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Fenta ET, Ayal BG, Kidie AA, Anagaw TF, Mekonnen TS, Ketema Bogale E, Berihun S, Tsega TD, Mengistie Munie C, Talie Fenta T, Kassie Worku N, Shiferaw Gelaw S, Tiruneh MG. Barriers to Medication Adherence Among Patients with Non-Communicable Disease in North Wollo Zone Public Hospitals: Socio-Ecologic Perspective, 2023. Patient Prefer Adherence 2024; 18:733-744. [PMID: 38533490 PMCID: PMC10964781 DOI: 10.2147/ppa.s452196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
Background The practice of taking medication as directed by a healthcare provider is known as medication adherence. Therefore, the application of a socio-ecological model to this study identifies multilevel factors on barriers of medication adherence on chronic non-communicable disease and provides information to develop scientific health communication interventional strategies to improve medication adherence. Objective This study aimed to explore barriers of medication adherence on non-communicable disease prevention and care among patients in North Wollo Zone public hospitals, northeast Ethiopia. Methods A phenomenological study design was carried out between February 5 and February 30, 2023. The study participants were chosen using a heterogeneous purposive sampling technique. In-depth interviews and targeted focus groups were used to gather data. The focus group discussions and in-depth interviews were captured on audio, accurately transcribed, and translated into English. Atlas TI-7 was utilized to do the thematic analysis. Results Four main themes, intrapersonal, interpersonal, community level, and health care related, as well as seven subthemes, financial problems, lack of family support, poor communication with healthcare providers, effects of social ceremonies, remote healthcare facility, and drug scarcity, were identified by this study. In this study participants reported that lack of knowledge about the disease and drugs were the main barrier for medication adherence. The study revealed that financial problems for medication and transportation cost were the main factor for medication adherence for non-communicable disease patients. Conclusion This study explored that lack of knowledge, financial problem, lack of family support, poor communication with healthcare providers, social ceremony effects, remote healthcare facility, and scarcity of drugs were barriers of medication adherence among non-communicable disease patients. In order to reduce morbidity and mortality from non-communicable diseases, it is advised that all relevant bodies look for ways to reduce medication adherence barriers for patients at every level of influence.
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Affiliation(s)
- Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Birtukan Gizachew Ayal
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Atitegeb Abera Kidie
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadele Fentabil Anagaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tesfaye Shumet Mekonnen
- Department of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Sileshi Berihun
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tilahun Degu Tsega
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | | | - Tizazu Talie Fenta
- Department of Medical Laboratory Science, Gamby Medical and Business College, Bahir Dar, Ethiopia
| | - Nigus Kassie Worku
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Sintayehu Shiferaw Gelaw
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Misganaw Guadie Tiruneh
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
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McCabe EM, Luk JW, Stangl BL, Schwandt ML, Ziausyte U, Kim H, Vergeer RR, Gunawan T, Fede SJ, Momenan R, Joseph PV, Goldman D, Diazgranados N, Ramchandani VA. Exercising healthy behaviors: A latent class analysis of positive coping during the COVID-19 pandemic and associations with alcohol-related and mental health outcomes. PLoS One 2024; 19:e0297060. [PMID: 38354113 PMCID: PMC10866465 DOI: 10.1371/journal.pone.0297060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/27/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE To identify latent classes of positive coping behaviors during the COVID-19 pandemic and examine associations with alcohol-related and mental health outcomes across participants with and without a history of alcohol use disorder (AUD). METHODS Baseline data from 463 participants who were enrolled in the NIAAA COVID-19 Pandemic Impact on Alcohol (C19-PIA) Study were analyzed. Latent class analysis (LCA) was applied to five positive coping behaviors during COVID-19: taking media breaks, taking care of their body, engaging in healthy behaviors, making time to relax, and connecting with others. Latent class differences and the moderating role of history of AUD on six alcohol-related and mental health outcomes were examined using multiple regression models. RESULTS LCA revealed two latent classes: 83.4% High Positive Coping and 16.6% Low Positive Coping. Low Positive Coping was associated with higher levels of perceived stress, anxiety symptoms, and loneliness. A history of AUD was consistently associated with higher levels of alcohol-related and mental health outcomes. Significant interactions between Coping Latent Classes and history of AUD indicated that the associations of Low Positive Coping with problematic alcohol use, depressive symptoms, and drinking to cope motives were either stronger or only significant among individuals with a history of AUD. CONCLUSIONS Individuals with a history of AUD may be particularly vulnerable to depressive symptoms and alcohol-related outcomes, especially when they do not utilize positive coping strategies. The promotion of positive coping strategies is a promising avenue to address alcohol-related and mental health problems during a public health crisis and warrants future research.
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Affiliation(s)
- Emma M. McCabe
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Jeremy W. Luk
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Bethany L. Stangl
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Melanie L. Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Ugne Ziausyte
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Hannah Kim
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Rhianna R. Vergeer
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Tommy Gunawan
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Samantha J. Fede
- Clinical NeuroImaging Research Core, Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Reza Momenan
- Clinical NeuroImaging Research Core, Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Paule V. Joseph
- Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, United States of America
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
| | - Vijay A. Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States of America
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Hormigo Pozo A, Torres Ortega D, García Ruiz AJ, Escribano Serrano J, Escribano Cobalea M, García-Agua Soler N. Approach to patients with diabetes and obesity in primary care. Aten Primaria 2024; 56:102807. [PMID: 37972467 PMCID: PMC10684366 DOI: 10.1016/j.aprim.2023.102807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023] Open
Abstract
AIMS The aim of this study is to analyse the effect of pharmacological and non-pharmacological treatment on weight control in patients with diabetes and obesity. DESIGN Epidemiological, descriptive, cross-sectional study. SITE: Primary care. In 11 health centres in Málaga and Cádiz during April and October 2022. PARTICIPANTS 281 patients over 18 years old with type 2 diabetes and obesity are included. MAIN MEASUREMENTS Socio-demographics, clinical, treatment and lifestyle habits variables were obtained from medical records and personal interview. Descriptive statistics were obtained for continuous variables. Statistical tests were performed based on the nature of the variables. RESULTS Variables like marital status, level of education and occupation, and smoking habit, shows differences regarding the sex (p<0.05). 82.3% of those who received education lost weight, compared to 67.5% of lost weight who received no health education (p=0.004). GLP1 and SGLT2 were more commonly prescribed for women (p=0.048), and SGLT2 more commonly prescribed for men (p=0.047). Patients taking GLP1, SGLT2 or both, regardless of sex, weight loss during the study period was -3.1kg (SE: 0.60), while the loss of those who took other medications was -1.33kg (SE: 0.62). The mean difference was 1.75kg (p=0.046). CONCLUSIONS In terms of weight loss, obese diabetics who took GLP1, SGLT2 or both were 2.5 times more likely to lose weight than those who did not. Healthy lifestyle choices are key to weight loss in obese diabetic patients.
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Affiliation(s)
- Antonio Hormigo Pozo
- Unidad de Gestión Clínica San Andres-Torcal Clinical, Distrito Málaga-Guadalhorce, Málaga, Spain
| | - Desireé Torres Ortega
- Programa de Doctorado en Biomedicina, Investigación Traslacional, y Nuevas Tecnologías en Salud, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.
| | - Antonio J García Ruiz
- Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain; IBIMA (Instituto de Investigación Biomédica de Malaga), Málaga, Spain
| | - José Escribano Serrano
- Unidad de Gestión Clínica San Roque, Área de Gestión Sanitaria Campo de Gibraltar Este, San Roque, Cádiz, Spain
| | | | - Nuria García-Agua Soler
- Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain; IBIMA (Instituto de Investigación Biomédica de Malaga), Málaga, Spain
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Liutsko L, Leonov S, Pashenko A, Polikanova I. Is Frequency of Practice of Different Types of Physical Activity Associated with Health and a Healthy Lifestyle at Different Ages? Eur J Investig Health Psychol Educ 2024; 14:256-271. [PMID: 38275342 PMCID: PMC10814358 DOI: 10.3390/ejihpe14010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Physical activity (PA) has been shown to be related to physical and mental health. Yet there are few studies on how the frequency of PA relates to health and a healthy lifestyle. We aimed to investigate how the frequency of different PAs is associated with the following health indicators: body mass index (BMI), substance consumption, physical health, and mental health. We focused on three types of PA: (1) medium- to high-intensity aerobic exercise; (2) low- to medium-intensity relaxing exercise; and (3) outdoor leisure PA. A total of 9617 volunteers, aged 19 to 81, participated in the study. The relationships between the frequencies of the three types of PA and health-related and sociodemographic factors were analyzed using multinomial logistic regression. We found that women more frequently engaged in PA type 2, and men in types 1 and 3. A higher frequency of PA was associated with lower BMI and less or no smoking behavior; higher education (PAs 1 and 3); higher age (PAs 2 and 3); better physical health (PAs 1 and 3); and better mental health (PA 3). In conclusion, higher frequency of different PAs was significantly associated with better physical and mental health, less smoking, higher age, and a higher level of education.
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Affiliation(s)
- Liudmila Liutsko
- ISAN, International Society of Applied Neuropsychology, 08787 La Pobla de Claramunt, Spain
- IDIAP JGol, 08007 Barcelona, Spain
| | - Sergey Leonov
- Federal Scientific Centre for Psychological and Interdisciplinary Research, Moscow 125009, Russia; (S.L.); (A.P.)
| | - Alexander Pashenko
- Federal Scientific Centre for Psychological and Interdisciplinary Research, Moscow 125009, Russia; (S.L.); (A.P.)
| | - Irina Polikanova
- Federal Scientific Centre for Psychological and Interdisciplinary Research, Moscow 125009, Russia; (S.L.); (A.P.)
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Mesinovic J, Fyfe JJ, Talevski J, Wheeler MJ, Leung GK, George ES, Hunegnaw MT, Glavas C, Jansons P, Daly RM, Scott D. Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies. Diabetes Metab J 2023; 47:719-742. [PMID: 37709502 PMCID: PMC10695715 DOI: 10.4093/dmj.2023.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
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Affiliation(s)
- Jakub Mesinovic
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Jackson J. Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Talevski
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia
- School of Rural Health, Monash University, Warragul, Australia
| | - Michael J. Wheeler
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Gloria K.W. Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Melkamu T. Hunegnaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Costas Glavas
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Paul Jansons
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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Gautam N, Dessie G, Rahman MM, Khanam R. Socioeconomic status and health behavior in children and adolescents: a systematic literature review. Front Public Health 2023; 11:1228632. [PMID: 37915814 PMCID: PMC10616829 DOI: 10.3389/fpubh.2023.1228632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Socioeconomic status affects individuals' health behaviors and contributes to a complex relationship between health and development. Due to this complexity, the relationship between SES and health behaviors is not yet fully understood. This literature review, therefore, aims to assess the association between socioeconomic status and health behaviors in childhood and adolescence. Preferred Reporting for Systematic Review and Meta-Analysis protocol guidelines were used to conduct a systematic literature review. The electronic online databases EBSCO Host, PubMed, Web of Science, and Science Direct were utilized to systematically search published articles. The Joanna Briggs Institute's critical appeal tool was used to assess the quality of included studies. Eligibility criteria such as study context, study participants, study setting, outcome measures, and key findings were used to identify relevant literature that measured the association between socioeconomic status and health behaviors. Out of 2,391 studies, only 46 met the final eligibility criteria and were assessed in this study. Our review found that children and adolescents with low socioeconomic status face an elevated risk of unhealthy behaviors (e.g., early initiation of smoking, high-energy-dense food, low physical activity, and involvement in drug abuse), in contrast to their counterparts. Conversely, children and adolescents from higher socioeconomic backgrounds exhibit a higher prevalence of health-promoting behaviors, such as increased consumption of fruit and vegetables, dairy products, regular breakfast, adherence to a nutritious diet, and engagement in an active lifestyle. The findings of this study underscore the necessity of implementing specific intervention measures aimed at providing assistance to families from disadvantaged socioeconomic backgrounds to mitigate the substantial disparities in health behavior outcomes in children and adolescents.
