Katharina Wick

Screening riskanten Essverhaltens bei 12-jährigen Mädchen und Jungen: psychometrischer Vergleich der deutschsprachigen Versionen von SCOFF und EAT-26

To detect eating disorders and risky eating behaviour at an early stage, screening tests should be economic, i. e. as short as possible but at the same time they should fulfil the psychometric quality criteria. We compared the German version of the Eating Attitudes Test (EAT-26D, which comprises 26 items) and the German version of the SCOFF test (which contains only 5 Yes-no questions) in a community sample of 425 12-year-old girls and 382 boys from Thuringia, Germany. Although the EAT-26D reached higher psychometric properties, the SCOFF has been proved as a useful screening tool with a test-retest reliability of r (tt)=0.73 and a maximum accuracy of 82% (area under the ROC curve). With the EAT-26D (20 point cut-off) as a reference the sensitivity of the SCOFF was 79%, specificity 74%, positive predictive value 25%, and the negative predictive value, which is more relevant for screenings, was 97%. The criterion validity reached r=0.53.

Primary prevention of eating-related problems in the real world

AimAs known from meta-analyses, prevention programs for eating disorders yield significant effects under ideal conditions. However, it is still unclear how these programs can be more widely disseminated. Since 2004 in Thuringia, Germany, several programs for preadolescent girls and boys (aged 10 to 15 years) covering a wide geographical range have been developed in order to prevent eating-related problems.Subjects and MethodsOver 3,500 pupils and more than 100 schools participated in the internal evaluation following the three-step standard of the Society of Prevention Research (SPR). To examine the program efficacy (step 1) and effectiveness (step 2), we conducted pre-post design studies with control groups. In order to describe the implementation process and the program dissemination (step 3), the Health Promoting School Approach (HEPS) was applied.ResultsGirls (6th grade) showed significant improvements in eating attitudes and self esteem about their bodies, whereas boys only improved their knowledge about eating and physical activity. The evaluations of the programs for 7th and 8th graders are still pending. On the HEPS checklist, our health promotion concept fulfilled 64 points out of a maximum of 74, which indicates a high intervention quality.ConclusionBroad dissemination of prevention programs requires methodological compromises and organizational flexibility. Quality assurance should be considered to be as important as the optimal level of evidence, which depends on the needs of all stakeholders and could not be derived from the standards for clinical studies. Furthermore, health promotion needs political support that is independent of legislative periods and the turnover of institutional staff.

Long-term effectiveness of a school-based primary prevention program for anorexia nervosa: A 7-to 8-year follow-up.

PURPOSE This is the first study to evaluate the long-term effectiveness of a school-based prevention program in Germany. The aim is to determine the long-term effects of the primary prevention program PriMa (Primary prevention of anorexia nervosa in preadolescent girls) on disordered eating and body self-esteem from childhood to young adulthood. METHODS PriMa was conducted and successfully evaluated in a quasi-experimental pre-post design with a control group from 2007 to 2008 consisting of 11-13year old girls (N=1508) from Thuringian schools in Germany. Seven to eight years after the intervention, the same cohort (mean age 19.8years) was invited to complete an online survey. Disordered eating (EAT-26), body self-esteem (FBeK) and BMI were assessed via self-report. The response rate at seven-to-eight-year follow-up was very low (7%). Data of N=100 girls were analyzed. RESULTS Concerning changes in disordered eating, results revealed no significant long-term effect of PriMa seven to eight years after the intervention. During this time, disordered eating remained stable without a significant increase or decrease. Regarding changes in body self-esteem, group courses differed significantly from each other. The results revealed a significant main effect of group, indicating significant differences in changes of body self-esteem between the intervention and the control group. Following the analysis of these changes of body self-esteem over time, it was found that the intervention group revealed an increase of body self-esteem after program participation and remained stable over time. By contrast, the control group revealed a decrease of body self-esteem over time. CONCLUSIONS Long-term intervention effects of PriMa could be found for body self-esteem but not for disordered eating. The findings suggest that PriMa prevented a decrease of body self-esteem from childhood to young adulthood. For a broader dissemination it is necessary to implement prevention programs consistently in school settings. In order to maintain the prevention effects, it would be interesting to investigate the effects of booster sessions which refresh the programs content on a regular basis. Furthermore, the results of this study revealed the implementation difficulties of primary prevention programs especially concerning the retention of the sample size.

