Three-year review of a capacity building pilot for a sustainable regional network on food, nutrition and health systems education in India.

BACKGROUND: In Kolkata (India), there are high rates of malnourished children (45.9%) under the age of three, impacting growth, organ development, function, and cognition. Mothers have a major role to play during this crucial development stage, with research showing nutrition knowledge, attitudes and practices (KAP) of mothers are important determinants of childhood malnutrition. AIMS: To document 3 years of capacity building towards a sustainable nutrition education network in Kolkata, India, while assessing the ability to perform data collection in the form of needs assessments, impact assessments and capacity reviews. METHODS: Descriptive review and analysis of engagement and impact from 3 years of work by the NNEdPro Global Centre for Nutrition and Health, initiating locally led nutrition education interventions. Mapping to the Indian National Nutrition Strategy was also performed to review adherence to nationwide priorities surrounding nutrition and determine the wider application potential of the network. RESULTS: Two simultaneous projects were taken forward by a team of local healthcare professionals and student champions. Project 1-medical college workshops for medical student nutrition education with added focus on underserved populations, Project 2-preparation for a 'Mobile Teaching Kitchen' (MTK) in marginalised communities to empower local women as nutrition educators.Data collection methods used for analysing markers of impact and sustainability were semi-structured interviews of the community members, and KAP questionnaires to assess response to educational sessions. CONCLUSION: With local support it is possible to create and sustain fieldwork for an extended period with meaningful outputs and impact. This initiative demonstrates that it is possible to use healthcare professionals, students and volunteers with low-intensity training and a low-cost approach to produce action research with considerable impact and results in rapid, reliable and robust manner

