TY - JOUR A1 - Wortmann, Hanna Rosalie A1 - Gisch, Ulrike Alexandra A1 - Bergmann, Manuela M. A1 - Warschburger, Petra T1 - Exploring the longitudinal stability of food neophilia and dietary quality and their prospective relationship in older adults BT - a cross-lagged panel analysis JF - Nutrients N2 - Poor dietary quality is a major cause of morbidity, making the promotion of healthy eating a societal priority. Older adults are a critical target group for promoting healthy eating to enable healthy aging. One factor suggested to promote healthy eating is the willingness to try unfamiliar foods, referred to as food neophilia. This two-wave longitudinal study explored the stability of food neophilia and dietary quality and their prospective relationship over three years, analyzing self-reported data from N = 960 older adults (MT1 = 63.4, range = 50–84) participating in the NutriAct Family Study (NFS) in a cross-lagged panel design. Dietary quality was rated using the NutriAct diet score, based on the current evidence for chronic disease prevention. Food neophilia was measured using the Variety Seeking Tendency Scale. The analyses revealed high a longitudinal stability of both constructs and a small positive cross-sectional correlation between them. Food neophilia had no prospective effect on dietary quality, whereas a very small positive prospective effect of dietary quality on food neophilia was found. Our findings give initial insights into the positive relation of food neophilia and a health-promoting diet in aging and underscore the need for more in-depth research, e.g., on the constructs’ developmental trajectories and potential critical windows of opportunity for promoting food neophilia. KW - food neophilia KW - dietary quality KW - NutriAct Family Study KW - cross-lagged panel analysis KW - healthy eating Y1 - 2023 U6 - https://doi.org/10.3390/nu15051248 SN - 2072-6643 VL - 15 IS - 5 PB - MDPI CY - Basel ER - TY - JOUR A1 - Göldel, Julia M. A1 - Kamrath, Clemens A1 - Minden, Kirsten A1 - Wiegand, Susanna A1 - Lanzinger, Stefanie A1 - Sengler, Claudia A1 - Weihrauch-Blüher, Susann A1 - Holl, Reinhard W. A1 - Tittel, Sascha René A1 - Warschburger, Petra T1 - Access to Healthcare for Children and Adolescents with a Chronic Health Condition during the COVID-19 Pandemic: First Results from the KICK-COVID Study in Germany JF - Children N2 - This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany. KW - chronic health condition KW - children and adolescents KW - health care KW - COVID-19 pandemic KW - diabetes KW - rheumatic diseases KW - obesity Y1 - 2022 U6 - https://doi.org/10.3390/children10010010 SN - 2227-9067 VL - 10 SP - 1 EP - 11 PB - MDPI CY - Basel, Schweiz ET - 1 ER - TY - JOUR A1 - Warschburger, Petra A1 - Wortmann, Hanna Rosalie A1 - Gisch, Ulrike Alexandra A1 - Baer, Nadja-Raphaela A1 - Schenk, Liane A1 - Anton, Verena A1 - Bergmann, Manuela M. T1 - An experimental approach to training interoceptive sensitivity BT - study protocol for a pilot randomized controlled trial JF - Nutrition Journal N2 - Background Eating in absence of hunger is quite common and often associated with an increased energy intake co-existent with a poorer food choice. Intuitive eating (IE), i.e., eating in accordance with internal hunger and satiety cues, may protect from overeating. IE, however, requires accurate perception and processing of one’s own bodily signals, also referred to as interoceptive sensitivity. Training interoceptive sensitivity might therefore be an effective method to promote IE and prevent overeating. As most studies on eating behavior are conducted in younger adults and close social relationships influence health-related behavior, this study focuses on middle-aged and older couples. Methods The present pilot randomized intervention study aims at investigating the feasibility and effectiveness of a 21-day mindfulness-based training program designed to increase interoceptive sensitivity. A total of N = 60 couples participating in the NutriAct Family Study, aged 50–80 years, will be recruited. This randomized-controlled intervention study comprises three measurement points (pre-intervention, post-intervention, 4-week follow-up) and a 21-day training that consists of daily mindfulness-based guided audio exercises (e.g., body scan). A three-arm intervention study design is applied to compare two intervention groups (training together as a couple vs. training alone) with a control group (no training). Each measurement point includes the assessment of self-reported and objective indicators of interoceptive sensitivity (primary outcome), self-reported indicators of intuitive and maladaptive eating (secondary outcomes), and additional variables. A training evaluation applying focus group discussions will be conducted to assess participants’ overall acceptance of the training and its feasibility. Discussion By investigating the feasibility and effectiveness of a mindfulness-based training program to increase interoceptive sensitivity, the present study will contribute to a deeper understanding of how to promote healthy eating in older age. KW - Digital