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Awoke MA, Earnest A, Joham AE, Hodge AM, Teede HJ, Brown WJ, Moran LJ. Weight gain and lifestyle factors in women with and without polycystic ovary syndrome. Hum Reprod 2021; 37:129-141. [PMID: 34788426 DOI: 10.1093/humrep/deab239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 10/11/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Do extrinsic factors including lifestyle, psychosocial factors and healthcare professional engagement independently contribute to weight gain in women with and without polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Women with PCOS had a higher rate of weight gain than women without PCOS which was most marked in those with unhealthy lifestyles. WHAT IS KNOWN ALREADY Women with PCOS have a higher prevalence of overweight/obesity and greater weight gain than women without PCOS. The association of lifestyle factors with weight change in PCOS is not known. STUDY DESIGN, SIZE, DURATION The study was a population-based observational study with data collected from seven surveys over 19 years (N = 14 127; Survey 1) involving women with and without PCOS. PARTICIPANTS/MATERIALS, SETTING, METHODS We used data from the 1973-1978 birth cohort of the Australian Longitudinal Study on Women's Health. MAIN RESULTS AND THE ROLE OF CHANCE Women with PCOS gained more weight annually (0.26 kg/year; 95% CI 0.12, 0.39; P < 0.0001) and over 19 years (4.62 kg; 95% CI 3.04, 6.21; P < 0.0001) than women without PCOS (adjusted analyses). For all women, there were positive associations between weight gain and energy intake, sitting time and stress; inverse associations with fibre intake and physical activity (PA); and no associations with diet quality, glycaemic index, healthcare utilization, depression or anxiety. There were interactions between lifestyle factors (energy intake P = 0.006, glycaemic index P = 0.025, sitting time P = 0.041 and PA P = 0.021), PCOS status and time such that weight gain varied between women with and without PCOS according to these factors. LIMITATIONS, REASONS FOR CAUTION The limitations of this study include the use of self-reported measures such as diet, PA, sitting time, psychological factors and health care utilization. WIDER IMPLICATIONS OF THE FINDINGS While women with PCOS are more prone to weight gain, lifestyle factors have a more profound impact on weight gain in women with PCOS than without PCOS. These study findings have implications for understanding the mechanisms of weight gain in women with PCOS. They also highlight the importance of early lifestyle intervention as soon as PCOS is diagnosed to address modifiable extrinsic factors and prevent excess weight gain and worsening of the clinical features of PCOS. STUDY FUNDING/COMPETING INTEREST(S) M.A.A. is funded by the Monash International Tuition Scholarship and Monash Graduate Scholarship and L.J.M. is funded by a National Heart Foundation Future Leader Fellowship. The authors declared no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Mamaru Ayenew Awoke
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Arul Earnest
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anju E Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wendy J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Thong EP, Milat F, Enticott JC, Joham AE, Ebeling PR, Mishra GD, Teede HJ. The diabetes-fracture association in women with type 1 and type 2 diabetes is partially mediated by falls: a 15-year longitudinal study. Osteoporos Int 2021; 32:1175-1184. [PMID: 33411006 DOI: 10.1007/s00198-020-05771-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 12/01/2020] [Indexed: 12/25/2022]
Abstract
UNLABELLED This study evaluated mediators of fracture risk in postmenopausal women with type 1 (T1D) and type 2 diabetes (T2D), over a 15-year follow-up period. This study provides evidence that the increased fracture risk in women with T1D or T2D is partially explained by falls. Furthermore, a shorter reproductive lifespan in women with T1D contributes modestly to fracture risk in this cohort. PURPOSE Skeletal fragility is associated with diabetes mellitus, while limited estrogen exposure during the reproductive years also predisposes to lower bone mass and higher fracture risk. We aimed to determine osteoporosis diagnosis, fall and fracture rates in women with type 1 (T1D) and type 2 (T2D) diabetes mellitus, and explore mediators of the diabetes-fracture relationship. METHODS Prospective observational data drawn from the Australian Longitudinal Study in Women's Health (ALSWH) from 1996 to 2010. Women were randomly selected from the national health insurance database. Standardized data collection occurred at six survey time points, with main outcome measures being self-reported osteoporosis, incident fracture, falls, and reproductive lifespan. Mediation analyses were performed to elucidate relevant intermediaries in the diabetes-fracture relationship. RESULTS Exactly 11,313 women were included at baseline (T1D, n = 107; T2D, n = 333; controls, n = 10,873). A total of 885 new cases of osteoporosis and 1099 incident fractures were reported over 15 years. Women with T1D or T2D reported more falls and fall-related injuries; additionally, women with T1D had a shorter reproductive lifespan. While fracture risk was increased in women with diabetes (T1D: OR 2.28, 95% CI 1.53-3.40; T2D: OR 2.40, 95% CI 1.90-3.03), compared with controls, adjustment for falls attenuated the risk of fracture by 10% and 6% in T1D and T2D, respectively. In women with T1D, reproductive lifespan modestly attenuated fracture risk by 4%. CONCLUSION Women with T1D and T2D have an increased risk of fracture, which may be partially explained by increased falls, and to a lesser extent by shorter reproductive lifespan, in T1D.
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Affiliation(s)
- E P Thong
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Victoria, Australia
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - F Milat
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
- Hudson Institute of Medical Research, Clayton, Victoria, Australia
| | - J C Enticott
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - A E Joham
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Victoria, Australia
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - P R Ebeling
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Victoria, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
| | - G D Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, St Lucia, Queensland, Australia
| | - H J Teede
- Departments of Endocrinology & Diabetes, Monash Health, Clayton, Victoria, Australia.
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia.
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Eagle DE, Rash JA, Tice L, Proeschold-Bell RJ. Evaluation of a remote, internet-delivered version of the Trier Social Stress Test. Int J Psychophysiol 2021; 165:137-144. [PMID: 33865901 DOI: 10.1016/j.ijpsycho.2021.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/24/2021] [Accepted: 03/24/2021] [Indexed: 01/25/2023]
Abstract
The Trier Social Stress Test (TSST) is a widely used, reliable, and ecologically valid method for inducing acute stress under controlled conditions. Traditionally, the TSST is administered with staff physically present with participants, which limits the participant populations that can be exposed to the TSST. We describe an adaptation of the TSST to remote, online delivery over video-conferencing, which we call the internet-delivered Trier Social Stress Test (iTSST). This adaption has participants use wearable, self-administered ECG monitors received and returned via mail. Fifty participants were recruited to take part in a pilot study evaluating stress-reduction interventions and completed the iTSST at two occasions separated by approximately 12 weeks. Perceived stress and heart rate variability (HRV) were measured during both administrations of the iTSST. Forty-one participants completed both assessments and were included in the set of analyses. Both administrations were characterized by an increase in self-reported stress and reduction in self-reported relaxation from the resting phase to the speech task, which returned to baseline during recovery. In terms of HRV, we observed a significant parasympathetic response to the iTSST in 90% of participants, evidenced by a decrease in RMSSD and increase in heart rate from resting to the speech task, which recovered during the recovery phase. In terms of repeatability, there was little evidence of habituation and the iTSST elicited a stress response during both the initial administration and the 12-week follow-up. While the utility is limited by the lack of a measure of sympathetic and HPA-axis activity, the iTSST represents a promising research tool when physically interacting with participants is not feasible.
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Affiliation(s)
- David E Eagle
- Duke Global Health Institute, Duke University, Durham, NC, United States of America.
| | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Logan Tice
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
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Lower Vegetable Variety and Worsening Diet Quality Over Time Are Associated With Higher 15-Year Health Care Claims and Costs Among Australian Women. J Acad Nutr Diet 2021; 121:655-668. [PMID: 33487591 DOI: 10.1016/j.jand.2020.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 11/30/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The relationship between diet quality and health care costs is unclear. OBJECTIVE The aim of this study was to investigate the relationship between baseline diet quality and change in diet quality over time, with 15-year cumulative health care claims/costs. DESIGN Data from a longitudinal cohort study were analyzed. PARTICIPANTS/SETTING Data for survey 3 (2001) (n = 7,868) and survey 7 (2013) (n = 6,349 both time points) from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health were analyzed. MAIN OUTCOME MEASURES Diet quality was assessed using the Australian Recommended Food Score (ARFS). Fifteen-year cumulative Medicare Benefits Schedule (Australia's universal health care coverage) data were reported by baseline ARFS quintile and category of diet quality change ("diet quality worsened" [ARFS change ≤ -4 points], "remained stable" [-3 ≤ change in ARFS ≤3 points], or "improved" [ARFS change ≥4 points]). STATISTICAL ANALYSES Linear regression analyses were conducted adjusting for area of residence, socioeconomic status, lifestyle factors, and private health insurance status. RESULTS Consuming a greater variety of vegetables at baseline but fewer fruit and dairy products was associated with lower health care costs. For every 1-point increment in the ARFS vegetable subscale, women made 3.3 (95% CI, 1.6-5.0) fewer claims and incurred AU$227 (95% CI, AU$104-350 [US$158; 95% CI, US$72-243]) less in costs. Women whose diet quality worsened over time made more claims (median, 251 claims; quintile 1, quintile 3 [Q1; Q3], 168; 368 claims) and incurred higher costs (AU$15,519; Q1; Q3, AU$9,226; AU$24,847 [US$10,793; Q1; Q3, US$6,417; US$17,281]) compared with those whose diet quality remained stable (median, 236 claims [Q1; Q3, 158; 346 claims], AU$14,515; Q1; Q3, AU$8,539; AU$23,378 [US$10,095; Q1; Q3, US$5,939; US$16,259]). CONCLUSIONS Greater vegetable variety was associated with fewer health care claims and costs; however, this trend was not consistent across other subscales. Worsening diet quality over 12 years was linked with higher health care claims and costs.
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Anderson AE, Cavenagh D, Forder P, Loxton D, Byles J. Alcohol-related risk from pre-loading and heavy episodic drinking (HED) among a cohort of young Australian women: a cross-sectional analysis. Aust N Z J Public Health 2020; 44:382-389. [PMID: 32776670 DOI: 10.1111/1753-6405.13018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 05/01/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To cross-sectionally examine heavy episodic drinking (HED) and pre-loading with alcohol among young Australian women in relation to the alcohol-induced adverse outcomes of memory loss, vomiting and injury. METHODS A total of 7,800 participants, aged 20-25 years, from the 1989-95 cohort of the Australian Longitudinal Study on Women's Health answered all questions on alcohol use, reported drinking alcohol in the previous year and were not pregnant at the third survey in 2015. Log-binomial models were used to estimate prevalence ratios for adverse outcomes associated with increased frequency of HED and pre-loading. RESULTS The majority of participants reported HED (83.4%) and/or pre-loading (65.6%), which had a moderate correlation (r=0.646). Just over half (55.2%) of participants experienced at least one adverse event, with vomiting being most common. As the frequency of HED or pre-loading increased, so did the risk of an adverse outcome. CONCLUSIONS Both HED and pre-loading pose a risk to young Australian women, and that risk rises with increased frequency. Implications for public health: Although HED has been a target of public health policy and interventions, pre-loading has received limited attention. In addition to addressing HED, there is a need to consider the risk posed by pre-loading, a related, yet unique risky drinking behaviour.
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Affiliation(s)
- Amy E Anderson
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, The University of Newcastle, New South Wales
| | - Dominic Cavenagh
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, The University of Newcastle, New South Wales
| | - Peta Forder
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, The University of Newcastle, New South Wales
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, The University of Newcastle, New South Wales
| | - Julie Byles
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, The University of Newcastle, New South Wales
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Rodríguez-Gómez I, Santalla A, Diez-Bermejo J, Munguía-Izquierdo D, Alegre LM, Nogales-Gadea G, Arenas J, Martín MA, Lucia A, Ara I. Sex Differences and the Influence of an Active Lifestyle on Adiposity in Patients with McArdle Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124334. [PMID: 32560448 PMCID: PMC7344565 DOI: 10.3390/ijerph17124334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 11/30/2022]
Abstract
McArdle disease (glycogenosis-V) is associated with exercise intolerance, however, how it affects an important marker of cardiometabolic health as it is adiposity remains unknown. We evaluated the association between physical activity (PA) and adiposity in patients with McArdle disease. We assessed 199 adults of both sexes (51 McArdle patients (36 ± 11 years) and 148 healthy controls (35 ± 10 years)). Body fat (BF) was determined using dual-energy X-ray absorptiometry (DXA) method and each patient’s PA was assessed with the International PA Questionnaire (IPAQ). Although body mass index values did not differ between patients and controls, McArdle patients had significantly higher values of BF in all body regions (p < 0.05) and higher risk of suffering obesity (odds ratio (OR): 2.54, 95% confidence interval (95% CI): 1.32–4.88). Male patients had higher BF and obesity risk (OR: 3.69, 95% CI: 1.46−9.34) than their sex-matched controls, but no differences were found within the female sex (p < 0.05). In turn, active female patients had lower trunk BF than their inactive peers (p < 0.05). Males with McArdle seem to have adiposity problems and a higher risk of developing obesity than people without the condition, while female patients show similar or even better levels in the trunk region with an active lifestyle. Therefore, special attention should be given to decrease adiposity and reduce obesity risk in males with McArdle disease.