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Affiliation(s)
- Nirmal Gautam
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Getenet Dessie
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mohammad Mafizur Rahman
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Rasheda Khanam
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
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Temple NJ. A Proposed Strategy against Obesity: How Government Policy Can Counter the Obesogenic Environment. Nutrients 2023; 15:2910. [PMID: 37447235 DOI: 10.3390/nu15132910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/25/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
An epidemic of obesity emerged in the USA in 1976-1980. The epidemic then spread to many other Westernized nations. Many interventions have been carried out with the goal of lowering the prevalence of obesity. These have mostly taken the form of various types of health promotion (i.e., providing people with education, advice, and encouragement). These actions have achieved, at most, only limited success. A strategy with a better chance of success starts with the recognition that the fundamental cause of obesity is that we live in an obesogenic environment. It is therefore necessary to change the environment so that it fosters a generally healthy lifestyle, thereby leading to enhanced health for the population, including improved weight control. A major goal is to increase the intake of healthy foods (especially fruit, vegetables, and whole grains), while decreasing intake of unhealthy foods (especially ultra-processed foods such as sugar). This will require major changes of many government policies. Some of the required policies are as follows. Schools should implement policies that create a healthy environment for children. For example, they should adopt a policy that only foods of high nutritional quality are sold in vending machines or given to students within school meals. Policies need to go well beyond the school setting; a broad strategy is needed that creates a healthy environment for children. Another important policy is the manipulation of food prices in order to shift the diet toward healthy foods. This requires using subsidies to lower the price of healthy foods, while adding a tax to less healthy foods to increase the price. This policy has been implemented in many cities and countries in the form of a tax on sugar-sweetened beverages (SSBs). The advertising of unhealthy foods (including fast-food restaurants) should be banned, especially where children and adolescents are the major target. Such a ban could be extended to a complete ban on all advertising for unhealthy foods, including that directed at adults. The proposed policy measures are likely to be strongly opposed by food corporations.
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Affiliation(s)
- Norman J Temple
- Centre for Science, Athabasca University, Athabasca, AB T9S 3A3, Canada
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Hunt CA, Letzen JE, Krimmel SR, Burrowes SAB, Haythornthwaite JA, Keaser M, Reid M, Finan PH, Seminowicz DA. Meditation Practice, Mindfulness, and Pain-Related Outcomes in Mindfulness-Based Treatment for Episodic Migraine. Mindfulness (N Y) 2023; 14:769-783. [PMID: 38435377 PMCID: PMC10907069 DOI: 10.1007/s12671-023-02105-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 04/07/2023]
Abstract
Objectives Mindfulness-based interventions (MBIs) have emerged as promising prophylactic episodic migraine treatments. The present study investigated biopsychosocial predictors and outcomes associated with formal, daily-life meditation practice in migraine patients undergoing MBI, and whether augmented mindfulness mechanistically underlies change. Methods Secondary analyses of clinical trial data comparing a 12-week enhanced mindfulness-based stress reduction course (MBSR + ; n = 50) to stress management for headache (SMH; n = 48) were conducted. Results Pre-treatment mesocorticolimbic system functioning (i.e., greater resting state ventromedial prefrontal cortex-right nucleus accumbens [vmPFC-rNAC] functional connectivity) predicted greater meditation practice duration over MBSR + (r = 0.58, p = 0.001), as well as the change in headache frequency from pre- to post-treatment (B = -12.60, p = 0.02) such that MBSR + participants with greater vmPFC-rNAC connectivity showed greater reductions in headache frequency. MBSR + participants who meditated more showed greater increases in mindfulness (B = 0.52, p = 0.02) and reductions in the helplessness facet of pain catastrophizing (B = -0.13, p = 0.01), but not headache frequency, severity, or impact. Augmented mindfulness mediated reductions in headache impact resulting from MBSR + , but not headache frequency. Conclusions Mesocorticolimbic system function is implicated in motivated behavior, and thus, motivation-enhancing interventions might be delivered alongside mindfulness-based training to enhance meditation practice engagement. Formal, daily-life meditation practice duration appears to benefit pain-related cognitions, but not clinical pain, while mindfulness emerges as a mechanism of MBIs on headache impact, but not frequency. Further research is needed to investigate the day-to-day effects of formal, daily-life meditation practice on pain, and continue to characterize the specific mechanisms of MBIs on headache outcomes. Preregistration This study is not preregistered.
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Affiliation(s)
- Carly A. Hunt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology, University of Virginia, VA, Charlottesville, USA
| | - Janelle E. Letzen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Samuel R. Krimmel
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Shana A. B. Burrowes
- Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA 02218, USA
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD 21201, USA
| | - Jennifer A. Haythornthwaite
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Keaser
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD 21201, USA
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD 21201, USA
| | - Matthew Reid
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick H. Finan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology, University of Virginia, VA, Charlottesville, USA
| | - David A. Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD 21201, USA
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD 21201, USA
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Brivio F, Viganò A, Paterna A, Palena N, Greco A. Narrative Review and Analysis of the Use of "Lifestyle" in Health Psychology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4427. [PMID: 36901437 PMCID: PMC10001804 DOI: 10.3390/ijerph20054427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Lifestyle is a complex and often generic concept that has been used and defined in different ways in scientific research. Currently, there is no single definition of lifestyle, and various fields of knowledge have developed theories and research variables that are also distant from each other. This paper is a narrative review of the literature and an analysis of the concept of lifestyle and its relationship to health. This contribution aims to shed light on the lifestyle construct in health psychology. In particular, the first part of this manuscript reexamines the main definitions of lifestyle in the psychological and sociological fields through three perspectives: internal, external, and temporal. The main components that characterise lifestyle are highlighted. The second part of this paper explores the main concepts of lifestyle in health, underlining their strengths and weaknesses, and proposes an alternative definition of a healthy lifestyle, which integrates the individual dimensions with the social and cycle dimensions of life. In conclusion, a brief indication of a research agenda is presented.
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Dang J, Shi D, Li X, Ma N, Liu Y, Zhong P, Yan X, Zhang J, Lau PWC, Dong Y, Song Y, Ma J. Artificial Light-at-Night Exposure and Overweight and Obesity across GDP Levels among Chinese Children and Adolescents. Nutrients 2023; 15:nu15040939. [PMID: 36839297 PMCID: PMC9961462 DOI: 10.3390/nu15040939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/23/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Evidence in adults suggests that exposure to artificial light-at-night (ALAN) leads to obesity. However, little is known about whether this effect exists in children and adolescents. We aimed to investigate whether ALAN exposure was associated with overweight and obesity in school-aged children and adolescents and whether this association varied with socioeconomic status. METHODS Data on the height and weight of 129,500 children and adolescents aged 10-18 years from 72 cities were extracted from the 2014 Chinese National Survey on Students' Constitution and Health (CNSSCH). The ALAN area percentage and average ALAN intensity were calculated using the Visible/Infrared Imager/Radiometer Suite. The subjects were separated into three categories based on the cities' gross domestic product per capita (GDPPC). A mixed-effect logistic regression model and generalized additive model (GAM) were utilized to evaluate the association between ALAN exposure and overweight and obesity in children and adolescents stratified by municipal GDPPC. RESULTS Both ALAN area (OR = 1.194, 95% CI: 1.175-1.212) and ALAN intensity (OR = 1.019, 95% CI: 1.017-1.020) were positively associated with overweight and obesity in children and adolescents, and the associations remained robust after adjusting for covariates. ORs for overweight and obesity and ALAN area decreased as GDPPC level increased (first tertile: OR = 1.457, 95% CI: 1.335-1.590; second tertile: OR = 1.350, 95% CI: 1.245-1.464; third tertile: OR = 1.100, 95% CI: 1.081-1.119). Similar results were observed for ALAN intensity. In the GAM models, thresholds existed in almost all these spline trends, indicating that ALAN might have a nonlinear association with overweight and obesity. CONCLUSIONS ALAN contributed to the development of overweight and obesity in children and adolescents and this effect differed with GDPPC. Future longitudinal studies should confirm the causal relationship between ALAN and obesity. Moreover, reducing unnecessary exposure to artificial light at night may have beneficial implications for controlling childhood and adolescent obesity, particularly in low-income areas.
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Affiliation(s)
- Jiajia Dang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Di Shi
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Xi Li
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430000, China
- Collaborative Innovation Centre of Geospatial Technology, Wuhan University, Wuhan 430000, China
| | - Ning Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Yunfei Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Xiaojin Yan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Jingshu Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Patrick W. C. Lau
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong 999077, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
- Correspondence: ; Tel.: +86-10-8280-1624
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China
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11
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DeShaw KJ, Lansing JE, Perez ML, Ellingson LD, Welk GJ. Effects of a peer health coaching program on college student lifestyle behaviors. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 36595662 DOI: 10.1080/07448481.2022.2155473] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/19/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Objective: Health coaching (HC) may promote healthy behaviors in incoming college students. Participants: 187 undergraduate students (76% female; age 18.6 ± 1.6) were recruited to participate in a peer HC program. Methods: Participants received four HC sessions in eight-weeks to work toward self-selected goals of physical activity (PA), diet, or stress management. PA was assessed using the International Physical Activity Questionnaire Short-Form, diet with the Eating Habits Confidence Survey, and stress with the Perceived Stress Scale. Results: Repeated measures ANOVAs investigated lifestyle behavior changes in 130 participants. Significant effects of time were reported, with a 39.6% gain in PA, 9.9% increase in dietary habit, and 16.3% decline in stress levels with moderate to large effect sizes (ηp2: 0.07-0.17; p< 0.01). Conclusion: The peer HC model promoted healthy lifestyles in college students. Additional research is needed to understand the effects of HC specifically for each goal, and student reactions to peer-led HC.
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Affiliation(s)
- K J DeShaw
- Kinesiology Program, Loras College, Dubuque, Iowa, USA
| | - J E Lansing
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - M L Perez
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - L D Ellingson
- Division of Health & Exercise Science, Western Oregon University, Monmouth, Oregon, USA
| | - G J Welk
- Department of Kinesiology, Iowa State University, Ames, Iowa, USA
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12
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Iwon K, Skibinska J, Jasielska D, Kalwarczyk S. Elevating Subjective Well-Being Through Physical Exercises: An Intervention Study. Front Psychol 2021; 12:702678. [PMID: 34975608 PMCID: PMC8719442 DOI: 10.3389/fpsyg.2021.702678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Physical activity is associated with higher levels of subjective well-being. However, little research has been conducted in naturalistic conditions with a longitudinal design. In the current study, we aimed to examine whether regular activity initiation can impact happiness, life satisfaction, and self-esteem 4 weeks later. Methods: The sample (N = 217, 124 women) was divided into three groups based on level of physical activity (active people, beginners, and inactive people). The participants completed measures of happiness, satisfaction with life, self-esteem, and a survey on physical activity. Ninety-five of participants who completed the same set of measures sent by email after 4 weeks were included in the analyses. Results: The study showed a strong relationship between subjective well-being and physical activity. Active people showed higher levels of happiness and self-esteem compared to beginners and inactive people and a higher level of life satisfaction than inactive people. Furthermore, after 4 weeks of exercising, beginners revealed greater life satisfaction and happiness compared to the baseline. Conclusion: These findings confirm that regular physical activity leads to higher levels of well-being. It seems that even a short engagement in physical activity (4 weeks) may contribute to an increase in subjective well-being.
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Affiliation(s)
- Katarzyna Iwon
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
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13
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Lavazza A, Farina M. Experts, naturalism, and democracy. JOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR 2021. [DOI: 10.1111/jtsb.12321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andrea Lavazza
- Department of Brain and Behavioural Sciences University of Pavia Pavia Italy
- Centro Universitario Internazionale Arezzo Italy
| | - Mirko Farina
- Faculty of Humanities and Social Sciences Innopolis University Innopolis Russian Federation
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14
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Kalinowski J, Kaur K, Newsome-Garcia V, Langford A, Kalejaiye A, Vieira D, Izeogu C, Blanc J, Taylor J, Ogedegbe O, Spruill T. Stress interventions and hypertension in Black women. ACTA ACUST UNITED AC 2021; 17:17455065211009751. [PMID: 34254559 PMCID: PMC8280834 DOI: 10.1177/17455065211009751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Hypertension is a risk factor for cardiovascular disease. Black women have high
rates of hypertension compared to women of other racial or ethnic groups and are
disproportionately affected by psychosocial stressors such as racial
discrimination, gender discrimination, and caregiving stress. Evidence suggests
that stress is associated with incident hypertension and hypertension risk.
