Taste preferences, diet and overweight in European children: An epidemiological perspective

This thesis investigated taste preferences of children from eight European countries. It is based on data from the epidemiological IDEFICS study. The methodological part of the thesis revealed that the reproducibility of the IDEFICS taste preference and -sensitivity tests was high while the reproducibility of the IDEFICS food frequency questionnaire (CEHQ-FFQ) was comparable to that of previous FFQs. Etiological analyses showed that country affiliation was the strongest predictor of taste preferences followed by age. Between ages 6 and 9, sweet and salty preference increased while umami preference decreased. Other factors were not uniformly related to taste preferences. Taste preferences for fat and sweet were also associated with an increased probability of overweight. However, they were not associated with the consumption of sweet and fatty foods. Taste preferences for fat or sweet taste could also not explain the association between TV habits and detrimental dietary behavior

Geschmackspräferenzen, Ernährung und Übergewicht bei europäischen Kindern: Eine epidemiologische Perspektive

This thesis investigated taste preferences of children from eight European countries. It is based on data from the epidemiological IDEFICS study. The methodological part of the thesis revealed that the reproducibility of the IDEFICS taste preference and -sensitivity tests was high while the reproducibility of the IDEFICS food frequency questionnaire (CEHQ-FFQ) was comparable to that of previous FFQs. Etiological analyses showed that country affiliation was the strongest predictor of taste preferences followed by age. Between ages 6 and 9, sweet and salty preference increased while umami preference decreased. Other factors were not uniformly related to taste preferences. Taste preferences for fat and sweet were also associated with an increased probability of overweight. However, they were not associated with the consumption of sweet and fatty foods. Taste preferences for fat or sweet taste could also not explain the association between TV habits and detrimental dietary behavior

Intentions of Patients With Cancer and Their Relatives to Use a Live Chat on Familial Cancer Risk: Results From a Cross-Sectional Web-Based Survey

Memenga P, Baumann E, Lütke Lanfer H, et al. Intentions of Patients With Cancer and Their Relatives to Use a Live Chat on Familial Cancer Risk: Results From a Cross-Sectional Web-Based Survey. Journal of Medical Internet Research. 2023;25: e45198.BACKGROUND: An important prerequisite for actively engaging in cancer prevention and early detection measures, which is particularly recommended in cases of familial cancer risk, is the acquisition of information. Although a lot of cancer information is available, not all social groups are equally well reached because information needs and communicative accessibility differ. Previous research has shown that a live chat service provided by health professionals could be an appropriate, low-threshold format to meet individual information needs on sensitive health topics such as familial cancer risk. An established German Cancer Information Service is currently developing such a live chat service. As it is only worthwhile if accepted by the target groups, formative evaluation is essential in the course of the chat service's development and implementation.; OBJECTIVE: This study aimed to explore the acceptance of a live chat on familial cancer risk by patients with cancer and their relatives (research question [RQ] 1) and examine the explanatory power of factors associated with their intentions to use such a service (RQ2). Guided by the Extended Unified Theory of Acceptance and Use of Technology (UTAUT2), we examined the explanatory power of the following UTAUT2 factors: performance expectancy, effort expectancy, social influence, facilitating conditions, and habit, supplemented by perceived information insufficiency, perceived susceptibility, perceived severity, and cancer diagnosis as additional factors related to information seeking about familial cancer.; METHODS: We conducted a cross-sectional survey via a German web-based access panel in March 2022 that was stratified by age, gender, and education (N=1084). The participants are or have been diagnosed with cancer themselves (n=144) or have relatives who are or have been affected (n=990). All constructs were measured with established scales. To answer RQ1, descriptive data (mean values and distribution) were used. For RQ2, a blockwise multiple linear regression analysis was conducted.; RESULTS: Overall, 32.7% of participants were (rather) willing, 28.9% were undecided, and 38.4% were (rather) not willing to use a live chat on familial cancer risk in the future. A multiple linear regression analysis explained 47% of the variance. It revealed that performance expectancy, social influence, habit, perceived susceptibility, and perceived severity were positively associated with the intention to use a live chat on familial cancer risk. Effort expectancy, facilitating conditions, information insufficiency, and cancer diagnosis were not related to usage intentions.; CONCLUSIONS: A live chat seems promising for providing information on familial cancer risk. When promoting the service, the personal benefits should be addressed in particular. UTAUT2 is an effective theoretical framework for explaining live chat usage intentions and does not need to be extended in the context of familial cancer risk. ©Paula Memenga, Eva Baumann, Hanna Luetke Lanfer, Doreen Reifegerste, Julia Geulen, Winja Weber, Andrea Hahne, Anne Muller, Susanne Weg-Remers. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 28.08.2023

Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests.