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Affiliation(s)
- Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (A.S.); (D.M.-I.); (A.L.)
| | - Alfredo Santalla
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (A.S.); (D.M.-I.); (A.L.)
- Department of Sport and Computer Science, Section of Physical Education and Sports, Faculty of Sport, Universidad Pablo de Olavide, 41013 Sevilla, Spain
| | - Jorge Diez-Bermejo
- Research Institute Hospital 12 de Octubre, 28041 Madrid, Spain; (J.D.-B.); (J.A.); (M.A.M.)
| | - Diego Munguía-Izquierdo
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (A.S.); (D.M.-I.); (A.L.)
- Department of Sport and Computer Science, Section of Physical Education and Sports, Faculty of Sport, Universidad Pablo de Olavide, 41013 Sevilla, Spain
| | - Luis M. Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (A.S.); (D.M.-I.); (A.L.)
| | - Gisela Nogales-Gadea
- Department of Neurosciences, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol I Campus Can Ruti, Universitat Autònoma de Barcelona, 08041 Badalona, Spain;
- CIBER of Rare Disorders (CIBERER), 28029 Madrid, Spain
| | - Joaquín Arenas
- Research Institute Hospital 12 de Octubre, 28041 Madrid, Spain; (J.D.-B.); (J.A.); (M.A.M.)
- CIBER of Rare Disorders (CIBERER), 28029 Madrid, Spain
| | - Miguel A. Martín
- Research Institute Hospital 12 de Octubre, 28041 Madrid, Spain; (J.D.-B.); (J.A.); (M.A.M.)
- CIBER of Rare Disorders (CIBERER), 28029 Madrid, Spain
| | - Alejandro Lucia
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (A.S.); (D.M.-I.); (A.L.)
- School of Research and Doctorate Studies, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (A.S.); (D.M.-I.); (A.L.)
- Correspondence: ; Tel.: +34-925-268-800 (ext. 5543)
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Aljadani HM, Patterson AJ, Sibbritt DW, Taylor RM, Collins CE. Improving diet quality over nine-years is associated with less weight gain in mid-age Australian women: A cohort study. Nutr Metab Cardiovasc Dis 2020; 30:223-232. [PMID: 31767421 DOI: 10.1016/j.numecd.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Most studies measure baseline diet quality exclusively and hence the impact of longitudinal changes in dietary intake in relation to weight change is not considered. Therefore, this study aimed to examine whether change in diet quality over nine-years was associated with weight change over the same period in mid-age Australian women. METHODS AND RESULTS Healthy mid-age (45-49 years) women from the Australian Longitudinal study on Women's Health (ALSWH) were eligible a valid total energy intake (TEI) was reported at baseline (n = 2381), determined using Goldberg cut-offs. Diet quality was measured by the Australian Recommended Food Score (ARFS) using data derived from a validated food frequency questionnaire. Multiple linear regressions were used to evaluate relationships between change in diet quality and weight in mid-age women (n = 1999). Women in the highest tertile of ARFS change improved diet quality [mean ± SD] [7 ± 4 points], while those in the lowest [-9 ±5 points] and middle [-1±2 points] tertiles had worse diet quality at follow-up. Overall, mean weight gain was 2.3 ± 7.2 kg over nine years. Those in the highest tertile of ARFS change gained significantly less weight, compared to the lowest tertile; β = -1.2 kg [95% CI: -2.31, -0.11; p = 0.03] after adjustment for changes in confounders and baseline weight, baseline ARFS, and total energy intake. CONCLUSIONS Improving diet quality could be an important strategy for promoting modest weight loss and potentially contribute to preventing weight gain in mid-age women, which is important for metabolic health.
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Affiliation(s)
- Haya M Aljadani
- Faculty of Nutrition and Health Science, King Abdulaziz University, Jeddah, MK, 80200, Saudi Arabia
| | - Amanda J Patterson
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, 2308, Australia; School of Health Sciences, University of Newcastle, Newcastle, NSW, 2308, Australia
| | - David W Sibbritt
- Faculty of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Rachael M Taylor
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, 2308, Australia; School of Health Sciences, University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Clare E Collins
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, 2308, Australia; School of Health Sciences, University of Newcastle, Newcastle, NSW, 2308, Australia.
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Albright CL, Wilkens LR, Saiki K, White KK, Steffen AD. Mediators of a 12-month change in physical activity in ethnically diverse sample of postpartum women. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2020; 4:215-224. [PMID: 31984225 DOI: 10.1249/tjx.0000000000000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose Understanding theoretically derived social and behavioral mediators of long-term increases in physical activity (PA) in a vulnerable population at risk for being underactive is needed to inform future research, clinical applications, and public health efforts. This is an analysis of potential mediators of an intervention that increased long-term (12-month) moderate-to-vigorous physical activity (MVPA) in postpartum (2-12months) women in a randomized trial, using a longitudinal analysis. Methods Healthy, underactive (i.e., not meeting national guidelines for MVPA) women (n = 311; mean age = 32 ± 5.6 years, 85% minorities) with infants (mean age: 5.7 ± 2.8 months) were randomly assigned to either a tailored eHealth condition consisting of personalized telephone counseling plus access to a website tailored to new mothers' MVPA issues or to a standard MVPA materials-only website. MVPA was assessed via surveys completed at baseline, then 6 and 12 months later. Theoretically derived mediators included social support for MVPA, self-efficacy to increase MVPA, barriers to increasing MVPA, and benefits of increasing MVPA. Results All mediators, except benefits, improved over the 12 months in the tailored eHealth condition. The tailored condition's effect on increasing MVPA from 6 months to 12 months was mediated by an increase in social support from baseline to six months. No other hypothesized mediators were significant. Conclusion Our results demonstrated that learning strategies to increase social support for MVPA was instrumental in new mothers' increase in MVPA over a 12 month intervention. During this brief but impactful life-stage, where the focus can understandably be on her baby, being able to elicit support from friends and family may facilitate women's efforts to focus on their own needs with respect to MVPA. Trial Registration ClinicalTrials.gov number.
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Affiliation(s)
- Cheryl L Albright
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, USA.,Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Kara Saiki
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Kami K White
- Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | - Alana D Steffen
- College of Nursing, University of Illinois, Chicago, Illinois, USA
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Lindsay-Smith G, Eime R, O'Sullivan G, Harvey J, van Uffelen JGZ. A mixed-methods case study exploring the impact of participation in community activity groups for older adults on physical activity, health and wellbeing. BMC Geriatr 2019; 19:243. [PMID: 31477054 PMCID: PMC6720859 DOI: 10.1186/s12877-019-1245-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 08/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular physical activity (PA) has many health benefits but declines with age. Community multi-activity groups offering volunteer-led socially-oriented activity programs could provide an opportunity for older people to maintain or increase PA levels and promote their health. The aim of this study was to examine the potential effect of becoming a member of an existing community activity group on PA levels, physical and mental health-related quality of life (HR QoL), comparing any impacts associated with participation in physical activity or social activity programs. METHODS This mixed-methods case study, combining a longitudinal quantitative-survey with qualitative focus groups to contextualise the survey results, focused on an Australian community organisation called Life Activities Clubs (LACs). LACs provide various physical activities (e.g. walking, cycling, dancing) and social activities (e.g. book groups, dine-outs, craft). Data were collected using a self-report survey administered at baseline, six and twelve-months after joining and group differences between participants of PA programs (PA group) and social programs (social group) were analysed using linear mixed-models. Two focus groups with LAC members were held, one representing each activity type and analysed using content and thematic analysis. RESULTS 35 people (mean age 67) completed the surveys and 11 people participated in the focus groups. PA levels and physical health-related QoL were maintained over 1 year in the PA group, and declined between baseline and 12-months in the social group. Focus groups suggested social aspects of PA programs increased motivation to maintain regular attendance and do more PA than participants would on their own and that physical activities provided health benefits. Mental HR QoL did not change in either group, focus groups suggested this was because the social aspects of both types of program provide benefits relating to mental health including stress relief, enjoyment and adapting to major life events, to prevent a decline in QoL. CONCLUSIONS Community PA programs appear to maintain PA levels and physical HR QoL in older adults, and both social and PA programs may maintain mental HR QoL. Incorporating both types of program into one organisation may also encourage less physically active members to try physical activities.
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Affiliation(s)
| | - Rochelle Eime
- Institute for Health and Sport, Victoria University, Melbourne, Australia.,School of Health and Life Sciences, Federation University, Ballarat, Australia
| | - Grant O'Sullivan
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Jack Harvey
- School of Health and Life Sciences, Federation University, Ballarat, Australia
| | - Jannique G Z van Uffelen
- Institute for Health and Sport, Victoria University, Melbourne, Australia.,Department of Movement Sciences, Physical Activity, Sports and Health Research Group, KU Leuven - University of Leuven, B-3000, Leuven, Belgium
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10
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Mason SA, Rasmussen B, van Loon LJC, Salmon J, Wadley GD. Ascorbic acid supplementation improves postprandial glycaemic control and blood pressure in individuals with type 2 diabetes: Findings of a randomized cross-over trial. Diabetes Obes Metab 2019; 21:674-682. [PMID: 30394006 DOI: 10.1111/dom.13571] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 10/23/2018] [Accepted: 10/31/2018] [Indexed: 12/14/2022]
Abstract
AIM The primary aim of this study was to investigate whether ascorbic acid (AA) supplementation improves postprandial glucose responses under free-living conditions in individuals with type 2 diabetes. A secondary aim was to investigate the effect of AA supplementation on blood pressure. MATERIALS AND METHODS A total of 31 individuals with type 2 diabetes (26 males and 5 females; aged 61.8 ± 6.8 years; duration of diabetes, 5.6 ± 4.6 years; HbA1c, 7.6% ± 0.7% [mean ± SD]) were enrolled in a randomized cross-over study involving 4 months of supplementation with oral AA (2 × 500 mg/d) or placebo. Participants wore continuous glucose monitors for 48 hours and consumed standardized meals pre- and post-supplementation. Measurements included postprandial glucose incremental areas under the curve (iAUC), duration of day in hyper- and hypo-glycaemia status, average 24-hour and daily postprandial glucose concentrations, HbA1c, insulin, blood pressure (BP) and oxidative stress (F2 -isoprostanes). RESULTS Following AA supplementation, significant decreases were observed in daily postprandial glucose iAUC (-36%), in duration of day with hyperglycaemia (-2.8 h/d) and postprandial hyperglycaemia (-1.7 h/d), in average 24-hour glucose (-0.8 mmol/L) and daily postprandial glucose (-1.1 mmol/L) concentrations, in systolic (-7 mm Hg) and diastolic (-5 mm Hg) blood pressures and in a specific fraction of free plasma F2 -isoprostanes (-47 pg/mL) as compared to placebo. CONCLUSIONS Individuals with type 2 diabetes experienced improved postprandial and 24-hour glycaemia and decreased BP after 4 months of AA supplementation as compared to placebo. These findings offer evidence for the proposed use of AA as an adjunct therapy to improve glycaemic and BP control in individuals with type 2 diabetes.