I Can Stand Learning: A Controlled Pilot Intervention Study on the Effects of Increased Standing Time on Cognitive Function in Primary School Children

Sedentarism is considered an independent cardiovascular risk factor. Thus, the present study investigated the effects of employing standing desks in classrooms on cognitive function. The intervention class (IG; n = 19) was supplied with standing desks and balance pads for 11 weeks. The control class (CG; n = 19) received lessons as usual. Standing time was assessed objectively (accelerometers) and subjectively (self-report sheets, external classroom observers). The impact of standing on the digit span task and Eriksen flanker task was analysed. The standing time of the IG was higher during the school day in comparison to the CG (lesson: p = 0.004; break: p = 0.003). The intra-class correlation coefficient between self-reports and external observation was high (ICC = 0.94). The IG improved slightly on the Digit Span Task compared to CG. Employing standing desks for at least 1 h per school day serves as a feasible and effective opportunity to improve cognitive function.

Zusammenhang zwischen Belastungsfaktoren und Ressourcen bei Patienten auf der Warteliste für ein Spenderorgan: Nieren- und leberinsuffiziente Patienten im Vergleich

INTRODUCTION Patients on the waiting list for organ transplantation are exposed to different stress factors and use individual resources for coping. The present study examines these factors in the context of health-related quality of life in different patient groups (patients with renal vs. liver insufficiency) and attachment pattern. MATERIAL & METHODS The following variables were measured by questionnaire in a clinical sample of 103 patients waiting for a liver or kidney transplant in Thuringia: Physical complaints (GBB), Depression and Anxiety (HADS-D), Coping (EFK), Self-efficacy expectations (SWE), Resilience (RS-13), Social support (F-SozU-K-14), Health-related quality of life (SF-8) and Attachment style (BFPE). RESULTS Patients with liver insufficiency have a higher level of anxiety and show more often an insecure attachment style as renal failure patients. Differences between secure and insecure attached patients waiting for a kidney transplant are found in physical complaints, depression, depressive coping and self-efficacy, resilience, social support, active coping and mental health, in favor of secure attachment. Insecure attachment in patients with liver insufficiency leads to a less frequent usage of active coping strategies. Furthermore, the variables anxiety, depression, resilience, social support and dysfunctional coping mediate the relationship between attachment and mental health completely. DISCUSSION RESULTS suggest that psychological interventions should specifically consider the variables anxiety, depression, resilience, self-efficacy, social support, coping and attachment. CONCLUSION The gained insights of this study make it possible to derive implications for interventions to reduce risk factors for the development of co-morbid mental disorders and to strengthen protective factors and thus improve the well-being and quality of life of patients.

Essstörungen wirksam vorbeugen mit den Schulprogrammen „PriMa“ und „Torera“ für Jugendliche in Klasse 6 und 7

The aim of this study was to assess the effects of 2 German school-based primary prevention programmes for (pre)adolescents, aged 11-13 years, with 9 manual-guided lessons. 92 (PriMa, n=1,553 girls) and 22 (Torera, n=256 boys, 277 girls) Thuringian secondary schools participated in controlled trials with pre-post assessment. Girls and students at risk showed significant improvements of conspicuous eating behaviour and body self-esteem with small to medium effect sizes. Implementation costs were € 2.50 per student.

Recommendations to enhance constructivist-based learning in Interprofessional Education using video-based self-assessment.

Introduction: Interprofessional collaboration is crucial to the optimization of patient care. Aim: This paper aims to provide recommendations for implementing an innovative constructivist educational concept with the core element of video-based self-assessment. Methodology: A course for students in medicine, physiotherapy, and nursing was developed through interprofessional, cross-institutional collaboration. The course consisted of drawing on prior knowledge about the work done by each professional group in regard to a specific clinical scenario and an interprofessional treatment situation, filming a role play of this treatment situation, and a structured self-assessment of the role play. We evaluated the preparation and implementation of the three courses conducted thus far. Concrete recommendations for implementation were made based on evaluation sheets (students), open discussions (tutors, instructors, institutions) and recorded meeting minutes (project managers, project participants). Results: Basic recommendations for implementation include: selecting appropriate criteria for self-assessment and a simulated situation that offers members of each professional group an equal opportunity to act in the role play. In terms of administrative implementation we recommend early coordination among the professions and educational institutions regarding the target groups, scheduling and attendance policy to ensure participant recruitment across all professions. Procedural planning should include developing teaching materials, such as the case vignette and treatment scenario, and providing technical equipment that can be operated intuitively in order to ensure efficient recording. Conclusion: These recommendations serve as an aid for implementing an innovative constructivist educational concept with video-based self-assessment at its core.