Stress management is associated with improvements improved blood pressure
outcomes. The purpose of this review is to synthesize evidence on effects of
stress management interventions on blood pressure in Black women. A
comprehensive search of scientific databases was conducted. Inclusion criteria
included studies that were: (1) primary research that tested an intervention;
(2) in the English language; (3) included African-American women; (4)
incorporated stress in the intervention; (5) included blood pressure as an
outcome; and (6) were US based. Eighteen studies met inclusion criteria. Ten
(56%) studies tested meditation-based interventions, two (11%) tested coping and
affirmation interventions, and six (33%) tested lifestyle modification
interventions that included stress management content. Thirteen of the studies
were randomized controlled trials. Reductions in blood pressure were observed in
all of the meditation-based interventions, although the magnitude and
statistical significance varied. Comprehensive lifestyle interventions were also
efficacious for reducing blood pressure, although the relative contribution of
stress management versus behavior modification could not be evaluated. Coping
and affirmation interventions did not affect blood pressure. Most of the
reviewed studies included small numbers of Black women and did not stratify
results by race and gender, so effects remain unclear. This review highlights
the urgent need for studies specifically focusing on Black women. Given the
extensive disparities in cardiovascular disease morbidity and mortality, whether
stress management can lower blood pressure and improve primary and secondary
cardiovascular disease prevention among Black women is an important question for
future research.
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Affiliation(s)
- Jolaade Kalinowski
- Department of Human Development and Family Sciences, The University of Connecticut, Storrs, CT, USA
| | - Kiran Kaur
- Department of Population Health, School of Medicine, New York University, New York, NY, USA
| | | | - Aisha Langford
- Department of Population Health, School of Medicine, New York University, New York, NY, USA
| | | | - Dorice Vieira
- Department of Population Health, School of Medicine, New York University, New York, NY, USA
| | - Chigozirim Izeogu
- Department of Population Health, School of Medicine, New York University, New York, NY, USA
| | - Judite Blanc
- Department of Population Health, School of Medicine, New York University, New York, NY, USA
| | | | - Olugbenga Ogedegbe
- Department of Population Health, School of Medicine, New York University, New York, NY, USA
| | - Tanya Spruill
- Department of Population Health, School of Medicine, New York University, New York, NY, USA
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15
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Kaczmarek T, Kavanagh DJ, Lazzarini PA, Warnock J, Van Netten JJ. Training diabetes healthcare practitioners in motivational interviewing: a systematic review. Health Psychol Rev 2021; 16:430-449. [PMID: 33970799 DOI: 10.1080/17437199.2021.1926308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diabetes presents significant self-care challenges that require sustained motivation. Motivational Interviewing (MI) has substantial support in enhancing motivation for behavioural change, but its effective application in routine healthcare requires practitioners to acquire and use related skills. The aim of this systematic review was to investigate the impact of MI training on MI-related skills of practitioners who provide diabetes healthcare. PubMed, EMBASE and PsycINFO were searched using the terms motivational interviewing, motivation enhancement, and diabetes. Two assessors independently screened titles, abstracts and full texts for papers reporting the impact of MI training on diabetes healthcare practitioners' outcomes. Of 625 abstracts screened, 22 papers from 17 unique studies were included. All 17 studies reported some improvement in MI skills, with 14 finding improvements in more than 50% and three less than 35%. However, the risk of bias and outcome measures varied widely between studies. All studies showed diabetes healthcare practitioners acquired and applied MI skills post-training, to varying levels. Findings suggest training should include education, role play, and ongoing supervision to maintain skills.
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Affiliation(s)
- Tracey Kaczmarek
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.,Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
| | - David J Kavanagh
- Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia.,Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Peter A Lazzarini
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.,Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Jason Warnock
- Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
| | - Jaap J Van Netten
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.,Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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16
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Bravo JJM. [Importance of adherence to healthy lifestyles in people with diabetes]. Semergen 2021; 47:141-143. [PMID: 33975690 DOI: 10.1016/j.semerg.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
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17
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Lisi EC, Ali N. Opinions of adults affected with later-onset lysosomal storage diseases regarding newborn screening: A qualitative study. J Genet Couns 2021; 30:1544-1558. [PMID: 33938615 DOI: 10.1002/jgc4.1421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 03/09/2021] [Accepted: 03/13/2021] [Indexed: 12/23/2022]
Abstract
Lysosomal storage diseases (LSDs) are a heterogeneous group of conditions causing substrate accumulation leading to progressive organ damage. Newborn screening (NBS) for several LSDs has become available in recent years due to advances in technology and treatment availability. While early initiation of treatment is lifesaving for those with infantile presentations, controversy continues regarding diagnosis of milder, later-onset diseases in infancy, including creation of pre-symptomatic populations of 'patients-in-waiting', the potential for medicalization, stigmatization, and/or discrimination. In-depth interviews were conducted with 36 adults [11 with Fabry disease (FD), 8 with Gaucher disease (GD), and 17 with late-onset Pompe disease (LOPD)], to determine their perspectives on NBS for their respective conditions. Thirty-four of 36 participants were in favor of NBS; both participants not in favor had GD1. Emergent themes influencing participants favorably toward NBS included earlier age of onset, a long diagnostic odyssey, less efficacious treatment, and the desire to have made different life decisions (e.g., relationships, career, or lifestyle) with the knowledge of their diagnosis. Concerns about insurance discrimination and psychological or physical burdens were associated with less favorable opinions of NBS. The ability for parents to make future reproductive decisions based their child's NBS result was considered favorably by some participants and unfavorably by others. Participants' specific condition (GD1, FD, or LOPD) contributed to these experiences differently. Participants with LOPD and FD favored NBS to initiate earlier treatment and prevent irreversible organ damage, whereas fewer patients with GD1 mentioned this benefit. Participants with LOPD had the longest diagnostic odyssey, while those with FD were more likely to report feeling misunderstood and experiencing accusations of malingering, both contributing to favorable views of NBS. Results expand prior quantitative findings by illuminating how participants' lived experiences can shape opinions about NBS. By understanding how currently affected individuals perceive the lifelong impact of a NBS result, genetic counselors can provide better anticipatory guidance to the parents of individuals diagnosed with a later-onset LSD by NBS.
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Affiliation(s)
- Emily C Lisi
- Department of Human Genetics, Emory University, Atlanta, GA, USA.,Graduate School for Arts and Sciences- Biomedical Sciences Division, Wake Forest University, Winston-Salem, NC, USA
| | - Nadia Ali
- Department of Human Genetics, Emory University, Atlanta, GA, USA
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18
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Vluggen S, Candel M, Hoving C, Schaper NC, de Vries H. A Web-Based Computer-Tailored Program to Improve Treatment Adherence in Patients With Type 2 Diabetes: Randomized Controlled Trial. J Med Internet Res 2021; 23:e18524. [PMID: 33620321 PMCID: PMC7943340 DOI: 10.2196/18524] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/17/2020] [Accepted: 12/21/2020] [Indexed: 01/01/2023] Open
Abstract
Background Adherence to core type 2 diabetes mellitus (T2DM) treatment behaviors is suboptimal, and nonadherence is generally not limited to one treatment behavior. The internet holds promise for programs that aim to improve adherence. We developed a computer-tailored eHealth program for patients with T2DM to improve their treatment adherence, that is, adherence to both a healthy lifestyle and medical behaviors. Objective The objective of this study is to examine the effectiveness of the eHealth program in a randomized controlled trial. Methods Patients with T2DM were recruited by their health professionals and randomized into either the intervention group, that is, access to the eHealth program for 6 months, or a waiting-list control group. In total, 478 participants completed the baseline questionnaire, of which 234 gained access to the eHealth program. Of the 478 participants, 323 were male and 155 were female, the mean age was 60 years, and the participants had unfavorable BMI and HbA1c levels on average. Outcome data were collected through web-based assessments on physical activity (PA) levels, caloric intake from unhealthy snacks, and adherence to oral hypoglycemic agents (OHAs) and insulin therapy. Changes to separate behaviors were standardized and summed into a composite change score representing changes in the overall treatment adherence. Further standardization of this composite change score yielded the primary outcome, which can be interpreted as Cohen d (effect size). Standardized change scores observed in separate behaviors acted as secondary outcomes. Mixed linear regression analyses were conducted to examine the effectiveness of the intervention on overall and separate treatment behavior adherence, accommodating relevant covariates and patient nesting. Results After the 6-month follow-up assessment, 47.4% (111/234) of participants in the intervention group and 72.5% (177/244) of participants in the control group were retained. The overall treatment adherence improved significantly in the intervention group compared with the control group, reflected by a small effect size (d=0.27; 95% CI 0.032 to 0.509; P=.03). When considering changes in separate treatment behaviors, a significant decrease was observed only in caloric intake from unhealthy snacks in comparison with the control group (d=0.36; 95% CI 0.136 to 0.584; P=.002). For adherence to PA (d=−0.14; 95% CI −0.388 to 0.109; P=.27), OHAs (d=0.27; 95% CI −0.027 to 0.457; P=.08), and insulin therapy (d=0.35; 95% CI −0.066 to 0.773; P=.10), no significant changes were observed. These results from the unadjusted analyses were comparable with the results of the adjusted analyses, the per-protocol analyses, and the sensitivity analyses. Conclusions Our multibehavior program significantly improved the overall treatment adherence compared with the control group. To further enhance the impact of the intervention in the personal, societal, and economic areas, a wide-scale implementation of our eHealth intervention is suggested. Trial Registration Netherlands Trial Register NL664; https://www.trialregister.nl/trial/6664
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Affiliation(s)
- Stan Vluggen
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
| | - Math Candel
- Department of Methodology and Statistics, Maastricht University, Maastricht, Netherlands
| | - Ciska Hoving
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
| | - Nicolaas C Schaper
- Department of Endocrinology and Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
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19
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Ramo DE, Thrul J, Vogel EA, Delucchi K, Prochaska JJ. Multiple Health Risk Behaviors in Young Adult Smokers: Stages of Change and Stability over Time. Ann Behav Med 2021; 54:75-86. [PMID: 31157881 DOI: 10.1093/abm/kaz025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Health risk behaviors (HRBs) are common, yet not well understood in young adult smokers. PURPOSE We examined HRB profiles over 12 months in young adult smokers participating in a Facebook smoking cessation intervention clinical trial. METHODS Participants (N = 500; age M = 20.9 years; 54.6% women) were recruited online and randomized to receive either a 3-month Facebook smoking cessation intervention or referral to Smokefree.gov (control). A Health Risk Assessment determined risk for 10 behaviors at baseline and 3, 6, and 12 months. Latent class analysis (LCA) and latent transition analysis (LTA) were used to identify patterns of HRBs and changes over time. RESULTS At baseline, participants reported an average of 5.4 (standard deviation [SD] = 1.7) risk behaviors, including smoking (100%), high-fat diet (84.8%), poor sleep hygiene (71.6%), and low fruit and vegetable intake (69.4%). A 3-class model fit the data best at baseline and all follow-up time points: low risk (28.8% at baseline) with low likelihood of risk on all behaviors except smoking, substance use risk (14.0% at baseline) characterized by heavy episodic drinking, cannabis use, and other illicit drug use, and metabolic risk (57.2% at baseline), with a high percentage of members at risk for a low fruit and vegetable intake, high-fat diet, inactivity, stress, and poor sleep hygiene. Classes were very stable at 3, 6, and 12 months, with few participants transitioning between classes. CONCLUSIONS Most young adult smokers engaged in multiple risk behaviors, with meaningful clustering of behaviors, and demonstrated stability over a year's time. In addition to smoking, targets for intervention are co-occurring substance use and metabolic risk behaviors. CLINICAL TRIALS REGISTRATION NCT02207036.
