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Lohse B, Nguyen B, Drees BM, Bailey-Davis L, Masters KS, Nicklas JM, Daniels BT, Ruder EH, Trabold N. Examination of eating competence in a geo-diverse sample with metabolic syndrome. Appetite 2024; 199:107373. [PMID: 38677621 DOI: 10.1016/j.appet.2024.107373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
Eating competence (EatC) is an intra-individual approach to eating attitudes and behaviors associated with greater well-being. EatC research has not included persons with confirmed metabolic syndrome (MetS). Therefore, EatC of persons with MetS was explored to identify unique associations and inform implementation of MetS lifestyle interventions using baseline data from a multisite, randomized trial of a 2-year lifestyle intervention with MetS. EatC, measured with the Satter Eating Competence Inventory 2.0 (ecSI 2.0™), was examined for relationships with bioclinical measures (e.g., blood pressure, lipids), medication use, BMI, waist circumference, fruit/vegetable intake, and psychosocial factors, (e.g., stress, mindfulness). Data were collected in person and video call by trained research personnel. EatC was examined as a continuous score and as a categorical variable with ecSI 2.0™ scores ≥ 32 considered eating competent. Participants (n = 618) were predominantly female (76%), White (74%), college educated (60%). Mean age was 55.5 ± 11 y. Mean ecSI 2.0™ was 29.9 ± 7.4 and 42% were eating competent. EatC was greater for males, persons who were older and food secure. Competent eaters (vs. non-eating competent) had lower waist circumference (112.7 ± 12.5 cm vs.116.8 ± 16.0 cm; P < 0.001) and BMI (35.0 ± 6.1 vs. 37.5 ± 7.3; P < 0.001). Serum triglycerides, HDL-cholesterol, fasting blood glucose, HbA1c, and blood pressure did not differ by EatC status. Compared to non-eating competent persons, competent eaters perceived less stress, were more mindful, indicated better physical function, and more habitual vegetable intake (all P < 0.001) and sensory awareness (P < 0.05). EatC in MetS paralleled the non-MetS profile. EatC was associated with a healthier psychosocial profile, waist circumference and BMI. Findings support further research to examine the mediational or moderating influence of EatC in the treatment of MetS.
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Affiliation(s)
- Barbara Lohse
- Rochester Institute of Technology, 180 Lomb Memorial Drive, Rochester, NY, 14623, USA.
| | - Bong Nguyen
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Betty M Drees
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108, USA.
| | - Lisa Bailey-Davis
- Geisinger Health System, 100 N Academy Avenue, Danville, PA, 17822, USA.
| | - Kevin S Masters
- University of Colorado Denver, 13001 E. 17th Place, Aurora, CO, 80045, USA.
| | - Jacinda M Nicklas
- University of Colorado Denver, 13001 E. 17th Place, Aurora, CO, 80045, USA.
| | - Bryce T Daniels
- Rush University Medical Center, 1700 W. Van Buren Street, Suite 470, Chicago, IL, 60612, USA.
| | - Elizabeth H Ruder
- Rochester Institute of Technology, 180 Lomb Memorial Drive, Rochester, NY, 14623, USA.
| | - Nicole Trabold
- Rochester Institute of Technology, 180 Lomb Memorial Drive, Rochester, NY, 14623, USA; Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY 13210, USA.
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Wiese LK, Williams IC, Holt JK, Williams CL, Lingler J, Galvin JE, Schoenberg NE. Testing the 'Faith Moves Mountains model' to increase Alzheimer's disease awareness, detection, and diagnosis among rural, racially, and ethnically diverse older adults. Aging Ment Health 2024; 28:943-956. [PMID: 38127408 PMCID: PMC11144567 DOI: 10.1080/13607863.2023.2294062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Racially and ethnically diverse populations have recently contributed to the majority of rural and small-town growth. Consequently, the disproportionately high risk and prevalence of Alzheimer's disease and related dementias (ADRD) among rural and minoritized older residents will likely increase. To address this threat, we tested the hypotheses that (1) a faith-based, resident-led approach would increase basic ADRD knowledge and diagnosis, and (2) older age, female gender, lower educational levels, and more years lived rural would predict number of referrals, new dementia diagnoses, and treatment. METHODS An adaptation of Schoenberg's Faith Moves Mountains model, previously successful in detection and management of other chronic illnesses in rural settings, guided this community-based participatory research. Local faith community members were trained as research assistants to recruit, administer surveys, conduct brief memory assessments, teach brain health strategies, and follow-up with residents. Outreaches were offered virtually during the pandemic, then in-person monthly at rotating church sites, and repeated ∼1 year later. RESULTS This rural sample was racially and ethnically diverse (74.5% non-White), with 28% reporting eight or less years of formal education. Findings included that referrals and years lived rural were significant and positive predictors of new ADRD treatments [(b = 3.74, χ2(1, n = 235) = 13.01, p < 0.001); (b = 0.02, χ2(1, n = 235 = 3.93, p = 0.048)], respectively, regardless of participant characteristics. CONCLUSION Resident-led action research in rural, diverse, faith communities is a successful approach to increasing ADRD disease knowledge, detection, diagnosis, and treatment.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Ishan C Williams
- University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Janet K Holt
- C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
- Southern Illinois University, Edwardsville, IL, USA
| | | | - Jennifer Lingler
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
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Wippold GM, Garcia KA, Frary SG, Griffith DM. Community Health Worker Interventions for Men: A Scoping Review Using the RE-AIM Framework. HEALTH EDUCATION & BEHAVIOR 2024; 51:128-143. [PMID: 37350223 DOI: 10.1177/10901981231179498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Community health workers (CHWs) are health promotion specialists who are trusted members of the community served and have a close understanding of the community's needs and values. CHWs are a cost-effective and scalable workforce to promote health among men through tailored approaches. The purpose of the present review was to use the RE-AIM Framework to assess design, implementation, and outcomes of CHW-implemented health promotion efforts tailored for men to provide recommendations for future efforts. METHODS The protocol was pre-registered with PROSPERO. The primary inclusion criteria were that the interventions were (a) implemented at least partially by CHWs, (b) conducted only among men, and (c) designed to improve a health-related outcome. PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Global Index Medicus were searched using a librarian-generated search strategy. In all, 1,437 articles were uploaded to Rayyan and two reviewers blindly reviewed each article for inclusion. A total of 24 articles met the inclusion criteria. RESULTS Most interventions (a) targeted men under 50 years, (b) were conducted among a subset of underserved men, (c) improved health outcomes, (d) community-based and informed, (e) atheoretical, and (f) had satisfactory retention rates. The roles and responsibilities of CHWs were varied. Attention was given to training of CHWs, but limited attention was given to how/if the CHWs were supervised. DISCUSSION CHW-implemented interventions can improve health outcomes among men. Opportunities exist to build on past interventions, such as addressing mental health and incorporating prosocial aspects of masculinity. The results have implications for designing similar interventions.