Lütke Lanfer H, Reifegerste D, Weber W, et al. Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests. BMC Health Services Research. 2024;24(1): 314.BACKGROUND: Clinical empathy is considered a crucial element in patient-centered care. The advent of digital technology in healthcare has introduced new dynamics to empathy which needs to be explored in the context of the technology, particularly within the context of written live chats. Given the growing prevalence of written live chats, this study aimed to explore and evaluate techniques of digital clinical empathy within a familial cancer-focused live chat, focusing on how health professionals can (a) understand, (b) communicate, and (c) act upon users' perspectives and emotional states.; METHODS: The study utilized a qualitative approach in two research phases. It examined the expected and implemented techniques and effectiveness of digital clinical empathy in a live chat service, involving semi-structured interviews with health professionals (n=9), focus group discussions with potential users (n=42), and two rounds of usability tests between health professionals (n=9) and users (n=18). Data were examined using qualitative content analysis.; RESULTS: Expected techniques of digital clinical empathy, as articulated by both users and health professionals, involve reciprocal engagement, timely responses, genuine authenticity, and a balance between professionalism and informality, all while going beyond immediate queries to facilitate informed decision-making. Usability tests confirm these complexities and introduce new challenges, such as balancing timely, authentic responses with effective, personalized information management and carefully framed referrals.; CONCLUSIONS: The study reveals that the digital realm adds layers of complexity to the practice of clinical empathy. It underscores the importance of ongoing adaptation and suggests that future developments could benefit from a hybrid model that integrates the strengths of both AI and human health professionals to meet evolving user needs and maintain high-quality, empathetic healthcare interactions. © 2024. The Author(s)

Understanding Trust Determinants in a Live Chat Service on Familial Cancer: Qualitative Triangulation Study With Focus Groups and Interviews in Germany

BackgroundIn dealing with familial cancer risk, seeking web-based health information can be a coping strategy for different stakeholder groups (ie, patients, relatives, and those suspecting an elevated familial cancer risk). In the vast digital landscape marked by a varied quality of web-based information and evolving technologies, trust emerges as a pivotal factor, guiding the process of health information seeking and interacting with digital health services. This trust formation in health information can be conceptualized as context dependent and multidimensional, involving 3 key dimensions: information seeker (trustor), information provider (trustee), and medium or platform (application). Owing to the rapid changes in the digital context, it is critical to understand how seekers form trust in new services, given the interplay among these different dimensions. An example of such a new service is a live chat operated by physicians for the general public with personalized cancer-related information and a focus on familial cancer risk. ObjectiveTo gain a comprehensive picture of trust formation in a cancer-related live chat service, this study investigates the 3 dimensions of trust—trustor, trustee, and application—and their respective relevant characteristics based on a model of trust in web-based health information. In addition, the study aims to compare these characteristics across the 3 different stakeholder groups, with the goal to enhance the service’s trustworthiness for each group. MethodsThis qualitative study triangulated the different perspectives of medical cancer advisers, advisers from cancer support groups, and members of the public in interviews and focus group discussions to explore the 3 dimensions of trust—trustor, trustee, and application—and their determinants for a new live chat service for familial cancer risk to be implemented at the German Cancer Information Service. ResultsThe results indicate that experience with familial cancer risk is the key trustor characteristic to using, and trusting information provided by, the live chat service. The live chat might also be particularly valuable for people from minority groups who have unmet needs from physician-patient interactions. Participants highlighted trustee characteristics such as ability, benevolence, integrity, and humanness (ie, not a chatbot) as pivotal in a trustworthy cancer live chat service. Application-related characteristics, including the reputation of the institution, user-centric design, modern technology, and visual appeal, were also deemed essential. Despite the different backgrounds and sociodemographics of the 3 stakeholder groups, many overlaps were found among the 3 trust dimensions and their respective characteristics. ConclusionsTrust in a live chat for cancer information is formed by different dimensions and characteristics of trust. This study underscores the importance of understanding trust formation in digital health services and suggests potential enhancements for effective, trustworthy interactions in live chat services (eg, by providing biographies of the human medical experts to differentiate them from artificial intelligence chatbots)

