Effectiveness of Training in Changing Allied Health Students’ Cultural Competency Skills

Purpose: Allied health students require cultural competence training to help them act as caring, ethical, and socially responsible health professionals. There is a lack of evidence for the effectiveness of cultural competence training changing the cultural skill level of allied health students or their behaviour in clinical practice. Method: We conducted a systematic search of the literature to examine the effectiveness of cultural competence training in changing allied health student cultural competency skills. CINAHL, Embase, ERIC, Medline and Scopus databases were searched from inception until August 2017. Search terms represented the population (e.g. allied health students), and cultural competence training. Two reviewers independently screened all retrieved studies and abstracts, then full text papers against inclusion criteria. All included studies were critically appraised, and data was extracted for analysis. Results: Of the initial 9,076 database hits, 15 intervention studies met the inclusion criteria; indicating this is a nascent area of research. Fourteen of the 15 studies demonstrated that cultural competence training provided to allied health students could significantly increase their perceived cultural competence skills, with effect sizes ranging from small to very large. Training was predominately conducted using traditional classroom teaching activities. The review identified that this field of research is dominated by the model and survey tool devised by Campinha-Bacote with a focus on skills required for patient assessment, rather than patient outcomes. Conclusions and possibly recommendations: Cultural competence training can improve allied health students’ perceived level of cultural competence skills for clinical practice. To ensure an effective translation of skill development to clinical practice, tertiary institutions seeking to develop and evaluate cultural competency training programs should focus on teaching cultural competency skills that lead to improved patient outcomes

Changes in use of time across retirement: a longitudinal study

This study aimed to investigate how daily use of time changes across the retirement transition and how these changes may differ according to socio-demographic characteristics.This longitudinal cohort study was based on interviews with 124 people at pre-retirement and at three, six and 12 months after retirement.The Multimedia Activity Recall for Children and Adults (MARCA), a computer-assisted telephone interview, measured use of time. Random effects mixed modelling (REMM) was used to examine time use changes across retirement, and ANCOVA to investigate the extent of the change by sex, education and health.Apart from the decrease in time spent in work across retirement (-122min/day,

A Systematic Analysis of Temporal Trends in the Handgrip Strength of 2,216,320 Children and Adolescents Between 1967 and 2017

Objective: To estimate national and international temporal trends in handgrip strength for children and adolescents, and to examine relationships between trends in handgrip strength and trends in health-related and sociodemographic indicators. Methods: Data were obtained through a systematic search of studies reporting temporal trends in the handgrip strength for apparently healthy 9–17 year-olds, and by examining large national fitness datasets. Temporal trends at the country-sex-age level were estimated by sample-weighted regression models relating the year of testing to mean handgrip strength. International and national trends were estimated by a post-stratified population-weighting procedure. Pearson’s correlations quantified relationships between trends in handgrip strength and trends in health-related/sociodemographic indicators. Results: 2,216,320 children and adolescents from 13 high-, 5 upper-middle-, and 1 low-income countries/special administrative regions between 1967 and 2017 collectively showed a moderate improvement of 19.4% (95%CI: 18.4 to 20.4) or 3.8% per decade (95%CI: 3.6 to 4.0). The international rate of improvement progressively increased over time, with more recent values (post-2000) close to two times larger than those from the 1960s/1970s. Improvements were larger for children (9–12 years) compared to adolescents (13–17 years), and similar for boys and girls. Trends differed between countries, with relationships between trends in handgrip strength and trends in health-related/sociodemographic indicators negligible-to-weak and not statistically significant. Conclusions: There has been a substantial improvement in absolute handgrip strength for children and adolescents since 1967. There is a need for improved international surveillance of handgrip strength, especially in low- and middle-income countries, to more confidently determine true international trends. PROSPERO registration number: CRD42013003657

Relationships between outdoor time, physical activity, sedentary time, and body mass index in children : a 12-country study