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Affiliation(s)
- Danielle E Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, Suite, San Francisco, CA, USA.,Hopelab, San Francisco, CA, USA
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Erin A Vogel
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, Suite, San Francisco, CA, USA
| | - Kevin Delucchi
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, Suite, San Francisco, CA, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
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20
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Shi Z, Chang J, Ma X, Yin F, Ma M, Li W, Zhu B, Ai Z, Zhao X. The Psychometric Properties of General Adherence Scale in Chinese (GAS-C) in Patients with Type 2 Diabetes Using Insulin. Diabetes Metab Syndr Obes 2021; 14:801-811. [PMID: 33654418 PMCID: PMC7910110 DOI: 10.2147/dmso.s286153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/08/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Translate General Adherence Scale (GAS) into Chinese and test its psychometric properties in middle-aged and elderly type 2 diabetes (T2D) patients using insulin in the Han people of urban China. SUBJECTS AND METHODS We translated the GAS into Chinese and established General Adherence Scale in Chinese (GAS-C). 136 T2D subjects were selected for testing GAS-C's reliability and validity, of which 100 study subjects were retested with GAS-C two weeks later. The other 200 T2D subjects were selected for performing Confirmatory Factor Analysis(CFA). The ceiling effect and floor effect of GAS-C data were checked. RESULTS No data was lost in our research. In exploratory factor analysis(EFA), the Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) =0.899, Bartlett's Test's χ2=611.821 (df=10 p<0.001). The communalities of the items were between 0.740 and 0.862; The values of Measure of Sampling Adequacy (MSA) were between 0.883 and 0.945. All five items entered the factor analysis process. A common factor was extracted, and it could explain 81.403% of the total variance. CFA validated the.one-factor model was good fits with the data of GAS-C (Ratio of Chi-square to Degrees of Freedom (CMIN/DF)=2.032, Goodness of Fit Index (GFI) =0.981, Comparative Fit Index (CFI) =0.996, Tucker-Lewis Index (TLI) =0.992, Root Mean Square Residual (RMR) =0.011, Root Mean Square Error of Approximation (RMSEA) =0.072). Correlation analysis was performed between GAS-C and MMAS-8 to calculate the criterion-related validity (r=0.542 p<0.001). The internal consistency reliability α=0.942, Intraclass Correlation Coefficient (ICC)= 0.941 (95% CI 0.924-0.955). The correlation coefficient r of the test-retest reliability was 0.772 (p<0.001). Spearman-Brown coefficient of split-half was 0.939. There was no floor effect and ceiling effect on the data. CONCLUSION GAS-C has good reliability and validity. It can be used for general adherence studies of middle-aged and elderly type 2 diabetic patients using insulin in the Han people of Chinese cities.
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Affiliation(s)
- Zhidao Shi
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
- Correspondence: Zhidao Shi; Xudong Zhao Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, 165 San-Lin Road, Shanghai, 200124, People’s Republic of China; Email ;
| | - Jingzhi Chang
- Department of Preventive Medicine, School of Public Health, Jiamusi University, Jiamusi, Heilongjiang Province, People’s Republic of China
| | - Xiquan Ma
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Feiyan Yin
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Min Ma
- Clinical Psychology Department, Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, People’s Republic of China
| | - Wentian Li
- Clinical Psychology Department, Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, People’s Republic of China
| | - Binggen Zhu
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - ZiSheng Ai
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
- Department of Medical Statistics, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Xudong Zhao
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China
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Jeon YJ, Pyo J, Park YK, Ock M. Health behaviors in major chronic diseases patients: trends and regional variations analysis, 2008-2017, Korea. BMC Public Health 2020; 20:1813. [PMID: 33246439 PMCID: PMC7694307 DOI: 10.1186/s12889-020-09940-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 11/19/2020] [Indexed: 12/20/2022] Open
Abstract
Background Improving the health behaviors of those with chronic diseases such as hypertension and diabetes is important for disease management. Few in-depth studies have been conducted in Korea on the health behaviors of chronic disease patients. This study examined the health behaviors of chronic disease patients over time and compared them with those of the general population. Methods Cross-sectional time-series data obtained from the Korea Community Health Survey from 2008 to 2017 were analyzed. Thirteen diseases were included in this analysis, namely, hypertension, diabetes, dyslipidemia, stroke, myocardial infarction, angina, osteoarthritis, osteoporosis, asthma, allergic rhinitis, atopic dermatitis, cataract, and depression. The current smoking rate, drinking rate, and the walking rate, which are leading health behaviors necessary for preventing chronic diseases, were analyzed by disease type. We compared patients’ health behaviors with those of the general population and identified regional variations. Results Although the current overall smoking rate was seemingly declining, the overall monthly drinking and high-risk drinking rates were increasing. In 2017, patients experiencing depression symptoms had a higher smoking rate than did the general population; hypertension and diabetes patients had a higher risk-drinking rate than did the latter. The general population’s walking rate was highest. There were considerable variations by region among chronic disease patients. Conclusions Chronic disease patients displayed worse health behaviors than those of the general population, in some instances. Rather than focusing only on chronic disease patients’ medication adherence, strategies must be devised to increase their smoking cessation rate, decrease their drinking rate, and increase their walking rate. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09940-7.
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Affiliation(s)
- Young-Jee Jeon
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea
| | - Young-Kwon Park
- Preventive Medicine Center, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea. .,Preventive Medicine Center, Ulsan University Hospital, Ulsan, Republic of Korea.
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22
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Pérez Unanua MP, Alonso Fernández M, López Simarro F, Soriano Llora T, Peral Martínez I, Mancera Romero J. [Adherence to healthy lifestyle behaviours in patients with type 2 diabetes in Spain]. Semergen 2020; 47:161-169. [PMID: 33160855 DOI: 10.1016/j.semerg.2020.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/03/2020] [Accepted: 08/09/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to report on the main lifestyle components and related factors in adults with diabetes type 2 treated in Primary Care clinics in Spain. MATERIAL AND METHODS A cross-sectional and multicentre study was performed on a consecutive sample of patients with type 2 diabetes attending 25 Primary Care clinics between April 2018 and April 2019. Data were collected by auditing the computerised medical records, and an interview. An analysis was carried out on adherence to 4 healthy lifestyle trends (Mediterranean diet, regular exercise, not smoking, and emotional well-being). RESULTS A total of 412 patients were included in the analysis (mean age 69 (SD 8.65) years; 50.2% men). Only a minority was highly adherent to the Mediterranean diet, 92 (22.3%). Regular physical activity was carried out by 189 (45.8%). A total of 361 (87.6%) were non-smoking, and 259 (62.8%) felt emotional well-being. A small number (9, 2.1%) of patients had not followed any of the healthy lifestyle recommendations, with 87 (21.1%) following one, 145 (35.1%) two, 128 (31%) three, and 43 (10.4%) all 4 healthy habits: diet, exercise, not smoking, and emotional well-being. Healthy lifestyle adherence was related to gender. Obesity is poorly associated with adherence to diet and physical activity. The results for age, time with the disease, socioeconomic status, and treatment regimen were not consistent. CONCLUSIONS This study suggest that adherence to a healthy lifestyle pattern in DM2 is low. Less than a quarter follow a healthy diet, and less than a half practice regular exercise. Gender is the variable that most influences a healthy lifestyle in DM2, but not age, time with the disease, or treatment regimen.
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Affiliation(s)
| | | | - F López Simarro
- Área Básica de Salud Martorell, Martorell, Barcelona, España
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23
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Mahmood R, Kayani WK, Ahmed T, Malik F, Hussain S, Ashfaq M, Ali H, Rubnawaz S, Green BD, Calderwood D, Kenny O, Rivera GA, Mirza B, Rasheed F. Assessment of antidiabetic potential and phytochemical profiling of Rhazya stricta root extracts. BMC Complement Med Ther 2020; 20:293. [PMID: 32993632 PMCID: PMC7523044 DOI: 10.1186/s12906-020-03035-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
Background Diabetes mellitus is a chronic disease characterized by hyperglycemia that may occur due to genetic, environmental or lifestyle factors. Natural remedies have been used to treat diabetes since long and many antidiabetic compounds of varied efficacies have been isolated from medicinal plants. Rhazya stricta has been used for decades for the treatment of diabetes mellitus and associated ailments. Considering the folkloric use of R. stricta against diabetes, it was aimed to investigate the effectiveness of its root extracts against diabetes through in vitro assays and in vivo studies using animal model along with phytochemical profiling through GCMS. Methods Various fractions of Rhazya stricta obtained through column chromatography were evaluated for a variety of assays including α-glucosidase, Dipeptidyl peptidase-IV (DPP-IV), β-secretase and Glucagon-like peptide-1 (GLP-1) secretion studies. For the in vivo studies the alloxan-induced diabetic mice were treated with root extracts and blood glucose levels, HbA1C, and other biochemical markers along with the histological study of the liver were done. The phytochemical identification was performed using an Agilent 7890B GC coupled to a 7010 Triple Quadrupole (MS/MS) system. GraphPad Prism software version 5.01 was used for statistical analysis. Results Majority of the extract fractions showed excellent results against diabetes by inhibiting enzymes DPP-IV (Up to 61%) and β-secretase (Up to 83%) with IC50s 979 μg/ml and 169 μg/ml respectively with increase in the GLP1 secretion. The results of in vivo studies indicated a marked reduction in blood glucose and HbA1c levels along with positive effects on other parameters like lipid profile, liver functions and renal functions of extract-treated mice as compared to control. The histological examination of the liver demonstrated hepatoprotective effects against diabetes led changes and various classes of phytochemicals were also identified through GCMS in different fractions. Conclusion The results revealed strong antidiabetic activity of R. stricta root with the potential to protect body organs against diabetic changes. Moreover, a variety of phytochemicals has also been identified through GCMS that might be responsible for the antidiabetic potential of Rhazya stricta root. Graphical abstract ![]()
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Affiliation(s)
- Rashid Mahmood
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.,Drugs Control & Traditional Medicines Division, National Institute of Health, Islamabad, Pakistan
| | - Waqas Khan Kayani
- Department of Plant Breeding, Swedish University of Agricultural Sciences, Växtskyddsvägen 1, SE-230 53 Alnarp, Uppsala, Sweden
| | - Tanveer Ahmed
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Farnaz Malik
- Drugs Control & Traditional Medicines Division, National Institute of Health, Islamabad, Pakistan
| | - Shahzad Hussain
- Drugs Control & Traditional Medicines Division, National Institute of Health, Islamabad, Pakistan
| | - Muhammad Ashfaq
- Drugs Control & Traditional Medicines Division, National Institute of Health, Islamabad, Pakistan
| | - Hussain Ali
- Animal House, National Institute of Health, Islamabad, Pakistan
| | - Samina Rubnawaz
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Brian D Green
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Danielle Calderwood
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Owen Kenny
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Gerardo A Rivera
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Bushra Mirza
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Faiza Rasheed
- KTH Royal Institute of Technology, School of Chemical Science and Engineering, SE-100 44, Stockholm, Sweden.
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24
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Healthy lifestyle and risk of incident heart failure with preserved and reduced ejection fraction among post-menopausal women: The Women's Health Initiative study. Prev Med 2020; 138:106155. [PMID: 32473271 DOI: 10.1016/j.ypmed.2020.106155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/16/2020] [Accepted: 05/22/2020] [Indexed: 01/09/2023]
Abstract
We examined associations of diet, physical activity, cigarette smoking, and body mass index (BMI), separately and as a cumulative lifestyle score, with incident hospitalized HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). This analysis included 40,095 postmenopausal women in the Women's Health Initiative clinical trial and observational studies, aged 50-79 years and without self-reported HF at baseline. A healthy lifestyle score (HLS) was developed, in which women received 1 point for each healthy lifestyle. A weighted HLS was also created to examine the independent magnitude of each of the lifestyle factors in HF subtypes. Trained adjudicators determined cases of incident hospitalized HF, HFpEF, HFrEF through March 2018. Multiple variable Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). During a mean follow-up period of 14.5 years, 659 incident HFrEF and 1276 HFpEF cases were documented. Across unweighted HLS of 0 (referent), 1, 2, 3, and 4, multivariable adjusted HRs (95% CI) for HFrEF were 1.00, 0.52 (0.38, 0.71), 0.40 (0.29, 0.56), 0.33 (0.23, 0.48), and 0.33 (0.19, 0.56) (P-trend = 0.03) and for HFpEF were 1.00, 0.47 (0.37, 0.59), 0.39 (0.30, 0.49), 0.26 (0.20, 0.34), and 0.23 (0.15, 0.35) (P-trend < 0.001). Results were similar for the weighted HLS. Our findings suggest that following a healthy lifestyle pattern is associated with lower risks of HFpEF and HFrEF among postmenopausal women.
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25
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Lifestyle risk score and mortality in Korean adults: a population-based cohort study. Sci Rep 2020; 10:10260. [PMID: 32581249 PMCID: PMC7314763 DOI: 10.1038/s41598-020-66742-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/19/2020] [Indexed: 11/30/2022] Open
Abstract
Individual lifestyle risk factors have been associated with an increased risk of mortality. However, limited evidence is available on the combined association of lifestyle risk factors with mortality in non-Western populations. The analysis included 37,472 participants (aged ≥19 years) in the Korea National Health and Nutrition Examination Surveys (2007–2014) for whom the data were linked to death certificates/medical records through December 2016. A lifestyle risk score was created using five unhealthy behaviors: current smoking, high-risk alcohol drinking, unhealthy weight, physical inactivity, and insufficient/prolonged sleep. Cox proportional hazards models were used to estimate hazard ratio (HR) and 95% confidence interval (CI). During up to 9 years of follow-up, we documented 1,057 total deaths. Compared to individuals with zero lifestyle risk factor, those with 4–5 lifestyle risk factors had 2.01 times (HR = 2.01, 95% CI = 1.43–2.82) and 2.59 times (HR = 2.59, 95% CI = 1.24–5.40) higher risk of all-cause and cardiovascular mortality, respectively. However, higher lifestyle risk score was not significantly associated with cancer mortality (p-trend >0.05). In stratified analyses, the positive associations tended to be stronger in adults aged <65 years, unemployed, and those with lower levels of education. In conclusion, combined unhealthy lifestyle behaviors were associated with substantially increased risk of total and cardiovascular mortality in Korean adults.