Digital clinical empathy in a live chat: multiple findings from a formative qualitative study and usability tests

Abstract Background Clinical empathy is considered a crucial element in patient-centered care. The advent of digital technology in healthcare has introduced new dynamics to empathy which needs to be explored in the context of the technology, particularly within the context of written live chats. Given the growing prevalence of written live chats, this study aimed to explore and evaluate techniques of digital clinical empathy within a familial cancer-focused live chat, focusing on how health professionals can (a) understand, (b) communicate, and (c) act upon users’ perspectives and emotional states. Methods The study utilized a qualitative approach in two research phases. It examined the expected and implemented techniques and effectiveness of digital clinical empathy in a live chat service, involving semi-structured interviews with health professionals (n = 9), focus group discussions with potential users (n = 42), and two rounds of usability tests between health professionals (n = 9) and users (n = 18). Data were examined using qualitative content analysis. Results Expected techniques of digital clinical empathy, as articulated by both users and health professionals, involve reciprocal engagement, timely responses, genuine authenticity, and a balance between professionalism and informality, all while going beyond immediate queries to facilitate informed decision-making. Usability tests confirm these complexities and introduce new challenges, such as balancing timely, authentic responses with effective, personalized information management and carefully framed referrals. Conclusions The study reveals that the digital realm adds layers of complexity to the practice of clinical empathy. It underscores the importance of ongoing adaptation and suggests that future developments could benefit from a hybrid model that integrates the strengths of both AI and human health professionals to meet evolving user needs and maintain high-quality, empathetic healthcare interactions

Infant feeding practices and prevalence of obesity in eight European countries: the IDEFICS study

Objective: To assess the association between exclusive breast-feeding and childhood overweight. Design: Cross-sectional data are from the baseline survey of the longitudinal cohort study IDEFICS. Exclusive rather than partial breast-feeding is the focus of the study due to the theoretical relationship between exclusive breast-feeding and development of dietary self-regulation. Children's measured heights and weights were used to calculate weight status, while waist-to-height ratio (WtHR) and skinfold measures were examined as alternative indicators of adiposity and fat patterning. Setting: Examination centres in eight European countries (Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain). Subjects: The analysis included 14 726 children aged 2-9 years for whom early feeding practices were reported by parents in standardized questionnaires. Results: After controlling for education, income and other potential confounders, breast-feeding exclusively for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breast-fed (OR=0.73; 95% CI 0.63, 0.85) across all measures of overweight. Exclusively breast-feeding for 6 months offered slightly more protection than for 4 and 5 months combined (OR=0.71; 95% CI 0.58, 0.85). The associations could not be explained by socio-economic characteristics or maternal overweight. Conclusions: This multi-country investigation indicated that exclusive breast-feeding for 4-6 months may confer protection against overweight in addition to other known benefits. There was no demonstrated benefit of exclusive breast-feeding for more than 6 months or combination feeding for any duration across all measures of overweight examined

Predictors and correlates of taste preferences in European children: the IDEFICS study

The present study investigated taste preferences in a sample of 1705 children aged 6 to 9years from survey centres in Italy, Estonia, Cyprus, Belgium, Sweden, Germany, Hungary, and Spain and aimed to identify factors correlated with taste preference. Children's preferences for varying levels of sucrose (sweet) in apple juice and fat, sodium chloride (salt) and monosodium glutamate (umami) in crackers were assessed using paired-comparison tests. Socio-demographics (age, sex, parental education), early feeding practises (breastfeeding, introduction of fruits), parenting behaviour (TV viewing, using food as a reward) and taste threshold sensitivity for sucrose (sweet), sodium chloride (salt), caffeine (bitter) and monosodium glutamate (umami) were investigated as possible correlates of taste preferences. Parents reported on socio-demographics, early feeding and parenting behaviour. Taste thresholds were determined via a paired-comparison staircase method. Country of residence was the strongest factor related to preferences for all four tastes. Taste preferences also differed by age. Preference for sugar and salt increased between 6 and 9years of age while preference for monosodium glutamate decreased. The age differences remained significant even after adjustment for sex, country of residence, parental education and early feeding habits. Sex, parental education, early feeding habits, TV viewing, using food as a reward and taste thresholds were not consistently related to taste preferences among the survey centres. In summary, the results highlight the importance of culture and age in taste preferences in children younger than 10years of age