Purpose: This study investigated the relationship between outdoor time and physical activity (PA), sedentary time (SED), and body mass index z scores among children from 12 lower-middle-income, upper-middle-income, and high-income countries. Methods: In total, 6478 children (54.4% girls) aged 9-11 years participated. Outdoor time was self-reported, PA and SED were assessed with ActiGraph GT3X+ accelerometers, and height and weight were measured. Data on parental education, neighborhood collective efficacy, and accessibility to neighborhood recreation facilities were collected from parent questionnaires. Country latitude and climate statistics were collected through national weather data sources. Gender-stratified multilevel models with parental education, climate, and neighborhood variables as covariates were used to examine the relationship between outdoor time, accelerometry measures, and body mass index z scores. Results: Each additional hour per day spent outdoors was associated with higher moderate-to vigorous-intensity PA (boys: +2.8 min/d; girls: +1.4 min/d), higher light-intensity PA (boys: +2.0 min/d; girls: +2.3 min/d), and lower SED (boys: -6.3 min/d; girls: -5.1 min/d). Effect sizes were generally weaker in lower-middle-income countries. Outdoor time was not associated with body mass index z scores. Conclusions: Outdoor time was associated with higher PA and lower SED independent of climate, parental education, and neighborhood variables, but effect sizes were small. However, more research is needed in low-and middle-income countries

Sleep characteristics and health-related quality of life in 9- to 11-year-old children from 12 countries

Introduction: Previous studies have linked short sleep duration, poor sleep quality, and late sleep timing with lower health-related quality of life (HRQoL) in children. However, almost all studies relied solely on self-reported sleep information, and most studies were conducted in high-income countries. To address these gaps, we studied both device-measured and self-reported sleep characteristics in relation to HRQoL in a sample of children from 12 countries that vary widely in terms of economic and human development. Methods: The study sample included 6,626 children aged 9-11 years from Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. Waist-worn actigraphy was used to measure total sleep time, bedtime, wake-up time, and sleep efficiency on both weekdays and weekends. Children also reported ratings of sleep quantity and quality. HRQoL was measured by the KIDSCREEN-10 survey. Multilevel regression models were used to determine the relationships between sleep characteristics and HRQoL. Results: Results showed considerable variation in sleep characteristics, particularly duration and timing, across study sites. Overall, we found no association between device-measured total sleep time, sleep timing or sleep efficiency, and HRQoL. In contrast, self-reported ratings of poor sleep quantity and quality were associated with HRQoL. Conclusions: Self-reported, rather than device-based, measures of sleep are related to HRQoL in children. The discrepancy related to sleep assessment methods highlights the importance of considering both device-measured and self-reported measures of sleep in understanding its health effects

Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study

Background: The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Methods: Cross-sectional results were based on 6128 children aged 9-11years from the 12 countries of ISCOLE. Sleep duration and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. Screen time was measured through self-report. Body weight and height were measured. Body mass index (BMI, kgm2) was calculated, and BMI z-scores were computed using age- and sex-specific reference data from the World Health Organization. Obesity was defined as a BMI z-score>+2 SD. Meeting the overall 24-h movement guidelines was defined as: 9 to 11h/night of sleep, ≤2h/day of screen time, and at least 60min/day of MVPA. Age, sex, highest parental education and unhealthy diet pattern score were included as covariates in statistical models. Associations between meeting vs. not meeting each single recommendation (and combinations) with obesity were assessed with odds ratios calculated using generalized linear mixed models. A linear mixed model was used to examine the differences in BMI z-scores between children meeting vs. not meeting the different combinations of recommendations. Results: The global prevalence of children meeting the overall recommendations (all three behaviors) was 7%, with children from Australia and Canada showing the highest adherence (15%). Children meeting the three recommendations had lower odds ratios for obesity compared to those meeting none of the recommendations (OR=0.28, 95% CI 0.18-0.45). Compared to not meeting the 24-h movement recommendations either independently or combined, meeting them was significantly associated with a lower BMI z-score. Whenever the MVPA recommendation was included in the analysis the odds ratios for obesity were lower. Conclusions: For ISCOLE participants meeting these 3 healthy movement recommendations the odds ratios of being obese or having high BMI z-scores were lower. However, only a small percentage of children met all recommendations. Future efforts should aim to find promising ways to increase daily physical activity, reduce screen time, and ensure an adequate night's sleep in children. Trial registration: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012)