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Plaisance A, Mallmes J, Kamateros A, Heyland DK. Evaluation of a French adaptation of a community-based advance serious illness planning decision aid. PEC INNOVATION 2023; 3:100182. [PMID: 38213761 PMCID: PMC10782113 DOI: 10.1016/j.pecinn.2023.100182] [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: 12/30/2022] [Revised: 06/17/2023] [Accepted: 06/17/2023] [Indexed: 01/13/2024]
Abstract
Objective The Plan Well Guide™ (PWG) is a decision aid that empowers lay persons to better understand different types of care and prepares them, and their substitute decision-makers, to express both their authentic values and informed treatment preferences in anticipation of serious illness. We aimed to determine the acceptability of the newly translated French PWG and to evaluate decisional readiness and decisional conflict following its use by lay people. Methods This is an acceptability and exploratory outcomes evaluation.Participants were requested to read and complete the French PWG and to engage in an online interview. We used the Acceptability Scale to determine the acceptability and the Preparation for Decision-making Scale and decisional conflict Scale to evaluate decisional readiness. Results Forty-two (42) people participated. The average score on the Acceptability Scale was 18.1 (scale range: 4-20 [high-better]) and 26.6 on the Preparation for Decision-Making Scale (scale range: 6-30 [high-better]). A significant number of respondents reported needing more support to help them make better decisions. Conclusion The French PWG has been deemed acceptable and relevant for lay people not currently facing clinical decisions. Innovation The Plan Well Guide is innovative as it is the first decision aid empowering lay people for advance serious illness planning.
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Hagerman CJ, Ehmann MM, Taylor LC, Forman EM. The role of self-compassion and its individual components in adaptive responses to dietary lapses. Appetite 2023; 190:107009. [PMID: 37619622 PMCID: PMC10543633 DOI: 10.1016/j.appet.2023.107009] [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: 01/13/2023] [Revised: 08/08/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023]
Abstract
Dietary lapses (i.e., instances of dietary non-adherence) are common during weight loss attempts, and compromise success in two ways: increasing caloric intake and demoralizing the participant, sometimes leading them to abandon their weight control goals altogether. Efforts to understand and prevent demoralization have received almost no research attention. Self-compassion has high potential to promote adaptive responses to these setbacks because it reframes "failure" and promotes self-improvement. Past research shows that when participants experience a lapse, those practicing higher self-compassion report higher self-efficacy and intentions to continue dieting. The current study extended this literature to examine whether self-compassion in response to a lapse would predict lower likelihood of a subsequent same-day lapse and greater reports of perceived control over weight management behaviors. We also examined whether the individual facets of self-compassion, including self-kindness (treating oneself the way one would a friend); common humanity (the understanding that everyone has struggles); and mindfulness (non-judgmental awareness of thoughts and feelings) are associated with these outcomes. Participants (N = 140) enrolled in a behavioral weight loss trial completed 6 ecological momentary assessment (EMA) surveys a day for seven days. Total self-compassion and each facet of self-compassion individually were all associated with less negative affect after a lapse. None of the self-compassion variables predicted the likelihood of participants reporting a lapse again that day. However, higher total self-compassion and higher self-kindness after a lapse were both associated with greater perceived self-control over weight management behaviors in the hours following. Common humanity and mindfulness, respectively, were not associated with reports of perceived control. Results suggest that self-compassion following dieting setbacks may prevent goal disengagement, and that self-kindness is the facet most strongly associated with adaptive responses to these setbacks.
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Affiliation(s)
- Charlotte J Hagerman
- Department of Psychological and Brain Sciences and Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Marny M Ehmann
- Department of Psychological and Brain Sciences and Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Lauren C Taylor
- Department of Psychological and Brain Sciences and Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Evan M Forman
- Department of Psychological and Brain Sciences and Center for Weight, Eating and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
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Lendvai D, Whittemore R, Womack JA, Fortier CB, Milberg WP, Fonda JR. The Impact of Blast Exposure-With or Without Traumatic Brain Injury-on Metabolic Abnormalities in Post-9/11 Veterans. J Head Trauma Rehabil 2023; 38:380-390. [PMID: 36951458 PMCID: PMC10514232 DOI: 10.1097/htr.0000000000000874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVE The primary aim included explorations of: (1) the associations between the history of blast exposure (BE), close blast exposure (CBE), and blast-related traumatic brain injury (bTBI) and metabolic abnormality; and (2) the potential mediating effect of comorbid psychological and somatic conditions on these associations. The secondary aim explored the association of dose-response impact of BE, CBE, and bTBI and metabolic abnormality. SETTING Data were collected by the Translational Research Center for TBI and Stress Disorders (TRACTS). PARTICIPANTS Post-9/11 veterans from the TRACTS baseline sample who had conflict-zone deployment experience ( N = 734). DESIGN Cross-sectional secondary data analysis. We computed relative risks (RRs) and 95% CI using modified Poisson regression. We quantified the impact of co-occurring psychological and somatic conditions on this association using mediation analyses. MAIN MEASURES Exposures included BE (<100 m), CBE (<10 m), and bTBI. Metabolic abnormality outcomes included (1) overweight/obesity (defined by abnormal waist-hip ratio [WHR] and abnormal waist circumference [WC]); (2) glucose dysregulation; and (3) meeting criteria for cardiometabolic syndrome (defined by guidelines). RESULTS The sample was majority male (91%) and White (68%), with a mean age of 34.6 years (SD = 8.99). Most participants had 1 or more BE (83%); 48% experienced 1 or more CBE. Overweight/obesity was highly prevalent in the sample (51% had abnormal WHR and 60% abnormal WC). There was no significant direct or indirect association between BE, CBE, and bTBI and metabolic abnormalities (RRs: 0.70-1.51; P 's > .05). CONCLUSION Future research is needed to investigate the association of BE with metabolic abnormalities with larger, more targeted sample selection, and longer follow-up. Effective and sustainable weight management and metabolic health prevention interventions for this veteran cohort are needed.
