“Mother’s Health and Well-Being Matters: Is a Mediated Social Cohesion Public Health Intervention Feasible?”

Abstract

Purpose

To test the feasibility of introducing ‘Free Time for Wellness’ (FT4W) an intervention to increase healthy behaviours and reduce the risk of cancer.

Design

Feasibility study; Setting: Washington Heights, New York, USA is a low socioeconomic status area.

Subjects

Mothers aged 18 and above with children under 12 years of age and living in Washington Heights were recruited.

Intervention

FT4W, a community-based intervention delivered through a neighbourhood-based app, offering weekly dance and yoga classes, food pantry visits and group playdates. Childcare professionals cared for participants' children during wellness activities.

Measures

A bespoke before and after survey was designed and tested for its ability to collect relevant data to assess the impact of FT4W. Outcomes included recruitment rates, participation, attrition, acceptability, and success of the community champion.

Analysis

Comparisons of proportions and means

Results

Twenty-one mothers participated in the study of which 90% attended ≥ 1 FT4W activity; 65% ≥ 2; 52% ≥ 3. The survey was completed by a 100% of participants indicating it was easy to understand and not too burdensome. All measures detected change in constructs from baseline to follow-up. Availability of childcare was the most commonly (66%) reported reason participants were able to engage in the offered wellness activities.

Conclusion

Conducting a larger-scale trial to assess the impact of FT4W is feasible considering 4 major lessons. (1) Recruitment, retention, and acceptability rates were high; however, moms need additional support to increase participation in wellness activities and improve tech literacy. (2) Research measures were sensitive enough to detect change, but the timing of assessments needs to be considered. (3) Participants greatly valued access to professional childcare. (4) The Community Champion is a necessary, but difficult role to fill that requires careful consideration by the Institutional Review Board (IRB).

Keywords

fitness low income health promoting community design women mobile health interventions health communications health disparities health policy

Get full access to this article

View all access options for this article.

References

Hastert

Beresford

SAA

Sheppard

White

. Disparities in cancer incidence and mortality by area-level socioeconomic status: a multilevel analysis. J Epidemiol Community Health. 2015;69(2):168-176.

Singh

Jemal

. Socioeconomic and racial/ethnic disparities in cancer mortality, incidence, and survival in the United States, 1950-2014: over six decades of changing patterns and widening inequalities. Journal of Environmental and Public Health. 2017;2017:2819372.

Shariff-Marco

Yang

John

, et al. Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity: the neighborhood and breast cancer study. Cancer Epidemiol Biomark Prev. 2014;23(5):793-811.

DeRouen

Schupp

Koo

, et al. Impact of individual and neighborhood factors on disparities in prostate cancer survival. Cancer Epidemiology. 2018;53:1-11.

Schneider

Diehl

Görig

, et al. Contextual influences on physical activity and eating habits -options for action on the community level. BMC Publ Health. 2017;17(1):760.

Moore

Patel

Matthews

, et al. Leisure time physical activity of moderate to vigorous intensity and mortality: a large pooled cohort analysis. PLoS Med. 2012;9(11):e1001335.

Sui

LaMonte

Laditka

, et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. Jama. 2007;298(21):2507-2516.

Tuomilehto

Silventoinen

Barengo

Peltonen

Jousilahti

. The effects of physical activity and body mass index on cardiovascular, cancer and all-cause mortality among 47 212 middle-aged Finnish men and women. Int J Obes. 2005;29(8):894-902.

Willett

Stampfer

Colditz

Manson

. Adiposity as compared with physical activity in predicting mortality among women. N Engl J Med. 2004;351(26):2694-2703.

10.

Smith

, et al. Physical activity and cause-specific mortality in the whitehall study. Publ Health. 2000;114(5):308-315.

11.

Eheman

Henley

Ballard-Barbash

, et al. Annual report to the nation on the status of cancer, 1975-2008, featuring cancers associated with excess weight and lack of sufficient physical activity. Cancer. 2012;118(9):2338-2366.

12.

Martin

Lippert

. Feeding her children, but risking her health: the intersection of gender, household food insecurity and obesity. Soc Sci Med. 2012;74(11):1754-1764.

13.

OECD . Perspectives on Global Development 2012. Paris, France: OECD Headquarters (CC13); 2011.

14.

Centola

. The spread of behavior in an online social network experiment. Science. 2010;329(5996):1194-1197.

15.

Irwin

. Physical activity interventions for cancer survivors. Br J Sports Med. 2009;43(1):32-38.

16.

