the regulation among micro, small and medium-scale corn millers. Strengthening efforts to identify and implement measures against non-compliers, demand creation for fortified products through educational and advocacy interventions, and supportive supervision can help reach more than 90% of the population with fortified corn flour in Tanzania.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"7 2","pages":"e000940"},"PeriodicalIF":3.3,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition and associated risk factors in orphanages in Punjab, Pakistan: an analytical study.","authors":"Muhammad Farhan Farid, Alfur Rehman, Ahmad Mujtaba Khaliq, Naveed Ali, Ahmad Hussen Tareq","doi":"10.1136/bmjnph-2024-000974","DOIUrl":"https://doi.org/10.1136/bmjnph-2024-000974","url":null,"abstract":"<p><strong>Background: </strong>Children living in orphanages face an increased susceptibility to malnutrition due to inadequate nutrition and psychological factors, in comparison to children who stay with their parents. A considerable proportion of institutionalised children remain unreported, and there is a dearth of information regarding the nutritional status of these children in Pakistan. This study set out to evaluate the status of malnutrition in the orphanages of Social Welfare Department Punjab.</p><p><strong>Methodology: </strong>A multicentre analytical cross-sectional study was conducted from 12 December 2021 to 30 June 2022, with 255 study participants (aged 6-18 years) in seven orphanages (4 girls, 3 boys) out of 12 orphanages of government of Punjab. Anthropometric measurements were taken using standardised measuring instruments, and data were collected using structured questionnaire. Subjects were classed as malnourished based on body mass index for age and height for age reference growth charts of WHO 2007. Binary logistic regression was used to identify potential risk factors of malnutrition in orphanages.</p><p><strong>Results: </strong>The study identified 36.1% malnourished children, of whom, 65.2% were orphans and 34% destitute children. The study reported 9.4% moderately underweight, 2.4% severely underweight, 4.3% overweight and 1.2% obese children and adolescents. The study established 17.6% moderately stunted, and 7.1% severely stunted children. Age at admission to orphanages (9-13 years) and lack of milk and meat consumption were identified as significant predictors of malnutrition in institutionalised children of Punjab.</p><p><strong>Conclusion: </strong>Central Punjab had the highest malnutrition rate compared to North and South Punjab. Micronutrient deficiencies were more pronounced in South Punjab orphanages. Effective prevention of malnutrition requires early assessment of malnutritional risk in Pakistani orphanages.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"7 2","pages":"e000974"},"PeriodicalIF":3.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional deficiencies and associated pathologies present unique challenges of diagnosing paediatric inflammatory bowel disease in sub-Saharan Africa.","authors":"Paula T Littlejohn, Taiba Jibril Afaa","doi":"10.1136/bmjnph-2024-001098","DOIUrl":"https://doi.org/10.1136/bmjnph-2024-001098","url":null,"abstract":"","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"7 2","pages":"e001098"},"PeriodicalIF":3.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early life adverse environmental, nutrition and infection factors are associated with lower developmental scores in Pakistani children at 5 years: a cohort study.","authors":"Doris González-Fernández, Aisha Yousafzai, Simon Cousens, Arjumand Rizvi, Imran Ahmed, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta","doi":"10.1136/bmjnph-2024-000900","DOIUrl":"https://doi.org/10.1136/bmjnph-2024-000900","url":null,"abstract":"<p><strong>Background: </strong>The effects of multiple early adverse psychosocial and biological factors on child development at preschool age in deprived settings are not fully understood.</p><p><strong>Methods: </strong>The 'Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development' (MAL-ED) project followed children from eight countries, recording sociodemographic, nutritional, illness, enteroinfection biomarkers and scores for quality of home environment (Home Observation for Measurement of the Environment (HOME)), development (Bayley) and maternal depression during the first year of life. In the Pakistan cohort, we investigated associations of these early factors with Z-scores (derived from the eight participating countries) of three developmental outcomes at 5 years: Executive Functions (Z-EF), the Wechsler Preschool and Primary Scale for Intelligence (Z-WPPSI) and the externalising behaviours component of the Strength and Difficulties test (Z-externalising behaviours).