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Affiliation(s)
- Dora Lendvai
- VA Connecticut Healthcare System, West Haven, Connecticut
- Yale University, School of Nursing, Orange, Connecticut
| | | | - Julie A. Womack
- VA Connecticut Healthcare System, West Haven, Connecticut
- Yale University, School of Nursing, Orange, Connecticut
| | - Catherine B. Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - William P. Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jennifer R. Fonda
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Hidirsah A, Chai Y, Flores R, Vidmar AP, Borzutzky C, Espinoza J. Paediatric obesity: Documentation, screening, and pharmacotherapy in a national cohort. Pediatr Obes 2023; 18:e13032. [PMID: 37017271 DOI: 10.1111/ijpo.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Multiple organizations have published guidelines for the screening and treatment of obesity and related comorbidities in youth, including the use of anti-obesity medications (AOM). This study aimed to determine which paediatric patients: (1) receive a diagnostic code for obesity; (2) are most likely to be screened for hyperlipidaemia, non-alcoholic fatty liver disease, and type 2 diabetes mellitus; and (3) are most likely to be prescribed AOM. METHODS A cohort of 35 898 patients 9 years 4 months to 17 years 6 months of age with a BMI > 30 or greater than the 95th% on three separate outpatient encounters was generated using the TriNetX database. Logistic regression models were used to estimate the associations between demographics in the study population and the likelihood of diagnosis of obesity, screening for comorbidities, and prescription of AOMs. RESULTS Asian, Black, and Hispanic youths had increased odds of having a diagnosis of obesity and being screened for all three comorbidities. Documentation of obesity was associated with increased odds of screening for all comorbidities. Female sex, documentation of obesity, and higher BMIs were associated with increased odds of being prescribed AOMs. Black and Native American races decreased the likelihood of being prescribed AOM. CONCLUSIONS Management of obesity in terms of documentation of disease, screening for comorbidities, and initiation of AOM continues to fall short of the guidelines put forth by multiple organizations. Race/ethnicity, sex, and BMI correlate with differences in care provided to obese paediatric patients. Further research is needed to identify the barriers to and causes of these disparities.
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Affiliation(s)
- Arek Hidirsah
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Yan Chai
- Biostatistics Core, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Ryan Flores
- Keck School of Medicine of USC, Los Angeles, California, USA
| | - Alaina P Vidmar
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, California, USA
- Center for Endocrinology, Diabetes and Metabolism, Los Angeles, California, USA
| | - Claudia Borzutzky
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
- Department of Pediatrics, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, California, USA
| | - Juan Espinoza
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Vlietstra L, Waters DL, Jones LM, Wilson L, Meredith-Jones K. High-intensity interval aerobic and resistance training to counteract low relative lean soft tissue mass in middle age: A randomized controlled trial. Exp Gerontol 2023; 171:111991. [PMID: 36403898 DOI: 10.1016/j.exger.2022.111991] [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: 07/13/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Age-related loss of skeletal muscle mass and function begins in early middle age, yet research to date has focused on older individuals, limiting our understanding of interventions earlier in the lifespan. To date, no high-intensity interval training studies have been conducted in middle-aged adults with low relative lean soft tissue mass. METHODS Eighty-two middle-aged adults (40-50 years of age) with low appendicular lean soft tissue mass index confirmed with dual energy x-ray absorptiometry (DXA) were randomly allocated (1:1) to group-based, 20-week, three times a week, high-intensity aerobic and resistance training (HIART) program or 60-min education session (Control). The primary outcome was change in total lean soft tissue mass measured by DXA. Secondary outcomes included cardiorespiratory fitness, physical function (handgrip strength, gait speed, 30-seconds sit-to-stand, quadriceps strength and muscle quality). Measures were obtained at baseline (0 weeks), mid-intervention (10 weeks) and post-intervention (20 weeks). RESULTS Mean age in HIART was 44.8 (SD 3.2) and 45.4 (SD 2.9) in Control group. The majority of the participants were female with 88 % in HIART and 83 % in Control group. Mean BMI in HIART was 25.8 kg/m2 (SD 3.5) and 26.4 kg/m2 (SD 4.1) Control group. Intention to treat analysis showed that post-intervention, HIART increased significantly more total lean soft tissue mass (0.8 kg, 95%CI 0.15, 1.46), appendicular lean soft tissue mass index (0.2 kg/m2, 95%CI 0.09, 0.33), peak oxygen uptake (5.18 mL/min/kg, 2.97 to 7.39 95%CI), grip strength (2.2 kg, 95%CI 0.09, 4.32), and 30-s sit-to-stand (1.3 times, 95%CI 0.43, 2.12) with significantly greater reductions in body fat percentage (-1.1 %, 95%CI -2.03, -0.10) and maximum gait speed (-0.2 m/s, 95 % CI -0.34, -0.03) compared Control. CONCLUSION The HIART program is an effective exercise intervention to increase total lean soft tissue mass in middle-aged adults with low relative lean soft tissue mass compared to a waitlist control group.
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Affiliation(s)
- Lara Vlietstra
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand.