Mobiiliterveyspeliin liittyvät tarpeet, toiveet ja ideat

Terveyssuuntautuneisuus on vahvistumassa, mikä edellyttää uudenlaisia keinoja terveyden edistämiseksi. Väestön koulutustason nousu mahdollistaa tiedon paremman hyväksikäytön sekä uudenlaisen tiedonvälityksen ja terveysneuvonnan. Opinnäytetyö liittyy InnoHealth- projektiin, jonka tarkoituksena on valmentaa terveys- ja hyvinvointiteknologian toimijoita monipuoliseen yhteistyöhön opetuksen ja työelämäkäytäntöjen kehittämiseksi. Yhteistyöyrityksenä on Dato Systems Ay, jonka tavoitteena on kehittää sovellus, joka vastaa asiakkaiden tarpeita terveyden edistämisen näkökulmasta. Nyt kehitteillä olevassa sovelluksessa keskitytään ravitsemukseen ja liikuntaan. Opinnäytetyön tarkoitus on ottaa selvää mitä tarpeita, toiveita ja ideoita 18–50 –vuotiailla älypuhelimen käyttäjillä on mobiiliterveyspelistä. Opinnäytetyön tavoitteena on tuottaa tietoa, joka auttaa yhteistyöyritystä kehittämään mobiiliterveyspeliä asiakaslähtöisesti. Opinnäytetyö on laadullinen tutkimus, jonka aineistonkeruumenetelmänä käytettiin teemahaastattelua. Teemahaastattelu toteutettiin haastattelemalla opinnäytetyön tekijöiden lähipiirin henkilöitä (n = 12), jotka olivat älypuhelimen käyttäjiä. Haastattelemalla saatu aineisto analysoitiin aineistolähtöistä sisällönanalyysiä käyttäen. Opinnäytetyön tulokset osoittivat, että kaikki haastateltavat kaipasivat tietoa ravitsemuksesta ja liikunnasta. Motivoitumiskeinoista tärkeimpinä pidettiin tulosten seurantaa, tavoitteita sekä niiden saavuttamista. Haastatteluista selvisi motivoitumisen olevan lähtöisin omista tarpeista ja taistelusta itseään vastaan. Sovelluksen helppokäyttöisyys, yksilöllisyys ja saatavuus olivat toiveita, joita haastateltavat korostivat vastauksissaan. Lisälaitteiksi toivottiin ainakin GPS-mahdollisuutta, sykemittaria, kalorilaskuria ja askelmittaria. Mobiililaite koettiin nopea- ja helppokäyttöiseksi. Selkeä hyötyä koettiin myös siitä, että mobiililaite kulkee aina mukana. Haastatteluvastauksissa korostui sovellukseen liittyvänä ideana se, että sovelluksen tulisi olla helppo ja yksinkertainen käyttää, mutta käyttöominaisuuksiltaan monipuolinen, jotta se vastaisi mahdollisimman laajan kohderyhmän tarpeisiin. Haastateltavat kokivat erityisesti kokonaisvaltaisen liikunnan ja ravitsemuksen yhdistävän sovelluksen tarpeelliseksi. Yhteistyöyritys on ollut tyytyväinen opinnäytetyön tuloksiin ja he ovat ottaneet ne huomioon tuotekehityksessään.Finnish people are becoming more health oriented and that requires new tools to promote health. The educational level is rising and it gives an opportunity to exploit more information in new ways. This thesis is based on InnoHealth project which aims to train healthcare and welfare technology operators in diverse collaboration to develop education and working life practices. Co-operation company is Dato Systems Ay. The company’s goal is to create a mobile phone application that is responding to clients’ needs in health promotion point of view. In this application the focus will be on nutrition and physical activity. The aim of the thesis is to provide information that helps co-operation company to develop customer-oriented mobile phone game for health. The goal is to find out what kind of needs, hopes and ideas 18 – 50 year old smartphone users have related to mobile phone game for health. In this thesis qualitative research was used and the data was collected by theme interviews. The interviews were accomplishing by interviewing smartphone users (n = 12) who belong to researcher’s inner circle. The collected data was analyzed by data-oriented content analysis. The results of the thesis pointed out that all interviewees need information concerning nutrition and physical activity. The most important motivating ways were setting goals, monitoring and accomplishing results. Most participants mentioned that they are motivated the best by their own needs and by competing against themselves. User friendliness, individuality and availability were hopes that the interviewees highlighted in their answers concerning the application. Additional devices like heart rate monitor, GPS, caloric counter and pedometer would be valuable qualities according the participants. Mobile phone was experienced as quick and easy to use. The mobile phone has the advantage of time and location independent training. The results pointed out that the application should be easy and simple to use but have versatile performance so that it would have potential to respond as many customer-oriented needs as possible. The interviewees experienced a comprehensive application that combines nutrition and physical activity especially necessary. The co-operation company has been satisfied with results and they have already used them in their product development

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3). Diabmemory (Austria). Case Study Report

In 2010, the Austrian Social Insurance Institution for Railways and Mining Industry (Versicherungsanstalt für Eisenbahnen und Bergbau, VAEB) started a proof-of-concept diabetes telemonitoring project called DiabMemory, as part of a wider programme called "Health Dialogue" (“Gesundheitsdialog”). DiabMemory allows diabetes patients to track health parameters using a mobile phone and share this data with their General Practitioner (GP). After being diagnosed with type 1 or 2 diabetes in primary or secondary care, patients insured by VAEB are given the opportunity to stay for a period of one to three weeks at a special rehabilitation facility in Breitenstein (Lower Austria) to receive education on all aspects relevant to their health and medical conditions like nutrition, physical activity, and psychological aspects. If they decide to join the programme, they receive the equipment and training on how to use the DiabMemory system and how to integrate it into their everyday lives. After their stay in Breitenstein, participants are able to use DiabMemory without further help. A web-based application allows health professionals responsible for therapy management within the Health Dialogue programme to access patient data and adjust therapy plans when needed. Moreover, they can provide users with motivational messages and feedback can be sent directly to the patient’s mobile.JRC.J.3-Information Societ

