Changes in intergenerational eating patterns and the impact on childhood obesity

The objective of this study was to examine intergenerational eating patterns within two sets of families, those with an obese child and those with a normal weight child, and to assess the impact of intergenerational influences on children's eating. A qualitative study design was used, incorporating focus groups and semi-structured interviews. Sixteen focus groups took place and 27 semi-structured interviews were held with different generations. Focus groups were conducted in the community with grandparents, parents and children from different families. This was followed by semi-structured interviews, involving individuals from three generations within families with an obese child and within families with a normal weight child. An examination of intergenerational eating has shown that eating patterns have changed regardless of whether or not families have children who are obese. The grandparent's eating patterns were more structured, whereas the children's eating patterns were less so. There have been more changes, and eating is less structured, within those families with an obese child than those families with a normal weight child. It is recommended that approaches to tackling childhood obesity concentrate on the family setting and the ways in which professionals can support families to change eating practices. Future research should formally test the relationship between the concept 'structured eating' and the 'what' of eating, in order to determine whether there is a link between intergenerational eating patterns and childhood obesity. © The Author(s) 2010

Young people with diabetes and their peers

Type 1 Diabetes (T1D) is amongst the most common form of chronic illness affecting young people in the UK. Self- management is crucial, but managing their T1D is often difficult for young people

How prepared are healthcare professionals for delivering physical activity guidance to those with diabetes? A formative evaluation

Physical activity is recognised as important for diabetes management and improved overall health of individuals with diabetes, yet many adults with diabetes are inactive. Healthcare professionals have been identified as key to promoting physical activity, including individuals with diabetes, but are ill-prepared to deliver this. Our paper evaluates the barriers/facilitators of healthcare professionals’ delivery of physical activity guidance to adults with diabetes and aims to inform efforts to investigate and enhance their preparedness to promote physical activity. A sequential mixed method, two-phase design was adopted involving a purposeful sample of healthcare professionals. Phase one was an online pilot survey designed to test assumptions around healthcare professionals’ knowledge, training and preparedness to deliver physical activity guidance. Phase two comprised eighteen semi-structured interviews, thematically analysed to provide an in-depth exploration of healthcare professionals’ experiences of delivering physical activity guidance to adults with diabetes. Healthcare professionals are committed to promoting physical activity to adults with diabetes and are reasonably confident in giving basic, generic guidance. Yet, significant challenges prevent them from achieving this in their practice, including: lack of education and training around physical activity, diabetes and health; ignorance of recommended physical activity and diabetes guidelines; lack of awareness of referral options; limited time and accessibility to appropriate resources. Nevertheless, healthcare professionals believed discussions around physical activity needed to be an integral part of consultations, incorporating improved communication strategies for conveying key physical activity messages. HCPs have a key role in the promotion of physical activity to people with long-term conditions such as diabetes and they are identified within both the strategic policy context and national interventions for physical activity. Yet, this study indicated that HCPs face multiple and at times complex barriers to physical activity promotion generally and with diabetes patients. Conversely HCPs also reported what works, why and how, when promoting physical activity. Rich information derived from the day-to-day, working healthcare professional is integral to shaping future practices going forward. The bottom up, iterative design adopted in this study provides an approach to tap into this information.Funding was received by School of Sport, Leeds Beckett Universit

Exploring how young people think about and respond to diabetes in their peers

Adolescence is a difficult time for people with diabetes and it is often accompanied by a deterioration in blood glucose control. This article looks at the effect the attitudes of peers can have on adolescents with diabetes. Three focus groups of 12–14-year-olds were asked about their knowledge of diabetes and were then presented with realistic vignettes about the condition, which they discussed. They then took part in a mythbusting session to help address misconceptions. The research team identified themes that emerged from the focus groups. Their findings suggest that a supportive peer network may be a valuable resource in good management of diabetes in young people. The research team suggest that more education about the condition is needed in schools and should be designed in collaboration with young people with diabetes

Promoting Physical Activity with Hard-to-Reach Women: An Iterative and Participatory Research Study

Approximately half of all UK women are insufficiently physically active, with the lowest activity rates among ‘Hard-to-Reach’ or unreached women. In this article, Kathryn Brook, Dr Andy Pringle FRSPH, Dr Jackie Hargreaves and Dr Nicky Kime of Leeds Beckett University outline their research into developing methods to assess and meet the needs of ‘Hard-to-Reach’ women in needs-led and person-centred interventions

A 150-mile ultra-endurance cycling event for people with type 1 diabetes: A qualitative analysis of knowledge, preparation and management strategies