| | - Debra L Waters
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand; School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin, New Zealand; Department of Internal Medicine, University of New Mexico, 915 Camino de Salud NE, Albuquerque, NM, USA
| | - Lynnette M Jones
- School of Physical Education, Sport & Exercise Sciences, University of Otago, 55/47 Union Street West, Dunedin, New Zealand
| | - Luke Wilson
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand
| | - Kim Meredith-Jones
- Department of Medicine, Otago Medical School, University of Otago, 201 Great King Street, Dunedin, New Zealand
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Dietary interventions using Facebook: a systematic review. Porto Biomed J 2023; 8:e185. [DOI: 10.1097/j.pbj.0000000000000185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/12/2022] [Accepted: 03/30/2022] [Indexed: 02/09/2023] Open
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Pérez-Muñoz A, Horn TL, Graber J, Chowdhury SMR, Bursac Z, Krukowski RA. Recruitment strategies for a post cessation weight management trial: A comparison of strategy cost-effectiveness and sample diversity. Contemp Clin Trials Commun 2022; 30:101037. [DOI: 10.1016/j.conctc.2022.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/28/2022] [Accepted: 11/07/2022] [Indexed: 11/09/2022] Open
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Bonn SE, Christenson A, Eke H, Sjöblom L, Dahlgren A, Trolle Lagerros Y. Does eating behaviour among adolescents and young adults seeking obesity treatment differ depending on sex, body composition, and parental country of birth? BMC Public Health 2022; 22:1895. [PMID: 36221108 PMCID: PMC9552712 DOI: 10.1186/s12889-022-14297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents and young adults around the world experience high rates of weight gain. The underlying eating behaviours that may lead to overconsumption of energy are complex and can depend on a number of factors. The aim of this study was to explore if eating behaviour among adolescents and young adults referred to specialized obesity treatment differed depending on sex, body composition, and parental country of birth. METHODS Adolescents and young adults aged 16-25 years, referred for obesity treatment in 2018-2021 were included in the study. Eating behaviour was assessed using the Three Factor Eating Questionnaire, comprising domains of uncontrolled-, emotional- and cognitive restraint eating. Student's t-test was used to compare differences in eating behaviour scores between males and females, and between those having at least one parent born in a Nordic country and those with both parents born outside the Nordic countries. Associations between BMI, waist circumference, and body fat percentage, and eating behaviour as the dependent variable, were examined using linear regression. RESULTS A total of 463 participants, mean age 21 years and mean BMI 41.3 kg/m2, were included in the analysis. Females scored statistically significantly higher than males on emotional eating (45.8 vs. 35.4, p = 0.002) and cognitive restraint eating (45.4 vs. 39.2, p = 0.009). Participants with at least one parent born in a Nordic country reported a statistically significantly lower score of uncontrolled eating (45.7 vs. 51.3, p = 0.02) compared to participants with both parents born outside the Nordic countries. Further, there were statistically significant inverse associations between cognitive restraint eating scores and BMI (β=-0.64, 95%CI: -0.97 to -0.31), waist circumference (β=-0.44, 95%CI: -0.61 to -0.27) and body fat percentage (β=-0.57, 95%CI: -1.01 to -0.14) in models adjusted for age, sex, smoking, and civil status. CONCLUSION Our findings suggest that sex and parental country of birth may influence eating behaviours among adolescents and young adults referred for specialist obesity treatment. We also found that cognitive restraint eating decreased with increasing BMI, waist circumference, and body fat percentage. This indicates that there may be an inverse association between the ability to restrain oneself from eating and gaining weight, however, the direction of the association must be investigated further. Increased knowledge about eating behaviours may be valuable in the clinical setting.
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Affiliation(s)
- Stephanie E Bonn
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.
| | - Anne Christenson
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Helén Eke
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Linnea Sjöblom
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Anna Dahlgren
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, SE-171 76, Stockholm, Sweden.,Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
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McDonald MD, Hunt K, Sivaramakrishnan H, Moullin J, Avenell A, Kerr DA, Birch JM, Ntoumanis N, Quested E. A systematic review examining socioeconomic factors in trials of interventions for men that report weight as an outcome. Obes Rev 2022; 23:e13436. [PMID: 35187778 PMCID: PMC9285916 DOI: 10.1111/obr.13436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 12/19/2022]
Abstract
Weight management interventions designed specifically for men have become more common, but the extent to which socioeconomic factors are considered in trials of these interventions is unclear. We synthesized study characteristics, methods, and reporting of interventions with a behavioral component for men that report weight as an outcome, to establish the extent to which socioeconomic factors are considered during intervention design, conduct, and reporting. A comprehensive search was conducted on Medline, Embase, PsycINFO, and CENTRAL for studies published from January 2000 to July 2021. Thirty-six trials were included. Educational attainment (n = 24) was the most frequently reported socioeconomic characteristic, followed by working status (n = 14) and area level deprivation (n = 12). Seven studies did not report any socioeconomic characteristics. Most studies (n = 20) did not mention the socioeconomic profile of their samples in relation to study strengths or limitations. Few (n = 4) consulted with men from lower socioeconomic groups during intervention design. One study examined potential differential intervention effects across socioeconomic groups, with most not powered to do so. Recent feasibility trials (n = 3) targeting specific socioeconomic groups suggest a potential nascent towards a greater consideration of factors related to equity. To best inform public health policy related to health inequalities, greater consideration of socioeconomic factors is required in trials of men's weight management interventions.
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Affiliation(s)
- Matthew D McDonald
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Kate Hunt
- Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia.,Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Hamsini Sivaramakrishnan
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Joanna Moullin
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Deborah A Kerr
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Jack M Birch
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Nikos Ntoumanis
- Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Eleanor Quested
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.,Physical Activity and Well-Being Research Group, enAble Institute, Curtin University, Perth, Western Australia, Australia
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13
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Kwasnicka D, Donnachie C, Thøgersen-Ntoumani C, Hunt K, Gray CM, Ntoumanis N, McBride H, McDonald MD, Newton RU, Gucciardi DF, Olson JL, Wyke S, Morgan PJ, Kerr DA, Robinson S, Quested E. The Aussie-FIT process evaluation: feasibility and acceptability of a weight loss intervention for men, delivered in Australian Football League settings. Psychol Health 2022; 37:470-489. [PMID: 33719789 DOI: 10.1080/08870446.2021.1890730] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This process evaluation aimed to evaluate the feasibility and acceptability of Aussie-FIT, a group-based weight loss intervention for men with overweight and obesity in Australia. DESIGN Process data and data collected from: (1) six-participant focus groups (n= 24), (2) coach interviews (n = 4), (3) audio recordings of Aussie-FIT sessions and (4) post-program participant surveys (n= 93) were analysed. MAIN OUTCOME MEASURES We explored the feasibility and acceptability of program setting and context, recruitment strategies, factors impacting implementation and mechanisms of impact. RESULTS Recruitment via Australian Football League (AFL) clubs was highly effective; 426 men expressed interest within 3 days of advertising, 130 men took part. Program attendance was not consistently recorded by coaches. Coach interviews indicated a 'core group of men' participated in each session (typically 10-12 of 15 men). Program delivery proved feasible in the AFL context. Program acceptability and satisfaction were high. Internalisation of autonomous motives was identified as driving behaviour change. Behaviour change to support maintained weight loss was facilitated through habit formation, goal setting and effective management of multiple goals. CONCLUSION Aussie-FIT sets a blueprint for future weight loss interventions that utilise behaviour change strategies and principles of self-determined motivation to support men to lose weight. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12617000515392. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
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Affiliation(s)