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26
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Hing M, Hoffman RM, Seleman J, Chibwana F, Kahn D, Moucheraud C. 'Blood pressure can kill you tomorrow, but HIV gives you time': illness perceptions and treatment experiences among Malawian individuals living with HIV and hypertension. Health Policy Plan 2020; 34:ii36-ii44. [PMID: 31723966 DOI: 10.1093/heapol/czz112] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2019] [Indexed: 01/03/2023] Open
Abstract
Non-communicable diseases like hypertension are increasingly common among individuals living with HIV in low-resource settings. The prevalence of hypertension among people with HIV in Malawi, e.g. has been estimated to be as high as 46%. However, few qualitative studies have explored the patient experience with comorbid chronic disease. Our study aimed to address this gap by using the health belief model (HBM) to examine how comparative perceptions of illness and treatment among participants with both HIV and hypertension may affect medication adherence behaviours. We conducted semi-structured interviews with 75 adults with HIV and hypertension at an urban clinic in Lilongwe, Malawi. Questions addressed participants' experiences with antiretroviral and antihypertensive medications, as well as their perspectives on HIV and hypertension as illnesses. Interviews were performed in Chichewa, transcribed, translated into English and analysed using ATLAS.ti. Deductive codes were drawn from the HBM and interview guide, with inductive codes added as they emerged from the data. Self-reported medication adherence was much poorer for hypertension than HIV, but participants saw hypertension as a disease at least as concerning as HIV-primarily due to the perceived severity of hypertension's consequences and participants' limited ability to anticipate them compared with HIV. Differences in medication adherence were attributed to the high costs of antihypertensive medications relative to the free availability of antiretroviral therapy, with other factors like lifestyle changes and self-efficacy also influencing adherence practices. These findings demonstrate how participants draw on past experiences with HIV to make sense of hypertension in the present, and suggest that although patients are motivated to control their hypertension, they face individual- and system-level obstacles in adhering to treatment. Thus, health policies and systems seeking to provide integrated care for HIV and hypertension should be attentive to the complex illness experiences of individuals living with these diseases.
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Affiliation(s)
- Matthew Hing
- Department of Medicine, University of California Los Angeles, David Geffen School of Medicine, Le Conte Ave, Los Angeles, CA, USA
| | - Risa M Hoffman
- Department of Medicine, University of California Los Angeles, David Geffen School of Medicine, Le Conte Ave, Los Angeles, CA, USA
- Partners in Hope, (Area 36/Plot 8), Lilongwe, Malawi
| | | | | | - Daniel Kahn
- Department of Medicine, University of California Los Angeles, David Geffen School of Medicine, Le Conte Ave, Los Angeles, CA, USA
| | - Corrina Moucheraud
- Department of Health Policy and Management, University of California Los Angeles, Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA, USA
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27
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Dieteren CM, Brouwer WBF, van Exel J. How do combinations of unhealthy behaviors relate to attitudinal factors and subjective health among the adult population in the Netherlands? BMC Public Health 2020; 20:441. [PMID: 32245376 PMCID: PMC7126128 DOI: 10.1186/s12889-020-8429-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background Health behaviours like smoking, nutrition, alcohol consumption and physical activity (SNAP) are often studied separately, while combinations can be particularly harmful. This study aims to contribute to a better understanding of lifestyle choices by studying the prevalence of (combinations of) unhealthy SNAP behaviours in relation to attitudinal factors (time orientation, risk attitude) and subjective health (self-rated health, life expectancy) among the adult Dutch population. Methods In total 1006 respondents, representative of the Dutch adult population (18–75 years) in terms of sex, age, and education, were drawn from a panel in 2016. They completed an online questionnaire. Groups comparisons and logistic regression analyses (crude and adjusted) were applied to analyse (combinations of) SNAP behaviours in relation to time orientation (using the Consideration of Future Consequences scale comprising Immediate (CFC-I) and Future (CFC-F) scales) and risk attitude (Health-Risk Attitude Scale; HRAS-6), as well as subjective health (visual analogue scale and subjective life expectancy). Results In the analyses, 989 respondents (51% men, average 52 years, 22% low, 48% middle, and 30% high educated) were included. About 8% of respondents engaged in four unhealthy SNAP behaviours and 18% in none. Self-rated health varied from 5.5 to 7.6 in these groups, whilst subjective life expectancy ranged between 73.7 and 85.5 years. Logistic regression analyses, adjusted for socio-demographic variables, showed that smoking, excessive drinking and combining two or more unhealthy SNAP behaviours were significantly associated with CFC-I scores, which increased the odds by 30%, 18% and 19%, respectively. Only physical inactivity was significantly associated with CFC-F scores, which increased the odds by 20%. Three out of the four SNAP behaviours were significantly associated with HRAS-6, which increased the odds between 6% and 12%. An unhealthy diet, excessive drinking, and physical inactivity were significantly associated with SRH, which decreased the odds by 11%. Only smoking was significantly associated with subjective life expectancy, which decreased the odds by 3%. Conclusion Our findings suggest that attitudinal factors and subjective health are relevant in the context of understanding unhealthy SNAP behaviours and their clustering. This emphasizes the relevance of a holistic approach to health prevention rather than focusing on a single unhealthy SNAP behaviour.
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Affiliation(s)
- Charlotte M Dieteren
- Erasmus University Rotterdam, Erasmus School of Health Policy & Management, P.O. Box 1738, 3000, DR, Rotterdam, the Netherlands.
| | - Werner B F Brouwer
- Erasmus University Rotterdam, Erasmus School of Health Policy & Management, P.O. Box 1738, 3000, DR, Rotterdam, the Netherlands.,Erasmus University Rotterdam, Erasmus School of Economics, Rotterdam, The Netherlands
| | - Job van Exel
- Erasmus University Rotterdam, Erasmus School of Health Policy & Management, P.O. Box 1738, 3000, DR, Rotterdam, the Netherlands.,Erasmus University Rotterdam, Erasmus School of Economics, Rotterdam, The Netherlands
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28
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Limited Improvements in Health Behaviors Suggest Need to Review Approaches to Health Promotion: A Repeated, Cross-Sectional Study. Am J Lifestyle Med 2020; 16:521-526. [DOI: 10.1177/1559827620909378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose. To broadly assess changes in key health behaviors (physical activity, fruit and vegetable consumption, smoking, and alcohol consumption) and one outcome (body mass index) between 2001-2006 and 2011-2016. Design. Repeated cross-sectional study. Setting. The United States of America. Participants. Noninstitutionalized adults age 24 to 39 participating in the National Health and Nutrition Examination Survey. Analysis. We used 2-sample t tests and χ2 tests to compare differences in health behaviors between the 2 time periods. Results. Data revealed a downward trend in both moderate and vigorous physical activity (P = .00), and fruit and vegetable consumption decreased (P = .003). Cigarette smoking decreased (P = .04), and there was no substantive change in heavy drinking between the 2 time periods. Body mass index was higher in the later time period (P = .00). Conclusion. Despite sustained funding efforts, we found little evidence that health behaviors improved between the 2 time periods. Indeed, many health behaviors have remained the same or worsened over time. These findings suggest the need to reflect on the appropriateness of the health promotion approaches being used.
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Derington CG, King JB, Bryant KB, McGee BT, Moran AE, Weintraub WS, Bellows BK, Bress AP. Cost-Effectiveness and Challenges of Implementing Intensive Blood Pressure Goals and Team-Based Care. Curr Hypertens Rep 2019; 21:91. [PMID: 31701259 DOI: 10.1007/s11906-019-0996-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW Review the effectiveness, cost-effectiveness, and implementation challenges of intensive blood pressure (BP) control and team-based care initiatives. RECENT FINDINGS Intensive BP control is an effective and cost-effective intervention; yet, implementation in routine clinical practice is challenging. Several models of team-based care for hypertension management have been shown to be more effective than usual care to control BP. Additional research is needed to determine the cost-effectiveness of team-based care models relative to one another and as they relate to implementing intensive BP goals. As a focus of healthcare shifts to value (i.e., cost, effectiveness, and patient preferences), formal cost-effectiveness analyses will inform which team-based initiatives hold the highest value in different healthcare settings with different populations and needs. Several challenges, including clinical inertia, financial investment, and billing restrictions for pharmacist-delivered services, will need to be addressed in order to improve public health through intensive BP control and team-based care.
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Affiliation(s)
- Catherine G Derington
- Department of Pharmacy, Kaiser Permanente Colorado, Aurora, CO, USA.,Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA
| | - Jordan B King
- Department of Population Health Sciences, School of Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA.,Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, 84112, USA
| | - Kelsey B Bryant
- Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Blake T McGee
- Byrdine F. Lewis College of Nursing & Health Professions, Georgia State University, Atlanta, GA, USA
| | - Andrew E Moran
- Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | | | - Brandon K Bellows
- Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Adam P Bress
- Department of Population Health Sciences, School of Medicine, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA.
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30
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Vluggen S, Hoving C, Schaper NC, De Vries H. Psychological predictors of adherence to oral hypoglycaemic agents: an application of the ProMAS questionnaire. Psychol Health 2019; 35:387-404. [PMID: 31588778 DOI: 10.1080/08870446.2019.1672873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: This study aimed to identify psychological predictors of oral hypoglycaemic agent (OHA) adherence and to compare adherence rates between a novel and well-known instrument, i.e. the Probabilistic Medication Adherence Scale (ProMAS) and Medication Adherence Report Scale (MARS-5).Design and main outcome measures: A longitudinal study design was applied with surveys at baseline and 6-month follow-up. At baseline, OHA adherence using the ProMAS and MARS-5, socio-cognitive determinants and demographics were assessed. At follow-up, the ProMAS was applied as outcome measure, on which socio-cognitive determinants and demographics were regressed using linear regression analysis.Results: The baseline and follow-up sample included 304 and 231 participants, respectively. When applying cut-off points of ≥15 for the ProMAS and ≥23 for the MARS-5, 47.4 and 89.5% adhered to their OHAs. Consistent predictors of better adherence comprised a low education, lower severity perceptions, and higher self-efficacy and intention. After correcting for baseline adherence, a low education and higher self-efficacy remained significant adherence predictors.Conclusions: Compared to the MARS-5, ProMAS data was less skewed, similar to objectively collected data, and yielded insights in a broader spectrum of (non)-adherence behaviours. Results stress the need for adherence improving interventions which particularly should target higher educated patients and patients with low self-efficacy, low intention and high severity perceptions.
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Affiliation(s)
- Stan Vluggen
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Ciska Hoving
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Department of Endocrinology and Internal Medicine, School CAPHRI, University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Hein De Vries
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands
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31
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Gayer BA, Avendano EE, Edelson E, Nirmala N, Johnson EJ, Raman G. Effects of Intake of Apples, Pears, or Their Products on Cardiometabolic Risk Factors and Clinical Outcomes: A Systematic Review and Meta-Analysis. Curr Dev Nutr 2019; 3:nzz109. [PMID: 31667463 PMCID: PMC6813372 DOI: 10.1093/cdn/nzz109] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/06/2019] [Accepted: 09/27/2019] [Indexed: 12/20/2022] Open
Abstract
Apples and pears contain nutrients that have been linked to cardiovascular health. We conducted a systematic review and meta-analysis to summarize related research. Medline, Cochrane Central, and Commonwealth Agricultural Bureau databases were searched for publications on apple or pear intake and cardiovascular disease (CVD)/ cardiometabolic disease (CMD). Studies in adults (healthy or at risk for CVD) that quantified apple or pear intake were included. Random-effects models meta-analysis was used when ≥3 studies reported the same outcome. In total, 22 studies were eligible including 7 randomized controlled trial, 1 nonrandomized trial, and 14 prospective observational studies. In RCTs, apple intake significantly decreased BMI, but made no difference in body weight, serum lipids, blood glucose, or blood pressure. In observational studies, apple or pear intake significantly decreased risk of cerebrovascular disease, cardiovascular death, type 2 diabetes mellitus, and all-cause mortality. No association was reported for cerebral infarction or intracerebral hemorrhage. In conclusion, apple or pear intake significantly decreased BMI and risk for CVD outcomes.