Examining the Correlates of Adolescent Food and Nutrition Knowledge in London, Ontario

Food literacy is a set of skills and knowledge that are integral to diet. It is common among teenagers to not have basic food literacy skills needed to consume a healthy diet. This exploratory study examined: (1) the current state of food and nutrition knowledge among adolescents in grades 9-12 in the London-Middlesex region of Ontario; and (2) predictors of food knowledge among adolescents. Data for this study were drawn from baseline youth and parent survey data collected for the SmartAPPetite project, a smartphone application-based intervention study which aims to improve food and nutrition knowledge and dietary habits of adolescents. Statistical analysis of the survey data indicates that higher household education and higher median neighbourhood family income, the use of mobile health applications, liking to cook, as well as confidence in reading and understanding food labels were all consistently associated with increased food and nutrition knowledge. Results of this thesis may help guide policymakers, researchers, and public health professionals in developing appropriate food and nutrition programs and curriculums to combat the decline in food literacy skills

Using mHealth to improve health care delivery in India: A qualitative examination of the perspectives of community health workers and beneficiaries.

BACKGROUND:mHealth technologies are proliferating globally to address quality and timeliness of health care delivery by Community Health Workers (CHWs). This study aimed to examine CHW and beneficiaries' perceptions of a new mHealth intervention (Common Application Software [CAS] for CHWs in India. The objectives of the study were to seek perspectives of CHWs and beneficiaries on the uptake of CAS, changes in CHW-beneficiary interactions since the introduction of CAS and potential barriers faced by CHWs in use of CAS. Further, important contextual factors related to CHW-beneficiary interface and dynamics that may have a bearing on CAS have been described. METHODS:A qualitative study was conducted in two states of India (Bihar and Madhya Pradesh) from March-April 2018 with CHWs (n = 32) and beneficiaries (n = 55). All interviews were conducted and recorded in Hindi, transcribed and translated into English, and coded and thematically analysed using Dedoose. FINDINGS:The mHealth intervention was acceptable to the CHWs who felt that CAS improved their status in the communities where they worked. Beneficiaries' views were a mix of positive and negative perceptions. The divergent views between CHWs and beneficiaries surrounding the use and impact of CAS highlight an underlying mistrust, socio-cultural barriers in engagement, and technological barriers in implementation. All these contextual factors can influence the perception and uptake of CAS. CONCLUSIONS:mHealth interventions targeting CHWs and beneficiaries have the potential to improve performance of CHWs, reduce barriers to information and potentially change the behaviors of beneficiaries. While technology is an enabler for CHWs to improve their service delivery, it does not necessarily help overcome social and cultural barriers that impede CHW-beneficiary interactions to bring about improvements in knowledge and health behaviors. Future interventions for CHWs including mHealth interventions should examine contextual factors along with the acceptability, accessibility, and usability by beneficiaries and community members

Iodine and pregnancy – a qualitative study focusing on dietary guidance and information

Iodine is essential for thyroid hormones synthesis and normal neurodevelopment; however, ~60% of pregnant women do not meet the WHO (World Health Organization) recommended intake. Using a qualitative design, we explored the perceptions, awareness, and experiences of pregnancy nutrition, focusing on iodine. Women in the perinatal period (n = 48) were interviewed and filled in a food frequency questionnaire for iodine. Almost all participants achieved the recommended 150 μg/day intake for non-pregnant adults (99%), but only 81% met the increased demands of pregnancy (250 μg/day). Most were unaware of the importance, sources of iodine, and recommendations for iodine intake. Attitudes toward dairy products consumption were positive (e.g., helps with heartburn; easy to increase). Increased fish consumption was considered less achievable, with barriers around taste, smell, heartburn, and morning sickness. Community midwives were the main recognised provider of dietary advice. The dietary advice received focused most often on multivitamin supplements rather than food sources. Analysis highlighted a clear theme of commitment to change behaviour, motivated by pregnancy, with a desired focus on user-friendly documentation and continued involvement of the health services. The study highlights the importance of redirecting advice on dietary requirements in pregnancy and offers practical suggestions from women in the perinatal period as the main stakeholder group