</p><p><strong>Results: </strong>Most children had 5-year development measurements below other MAL-ED countries (Z-EF<0, 80.3%, Z-WPPSI<0, 69.3%) and 45.6% had Z-externalising behaviours>0. Higher Z-EF was associated with higher HOME (coeff: 0.03 (95% CI 0.005, 0.05), p=0.017) and Bayley scores (0.01 (0.002, 0.01), p=0.010). Higher Z-WPPSI was associated with more household assets (0.02 (0.01, 0.03), p=0.003), but with lower alpha-1 antitrypsin (µmol/L, protein-losing enteropathy) (-0.01 (-0.02, -0.005), p=0.003). Lower externalising behaviour was associated with female sex (-0.30 (-0.53, -0.08), p=0.009), higher soluble-transferrin-receptors (mg/L) (-0.07 (-0.14, -0.01), p=0.024) and initiation of solids/semisolids≥6 months (-0.16 (-0.31, -0.01), p=0.033), but higher externalising behaviour was associated with underweight (0.35 (0.07, 0.62), p=0.014), more diarrhoeal episodes (0.03 (0.004, 0.06), p=0.022) and higher Maternal Depression Score (0.04 (0.01, 0.07), p=0.003) in the first year.</p><p><strong>Conclusion: </strong>Adverse environmental, nutrition and infectious factors, and indicators of deprived early development in the first year of life have a negative association with developmental scores at 5 years. Addressing early stressors, improving diet, infections and environment stimulation early in life could positively impact child development in resource-constrained settings.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"7 2","pages":"e000900"},"PeriodicalIF":3.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haptoglobin polymorphism, vitamin E and mortality: the Ludwigshafen Risk and Cardiovascular Health Study.","authors":"Graciela E Delgado, Marcus E Kleber, Angela P Moissl, Brigitte M Winklhofer-Roob, Bernhard K Krämer, Wilfried Renner, Tanja Langsenlehner, Thomas B Dschietzig, Winfried März, Franz P Armbruster","doi":"10.1136/bmjnph-2024-001061","DOIUrl":"https://doi.org/10.1136/bmjnph-2024-001061","url":null,"abstract":"<p><strong>Objective: </strong>In humans, haptoglobin (Hp) exists in two allelic forms, Hp1 and Hp2, that differ significantly in their ability to protect the organism from oxidative stress. It has been proposed that in patients with diabetes mellitus carriers of the Hp2-2 genotype may benefit from vitamin E supplementation. Aim of our study was to investigate if there is evidence regarding a potential interaction between the Hp polymorphism and vitamin E with regard to mortality in individuals at medium-to-high cardiovascular risk with and without diabetes mellitus.</p><p><strong>Research design and methods: </strong>Data from 3176 participants of the Ludwigshafen Risk and Cardiovascular Health study, a monocentric hospital-based study of patients referred for coronary angiography, were analysed using Cox proportional hazard regression.</p><p><strong>Results: </strong>Participants with the Hp2-2 genotype demonstrated significantly lower Hp levels, while carriers of at least one Hp-2 allele displayed elevated levels of the inflammatory markers high-sensitive C reactive protein and serum amyloid A. No notable differences in comorbidities were observed among the various HP genotype groups. While the HP genotype showed no direct association with mortality, a borderline significant correlation between α-tocopherol plasma concentration and overall mortality was noted. An interaction between vitamin E status and the HP genotype regarding mortality risk was evident, particularly among patients with diabetes mellitus, with a p value of 0.021 for the interaction term. In restricted cubic splice analysis, patients with diabetes mellitus who are carriers of the Hp2-2 genotype seem to benefit from higher γ-tocopherol concentrations whereas for the other genotype groups there was a direct association with mortality risk.