- Dominika Kwasnicka
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia.,Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Craig Donnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cecilie Thøgersen-Ntoumani
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Kate Hunt
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nikos Ntoumanis
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Hannah McBride
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Matthew D McDonald
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Daniel F Gucciardi
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Jenny L Olson
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, School of Education, University of Newcastle, Newcastle, Australia
| | - Deborah A Kerr
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Suzanne Robinson
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - Eleanor Quested
- Physical Activity and Well-being Research Group, Curtin University, Perth, Australia.,Curtin School of Population Health, Curtin University, Perth, Australia
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14
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Ellington M, Connelly J, Clayton P, Lorenzo CY, Collazo-Velazquez C, Trak-Fellermeier MA, Palacios C. Use of Facebook, Instagram, and Twitter for recruiting healthy participants in nutrition-, physical activity-, or obesity-related studies: a systematic review. Am J Clin Nutr 2021; 115:514-533. [PMID: 34669955 PMCID: PMC8827067 DOI: 10.1093/ajcn/nqab352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There are limited systematic reviews exploring the use of social media for recruiting participants specifically for nutrition-, physical activity-, and obesity-related studies. OBJECTIVES The aim was to conduct a systematic review on the effectiveness of using social media (Facebook, Instagram, and Twitter) for recruiting healthy participants in nutrition-, physical activity-, or obesity-related studies. METHODS Studies were identified from 5 databases and included if they reported the number of participants recruited by social media (Facebook, Instagram, or Twitter) vs. traditional (print, e-mail, etc.). The effectiveness of recruitment was compared between methods by study procedures (in-person vs. online procedures). The cost-effectiveness of methods was also explored. The protocol was published in the Prospero database (ID# CRD42020204414). RESULTS Twenty-six studies were included. Among studies with both types of recruitment methods, 49% of the sample was reached through traditional methods, 40% through social media, and the rest by other methods. For in-person study procedures, the median number of participants recruited using social media was 19 (range: 3-278) and for online study procedures, it was 298 (range: 3-17,069). Median recruitment cost using social media (n = 14 studies) was $11.90 (range: $0-517) per participant, while this varied considerably for traditional methods depending on how it was calculated ($214, $18.9-$777). The ratio of participants reached vs. recruited was 0.12%; the overall ratio of participants interactions vs. recruited was 21.2%. CONCLUSIONS For in-person study procedures, traditional recruitment methods were more effective than social media, but for online study procedures, about half reported that social media was more effective. While more potential participants were reached through social media, only 21.2% of those who interacted with ads were enrolled. With the increased use of social media, their use for recruitment may be more frequent; therefore, future reviews may show different results.
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Affiliation(s)
- Malik Ellington
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Jeneene Connelly
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Priscilla Clayton
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - C Yaisli Lorenzo
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Christina Collazo-Velazquez
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - María Angélica Trak-Fellermeier
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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15
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SantaBarbara N, Rezai R, Terry E, Shedd K, Comulada WS. Preliminary Efficacy and Acceptability of an Online Exercise and Nutrition Workplace Wellness Program: A Brief Report. Workplace Health Saf 2021; 70:90-96. [PMID: 34558353 DOI: 10.1177/21650799211037528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Workplace wellness programs (WWP) offer physiological and psychological benefits to employees and financial and productivity benefits to employers. However, the COVID-19 pandemic has prevented in-person sessions and has required WWP's to transition to online platforms. The purpose of this brief report was to assess the preliminary feasibility, acceptability, and efficacy of a mobile version of the Bruin Health Improvement Program (BHIP mobile) WWP. METHODS Participants virtually attended (i.e., via Zoom) twice weekly physical activity sessions and a once weekly nutrition seminar for 10-weeks with the option of a 30-minute one-on-one consultation with a registered dietician. Demographics, anthropometric indices, stress, muscular endurance, and aerobic fitness were assessed at baseline and follow-up. All analyses were conducted in SPSS v. 27. RESULTS Twenty-seven participants (96% female) enrolled and 13 (100% female) completed the 10-week program. There were significant reductions in bodyweight (p < .01) and body mass index (p < .02) but not stress (p > .05), and significant increases in muscular endurance (p < .01) but not aerobic fitness (p > .05). Overall, BHIP mobile appears to be acceptable to participants but logistical concerns such as inconsistent internet connection was noted as potential downfalls. CONCLUSIONS/APPLICATIONS TO PRACTICE Improvements in health outcome among completers of a mobile WWP were promising. Completer feedback highlighted program strengths as the flexibility and comfort of attending exercise sessions and nutrition classes from home. Future versions of the program will allocate resources to improve completion and expand appeal for men and women.
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16
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"Replanning" a Statewide Walking Program Through the Iterative Use of the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework. J Phys Act Health 2021; 18:1310-1317. [PMID: 34433697 DOI: 10.1123/jpah.2021-0034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/03/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Interventions undergo adaptations when moving from efficacy to effectiveness trials. What happens beyond these initial steps-that is, when the "research" is over-is often unknown. The degree to which implementation quality remains high and impacts remain robust is underreported as these data are often less valued by community entities. Comprehensive and iterative evaluation is recommended to ensure robust outcomes over time. METHODS The reach, effectiveness, adoption, implementation, and maintenance framework was used within an assess, plan, do, evaluate, report process to determine the degree to which a statewide physical activity promotion program aligned with evidence-based core components, assess who was reached and impacts on physical activity behaviors, and make decisions for future iterations. RESULTS Walk Across Arkansas was adopted by a majority of delivery agents and was effective at increasing physical activity levels postprogram, but those effects were not maintained after 6 months. Future decisions included recruitment strategies to reach a more diverse population and a blueprint document to reduce program drift. CONCLUSIONS This article details the process of "replanning" a community-based physical activity intervention to understand public health impact and make decisions for future iterations. Pragmatic reach, effectiveness, adoption, implementation, and maintenance questions were useful throughout the assess, plan, do, evaluate, report process.
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17
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Effects of Behaviorally Supported Exercise and Exercise-Induced Mood Changes on Elevated Blood Pressure and Hypertension in African American Adults with Severe Obesity. J Immigr Minor Health 2021; 24:721-729. [PMID: 34036517 PMCID: PMC8147905 DOI: 10.1007/s10903-021-01220-9] [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] [Accepted: 05/18/2021] [Indexed: 10/29/2022]
Abstract
African Americans with obesity have high rates of hypertension. Exercise has been shown to significantly reduce high blood pressure; however, effects through associated reductions in anxiety and depression are unclear. African American adults with either class 2 or 3 obesity (n = 86; Mage = 43.4 years) and either elevated blood pressure (n = 16) or stage 1 (n = 33) or stage 2 (n = 37) hypertension participated in a theoretically driven community-based weight-management program. There were significant increases in exercise outputs; while systolic and diastolic blood pressure, anxiety, and depression significantly decreased from baseline-month 6. Increased exercise significantly predicted reduced anxiety, depression, and diastolic blood pressure. Change in anxiety significantly mediated the relationship between exercise and both systolic and diastolic blood pressure changes. Increasing exercise from the equivalent of 1.5 to 4.5 moderate bouts/week reduced elevated blood pressure/hypertension in African American adults with severe obesity largely through their exercise-associated improvement in anxiety.