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Affiliation(s)
- Shaun A Mason
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Western Health, Sunshine Hospital, St Albans, Victoria, Australia
| | - Luc J C van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Glenn D Wadley
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
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11
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Susanto M, Hubbard RE, Gardiner PA. Association of 12-Year Trajectories of Sitting Time With Frailty in Middle-Aged Women. Am J Epidemiol 2018; 187:2387-2396. [PMID: 29868880 DOI: 10.1093/aje/kwy111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/14/2018] [Indexed: 12/29/2022] Open
Abstract
Prolonged sitting time is associated with several health outcomes; limited evidence indicates associations with frailty. Our aims in this study were to identify patterns of sitting time over 12 years in middle-aged (ages 50-55 years) women and examine associations of these patterns with frailty in older age. We examined 5,462 women born in 1946-1951 from the Australian Longitudinal Study on Women's Health who provided information on sociodemographic attributes, daily sitting time, and frailty in 2001 and then again every 3 years until 2013. Frailty was assessed using the FRAIL (fatigue, resistance, ambulation, illness, loss of weight) scale (0 = healthy; 1-2 = prefrail; 3-5 = frail), and group-based trajectory analyses identified trajectories of sitting time. We identified 5 sitting-time trajectories: low (26.9%), medium (43.1%; referent), increasing (6.9%), decreasing (18.1%), and high (4.8%). In adjusted models, the likelihoods of being frail were statistically higher for women in the increasing (odds ratio (OR) = 1.29, 95% confidence interval (CI): 1.03, 1.61) and high (OR = 1.42, 95% CI: 1.10, 1.84) trajectories. In contrast, women in the low trajectory group were less likely to be frail (OR = 0.86, 95% CI: 0.75, 0.98), and there was no difference in the likelihood of frailty in the decreasing trajectory group. Our study suggests that patterns of sitting time over 12 years in middle-aged women predict frailty in older age.
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Affiliation(s)
- Maja Susanto
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- The Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- The Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Paul A Gardiner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
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12
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Gadgil MD, Ehrlich SF, Zhu Y, Brown SD, Hedderson MM, Crites Y, Ferrara A. Dietary Quality and Glycemic Control Among Women with Gestational Diabetes Mellitus. J Womens Health (Larchmt) 2018; 28:178-184. [PMID: 30376391 DOI: 10.1089/jwh.2017.6788] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/OBJECTIVE Poor dietary quality, measured by the Healthy Eating Index 2010 (HEI-2010), is associated with risk of gestational diabetes mellitus (GDM) and type 2 diabetes. The aim was to investigate the association between dietary quality and glycemic control in women with GDM. MATERIALS AND METHODS The study included 1220 women with GDM. Dietary quality was calculated by HEI-2010 score from a Food Frequency Questionnaire administered shortly after GDM diagnosis; higher scores indicate higher dietary quality. Subsequent glycemic control was defined as ≥80% of all capillary glucose measurements meeting recommended clinical targets below 95 mg/dL for fasting, and below 140 mg/dL 1-hour glucose after meals. RESULTS As compared with Quartile 1 of HEI-2010 score, Quartiles 2, 3, and 4 showed increased adjusted odds of overall optimal glycemic control (odds ratio [95% confidence interval] 1.90 [1.34-2.70], 1.77 [1.25-2.52], and 1.55 [1.09-2.20], respectively). Increased odds of glycemic control were observed in Quartiles 2, 3, and 4 as compared with Quartile 1 of HEI-2010 score for 1-hour postbreakfast and 1-hour postdinner. Mean capillary glucose was lower in Quartiles 2, 3, and 4 of HEI-2010 score when compared with Quartile 1 for 1-hour postdinner (p = 0.03). CONCLUSIONS Clinicians should be aware that even a small improvement in diet quality may be beneficial for the achievement of improved glycemic control in women with GDM. TRIAL REGISTRATION Clinical Trials.gov number, NCT01344278.
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Affiliation(s)
- Meghana D Gadgil
- 1 Division of General Internal Medicine, University of California , San Francisco, San Francisco, California
| | - Samantha F Ehrlich
- 2 Department of Public Health, University of Tennessee Knoxville , Knoxville, Tennessee
| | - Yeyi Zhu
- 3 Division of Research, Kaiser Permanente Northern California , Oakland, California
| | - Susan D Brown
- 3 Division of Research, Kaiser Permanente Northern California , Oakland, California
| | - Monique M Hedderson
- 3 Division of Research, Kaiser Permanente Northern California , Oakland, California
| | - Yvonne Crites
- 4 Division of Perinatology, Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center , Santa Clara, California
| | - Assiamira Ferrara
- 3 Division of Research, Kaiser Permanente Northern California , Oakland, California
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13
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Xu H, Tang L, Hu Z, Gao F, Yang Y, Qin L, Luo BA. Association between physical activity and health-related quality of life in elderly individuals with pre-diabetes in rural Hunan Province, China: a cross-sectional study. BMJ Open 2018; 8:e019836. [PMID: 29654016 PMCID: PMC5898310 DOI: 10.1136/bmjopen-2017-019836] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES There are few data on the relationship between health-related quality of life (HRQoL) and physical activity among elderly individuals with pre-diabetes. This study aimed to determine if differences existed in HRQoL between individuals with pre-diabetes who were physically active compared with those who were physically inactive in rural China. DESIGN, SETTING AND PARTICIPANTS A cross-sectional survey was conducted among the elderly (≧60 years) in rural communities in Yiyang City of China. Multistage cluster random sampling was carried out to select 42 areas, and interviews were conducted among 434 elderly individuals with pre-diabetes. Pre-diabetes was screened using an oral glucose tolerance test. MAIN OUTCOME MEASURES The Medical Outcomes Study 36-Item Short Form Health Survey questionnaire was used to measure HRQoL. Physical activity was assessed using the International Physical Activity Questionnaire. Multivariate analysis of covariance (MANCOVA) was used to test for differences in HRQoL between the physically active group and the inactive group. RESULTS A total of 434 individuals with pre-diabetes were included in this study. The physical component summary (PCS) score of HRQoL was 42.1±10.2 and the mental component summary score was 46.4±8.9. A median total physical activity of 524 metabolic equivalent-min/week was reported. A significant MANCOVA model (Wilks' λ=0.962, F(2,423)=8.44, P<0.001) indicated that elderly individuals with pre-diabetes who were physically active reported higher PCS scores (Mdiff=5.2, P<0.001, effective size=0.47) compared with those physically inactive after adjusting for the following covariates: age, gender, marital status, education, smoking, chronic disease, body mass index and waist:hip ratio. CONCLUSIONS The HRQoL of elderly individuals with pre-diabetes is poor in rural China. These findings demonstrated that elderly individuals with pre-diabetes who were physically active had higher PCS scores than those who were physically inactive. Furthermore, these results support the rationale for developing a physical activity intervention for HRQoL of individuals with pre-diabetes. TRIAL REGISTRATION NUMBER ChiCTR-IOR-15007033; Results.
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Affiliation(s)
- Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Lu Tang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Fan Gao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yang Yang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Lulu Qin
- Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha, China
| | - Bang-an Luo
- Department of Mental Health, Brain Hospital of Hunan Province, Changsha, China
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14
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Rodríguez-Gómez I, Santalla A, Díez-Bermejo J, Munguía-Izquierdo D, Alegre LM, Nogales-Gadea G, Arenas J, Martín MÁ, Lucía A, Ara I. A New Condition in McArdle Disease: Poor Bone Health-Benefits of an Active Lifestyle. Med Sci Sports Exerc 2018; 50:3-10. [PMID: 29251685 DOI: 10.1249/mss.0000000000001414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION-PURPOSE McArdle disease (muscle glycogen phosphorylase deficiency) is a genetic condition associated with exercise intolerance, but how it affects lean mass (LM) and bone mineral content (BMC) and density (BMD) in patients is unknown. We compared these variables between McArdle patients and age-/sex-matched healthy controls and assessed their potential association with physical activity levels in patients. METHODS A case-control, cross-sectional design was used to examine LM, BMC, and BMD by using dual-energy x-ray absorptiometry in 136 young adults of both sexes (36 McArdle patients (33 ± 15 yr) and 103 controls (34 ± 11 yr)). Physical activity was assessed using the International Physical Activity Questionnaire. RESULTS McArdle patients had significantly lower LM values in whole-body and regional sites compared with their corresponding controls, whereas no differences were found (except for the trunk) when physically active patients (n = 23) were compared with controls. All bone-related variables were significantly lower in patients than in controls (average difference of 13% for BMC and 7.6% for BMD). By contrast, no significant differences at the lumbar spine, pelvis, and femur sites were found between physically active patients and controls. CONCLUSIONS We report on a previously undescribed condition in McArdle patients, poor bone health, which warrants further attention because it can occur in relatively young adults. An active lifestyle can at least partly alleviate this disorder presumably because of its beneficial effect on LM.
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Affiliation(s)
- Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Alfredo Santalla
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Jorge Díez-Bermejo
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Diego Munguía-Izquierdo
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Luis M Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Gisela Nogales-Gadea
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Joaquin Arenas
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Miguel Ángel Martín
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Alejandro Lucía
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN.,GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, SPAIN
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15
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Oviedo-Caro MÁ, Bueno-Antequera J, Munguía-Izquierdo D. Transcultural adaptation and psychometric properties of Spanish version of Pregnancy Physical Activity Questionnaire: the PregnActive project. GACETA SANITARIA 2018; 33:369-376. [PMID: 29566956 DOI: 10.1016/j.gaceta.2017.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/28/2017] [Accepted: 12/31/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To transculturally adapt the Spanish version of Pregnancy Physical Activity Questionnaire (PPAQ) analyzing its psychometric properties. METHODS The PPAQ was transculturally adapted into Spanish. Test-retest reliability was evaluated in a subsample of 109 pregnant women. The validity was evaluated in a sample of 208 pregnant women who answered the questionnaire and wore the multi-sensor monitor for 7 valid days. The reliability (intraclass correlation coefficient), concordance (concordance correlation coefficient), correlation (Pearson correlation coefficient), agreement (Bland-Altman plots) and relative activity levels (Jonckheere-Terpstra test) between both administrations and methods were examined. RESULTS Intraclass correlation coefficients between both administrations were good for all categories except transportation. A low but significant correlation was found for total activity (light and above) whereas no correlation was found for other intensities between both methods. Relative activity levels analysis showed a significant linear trend for increased total activity between both methods. CONCLUSIONS Spanish version of PPAQ is a brief and easily interpretable questionnaire with good reliability and ability to rank individuals, and poor validity compared with multi-sensor monitor. The use of PPAQ provides information of pregnancy-specific activities in order to establish physical activity levels of pregnant women and adapt health promotion interventions.
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Affiliation(s)
- Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.
| | - Javier Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain
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16
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Vincze L, Rollo ME, Hutchesson MJ, Callister R, Collins CE. VITAL change for mums: a feasibility study investigating tailored nutrition and exercise care delivered by video-consultations for women 3-12 months postpartum. J Hum Nutr Diet 2018. [PMID: 29543356 DOI: 10.1111/jhn.12549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND A tailored approach to nutrition and physical activity advice can support women following childbirth in managing barriers (i.e. time and childcare) to making healthy lifestyle changes. The aim of the present study was to evaluate the implementation, acceptability and preliminary efficacy of a personally tailored nutrition and exercise programme for postpartum women delivered via video-consultations by an accredited practising dietitian (APD) and accredited exercise physiologist (AEP). METHODS In this feasibility study (VITAL change for mums), postpartum (3-12 months) women (body mass index ≥25 or >2 kg above pre-pregnancy weight) who were seeking to achieve a healthy weight participated in a single-arm intervention. Participants received up to five real-time personalised video-consultations (2 × APD, 2 × AEP, 1 × either) over the 8-week intervention period. Implementation (recruitment, retention, utilisation), acceptability (participant satisfaction) and preliminary efficacy (anthropometry, dietary intake, cardiovascular fitness, physical activity level, psychological wellbeing) were assessed. RESULTS Thirty women [mean (SD) age 31.6 (3.1) years, body mass index 29.0 (4.0) kg m-2 , 100% married/de facto, 80% university level education] were recruited within 10 days and 27 completed the study. Women's mean (SD) ratings (out of a score of 5) indicated satisfaction with the video-consultations [4.4 (0.9)] and the online setting [4.5 (0.8)]. Women agreed that accessing an APD [4.4 (0.8)] and AEP [4.3 (0.9)] was easier using video-consultations than attending an in-person consultation. Statistically significant improvements in waist circumference, body composition, cardiorespiratory fitness, dietary intake and physical activity were observed from baseline to 8 weeks. CONCLUSIONS The findings of the present study suggest that a nutrition and exercise intervention delivered by qualified health professionals via video-consultations is feasible, acceptable and achieves positive outcomes for women following childbirth.
