Peer-supported lifestyle interventions on body weight, energy intake, and physical activity in adults: A systematic review and meta-analysis

Effectiveness of improving nutrition on depressive symptoms and work ability: Study protocol for the mind nutrition randomized controlled trial

Background: Depression is a growing public health concern that negatively impacts work ability and performance. Psychiatric nurses have an elevated risk for depressive symptoms, and it is essential to ensure their good mental health and work ability. The association between nutrition and depression is recognized, but there is a need for randomized, controlled intervention studies investigating the effectiveness of diet on depressive symptoms and related work impairment. Aim: Mind Nutrition is a randomized, controlled intervention study examining whether improving nutrition can reduce depressive symptoms and depressive symptoms-related sick leaves and enhance work ability and quality of life among mental health and substance abuse professionals. Methods: We will recruit 125 nurses and social welfare professionals from the mental health and substance abuse field of the Satakunta Wellbeing Services County. Half of the participants will be randomized to the intervention and half to the control group. Subjects in the intervention group will participate in two individual and three group counselling sessions during a 6-month intervention. Nutrition counselling follows the Finnish Nutrition Recommendations. The control group will maintain their habitual diet. The Center for Epidemiological Studies - Depression, depressive symptoms-related sick leave days, two work ability indicators, a Food Frequency Questionnaire, three-day food records, Three-Factor Eating Questionnaire - 18 and WHO-8 Eurohis Quality of Life will be assessed at baseline and 6 months. Summary: This study will provide evidence of the effectiveness of nutrition counselling on depressive symptoms and related sick leave days, work ability and quality of life.

Peer Intervention in Obesity and Physical Activity: Effectiveness and Implementation

PURPOSE OF REVIEW

This paper reports the effectiveness of peer intervention in physical activity and obesity, with a focus on implementation. Peer intervention is a parallel method to traditional professional clinical processes, often targeting hard to reach populations. It includes peer education, peer counseling and peer support.

RECENT FINDINGS

There were ten reviews on Physical Activity and seven on Obesity. Six reviews on obesity had mainly positive results; one on obesity in mental health was more negative. About two-thirds of reviews of Physical Activity interventions had positive outcomes. The overall effect was moderate. There were 39 single studies on Obesity and 46 on Physical Activity. 36% of Obesity studies and 13% of Physical Activity studies were from developing countries. Three single studies from developing countries and three from developed countries were elaborated. The extensively described implementation program was from a developed country. Discussion of limitations and strengths led to recommendations for implementation and evaluation. Overall, peer intervention in both obesity and physical activity showed quite strong evidence of effectiveness. Had all studies followed the implementation/evaluation recommendations, the strength of evidence might have been better. Future research should focus on cost-effectiveness and long-term follow-up.

General practitioner-centered rural obesity management: Design, protocol and baseline data of the German HAPpEN pragmatic trial

Objective

HAPpEN aims to implement and evaluate a holistic general practitioner-centered, interdisciplinary obesity management strategy in rural Germany, focusing on feasibility, health outcomes, and economic benefits.

Methods

HAPpEN is a 12-month, pragmatic single-arm, multicenter trial, informed by a formative survey, and initiated in April 2023 with 98 obese participants (body mass index, BMI ≥ 30 kg/m2) in Kulmbach, Germany. The program integrates nutritional counseling, physical activity, and behavior change techniques, including smartphone-based self-monitoring. Monthly consultations help set personalized goals using a multi-stage grading scale. Primary outcomes include BMI, body weight, waist circumference, heart rate, blood pressure and parameters, while secondary outcomes assess quality of life, wellbeing, health literacy, social interaction, and digital therapy support.

Results

The baseline cohort (mean age: 46.9 ± 11.8 years, 74.1 % female) exhibited high obesity rates (mean BMI: 40.1 ± 6.1 kg/m2), with 48.5 % classified as grade III obese. Common comorbidities were hypertension (51.8 %), dyslipidemia (30.5 %) and diabetes (21.8 %). Chronic joint paint, mainly in the knees and hips, affected up to 82.4 %. A familial aggregation of obesity, diabetes, and cardiovascular diseases was noted, alongside behavioral challenges such as lack of physical activity (81.8 %) and unhealthy eating habits (56.8 %).

Conclusion

HAPpEN addresses obesity's multifactorial nature through general practitioner-led, community-based, and digital strategies to promote sustainable lifestyle changes in rural areas. The trial aims to inform primary care obesity management guidelines, focusing on improving health literacy, patient engagement, and long-term clinical benefits. German Clinical Trials Register: DRKS00033916.