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Affiliation(s)
- Bridget A Gayer
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Esther E Avendano
- Institute for Clinical Research and Health Policy Studies, Center for Clinical Evidence Synthesis, Tufts Medical Center, Boston, MA
| | - Emily Edelson
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Nanguneri Nirmala
- Institute for Clinical Research and Health Policy Studies, Center for Clinical Evidence Synthesis, Tufts Medical Center, Boston, MA
| | - Elizabeth J Johnson
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Gowri Raman
- Institute for Clinical Research and Health Policy Studies, Center for Clinical Evidence Synthesis, Tufts Medical Center, Boston, MA
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32
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Johnson PJ, Jou J, Rockwood TH, Upchurch DM. Perceived Benefits of Using Complementary and Alternative Medicine by Race/Ethnicity Among Midlife and Older Adults in the United States. J Aging Health 2019; 31:1376-1397. [PMID: 29900809 PMCID: PMC8048740 DOI: 10.1177/0898264318780023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To describe, for a national sample of midlife and older adults, the types of complementary and alternative medicine (CAM) used for health and wellness and the perceived benefits of CAM use by race/ethnicity. Method: Using data from the 2012 National Health Interview Survey, we ran multiple logistic regression models to estimate the odds of each perceived benefit among adults ages 50 and older. Results: More than 38% of midlife and older adults used CAM in the past year. For six of seven perceived benefits examined, we found significant differences by race/ethnicity, with each group having higher odds of two or more perceived benefits compared with non-Hispanic Whites. Discussion: Although racial/ethnic minority groups are less likely to use CAM compared with non-Hispanic Whites, those who use CAM perceive great benefit. Future research should examine the potential contribution of evidence-based CAM to promoting health and well-being in a diverse aging population.
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Affiliation(s)
| | - Judy Jou
- University of California, Los Angeles, USA
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Vallis M, Lee-Baggley D, Sampalli T, Shepard D, McIssaac L, Ryer A, Ryan-Carson S, Manley S. Integrating behaviour change counselling into chronic disease management: a square peg in a round hole? A system-level exploration in primary health care. Public Health 2019; 175:43-53. [PMID: 31382084 DOI: 10.1016/j.puhe.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/31/2019] [Accepted: 06/19/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The objective of this study is to evaluate the uptake of competency-based behaviour change counselling training within a primary healthcare setting. Specific questions concerning provider readiness for training, perceived importance of training in the context of service demands and perceptions of competence after training were addressed. STUDY DESIGN A process-focused study which adopted a complex systems approach to implementation. Each step was evaluated before the next step was developed. The design was guided by the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. METHODS Four specific primary care services were identified and behaviour change counselling training tailored to each service was provided, based on a model of training built around competencies in establishing change-based relationships, assessing and promoting readiness to change, using evidence-based behaviour modification skills when ready and addressing psychosocial determinants of behaviour within scope of practice. Before training, a manager's readiness to facilitate training and identification of peer leaders to support ongoing practice of skills were completed. RESULTS Two programs negotiated 8 h of formal training, one program received 10 h and one program received 12 h. All programs engaged in peer support activities. Despite willingness to support training, 90% of managers were ambivalent about training activities, relative to one half of healthcare providers (HCPs). Few HCPs and no managers self-identified as ready without ambivalence. Furthermore, HCPs were reluctant to be evaluated by an expert and preferred self-evaluation methods. In contrast, HCPs uniformly endorsed the relevance, value and professional commitment to all component skills of the behaviour change counselling model. At the end of the training, over 75% of staff reported receiving formal training (reach). Almost 80% of staff reported using change-based relationship skills daily, with less frequent use of skills associated with addressing psychosocial issues. The degree of corrective feedback was generally low, however. An index of competency based on formal training, frequent use and receiving corrective feedback indicated that most HCPs did not meet these criteria. CONCLUSION Training in behaviour change counselling competencies was successfully implemented in this project. The vast majority of HCPs received training, despite ambivalence. Furthermore, HCPs strongly valued these skills and used them frequently. However, they were reluctant to accept corrective feedback. Future research is needed to evaluate innovative strategies to overcome obstacles to receiving corrective feedback in the use of behaviour change counselling skills.
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Affiliation(s)
- M Vallis
- Nova Scotia Health Authority, Canada; Family Medicine, Dalhousie University, Canada.
| | - D Lee-Baggley
- Nova Scotia Health Authority, Canada; Family Medicine, Dalhousie University, Canada
| | | | - D Shepard
- Nova Scotia Health Authority, Canada
| | | | - A Ryer
- Nova Scotia Health Authority, Canada
| | | | - S Manley
- Nova Scotia Health Authority, Canada
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Shen A. Religious Attendance, Healthy Lifestyles, and Perceived Health: A Comparison of Baby Boomers with the Silent Generation. JOURNAL OF RELIGION AND HEALTH 2019; 58:1235-1245. [PMID: 30467618 DOI: 10.1007/s10943-018-0736-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Baby boomers are aging, and their health is an important concern. Research has suggested that (1) aging boomers are more vulnerable to mental and physical health problems than their parents' generation; (2) adoption of healthy lifestyles is critically important for the health of the aging population; and (3) religious attendance, often found to be associated with health-related outcomes, is lower among aging boomers than their parents' generation. In this research, we use a large national dataset to examine (1) whether the baby boom generation lags behind their parents' generation in adoption of healthy lifestyles and perceived health; and (2) if it does, whether the lag might possibly be attributed to lower religious attendance. We analyzed data collected by University of Michigan's Health and Retirement Study from the silent generation in 1994 and from the baby boom generation in 2010 when both generation cohorts were at about the same age (age 49-64 years). The results indicated that (1) the baby boom generation lagged behind the silent generation in adoption of three healthy lifestyles (not smoking, not drinking excessively, and not being overweight or obese) and in perceived health; (2) the lag may be partially attributed to lower religious attendance in the baby boom generation. We also discuss implications for the health of the baby boom generation and for promoting healthy lifestyles and health to the baby boom generation.
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Affiliation(s)
- Anyuan Shen
- School of Business, State University of New York at New Paltz, New Paltz, USA.
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Park YMM, White AJ, Jackson CL, Weinberg CR, Sandler DP. Association of Exposure to Artificial Light at Night While Sleeping With Risk of Obesity in Women. JAMA Intern Med 2019; 179:1061-1071. [PMID: 31180469 PMCID: PMC6563591 DOI: 10.1001/jamainternmed.2019.0571] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Short sleep has been associated with obesity, but to date the association between exposure to artificial light at night (ALAN) while sleeping and obesity is unknown. OBJECTIVE To determine whether ALAN exposure while sleeping is associated with the prevalence and risk of obesity. DESIGN, SETTING, AND PARTICIPANTS This baseline and prospective analysis included women aged 35 to 74 years enrolled in the Sister Study in all 50 US states and Puerto Rico from July 2003 through March 2009. Follow-up was completed on August 14, 2015. A total of 43 722 women with no history of cancer or cardiovascular disease who were not shift workers, daytime sleepers, or pregnant at baseline were included in the analysis. Data were analyzed from September 1, 2017, through December 31, 2018. EXPOSURES Artificial light at night while sleeping reported at enrollment, categorized as no light, small nightlight in the room, light outside the room, and light or television in the room. MAIN OUTCOMES AND MEASURES Prevalent obesity at baseline was based on measured general obesity (body mass index [BMI] ≥30.0) and central obesity (waist circumference [WC] ≥88 cm, waist-to-hip ratio [WHR] ≥0.85, or waist-to-height ratio [WHtR]≥0.5). To evaluate incident overweight and obesity, self-reported BMI at enrollment was compared with self-reported BMI at follow-up (mean [SD] follow-up, 5.7 [1.0] years). Generalized log-linear models with robust error variance were used to estimate multivariable-adjusted prevalence ratios (PRs) and relative risks (RRs) with 95% CIs for prevalent and incident obesity. RESULTS Among the population of 43 722 women (mean [SD] age, 55.4 [8.9] years), having any ALAN exposure while sleeping was positively associated with a higher prevalence of obesity at baseline, as measured using BMI (PR, 1.03; 95% CI, 1.02-1.03), WC (PR, 1.12; 95% CI, 1.09-1.16), WHR (PR, 1.04; 95% CI, 1.00-1.08), and WHtR (PR, 1.07; 95% CI, 1.04-1.09), after adjusting for confounding factors, with P < .001 for trend for each measure. Having any ALAN exposure while sleeping was also associated with incident obesity (RR, 1.19; 95% CI, 1.06-1.34). Compared with no ALAN, sleeping with a television or a light on in the room was associated with gaining 5 kg or more (RR, 1.17; 95% CI, 1.08-1.27; P < .001 for trend), a BMI increase of 10% or more (RR, 1.13; 95% CI, 1.02-1.26; P = .04 for trend), incident overweight (RR, 1.22; 95% CI,1.06-1.40; P = .03 for trend), and incident obesity (RR, 1.33; 95% CI, 1.13-1.57; P < .001 for trend). Results were supported by sensitivity analyses and additional multivariable analyses including potential mediators such as sleep duration and quality, diet, and physical activity. CONCLUSIONS AND RELEVANCE These results suggest that exposure to ALAN while sleeping may be a risk factor for weight gain and development of overweight or obesity. Further prospective and interventional studies could help elucidate this association and clarify whether lowering exposure to ALAN while sleeping can promote obesity prevention.
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Affiliation(s)
- Yong-Moon Mark Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Clarice R Weinberg
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
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Assessment of health-promoting lifestyle behaviors of adults living in the semi-rural area. North Clin Istanb 2019; 6:13-20. [PMID: 31180385 PMCID: PMC6526993 DOI: 10.14744/nci.2017.19327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/31/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: The aim of the present study was to determine the level of healthy lifestyle behaviors and related factors in the individuals who applied to the primary health-care center. METHODS: The study is a cross-sectional study of adults aged 18 years and over who applied to the primary health-care center. The sample size of the study was calculated as 992 people and 995 participants were accessible. The health-promoting behaviors of the individuals were assessed by the Health-Promoting Lifestyle Profile II (HPLP-II). In the analysis of the data, Mann–Whitney U-test, Kruskal–Wallis tests, and multiple linear regression analysis were used to determine effective variables on scale score. RESULTS: The mean age of the participants was 43.8±17.1. Of the total participants, 45.7% (n=455) of them were female. The median score obtained from the HPLP-II was 132. Health responsibility, nutrition, and interpersonal relations subscale scores of male were lower than female patients, while physical activity subscale scores were higher in male patients. In participants under the age of 48 years in the study, health responsibility, nutrition, interpersonal relations, and stress management subscale scores were higher. The scores of the married participants were higher than the areas out of the stress management subdimension. Stress management subscale scores were higher in individuals with primary and lower education levels in terms of health care, nutrition, and interpersonal relations. Those who had good family income status and health perception scores also received higher scores in terms of all subscale scores. CONCLUSION: Gender, age group, marital status, education level, income level, physician-diagnosed chronic disease history, and perceived health status were found to be related to health-promoting behaviors. Educational programs should be prepared in these issues by determining the issues that individuals are lacking in protecting and developing their health and social needs should be taken into consideration when these programs are being prepared.
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Johnson MI. Opinions on Paleolithic physiology living in painogenic environments: changing the perspective through which we view chronic pain. Pain Manag 2019; 9:219-224. [PMID: 31141471 DOI: 10.2217/pmt-2018-0095] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Mark I Johnson
- Centre for Pain Research, School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, West Yorkshire, LS1 3HE, UK
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Akhmedzhanov NM, Nebieridze DV, Safaryan AS. Correction of Hypercholesterolemia in Primary and Secondary Prevention of Cardiovascular Diseases: Features and Controversial Issues. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2019. [DOI: 10.20996/1819-6446-2018-14-6-917-921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The article discusses the current prevalence of hypercholesterolemia in everyday clinical practice in patients of different risk categories and approaches to its correction in the most frequently used clinical guidelines. High prevalence of hypercholesterolemia in practical health care with little change over time is shown. The existing problems of the practical implementation of the principles of a healthy lifestyle as the basis for reducing cardiovascular risk and possible solutions are described. Attention is focused on a low number of patients taking statins, and even less – reaching recommended target cholesterol levels. It is emphasized the validity of lower, compared to previous, target cholesterol levels in National recommendations on the correction of dyslipidemia in patients with proven atherosclerosis-related cardiovascular diseases as well as the feasibility in some cases of combined lipidlowering therapy (statins in combination with intestinal cholesterol absorption blockers, PCSK9 inhibitors, high doses of ethyl eicosopentaenoic acid). It is commented the need to prescribe statins in persons older than 75 years, but with a careful approach. Particular attention is paid to the use of statins in the primary prevention of cardiovascular complications. The validity of prescribing fixed moderate doses of statins for this purpose is discussed, which is both scientifically based and more realistic in practical terms.