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Affiliation(s)
- L Vincze
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - M E Rollo
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - M J Hutchesson
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - R Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - C E Collins
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
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17
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Validity and Responsiveness of the FRAIL Scale in Middle-Aged Women. J Am Med Dir Assoc 2018; 19:65-69. [DOI: 10.1016/j.jamda.2017.08.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/07/2017] [Indexed: 11/18/2022]
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18
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Roach LA, Lambert K, Holt JL, Meyer BJ. Diet quality in patients with end-stage kidney disease undergoing dialysis. J Ren Care 2017; 43:226-234. [PMID: 28944596 DOI: 10.1111/jorc.12215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND People on haemodialysis (HD) are at risk of consuming a poor quality diet. This includes inadequate intake of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). OBJECTIVE This study aims to investigate diet quality, with a particular focus on n-3 LCPUFA intake, in a population of incentre HD patients. DESIGN Dietary intake was measured using three 24 hour recalls; the Polyunsaturated food frequency questionnaire (PUFA FFQ) and the Total Diet Score (TDS). Dietary intake was also compared to evidence based practice guidelines (EBPG). Nutritional status was assessed using the Patient Generated Subjective Global Assessment (PG SGA). SUBJECTS A total of 32 dialysis patients were recruited, from two regional HD centres in New South Wales, Australia. MAIN OUTCOME MEASURE Diet quality was the main outcome measure. RESULTS Diet quality of study participants was poor, with the majority not meeting the EBPG for energy, protein and potassium. All participants exceeded the recommended amount of saturated fat. The mean TDS of the dialysis cohort was 10.2, which was significantly higher than the TDS of 9.3 of a healthy disease free cohort (p < 0.05). Positive correlations were found between TDS and LC omega-3 intake (r = 0.392) and TDS and total omega-6 intake (r = 0.363). Only 22% of participants met the suggested dietary target for n-3 LCPUFA intake. CONCLUSION Dialysis patients in this study had suboptimal diet quality. Improvements are required for better adherence to the EBPG. Increased consumption of n-3 LCPUFA fatty acids may also be of benefit.
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Affiliation(s)
- Lauren A Roach
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kelly Lambert
- Illawarra Shoalhaven Local Health District, Department of Clinical Nutrition, Wollongong, New South Wales, Australia
| | - Jane L Holt
- Illawarra Shoalhaven Local Health District, Renal Service, Wollongong, New South Wales, Australia
| | - Barbara J Meyer
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Caperchione CM, Bottorff JL, Oliffe JL, Johnson ST, Hunt K, Sharp P, Fitzpatrick KM, Price R, Goldenberg SL. The HAT TRICK programme for improving physical activity, healthy eating and connectedness among overweight, inactive men: study protocol of a pragmatic feasibility trial. BMJ Open 2017; 7:e016940. [PMID: 28882920 PMCID: PMC5588940 DOI: 10.1136/bmjopen-2017-016940] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Physical activity, healthy eating and maintaining a healthy weight are associated with reduced risk of cardiovascular disease, type 2 diabetes and cancer and with improved mental health. Despite these benefits, many men do not meet recommended physical activity guidelines and have poor eating behaviours. Many health promotion programmes hold little appeal to men and consequently fail to influence men's health practices. HAT TRICK was designed as a 12-week face-to-face, gender-sensitised intervention for overweight and inactive men focusing on physical activity, healthy eating and social connectedness and was delivered in collaboration with a major junior Canadian ice hockey team (age range 16-20 years). The programme was implemented and evaluated to assess its feasibility. This article describes the intervention design and study protocol of HAT TRICK. METHODS AND ANALYSIS HAT TRICK participants (n=60) were men age 35 years, residing in the Okanagan Region of British Columbia, who accumulate 150 min of moderate to vigorous physical activity a week, with a body mass index of >25 kg/m2 and a pant waist size of >38'. Each 90 min weekly session included targeted health education and theory-guided behavioural change techniques, as well as a progressive (ie, an increase in duration and intensity) group physical activity component. Outcome measures were collected at baseline, 12 weeks and 9 months and included the following: objectively measured anthropometrics, blood pressure, heart rate, physical activity and sedentary behaviour, as well as self-reported physical activity, sedentary behaviour, diet, smoking, alcohol consumption, sleep habits, risk of depression, health-related quality of life and social connectedness. Programme feasibility data (eg, recruitment, satisfaction, adherence, content delivery) were assessed at 12 weeks via interviews and self-report. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of British Columbia Okanagan Behavioural Research Ethics Board (reference no H1600736). Study findings will be disseminated through academic meetings, peer-reviewed publication, web-based podcasts, social media, plain language summaries and co-delivered community presentations. TRIAL REGISTRATION NUMBER ISRCTN43361357,Pre results.
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Affiliation(s)
- Cristina M Caperchione
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, British Columbia, Canada
| | - Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, British Columbia, Canada
- School of Nursing, University of British Columbia, Kelowna, Canada
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Steven T Johnson
- Faculty of Health Disciplines, Athabasca University, Edmonton, Alberta, Canada
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Paul Sharp
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kayla M Fitzpatrick
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Ryley Price
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - S Larry Goldenberg
- Department of Urology, University of British Columbia, Vancouver, Canada
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20
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Brady SRE, Monira Hussain S, Brown WJ, Heritier S, Wang Y, Teede H, Urquhart DM, Cicuttini FM. Predictors of Back Pain in Middle-Aged Women: Data From the Australian Longitudinal Study of Women's Health. Arthritis Care Res (Hoboken) 2017; 69:709-716. [DOI: 10.1002/acr.22982] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 05/20/2016] [Accepted: 06/28/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Sharmayne R. E. Brady
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Wendy J. Brown
- School of Human Movement and Nutrition Studies, University of Queensland; St. Lucia Queensland Australia
| | - Stephane Heritier
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Helena Teede
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia, and Monash Health; Clayton Victoria Australia
| | - Donna M. Urquhart
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
| | - Flavia M. Cicuttini
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria Australia
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Clark BK, Kolbe-Alexander TL, Duncan MJ, Brown W. Sitting Time, Physical Activity and Sleep by Work Type and Pattern-The Australian Longitudinal Study on Women's Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E290. [PMID: 28287446 PMCID: PMC5369126 DOI: 10.3390/ijerph14030290] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/27/2017] [Accepted: 03/04/2017] [Indexed: 11/16/2022]
Abstract
Data from the Australian Longitudinal Study on Women's Health were used to examine how work was associated with time spent sleeping, sitting and in physical activity (PA), in working women. Young (31-36 years; 2009) and mid-aged (59-64 years; 2010) women reported sleep (categorised as shorter ≤6 h/day and longer ≥8 h/day) and sitting time (work, transport, television, non-work computer, and other; summed for total sitting time) on the most recent work and non-work day; and moderate and vigorous PA (categorised as meeting/not meeting guidelines) in the previous week. Participants reported occupation (manager/professional; clerical/sales; trades/transport/labourer), work hours (part-time; full-time) and work pattern (shift/night; not shift/night). The odds of shorter sleep on work days was higher in both cohorts for women who worked shift or night hours. Longer sitting time on work days, made up primarily of sitting for work, was found for managers/professionals, clerical/sales and full-time workers. In the young cohort, clerical/sales workers and in the mid-aged cohort, full-time workers were less likely to meet PA guidelines. These results suggest multiple behaviour interventions tailored to work patterns and occupational category may be useful to improve the sleep, sitting and activity of working women.
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Affiliation(s)
- Bronwyn K Clark
- Cancer Prevention Research Centre, School of Public Health, The University of Queensland, Herston 4006, Australia.
| | - Tracy L Kolbe-Alexander
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia 4072, Australia.
- School of Health and Wellbeing, The University of Southern Queensland, Ipswich 4305, Australia.
| | - Mitch J Duncan
- School of Medicine & Public Health, Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
| | - Wendy Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia 4072, Australia.
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Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling. PLoS One 2017; 12:e0172126. [PMID: 28222165 PMCID: PMC5319684 DOI: 10.1371/journal.pone.0172126] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/31/2017] [Indexed: 12/20/2022] Open
Abstract
Background Type 2 diabetes is associated with significant morbidity and mortality. Modifiable risk factors have been found to contribute up to 60% of type 2 diabetes risk. However, type 2 diabetes continues to rise despite implementation of interventions based on traditional risk factors. There is a clear need to identify additional risk factors for chronic disease prevention. The aim of this study was to examine the relationship between perceived stress and type 2 diabetes onset, and partition the estimates into direct and indirect effects. Methods and findings Women born in 1946–1951 (n = 12,844) completed surveys for the Australian Longitudinal Study on Women’s Health in 1998, 2001, 2004, 2007 and 2010. The total causal effect was estimated using logistic regression and marginal structural modelling. Controlled direct effects were estimated through conditioning in the regression model. A graded association was found between perceived stress and all mediators in the multivariate time lag analyses. A significant association was found between hypertension, as well as physical activity and body mass index, and diabetes, but not smoking or diet quality. Moderate/high stress levels were associated with a 2.3-fold increase in the odds of diabetes three years later, for the total estimated effect. Results were only slightly attenuated when the direct and indirect effects of perceived stress on diabetes were partitioned, with the mediators only explaining 10–20% of the excess variation in diabetes. Conclusions Perceived stress is a strong risk factor for type 2 diabetes. The majority of the effect estimate of stress on diabetes risk is not mediated by the traditional risk factors of hypertension, physical activity, smoking, diet quality, and body mass index. This gives a new pathway for diabetes prevention trials and clinical practice.
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Kanesarajah J, Waller M, Whitty JA, Mishra GD. The relationship between SF-6D utility scores and lifestyle factors across three life stages: evidence from the Australian Longitudinal Study on Women’s Health. Qual Life Res 2017; 26:1507-1519. [DOI: 10.1007/s11136-017-1498-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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Aljadani HM, Patterson AJ, Sibbritt D, Collins CE. Diet quality and six-year risk of overweight and obesity among mid-age Australian women who were initially in the healthy weight range. Health Promot J Austr 2017; 27:29-35. [PMID: 26568282 DOI: 10.1071/he14070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 09/24/2015] [Indexed: 02/01/2023] Open
Abstract
Issue addressed The present study investigated the association between diet quality, measured using the Australian Recommended Food Score (ARFS), and 6-year risk of becoming overweight or obese in mid-age women from the Australian Longitudinal Study of Women's Health (ALSWH). Methods Women (n=1107) aged 47.6-55.8 years who were a healthy weight (body mass index (BMI) between ≤18.5 and <25.0kgm(-2)) at baseline and who reported valid total energy intakes were included in the study. BMI was calculated from self-reported data in 2001 and 2007. ARFS scores were calculated from data collected using the Dietary Questionnaire for Epidemiological Studies Version 2. Logistic regression was used to examine the relationship between ARFS score as a continuous variable and risk of becoming overweight or obese. Results The 6-year incidence of overweight and obesity was 18.5% and 1.1%, respectively. The mean (± s.d.) ARFS (maximum possible 74) among those who remained within the healthy weight range and those who became overweight or obese at follow-up was 35.3±8.1 and 34.3±8.8, respectively. There was no relationship between baseline ARFS and risk of becoming overweight or obese over 6 years. Women who were smokers were more likely to become overweight or obese (odds ratio 1.5; 95% confidence interval 1.11-2.09; P=0.008). Conclusions Poor diet quality was common among mid-age women of a healthy weight in the ALSWH. Higher diet quality was not associated with the risk of overweight or obesity after 6 years, yet smoking status was. So what? Better diet quality alone will not achieve maintenance of a healthy weight, but should be encouraged to improve other health outcomes.
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Affiliation(s)
- Haya M Aljadani
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Amanda J Patterson
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - David Sibbritt
- Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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Bottorff JL, Oliffe JL, Sarbit G, Caperchione C, Clark M, Anand A, Howay K. Assessing the feasibility, acceptability and potential effectiveness of an integrated approach to smoking cessation for new and expectant fathers: The Dads in Gear study protocol. Contemp Clin Trials 2017; 54:77-83. [PMID: 28088514 DOI: 10.1016/j.cct.2017.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 01/06/2017] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Evidence related to the effects of tobacco exposure in pregnancy and on infant and child health have focused on women's smoking cessation. Less often addressed is men's smoking, which when continued in fatherhood, reduces the chances of female partners' cessation and can negatively impact children's health as well as men's health. Dads in Gear (DIG) is an innovative program designed specifically for new fathers who want to reduce and quit smoking that includes three components: smoking cessation, fathering, and physical activity. The over-arching purpose of this study is to evaluate the feasibility of the DIG program and provide estimates of program efficacy. The purpose of this article is to describe the rationale and protocol for evaluating the DIG program's feasibility, acceptability and potential effectiveness. METHODS Using a prospective, non-comparative design, the DIG program will be implemented and evaluated in six communities. The program will be offered by trained facilitators to fathers who currently smoke and want to quit. The RE-AIM framework will guide the evaluation. Open-ended questions in participant surveys, and semi-structured interviews and weekly telephone de-briefs with facilitators will provide data for a process evaluation. Estimates of effectiveness include smoking behavior, fathering and physical activity measures at baseline, end of program, and 3-month follow up. CONCLUSION The DIG program could support positive changes with respect to smoking cessation, physical activity and overall health for men. These effects could also promote family health. The program might also provide an effective model for engaging men in other health behavior change.
