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Kourpas E, Makrilakis K, Dafoulas G, Iotova V, Tsochev K, Dimova R, Cardon G, González-Gil EM, Moreno L, Kivelä J, Lindström J, Rurik I, Antal E, Timpel P, Schwartz P, Mavrogianni C, Manios Y, Liatis S. Factors affecting continuous participation in follow-up evaluations during a lifestyle intervention programme for type 2 diabetes prevention: The Feel4Diabetes-study. Diabet Med 2024:e15368. [PMID: 38837852 DOI: 10.1111/dme.15368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
AIMS Community- and school-based lifestyle interventions are an efficient method of preventing type 2 diabetes in vulnerable populations. Many participants, however, fail to complete the necessary follow-ups. We investigated factors affecting the continuous participation in follow-up evaluations during the Feel4Diabetes-study, a multilevel intervention programme implemented across Europe. METHODS Socioeconomic, sociodemographic and clinical factors were assessed for 2702 participants within six participating countries: Bulgaria and Hungary (low-to-middle-income countries, LMIC), Belgium and Finland (high-income countries, HIC) and Greece and Spain (high-income countries under austerity measures, HICAM). RESULTS Statistically significant differences were detected with respect to sex, control group, education level, employment status, BMI and blood pressure measurements (systolic and diastolic blood pressure). Post hoc analysis revealed significant differences within socioeconomic regions. Higher levels of education were associated with significantly lower attrition in HIC (p < 0.05) and HICAM (p < 0.001), higher employment status was associated with lower attrition in HICAM (p < 0.001) and being female was associated with lower attrition in LMIC (p < 0.001). Surprisingly, the intervention group exhibited higher-than-expected attrition in HIC (p < 0.001) and HICAM (p = 0.003), and lower attrition in LMIC (p = 0.007). When tested together in the same multivariable predictive model, all sociodemographic and socioeconomic variables along with higher BMI retained their statistical significance, while systolic and diastolic blood pressure failed to remain significant. CONCLUSIONS Key socioeconomic and sociodemographic factors along with BMI play a significant role in determining continuous participation in follow-up evaluations during school- and community-based intervention programmes.
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Affiliation(s)
- Elias Kourpas
- Department of Business Administration, Gies College of Business, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Diabetes Centre, Laiko General Hospital, Athens, Greece
| | - George Dafoulas
- Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Roumyana Dimova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Esther M González-Gil
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Moreno
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Lindström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Peter Schwartz
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Stavros Liatis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Diabetes Centre, Laiko General Hospital, Athens, Greece
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Keshavarz M, Sénéchal M, Bouchard DR. Online Circuit Training Increases Adherence to Physical Activity: A Randomized Controlled Trial of Men with Obesity. Med Sci Sports Exerc 2023; 55:2308-2315. [PMID: 37535330 DOI: 10.1249/mss.0000000000003270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
PURPOSE This study aimed to examine adherence to the weekly physical activity guidelines (≥150 min of aerobic activities at moderate-to-vigorous intensity and two or more sessions of strength training (yes or no)) and health outcomes during the COVID-19 pandemic for men living with obesity, 46 wk after being offered an online muscle-strengthening circuit program for 12 wk. METHODS Sixty men (age ≥19 yr) living with obesity (body fat percentage ≥25%) were randomly assigned to the intervention group ( n = 30) or the control condition ( n = 30) for 12 wk. The intervention group was offered an online circuit training, three sessions per week, whereas the control group received a website helping them to reach the physical activity guidelines. Adherence to the weekly physical activity guidelines was evaluated 46 wk after enrolling in the program using a heart rate tracker (Fitbit Charge 3) and an exercise log. Health outcomes (e.g., anthropometrics, body composition) were measured at baseline and after 12, 24, and 46 wk. RESULTS The intervention group had higher adherence to physical activity guidelines at 46 wk (36.8%) than the control group (5.3%; P = 0.02). However, no difference in health outcomes was observed between participants in the intervention group compared with the control group after 12, 24, and 46 wk. CONCLUSIONS Increasing adherence to exercise in men living with obesity is challenging. The proposed program increased adherence to the physical activity guidelines after about a year for men living with obesity; however, more studies are needed to understand how to improve health outcomes when following an online delivery exercise program in this population.
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Huttunen-Lenz M, Raben A, Adam T, Macdonald I, Taylor MA, Stratton G, Mackintosh K, Martinez JA, Handjieva-Darlenska T, Bogdanov GA, Poppitt SD, Silvestre MP, Fogelholm M, Jalo E, Brand-Miller J, Muirhead R, Schlicht W. Socio-economic factors, mood, primary care utilization, and quality of life as predictors of intervention cessation and chronic stress in a type 2 diabetes prevention intervention (PREVIEW Study). BMC Public Health 2023; 23:1666. [PMID: 37649005 PMCID: PMC10466828 DOI: 10.1186/s12889-023-16569-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW study were examined. METHODS Baseline Quality of Life (QoL), social support, primary care utilization, and mood were examined as predictors of intervention cessation and chronic stress for participants aged 25 to 70 with prediabetes (n = 2,220). Moderating effects of sex and socio-economic status (SES) and independence of predictor variables of BMI were tested. RESULTS Participants with children, women, and higher SES quitted intervention earlier than those without children, lower SES, and men. Lower QoL, lack of family support, and primary care utilization were associated with cessation. Lower QoL and higher mood disturbances were associated with chronic stress. Predictor variables were independent (p ≤ .001) from BMI, but moderated by sex and SES. CONCLUSIONS Policy-based strategy in public health should consider how preventive interventions may better accommodate different individual states and life situations, which could influence intervention completion. Intervention designs should enable in-built flexibility in delivery enabling response to individual needs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01777893.
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Affiliation(s)
- Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education Schwäbisch Gmünd, Oberbettringerstraße 200, 73525, Schwäbisch Gmünd, Germany.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958, Frederiksberg, Denmark
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Tanja Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Ian Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, School of Life Sciences, Nottingham, NG7 2UH, UK
- Nestle Institute of Health Sciences, Nestle Research, Route du Jorat 57, 1000, Lausanne 26, CH, Switzerland
| | - Moira A Taylor
- University of Nottingham, School of Life Sciences, Nottingham, NG7 2UH, UK
| | - Gareth Stratton
- Sport and Exercise Sciences, Swansea University, Swansea, West Glamorgan, UK
| | - Kelly Mackintosh
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, West Glamorgan, UK
| | - J Alfredo Martinez
- Department of Medicine and Endocrinology, University of Valladolid, Valladolid, Spain
- CIBER Fisiopatología Obesidad Y Nutrición (CIBERobn), Instituto de Salud Carlos III, IMDEAfood Madrid, 28029, Madrid, Spain
| | | | - Georgi Assenov Bogdanov
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, 1000, Bulgaria
| | - Sally D Poppitt
- Department of Medicine, University of Auckland, Human Nutrition Unit, School of Biological Sciences, Auckland, 1024, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, 1024, New Zealand
- Nutrition & Metabolism, CINTESIS, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, 00014, Helsinki, Finland
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, 00014, Helsinki, Finland
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Wolfgang Schlicht
- Department of Exercise and Health Sciences, University of Stuttgart, 70569, Stuttgart, Germany
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Cohen Rodrigues TR, Reijnders T, de Buisonjé DR, Breeman LD, van den Broek I, Janssen VR, Kraaijenhagen RA, Atsma DE, Evers AW. Lifestyle support preferences of patients with cardiovascular diseases: What lifestyle support might work best for whom? PEC INNOVATION 2022; 1:100071. [PMID: 37213735 PMCID: PMC10194186 DOI: 10.1016/j.pecinn.2022.100071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/15/2022] [Accepted: 08/12/2022] [Indexed: 05/23/2023]
Abstract
Background Lifestyle support is essential in preventing and treating cardiovascular diseases (CVD), and eHealth may be an easy and affordable solution to provide this support. However, CVD patients vary in their ability and interest to use eHealth. This study investigates demographic characteristics determining CVD patients' online and offline lifestyle support preferences. Methods We used a cross-sectional study design. 659 CVD patients (Harteraad panel) completed our questionnaire. We assessed demographic characteristics and preferred lifestyle support type (coach, eHealth, family/friends, self-supportive). Results Respondents mostly preferred being self-supportive (n = 179, 27.2%), and a coach in a group or individually (n = 145, 22.0%; n = 139, 21.1%). An app/internet to work independently (n = 89, 13.5%) or being in touch with other CVD patients (n = 44, 6.7%) was least preferred. Men were more likely to prefer being supported by family/friends (p = .016) or self-supportive (p < .001), while women preferred a coach individually or via an app/internet (p < .001). Older patients mostly preferred self-support (p = .001). Patients with low social support were more likely to prefer being coached individually (p < .001), but not support from family/friends (p = .002). Conclusion Men and older patients are more interested in being self-supportive, and patients with lower levels of social support could need extra support outside their social network. eHealth could provide a solution, but attention should be paid to spike interest for digital interventions among certain groups.