</p><p><strong>Conclusion: </strong>Particularly in patients with diabetes mellitus we could show a significant interaction of γ-tocopherol plasma concentration and HP genotype. Carriers of the Hp2-2 genotype seemed to benefit from higher plasma concentrations of γ-tocopherol. Further research is warranted to elucidate the underlying mechanisms and potential therapeutic implications in cardiovascular disease management.</p>","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"7 2","pages":"e001061"},"PeriodicalIF":3.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal prenatal, with or without postpartum, vitamin D3 supplementation does not improve maternal iron status at delivery or infant iron status at 6 months of age: secondary analysis of a randomised controlled trial","authors":"Karen M O'Callaghan, Huma Qamar, Alison D Gernand, AK Onoyovwi, Stanley Zlotkin, Abdullah A Mahmud, Tahmeed Ahmed, Farhana K Keya, Daniel E Roth","doi":"10.1136/bmjnph-2023-000758","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000758","url":null,"abstract":"Background Vitamin D may modify iron status through regulation of hepcidin and inflammatory pathways. This study aimed to investigate effects of maternal vitamin D supplementation on iron status in pregnancy and early infancy. Methods In a trial in Dhaka, Bangladesh, women (n=1300) were randomised to one of five vitamin D 3 regimens from 17 to 24 weeks’ gestation until 26 weeks postpartum (prenatal; postpartum doses): 0;0, 4200;0, 16 800;0, 28 000;0 or 28 000;28 000 IU/week. All participants received standard iron-folic acid supplementation. In this secondary analysis (n=998), we examined effects of prenatal;postpartum vitamin D on serum ferritin and other biomarkers of maternal iron status (transferrin saturation, total iron binding capacity, soluble transferrin receptor and hepcidin) at delivery, and infant ferritin and haemoglobin at 6 months of age. Using linear regression, we estimated per cent mean differences between each intervention group and placebo with 95% CIs, with and without adjustment for baseline ferritin or inflammatory biomarkers (C reactive protein and α-1-acid glycoprotein (AGP)). Results At delivery, ferritin concentrations were similar between each intervention group and placebo in unadjusted (n=998) and baseline ferritin-adjusted analyses (n=992; p>0.05). Compared with placebo, AGP was lower in each intervention group (per cent difference (95% CI) = −11% (−21 to –1.0), −14% (−23 to –3.5) and −11% (−19 to –2.0) in the 4200 IU/week, 16 800 IU/week and 28 000 IU/week groups, respectively; n=779). In the subgroup of women with baseline 25-hydroxyvitamin D < 30 nmol/L, ferritin was lower in each intervention group versus placebo (−23% (−37 to –5.0), −20% (−35 to –1.9) and −20% (−33 to –4.1) in the 4200 IU/week, 16 800 IU/week and 28 000 IU/week groups, respectively; n=645); effects were slightly attenuated after adjustment for inflammation (n=510). There were no effects of vitamin D on other iron biomarkers among women at delivery or infants aged 6 months. Conclusion These findings do not support improvement of iron status by vitamin D. The effect of prenatal vitamin D supplementation on ferritin may reflect an anti-inflammatory mechanism.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"68 19","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134900622","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}

{"title":"Effects of behavioural change communication (BCC) on menstrual hygiene practices among urban school adolescent girls: a pilot study","authors":"Farzana Saleh, Kazi Rumana Ahmed, Taslima Khatun, Nandini Roy, Sadia Uddin, Md Rowshan Kabir","doi":"10.1136/bmjnph-2023-000754","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000754","url":null,"abstract":"Background Research on menstrual hygiene management practices (MHMP) has yet to be conducted among adolescent girls in Bangladesh who have gained services from the Urban Primary Health Care Project (UPHCP). This study aimed to assess the effects of behavioural change communication activities on MHMP among urban school adolescent girls. Methods A convenience sample of 270 adolescent girls (aged 10–19) who had no chronic diseases from 5 schools in Dhaka city was selected using a descriptive cross-sectional design from February to May 2018. A semistructured (interviewer-administered) questionnaire was used. Frequencies were calculated for descriptive analysis. Results About 17% of girls had irregular menstrual cycles, 57% felt uneasy and 27% had &gt;7 days of menstrual flow. Fifty-five per cent of the girls used sanitary napkins. Most (95%) and 26% of the girls did not change their pads during school and at night, respectively. Sixty-five per cent of girls disposed of the used pads at the public dustbin, and 83% bathed during menstrual. Only 4% of girls were aware of the iron folic acid tablets. Conclusions Despite the availability of services from UPHCP, the acceptance and adherence to MHMP among adolescent girls still need to be improved.","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"69 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134900752","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}