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Affiliation(s)
- Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 1147 Research Road, Art 223, Kelowna, British Columbia VIV 1V7, Canada; Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.
| | - John L Oliffe
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia V6T 2B5, Canada.
| | - Gayl Sarbit
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 1147 Research Road, Art 223, Kelowna, British Columbia VIV 1V7, Canada.
| | - Cristina Caperchione
- School of Health and Exercise Sciences, University of British Columbia, 1147 Research Road, Art 360, Kelowna, British Columbia VIV 1V7, Canada.
| | - Marianne Clark
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 1147 Research Road, Art 223, Kelowna, British Columbia VIV 1V7, Canada.
| | - Anima Anand
- The Bridge Youth and Family Services, #8-2604 Enterprise Way, Kelowna, British Columbia V1X 7Y5, Canada.
| | - Kym Howay
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 1147 Research Road, Art 223, Kelowna, British Columbia VIV 1V7, Canada.
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Barrett JE, Plotnikoff RC, Courneya KS, Raine KD. Physical Activity and Type 2 Diabetes. DIABETES EDUCATOR 2017; 33:128-43. [PMID: 17272799 DOI: 10.1177/0145721706297453] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to explore (1) patterns in physical activity behaviors and (2) the meaning and personal significance of social cognitive theory (SCT) constructs on physical activity, across gender and income groups among people with type 2 diabetes (T2DM). METHODS Albertans, 18 years and older (x- = 63, SD = 12.08) with T2DM (N = 1614) completed self-report measures of demographic characteristics and physical activity. Two-way, between-groups analyses of variance (ANOVAs) assessed main and interaction effects of gender and income on leisure time physical activity (LTPA). A subsample of these participants (n = 20) subsequently completed qualitative telephone interviews to provide contextual understanding of the quantitative data and to explore salient SCT influences on physical activity. RESULTS Significant findings indicated that men participate in more LTPA than women do, and those from the highest income group participate in more LTPA than low- or middle-income groups (P < .01). Interview results suggested that walking is the most popular form of physical activity; however, gender and income groups differ in other leisure and nonleisure physical activities. Furthermore, patterns for SCT constructs related to physical activity were apparent across gender and income, most noticeably for self-efficacy and environmental and situational influences. Specifically among men, noteworthy differences existed between income groups for self-control and reinforcement strategies. CONCLUSIONS The study highlights the need for more sensitive self-report measures and objective measures of physical activity to help distinguish whether true differences exist between certain demographic groups. Moreover, interventions that promote walking may be beneficial for people with T2DM, provided that appropriate environmental and policy changes occur to accommodate walking and other physical activity behaviors.
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Affiliation(s)
- Jennifer E Barrett
- The Centre for Health Promotion Studies, School of Public Health, University of Alberta, Alberta, Canada (Ms Barrett, Dr Plotnikoff, Dr Raine)
| | - Ronald C Plotnikoff
- The Centre for Health Promotion Studies, School of Public Health, University of Alberta, Alberta, Canada (Ms Barrett, Dr Plotnikoff, Dr Raine)
- The Faculty of Physical Education (Dr Plotnikoff, Dr Courneya)
| | | | - Kim D Raine
- The Centre for Health Promotion Studies, School of Public Health, University of Alberta, Alberta, Canada (Ms Barrett, Dr Plotnikoff, Dr Raine)
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Heesch KC, van Gellecum YR, Burton NW, van Uffelen JGZ, Brown WJ. Physical activity and quality of life in older women with a history of depressive symptoms. Prev Med 2016; 91:299-305. [PMID: 27612579 DOI: 10.1016/j.ypmed.2016.09.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/30/2016] [Accepted: 09/06/2016] [Indexed: 01/07/2023]
Abstract
Physical activity (PA) is positively associated with health-related quality of life (HRQL) in older adults. It is not evident whether this association applies to older adults with poor mental health. This study examined associations between PA and HRQL in older women with a history of depressive symptoms. Participants were 555 Australian women born in 1921-1926 who reported depressive symptoms in 1999 on a postal survey for the Australian Longitudinal Study on Women's Health. They completed additional surveys in 2002, 2005 and 2008 that assessed HRQL and weekly minutes walking, in moderate PA, and in vigorous PA. Random effects mixed models were used to examine concurrent and prospective associations between PA and each of 10 HRQL measures (eight SF-36 subscales; two composite scales). In concurrent models, higher levels of PA were associated with better HRQL (p<0.001). The strongest associations were found for the bodily pain, physical functioning, general health perceptions, social functioning and vitality measures. Associations were attenuated in prospective models, more so for mental HRQL-related scales than for physical HRQL-related scales. However, strong associations (>3 point differences) were evident for physical functioning, general health, vitality and social functioning. For women in their 70s-80s with a history of depressive symptoms, PA is positively associated with HRQL concurrently, and to a lesser extent prospectively. This study extends previous work by showing significant associations in older women with a history of depressive symptoms. Incorporating PA into depression management of older women may improve their HRQL.
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Affiliation(s)
- Kristiann C Heesch
- School of Public Health and Social Work and Institute of Health & Biomedical Innovation, Queensland University of Technology Victoria, Park Road, Brisbane, QLD 4059, Australia.
| | - Yolanda R van Gellecum
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive, Brisbane, QLD 4072, Australia.
| | - Nicola W Burton
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive, Brisbane, QLD 4072, Australia.
| | - Jannique G Z van Uffelen
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive, Brisbane, QLD 4072, Australia; Institute of Sport, Exercise and Active Living, Victoria University, Footscray Park Campus, Ballarat Road, Melbourne, VIC 8001, Australia.
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive, Brisbane, QLD 4072, Australia.
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Plotnikoff RC, Brunet S, Courneya KS, Spence JC, Birkett NJ, Marcus B, Whiteley J. The Efficacy of Stage-Matched and Standard Public Health Materials for Promoting Physical Activity in the Workplace: The Physical Activity Workplace Study (PAWS). Am J Health Promot 2016; 21:501-9. [PMID: 17674637 DOI: 10.4278/0890-1171-21.6.501] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To compare the effects of stage-matched and standard print materials for physical activity (PA) change. Design. Participants were randomized into (1) a stage-matched intervention group (n = 165), (2) a standard intervention group (n = 176), or (3) a no-contact control group (n = 166). The stage-matched and standard intervention groups both received materials at baseline, 3 months, and 6 months. Assessments of all three groups were conducted at baseline, 6, and 12 months. Setting. Canadian worksites. Subjects. Employees (N = 507). Interventions. Five motivationally targeted booklets were developed for the stage-matched group. The standard group received Canada's Physical Activity Guide and handbook. Measures. The main dependent variable was PA, expressed as metabolic equivalent (MET) minutes and measured using the Godin Leisure-Time Exercise Questionnaire. Demographic characteristics and stages of change for PA were also assessed. Results. At 12 months mean weekly MET minutes for combined moderate and vigorous activity increased from baseline by 223, 67, and 78 for the stage-matched, standard, and control groups, respectively; however, differences were not significant (p > .05). Women in the stage-matched group over the 12-month period significantly increased their activity by 327 weekly MET minutes whereas the standard and control groups declined their activity (F = 3.01, p < .05). Conclusion. PA stage-matched materials delivered in the workplace are efficacious for women but not men. Future interventions should explore the use of these intervention materials in conjunction with multilevel strategies, and particular attention should be paid to possible gender differences.
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Giles-Corti B, Macintyre S, Clarkson JP, Pikora T, Donovan RJ. Environmental and Lifestyle Factors Associated with Overweight and Obesity in Perth, Australia. Am J Health Promot 2016; 18:93-102. [PMID: 13677967 DOI: 10.4278/0890-1171-18.1.93] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To examine associations between environmental and lifestyle factors and overweight or obesity. Design. A cross-sectional survey and an environmental scan of recreational facilities. Setting. Metropolitan Perth, Western Australia. Subjects. Healthy sedentary workers and homemakers aged 18 to 59 years (n = 1803) living in areas within the top and bottom quintiles of social disadvantage. Measures. Four lifestyle factors, one social environmental factor, and five physical environment factors (three objectively measured). Results. After adjustment for demographic factors and other variables in the model, overweight was associated with living on a highway (odds ratio [OR], 4.24; 95% confidence interval [CI], 1.62–11.09) or streets with no sidewalks or sidewalks on one side only (OR, 1.35; 95% CI, 1.03–1.78) and perceiving no paths within walking distance (OR, 1.42; 95% CI, 1.08–1.86). Poor access to four or more recreational facilities (OR, 1.68; 95% CI, 1.11–2.55) and sidewalks (OR, 1.62; 95% CI, .98–2.68) and perceiving no shop within walking distance (OR, 1.84; 95% CI, 1.01–3.36) were associated with obesity. Conversely, access to a motor vehicle all the time was negatively associated with obesity (OR, .56; 95% CI, .32–.99). Watching 3 or more hours of television daily (ORs, 1.92 and 1.85, respectively) and rating oneself as less active than others (ORs, 1.66 and 4.05, respectively) were associated with both overweight and obesity. After adjustment for individual demographic factors and all other variables in the model, socioeconomic status of area of residence and leisure-time physical activity were not associated with overweight or obesity. Conclusion. Factors that influence overweight and obesity appear to differ, but aspects of the physical environment may be important. Objectively measured neighborhood environment factors warrant further investigation.
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Affiliation(s)
- Billie Giles-Corti
- School of Population Health, University of Western Australia, Crawley 6009, Western Australia
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30
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Bauman A, Phongsavan P, Schoeppe S, Owen N. Physical activity measurement- a primer for health promotion. ACTA ACUST UNITED AC 2016; 13:92-103. [PMID: 17017286 DOI: 10.1177/10253823060130020103] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As the importance of physical activity is recognised in health promotion, the task of measuring it becomes a central research and practice challenge. Measurement of physical activity is important to policy makers interested in population surveillance, as well as to practitioners interested in programme evaluation and research. This review outlines 'best practice' in physical activity measurement, and provides an inventory of established physical activity and related measures for use in health promotion programme evaluation, research and surveillance at the national and local level.
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Affiliation(s)
- Adrian Bauman
- Centre for Physical Activity and Health, School of Public Health, Building K25, University of Sydney, Australia.
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Caperchione CM, Sabiston CM, Clark MI, Bottorff JL, Toxopeus R, Campbell KL, Eves ND, Ellard SL, Gotay C. Innovative approach for increasing physical activity among breast cancer survivors: protocol for Project MOVE, a quasi-experimental study. BMJ Open 2016; 6:e012533. [PMID: 27531738 PMCID: PMC5013483 DOI: 10.1136/bmjopen-2016-012533] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Physical activity is a cost-effective and non-pharmaceutical strategy that can help mitigate the physical and psychological health challenges associated with breast cancer survivorship. However, up to 70% of women breast cancer survivors are not meeting minimum recommended physical activity guidelines. Project MOVE is an innovative approach to increase physical activity among breast cancer survivors through the use of Action Grants, a combination of microgrants (small amounts of money awarded to groups of individuals to support a physical activity initiative) and financial incentives. The purpose of this paper is to describe the rationale and protocol of Project MOVE. METHOD AND ANALYSIS A quasi-experimental pre-post design will be used. Twelve groups of 8-12 adult women who are breast cancer survivors (N=132) were recruited for the study via face-to-face meetings with breast cancer-related stakeholders, local print and radio media, social media, and pamphlets and posters at community organisations and medical clinics. Each group submitted a microgrant application outlining their proposed physical activity initiative. Successful applicants were determined by a grant review panel and informed of a financial incentive on meeting their physical activity goals. An evaluation of feasibility will be guided by the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework and assessed through focus groups, interviews and project-related reports. Physical activity will be assessed through accelerometry and by self-report. Quality of life, motivation to exercise and social connection will also be assessed through self-report. Assessments will occur at baseline, 6 months and 1 year. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of British Columbia's Behavioural Research Ethics Board (#H14-02502) and has been funded by the Canadian Cancer Society Research Institute (project number #702913). Study findings will be disseminated widely through peer-reviewed publications, academic conferences, local community-based presentations, as well as partner organisations, including the Canadian Cancer Society.