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Exploring the potential role of mesocorticolimbic circuitry in motivation for and adherence to chronic pain self-management interventions. Neurosci Biobehav Rev 2018; 98:10-17. [PMID: 30543904 DOI: 10.1016/j.neubiorev.2018.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 12/04/2018] [Accepted: 12/08/2018] [Indexed: 12/28/2022]
Abstract
Adherence to pain self-management strategies is associated with favorable psychobehavioral outcomes among individuals with chronic pain. Substantive adherence to treatments teaching these adaptive skills often proves challenging, resulting in poor individual and societal outcomes. Evidence demonstrates motivation for behavior change as a key predictor of treatment adherence. Despite behavioral techniques that target motivation, however, nonadherence persists as a barrier to positive clinical outcomes in chronic pain. Understanding the neurobiological mechanisms underlying treatment motivation might highlight novel avenues for augmentative therapies. The purpose of this review is to present theory and evidence that the mesocorticolimbic system (i.e., brain circuitry associated with reward processing and motivation) contributes to treatment motivation among chronic pain patients, ultimately influencing adherence. We review evidence for motivation as a key adherence determinant, detail neuroimaging findings relating mesocorticolimbic circuitry and motivation, and discuss data supporting mesocorticolimbic dysfunction among chronic pain patients. We propose a neurobehavioral model for adherence to pain self-management interventions, listing testable hypotheses. Finally, we discuss potential research and intervention implications from the proposed model.
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van Marken Lichtenbelt WD, Pallubinsky H, Te Kulve M. Modulation of thermogenesis and metabolic health: a built environment perspective. Obes Rev 2018; 19 Suppl 1:94-101. [PMID: 30511507 DOI: 10.1111/obr.12789] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 09/13/2018] [Accepted: 09/13/2018] [Indexed: 01/21/2023]
Abstract
Lifestyle interventions, obviating the increasing prevalence of the metabolic syndrome, generally focus on nutrition and physical activity. Environmental factors are hardly covered. Because we spend on average more that 90% of our time indoors, it is, however, relevant to address these factors. In the built environment, the attention has been limited to the (assessment and optimization of) building performance and occupant thermal comfort for a long time. Only recently well-being and health of building occupants are also considered to some extent, but actual metabolic health aspects are not generally covered. In this review, we draw attention to the potential of the commonly neglected lifestyle factor 'indoor environment'. More specifically, we review current knowledge and the developments of new insights into the effects of ambient temperature, light and the interaction of the two on metabolic health. The literature shows that the effects of indoor environmental factors are important additional factors for a healthy lifestyle and have an impact on metabolic health.
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Affiliation(s)
- W D van Marken Lichtenbelt
- Department of Nutrition and Movement Sciences, NUTRIM Maastricht University Medical Center, Maastricht, The Netherlands
| | - H Pallubinsky
- Department of Nutrition and Movement Sciences, NUTRIM Maastricht University Medical Center, Maastricht, The Netherlands
| | - M Te Kulve
- Department of Nutrition and Movement Sciences, NUTRIM Maastricht University Medical Center, Maastricht, The Netherlands.,BBA Binnenmilieu, The Hague, The Netherlands
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Hackett RA, Moore C, Steptoe A, Lassale C. Health behaviour changes after type 2 diabetes diagnosis: Findings from the English Longitudinal Study of Ageing. Sci Rep 2018; 8:16938. [PMID: 30446674 PMCID: PMC6240033 DOI: 10.1038/s41598-018-35238-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/01/2018] [Indexed: 12/13/2022] Open
Abstract
Healthy lifestyle is key for type 2 diabetes (T2D) management. It is unclear whether individuals change health behaviours in response to T2D diagnosis. We compared smoking, physical activity, fruit and vegetable intake and alcohol consumption at three times (pre-diagnosis, at diagnosis, 2-4 years post-diagnosis) in individuals who developed T2D and controls. Behaviours were assessed in 6877 individuals at waves 3-7 of the English Longitudinal Study of Ageing. Generalized estimating equations were used to examine differences by group and time and group-by-time interactions. The T2D group were less active (p < 0.001) and consumed less alcohol (p < 0.001). Smoking (p < 0.001), alcohol consumption (p = 0.037) and physical activity (p = 0.042) decreased over time in the overall sample, fruit and vegetable intake (p = 0.012) and sedentary activity (p < 0.001) increased. A group-by-time interaction was found for smoking, with the T2D group having greater reductions in smoking over time (p < 0.001). No significant interactions were detected for other behaviours. We found limited evidence that T2D diagnosis encourages behaviour change, other than a reduction in smoking. Given the importance of lifestyle for T2D outcomes, strategies for motivating behaviour change need to be identified.
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Affiliation(s)
- Ruth A Hackett
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Catherine Moore
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Camille Lassale
- Department of Behavioural Science and Health, University College London, London, UK
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Vluggen S, Hoving C, Schaper NC, de Vries H. A web-based program to improve treatment adherence in patients with type 2 diabetes: Development and study protocol. Contemp Clin Trials 2018; 74:38-45. [PMID: 30290275 DOI: 10.1016/j.cct.2018.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many patients with type 2 diabetes mellitus (T2DM) sub-optimally adhere to core treatment recommendations, such as healthy diets, sufficient physical activity and pharmacological support. This paper describes the development of the web-based computer-tailored program My Diabetes Profile (MDP), incorporating identified success factors of web-based interventions, and the protocol for testing the effectiveness of this program in a randomized multicentre trial. METHODS Formative research - including the input of a program committee, qualitative and quantitative studies with patients and health professionals and a literature search - yielded input for the development of the MDP program. MDP provides video and text tailored advice, based on determinants and salient beliefs derived from the I-Change Model, on decreasing unhealthy snack intake, increasing physical activity, and improving adherence to both oral blood glucose lowering drugs and self-administered insulin therapy. Patients with T2DM recruited by practice nurses and diabetes nurses across the Netherlands fill in online questionnaires at baseline and six-months follow-up. Participants are randomized on patient level to the intervention group (access to the MDP program) or control group (receiving care as usual). DISCUSSION The formative research using co-creation principles proved essential in the development of the MDP program and involved various disciplines in T2DM management including target group representatives. Co-creation revealed clearly that patients needed short and attractive messages. Consequently, a mix of video and short text messages were chosen for the ultimate program format. Pilot testing was useful to further shape the program to needs of patients and professionals. TRIAL REGISTRATION Dutch Trial Register NTR6840; Archived program website: http://www.webcitation.org/6xXz01S7X.
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Affiliation(s)
- S Vluggen
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands.
| | - C Hoving
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands.
| | - N C Schaper
- Department of Endocrinology and Internal Medicine, School CAPHRI, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
| | - H de Vries
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands.
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Sackner MA, Patel S, Adams JA. Changes of blood pressure following initiation of physical inactivity and after external addition of pulses to circulation. Eur J Appl Physiol 2018; 119:201-211. [PMID: 30350153 PMCID: PMC6342894 DOI: 10.1007/s00421-018-4016-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/15/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To determine whether an innovative, motorized, wellness device that effortlessly produces physical activity (JD) can mitigate the hypertensive effects of prolonged sitting or lying down. METHODS Twenty-two normotensive and hypertensive adults of both genders gave informed consent to participate in a randomized controlled crossover study of a passive simulated jogging device (JD) in both supine and seated postures. Each study participant was monitored with a continuous non-invasive arterial pressure monitoring device (CNAP) over 60 min. The initial 10 min served as baseline for each posture. The subjects were randomized to begin with either JD or SHAM control for 30 min, and monitoring was continued for an additional 10 min in one posture; three days later posture and order of JD or SHAM were changed. RESULTS In both seated and supine postures, SHAM was associated with a significant rise in blood pressure (BP) which was observed within 5-10 min; it continued to rise or remain elevated for over a 40-min observation period. In contrast, JD produced a significant decrease in both systolic and diastolic blood pressure in both postures. During recovery in seated posture JD decreased systolic and diastolic BP by - 8.1 and - 7.6 mmHg, respectively. In supine posture, a similar decrease in BP occurred. CONCLUSIONS There is rapid onset of increase in systolic and diastolic BP with physical inactivity in both supine and seated postures. Administration of JD significantly decreased BP in both postures. Further studies are needed to assess long-term effectiveness.
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Affiliation(s)
- Marvin A Sackner
- Emeritus Director of Medical Services, Mt Sinai Medical Center of Greater Miami, Miami Beach, FL, USA
| | | | - Jose A Adams
- Division Neonatology, Mt Sinai Medical Center of Greater Miami, Miami Beach, FL, USA.
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Sasaki S, Ukawa S, Okada E, Wenjing Z, Kishi T, Sakamoto A, Tamakoshi A. Comparison of a new wrist-worn accelerometer with a commonly used triaxial accelerometer under free-living conditions. BMC Res Notes 2018; 11:746. [PMID: 30342547 PMCID: PMC6195952 DOI: 10.1186/s13104-018-3849-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/11/2018] [Indexed: 11/18/2022] Open
Abstract
Objective The Life Microscope is a new wristband-based life recorder system that can identify various human movements. We aimed to compare physical activity data captured using the Life Microscope with data from a commonly used accelerometer. Results Twenty-nine participants (34.6 ± 12.5 years) wore both the Life Microscope and an Active Style Pro accelerometer for 7 days. Physical activity categories were calculated by converting daily accelerometer data output into time spent at sedentary, light, moderate, and vigorous physical activity. Correlations between the physical activity category and step count data obtained from the two accelerometers were assessed using Pearson correlations, paired t-tests, intra-class coefficients, and the Bland–Altman method. Our results showed good reliability between the physical activity patterns and daily step counts obtained using both devices. Bland–Altman analysis showed good agreement between data from both accelerometers. In conclusion, both accelerometers were comparable in their measurement of step counts and time spent in different physical activity intensities under free-living conditions, and either could be used for population studies.
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Affiliation(s)
- Sachiko Sasaki
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.,Department of Physical Therapy, Faculty of Human Science, Hokkaido Bunkyo University, 5-196-1 Kogane-chuo, Eniwa, 061-1449, Japan
| | - Shigekazu Ukawa
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.,Research Unit of Advanced Interdisciplinary Care Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Emiko Okada
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.,Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Zhao Wenjing
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Tomoko Kishi
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Ai Sakamoto
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Akiko Tamakoshi
- Department of Public Health Sciences, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
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Polak R, Tirosh A, Livingston B, Pober D, Eubanks JE, Silver JK, Minezaki K, Loten R, Phillips EM. Preventing Type 2 Diabetes with Home Cooking: Current Evidence and Future Potential. Curr Diab Rep 2018; 18:99. [PMID: 30218282 DOI: 10.1007/s11892-018-1061-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Various dietary regimes have proven effective in preventing diabetes, yet its prevalence is growing. This review's goals are to examine the relationship between home cooking and diabetes and to present the literature on home cooking education programs as a novel strategy to improve adherence to healthy nutrition, thus decreasing the risk of diabetes. RECENT FINDINGS Consumption of home-cooked food is linked to healthier nutrition and decreased risk of diabetes. Further, home cooking interventions have a short-term positive impact on nutritional intake of both children and adults, and on diabetes prevention. Well-designed randomized controlled studies are needed to rigorously evaluate the long-term impact of home cooking interventions on cooking behavior, dietary intake, diabetes, and healthcare costs. Culinary education is an emerging field that aims to change nutrition education paradigms. Clinicians can empower patients to adopt home cooking by role modeling home cooking themselves, including home cooking content in their medical encounters, and through comprehensive lifestyle medicine interventions.
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Affiliation(s)
- Rani Polak
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA.