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Affiliation(s)
- Talia R. Cohen Rodrigues
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
- Corresponding author at: Wassenaarseweg 52, 2333 AK Leiden, the Netherlands.
| | - Thomas Reijnders
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
- Department of Human-Centered Design, Faculty of Industrial Design Engineering, TU Delft, Delft, the Netherlands
| | | | - Linda D. Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
| | | | - Veronica R. Janssen
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
- Department of Cardiology, Leiden University Medical Center, the Netherlands
| | - Roderik A. Kraaijenhagen
- NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, the Netherlands
- Vital10, Amsterdam, the Netherlands
| | - Douwe E. Atsma
- Department of Cardiology, Leiden University Medical Center, the Netherlands
| | - Andrea W.M. Evers
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
- Medical Delta, Leiden University, Technical University of Delft, Erasmus University Rotterdam, the Netherlands
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Sanchez-Johnsen L, Dykema-Engblade A, Rosas CE, Calderon L, Rademaker A, Nava M, Hassan C. Mexican and Puerto Rican Men's Preferences Regarding a Healthy Eating, Physical Activity and Body Image Intervention. Nutrients 2022; 14:4634. [PMID: 36364897 PMCID: PMC9654900 DOI: 10.3390/nu14214634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 01/28/2024] Open
Abstract
This study examined the logistical, practical, and cultural preferences of Latinos regarding the design of a healthy eating, physical activity, and body image intervention. Puerto Rican and Mexican men (n = 203) completed an interview as part of an NIH-funded study. Overall, 66.5% preferred the intervention to be in Spanish only or both Spanish and English; 88.67% said it was moderately, very or extremely important for the intervention leader to be bilingual; and 66.01% considered it moderately to extremely important for the leader to be Hispanic or Latino. Most participants (83.74%) reported they would be willing to attend an intervention that met twice per week and 74.38% said they would be willing to attend an intervention that met for 1.5 to 2 h, twice weekly. Overall, the majority said they would be moderately to extremely interested in attending an exercise program if it consisted of aerobics with Latin or salsa movements (74.88%) and if it consisted of aerobics with Latin or salsa music (70.44%). Some participants were moderately to extremely interested in attending an intervention if it included dichos (Latino sayings) (65.02%) and cuentos (folktales or stories) (69.46%). The findings have implications for lifestyle and body image interventions aimed at preventing cardiometabolic diseases.
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Affiliation(s)
- Lisa Sanchez-Johnsen
- Department of Family and Preventive Medicine, Rush University Medical Center, 1645 West Jackson Blvd, Suite 302, Chicago, IL 60612, USA
- Department of Psychology, University of Illinois at Chicago, 1007 W Harrison St., Chicago, IL 60607, USA
| | - Amanda Dykema-Engblade
- Department of Psychology, Northeastern Illinois University, 5500 North St. Louis Ave, Chicago, IL 60625, USA
| | - Carlos E. Rosas
- Department of Family and Preventive Medicine, Rush University Medical Center, 1645 West Jackson Blvd, Suite 302, Chicago, IL 60612, USA
- Department of Psychology, University of Illinois at Chicago, 1007 W Harrison St., Chicago, IL 60607, USA
| | - Leonilda Calderon
- Puerto Rican Cultural Center, 2628 W. Division St., Chicago, IL 60612, USA
| | - Alfred Rademaker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite #1400, Chicago, IL 60611, USA
| | - Magdalena Nava
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave Suite #1100, Chicago, IL 60601, USA
| | - Chandra Hassan
- Department of Surgery, University of Illinois at Chicago, 840 South Wood Street (MC 958), Chicago, IL 60612, USA
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Hochheim M, Ramm P, Wunderlich M, Amelung V. A cross-sectional study to validate an administrative back pain severity classification tool based on the graded chronic pain scale. Sci Rep 2022; 12:16927. [PMID: 36209228 PMCID: PMC9547910 DOI: 10.1038/s41598-022-21422-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 09/27/2022] [Indexed: 12/29/2022] Open
Abstract
Treatment of chronic lower back pain (CLBP) should be stratified for best medical and economic outcome. To improve the targeting of potential participants for exclusive therapy offers from payers, Freytag et al. developed a tool to classify back pain chronicity classes (CC) based on claim data. The aim of this study was to evaluate the criterion validity of the model. Administrative claim data and self-reported patient information from 3,506 participants (2014-2021) in a private health insurance health management programme in Germany were used to validate the tool. Sensitivity, specificity, and Matthews' correlation coefficient (MCC) were calculated comparing the prediction with actual grades based on von Korff's graded chronic pain scale (GCPS). The secondary outcome was an updated view on direct health care costs (€) of patients with back pain (BP) grouped by GCPS. Results showed a fair correlation between predicted CC and actual GCPS grades. A total of 69.7% of all cases were correctly classified. Sensitivity and specificity rates of 54.6 and 76.4% underlined precision. Correlation between CC and GCPS with an MCC of 0.304 also indicated a fair relationship between prediction and observation. Cost data could be clearly grouped by GCPS: the higher the grade, the higher the costs and the use of health care. This was the first study to compare the predicted severity of BP using claim data with the actual severity of BP by GCPS. Based on the results, the usage of CC as a single tool to determine who receives CLBP treatment cannot be recommended. CC is a good tool to segment candidates for specific types of intervention in BP. However, it cannot replace a medical screening at the beginning of an intervention, as the rate of false negatives is too high. Trial registration The study was conducted using routinely collected data from an intervention, which was previously evaluated and registered retrospectively in the German Registry of Clinical Trials under DRKS00015463 (04/09/2018). Informed consent and the self-reported questionnaire have remained unchanged since the study and, therefore, are still valid according to the ethics proposal.
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Affiliation(s)
- M Hochheim
- Institute of Epidemiology, Social Medicine, and Health System Research, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
- Generali Health Solutions GmbH (GHS), Hansaring 40 - 50, 50670, Köln, Germany.