Evaluating the efficacy of the Thai Health Improvement Profile intervention for preventing weight gain in people with early stage psychosis: A randomized controlled trial

OBJECTIVES

To investigate the efficacy of the Thai Health Improvement Profile intervention for preventing clinically significant weight gain in people with early stage psychosis.

METHODS

We undertook a randomised controlled trial from 10/2018 to 05/2021. Participants with early stage psychosis (<5 year duration) were recruited using convenience sampling from the caseloads of community psychiatric nurses in Thailand and randomly allocated to either the Thai Health Improvement Profile intervention or treatment as usual group following baseline assessment. Outcome assessors were blind to group allocation, whereas participants were not. Participants in the intervention group received three monthly (five in total) systematic health checks using the Thai Health Improvement Profile tool, which was used to develop a personal health plan in collaboration with a family member/carer. Nurses supported participants to implement the health plan using behaviour change techniques derived from motivational interviewing. The treatment as usual group consisted of medication and psychosocial support, and no additional intervention was provided. The primary outcome was weight gain (defined as a greater or equal to 7 % increase in weight against baseline) within 1 year.

RESULTS

Fifty-three participants were allocated to the intervention and an equal number to the treatment as usual group. Primary outcome data were available for 30 participants in each group at the 12 month follow-up. We undertook an intention to treat analysis with multiple imputation (to handle the missing data) for the primary outcome. The treatment as usual group was found to have higher odds than the Thai Health Improvement Profile intervention group of gaining ≥7 % of baseline body weight (OR = 6.52; 95 % CI: 1.88-22.65, p = 0.004).

CONCLUSIONS

The Thai Health Improvement Profile intervention was effective at preventing weight gain in people with early stage psychosis at one year, though attrition was relatively high. The results highlight the need for community mental health nurses to adopt a holistic approach, the potential benefits of conducting regular comprehensive health checks and the importance of involving family members when aiming to improve the physical health of people diagnosed with early stage psychosis. A large definitive multi-site randomised controlled trial of the Thai Health Improvement Profile with a longer follow-up is now justified.

TRIAL REGISTRATION

Prospectively registered with the Thai Clinical Trials Registry (reference: TCTR20180305002).

Peer Education and Peer Counselling for Health and Well-Being: A Review of Reviews

Peer education and peer counselling for health and wellbeing have been recognized as complementary approaches to professional intervention for over 50 years, but it is relatively recently that research into effects has become adequate. Potentially, they have advantages in reaching where professionals cannot, but it has not been clear if that potential is fulfilled, although the measurement of effects is difficult. The present paper examines 58 narrative and systematic reviews and meta-analyses on the topic. In peer education, there were many reviews of sexual health and of HIV/AIDS interventions, followed by reviews of various medical conditions and in the context of prisons. More general reviews covered a wider field. In peer counselling, there were several reviews of breast-feeding and mental health. Many early reviews complained of the lack of evaluation; then, later reviews found knowledge gains but not behavior gains; then, still later reviews found both knowledge and behavior gains. Thus, peer education and counselling appear effective but only if organizational factors are well managed and the cultural context of the country respected. The implications for future practice, policy and research were outlined.

Effect of a 1-Year Controlled Lifestyle Intervention on Body Weight and Other Risk Markers (the Healthy Lifestyle Community Programme, Cohort 2)

INTRODUCTION

The prevalence of obesity is high and increasing worldwide. Obesity is generally associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a lifestyle intervention on body weight and other chronic disease risk markers.

METHODS

A non-randomized controlled trial was conducted, including mostly middle-aged and elderly participants recruited from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme, focussing on four key areas: a largely plant-based diet (strongest emphasis), physical activity, stress management, and community support. Parameters were assessed at baseline, 10 weeks, 6 months, and 1 year. The control group received no intervention.

RESULTS

Compared to the control, in the intervention group, significantly lower 1-year trajectories were observed for body weight, body mass index (BMI), waist circumference (WC), total cholesterol, calculated LDL cholesterol, non-HDL cholesterol, remnant cholesterol (REM-C), glucose, HbA1c, and resting heart rate (RHR). However, between-group differences at 1 year were small for glucose, HbA1c, and cholesterol (apart from REM-C). No significant between-group differences were found for 1-year trajectories of measured LDL cholesterol, HDL cholesterol, triglycerides, insulin, blood pressure, and pulse pressure.

CONCLUSION

The intervention successfully reduced body weight, BMI, WC, REM-C, and RHR. However, at 1 year, effectiveness of the intervention regarding other risk markers was either very modest or could not be shown.