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18
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Turner-McGrievy GM, Wilson MJ, Bailey S, Bernhart JA, Wilcox S, Frongillo EA, Murphy EA, Hutto B. Effective recruitment strategies for African-American men and women: the Nutritious Eating with Soul study. HEALTH EDUCATION RESEARCH 2021; 36:206-211. [PMID: 33582788 PMCID: PMC8041456 DOI: 10.1093/her/cyab003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Previous studies have found it challenging to recruit African-American (AA) participants into health education research studies. The goal of this article is to describe the recruitment methods used for the Nutritious Eating with Soul (NEW Soul) study, a 2-year randomized behavioral health education intervention, conducted in two cohorts, with emphasis on methods used for reaching men. Participants indicated how they learned about the study on an online screening questionnaire from a list of the recruitment strategies we employed. Due to limited recruitment of men in Cohort 1, recruitment strategies for Cohort 2 focused on reaching men. Across the two cohorts, a total of 568 (23% men) participants completed the online screener and 159 (21% men) completed all baseline assessments and enrolled in the study. The most effective methods for completing screening questionnaires were radio ads, referrals from friends and family, TV interviews, social media posts and community events. Men were primarily recruited via radio ads, whereas women were more often recruited through TV and social media. Radio was an effective way to recruit AA adults into nutrition interventions, particularly men. In addition, low-cost methods, such as personal referrals, social media posts and community events were also effective strategies.
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Affiliation(s)
- Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Mary J Wilson
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Shiba Bailey
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - E Angela Murphy
- Department of Pathology, Microbiology and Immunology, School of Medicine, University of South Carolina, 6439 Garners Ferry Rd, Columbia, SC 29209, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
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Punt SE, Kurz DL, Befort CA. Recruitment of Men Into a Pragmatic Rural Primary Care Weight Loss Trial. Am J Mens Health 2020; 14:1557988320971917. [PMID: 33174488 PMCID: PMC7673057 DOI: 10.1177/1557988320971917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Men remain underrepresented in behavioral weight loss trials and are more difficult to recruit compared to women. We describe recruitment response of men and women into a mixed-gender behavioral weight loss trial conducted within 36 rural primary care clinics. Participants were recruited through primary care clinics via direct mailings (n = 15,076) and in-clinic referrals by their primary care provider (PCP). Gender differences were examined in response rate to direct mailings, study referral source, and rates of proceeding to study screening, being eligible, and enrolling. Men had a lower response rate to direct mailings than women (7.8% vs. 17.7%, p < .001). Men (vs. women) responding to the mailing were more likely to respond by opt-in postcard (64.6% vs. 56.8%) and less likely to respond by phone (33.9% vs. 39.6%), p = .002. Among potential participants contacting the study (n = 2413), men were less likely to report being referred by PCPs (15.2% vs. 21.6%; p < .001), but were just as likely to proceed to screening, be eligible, and enroll. Men and women were more likely to proceed to screening when referred by PCPs (93.3% vs. 95.4%) compared to direct mailings (74.2% vs. 73.9%). Enrolled men were older (p < .001), more likely to be married (p = .04), and had higher levels of education (p = .01). Men were less likely than women to respond to direct mailings and to be referred by their PCP, but after contacting the study, had similar screening, eligibility, and enrollment rates. Encouraging and training providers to refer men during clinic visits may help recruit more men into primary care-based weight loss trials.
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Affiliation(s)
- Stephanie E Punt
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Daniel L Kurz
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
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20
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Darmawan I, Bakker C, Brockman TA, Patten CA, Eder M. The Role of Social Media in Enhancing Clinical Trial Recruitment: Scoping Review. J Med Internet Res 2020; 22:e22810. [PMID: 33104015 PMCID: PMC7652693 DOI: 10.2196/22810] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/31/2020] [Accepted: 09/15/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Recruiting participants into clinical trials continues to be a challenge, which can result in study delay or termination. Recent studies have used social media to enhance recruitment outcomes. An assessment of the literature on the use of social media for this purpose is required. OBJECTIVE This study aims to answer the following questions: (1) How is the use of social media, in combination with traditional approaches to enhance clinical trial recruitment and enrollment, represented in the literature? and (2) Do the data on recruitment and enrollment outcomes presented in the literature allow for comparison across studies? METHODS We conducted a comprehensive literature search across 7 platforms to identify clinical trials that combined social media and traditional methods to recruit patients. Study and participant characteristics, recruitment methods, and recruitment outcomes were evaluated and compared. RESULTS We identified 2371 titles and abstracts through our systematic search. Of these, we assessed 95 full papers and determined that 33 studies met the inclusion criteria. A total of 17 studies reported enrollment outcomes, of which 9 achieved or exceeded their enrollment target. The proportion of participants enrolled from social media in these studies ranged from 0% to 49%. Across all 33 studies, the proportion of participants recruited and enrolled from social media varied greatly. A total of 9 studies reported higher enrollment rates from social media than any other methods, and 4 studies reported the lowest cost per enrolled participant from social media. CONCLUSIONS While the assessment of the use of social media to improve clinical trial participation is hindered by reporting inconsistencies, preliminary data suggest that social media can increase participation and reduce per-participant cost. The adoption of consistent standards for reporting recruitment and enrollment outcomes is required to advance our understanding and use of social media to support clinical trial success.