| | - P Ramm
- Generali Health Solutions GmbH (GHS), Hansaring 40 - 50, 50670, Köln, Germany
| | - M Wunderlich
- Generali Health Solutions GmbH (GHS), Hansaring 40 - 50, 50670, Köln, Germany
| | - V Amelung
- Generali Health Solutions GmbH (GHS), Hansaring 40 - 50, 50670, Köln, Germany
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McMahon J, Thompson DR, Brazil K, Ski CF. An eHealth intervention (ManGuard) to reduce cardiovascular disease risk in male taxi drivers: protocol for a feasibility randomised controlled trial. Pilot Feasibility Stud 2022; 8:209. [PMID: 36104740 PMCID: PMC9472349 DOI: 10.1186/s40814-022-01163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 08/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Men are at higher risk then women of developing cardiovascular disease (CVD), and male taxi drivers are a particularly high-risk group because of their typically unhealthy behaviours, such as poor eating habits, smoking and sedentary lifestyle. However, only two studies of behavioural interventions targeting taxi drivers have been identified, one of which reported a high attrition rate. Therefore, an eHealth intervention co-designed by taxi drivers may prove more acceptable and effective. The aim of this study is to assess the feasibility an eHealth intervention (ManGuard) to reduce CVD risk in male taxi drivers. Methods A randomised wait-list controlled trial will be conducted with a sample of 30 male taxi drivers to establish feasibility, including recruitment, engagement, and retention rates. Program usability and participant satisfaction will be assessed by a survey completed by all participants at 3 months after allocation. Additionally, an in-depth qualitative process evaluation to explore acceptability of the intervention will be conducted with a subset of participants by semi-structured telephone interviews. Preliminary efficacy of ManGuard for improving key CVD-related outcomes will be assessed, including biomarkers (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and total/HDL cholesterol ratio), blood pressure, anthropometry (body mass index, body fat percentage, and waist circumference), physical activity (accelerometery, and self-report) and psychosocial status (health-related quality of life, self-efficacy, and social support). Outcomes will be assessed at baseline, 7 weeks, and 3 months after group allocation. The wait-list control group will be offered access to the intervention at the completion of data collection. Discussion eHealth interventions show potential for promoting behaviour change and reducing CVD risk in men, yet there remains a paucity of robust evidence pertaining to male taxi drivers, classified as a high-risk group. This study uses a randomised controlled trial to assess the feasibility of ManGuard for reducing CVD risk in male taxi drivers. It is envisaged that this study will inform a fully powered trial that will determine the effectiveness of eHealth interventions for this high risk and underserved population. Trial registration This trial has been registered prospectively on the ISRCTN registry on 5 January 2022, registration number ISRCTN29693943 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01163-4.
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Murphy R, Al Rasheed A, Keaver L. Effect of a brief dietary counselling intervention on emergency department cardiac chest pain presentations. BMJ Nutr Prev Health 2022; 5:159-163. [PMID: 36619327 PMCID: PMC9813630 DOI: 10.1136/bmjnph-2021-000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/20/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction 15% of all presentations to our emergency department last year were chest pain related. This presented an opportunity to evaluate the impact of a brief physician counselling intervention on patient-reported changes in cardio-protective foodstuff intake. Methods This is a prospective non-randomised before and after comparison study without controls, conducted between an emergency department presentation and a scheduled follow-up visit at a cardiac diagnostics department. Participants were recruited between February and March 2021. The selected dietary components for inclusion after review of the literature were green leafy vegetables, other coloured vegetables, wholegrains, legumes and fruits. A food frequency questionnaire was completed by patients before and after a physician counselling intervention aided by a dietary infographic. Additionally, using the transtheoretical model for health behaviour change, we assessed each patient's evolution during the study. Results 38 patients were recruited. For patients with total baseline consumptions of five or fewer per day, there was an increase in cardioprotective foodstuff intakes (z=-2.784 p<0.005 effect size 0.39). Corresponding to this, there was a participant shift observed towards the action and maintenance phases of behaviour change from the contemplation and preparation phases. Discussion We demonstrated a statistically significant change with moderate effect size using a simple infographic, coupled with brief physician counselling, to promote increased intake of cardioprotective foodstuffs by patients with poor baseline intakes (<5 cardio-protective foods per day) and known modifiable risk factors for ischaemic heart disease. Conclusion Diet is one arm in the prevention of cardiovascular disease that is often neglected by physicians. This study found that a brief dietary counselling intervention applied in an emergency department setting, administered by non-nutritionists can have a role in changing patient dietary behaviour.
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Affiliation(s)
- Ronan Murphy
- Emergency Department, Sligo University Hospital, Sligo, Ireland
| | | | - Laura Keaver
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland,Health and Biomedical (HEAL) Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
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Perruccio AV, Roos EM, Skou ST, Grønne DT, Davis AM. Factors Influencing Pain Response Following Patient Education and Supervised Exercise in Male and Female Subjects With Hip Osteoarthritis. Arthritis Care Res (Hoboken) 2022; 75:1140-1146. [PMID: 35587461 DOI: 10.1002/acr.24954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/20/2022] [Accepted: 05/10/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To understand factors associated with pain intensity responder status following nonsurgical hip osteoarthritis (OA) intervention, according to sex. METHODS Data were from individuals with hip OA participating in the Danish Good Life With Osteoarthritis in Denmark 8-week education and exercise program. The following factors were recorded at program entry: age; education; mental well-being; comorbidities; body mass index; symptoms in hip, knee, and low back; and program-specific factors including education sessions, former participant lectures, and supervised exercise sessions. Pain intensity was recorded at baseline and at month 3 (post-program) on a 0-100-mm visual analog scale. Response was defined as pain intensity improvement of ≥30% from baseline to post-program. Logistic regression was used and conducted separately in male and female subjects. RESULTS The sample included 791 men and 2,253 women. Female subjects had a mean baseline pain score of 47.2 of 100 (95% confidence interval [95% CI] 46.4-48.1) and male subjects had a score of 41.7 (95% CI 40.3-43.1). By post-program, the proportion of pain responders was 50.4% among women and 45.8% among men (difference P = 0.025). Among women, program-specific factors (attending former participant lectures and more supervised exercise sessions) were positively associated with pain response, as were better mental well-being and fewer comorbidities, while symptoms in other joints/sites were associated with a decreased likelihood of response. Among men, program-specific factors were not associated with response, while better mental well-being and fewer comorbidities were associated with being a responder. CONCLUSION Findings suggest that the influence of some factors on pain response differ for male and female subjects and point to a potential need for targeted approaches for men and women who may require different key messages/approaches from health care providers.
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Affiliation(s)
- Anthony V Perruccio
- University Health Network, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ewa M Roos
- University of Southern Denmark, Odense, Denmark
| | - Søren T Skou
- University of Southern Denmark, Odense, Denmark, and Naestved-Slagelse-Ringsted Hospital, Slagelse, Denmark
| | | | - Aileen M Davis
- University Health Network, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Foettinger L, Albrecht BM, Altgeld T, Gansefort D, Recke C, Stalling I, Bammann K. The Role of Community-Based Men’s Sheds in Health Promotion for Older Men: A Mixed-Methods Systematic Review. Am J Mens Health 2022; 16:15579883221084490. [PMID: 35287514 PMCID: PMC8928410 DOI: 10.1177/15579883221084490] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Men’s Sheds are a community-based health promotion concept which brings men together to engage in joint activities. Prior research reported beneficial effects on health and well-being of the participants; however, evidence is limited. The main objective of this systematic review is to provide an extensive overview of current research on the effectiveness of Men’s Sheds on self-rated health, social isolation, and well-being by applying a mixed-methods approach. In addition, this review aims to identify how to successfully transfer and implement the concept. Eligible for inclusion were all studies published in English, German, or French that specifically referred to the concept of Men’s Sheds. Four databases were searched for eligible studies, followed by a hand search on websites and reference lists. Methodological quality of included studies was assessed using checklists developed by the Joanna Briggs Institute. Following the convergent integrated approach, quantitative data were transformed and merged with qualitative data to conduct a thematic analysis. Overall, 35 qualitative, nine quantitative, and eight mixed-methods studies were included. We found evidence regarding benefits of shed participation on self-rated health, social isolation, and well-being. We identified three key characteristics of a successful Men’s Shed, including appropriate shed facilities, sufficient funding as well as a participant-driven management and organization of the shed. This mixed-methods systematic review provides a comprehensive overview of the evidence base concerning Men’s Sheds and highlights the need for longitudinal studies investigating causal relationships and gathering sufficient information on how to successfully transfer and implement the concept of Men’s Sheds in other countries.
