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  1. Chan C, Moy FM, Lim JNW, Dahlui M
    Am J Health Promot, 2018 03;32(3):806-811.
    PMID: 28279088 DOI: 10.1177/0890117117695888
    PURPOSE: To assess the awareness, facilitators, and barriers to policy implementation related to obesity prevention for primary school children.

    DESIGN: A cross-sectional study administered using an online questionnaire.

    SETTING: Conducted in 447 primary schools in a state in Malaysia.

    PARTICIPANTS: One school administrator from each school served as a participant.

    MEASURES: The questionnaires consisted of 32 items on awareness, policy implementation, and facilitators and barriers to policy implementation.

    ANALYSIS: Descriptive analysis was used to describe the awareness, facilitators, and barriers of policies implementation. Association between schools' characteristics and policy implementation was assessed using logistic regression.

    RESULTS: The majority (90%) of school administrators were aware of the policies. However, only 50% to 70% of schools had implemented the policies fully. Reported barriers were lack of equipment, insufficient training, and limited time to complete implementation. Facilitators of policy implementation were commitment from the schools, staff members, students, and canteen operators. Policy implementation was comparable in all school types and locality; except the policy on "Food and Drinks sold at the school canteens" was implemented by more rural schools compared to urban schools (odds ratio: 1.74, 95% confidence interval: 1.13-2.69).

    CONCLUSION: Majority of the school administrators were aware of the existing policies; however, the implementation was only satisfactory. The identified barriers to policy implementation were modifiable and thus, the stakeholders should consider restrategizing plans in overcoming them.

  2. Jourabchi Z, Sharif S, Lye MS, Saeed A, Khor GL, Tajuddin SHS
    Am J Health Promot, 2019 03;33(3):363-371.
    PMID: 30011998 DOI: 10.1177/0890117118779808
    PURPOSE: To evaluate the association between preconception care and the risk of adverse birth outcomes.

    DESIGN: A quasi-experimental study comparing 2 groups: (1) integrated maternal health care (MHC) program (with preconception care) and (2) standard MHC program (without preconception care).

    SETTING: Maternal health-care clinics in Alvand and Qazvin cities in Qazvin Province, Iran.

    PARTICIPANTS: A total of 152 and 247 Iranian women aged 16 to 35 years were enrolled in the integrated MHC and standard MHC program, respectively.

    MEASURES: The birth outcomes measured included low birth weight, preterm birth, maternal and neonatal complications, and mode of delivery (normal vaginal delivery and cesarean delivery).

    ANALYSIS: Multiple logistic regression was performed to determine the impact of preconception care and risk of adverse birth outcomes with adjusted odds ratios (ORs) as effect sizes.

    RESULTS: One hundred forty-seven women in integrated MHC and 218 women in standard MHC completed this study. Preconception care was associated with reduced risk of preterm birth (OR = 0.298; 95% confidence interval [CI] = 0.120-0.743; P = .009), low birth weight (OR = 0.406; 95% CI = 0.169-0.971; P = .043), maternal complication (OR = 0.399; 95% CI = 0.241-0.663; P < .001), and neonatal complications (OR = 0.460; 95% CI = 0.275-0.771; P = .003).

    CONCLUSION: The findings of the present study revealed advantages of preconception care with reduced adverse birth outcomes.

  3. Jones C, Gibbons M, Magsamen-Conrad K, Ulanday KT, Watterson J, Oakley-Girvan I, et al.
    Am J Health Promot, 2022 Mar;36(3):410-420.
    PMID: 34907785 DOI: 10.1177/08901171211055317
    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).

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