intervention KW - Older adults KW - Interoception KW - Eating behavior KW - Intuitive eating KW - Partnership KW - Mindfulness KW - Randomized-controlled trial KW - NutriAct Family Study KW - Mixed methods Y1 - 2022 U6 - https://doi.org/10.1186/s12937-022-00827-4 SN - 1475-2891 VL - 21 PB - Springer Nature CY - London ER - TY - JOUR A1 - Warschburger, Petra A1 - Petersen, Ann-Christin A1 - von Rezori, Roman Enzio A1 - Buchallik, Friederike A1 - Baumeister, Harald A1 - Holl, Reinhard A1 - Minden, Kirsten A1 - Müller-​Stierlin, Annabel Sandra A1 - Reinauer, Christina A1 - Staab, Doris A1 - COACH consortium, T1 - A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study JF - BMC Pediatrics N2 - Background Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions. Methods/design We plan to consecutively recruit N = 450 adolescents (12–21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups – “inconspicuous” (PHQ-9 and GAD-7 < 7) vs. “conspicuous” (PHQ-9 or GAD-7 ≥ 7) – participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey. Discussion The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation. Trial registration German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021. KW - Chronic conditions KW - Adolescents KW - Prospective KW - Quality of life KW - Resiliency KW - Coping KW - Protective factors KW - Type 1 diabetes KW - Juvenile idiopathic arthritis KW - Cystic fibrosis Y1 - 2021 U6 - https://doi.org/10.1186/s12887-021-02869-9 SN - 1471-2431 VL - 21 SP - 1 EP - 13 PB - BMC pediatrics CY - London ER - TY - JOUR A1 - Gmeiner, Michaela Silvia A1 - Warschburger, Petra T1 - Intrapersonal predictors of weight bias internalization among elementary school children BT - a prospective analysis JF - BMC Pediatrics N2 - Background Weight-related stigmatization is a widespread problem. Particularly the internalization of weight-related stereotypes and prejudices (weight bias internalization, WBI) is related to mental and physical health impairments. To date, little is known about the risk factors of WBI. Previous studies are mainly cross-sectional and based on adult samples. As childhood is a sensitive period for the development of a healthy self-concept, we examined predictors of WBI in children. Methods The final sample included 1,463 schoolchildren (6–11 years, 51.7% female) who took part in a prospective study consisting of three measurement waves. The first two waves delivered data on objective weight status and self-reported weight-related teasing, body dissatisfaction, relevance of one’s own figure, self-esteem and depressive symptoms; WBI was measured during the third wave. To examine predictors of WBI, we ran hierarchical regression analyses and exploratory mediation analyses. Results Lower parental education level, higher child weight status, female gender, experience of teasing, higher body dissatisfaction, higher figure-relevance, and higher depression scores were found to be predictive for higher WBI scores. Body dissatisfaction (only for girls) and the relevance of one’s own figure (both genders) mediated the association between self-esteem and WBI; no weight-related differences were observed. Conclusions Our study offers longitudinal evidence for variables that enable the identification of children who are at risk for WBI. Thus, the findings deliver starting points for interventions aimed at the prevention of adverse health developments that come along with WBI. KW - Weight bias internalization KW - Self-stigmatization KW - Weight KW - Children KW - Predictors Y1 - 2020 U6 - https://doi.org/10.1186/s12887-020-02264-w SN - 1471-2431 VL - 20 PB - BioMed Central CY - London ER - TY - JOUR A1 - Warschburger, Petra A1 - Zitzmann, Jana T1 - Does an Age-Specific Treatment Program Augment the Efficacy of a Cognitive-Behavioral Weight Loss Program in Adolescence and Young Adulthood? BT - Results from a Controlled Study JF - Nutrients N2 - Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach. KW - adolescents KW - emerging adults KW - behavioral weight loss KW - obesity KW - controlled trial KW - quality of life Y1 - 2019 U6 - https://doi.org/10.3390/nu11092053 SN - 2072-6643 VL - 2019 IS - 11 PB - MDPI CY - Basel ER - TY - JOUR A1 - Hoffmann, Svenja Sarah Helen A1 - Cortes-Garcia, Laura A1 - Warschburger, Petra T1 - Weight/shape and muscularity concerns and emotional problems in adolescent boys and girls BT - A cross-lagged panel analysis JF - Journal of adolescence N2 - Introduction: The goal of the present study was to identify the prospective relations between weight/shape and muscularity concerns and emotional problems in adolescents. Methods: Self-report data of 966 German male and female adolescents were analyzed in a cross lagged panel design. Results: Analyses of latent means revealed significant correlations between weight/shape concern and emotional problems as well as between muscularity concern and emotional problems in both genders. Moreover, weight/shape concern predicted emotional problems prospectively, but only in girls. Regarding muscularity concern, we could not find any prospective relation with emotional problems In boys or girls from