The purpose of this study is to characterise the decision-making and self-management strategies of individuals with Type 1 diabetes (T1D) participating in a 150-mile ultra-endurance cycling event and inform Healthcare Professionals working in T1D. Participation in ultra-endurance exercise is becoming increasingly popular in the T1D community and self-management in this context needs further investigation. Qualitative, semi-structured interviews were conducted with 12 participants with T1D who took part in the ‘Coast to Coast in a Day’ cycling sportive. Event-specific and T1D self-management strategies in the context of endurance exercise were assessed using the Thematic Network Approach to analysis. Participants reported that they took part in the event "as a cyclist rather than a Type 1 diabetic". A range of self-management strategies to manage glycaemic control were identified, but all were grounded in experience of a "trial-and-error" approach to determine "successful practice". Engagement with Healthcare Professionals in preparation for the event was limited due to a perceived lack of endurance exercise knowledge. Participants reflected that T1D can be controlled in ultra-endurance events through careful and practised self-management of energy intake and insulin strategies. Individuals with T1D are capable of taking part and excelling in ultra-endurance events, but current Healthcare Professional advice does not match patient ambition and practice, which is grounded in an identity that is first and foremost as a ‘cyclist and person’. Limitations in participants’ "trial-and-error" practices require further understanding from Healthcare Professionals to provide advice around existing knowledge, preparation and self-management strategies for ultra-endurance exercise.N

A mixed-methods evaluation of care (cancer and rehabilitation exercise): a physical activity and health intervention, delivered in a community football trust

With increasing cancer survivorship has come an increased necessity to support people living with cancer (PLWC) to have a good quality of life including being physically active. Using mixed methods, the current study aimed to use the RE-AIM evaluation framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to determine how the football community trust delivered CARE (Cancer and Rehabilitation Exercise) intervention was able to increase participants’ physical activity in order to improve their quality of life and regain physiological and psychological function. Quantitative outcome data were collected at baseline, 3 and 6 months using the Cancer Physical Activity Standard Evaluation Framework questionnaire. Semi-structured focus groups (n = 5) captured participants’ (n = 40) lived experience of the reach, effectiveness, adoption, implementation, and maintenance of CARE. Questionnaire data were analysed using repeated measures ANOVAs and qualitative data were thematically analysed. Following diagnosis, CARE was successful in providing participants with a unique and accessible opportunity to become or restart physically activity, by providing a local, socially supportive, and inclusive environment. This resulted in significant increases in physical activity (F(1.58, 23) = 5.98, p = 0.009), quality of life (QoL) (F(2,36) = 13.12, p = 0.000) and significant reductions in fatigue (F(1.57,31) = 11.19, p = 0.000) over 6 months. Participants also reported becoming more active, recovering physical function, regaining independence, and enhanced psychological well-being as a result of attending CARE. Key design features of CARE were also identified across RE-AIM. CARE, a football community trust delivered physical activity intervention was successful in significantly improving participants’ QoL and in regaining the physical and psychological functioning of people living with cancer. Results suggest that maintaining engagement in CARE for 6 months and beyond can support people to maintain these changes. Engaging in robust evaluations such as this can help organizations to successfully secure future funding for their programs.This research was supported by Leeds Beckett University who received funding from Notts County Foundation

A 150‐mile ultra‐endurance type 1 diabetes cycling event: qualitative analysis of knowledge, preparation and management strategies

Purpose: The purpose of this study is to characterise the decision-making and self-management strategies of individuals with type 1 diabetes (T1D) participating in a 150-mile ultra-endurance cycling event and inform health care professionals working in T1D. Participation in ultra-endurance exercise is becoming increasingly popular in the T1D community and self-management in this context needs further investigation. Method: Qualitative, semi-structured interviews were conducted with 12 participants with T1D who took part in the ‘Coast to Coast in a Day’ cycling sportive. Event-specific and T1D self-management strategies in the context of endurance exercise were assessed using the Thematic Network Approach to analysis. Results: Participants reported that they took part in the event ‘as a cyclist rather than a type 1 diabetic’. A range of self-management strategies to manage glycaemic control were identified, but all were grounded in experience of a ‘trial-and-error’ approach to determine ‘successful practice’. Engagement with health care professionals in preparation for the event was limited due to a perceived lack of endurance exercise knowledge. Participants reflected that T1D can be controlled in ultra-endurance events through careful and practised self-management of energy intake and insulin strategies. Conclusions: Individuals with T1D are capable of taking part and excelling in ultra-endurance events, but current health care professional advice does not match patient ambition and practice, which is grounded in an identity that is first and foremost as a ‘cyclist and person’. Limitations in participants’ ‘trial-and-error’ practices require further understanding from health care professionals to provide advice around existing knowledge, preparation and self-management strategies for ultra-endurance exercise