Joint association of birth weight and physical activity/sedentary behavior with obesity in children ages 9-11 years from 12 countries

Objective: To examine the joint association of birth weight and physical activity/sedentary time with childhood obesity in 12 countries. Methods: A cross-sectional study of 5,088 children aged 9 to 11 years was conducted. Birth weight was recalled by parents or guardians. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior were objectively measured using accelerometry. Results: The association of birth weight with the odds of obesity, central obesity, and high body fat was significant among children with either low MVPA or high sedentary time but not among children with either high MVPA or low sedentary time. In comparison with children with normal birth weight and high MVPA, children with high birth weight and low MVPA showed 4.48- to 5.18-fold higher odds of obesity, central obesity, and high body fat; children with normal birth weight and low MVPA showed 3.00- to 3.30-fold higher odds of obesity, central obesity, and high body fat, and children with high birth weight and high MVPA showed 1.16- to 1.68-fold higher odds of obesity, central obesity, and high body fat. Conclusions: High MVPA is more important than high birth weight as a correlate of obesity in children

Time use clusters of New Zealand adolescents are associated with weight status, diet and ethnicity

In recent times, the heath of adolescents and young people has been considered a priority area by governments around the world. The New Zealand (NZ) Ministry of Health has identified the current health issues in young people (12–24 years) as mental health problems, alcohol abuse, increasing rates of obesity and decreasing rates of physical activity.1 Significant health inequalities exist among NZ adolescents, with young Māori and Pacific Island people in particular experiencing poorer health outcomes than their peers.2 Māori and Pacific adolescents (10–14 years) are more likely to suffer chronic health conditions, asthma, skin conditions, poorer dental health and overweight and obesity.3 Recent data suggest that 10% of 10–18 year olds in NZ are obese and an additional 24% are overweight.4Recent interventions to improve the health and well-being of adolescents have been implemented at government, community and individual levels.5–7 Yet it appears NZ adolescents are receiving only small benefits, with health trend data suggesting little change1 and health-related interventions yielding generally small effect sizes.8–10 Relationships between individual aspects of time use, such as screen time and health outcomes, have been investigated.11,12 However, there is a suggestion that multi-dimensional patterns of behaviour may affect health in ways not explained when such one-dimensional relationships are investigated.13 Exploring young people\u27s multi-dimensional time use behaviours may further our understanding of the complex health and well-being relationships, and offer insights into the design of targeted health interventions.Cluster analysis is classified as an unsupervised data mining algorithm which attempts to group the data into classes or clusters, such that ‘cases’ within the clusters are similar to each other and relatively dissimilar to the ‘cases’ in the other clusters. Cluster analysis allows empirical definition of data patterns, and does not rely on current theory or knowledge in the related field of study. In recent years, the research fields of dietary patterning14 and disease symptomology15 have successfully utilised cluster analysis to identify underlying patterns in data.16 Cluster analysis to identify adolescent time use patterns has not been a common approach to date. Only 19 adolescent time use clustering studies could be sourced as part of a recent systematic review of the literature.17 The studies reported on adolescents from different countries and relative socioeconomic backgrounds. Regardless of the differences, some similar multi-dimensional time use cluster patterns were identifiable, as were patterns of relationship with socio-demographic variables. No time use clustering studies have reported the time use clusters or patterns of NZ adolescents.The aims of this study are to investigate the time use clusters among NZ adolescents (10–16 years) and determine which time use activity, socio-demographic, anthropometric, physical activity and diet variables best characterise each cluster. To achieve this aim, the study will cluster-analyse 24-hour recall data from a nationally representative sample of NZ adolescents. Authors: Katia Ferrar, Tim Olds, Carol Maher, Ralph MaddisonAustralian and New Zealand Journal of Public Health, Volume 37, Issue 1, pages 39–46, February 2013&nbsp