the general population. Conclusions: It is assumed that as appearance is highly relevant for the self-concept in girls, concerns about the look might promote emotional problems. Thus, weight/shape concern should be addressed in the prevention of emotional problems in adolescent girls, whereas further research is necessary investigating the contribution of muscularity concern in this context. KW - Weight/shape concern KW - Muscularity concern KW - Depressive symptoms KW - Adolescents KW - Cross-lagged panel analysis Y1 - 2018 U6 - https://doi.org/10.1016/j.adolescence.2018.07.005 SN - 0140-1971 SN - 1095-9254 VL - 68 SP - 70 EP - 77 PB - Elsevier CY - London ER - TY - JOUR A1 - Reinauer, Christina A1 - Viermann, Rabea A1 - Foertsch, Katharina A1 - Linderskamp, Hannah A1 - Warschburger, Petra A1 - Holl, Reinhard W. A1 - Staab, Doris A1 - Minden, Kirsten A1 - Muche, Rainer A1 - Domhardt, Matthias A1 - Baumeister, Harald A1 - Meissner, Thomas T1 - Motivational Interviewing as a tool to enhance access to mental health treatment in adolescents with chronic medical conditions and need for psychological support (COACH-MI) BT - study protocol for a clusterrandomised controlled trial JF - Trials N2 - Background This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents’ utilisation of psychological health care for symptoms of anxiety or depression. Methods/design In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session. Discussion This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents’ long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood. KW - Adolescents KW - adherence to medical treatment KW - anxiety KW - chronic condition KW - depression KW - motivational interviewing Y1 - 2018 U6 - https://doi.org/10.1186/s13063-018-2997-5 SN - 1745-6215 VL - 19 PB - BMC CY - London ER - TY - JOUR A1 - Warschburger, Petra T1 - Jugendliche und junge Erwachsene mit Adipositas T1 - Adolescents and Young Adults BT - Wie sollte in ihren Augen „die perfekte Therapie“ aussehen? BT - What Would a "Perfect Therapy" Look Like? JF - Die Rehabilitation : Zeitschrift für Praxis und Forschung in der Rehabilitation N2 - Hauptziel Adipositas ist eine der Hauptindikationen in der Kinder- und Jugend-Rehabilitation. Für ältere Jugendliche und junge Erwachsene fehlen altersspezifische Therapieangebote fast vollständig. Ziel war es die Wünsche bezüglich der Inhalte und Methoden einer „perfekten Therapie“ im Rahmen eines Rehabilitationsaufenthalts zu untersuchen. Methode Im Rahmen der YOUTH-Studie wurden 147 adipöse Jugendliche und junge Erwachsene beiderlei Geschlechts (zwischen 15 und 21 Jahren) mithilfe eines standardisierten Fragebogens befragt. Ergebnis Insgesamt zeigten sich relativ wenige alters- und geschlechtsspezifische Unterschiede. Interdisziplinär geleitete, koedukative Gruppen mit Elterneinbindung wurden gewünscht. Wichtige Themen waren gesunde Ernährung sowie psychosoziale Aspekte. Auch der Prävention von Rückfällen wurde eine hohe Relevanz zugeschrieben. Schlussfolgerung Psychosoziale Aspekte und die Vorbereitung auf mögliche Rückfallsituationen sollten integraler Bestandteil der Therapie sein. N2 - Principal objective Obesity is a major indication for pediatric and adolescent-rehabilitation. Age-specific therapies for „emerging adults“ are lacking. The aim was to examine the patients’ preferences with respect to the contents and methods of the „perfect therapy“ within an inpatient setting. Method In the context of the YOUTH study 147 obese male and female adolescents (aged 15–21 years) filled in standardized questionnaires. Results Overall little age- and gender-specific differences were observed. The participants expressed a preference for interdisciplinary coordinated and coeducational group approaches with involvement of the parents. Major topics were healthy nutrition and psychosocial aspects. Prevention of relapses is considered as important as well. Conclusion Psychosocial aspects and preparing coping with risk situations should be an integral part of treatment programs. KW - obesity KW - adolescents KW - young adults KW - therapy KW - requirements KW - Jugendliche KW - junge Erwachsene KW - Therapie KW - Anforderungen KW - Adipositas Y1 - 2017 U6 - https://doi.org/10.1055/s-0043-107930 SN - 0034-3536 SN - 1439-1309 VL - 57 IS - 5 SP - 295 EP - 302 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Warschburger, Petra A1 - Kröller, Katja T1 - Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC) JF - BMC pediatrics N2 - Background Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting. Methods Five hundred twenty-three parents and their 7–13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses. Results Objective weight data were available for 49.6 (67.0) % of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child’s quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant. Conclusions The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background. KW - Attrition KW - Obesity KW - Child KW - Predictors KW - Weight management trial Y1 - 2016 U6 - https://doi.org/10.1186/s12887-016-0727-2 SN - 1471-2431 VL - 16 PB - BioMed Central CY - London ER -