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Affiliation(s)
- Cristina M Caperchione
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
- School of Nursing and Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, British Columbia, Canada
- Centre for Heart, Lung and Vascular Health, University of British Columbia, Kelowna, British Columbia, Canada
| | | | - Marianne I Clark
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
- School of Nursing and Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, British Columbia, Canada
| | - Joan L Bottorff
- School of Nursing and Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, Kelowna, British Columbia, Canada
- Faculty of Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Renee Toxopeus
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neil D Eves
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
- Centre for Heart, Lung and Vascular Health, University of British Columbia, Kelowna, British Columbia, Canada
| | - Susan L Ellard
- Cancer Centre of the Southern Interior, British Columbia Cancer Agency, Kelowna, British Columbia, Canada
| | - Carolyn Gotay
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
Fertility rates in the developed world have been below replacement level for 25 years, and it is often assumed that this results from deliberate, unconstrained individual choice. Data from 7448 childless women aged 22 to 27, participating in the Australian Longitudinal Study on Women’s Health, indicate that 9 per cent aspire to childlessness, with 72 per cent wanting 1 or 2 children and 19 per cent more. Differences in psychological functioning disappear after adjustment for socioeconomic variables. Women wanting 1 or 2 children also want paid work, while those wanting many children generally have traditional aspirations. Policy-makers need to consider strategies that support women to negotiate motherhood and paid work.
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Affiliation(s)
- Christina Lee
- School of Psychology, University of Queensland, St Lucia, Australia.
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Brady SRE, Hussain SM, Brown WJ, Heritier S, Billah B, Wang Y, Teede H, Urquhart DM, Cicuttini FM. Relationships Between Weight, Physical Activity, and Back Pain in Young Adult Women. Medicine (Baltimore) 2016; 95:e3368. [PMID: 27175634 PMCID: PMC4902476 DOI: 10.1097/md.0000000000003368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Back pain causes enormous financial and disability burden worldwide, which could potentially be reduced by understanding its determinants to develop effective prevention strategies. Our aim was to identify whether modifiable risk factors, weight and physical activity, are predictive of back pain in young adult women.Women born between 1973 and 1978 were randomly selected from the national health insurance scheme database to participate in The Australian Longitudinal Study of Women's Health. Self-reported data on back pain in the last 12 months, weight, height, age, education status, physical activity, and depression were collected in 2000, 2003, 2006, 2009, and 2012. In 2000, 9688 women completed the questionnaire and 83% completed follow-up 12 years later.At baseline, median age was 24.6 years and 41% had self-reported back pain. For every 5 kg higher weight at baseline, there was a 5% (95% confidence interval [CI] 4%-6%) increased risk of back pain over the next 12 years. Higher weight at each survey also predicted back pain risk 3 years later (P < 0.001). The effects of weight on back pain were most significant in those with BMI ≥25 kg/m and were observed at all levels of physical activity. Inadequate physical activity and depression were independent predictors of back pain over the following 12 years (both P < 0.001), after adjusting for age, weight, height, and education status.Back pain is common in community-based young adult women. Higher weight, inadequate levels of physical activity, and depression were all independent predictors of back pain over the following decade. Furthermore, the adverse effects of weight on back pain were not mitigated by physical activity. Our findings highlight the role of both higher weight and physical inactivity in back pain among young women and suggest potential opportunities for future prevention.
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Affiliation(s)
- Sharmayne R E Brady
- From the Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria (SREB, SMH, SH, BB, YW, DMU, FMC); School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland (WJB); Monash Center for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University (HT); and Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Victoria, Australia (HT)
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Dontje ML, Krijnen WP, de Greef MHG, Peeters GGMEE, Stolk RP, van der Schans CP, Brown WJ. Effect of diagnosis with a chronic disease on physical activity behavior in middle-aged women. Prev Med 2016; 83:56-62. [PMID: 26656407 DOI: 10.1016/j.ypmed.2015.11.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/12/2015] [Accepted: 11/29/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Although regular physical activity is an effective secondary prevention strategy for patients with a chronic disease, it is unclear whether patients change their daily physical activity after being diagnosed. Therefore, the aims of this study were to (1) describe changes in levels of physical activity in middle-aged women before and after diagnosis with a chronic disease (heart disease, diabetes, asthma, breast cancer, arthritis, depression); and to (2) examine whether diagnosis with a chronic disease affects levels of physical activity in these women. METHODS Data from 5 surveys (1998-2010) of the Australian Longitudinal Study on Women's Health (ALSWH) were used. Participants (N=4840, born 1946-1951) completed surveys every three years, with questions about diseases and leisure time physical activity. The main outcome measure was physical activity, categorized as: nil/sedentary, low active, moderately active, highly active. RESULTS At each survey approximately half the middle-aged women did not meet the recommended level of physical activity. Between consecutive surveys, 41%-46% of the women did not change, 24%-30% decreased, and 24%-31% increased their physical activity level. These proportions of change were similar directly after diagnosis with a chronic disease, and in the years before or after diagnosis. Generalized estimating equations showed that there was no statistically significant effect of diagnosis with a chronic disease on levels of physical activity in women. CONCLUSION Despite the importance of physical activity for the management of chronic diseases, most women did not increase their physical activity after diagnosis. This illustrates a need for tailored interventions to enhance physical activity in newly diagnosed patients.
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Affiliation(s)
- Manon L Dontje
- Hanze University of Applied Sciences, Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
| | - Wim P Krijnen
- Hanze University of Applied Sciences, Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands.
| | - Mathieu H G de Greef
- Hanze University of Applied Sciences, Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.
| | - Geeske G M E E Peeters
- The University of Queensland, School of Population Health, Brisbane, Australia; The University of Queensland, School of Human Movement Studies, Brisbane, Australia.
| | - Ronald P Stolk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
| | - Cees P van der Schans
- Hanze University of Applied Sciences, Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation, Groningen, The Netherlands.
| | - Wendy J Brown
- The University of Queensland, School of Human Movement Studies, Brisbane, Australia.
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Al Sayah F, Johnson ST, Vallance J. Health Literacy, Pedometer, and Self-Reported Walking Among Older Adults. Am J Public Health 2015; 106:327-33. [PMID: 26691129 DOI: 10.2105/ajph.2015.302901] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association of health literacy with physical activity and physical activity guideline adherence in older adults. METHODS We used cross-sectional data from a 2012 population-based study in Alberta, Canada, assessing health literacy, and deriving moderate-to-vigorous physical activity (MVPA) and metabolic equivalent of task (MET) minutes per week from the Godin Leisure-Time Exercise Questionnaire, and steps per day via a pedometer. RESULTS Mean age of participants (n = 1296) was 66.4 (SD = 8.2) years, 57% were female, and 94% were White. Nine percent had inadequate health literacy, and 46% met guidelines for self-reported physical activity and 18% for steps per day. Participants with inadequate health literacy had nonsignificant adjusted decrements of 58 MVPA minutes and 218 MET minutes per week and were less likely to meet physical activity guidelines (MVPA: odds ratio = 0.63; 95% confidence interval [CI] = 0.41, 0.97; P = .037; MET: odds ratio = 0.65; 95% CI = 0.42, 1.01; P = .057) compared with their health-literate counterparts. Such differences were nonsignificant for steps per day. CONCLUSIONS Inadequate health literacy was associated with less likelihood of meeting MVPA guidelines based on self-reported physical activity, but not based on an objective measure of steps per day.
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Affiliation(s)
- Fatima Al Sayah
- Fatima Al Sayah is with School of Public Health, University of Alberta, Edmonton, Alberta, Canada. Steven T. Johnson and Jeff K. Vallance are with Centre for Nursing and Health Studies, Athabasca University, Edmonton
| | - Steven T Johnson
- Fatima Al Sayah is with School of Public Health, University of Alberta, Edmonton, Alberta, Canada. Steven T. Johnson and Jeff K. Vallance are with Centre for Nursing and Health Studies, Athabasca University, Edmonton
| | - Jeff Vallance
- Fatima Al Sayah is with School of Public Health, University of Alberta, Edmonton, Alberta, Canada. Steven T. Johnson and Jeff K. Vallance are with Centre for Nursing and Health Studies, Athabasca University, Edmonton
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Caperchione CM, Sharp P, Bottorff JL, Stolp S, Oliffe JL, Johnson ST, Jones-Bricker M, Errey S, Christian H, Healy T, Medhurst K, Lamont S. The POWERPLAY workplace physical activity and nutrition intervention for men: Study protocol and baseline characteristics. Contemp Clin Trials 2015; 44:42-47. [DOI: 10.1016/j.cct.2015.07.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/07/2015] [Accepted: 07/12/2015] [Indexed: 12/16/2022]
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Taylor LM, Raine KD, Plotnikoff RC, Vallance JK, Sharma AM, Spence JC. Understanding physical activity in individuals with prediabetes: an application of social cognitive theory. PSYCHOL HEALTH MED 2015; 21:254-60. [DOI: 10.1080/13548506.2015.1058486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tzelepis F, Paul CL, Wiggers J, Kypri K, Bonevski B, McElduff P, Hill MA, Morgan PJ, Lynagh M, Collins CE, Campbell E, Courtney RJ, Chapman K, Wolfenden L, Guillaumier A, Searles A. Targeting multiple health risk behaviours among vocational education students using electronic feedback and online and telephone support: protocol for a cluster randomised trial. BMC Public Health 2015; 15:550. [PMID: 26071306 PMCID: PMC4465000 DOI: 10.1186/s12889-015-1898-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 06/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Technical and Further Education (TAFE) colleges are the primary provider of vocational education in Australia. Most TAFE students are young adults, a period when health risk behaviours become established. Furthermore, high rates of smoking, risky alcohol consumption, inadequate fruit and vegetable intake and insufficient physical activity have been reported in TAFE students. There have been no intervention studies targeting multiple health risk behaviours simultaneously in this population. The proposed trial will examine the effectiveness of providing TAFE students with electronic feedback regarding health risk behaviours and referral to a suite of existing online and telephone services addressing smoking, risky alcohol consumption, fruit and vegetable intake, and physical activity levels. METHODS/DESIGN A two arm, parallel, cluster randomised trial will be conducted within TAFE campuses in New South Wales (NSW), Australia. TAFE classes will be randomly allocated to an intervention or control condition (50 classes per condition). To be eligible, students must be: enrolled in a course that runs for more than 6 months; aged 16 years or older; and not meet Australian health guideline recommendations for at least one of the following: smoking, alcohol consumption, fruit and/or vegetable intake, or physical activity. Students attending intervention classes, will undertake via a computer tablet a risk assessment for health risk behaviours, and for behaviours not meeting Australian guidelines be provided with electronic feedback about these behaviours and referral to evidence-based online programs and telephone services. Students in control classes will not receive any intervention. Primary outcome measures that will be assessed via online surveys at baseline and 6 months post-recruitment are: 1) daily tobacco smoking; 2) standard drinks of alcohol consumed per week; 3) serves of fruit consumed daily; 4) serves of vegetables consumed daily; and 5) metabolic equivalent minutes of physical activity per week. DISCUSSION Proactive enrolment to existing online and telephone services has the potential to address modifiable determinants of disease. This trial will be the first to examine a potentially scalable intervention targeting multiple health risk behaviours among students in the vocational training setting. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12615000105549; Registered 5/2/15.
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Affiliation(s)
- Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter New England Population Health, Hunter New England Area Health District, New South Wales, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Christine L Paul
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter New England Population Health, Hunter New England Area Health District, New South Wales, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Billie Bonevski
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Patrick McElduff
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Mary Ann Hill
- Hunter Institute of Technical and Further Education (TAFE), TAFE New South Wales, New South Wales, Australia.
| | - Philip J Morgan
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia. .,School of Education, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Marita Lynagh
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Clare E Collins
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia. .,School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, New South Wales, Australia.
| | - Elizabeth Campbell
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter New England Population Health, Hunter New England Area Health District, New South Wales, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia.
| | - Kathy Chapman
- Cancer Council New South Wales, Woolloomoolloo, New South Wales, Australia.