Requirements for a Nutrition Education Demonstrator

[Context and Motivation] Development of innovative ICT-based applications is a complex process involving collaboration of all relevant disciplines. This complexity arises due to differences in terminology, knowledge and often also the ways of working between developers in the disciplines involved. [Question/problem] Advances in each discipline bring a rich design environment of theories, models, methods and techniques. Making a selection from these makes the development of distributed applications very challenging, often requiring a holistic approach to address the needs of the disciplines involved. This paper describes early stage requirements acquisition of a mobile nutrition education demonstrator which supports overweight persons in adopting healthier dietary behaviour. [Principal idea/results] We present a novel way to combine and use known requirements acquisition methods involving a two stage user needs analysis based on scenarios which apply a theory-based model of behavioural change and are onstructed in two phases. The first phase scenarios specify an indicative description reflecting the use of the transtheoretical model of behavioural change. In the second phase, a handshake protocol adds elements of optative system-oriented descriptions to the scenarios such that the intended system can support the indicative description. [Contribution] The holistic and phased approach separates design concerns to which each of the disciplines contributes with their own expertise and domain principles. It preserves the applied domain principles in the design and it bridges gaps in terminology, knowledge and ways of working

A systematic review of digital interventions for improving the diet and physical activity behaviors of adolescents

Many adolescents have poor diet and physical activity behaviors, which can lead to the development of noncommunicable diseases in later life. Digital platforms offer inexpensive means of delivering health interventions, but little is known about their effectiveness. This systematic review was conducted to synthesize evidence on the effectiveness of digital interventions to improve diet quality and increase physical activity in adolescents, to effective intervention components and to assess the cost-effectiveness of these interventions. Following a systematic search, abstracts were assessed against inclusion criteria, and data extraction and quality assessment were performed for included studies. Data were analyzed to identify key features that are associated with significant improvement in behavior. A total of 27 studies met inclusion criteria. Most (n = 15) were Web site interventions. Other delivery methods were text messages, games, multicomponent interventions, emails, and social media. Significant behavior change was often seen when interventions included education, goal setting, self-monitoring, and parental involvement. None of the publications reported cost-effectiveness. Due to heterogeneity of studies, meta-analysis was not feasible.It is possible to effect significant health behavior change in adolescents through digital interventions that incorporate education, goal setting, self-monitoring, and parental involvement. Most of the evidence relates to Web sites and further research into alternate media is needed, and longer term outcomes should be evaluated. There is a paucity of data on the cost-effectiveness of digital health interventions, and future trials should report these data

Hunger Report

In August 2008, as part of The Chicago Community Trust's and the Chicago Metropolitan Agency for Planning's (CMAP) joint effort to develop a long-range plan for the Chicago region, a "hunger advisory committee" comprised of 20 individuals representing an array of community-based nonprofit organizations, government agencies and private corporations came together for the first of six meetings. The purpose of the advisory committee was to produce a planning document that would provide an overview of hunger in our region, identify the challenges and opportunities in responding to hunger, and identify strategies that would lead to the elimination of hunger and, in turn, create a stronger and healthier community. Over the course of nine months, the Hunger Advisory Committee defined a vision of equitable access to quality food, along with supporting principles that laid the groundwork for a set of recommendations that will redefine the way families and individuals access emergency and supplemental food within our region.While the Hunger Advisory Committee recognizes hunger as a symptom of poverty and, thus, is unlikely to be entirely eradicated in three decades, we also believe that an enhanced, streamlined system can ensure that all individuals in our region -- regardless of age, gender, race, economic circumstances, or citizenship status -- should and can have access to quality, nutritious food delivered in a dignified manner