Mazzoni

A-S

Carlsson

Berntsen

Nordin

Demmelmaier

. “Finding my own motivation” - a mixed methods study of exercise and behaviour change support during oncological treatment. Int J Behav Med. 2019;26(5):499-511.

17.

Diez Roux

A-V

. Neighborhoods and health: where are we and were do we go from here? Rev Epidémiol Santé Publique. 2007;55(1):13-21.

18.

Emley

Musher-Eizenman

. Social movement involvement and healthy diet and activity behaviors among US adults. Health Promot Int. 2019;34(3):490-500.

19.

Oakley-Girvan

Watterson

Jones

, et al. Use of social media for cancer prevention through neighborhood social cohesion: protocol for a feasibility study. JMIR Res Protocols. 2021;10(7):e28147.

20.

Edwards

Charles

Lloyd-Williams

. Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues. BMC Publ Health. 2013;13:1001.

21.

Arain

Campbell

Cooper

Lancaster

. What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol. 2010;10(1):67.

22.

NIHR. Health.

Economic Input in a Feasibility Study. RDS: London. 2021 10/07/2021. Available from: https://www.rds-london.nihr.ac.uk/resources/health-economics/health-economic-input-in-a-feasibility-study/.

23.

Craig

Dieppe

Macintyre

Michie

Nazareth

Petticrew

. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.

24.

Envoy Partnership . Community Champions: Social Return on Investment Evaluation. UK: Community Champions; 2019.

25.

Miech

Rattray

Flanagan

Damschroder

Schmid

Damush

, Inside help: an integrative review of champions in healthcare-related implementation. SAGE open medicine. 2018;6:2050312118773261.

26.

Opportunity N . Poverty in NYC: Data Tool. [cited 2019]. Available from: https://www1.nyc.gov/site/opportunity/poverty-in-nyc/data-tool.page. https://www1.nyc.gov/site/opportunity/poverty-in-nyc/data-tool.page.

27.

Craig

Marshall

Sjöström

, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-1395.

28.

Houghton

, et al. Free time for wellness: a co-designed intervention utilizing social networks to encourage physical activity for cancer prevention among low resourced mothers. BMC Publ Health. In Press.

29.

Chavis

Lee

Acosta

. The sense of community (SCI) revised: the reliability and validity of the SCI-2. In: The 2nd International Community Psychology Conference, Lisboa, Portugal, June 4-6: 2008.

30.

Statistics

NCFH

National Health interview Survey, 2018 . Public-use Data File and Documentation. 2019.

31.

EuroQol. EQ-5D . 2019. Available from: https://euroqol.org/.

32.

Al-Janabi

N Flynn

Coast

. Development of a self-report measure of capability wellbeing for adults: the ICECAP-A. Qual Life Res. 2012;21(1):167-176.

33.

Coast

Smith

Lorgelly

. Should the capability approach be applied in health economics? Health Econ. 2008;17(6):667-670.

34.

Hutchinson

Berndt

Gilbert-Hunt

George

Ratcliffe

. Valuing the impact of health and social care programmes using social return on investment analysis: how have academics advanced the methodology? A protocol for a systematic review of peer-reviewed literature. BMJ Open. 2018;8(12):e022534.

35.

Sen

36.

Herdman

Gudex

Lloyd

, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727-1736.

37.

Lancaster

Dodd

Williamson

. Design and analysis of pilot studies: recommendations for good practice. J Eval Clin Pract. 2004;10(2):307-312.

38.

Glowacki

, et al. Technological capital within aging United States-based populations: challenges and recommendations for online intervention uptake. J Appl Commun Res. 2021;49(3):347-367.

39.

Conrad

Magsamen-Conrad

. Understanding the impact of the coronavirus pandemic on families involved in the child welfare system: Technological capital and pandemic practice. Journal of Child and Family Social Work 2021;1:1-11. doi:10.1111/cfs.12876.

40.

Helander

Wansink

Chieh

. Weight gain over the holidays in three countries. N Engl J Med. 2016;375(12):1200-1202.

41.

Pickard

Law

Jiang

, et al. United States valuation of EQ-5D-5L health states using an international protocol. Value Health. 2019;22(8):931-941.

42.

Flynn

Huynh

Peters

, et al. Scoring the icecap-a capability instrument. estimation of a UK general population tariff. Health Econ. 2015;24(3):258-269.

43.

Houghton

Gibbons

Shekelle

, et al. Free Time For Wellness: a co-designed intervention utilizing social networks to encourage physical activity for cancer prevention among low resourced mothers. BMC Public Health 2021;21(1):1805. doi:10.1186/s12889-021-11775-9. 34620141.