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Affiliation(s)
- Ida Darmawan
- Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis, MN, United States
| | - Caitlin Bakker
- Health Sciences Libraries, University of Minnesota, Minneapolis, MN, United States
| | - Tabetha A Brockman
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
- Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Milton Eder
- Department of Family Medicine & Community Health, University of Minnesota, Minneapolis, MN, United States
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, United States
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21
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McDonald MD, Dombrowski SU, Skinner R, Calveley E, Carroll P, Elders A, Gray CM, Grindle M, Harris FM, Jones C, Hoddinott P. Recruiting men from across the socioeconomic spectrum via GP registers and community outreach to a weight management feasibility randomised controlled trial. BMC Med Res Methodol 2020; 20:249. [PMID: 33023501 PMCID: PMC7542377 DOI: 10.1186/s12874-020-01136-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background Men, particularly those living in disadvantaged areas, are less likely to participate in weight management programmes than women despite similar levels of excess weight. Little is known about how best to recruit men to weight management interventions. This paper describes patient and public involvement in pre-trial decisions relevant to recruitment and aims to report on recruitment to the subsequent men-only weight management feasibility trial, including the: i) acceptability and feasibility of recruitment; and ii) baseline sample characteristics by recruitment strategy. Methods Men with BMI ≥30 kg/m2 and/or waist circumference ≥ 40 in. were recruited to the feasibility trial via two strategies; community outreach (venue information stands and word of mouth) and GP letters, targeting disadvantaged areas. Recruitment activities (e.g. letters sent, researcher venue hours) were recorded systematically, and baseline characteristics questionnaire data collated. Qualitative interviews (n = 50) were conducted three months post-recruitment. Analyses and reporting followed a complementary mixed methods approach. Results 105 men were recruited within four months (community n = 60, GP letter n = 45). Community outreach took 2.3 recruiter hours per participant and GP letters had an opt-in rate of 10.2% (n = 90/879). More men were interested than could be accommodated. Most participants (60%) lived in more disadvantaged areas. Compared to community outreach, men recruited via GP letters were older (mean = 57 vs 48 years); more likely to report an obesity-related co-morbidity (87% vs 44%); and less educated (no formal qualifications, 32% vs 10%, degree educated 11% vs 41%). Recruitment strategies were acceptable, a sensitive approach and trusting relationships with recruiters valued, and the ‘catchy’ study name drew attention. Conclusions Targeted community outreach and GP letters were acceptable strategies that successfully recruited participants to a men-only weight management feasibility trial. Both strategies engaged men from disadvantaged areas, a typically underserved population. Using two recruitment strategies produced samples with different health risk profiles, which could add value to research where either primary or secondary prevention is of interest. Further work is required to examine how these strategies could be implemented and sustained in practice. Trial registration ClinicalTrials.gov: NCT03040518, 2nd February 2017.
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Affiliation(s)
- Matthew D McDonald
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK. .,Physical Activity and Wellbeing Research Group, Curtin University, Perth, Australia. .,School of Psychology, Curtin University, Perth, Australia.
| | - Stephan U Dombrowski
- Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada.,Division of Psychology, University of Stirling, Stirling, UK
| | - Rebecca Skinner
- Division of Psychology, University of Stirling, Stirling, UK
| | - Eileen Calveley
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | | | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Cindy M Gray
- School of Social and Political Sciences, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Mark Grindle
- Institute for Health Research and Innovation, University of the Highlands and Islands, Inverness, UK
| | - Fiona M Harris
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
| | - Claire Jones
- Health Informatics Centre, University of Dundee, Dundee, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
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22
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Sinclair K, Carty C, Gonzales K, Nikolaus C, Gillespie L, Buchwald D. Strong Men, Strong Communities: Design of a Randomized Controlled Trial of a Diabetes Prevention Intervention for American Indian and Alaska Native Men. Am J Mens Health 2020; 14:1557988320945457. [PMID: 32757825 PMCID: PMC7412907 DOI: 10.1177/1557988320945457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 01/04/2023] Open
Abstract
Type 2 diabetes is a serious global epidemic that disproportionately affects disadvantaged populations. American Indians and Alaska Natives (AIs/ANs) have the highest rates of diabetes in the nation with a prevalence of 14.7% in 2018, more than twice that of non-Hispanic Whites. AI/AN men have the highest prevalence of diagnosed type 2 diabetes (14.5%) compared to non-Hispanic Black (11.4%), non-Hispanic Asian (10.0%), and non-Hispanic White (8.6%) men. Several landmark clinical trials have shown that lifestyle interventions can effectively prevent or delay the onset of diabetes among those at risk, including in AIs/ANs. Despite positive outcomes for AIs/ANs in these studies, very few were men. To date, there have been no concerted efforts to recruit and retain AI/AN men in interventions that promote weight loss and healthy lifestyles to prevent diabetes, and they remain underrepresented in these types of studies. This article describes the design and methods of the first randomized controlled trial of a diabetes prevention program with a study sample comprised entirely of AI/AN men. Research to date has demonstrated suboptimal patterns of recruitment and retention of AI/AN men, resulting in their virtual absence in health and intervention research. Effective methods to recruit and retain AI/AN men, and potential benefit gained from participation in diabetes prevention research, are unknown for this population who experience a high prevalence of type 2 diabetes. The study design presented in this article offers promising insights to help remedy these important shortcomings in the science of recruitment and retention of AI/AN men in research.
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Affiliation(s)
- Ka‘imi Sinclair
- College of Nursing, Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA, USA
| | - Cara Carty
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA, USA
| | - Kelly Gonzales
- Portland State University-Oregon Health Sciences University Joint School of Public Health, Portland, OR, USA
| | - Cassandra Nikolaus
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA, USA
| | - Lucas Gillespie
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA, USA
| | - Dedra Buchwald
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA, USA
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23
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Jamieson LM, Antonsson A, Garvey G, Ju X, Smith M, Logan RM, Johnson NW, Hedges J, Sethi S, Dunbar T, Leane C, Hill I, Brown A, Roder D, De Souza M, Canfell K. Prevalence of Oral Human Papillomavirus Infection Among Australian Indigenous Adults. JAMA Netw Open 2020; 3:e204951. [PMID: 32511719 PMCID: PMC7280951 DOI: 10.1001/jamanetworkopen.2020.4951] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Human papillomavirus (HPV) infection is associated with oropharyngeal squamous cell carcinoma. International estimates suggest overall oral HPV prevalence is 7.5%, with prevalence of oral HPV types 16 and 18 being 1.6%; prior Australian estimates suggest oral HPV prevalence is 2.3%, with HPV-16 and HPV-18 being 1.3%. OBJECTIVES To estimate the prevalence of oral HPV infection among Indigenous Australians and to report the prevalence of factors associated with high-risk HPV types (ie, HPV-16 and HPV-18) and HPV types linked with Heck disease (ie, HPV-13 and HPV-32). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed HPV screening results from saliva samples collected from 1011 Indigenous Australians between February 2018 and January 2019. Data were analyzed from May 2018 to May 2019. Recruitment occurred through Aboriginal Community Controlled Health Organisations in South Australia. Eligibility included identifying as Indigenous, residing in South Australia, and being aged 18 years or older. MAIN OUTCOMES AND MEASURES Saliva samples were collected, with microbial DNA for genotyping extracted. Sociodemographic parameters, health-related behaviors, and sexual history data were collected. Analyses were stratified by sex as well as by HPV types 13 and 32 (Heck disease) and 16 and 18 (high risk of oropharyngeal squamous cell carcinoma). Multivariable analyses were conducted to obtain adjusted odds ratios (ORs). RESULTS Data were obtained for 910 participants (median [interquartile range] age, 37 [27-51] years); 595 participants (65%) were female and 572 (63%) resided in nonmetropolitan locations. In all, 321 saliva samples (35.3%; 95% CI, 32.2%-38.4%) were positive for oral HPV (106 [33.7%] men; 215 [36.1%] women). The highest prevalence was found for HPV types 13 and 32 (207 [22.7%] total; 60 [19.0%] men; 147 [24.7%] women) followed by HPV types 16 and 18 (30 [3.3%] total; 9 [2.9%] men; 21 [3.5%] women). After multivariable analysis, risk factors associated with HPV types 13 and 32 included nonmetropolitan residential status (OR, 2.06; 95% CI, 1.10-3.88) and not having had a tonsillectomy (OR, 2.74; 95% CI, 1.05-7.16). Among women, having obtained a high school education or less was associated with lower odds of HPV-16 and HPV-18 infection (OR, 0.16; 95% CI, 0.03-0.97). CONCLUSIONS AND RELEVANCE Prevalence of oral HPV infection in a large sample of Indigenous Australians was high, with one-third testing positive. The most prevalent HPV types were those associated with Heck disease. The prevalence of HPV types associated with oropharyngeal squamous cell carcinoma exceeded both Australian and international population-level estimates.