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter New England Population Health, Hunter New England Area Health District, New South Wales, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Ashleigh Guillaumier
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
| | - Andrew Searles
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, 2308, Australia. .,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
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Heesch KC, van Gellecum YR, Burton NW, van Uffelen JGZ, Brown WJ. Physical activity, walking, and quality of life in women with depressive symptoms. Am J Prev Med 2015; 48:281-91. [PMID: 25595606 DOI: 10.1016/j.amepre.2014.09.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/15/2014] [Accepted: 09/26/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical activity (PA) has a positive association with health-related quality of life (HRQL) in the general population. The association between PA and HRQL in those with poor mental health is less clear. PURPOSE To examine the concurrent and prospective dose-response relationships between total PA (TPA) and walking only with HRQL in women aged 50-55 years with depressive symptoms in 2001. METHODS Participants were 1,904 women born in 1946-1951 who completed mailed surveys for the Australian Longitudinal Study on Women's Health in 2001, 2004, 2007, and 2010, and reported depressive symptoms in 2001. At each time point, they reported their weekly minutes of walking, moderate PA, and vigorous PA. A summary TPA score was created that accounted for differences in energy expenditure among the three PA types. Mixed models were used to examine associations between TPA and HRQL (short form-36 [SF-36] component and subscale scores) and between walking and HRQL, for women who reported walking as their only PA. Analyses were conducted in 2013-2014. RESULTS Concurrently, higher levels of TPA and walking were associated with better HRQL (p<0.05). The strongest associations were found for physical functioning, vitality, and social functioning subscales. In prospective models, associations were attenuated, yet compared with women doing no TPA or walking, women doing "sufficient" TPA or walking had significantly better HRQL over time for most SF-36 scales. CONCLUSIONS This study extends previous work by demonstrating trends between both TPA and walking and HRQL in women reporting depressive symptoms.
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Affiliation(s)
- Kristiann C Heesch
- Queensland University of Technology, Institute of Health & Biomedical Innovation and the School of Public Health and Social Work, QLD, Australia; The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia.
| | - Yolanda R van Gellecum
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia
| | - Nicola W Burton
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia
| | - Jannique G Z van Uffelen
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia; Victoria University, Institute of Sport, Exercise and Active Living, Melbourne, VIC, Australia
| | - Wendy J Brown
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia
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Abdi J, Eftekhar H, Mahmoodi M, Shojayzadeh D, Sadeghi R. Physical Activity Status and Position of Governmental Employees in Changing Stage Based on the Trans-Theoretical Model in Hamadan, Iran. Glob J Health Sci 2015; 7:23-32. [PMID: 26156899 PMCID: PMC4803843 DOI: 10.5539/gjhs.v7n5p23] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/19/2015] [Indexed: 01/18/2023] Open
Abstract
Physical inactivity is the fourth leading risk factor for death worldwide. Given the key role of employees as valuable human resources and increasing sedentary life style among them, the aim of this study was to evaluate physical activity status and position of governmental employees in changing stage based on the Trans-Theoretical Model (TTM) in Hamadan, Iran, in 2014. This descriptive-analytical study was performed on 1200 government employees selected using proportional stratified random sampling. Data collection was performed using a three-section questionnaire containing demographic characteristics, SQUASH (Short questionnaire to assess health-enhancing physical activity) questionnaire and Marcus et al’s five-part algoritm. Data were analyzed by multiple linear and logistic regression, Chi-square, T-test and ANOVA using SPSS-20. The mean age of the participants was 38.12±8.04 years. About a half of the employees were in the preparatory stage of TTM.49.2% and 50.8% of the sample were classified as active and inactive, respectively. Associations between physical activity status and exercise stage of change were found. The associations between exercise stage of change and age, sex, work experience, education and marital status were significant (p<0.05). Work experience and education were strongly predictors of physical activity (PA) status and accounted for 31.2% of variance in PA (adjusted R2=0.312, R2 change=0.01). The results of this study showed that TTM was useful to evaluate and predict physical activity behavior among the Iranian governmental employees and can be utilized by health planners to inform appropriate intervention strategies, specifically in work place.
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Affiliation(s)
- Jalal Abdi
- Department of Health Education and Promotion, School of public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Albright CL, Saiki K, Steffen AD, Woekel E. What barriers thwart postpartum women's physical activity goals during a 12-month intervention? A process evaluation of the Nā Mikimiki Project. Women Health 2015; 55:1-21. [PMID: 25402618 DOI: 10.1080/03630242.2014.972014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Approximately 70% of new mothers do not meet national guidelines for moderate-to-vigorous physical activity (MVPA). The Nā Mikimiki ("the active ones") Project (2008-2011) was designed to increase MVPA among women with infants 2-12 months old. Participants' barriers to exercising and achievement of specific MVPA goals were discussed during telephone counseling calls over 12 months. Healthy, inactive women (n = 115, mean age = 31 ± 5 years, infants' mean age = 5.5 ± 3 months; 80% racial/ethnic minorities) received a total of 17 calls over 12 months in three phases. During Phase 1 weekly calls were made for a month, in Phase 2 biweekly calls were made for 2 months, and in Phase 3 monthly calls were made for 9 months. Across all phases, the most frequent barriers to achieving MVPA goals were: time/too busy (25%), sick child (11%), and illness (10%). Goals for MVPA minutes per week were achieved or surpassed 40.6% of the time during weekly calls, 39.9% during biweekly calls, and 42.0% during monthly calls. The least likely MVPA goals to be achieved (p < 0.04) were those which the woman encountered and for which she failed to overcome the barriers she had previously anticipated would impair her improvement of MVPA. This process evaluation demonstrated that telephone counseling somewhat facilitated the resolution of barriers and achievement of MVPA goals; thus, if clinical settings adopted such methods, chronic disease risks could be reduced in this vulnerable population of new mothers.
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Affiliation(s)
- Cheryl L Albright
- a School of Nursing & Dental Hygiene , University of Hawaii at Manoa , Honolulu , Hawaii , USA
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Weir DL, Johnson ST, Mundt C, Bray D, Taylor L, Eurich DT, Johnson JA. A primary care based healthy-eating and active living education session for weight reduction in the pre-diabetic population. Prim Care Diabetes 2014; 8:301-307. [PMID: 24582002 DOI: 10.1016/j.pcd.2014.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 01/27/2014] [Accepted: 01/28/2014] [Indexed: 11/23/2022]
Abstract
AIMS Many studies have demonstrated the effectiveness of primary prevention strategies in type 2 diabetes, however, questions remain around the feasibility of high resource, intensive interventions within a healthcare setting. We report the results of a dietitian-led pre-diabetes education session targeting healthy eating and active living as strategies for weight reduction. METHODS Participants were asked to complete a baseline questionnaire prior to completing the pre-diabetes education session and were sent follow-up questionnaires at 3 and 6 months. Differences between participants at baseline, 3 and 6 months were determined using χ(2), t-tests and ANOVA. RESULTS Of the 211 participants asked to fill out baseline questionnaires, 45 participants completed questionnaires at baseline, 3 months and 6 months. Although we observed general trends towards improvements in diet, physical activity and weight related behaviours among the 45 completers, no significant changes were observed among participants between questionnaire periods. CONCLUSION A "one-off", theory-guided group education session may be insufficient to support lifestyle modifications in the context of weight management in a pre-diabetic population. Further evaluation of the efficacy and feasibility of the PCN as a setting for lifestyle intervention is required.
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Affiliation(s)
- Daniala L Weir
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
| | - Steven T Johnson
- Centre for Nursing and Health Studies, Athabasca University, Athabasca, Alberta, Canada.
| | - Clark Mundt
- Centre for Nursing and Health Studies, Athabasca University, Athabasca, Alberta, Canada.
| | - Dianne Bray
- St. Albert-Sturgeon Primary Care Network, Alberta, Canada.
| | - Lorian Taylor
- Nutrition Services' Alberta Health Services, Alberta, Canada.
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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Effectiveness of a 12-month randomized clinical trial to increase physical activity in multiethnic postpartum women: results from Hawaii's Nā Mikimiki Project. Prev Med 2014; 69:214-23. [PMID: 25285751 PMCID: PMC4312232 DOI: 10.1016/j.ypmed.2014.09.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 08/16/2014] [Accepted: 09/24/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Few postpartum ethnic minority women perform leisure-time moderate-to-vigorous physical activity (MVPA). The study tested the effectiveness of a 12-month tailored intervention to increase MVPA in women with infants 2-12months old. METHODS From 2008 to 2011, women (n=311) with infants (average age=5.7months) from Honolulu, Hawaii were randomly assigned to receive tailored telephone calls and access to a mom-centric website (n=154) or access to a standard PA website (n=157). MVPA was measured at baseline, 6, and 12months using self-report and acclerometers. RESULTS Controlling for covariates, the tailored condition significantly increased self-reported MVPA from an average of 44 to 246min/week compared with 46 to 156min/week for the standard condition (p=0.027). Mothers with≥2 children had significantly greater increases in MVPA in response to the tailored intervention than those with one child (p=0.016). Accelerometer-measured MVPA significantly increased over time (p=0.0001), with no condition differences. There was evidence of reactivity to initially wearing accelerometers; the tailored intervention significantly increased MVPA among women with low baseline accelerometer MVPA minutes, but not among those with high minutes (pinteraction=0.053). CONCLUSION A tailored intervention effectively increased MVPA over 12months in multiethnic women with infants, particularly those with more than one child.
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Clark BK, Peeters GMEE, Gomersall SR, Pavey TG, Brown WJ. Nine year changes in sitting time in young and mid-aged Australian women: findings from the Australian Longitudinal Study for Women's Health. Prev Med 2014; 64:1-7. [PMID: 24657548 DOI: 10.1016/j.ypmed.2014.03.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/27/2014] [Accepted: 03/12/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine changes in sitting time (ST) in women over nine years and to identify associations between life events and these changes. METHODS Young (born 1973-78, n=5215) and mid-aged (born 1946-51, n=6973) women reported life events and ST in four surveys of the Australian Longitudinal Study on Women's Health between 2000 and 2010. Associations between life events and changes in ST between surveys (decreasers ≥2 h/day less, increasers ≥2 h/day more) were estimated using generalized estimating equations. RESULTS Against a background of complex changes there was an overall decrease in ST in young women (median change -0.48 h/day, interquartile range [IQR]=-2.54, 1.50) and an increase in ST in mid-aged women (median change 0.43 h/day; IQR=-1.29, 2.0) over nine years. In young women, returning to study and job loss were associated with increased ST, while having a baby, beginning work and decreased income were associated with decreased ST. In mid-aged women, changes at work were associated with increased ST, while retiring and decreased income were associated with decreased ST. CONCLUSIONS ST changed over nine years in young and mid-aged Australian women. The life events they experienced, particularly events related to work and family, were associated with these changes.
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Affiliation(s)
- B K Clark
- The University of Queensland, Centre for Research on Exercise Physical Activity and Health, School of Human Movement Studies, Brisbane, Australia.
| | - G M E E Peeters
- The University of Queensland, Centre for Research on Exercise Physical Activity and Health, School of Human Movement Studies, Brisbane, Australia; The University of Queensland, School of Population Health, Brisbane, Australia
| | - S R Gomersall
- The University of Queensland, Centre for Research on Exercise Physical Activity and Health, School of Human Movement Studies, Brisbane, Australia
| | - T G Pavey
- The University of Queensland, Centre for Research on Exercise Physical Activity and Health, School of Human Movement Studies, Brisbane, Australia
| | - W J Brown
- The University of Queensland, Centre for Research on Exercise Physical Activity and Health, School of Human Movement Studies, Brisbane, Australia
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Unsaturated fat intakes and mental health outcomes in young women from the Australian Longitudinal Study on Women’s Heath. Public Health Nutr 2014; 18:546-53. [DOI: 10.1017/s1368980014000561] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractObjectiveTo determine if associations exist between a range of unsaturated fatty acid intakes and mental health outcomes.DesignCross-sectional data analysis of the Australian Longitudinal Study on Women’s Health (ALSWH) Young Cohort Survey 3 that included the validated seventy-four-item Dietary Questionnaire for Epidemiological Studies FFQ, validated mental health scales and self-report questions on depression and anxiety.SettingAustralia, 2003.SubjectsA nationally representative sample of young Australian women (25–30 years) from ALSWH. The 7635 women with plausible energy intakes (>4·5 but <20·0 MJ/d) were included in the analyses.ResultsAdjusted logistic regression analyses found statistically significant associations between higher intakes of α-linolenic acid and decreased likelihood of depressive symptoms indicated by the ten-item Center for Epidemiological Studies Depression Scale (CESD-10; OR=0·77; 95 % CI 0·60, 0·99; P=0·040) and the Short Form Health Survey (SF-36) mental health subscale (OR=0·73 95 % CI 0·56, 0·96; P=0·024). Furthermore, higher intakes of n-6 fatty acids (OR=0·96, 95 % CI 0·93, 0·99; P=0·019) and linoleic acid (OR=0·96, 95 % CI 0·93, 0·99; P=0·020) were associated with decreased likelihood of self-reported diagnosed anxiety and higher intakes of n-9 fatty acids (OR=1·02, 95 % CI 1·00, 1·04; P=0·041) and oleic acid (OR=1·02, 95 % CI 1·00, 1·05; P=0·046) were associated with increased likelihood of self-reported diagnosed anxiety.Conclusions:Increased intakes of α-linolenic acid were associated with a reduced likelihood of depressive symptoms, increased intakes of n-6 fatty acids and linoleic acid were associated with a reduced likelihood of self-reported anxiety, and increased intakes of n-9 fatty acids and oleic acid were associated with an increased likelihood of anxiety. Additional studies are needed to further elucidate associations between unsaturated fatty acids and depression and anxiety.