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Affiliation(s)
- Linda Foettinger
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Birte Marie Albrecht
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Thomas Altgeld
- State Association for Health and Academy for Social Medicine Lower Saxony, Lower Saxony, Hannover, Germany
| | - Dirk Gansefort
- State Association for Health and Academy for Social Medicine Lower Saxony, Lower Saxony, Hannover, Germany
| | - Carina Recke
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Imke Stalling
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Karin Bammann
- Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
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11
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Jennings C, Patterson E, Curtis RG, Mazzacano A, Maher CA. Effectiveness of a Lifestyle Modification Program Delivered under Real-World Conditions in a Rural Setting. Nutrients 2021; 13:nu13114040. [PMID: 34836296 PMCID: PMC8620632 DOI: 10.3390/nu13114040] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022] Open
Abstract
Whilst there is considerable evidence to support the efficacy of physical activity and dietary interventions in disease and death prevention, translation of knowledge into practice remains inadequate. We aimed to examine the uptake, retention, acceptability and effectiveness on physical activity, physical function, sitting time, diet and health outcomes of a Healthy Eating Activity and Lifestyle program (HEALTM) delivered under real-world conditions. The program was delivered to 430 adults living across rural South Australia. Participants of the program attended weekly 2 h healthy lifestyle education and exercise group-based sessions for 8 weeks. A total of 47 programs were delivered in over 15 communities. In total, 548 referrals were received, resulting in 430 participants receiving the intervention (78% uptake). At baseline, 74.6% of participants were female, the mean age of participants was 53.7 years and 11.1% of participants identified as Aboriginal and/or Torres Strait Islander. Follow-up assessments were obtained for 265 participants. Significant improvements were observed for walking, planned physical activity, incidental physical activity, total physical activity, 30 s chair stand, 30 s arm curl, 6 min walk, fruit consumption and vegetable consumption, sitting time and diastolic blood pressure. Positive satisfaction and favourable feedback were reported. The healthy lifestyle program achieved excellent real-world uptake and effectiveness, reasonable intervention attendance and strong program acceptability amongst rural and vulnerable communities.
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Affiliation(s)
- Cally Jennings
- Sonder, Edinburgh North, SA 5113, Australia; (E.P.); (A.M.)
- Correspondence:
| | | | - Rachel G. Curtis
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; (R.G.C.); (C.A.M.)
| | - Anna Mazzacano
- Sonder, Edinburgh North, SA 5113, Australia; (E.P.); (A.M.)
| | - Carol A. Maher
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia; (R.G.C.); (C.A.M.)
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12
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Bergin N, Richardson N. 'Sheds for Life': getting the balance right in delivering health promotion through Sheds in Ireland. Health Promot Int 2021; 36:605-615. [PMID: 32830228 DOI: 10.1093/heapro/daaa082] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Men with the poorest health outcomes are, paradoxically, the least likely to access health services or to engage with health promotion interventions. This has focused attention on developing gender-sensitive and strengths-based approaches to engage so-called 'hard-to-reach' men. Men's Sheds ('Sheds') are recognized as an alternative space in which to engage older and more marginalized groups of men in health. The aim of this study was to establish key principles that could align the ethos of Sheds with a national health promotion initiative ('Sheds for Life'; SFL) in terms of methods of engagement, programme content and models of delivery. Qualitative methods incorporating semi-structured interviews, focus groups and observations were conducted with men in Sheds ('Shedders'; n = 38), oversight/advisory groups (n = 11) and partner organizations (n = 8). The principles of grounded theory were used to inform data collection and analysis. Findings revealed a range of mediating factors in terms of how Shedders engage with or 'do' health that were grounded in a recognition of the health-enhancing 'essence' of Sheds and in 'making men's health men's business'. Key learnings arising from the process of engaging with Shedders included the importance of investing in relationships, establishing credibility and tailoring SFL programme content and delivery to individual Sheds. In terms of conceptualizing SFL, attention was drawn to the need for a coherent and formalized SFL strategy and 'rules of engagement', as well as a robust and sustainable system for implementation. This is the first study that informs a more systematic and formal approach to health promotion in Sheds.
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Affiliation(s)
- Niamh Bergin
- National Centre for Men's Health, Institute of Technology Carlow, Ireland
| | - Noel Richardson
- National Centre for Men's Health, Institute of Technology Carlow, Ireland
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13
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McMahon J, Thompson DR, Pascoe MC, Brazil K, Ski CF. eHealth interventions for reducing cardiovascular disease risk in men: A systematic review and meta-analysis. Prev Med 2021; 145:106402. [PMID: 33388336 DOI: 10.1016/j.ypmed.2020.106402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/02/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. Although men often indicate a preference for gender-specific information and support, this rarely occurs. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear. Therefore, the aim of this systematic review and meta-analysis was to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men. A search of published randomised controlled trials with no date restrictions up to July 2020 was conducted to identify those targeting at least two major CVD risk factors. Nine trials were identified and reviewed. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p=0.01), body weight (Z=-3.25, p=0.01), waist circumference (Z=-2.30, p=0.02) and systolic (Z=-3.57, p=0.01) and diastolic (Z=-3.56, p=0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.
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Affiliation(s)
- James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Michaela C Pascoe
- Institute for Health & Sport, Victoria University, Melbourne, Australia
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Chantal F Ski
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK; Integrated Care Academy, University of Suffolk, Ipswich, UK.
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14
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Reynolds GL, Fisher DG. The Role of the Medicaid Expansion in the Use of Preventive Health Care Services in California Men. Am J Mens Health 2021; 14:1557988320903193. [PMID: 31997707 PMCID: PMC6993173 DOI: 10.1177/1557988320903193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Men’s use of preventive care services may be constrained due to a number of factors including lack of health care insurance. California used the Medicaid expansion provisions of the Affordable Care Act (ACA) to enroll low-income men between the ages of 18 and 64 years in publicly funded health insurance. Most studies on the effect of the ACA on health care services have focused on racial/ethnic differences rather than gender. Data from the California Health Interview Survey for the 2015–2016 survey period were used to model the use of preventive health care services in the year prior to interview. Population weights were used in the analysis which was done using PROC SURVEY LOGISTIC in SAS software, version 9.4. The sample consisted of men between the ages of 18 and 64 years (N = 6,180). Of these 66% (n = 4,088) reporting receiving any preventive care services in the year prior to interview. The largest proportions of respondents fell into the youngest group aged 18–25 (17%) followed by the oldest group aged 60–64 (16.9%); 43% reported they were married, 57% had incomes at greater than 300% of the federal poverty level. There was no effect of race or ethnicity on receiving preventive care services. Having a chronic condition such as hypertension or diabetes was associated with a greater odds of receiving preventive care. Expanding Medicaid to include low-income men below the age of 65 is associated with increased use of preventive health care, especially among those with chronic conditions.
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Affiliation(s)
- Grace L Reynolds
- Department of Health Care Administration, California State University, Long Beach, CA, USA.,Center for Behavioral Research & Services, California State University, Long Beach, CA, USA
| | - Dennis G Fisher
- Center for Behavioral Research & Services, California State University, Long Beach, CA, USA.,Department of Psychology, California State University, Long Beach, CA, USA
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15
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Cagas JY, Biddle SJH, Vergeer I. Yoga not a (physical) culture for men? Understanding the barriers for yoga participation among men. Complement Ther Clin Pract 2020; 42:101262. [PMID: 33276223 DOI: 10.1016/j.ctcp.2020.101262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 12/13/2022]
Abstract
Yoga offers an integrated approach to health and well-being that could potentially benefit men. This qualitative descriptive study examined men's perceptions of yoga, and identified barriers and possible facilitators for participation. Twenty-one non-yoga participant men, 18-60 years old, and living in Queensland, Australia, were interviewed. Two major barriers were identified using thematic analysis: (1) preference for other forms of physical activity, and (2) gender-related perceptions and pressures (i.e., perception of yoga as feminine, and presence of "bloke" culture and masculine ideals in society). Potential facilitators included: (1) acceptability of yoga among men, (2) providing brief information sessions, and (3) men-only classes. The non-competitive nature of yoga, in addition to being predominantly undertaken by women, makes it less appealing for men living in Australia. These barriers need to be considered if yoga is to be promoted as an option for men, particularly those not drawn to traditional sports or exercise.