{"title":"Effects of a 5-week intake of erythritol and xylitol on vascular function, abdominal fat and glucose tolerance in humans with obesity: a pilot trial","authors":"Valentine Bordier, Fabienne Teysseire, Jürgen Drewe, Philipp Madörin, Oliver Bieri, Arno Schmidt-Trucksäss, Henner Hanssen, Christoph Beglinger, Anne Christin Meyer-Gerspach, Bettina K Wölnerhanssen","doi":"10.1136/bmjnph-2023-000764","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000764","url":null,"abstract":"Introduction Previous studies in humans and rats suggest that erythritol might positively affect vascular function, xylitol decrease visceral fat mass and both substances improve glycaemic control. The objective of this study was to investigate the impact of a 5-week intake of erythritol and xylitol on vascular function, abdominal fat and blood lipids, glucose tolerance, uric acid, hepatic enzymes, creatinine, gastrointestinal tolerance and dietary patterns in humans with obesity. Methods Forty-two participants were randomised to consume either 36 g erythritol, 24 g xylitol, or no substance daily for 5 weeks. Before and after the intervention, arterial stiffness (pulse wave velocity, arteriolar-to-venular diameter ratio), abdominal fat (liver volume, liver fat percentage, visceral and subcutaneous adipose tissue, blood lipids), glucose tolerance (glucose and insulin concentrations), uric acid, hepatic enzymes, creatinine, gastrointestinal tolerance and dietary patterns were assessed. Data were analysed by linear mixed effect model. Results The 5-week intake of erythritol and xylitol showed no statistically significant effect on vascular function. Neither the time nor the treatment effects were significantly different for pulse wave velocity (time effect: p=0.079, Cohen’s D (95% CI) −0.14 (−0.54–0.25); treatment effect: p=0.792, Cohen’s D (95% CI) control versus xylitol: −0.11 (–0.61–0.35), control versus erythritol: 0.05 (0.44–0.54), erythritol versus xylitol: 0.07 (–0.41–0.54)). There was no statistically significant effect on abdominal fat, glucose tolerance, uric acid, hepatic enzymes and creatinine. Gastrointestinal tolerance was good except for a few diarrhoea-related symptoms. Participants of all groups reduced their consumption of sweetened beverages and sweets compared with preintervention. Conclusions The 5-week intake of erythritol and xylitol showed no statistically significant effects on vascular function, abdominal fat, or glucose tolerance in people with obesity. Clinical trial registration NCT02821923 .","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"7 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134992180","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}

{"title":"Estimated impact of the UK soft drinks industry levy on childhood hospital admissions for carious tooth extractions: interrupted time series analysis","authors":"Nina Trivedy Rogers, David I Conway, Oliver Mytton, Chrissy H Roberts, Harry Rutter, Andrea Sherriff, Martin White, Jean Adams","doi":"10.1136/bmjnph-2023-000714","DOIUrl":"https://doi.org/10.1136/bmjnph-2023-000714","url":null,"abstract":"Introduction Tooth extraction due to dental caries is associated with socioeconomic deprivation and is a major reason for elective childhood hospital admissions in England. Consumption of sugar-sweetened beverages is a risk factor for dental caries. We examined whether the soft drinks industry levy (SDIL), announced in March 2016 and implemented in April 2018, was associated with changes in incidence rates of hospital admissions for carious tooth extraction in children, 22 months post-SDIL implementation. Methods Changes in incidence rates of monthly National Health Service hospital admissions for extraction of teeth due to a primary diagnosis of dental