The effects of music and movement on mother-infant interactions

Two experiments investigated the effects of a music and movement (M&M) programme on healthy first-time mothers and their 2–6-month-old infants over a five-week period. Experiment 1 (N = 96) examined the effects of the M&M activities and the face-to-face (F2F) social contact of a group instruction method on the perception of mothers' interactions with their infants and maternal postnatal attachment. Generally, M&M increased mothers' interactions with their infants specific to music-type activities and mothers' attachment to their infants. Contrary results occurred for No M&M-control group mothers. The presence/absence of F2F had no effect. Experiment 2 (N = 44) focused on behavioural effects of M&M on mothers' infant-directed speech (IDS) and mother–infant reciprocity. M&M increased dyadic reciprocity, and increased the duration, mean pitch and pitch range of mothers' IDS. Without M&M a decrease in attentional characteristics of mothers' IDS and dyadic reciprocity occurred

The effect of clinical characteristics and dietary habits on the relationship between education status and 5-year incidence of cardiovascular disease: The ATTICA study

Objective: The aim of this work was to investigate whether clinical characteristics and dietary habits influence the association between education status and 5-year incidence of cardiovascular disease (CVD). Methods: From 2001 to 2002, 1,514 men and 1,528 women (>18 year) without known CVD were enrolled. In 2006, the 5-year follow-up was performed (31% participants were lost to follow-up). Development of fatal or non-fatal CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to WHO-ICD-10 criteria. Education status was measured in years of school, while baseline dietary habits were assessed through a semi-quantitative food-frequency questionnaire (EPIC-Greek). The Mediterranean-Diet-Score was applied to assess overall adherence to this pattern using scores of 11 food-variables and alcohol, according to the principles of the Mediterranean-diet. Results: The 5-year incidence of CVD was 108 (11.0%) cases in men and 62 (6.1%) cases in women (P < 0.001); 32 (1.6%) of these events were fatal (21 in men). People in the low education group had significantly higher prevalence of hypertension, diabetes, and dyslipidemias, were more likely to be sedentary and smokers, compared to high group. Moreover, compared to high, people in low education group had less healthy dietary habits, as assessed using the diet score (P < 0.001). Multi-adjusted analysis revealed that low education was positively associated with 5-year incidence of CVD, after adjusting for age and sex (HR = 1.64; 95%CI 1.05-2.55); however this association lost its significance when clinical characteristics and dietary habits were taken into account (HR = 1.31; 95%CI 0.63-2.74). Conclusions: Low education seems to increase CVD risk, an observation that was partially explained by baseline clinical characteristics and unhealthy dietary choices of people belonging into this group. © 2008 Spinger

Dietary habits mediate the relationship between socio-economic status and CVD factors among healthy adults: The ATTICA study

Background: The aims of the present work were to investigate whether dietary habits are associated with socio-economic status (SES), and if they modify the relationship between SES and CVD risk factors, in a sample of men and women free from known CVD. Methods: This population-based study was carried out in the province of Attica, where Athens is a major metropolis. During 2001-2002, information from 1528 men (18-87 years old) and 1514 women (18-89 years old) was collected (75 % participation rate). Among several sociodemographic, clinical and biological factors, adherence to the Mediterranean diet was assessed by a special diet score (Mediterranean Diet Score, MDS) that incorporated the inherent characteristics of this traditional diet. CVD risk factors were examined across the participants' educational level and annual income that defined their SES. Results: Low SES groups exhibited higher prevalence of CVD risk factors, such as obesity, hypertension, diabetes mellitus and hypercholesterolaemia (all P < 0.001). Low SES groups also showed less adherence to the Mediterranean diet than high SES groups (MDS: 23.6 (sd 8.1) v. 25.6 (sd 5.6), P < 0.001). Higher SES index was associated with lower likelihood of having hypercholesterolaemia (OR = 0.91; 95 % CI 0.83, 1.00) and diabetes (OR = 0.83; 95 % CI 0.72, 0.95), after adjusting for various potential confounders. However, the previously mentioned inverse relationship observed between SES and prevalence of CVD risk factors was mainly explained by the dietary habits of the participants. Conclusions: Low SES groups showed less adherence to the Mediterranean diet compared with high SES groups. This finding may, in part, explain the higher CVD risk factors profile observed among low SES participants. © The Authors 2008

Quality, but not cost, of diet is associated with 5-year incidence of CVD: The ATTICA study