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Affiliation(s)
- Jonathan Y Cagas
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia; Department of Sports Science, College of Human Kinetics, University of the Philippines Diliman, Quezon City, Philippines.
| | - Stuart J H Biddle
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Ineke Vergeer
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
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16
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Jackson MC, Dai S, Skeete RA, Owens-Gary M, Cannon MJ, Smith BD, Jabrah R, Masalovich SE, Soler RE. An Examination of Gender Differences in the National Diabetes Prevention Program's Lifestyle Change Program. DIABETES EDUCATOR 2020; 46:580-586. [PMID: 33063641 DOI: 10.1177/0145721720964585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of the study was to examine how gender was related to enrollment and number of sessions attended in the National Diabetes Prevention Program's Lifestyle Change Program (DPP LCP). METHODS To better understand program uptake, a population of those who would be eligible for the LCP was compared to those who enrolled. Estimates of those eligible were computed using data from the National Health and Nutrition Examination Survey, whereas enrollment and sessions attended were computed using data from the Centers for Disease Control and Prevention's Diabetes Prevention Recognition Program. RESULTS Results revealed that although similar numbers of males and females were eligible for the program, only 39 321 males versus 121 007 females had enrolled in the National DPP LCP by the end of 2017 (odds ratio = 3.20; 95% CI, 3.17-3.24). The gender differences persisted even when stratifying by age or race/ethnicity. In contrast, no significant gender differences were found between the average number of sessions attended for males (14.0) and females (13.8). DISCUSSION Results of the study can help inform efforts to market and tailor programs to appeal more directly to men and other groups that are underrepresented in the National DPP LCP.
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Affiliation(s)
- Matt C Jackson
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Shifan Dai
- CyberData Technologies, Herndon, Virginia
| | - Renée A Skeete
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | | | | | | | | | | | - Robin E Soler
- Centers for Disease Control and Prevention, Atlanta, Georgia
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17
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Bean C, Dineen T, Locke SR, Bouvier B, Jung ME. An Evaluation of the Reach and Effectiveness of a Diabetes Prevention Behaviour Change Program Situated in a Community Site. Can J Diabetes 2020; 45:360-368. [PMID: 33323314 DOI: 10.1016/j.jcjd.2020.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 02/05/2023]
Abstract
More than 350 million people are living with prediabetes. Preventing type 2 diabetes (T2D) progression can reduce morbidity, mortality and health-care costs. Interventions can support people with diet and physical activity behaviour changes; however, many interventions are university-based, posing barriers (e.g. accessibility, limited reach and maintenance), which highlight the need for community intervention. Limited research has comprehensively evaluated programs in community contexts. The purpose of this study was to pragmatically examine the reach and effectiveness of a diabetes prevention behaviour change program in the community using the RE-AIM framework. Demographic and outcome data were collected through telephone screening and survey data, and analyzed using descriptive and multivariate analyses. Over 2 years, 9,954 individuals were identified by a medical laboratory as living with prediabetes. Information letters were sent by the laboratory to individuals upon physician approval (N=2,241, 22.5%) as a main form of recruitment. From this, 271 individuals and an additional 160 individuals via other recruitment methods contacted the research team (N=431). Two hundred thirteen adults with prediabetes were enrolled (87.4% Caucasian, 69.7% female; 95% program completion). Analyses of 6-month follow-up data revealed significant maintenance of reductions in weight and waist circumference and improvements in physical function, self-reported physical activity and all-food frequency items except fruit intake (N=121, d=0.21 to 0.68, p <0.05 to 0.001). The program demonstrated diabetes risk-reducing benefits for enrolled individuals. Future work is needed to increase physician referral and participant response rates and to explore program expansion through digitization to reach more individuals at risk of developing T2D.
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Affiliation(s)
- Corliss Bean
- Faculty of Health and Social Development, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Tineke Dineen
- Faculty of Health and Social Development, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Sean R Locke
- Faculty of Health and Social Development, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Brooklyn Bouvier
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mary E Jung
- Faculty of Health and Social Development, The University of British Columbia, Kelowna, British Columbia, Canada.
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18
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Gaiha SM, Gillander Gådin K. 'No time for health:' exploring couples' health promotion in Indian slums. Health Promot Int 2020; 35:70-81. [PMID: 30590523 DOI: 10.1093/heapro/day101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Joint involvement of couples is an effective strategy to increase contraceptive use and improve reproductive health of women. However, engaging couples to understand how their gender attitudes affect their personal and family health is an idea in search of practice. This mixed-methods study explores opportunities and barriers to couples' participation in health promotion in three slums of Delhi. For each couple, surveys and semi-structured interviews were conducted with husbands and wives individually to contrast self and spousal work, time, interest in health, sources of information related to health and depth of knowledge (n = 62). Urban poverty forces men to work long hours and women to enter part-time work in the informal sector. Paid work induces lack of availability at home, lack of interest in health information and in performing household chores and a self-perception of being healthy among men. These factors inhibit men's' participation in community-based health promotion activities. Women's unpaid work in the household remains unnoticed. Women were expected to be interested in and to make time to attend community-based health-related activities. Men recalled significantly less sources of health information than their spouse. Men and their wives showed similar depth of health-related knowledge, likely due to their spousal communication, with women acting as gatekeepers. Health promotion planners must recognize time constraints, reliance on informal interpersonal communication as a source of health information and the need to portray positive masculinities that address asymmetric gender relations. Innovative, continuous and collaborative approaches may support couples to proactively care about health in low-resource settings.
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Affiliation(s)
- Shivani Mathur Gaiha
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.,Health Communication, Public Health Foundation of India, New Delhi, India
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19
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Huttunen-Lenz M, Raben A, Meinert-Larsen T, Drummen M, Macdonald I, Martínez JA, Handjieva-Darlenska T, Poppitt SD, Jalo E, Muirhead R, Schlicht W. Sociocognitive factors associated with lifestyle intervention attrition after successful weight loss among participants with prediabetes-The PREVIEW study. Public Health Nurs 2020; 37:393-404. [PMID: 32160348 DOI: 10.1111/phn.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Major risk factors for type 2 diabetes are lifestyle choices such as lack of physical activity (PA) and poor diet. Many individuals either do not take part or struggle to complete interventions supporting lifestyle changes. Demographic and theory-based sociocognitive factors associated with PREVIEW intervention attrition after successful weight loss were examined. METHODS Participants (1,856) who started the weight maintenance phase after completion of low-energy diet were retrospectively divided into three clusters depending on the point they left the trial. Discriminant analysis examined which demographic and theory-based sociocognitive variables were associated with cluster membership. RESULTS Most of the participants were women and well-educated. Two discriminant functions were calculated (χ2 (24) = 247.0, p ≥ .05, d = 0.78). The demographic variables, such as age and ethnicity, and the social cognitive variable outcome expectancies on the other side were associated with cluster membership. Older age, Caucasian ethnicity, and fewer expected disadvantages of PA were associated with high success. DISCUSSION The discriminant model gave insight into some factors associated with early attrition. For practitioners planning interventions it underlines the necessity to take extra attention to younger participants and to those being afraid that being physically active causes unpleasant ramifications.
