Violet Perez Siwik

Interests

Teaching

Childhood/Adult Obesity, Wellness and Nutrition, Healer’s Art –Grief and Loss, Mystery and Awe

Research

Childhood Obesity, Type 2 Diabetes and medical student teaching/advising

Courses

Scholarly Contributions

Journals/Publications

• Kutob, R., Siwik, V., Aickin, M., & Ritenbaugh, C. (2014). Families United/Familias Unidas: Family Group Office Visits to Reduce Risk Factors for Type 2 Diabetes. The Diabetes Educator, 40(2). doi:10.1177/0145721714520722
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  Purpose The purpose of the Families United/Familias Unidas study was to evaluate the feasibility and efficacy of group office visits on reducing diabetes risk in a multiethnic, primary care population. Adults, ages 18 to 70 years, with any diabetes risk factor were recruited to attend 12 group office visits over 6 months. Each participant identified 1 support person, age 14 to 70 years, to accompany them. Data were collected at baseline, postintervention, 6 months, and 12 months. Primary outcome measures were reduction in the total number of predefined, modifiable risk factors (ie, body mass index ≥25 kg/m2; waist circumference ≥88 cm [women], ≥102 cm [men]; blood pressure ≥140/90 mm Hg; hemoglobin A1C ≥5.7%; fasting insulin ≥15 µU/mL; glycemic index ≥52.5% [women], ≥53.4% [men]; and physical activity
• Ritenbaugh, C., Aickin, M., Cruz, L., Going, S. B., Kutob, R. M., Senf, J. H., Shatte, A., & Siwik, V. P. (2013). Intervention in overweight children improves body mass index (BMI) and physical activity.. Journal of the American Board of Family Medicine : JABFM, 26(2), 126-37. doi:10.3122/jabfm.2013.02.120118
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  Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model..The intervention lasted for 3 months, with half of the children crossing over to intervention after 6 months in the study. Participants included 35 children who met eligibility criteria of being in third through fifth grades and having a body mass index (BMI) above the 85th percentile. The 3-month, 12-session intervention, "Choices," included topics on nutrition, physical activity, and resiliency. The sessions were developed for delivery by a family physician and a nutritionist who received training in positive psychology and resilience skills. Main outcome measures were BMI z scores for age and sex and z scores for weight by age and sex, as well as qualitative interviews to understand individual and family processes..The intervention resulted in a significant effect on one primary outcome, BMI z score (-0.138 per 9 months [P = .017]) and a trend toward significance on the weight for age z score (-0.87 per 9 months [P = .09]). The net shift of activity from the low metabolic equivalents (METs) to the high METs had an intervention effect of 2.84 METs (P = .037). Families reported lasting changes in behaviors and attitudes..The innovative approach used in this study demonstrated modest efficacy in reducing BMI z score, changing physical activity levels, and possibly shifting family dynamics.
• Perez Siwik, V., Kutob, R., Ritenbaugh, C., Aickin, M., & Gordon, J. (2012). Families United/Familias Unidas: Development and Implementation of a Family-Based Group Office Visit Model for the Primary Prevention of Type 2 Diabetes. The Diabetes Educator, 38(6). doi:10.1177/0145721712461533
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  Purpose The purpose of this study is to describe the development and implementation of a new diabetes prevention intervention that combines the benefits of family support with the group office model. Intensive lifestyle modification can effectively delay the onset of type 2 diabetes, yet health providers are challenged in translating these results to their patients. The group outpatient visit model can provide a means to address prevention issues in a financially sustainable manner. Materials from the Diabetes Prevention Program and a previously developed group office visit program were combined to create the Families United/Familias Unidas curriculum. The session content utilized a multiculturally tailored approach designed to help participants decrease portion size, decrease carbohydrate intake, increase physical activity, and increase resiliency. Adults aged 18 to 70 were recruited who had any diabetes risk factors but did not have diabetes. Eligible participants enlisted a support person, aged 14 to 70, to join them in the 6-month group office visit intervention. Twenty-nine pairs (n = 58) of primary participants plus support persons were recruited. Participants’ average age was 45; 74% were female; 56.9% identified themselves as white and 37.9% as Hispanic/Latino. Over one-third had 4 or more diabetes risk factors. Twelve family group office visits were delivered over 6 months. The attendance rate for those who attended at least one session was 72%. Group office visits can provide a new sustainable model for diabetes prevention and are a natural fit for primary care physicians in collaboration with other health care professionals, such as dieticians or diabetes educators. © 2012, SAGE Publications. All rights reserved.
• Siwik, V., & Senf, J. (2006). Food Cravings, Ethnicity and Other Factors Related to Eating Out. Journal of the American College of Nutrition, 25(5). doi:10.1080/07315724.2006.10719549
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  Objective: Our objective was to study factors related to eating patterns, specifically whether certain food cravings were associated with frequency of meals eaten away from home. Methods: Data were collected from 277 patients from a family medicine residency office in Arizona. The survey questionnaire included information about the respondents’ demographics, socioeconomic status, food cravings, as well as, number of meals eaten away from home. The food craving inventory included foods in four categories identified by factor analysis: fast foods, carbohydrates, sweets and snacks. Data on food cravings were factor analyzed and scale scores were derived. Results: Being a Hispanic adult, working outside the home, and cravings for individual food items were related to eating more meals away from home. If the mother was working outside the home, the youngest child ate an average of two additional meals away from home each week. In general respondent’s cravings for some specific food items were also related to higher numbers of meals their child ate away from home. Cravings for both fast food and snacks were positively correlated with adult eating out. None of the respondents’ scale scores were related to child’s eating away from home. Adults with Arizona Health Care Cost Containment System insurance (AHCCCS—a form of Medicaid) and older adults were less likely to eat away from home compared to patients with other types of insurance. Conclusions: Socioeconomic status, ethnicity, and food cravings are related to adult and child patterns of eating meals away from home. © 2006 American College of Nutrition.

Others

• Kutob, R. M., Siwik, V. P., Aickin, M., & Ritenbaugh, C. (2014). Families United/Familias Unidas: family group office visits to reduce risk factors for type 2 diabetes. The Diabetes educator.
  More info

  The purpose of the Families United/Familias Unidas study was to evaluate the feasibility and efficacy of group office visits on reducing diabetes risk in a multiethnic, primary care population.
• Siwik, V., Kutob, R., Ritenbaugh, C., Cruz, L., Senf, J., Aickin, M., Going, S., & Shatte, A. (2013). Intervention in overweight children improves body mass index (BMI) and physical activity. Journal of the American Board of Family Medicine : JABFM.
  More info

  Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model.