Objective The aim of the present work was to calculate the current cost of the Mediterranean diet in Greece and to evaluate the role of diet cost in the development of cardiovascular events after a 5-year follow-up.Design Cross-sectional. Cost of diet was measured in/week based on common Greek dietary choices, while baseline dietary habits were assessed through a semi-quantitative FFQ (Greek-EPIC). The Mediterranean Diet Score (MedDietScore) was applied to assess overall adherence to this pattern using scores of eleven food variables and alcohol, according to the principles of the Mediterranean diet.Setting Five-year follow-up of the ATTICA study, a nutrition and health survey of a representative, free-living sample of the Greek population resident in the province of Attica, where Athens is a major metropolis.Subjects From 2001 to 2002, 1514 men and 1528 women (aged >18 years) without known CVD were enrolled. In 2006, the 5-year follow-up was performed.Results The weekly cost of participants diets varied from 535 to 8357/week in men (mean 2545 (sd 680)/week) and from 1089 to 5549/week in women (mean 2563 (sd 630)/week). Diet cost was correlated marginally to MedDietScore (r = 0060, P = 005) as well as being associated with history of hypercholesterolaemia (mean (sd), yes v. no: 2490 (573) v. 2582 (695)/week, P = 0027), physical activity (mean (sd), yes v. no: 2642 (690) v. 2482 (620)/week, P < 0001) and current smoking (mean (sd), yes v. no: 2499 (640) v. 2598 (670)/week, P = 0017). No significant association was found between diet cost and 5-year incidence of CVD (hazard ratio = 1021, 95 % CI 0965, 1081). However, adherence to the traditional Mediterranean diet was inversely associated with the development of CVD (relative risk per 1-unit increase in MedDietScore = 092, 95 % CI 089, 094) after adjustment for various potential confounders including diet cost.Conclusions Quality but not cost of the diet is associated with the development of CVD. Copyright © 2010 The Authors

Who Follows eHealth Interventions as Recommended? A Study of Participants' Personal Characteristics From the Experimental Arm of a Randomized Controlled Trial

BACKGROUND: Computer-tailored eHealth interventions to improve health behavior have been demonstrated to be effective and cost-effective if they are used as recommended. However, different subgroups may use the Internet differently, which might also affect intervention use and effectiveness. To date, there is little research available depicting whether adherence to intervention recommendations differs according to personal characteristics. OBJECTIVE: The aim was to assess which personal characteristics are associated with using an eHealth intervention as recommended. METHODS: A randomized controlled trial was conducted among a sample of the adult Dutch population (N=1638) testing an intervention aimed at improving 5 healthy lifestyle behaviors: increasing fruit and vegetable consumption, increasing physical activity, reducing alcohol intake, and promoting smoking cessation. Participants were asked to participate in those specific online modules for which they did not meet the national guideline(s) for the respective behavior(s). Participants who started with fewer than the recommended number of modules of the intervention were defined as users who did not follow the intervention recommendation. RESULTS: The fewer modules recommended to participants, the better participants adhered to the intervention modules. Following the intervention recommendation increased when participants were older (chi(2) 1=39.8, P<.001), female (chi(2) 1=15.8, P<.001), unemployed (chi(2) 1=7.9, P=.003), ill (chi(2) 1=4.5, P=.02), or in a relationship (chi(2) 1=7.8, P=.003). No significant relevant differences were found between groups with different levels of education, incomes, or quality of life. CONCLUSION: Our findings indicate that eHealth interventions were used differently by subgroups. The more frequent as-recommended intervention use by unemployed, older, and ill participants may be an indication that these eHealth interventions are attractive to people with a greater need for health care information. Further research is necessary to make intervention use more attractive for people with unhealthy lifestyle patterns

Impact of Educational Level on Study Attrition and Evaluation of Web-Based Computer-Tailored Interventions: Results From Seven Randomized Controlled Trials

Background: Web-based computer-tailored interventions have shown to be effective in improving health behavior; however, high dropout attrition is a major issue in these interventions. Objective: The aim of this study is to assess whether people with a lower educational level drop out from studies more frequently compared to people with a higher educational level and to what extent this depends on evaluation of these interventions. Methods: Data from 7 randomized controlled trials of Web-based computer-tailored interventions were used to investigate dropout rates among participants with different educational levels. To be able to compare higher and lower educated participants, intervention evaluation was assessed by pooling data from these studies. Logistic regression analysis was used to assess whether intervention evaluation predicted dropout at follow-up measurements. Results: In 3 studies, we found a higher study dropout attrition rate among participants with a lower educational level, whereas in 2 studies we found that middle educated participants had a higher dropout attrition rate compared to highly educated participants. In 4 studies, no such significant difference was found. Three of 7 studies showed that participants with a lower or middle educational level evaluated the interventions significantly better than highly educated participants ("Alcohol-Everything within the Limit": F-2,F-376=5.97, P=.003; "My Healthy Behavior": F-2,F-359=5.52, P=.004; "Master Your Breath": F-2,F-317=3.17, P=.04). One study found lower intervention evaluation by lower educated participants compared to participants with a middle educational level ("Weight in Balance": F-2,F-37=3.17, P=.05). Low evaluation of the interventions was not a significant predictor of dropout at a later follow-up measurement in any of the studies. Conclusions: Dropout attrition rates were higher among participants with a lower or middle educational level compared with highly educated participants. Although lower educated participants evaluated the interventions better in approximately half of the studies, evaluation did not predict dropout attrition. Further research is needed to find other explanations for high dropout rates among lower educated participants