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Affiliation(s)
- Maija Huttunen-Lenz
- Institute of Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Thomas Meinert-Larsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Ian Macdonald
- School of Life Sciences, MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - José Alfredo Martínez
- Department of Nutrition and Physiology, Center for Nutrition Research, University of Navarra Pamplona, IDISNA Navarra, Pamplona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III IMDEAfood Madrid, Madrid, Spain
| | | | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Wolfgang Schlicht
- Department of Exercise and Health Sciences, University of Stuttgart, Stuttgart, Germany
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20
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Prevalence of Systemic Arterial Hypertension Diagnosed, Undiagnosed, and Uncontrolled in Elderly Population: SABE Study. J Aging Res 2019; 2019:3671869. [PMID: 31565434 PMCID: PMC6745120 DOI: 10.1155/2019/3671869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 08/16/2019] [Indexed: 02/05/2023] Open
Abstract
Systemic arterial hypertension is the most prevalent chronic noncommunicable disease among older people. This study aimed to estimate the prevalence of hypertension in the elderly and to analyze factors associated with diagnosed, undiagnosed, and uncontrolled hypertension. This is a cross-sectional study of data from the SABE study—Health, Well-Being, and Aging Survey—a multiple-cohort study, obtained in 2010, composed of a probabilistic sample representative of the population of the São Paulo city aged ≥60 years. Hypertension was self‐reported or defined by increased blood pressure. Multinomial regression assessed factors associated with diagnosis and lack of diagnosis of hypertension (reference: no hypertension), and logistic regression assessed factors associated with uncontrolled hypertension (reference: controlled). The prevalence of hypertension was 79.5%, and in 51% of individuals with the condition, hypertension was uncontrolled. Undiagnosed hypertension was associated with nonwhite skin color (OR: 1.89, CI: 1.11–3.19), being uninsured (OR: 1.77, CI: 1.04–3.03), overweight (OR: 2.38, CI: 1.09–5.19), higher education (OR: 0.46, CI: 0.22–1.94), and ≥1 chronic disease (OR: 0.28; CI: 0.13–0.58). Diagnosed hypertension was associated with age between 70 and 79 years (OR: 2.02, CI: 1.34–3.05), age ≥80 (OR: 2.73, CI: 1.72–4.31), nonwhite skin color (OR: 1.48, CI: 1.01–2.18), being uninsured (OR: 1.70, CI: 1.18–2.47), at least one medical consultation in the last year (OR: 1.86, CI: 1.06–3.25), obesity (OR: 2.50, CI: 1.61–3.88), and ≥1 chronic disease (OR: 2.81, CI: 1.94–4.08). Among those with hypertension, being uncontrolled was associated with widowhood (OR: 1.73, CI: 1.23–2.43), being uninsured (OR: 1.38, CI: 1.02–1.87), and female gender (OR: 0.61, CI: 0.43–0.87). The prevalence of hypertension was high in this population, and its diagnosis and control were associated with socioeconomic, demographic, and healthcare access factors.
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21
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Thøgersen-Ntoumani C, Quested E, Biddle SJH, Kritz M, Olson J, Burton E, Cerin E, Hill KD, McVeigh J, Ntoumanis N. Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE-AIM framework: the residents in action trial (RiAT). Health Psychol Behav Med 2019; 7:202-233. [PMID: 34040848 PMCID: PMC8114369 DOI: 10.1080/21642850.2019.1629934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptability, and 2) evaluate the processes involved in the implementation of the intervention using the RE-AIM framework. Method: A mixed methods design was employed, consisting of data from accelerometers, surveys, (individual, pair-based and focus group) interviews, and participant logbooks. Participants included 116 walkers (M(SD) age = 78.37(8.30); 92% female), 8 peer leaders (i.e. ambassadors) and 3 retirement village managers from 14 retirement villages. Descriptives and linear mixed modelling were used to analyse the quantitative data and inductive thematic analyses were employed to analyse the interview data. Results: The intended cluster randomised controlled design became quasi-experimental due to insufficient numbers of recruited ambassadors. The perceived burden of the number and frequency of research assessments was a frequently mentioned reason for a poor recruitment. Facilitators to walking maintenance were the use of self-monitoring, goal setting, social support, and having a routine. Reach was modest (about 14% of eligible participants were recruited from each village), but retention was excellent (92%). The motivational strategies taught appeared to have been implemented, at least in part, by the ambassadors. The walkers in the main experimental condition increased marginally their step counts, but there were no group differences on mental health and well-being outcomes, partly because of low statistical power. Conclusions: Walkers and ambassadors who did take part in the study suggested that they enjoyed the programme and found it useful in terms of becoming more active and making social connections. However, the group format was not appealing to some participants, hence, other delivery options should be explored in the future.
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Affiliation(s)
| | - Eleanor Quested
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
| | - Stuart J H Biddle
- Physically Active Lifestyles Research Group, University of Southern Queensland, Springfield, Australia
| | - Marlene Kritz
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
| | - Jenny Olson
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia.,Physically Active Lifestyles Research Group, University of Southern Queensland, Springfield, Australia
| | - Elissa Burton
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Joanne McVeigh
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Witwatersrand, South Africa
| | - Nikos Ntoumanis
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
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22
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Kaasalainen K, Kasila K, Komulainen J, Malvela M, Poskiparta M. Changes in Psychosocial Factors and Physical Activity Among Finnish Working-Age Men in the Adventures of Joe Finn Campaign. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 39:39-49. [PMID: 30479194 DOI: 10.1177/0272684x18811018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study evaluated changes in psychosocial factors and self-reported physical activity (PA) among the sample of Finnish men who underwent the fitness tests during the national health campaign. Another aim was to examine whether the fitness test feedback was a meaningful experience for PA change. Baseline data were collected in 2011 by fitness test and questionnaire. Men who had low/moderate fitness along with overweight ( n = 361) were recruited to the postcampaign study in 2014. Data were analyzed with nonparametric tests, logistic regression analysis, and content analysis. The postcampaign survey was completed by 102 men. Positive PA change was associated with high goals, planning skills, and self-efficacy for PA. One fourth of men recalled that they had surprisingly poor fitness at baseline. This experience was not related to positive PA change. A fitness test may awake motivation, but promotion of self-efficacy and self-regulatory skills is needed to support concrete behavior change.
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Affiliation(s)
| | - Kirsti Kasila
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jyrki Komulainen
- 2 Fit for Life Program, LIKES Foundation for Promotion of Physical Activity and Public Health, Finland
| | - Miia Malvela
- 2 Fit for Life Program, LIKES Foundation for Promotion of Physical Activity and Public Health, Finland
| | - Marita Poskiparta
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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23
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Stephens LD, Crawford D, Thornton L, Olstad DL, Morgan PJ, van Lenthe FJ, Ball K. A qualitative study of the drivers of socioeconomic inequalities in men's eating behaviours. BMC Public Health 2018; 18:1257. [PMID: 30428860 PMCID: PMC6236940 DOI: 10.1186/s12889-018-6162-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 10/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background Men of low socioeconomic position (SEP) are less likely than those of higher SEP to consume fruits and vegetables, and more likely to eat processed discretionary foods. Education level is a widely used marker of SEP. Few studies have explored determinants of socioeconomic inequalities in men’s eating behaviours. The present study aimed to explore intrapersonal, social and environmental factors potentially contributing to educational inequalities in men’s eating behaviour. Methods Thirty Australian men aged 18–60 years (15 each with tertiary or non-tertiary education) from two large metropolitan sites (Melbourne, Victoria; and Newcastle, New South Wales) participated in qualitative, semi-structured, one-on-one telephone interviews about their perceptions of influences on their and other men’s eating behaviours. The social ecological model informed interview question development, and data were examined using abductive thematic analysis. Results Themes equally salient across tertiary and non-tertiary educated groups included attitudes about masculinity; nutrition knowledge and awareness; ‘moralising’ consumption of certain foods; the influence of children on eating; availability of healthy foods; convenience; and the interplay between cost, convenience, taste and healthfulness when choosing foods. More prominent influences among tertiary educated men included using advanced cooking skills but having relatively infrequent involvement in other food-related tasks; the influence of partner/spouse support on eating; access to healthy food; and cost. More predominant influences among non-tertiary educated men included having fewer cooking skills but frequent involvement in food-related tasks; identifying that ‘no-one’ influenced their diet; having mobile worksites; and adhering to food budgets. Conclusions This study identified key similarities and differences in perceived influences on eating behaviours among men with lower and higher education levels. Further research is needed to determine the extent to which such influences explain socioeconomic variations in men’s dietary intakes, and to identify feasible strategies that might support healthy eating among men in different socioeconomic groups. Electronic supplementary material The online version of this article (10.1186/s12889-018-6162-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lena D Stephens
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lukar Thornton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, New South Wales, Australia
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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24
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Garbers S, Hunersen K, Nechitilo M, Fisch M, Bell DL, Byrne MW, Gold MA. Healthy Weight and Cardiovascular Health Promotion Interventions for Adolescent and Young Adult Males of Color: A Systematic Review. Am J Mens Health 2018; 12:1328-1351. [PMID: 29808765 PMCID: PMC6142141 DOI: 10.1177/1557988318777923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease is the leading cause of mortality in the United States, accounting for one fourth of deaths. Higher rates of obesity put Hispanic and Black men at increased risk. The American Heart Association cites diet quality, physical activity, and body weight as alterations responsive to health promotion intervention. Prevention strategies need to begin in adolescence and the emerging adulthood years to impact cumulative risk factors. A scoping review identified search terms and this was followed by a systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases for articles published in English from January 1, 2002, through May 11, 2017. This review explores community-based content, delivery, recruitment, or retention strategies used with young men of color aged 15 to 24 years. Of 17 articles describing 16 individual interventions and 1 describing multiple interventions (with samples ranging from 37 to 4,800), 13 reported significant results in one or more domains. No studies specifically targeted the needs of young men and only three had more than 50% male participants. There was a gap in studies that addressed young men in the ages of interest with most interventions reaching participants aged 11 to 19 years. Cultural tailoring was addressed through recruitment setting, interventionist characteristics, community involvement, and theoretical frameworks such as motivational interviewing that allow individual goal setting. Because young men seek access to preventive health services less than young women, it is suggested that interventions that are community based or use push technology (send information directly to the user) be increased.
