Mr Epidemiology

No, I'm not a skin doctor



The Use of Research in Public Health Decision Making Processes

As researchers, we hope that when politicians are making decisions about policy, they use our research to help ground their thinking. In Canada, CIHR (Canadian Institutes of Health Research), encourages researchers to make their work accessible, and has specific grant applications focused on Knowledge Translation (KT).

Part of the trouble with evaluating whether or not politicians use research when making decisions about public health is the sheer scope of public health. While we may consider very direct issues, such as vaccinations, one could argue that macro level issues such as agriculture, crime and town planning all affect public health (I briefly mentioned the latter in a previous post).

The problem is further exacerbated by how complicated the literature on public health is. While you can make decisions about drug effectiveness using randomized controlled trial data, public health research can include surveys, cohort/case-control studies and cost-effectiveness analyses. Even expert opinion can be considered a valid resource when used properly.

Now, knowing how complicated this all is, you can still try to draw some conclusions. First, is research evidence used? Secondly, if it is, what kind of evidence is used when making decisions? Third, how do they use evidence? Fourth, what else do they use when making a decision? And finally, what stops them from using research evidence?

More after the jump.

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Perceived weight status, actual weight status and weight control

Obesity is accompanied by many health risks, including diabetes, heart disease and musculoskeletal problems. Small decreases in weight have been associated with decreases in the risk of these adverse health outcomes, however, sustained weight loss is incredibly difficult to accomplish.

It has been well documented that people underestimate their height and weight (see my previous post on parental perceptions of child BMI). However, does knowledge of one’s weight affect willingness to start weight control behaviours? How much does your perceived weight differ from your actual weight? And more importantly, can health care professionals affect starting weight control behaviours?

More after the jump.

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Breakfast Skipping and Change in Body Mass Index in Young Children

Breakfast: The most important meal of the day!

As mothers everywhere know, breakfast is the most important meal of the day. However, as scientists, we want empirical evidence. Breakfast has been associated with several health outcomes, ranging from increased academic performance, to improved quality of life, as well as enhanced dietary profiles.

While many cross-sectional studies have found that those who skip breakfast are more likely to be obese, you cannot infer temporality from this relationship. In order to do that, you need a prospective cohort study, where you follow people forward through time to determine their weight gain.

While there are very few prospective cohort studies investigating breakfast eating habits among youth, even fewer have looked at this in Asian populations. And so Tin et al set out to look at the effect of skipping breakfast on BMI among youth in Hong Kong.

More after the jump.

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Parental Perception of Child Weight Status

There is only one pretty child in the world, and every mother has it.

– Chinese proverb

Childhood obesity is a growing problem for our society. However, we are still trying to find effective methods of dealing with this public health concern. Some researchers have suggested that family based interventions could be the most effective way to tackle this issue, as parents can help instil healthy behaviours in their children.

However, what if parents don’t realize that their children are overweight or obese? What if they don’t realize that their child is gaining weight at an unhealthy rate?  If they don’t realize that there is a problem, why would they seek help?

A recent systematic review found that less than half of the parents surveyed correctly identified their children as being overweight in 19 of the 23 studies they examined.

So the question then becomes: Do parents only fail to recognize if their own children are overweight or obese, or do they do this for all children? And that is what a recent study by Jones et al, published in the International Journal of Obesity investigated.

More after the jump.

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How effective are interventions aimed at reducing “screen time” among youth?

Increased screen time is a problem among youth

Edit (14/07/11): Thanks to Gopinath for the article!

A common reason people give for the increased prevalence of childhood obesity is how youth spend more time in front of the TV/computer/video games now than they used to (a measure referred to as “screen time”). The average Canadian youth spends 6 hours in front of the TV/computer every weekday, and over 7 hours a day on the weekend (AHKC Report Card, 2011). So that begs the question – how can we reduce screen time?

Several interventions have been performed, and they have shown mixed results. But this could be due to a number of factors: the population they used, the methods they used or even chance. We can identify all the studies that have been done in this area using a systematic review, and then decide if they’re effective using a meta analysis. And that’s exactly what Wahi and colleagues did, in a study published in Arch Pediatr Adolesc Med this July.

More after the jump.

Continue reading “How effective are interventions aimed at reducing “screen time” among youth?”

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