caries (International Classification of Diseases; ICD-10 code: K02) in England, between January 2012 and February 2020, were estimated using interrupted time series and compared with a counterfactual scenario where SDIL was not announced or implemented. Periodical changes in admissions, autocorrelation and population structure were accounted for. Estimates were calculated overall, by Index of Multiple Deprivation (IMD) fifths and by age group (0–4 years, 5–9 years, 10–14 years, 15–18 years). Results Compared with the counterfactual scenario, there was a relative reduction of 12.1% (95% CI 17.0% to 7.2%) in hospital admissions for carious tooth extractions in all children (0–18 years). Children aged 0–4 years and 5–9 years had relative reductions of 28.6% (95% CI 35.6% to 21.5%) and 5.5% (95% CI 10.5% to 0.5%), respectively; no change was observed for older children. Reductions were observed in children living in most IMD areas regardless of deprivation. Conclusion The UK SDIL was associated with reductions in incidence rates of childhood hospital admissions for carious tooth extractions, across most areas regardless of deprivation status and especially in younger children. Trial registration number ISRCTN18042742 .","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"33 16","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134993577","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}

{"title":"Physiotherapy-led telehealth and exercise intervention to improve mobility in older people receiving aged care services (TOP UP): protocol for a randomised controlled type 1 hybrid effectiveness-implementation trial","authors":"Rik Dawson, Marina Pinheiro, Vasikaran Nagathan, Morag Taylor, Kim Delbaere, Juliana Olivera, Abby Haynes, Jenny Rayner, Leanne Hassett, Catherine Sherrington","doi":"10.1136/bmjnph-2022-000606","DOIUrl":"https://doi.org/10.1136/bmjnph-2022-000606","url":null,"abstract":"Introduction Deteriorating mobility and falls reduce independence and quality of life for older people receiving aged care services. This trial aims to establish effectiveness on the mobility of older people, and explore cost-effectiveness and implementation of a telehealth physiotherapy programme. Method and analysis This type 1 hybrid effectiveness-implementation randomised controlled trial will involve 240 people aged 65+ years receiving aged care services in community or residential settings. Participants will be randomised to either: (1) the Telehealth Physiotherapy for Older People (TOP UP) Program or (2) a wait-list control group. The 6-month intervention includes 10 physiotherapy sessions delivered by videocall (Zoom). The intervention will include the local support of an aged care worker and online exercise resources. Primary outcome is mobility at 6 months post randomisation measured by the Short Physical Performance Battery. Secondary outcomes include rate of falls, sit-to-stand, quality of life, and goal attainment at 6 months after randomisation. Regression models will assess the effect of group allocation on mobility and the other continuously scored secondary outcomes, adjusting for baseline scores. The number of falls per person over 6 months will be analysed using negative binomial regression models to estimate between-group differences. An economic analysis will explore the cost-effectiveness of the TOP UP programme compared with usual care. Implementation outcomes and determinants relating to the intervention’s reach, fidelity, exercise dose delivered, adoption, feasibility, acceptability, barriers and facilitators will be explored using mixed methods. Conclusion This is the first trial to investigate the effectiveness, cost-effectiveness and implementation of a physiotherapy intervention in aged care delivered solely by telehealth internationally. The study has strong aged care co-design and governance and is guided by steering and advisory committees that include staff from aged care service providers and end-users. Trial results will be disseminated via peer-reviewed articles, conference presentations and lay summaries. Trial registration number The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12621000734864).","PeriodicalId":36307,"journal":{"name":"BMJ Nutrition, Prevention and Health","volume":"69 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134900753","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}