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Affiliation(s)
- Samantha Garbers
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kara Hunersen
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Marylynn Fisch
- 2 Columbia University College of Physicians and Surgeons, New York, USA
| | - David L Bell
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
| | | | - Melanie A Gold
- 1 Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY, USA.,2 Columbia University College of Physicians and Surgeons, New York, USA
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25
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Petrella RJ, Gill DP, Zou G, DE Cruz A, Riggin B, Bartol C, Danylchuk K, Hunt K, Wyke S, Gray CM, Bunn C, Zwarenstein M. Hockey Fans in Training: A Pilot Pragmatic Randomized Controlled Trial. Med Sci Sports Exerc 2018; 49:2506-2516. [PMID: 28719494 PMCID: PMC5704649 DOI: 10.1249/mss.0000000000001380] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction Hockey Fans in Training (Hockey FIT) is a gender-sensitized weight loss and healthy lifestyle program. We investigated 1) feasibility of recruiting and retaining overweight and obese men into a pilot pragmatic randomized controlled trial and 2) potential for Hockey FIT to lead to weight loss and improvements in other outcomes at 12 wk and 12 months. Methods Male fans of two ice hockey teams (35–65 yr; body mass index ≥28 kg·m−2) located in Ontario (Canada) were randomized to intervention (Hockey FIT) or comparator (wait-list control). Hockey FIT includes a 12-wk active phase (weekly, coach-led group meetings including provision of dietary information, practice of behavior change techniques, and safe exercise sessions plus incremental pedometer walking) and a 40-wk minimally supported phase (smartphone app for sustaining physical activity, private online social network, standardized e-mails, booster session/reunion). Measurement at baseline and 12 wk (both groups) and 12 months (intervention group only) included clinical outcomes (e.g., weight) and self-reported physical activity, diet, and self-rated health. Results Eighty men were recruited in 4 wk; trial retention was >80% at 12 wk and >75% at 12 months. At 12 wk, the intervention group lost 3.6 kg (95% confidence interval, −5.26 to −1.90 kg) more than the comparator group (P < 0.001) and maintained this weight loss to 12 months. The intervention group also demonstrated greater improvements in other clinical measures, physical activity, diet, and self-rated health at 12 wk; most sustained to 12 months. Conclusions Results suggest feasible recruitment/retention of overweight and obese men in the Hockey FIT program. Results provide evidence for the potential effectiveness of Hockey FIT for weight loss and improved health in at-risk men and, thus, evidence to proceed with a definitive trial.
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Affiliation(s)
- Robert J Petrella
- 1Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, CANADA; 2Lawson Health Research Institute, London, Ontario, CANADA; 3School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, CANADA; 4School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, CANADA; 5Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, CANADA; 6Robarts Clinical Trials, Robarts Research Institute, Western University, London, Ontario, CANADA; 7MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UNITED KINGDOM; and 8Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
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26
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Gilson ND, Pavey TG, Wright OR, Vandelanotte C, Duncan MJ, Gomersall S, Trost SG, Brown WJ. The impact of an m-Health financial incentives program on the physical activity and diet of Australian truck drivers. BMC Public Health 2017; 17:467. [PMID: 28521767 PMCID: PMC5437648 DOI: 10.1186/s12889-017-4380-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 05/07/2017] [Indexed: 12/27/2022] Open
Abstract
Background Chronic diseases are high in truck drivers and have been linked to work routines that promote inactivity and poor diets. This feasibility study examined the extent to which an m-Health financial incentives program facilitated physical activity and healthy dietary choices in Australian truck drivers. Methods Nineteen men (mean [SD] age = 47.5 [9.8] years; BMI = 31.2 [4.6] kg/m2) completed the 20-week program, and used an activity tracker and smartphone application (Jawbone UP™) to regulate small positive changes in occupational physical activity, and fruit, vegetable, saturated fat and processed/refined sugar food/beverage choices. Measures (baseline, end-program, 2-months follow-up; April–December 2014) were accelerometer-determined proportions of work time spent physically active, and a workday dietary questionnaire. Statistical (repeated measures ANOVA) and thematic (interviews) analyses assessed program impact. Results Non-significant increases in the mean proportions of work time spent physically active were found at end-program and follow-up (+1%; 7 mins/day). Fruit (p = 0.023) and vegetable (p = 0.024) consumption significantly increased by one serve/day at end-program. Non-significant improvements in saturated fat (5%) and processed/refined sugar (1%) food/beverage choices were found at end-program and follow-up. Overall, 65% (n = 11) of drivers demonstrated positive changes in physical activity, and at least one dietary choice (e.g. saturated fat) at follow-up. Drivers found the financial incentives component of the program to be a less effective facilitator of change than the activity tracker and smartphone application, although this technology was easier to use for monitoring of physical activity than healthy dietary choices. Conclusions Not all drivers benefitted from the program. However, positive changes for different health behaviours were observed in the majority of participants. Outcomes from this feasibility study inform future intervention development for studies with larger samples. Trial registration ANZCTR12616001513404. Registered November 2nd, 2016 (retrospectively registered).
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Affiliation(s)
- Nicholas D Gilson
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Toby G Pavey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Olivia Rl Wright
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Corneel Vandelanotte
- Central Queensland University, School for Health, Medical and Social Science, Rockhampton, Australia.
| | - Mitch J Duncan
- School of Medicine and Public Health, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
| | - Sjaan Gomersall
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Stewart G Trost
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Wendy J Brown
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
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27
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Ashton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Collins CE. Motivators and Barriers to Engaging in Healthy Eating and Physical Activity. Am J Mens Health 2017; 11:330-343. [PMID: 27923963 PMCID: PMC5675273 DOI: 10.1177/1557988316680936] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 10/25/2016] [Accepted: 10/27/2016] [Indexed: 11/16/2022] Open
Abstract
Many Australian young men (18-25 years) fail to meet recommendations in national dietary or physical activity (PA) guidelines. However, there is a lack of understanding of their perspectives on PA and diet to inform intervention design. This study examined young men's motivators and barriers to healthy eating and PA, along with differences by demographic and behavioral factors. A cross-sectional online survey was completed by 282 men aged 18 to 25 years in Australia. Results identified the most common motivators for healthy eating included improving health (63.5%), body image (52.3%), and increasing energy (32.1%). Motivators for PA included improving body image (44.6%), fitness (44.2%), and health (41.0%). Common barriers to healthy eating were access to unhealthy foods (61.1%), time to cook/prepare healthy foods (55.0%), and motivation to cook healthy foods (50.7%). Barriers for PA included motivation (66.3%), time (57.8%), and cost of equipment/facilities (33.3%). Significant differences ( p < .01) in motivators to healthy eating and/or PA were identified for BMI category, marital status, PA level, alcohol intake, and stress levels. Significant differences were identified for barriers to healthy eating and/or PA by BMI, PA level, stress, and fruit and vegetable intake, assessed using Pearson's chi-square test. Findings suggest that promotion of benefits related to health, appearance/body image, increased energy and fitness, and addressing key barriers including motivation, time, financial restraints, and accessibility of unhealthy foods, could engage young men in improving lifestyle behaviors. Differences by demographic and behavioral factors suggest development of tailored programs to address diversity among young men may be required.