- Lifestyle Medicine Center, Sheba Medical Center, Tel Hashomer, Israel.
| | - Amir Tirosh
- Endocrinology Institute, Sheba Medical Center, Tel Hashomer, Israel
| | | | - David Pober
- Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - James E Eubanks
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA
- Massachusetts General Hospital, Boston, MA, USA
- Brigham and Women's Hospitals, Boston, MA, USA
| | - Kaya Minezaki
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Loten
- The Institute of Biochemistry, Food and Nutrition Science; The Robert H. Smith Faculty of Agriculture Food and the Environment, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Joseph Sagol Neuroscience Center Tel Hashomer, Tel Hashomer, Israel
| | - Edward M Phillips
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Institute of Lifestyle Medicine, Spaulding Rehabilitation Hospital, 300, 1st Avenue, Boston, MA, 02129, USA
- Massachusetts General Hospital, Boston, MA, USA
- Brigham and Women's Hospitals, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
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Huang C, Lv XW, Xu T, Ni MM, Xia JL, Cai SP, Zhou Q, Li X, Yang Y, Zhang L, Yao HW, Meng XM, Wang H, Li J. Alcohol use in Hefei in relation to alcoholic liver disease: A multivariate logistic regression analysis. Alcohol 2018; 71:1-4. [PMID: 29864674 DOI: 10.1016/j.alcohol.2017.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 08/04/2017] [Accepted: 08/05/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND An increase in alcohol consumption and related harmful effects has been reported among the elderly population in Asia. Of note, it is important to monitor patterns of alcohol use, and to establish a valid and reliable evaluation system when screening for risky consumption in this age group. OBJECTIVE The aim of the current study was to evaluate the possible alcoholic liver disease (ALD) risk factors of a local population in elderly Chinese adults. METHODS A questionnaire was sent to 3393 Chinese adults over 40 years old in Hefei. Alcohol consumption was determined based on the AUDIT questionnaire. ALD was defined by ALD diagnostic standards. Adjusted odds ratios and 95% confidence intervals (95% CI) derived from multiple logistic regression models were used to assess the relationship between ALD and sociodemographic variables. RESULTS Among 2545 total interviewees, 448 (17.6%) reported a history of alcohol consumption in the previous 12 months. Of these drinkers, 46.7% were male and 53.3% were female. The overall Cronbach's alpha coefficient for AUDIT was 0.648. The rate of ALD was 6.83%. Alcohol abuse was significantly associated with ALD. In the logistical model, alcohol abuse was independently associated with ALD (OR = 6.17, 95% CI: 3.69-15.24; p < 0.01). CONCLUSIONS Alcohol use, sex, age, and facial flushing were risk factors for ALD. These results provide important evidence for the prevention and therapy of ALD.
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Affiliation(s)
- Cheng Huang
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Xiong-Wen Lv
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Tao Xu
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Ming-Ming Ni
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Jia-Lu Xia
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Shuang-Peng Cai
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Qun Zhou
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Xing Li
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Yang Yang
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Lei Zhang
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Hong-Wei Yao
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China
| | - Xiao-Ming Meng
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China
| | - Hua Wang
- Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China; Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Jun Li
- School of Pharmacy, Anhui Key Laboratory of Bioactivity of Natural Products, Anhui Medical University, Hefei 230032, China; Institute for Liver Diseases of Anhui Medical University (ILD-AMU), Anhui Medical University, Hefei 230032, China.
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Teufel-Shone NI, Jiang L, Rockell J, Chang J, Beals J, Bullock A, Manson SM. Food choices and distress in reservation-based American Indians and Alaska Natives with type 2 diabetes. Public Health Nutr 2018; 21:2367-2375. [PMID: 29681247 PMCID: PMC6542635 DOI: 10.1017/s1368980018000897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 02/23/2018] [Accepted: 03/12/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine the association between food choice and distress in a large national sample of American Indians/Alaska Natives (AI/AN) with type 2 diabetes. DESIGN Participants completed a sociodemographic survey, an FFQ and the Kessler-6 Distress Scale. Foods were identified as 'healthy' or 'unhealthy' using a classification grounded in the health education provided by the programme case managers; healthy and unhealthy food scores were calculated using reported intake frequencies. Pearson's correlation coefficients for distress and food scores were calculated for all participants and by gender. Multiple linear regression models stratified by gender assessed the association between distress and food scores, controlling for sociodemographics and duration of type 2 diabetes. SETTING Rural AI reservations and AN villages. SUBJECTS AI/AN (n 2484) with type 2 diabetes. RESULTS Both males (34·9 %) and females (65·1 %) had higher healthy food scores than unhealthy scores. In bivariate analysis, distress level had a significant negative correlation with healthy food scores among female participants, but the association was not significant among males. Significant positive correlations between distress and unhealthy food scores were found in both genders. In the final multivariate models, healthy food scores were not significantly related to distress; however, unhealthy food scores showed significant positive relationships with distress for both genders (females: β=0·078, P=0·0007; males: β=0·139, P<0·0001). CONCLUSIONS Health professionals working with AI/AN diagnosed with type 2 diabetes should offer food choice strategies during difficult times and recognize that males may be more likely than females to select unhealthy foods when distressed.
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Affiliation(s)
- Nicolette I Teufel-Shone
- Department of Health Sciences and Center for Health Equity Research, PO Box 4065, ARD Building, Suite 120, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Luohua Jiang
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Jennifer Rockell
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Jennifer Chang
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Janette Beals
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Ann Bullock
- Division of Diabetes Treatment and Prevention, Indian Health Service, Rockville, MD, USA
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Center, Aurora, CO, USA
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Zhang M, Chao J, Li D, Gu J, Chen W, Xu H, Hussain M, Wu W, Deng L, He T, Zhang R. The effect of older-person centered and integrated health management model on multiple lifestyle behaviors: A randomized controlled trial from China. Arch Gerontol Geriatr 2018; 79:45-51. [PMID: 30103079 DOI: 10.1016/j.archger.2018.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the effectiveness of the older-centered Integrated Health Management Model Project (OPCHMP) for multiple lifestyle behaviours in the elderly. METHODS A 2-arm, parallel, randomized controlled trial was conducted in Nanjing. The elderly were recruited from multiple community health service centres. The intervention group was intervened and received a personalized, 2-year OPCHMP. The control group only received usual care. Adherence to healthy lifestyle behaviours (ATHLBS) is the primary outcome, obtained through a self-reported composite health behaviour score. The secondary outcomes were health indicators. General estimating equation models were performed to analyse longitudinal dichotomous data and continuous data. RESULTS 637 (intervention = 323; control = 314) participants were included in the study. The participants mean age was 70.53 ± 6.07 years. Significant ATHLBS correction was achieved after 24-month follow-up in the intervention group, comparing to controls. And the intervention group reported significantly better health indicators. CONCLUSION OPCHMP had positive effect on multiple lifestyle habits in elderly population, which is very encouraging.
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Affiliation(s)
- Man Zhang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
| | - Jianqian Chao
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
| | - Dan Li
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
| | - Jiayi Gu
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
| | - Wenji Chen
- Department of General Practice, Zhongda Hospital, Affiliated to Southeast University, Nanjing, Jiangsu, China.
| | - Hui Xu
- Hospital Office, Hospital of Qinhuai, Nanjing, Jiangsu, China.
| | - Mubashir Hussain
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Wenjuan Wu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210096, China.
| | - Lin Deng
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
| | - Tingting He
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
| | - Ruizhi Zhang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
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Jezewska-Zychowicz M, Gębski J, Guzek D, Świątkowska M, Stangierska D, Plichta M, Wasilewska M. The Associations between Dietary Patterns and Sedentary Behaviors in Polish Adults (LifeStyle Study). Nutrients 2018; 10:E1004. [PMID: 30071656 PMCID: PMC6115718 DOI: 10.3390/nu10081004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 07/24/2018] [Accepted: 07/30/2018] [Indexed: 12/28/2022] Open
Abstract
Sedentary behavior, a low physical activity level, and unhealthy dietary patterns are risk factors for major chronic diseases, including obesity. The aim of this study was to assess the associations of dietary patterns (DPs) with sedentary behaviors (SB) and self-reported physical activity (PA). The data was collected in November 2016 through a cross-sectional quantitative survey amongst 1007 Polish adults. Principal components analysis (PCA) was conducted to derive DPs. Logistic regression analysis was used to verify associations between PA and SD (independent variables), and DPs (dependent variables). Five DPs ('Fast foods & sweets'-FF&S; 'Meat & meat products'-M&MP; 'Fruit & vegetable'-F&V; 'Wholemeal food'-WF; 'Fruit & vegetable juices'-F&VJ) were identified. Representing M&MP independently increased the chance of watching TV at least once a day (by 73%). There was no such relationship between the FF&S and sedentary behaviors. Being in the upper tertiles of pro-health DPs increased the chance of reading books (by 177%-F&V, 149%-WF, 54%-F&VJ) and watching TV (by 71%-F&V). On the other hand, belonging to the upper tertile of WF reduced the chance of using the computer for more than 4 h a day. Belonging to the upper tertile of healthy DPs (WF and F&VJ) increased the chances of moderate or high physical activity, both at work/school and during leisure time. Within F&V, there was a lower chance of moderate or high physical activity at work/school. Being in the upper tertile of unhealthy DPs (FF&S and M&MP) did not show any significant association with physical activity. The study indicated the associations between both healthy and unhealthy DPs and some sedentary behaviors. Association between F&V and watching TV and reading books/newspapers should be recognized as potentially efficient in education. Association between M&MP and watching television can be indicative of the mutual overlap of a negative lifestyle resulting in the development of overweight and obesity, especially since the extent of occurrence of sedentary behaviors is high.
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Affiliation(s)
- Marzena Jezewska-Zychowicz
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Jerzy Gębski
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Dominika Guzek
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Monika Świątkowska
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Dagmara Stangierska
- Section of Horticultural Economic, Faculty of Horticulture, Biotechnology and Landscape Architecture, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Marta Plichta
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
| | - Milena Wasilewska
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland.
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50
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Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, Kaptoge S, Di Angelantonio E, Stampfer M, Willett WC, Hu FB. Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population. Circulation 2018; 138:345-355. [PMID: 29712712 PMCID: PMC6207481 DOI: 10.1161/circulationaha.117.032047] [Citation(s) in RCA: 396] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Americans have a shorter life expectancy compared with residents of almost all other high-income countries. We aim to estimate the impact of lifestyle factors on premature mortality and life expectancy in the US population. METHODS Using data from the Nurses' Health Study (1980-2014; n=78 865) and the Health Professionals Follow-up Study (1986-2014, n=44 354), we defined 5 low-risk lifestyle factors as never smoking, body mass index of 18.5 to 24.9 kg/m2, ≥30 min/d of moderate to vigorous physical activity, moderate alcohol intake, and a high diet quality score (upper 40%), and estimated hazard ratios for the association of total lifestyle score (0-5 scale) with mortality. We used data from the NHANES (National Health and Nutrition Examination Surveys; 2013-2014) to estimate the distribution of the lifestyle score and the US Centers for Disease Control and Prevention WONDER database to derive the age-specific death rates of Americans. We applied the life table method to estimate life expectancy by levels of the lifestyle score. RESULTS During up to 34 years of follow-up, we documented 42 167 deaths. The multivariable-adjusted hazard ratios for mortality in adults with 5 compared with zero low-risk factors were 0.26 (95% confidence interval [CI], 0.22-0.31) for all-cause mortality, 0.35 (95% CI, 0.27-0.45) for cancer mortality, and 0.18 (95% CI, 0.12-0.26) for cardiovascular disease mortality. The population-attributable risk of nonadherence to 5 low-risk factors was 60.7% (95% CI, 53.6-66.7) for all-cause mortality, 51.7% (95% CI, 37.1-62.9) for cancer mortality, and 71.7% (95% CI, 58.1-81.0) for cardiovascular disease mortality. We estimated that the life expectancy at age 50 years was 29.0 years (95% CI, 28.3-29.8) for women and 25.5 years (95% CI, 24.7-26.2) for men who adopted zero low-risk lifestyle factors. In contrast, for those who adopted all 5 low-risk factors, we projected a life expectancy at age 50 years of 43.1 years (95% CI, 41.3-44.9) for women and 37.6 years (95% CI, 35.8-39.4) for men. The projected life expectancy at age 50 years was on average 14.0 years (95% CI, 11.8-16.2) longer among female Americans with 5 low-risk factors compared with those with zero low-risk factors; for men, the difference was 12.2 years (95% CI, 10.1-14.2). CONCLUSIONS Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults.
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Affiliation(s)
- Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dong D. Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xiaoran Liu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Klodian Dhana
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Stephen Kaptoge
- Department of Public Health and Primary Care University of Cambridge, United Kingdom
| | - Emanuele Di Angelantonio
- Department of Public Health and Primary Care University of Cambridge, United Kingdom
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, Cambridge, United Kingdom
- National Health Service Blood and Transplant, Cambridge, United Kingdom
| | - Meir Stampfer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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