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Ibrahim N, Moy FM, Awalludin IAN, Ali Z, Ismail IS. The health-related quality of life among pre-diabetics and its association with body mass index and physical activity in a semi-urban community in Malaysia--a cross sectional study. BMC Public Health 2014; 14:298. [PMID: 24684809 PMCID: PMC3976088 DOI: 10.1186/1471-2458-14-298] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 03/20/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND People with pre-diabetes are at high risk of developing type 2 diabetes and cardiovascular diseases. Measurements of health-related quality of life (HRQOL) among pre-diabetics enable the health care providers to understand their overall health status and planning of interventions to prevent type 2 diabetes. Therefore we aimed to determine the HRQOL and physical activity level; and its association with Body Mass Index (BMI) among pre-diabetics. METHODS This was a cross sectional study carried out in two primary care clinics in a semi-urban locality of Ampangan, Negeri Sembilan, Malaysia. Data was collected through self-administered questionnaires assessing the demographic characteristics, medical history, lifestyle and physical activity. The Short Form 36-items health survey was used to measure HRQOL among the pre-diabetics. Data entry and analysis were performed using the SPSS version 19. RESULTS A total of 268 eligible pre-diabetics participated in this study. The prevalence of normal weight, overweight and obesity were 7.1%, 21.6% and 71.3% respectively. Their mean (SD) age was 52.5 (8.3) years and 64.2% were females. Among the obese pre-diabetics, 42.2% had both IFG and IGT, 47.0% had isolated IFG and 10.8% had isolated IGT, 36.2% had combination of hypertension, dyslipidemia and musculoskeletal diseases. More than 53.4% of the obese pre-diabetics had family history of diabetes, 15.7% were smokers and 60.8% were physically inactive with mean PA of <600 MET-minutes/week. After adjusted for co-variants, Physical Component Summary (PCS) was significantly associated with BMI categories [F (2,262)=11.73, p<0.001] where pre-diabetics with normal weight and overweight had significantly higher PCS than those obese; normal vs obese [Mdiff=9.84, p=0.006, 95% CIdiff=2.28, 17.40] and between overweight vs obese [Mdiff=8.14, p<0.001, 95% CIdiff=3.46, 12.80]. CONCLUSION Pre-diabetics who were of normal weight reported higher HRQOL compared to those overweight and obese. These results suggest a potentially greater risk of poor HRQOL among pre-diabetics who were overweight and obese especially with regard to the physical health component. Promoting recommended amount of physical activity and weight control are particularly important interventions for pre-diabetics at the primary care level.
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Affiliation(s)
- Norliza Ibrahim
- Department of Social and Preventive Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Foong Ming Moy
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | | | - Zainudin Ali
- State Health Department of Negeri Sembilan, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia
| | - Ikram Shah Ismail
- Diabetes Association, Petaling Jaya, 46200 Selangor, Malaysia
- Department of Medicine, University Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia
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Ferrara A, Hedderson MM, Albright CL, Brown SD, Ehrlich SF, Caan BJ, Sternfeld B, Gordon NP, Schmittdiel JA, Gunderson EP, Mevi AA, Tsai AL, Ching J, Crites Y, Quesenberry CP. A pragmatic cluster randomized clinical trial of diabetes prevention strategies for women with gestational diabetes: design and rationale of the Gestational Diabetes' Effects on Moms (GEM) study. BMC Pregnancy Childbirth 2014; 14:21. [PMID: 24423410 PMCID: PMC3897959 DOI: 10.1186/1471-2393-14-21] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 12/18/2013] [Indexed: 12/04/2022] Open
Abstract
Background Women with gestational diabetes (GDM) are at high risk of developing diabetes later in life. After a GDM diagnosis, women receive prenatal care to control their blood glucose levels via diet, physical activity and medications. Continuing such lifestyle skills into early motherhood may reduce the risk of diabetes in this high risk population. In the Gestational Diabetes’ Effects on Moms (GEM) study, we are evaluating the comparative effectiveness of diabetes prevention strategies for weight management designed for pregnant/postpartum women with GDM and delivered at the health system level. Methods/Design The GEM study is a pragmatic cluster randomized clinical trial of 44 medical facilities at Kaiser Permanente Northern California randomly assigned to either the intervention or usual care conditions, that includes 2,320 women with a GDM diagnosis between March 27, 2011 and March 30, 2012. A Diabetes Prevention Program-derived print/telephone lifestyle intervention of 13 telephonic sessions tailored to pregnant/postpartum women was developed. The effectiveness of this intervention added to usual care is to be compared to usual care practices alone, which includes two pages of printed lifestyle recommendations sent to postpartum women via mail. Primary outcomes include the proportion of women who reach a postpartum weight goal and total weight change. Secondary outcomes include postpartum glycemia, blood pressure, depression, percent of calories from fat, total caloric intake and physical activity levels. Data were collected through electronic medical records and surveys at baseline (soon after GDM diagnosis), 6 weeks (range 2 to 11 weeks), 6 months (range 12 to 34 weeks) and 12 months postpartum (range 35 to 64 weeks). Discussion There is a need for evidence regarding the effectiveness of lifestyle modification for the prevention of diabetes in women with GDM, as well as confirmation that a diabetes prevention program delivered at the health system level is able to successfully reach this population. Given the use of a telephonic case management model, our Diabetes Prevention Program-derived print/telephone intervention has the potential to be adopted in other settings and to inform policies to promote the prevention of diabetes among women with GDM. Trial registration Clinical Trials.gov number, NCT01344278.
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Affiliation(s)
- Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, USA.
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Potter JL, Collins CE, Brown LJ, Hure AJ. Diet quality of Australian breast cancer survivors: a cross-sectional analysis from the Australian Longitudinal Study on Women's Health. J Hum Nutr Diet 2014; 27:569-76. [PMID: 24387188 DOI: 10.1111/jhn.12198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Evidence supports strong associations between healthful eating patterns and maintaining a healthy weight with favourable health outcomes for breast cancer survivors (BCS). The present study aimed to evaluate the diet quality of Australian BCS and to determine whether diet quality differed between BCS and age-matched healthy controls (HC) or by geographical location. METHODS This cross-sectional study included 281 BCS and 4069 HC from the Australian Longitudinal Study on Women's Health mid-aged cohort completing Survey 3 in 2001. Data from the Dietary Questionnaire for Epidemiological Studies food frequency questionnaire were used to calculate the Australian Recommended Food Score (ARFS), a validated summary estimate of diet quality based on adherence to the Australian dietary guidelines. RESULTS The mean (SD) ARFS of the BCS group was 33.2 (9.4) out of a maximum of 74. Mean (SD) total ARFS and component scores of BCS did not differ from the HC group [32.9 (8.7)] and no differences were found in ARFS between urban and rural BCS. CONCLUSIONS This is the first study dedicated exclusively to describing the diet quality of Australian BCS. Although no difference was found when comparisons were made with a HC group, there is considerable room for improvement in the diet quality of Australian BCS. Given research suggesting higher risk of chronic conditions such as obesity amongst BCS, and the recognition of optimising diet quality as a key factor in health promotion for all population groups, data from the present study suggest the need for research targeting the feasibility and impact of improving diet quality of Australian BCS.
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Affiliation(s)
- J L Potter
- School of Health Sciences, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW, Australia
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Badr H, Chandra J, Paxton RJ, Ater JL, Urbauer D, Cruz CS, Demark-Wahnefried W. Health-related quality of life, lifestyle behaviors, and intervention preferences of survivors of childhood cancer. J Cancer Surviv 2013; 7:523-34. [PMID: 23749663 PMCID: PMC3825822 DOI: 10.1007/s11764-013-0289-3] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 04/15/2013] [Indexed: 12/01/2022]
Abstract
PURPOSE Childhood cancer survivors (CCSs) are at increased risk for poor health-related quality of life (HRQOL) and chronic health conditions-both of which can be exacerbated by unhealthy lifestyle behaviors. Developing a clearer understanding of the associations between HRQOL, lifestyle behaviors, and medical and demographic variables (e.g., age/developmental stage at time of diagnosis) is an important step toward developing more targeted behavioral interventions for this population. METHOD Cross-sectional questionnaires were completed by 170 CCSs who were diagnosed with leukemia, lymphoma, sarcoma, or a cancer of the central nervous system (CNS) and treated at a comprehensive cancer center between 1992 and 2007. Questionnaires addressed weight status, lifestyle behaviors, aspects of HRQOL, and intervention preferences. RESULTS Adolescent and young adult survivors (AYAs) and survivors of CNS tumors or lymphoma reported significantly (p < .05) poorer HRQOL across multiple domains compared to those diagnosed at an earlier age, survivors of leukemia or sarcoma, and healthy populations. A significant proportion also failed to meet national recommendations for dietary intakes (39-94 %) and physical activity (65 %). Female survivors reported poorer physical functioning and consumed less dietary fiber and fruits and vegetables than did male survivors. They also expressed the strongest interest in participating in diet and exercise interventions. CONCLUSION Findings support the premise that females, AYAs, and survivors of cancers of the CNS or lymphoma are "at risk" subgroups within the CCS population for poor dietary practices, sedentary behaviors, and poor HRQOL. Future research should focus on developing diet and PA interventions to improve HRQOL that target these groups. IMPLICATIONS FOR CANCER SURVIVORS Greater consideration of the role of gender, developmental stage, and the HRQOL challenges facing CCSs may help researchers to develop targeted behavioral interventions for those who stand to benefit the most.
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Affiliation(s)
- Hoda Badr
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA,
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Jones C, Jancey J, Howat P, Dhaliwal S, Burns S, McManus A, Hills AP, Anderson AS. Utility of stages of change construct in the planning of physical activity interventions among playgroup mothers. BMC Res Notes 2013; 6:300. [PMID: 23895288 PMCID: PMC3734053 DOI: 10.1186/1756-0500-6-300] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 07/17/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The objective of this research was to assess the physical activity levels among a unique cohort of Western Australian (WA) mothers with young children who attend a WA Playgroup. Associated factors were also investigated, including self-efficacy for physical activity, social support for exercise, relevant socio-demographic correlates, as well as the stages of change construct within the Transtheoretical Model (TTM). RESULTS 421 women completed a questionnaire assessing physical activity behaviours. Of these, 368 participants completed the relevant physical activity evaluation items. 82.5% and 17.5% of the sample were classified as active and inactive, respectively. Associations between physical activity status and exercise stage of change were found. Additional associations were established for partner support and self-efficacy for physical activity. CONCLUSION The majority of the sample was classified as active. Despite the high percentage of active participants, this study confirms the usefulness of the stages of change measure in that it can be utilised by health promotion practitioners to report physical activity behaviour and develop appropriate intervention strategies among a time poor and hard to reach population. Specifically the results are relevant to mothers in over 16,000 WA families who are involved with Playgroup WA programs. Interventions aimed at improving physical activity levels in mothers with young children should also consider the need to improve self-efficacy and social support.
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Affiliation(s)
- Carlie Jones
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Perth, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Perth, Australia
| | - Jonine Jancey
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Perth, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Perth, Australia
| | - Peter Howat
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Perth, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Perth, Australia
| | - Satvinder Dhaliwal
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Perth, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Perth, Australia
| | - Sharyn Burns
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Perth, Australia
| | - Alexandra McManus
- Curtin Health Innovation Research Institute, Curtin University, Western Australia, Perth, Australia
| | - Andrew P Hills
- Mater Mother’s Hospital, Mater Medical Research Institute and Griffith Health Institute, Griffith University, Queensland, Nathan, Australia
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, UK
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