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Affiliation(s)
- Lee M. Ashton
- University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Megan E. Rollo
- University of Newcastle, Callaghan, New South Wales, Australia
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28
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Gill DP, Blunt W, De Cruz A, Riggin B, Hunt K, Zou G, Sibbald S, Danylchuk K, Zwarenstein M, Gray CM, Wyke S, Bunn C, Petrella RJ. Hockey Fans in Training (Hockey FIT) pilot study protocol: a gender-sensitized weight loss and healthy lifestyle program for overweight and obese male hockey fans. BMC Public Health 2016; 16:1096. [PMID: 27756351 PMCID: PMC5070306 DOI: 10.1186/s12889-016-3730-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/28/2016] [Indexed: 11/18/2022] Open
Abstract
Background Effective approaches that engage men in weight loss and lifestyle change are important because of worldwide increases, including in Canada, in obesity and chronic diseases. Football Fans in Training (FFIT), developed in Scotland, successfully tackled these problems by engaging overweight/obese male football fans in sustained weight loss and positive health behaviours, through program deliveries at professional football stadia. Methods Aims: 1) Adapt FFIT to hockey within the Canadian context and integrate with HealtheSteps™ (evidence-based lifestyle program) to develop Hockey Fans in Training (Hockey FIT); 2) Explore potential for Hockey FIT to help overweight/obese men lose weight and improve other outcomes by 12 weeks, and retain these improvements to 12 months; 3) Evaluate feasibility of recruiting and retaining overweight/obese men; 4) Evaluate acceptability of Hockey FIT; and 5) Conduct program optimization via a process evaluation. We conducted a two-arm pilot pragmatic randomized controlled trial (pRCT) whereby 80 overweight/obese male hockey fans (35–65 years; body-mass index ≥28 kg/m2) were recruited through their connection to two junior A hockey teams (London and Sarnia, ON) and randomized to Intervention (Hockey FIT) or Comparator (Wait-List Control). Hockey FIT includes a 12-week Active Phase (classroom instruction and exercise sessions delivered weekly by trained coaches) and a 40-week Maintenance Phase. Data collected at baseline and 12 weeks (both groups), and 12 months (Intervention only), will inform evaluation of the potential of Hockey FIT to help men lose weight and improve other health outcomes. Feasibility and acceptability will be assessed using data from self-reports at screening and baseline, program fidelity (program observations and coach reflections), participant focus group discussions, coach interviews, as well as program questionnaires and interviews with participants. This information will be analyzed to inform program optimization. Discussion Hockey FIT is a gender-sensitive program designed to engage overweight/obese male hockey fans to improve physical activity and healthy eating choices, thereby leading to weight loss and other positive changes in health outcomes. We expect this study to provide evidence for a full-scale confirmatory pRCT. Trial registration NCT02396524 (Clinicaltrials.gov). Date of registration: Feb 26, 2015.
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Affiliation(s)
- Dawn P Gill
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
| | - Wendy Blunt
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Ashleigh De Cruz
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Brendan Riggin
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Canada
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Guangyong Zou
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada.,Robarts Clinical Trials, Robarts Research Institute, Western University, London, Canada
| | - Shannon Sibbald
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, Canada.,The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Karen Danylchuk
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Canada
| | - Merrick Zwarenstein
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Robert J Petrella
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. .,School of Kinesiology, Faculty of Health Sciences, Western University, London, Canada.
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29
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Doubova SV, Sánchez-García S, Infante-Castañeda C, Pérez-Cuevas R. Factors associated with regular physical exercise and consumption of fruits and vegetables among Mexican older adults. BMC Public Health 2016; 16:952. [PMID: 27612444 PMCID: PMC5016856 DOI: 10.1186/s12889-016-3628-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/02/2016] [Indexed: 12/21/2022] Open
Abstract
Background To analyze the factors associated with regular physical exercise and routine consumption of fruits and vegetables, and both healthy behaviors among Mexican older adults. Methods We conducted a secondary data analysis of the baseline data (2014) of the Study on Obesity, Sarcopenia and Fragility in older adults affiliated with the Mexican Institute of Social Security. The study included 948 adults who were ≥60 years of age. Multiple Poisson regression was performed. Results Routine consumption of fruits and vegetables was reported by 53.8 % of older adults, 42.7 % reported engaging in regular physical exercise and 23.1 % reported participating in both types of healthy behaviors. Women, adults with a stable income, those with a self-perception of good health and those with a history of physical exercise at the age of 50 years had an increased likelihood of engaging in healthy eating and regular physical activity. Conclusions Many older adults do not routinely consume fruits and vegetables or engage in regular physical exercise despite the fact that most have a fixed income and a social network. It is relevant to conduct research-based interventions that take into account the contextual factors to promote healthy behaviors.
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Affiliation(s)
- Svetlana V Doubova
- Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtemoc 330, Col. Doctores, Del. Cuauhtemoc, CP 06720, Mexico City, Mexico.
| | - Sergio Sánchez-García
- Epidemiology and Health Services Research Unit, Aging Area. CMN Siglo XXI, Mexican Social Security Institute, Av. Cuauhtemoc 330, Edificio CORSE 3er piso. Col. Doctores. Del. Cuauhtemoc, CP 06720, Mexico City, Mexico
| | | | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Inter-American Development Bank, Mexico City, Mexico
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30
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Heckert C. Blaming Machismo: How the Social Imaginary is Failing Men with HIV in Santa Cruz, Bolivia. Med Anthropol 2016; 36:157-169. [PMID: 26813892 DOI: 10.1080/01459740.2016.1142989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Drawing from an ethnography of HIV care in Santa Cruz, Bolivia, in this article I explore how the social imaginary surrounding gender relations shapes men's experiences of seeking care for and living with HIV. Popular understandings of gender relations, which draw heavily on the machismo concept, intersect with a global health master narrative that frames women as victims in the AIDS epidemic in a way that generates a strong sentiment of blaming machismo within local HIV/AIDS-related services. Statements such as, "it's because of machismo" are used to explain away epidemiological trends. Participant observation in the context of HIV care, coupled with illness narrative interviews, illuminate how blaming machismo shapes men's experiences of care and the ways that they feel excluded from various forms of support. Thus, the illness experiences of men with HIV problematize the machismo concept and how it is drawn upon in the context of care.
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Affiliation(s)
- Carina Heckert
- a Department of Sociology and Anthropology , University of Texas at El Paso , El Paso , Texas , USA
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31
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Kaasalainen K, Kasila K, Komulainen J, Malvela M, Poskiparta M. Psychometric Properties of a Short Measure for Psychosocial Factors and Associations With Phase of Physical Activity Change Among Finnish Working-Aged Men. Am J Mens Health 2015; 11:1525-1535. [PMID: 26614443 DOI: 10.1177/1557988315614615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Insufficient physical activity (PA) and poor physical fitness are risks for several noncommunicable diseases among working-aged men. PA programs have been launched to increase activity levels in the population but working-aged men have been underrepresented in these programs. The aim of the present cross-sectional study was to evaluate validity of a short scale for psychosocial factors among Finnish working-aged men who participated in a PA campaign. The study examined also the associations between psychosocial factors and phase of PA change across fitness groups. Physical fitness was assessed with a body fitness index constructed on the basis of a handgrip test, the Polar OwnIndex Test, and body composition analysis (InBody 720). The men were classified into low ( n = 162), moderate ( n = 358), and high ( n = 320) body fitness index groups. Psychosocial factors and self-reported phase of PA change were assessed with a questionnaire. Psychometric properties of the scale were assessed with confirmatory factor analysis and differences between phases of PA change were examined with one-way analysis of variance. The evaluated scale included factors for self-efficacy, goal setting, skills, and social support. Good physical fitness was related to better perceived self-efficacy and ability to manage one's PA environment. Goal setting was critical for PA change at all fitness levels. Better understanding of the interactions between psychosocial factors and PA change could help in targeting PA programs to low-fit men. Further study should examine the validity of the improved psychosocial measure.
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Affiliation(s)
| | | | - Jyrki Komulainen
- 2 LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland
| | - Miia Malvela
- 2 LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland
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