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Affiliation(s)
- Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - Annika Antonsson
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, Australia
| | - Gail Garvey
- Menzies School of Health Research, Spring Hill, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - Megan Smith
- Cancer Council New South Wales, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | | | - Newell W. Johnson
- Menzies Health Institute Queensland, Griffith University and Faculty of Dentistry, Queensland, Australia
- Oral and Craniofacial Sciences, King’s College, London, United Kingdom
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - Terry Dunbar
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, Australian National University, Australian Capital Territory, Australia
| | - Cathy Leane
- Strategic Partnerships, Aboriginal Health Division Women's and Children's Health Network, Adelaide, Adelaide, Australia
| | - Isaac Hill
- Aboriginal Health Council of South Australia, Adelaide, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - David Roder
- University of South Australia School of Health Sciences, Adelaide, Australia
| | - Marjorie De Souza
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, Australia
| | - Karen Canfell
- Cancer Council New South Wales, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
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24
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Befort CA, Kurz D, VanWormer JJ, Ellerbeck EF. Recruitment and reach in a pragmatic behavioral weight loss randomized controlled trial: implications for real-world primary care practice. BMC FAMILY PRACTICE 2020; 21:47. [PMID: 32126987 PMCID: PMC7055122 DOI: 10.1186/s12875-020-01117-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/25/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Obesity is a major risk factor behind some of the most common problems encountered in primary care. Although effective models for obesity treatment have been developed, the 'reach' of these interventions is poor and only a small fraction of primary care patients receive evidence-based treatment. The purpose of this study is to identify factors that impact the uptake (reach) of an evidence-based obesity treatment program within the context of a pragmatic cluster randomized controlled trial comparing three models of care delivery. METHODS Recruitment and reach were evaluated by the following measures: 1) mailing response rates, 2) referral sources among participants contacting the study team, 3) eligibility rates, 4) participation rates, and 5) representativeness based on demographics, co-morbid conditions, and healthcare utilization of 1432 enrolled participants compared to > 17,000 non-participants from the clinic-based patient populations. Referral sources and participation rates were compared across study arms and level of clinic engagement. RESULTS The response rate to clinic-based mailings was 13.2% and accounted for 66% of overall program recruitment. An additional 22% of recruitment came from direct clinic referrals and 11% from media, family, or friends. Of those screened, 87% were eligible; among those eligible, 86% enrolled in the trial. Participation rates did not vary across the three care delivery arms, but were higher at clinics with high compared to low provider involvement. In addition, clinics with high provider involvement had a higher rate of in clinic referrals (33% versus 16%) and a more representative sample with regards to BMI, rurality, and months since last clinic visit. However, across clinics, enrolled participants compared to non-participants were older, more likely to be female, more likely to have had a joint replacement but less likely to have CVD or smoke, and had fewer hospitalizations. CONCLUSIONS A combination of direct patient mailings and in-clinic referrals may enhance the reach of primary care behavioral weight loss interventions, although more proactive outreach is likely necessary for men, younger patients, and those at greater medial risk. Strategies are needed to enhance provider engagement in referring patients to behavioral weight loss programs. TRIAL REGISTRATION clnicialtrials.gov NCT02456636. Registered May 28, 2015, https://www.clinicaltrials.gov/ct2/results?cond=&term=RE-POWER&cntry=&state=&city=&dist=.
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Affiliation(s)
- Christie A Befort
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 1008, Kansas City, KS, 66160, USA.
| | - Danny Kurz
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 1008, Kansas City, KS, 66160, USA
| | - Jeffrey J VanWormer
- Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave (ML2), Marshfield, WI, 54449, USA
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 1008, Kansas City, KS, 66160, USA
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25
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Energy Restriction Enhances Adult Hippocampal Neurogenesis-Associated Memory after Four Weeks in an Adult Human Population with Central Obesity; a Randomized Controlled Trial. Nutrients 2020; 12:nu12030638. [PMID: 32121111 PMCID: PMC7146388 DOI: 10.3390/nu12030638] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 01/13/2023] Open
Abstract
Adult neurogenesis, the generation of new neurons throughout life, occurs in the subventricular zone of the dentate gyrus in the human hippocampal formation. It has been shown in rodents that adult hippocampal neurogenesis is needed for pattern separation, the ability to differentially encode small changes derived from similar inputs, and recognition memory, as well as the ability to recognize previously encountered stimuli. Improved hippocampus-dependent cognition and cellular readouts of adult hippocampal neurogenesis have been reported in daily energy restricted and intermittent fasting adult mice. Evidence that nutrition can significantly affect brain structure and function is increasing substantially. This randomized intervention study investigated the effects of intermittent and continuous energy restriction on human hippocampal neurogenesis-related cognition, which has not been reported previously. Pattern separation and recognition memory were measured in 43 individuals with central obesity aged 35-75 years, before and after a four-week dietary intervention using the mnemonic similarity task. Both groups significantly improved pattern separation (P = 0.0005), but only the intermittent energy restriction group had a significant deterioration in recognition memory. There were no significant differences in cognitive improvement between the two diets. This is the first human study to investigate the association between energy restriction with neurogenesis-associated cognitive function. Energy restriction may enhance hippocampus-dependent memory and could benefit those in an ageing population with declining cognition. This study was registered on ClinicalTrials.gov (NCT02679989) on 11 February 2016.
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