1
|
Petrusevski C, MacDermid JC, Wilson MG, Richardson J. Framing Physical Literacy for Adults Through a Rehabilitation Lens: An Expert Consensus Study. J Aging Phys Act 2024; 32:488-495. [PMID: 38417423 DOI: 10.1123/japa.2023-0095] [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: 04/03/2023] [Revised: 11/29/2023] [Accepted: 01/13/2024] [Indexed: 03/01/2024]
Abstract
Research indicates a positive relationship between physical literacy and healthy aging; however, there is no consensus on the components required to become a physically literate adult. The objective of this study was to understand how physical literacy for adults with chronic conditions is characterized from the perspective of healthcare professionals. Physiotherapy leaders and physical literacy researchers within North America were invited to an online consensus panel and presented with questions related to physical literacy and rehabilitation. A nominal group technique was used for idea generation, clarification, and ranking. Confidence and safety with movements, motivation and commitment to physical activity, the ability to self-monitor changes in function, and understanding the benefits of physical activity were key components when defining physical literacy. There is a need to reconceptualize physical literacy to include the rehabilitation needs of adults living with chronic conditions, and to design programs that promote physical literacy to enhance function and mobility.
Collapse
Affiliation(s)
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Physical Therapy and Surgery, Western University, London, ON, Canada
- Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
| | - Michael G Wilson
- Department of Health Evidence & Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Department of Health Evidence & Impact, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
2
|
Dong C, Chen H, Li Y, Sun Y, Pan Y, Xu Q, Sun H. Patterns of Health-Risk Behaviours and Their Associations With Anxiety and Depression Among Chinese Young Adults by Gender: A Latent Class Analysis. Psychol Rep 2024:332941241258922. [PMID: 38842056 DOI: 10.1177/00332941241258922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
This study investigated gender differences in health-risk behaviour patterns among young adults and assessed the associations of anxiety and depression with these patterns. A cross-sectional survey was conducted with 1740 young Chinese adults aged 18-24 years. Latent class analysis (LCA) and multinomial logistic regression were conducted to identify the clusters of health-risk behaviours and their associations with anxiety and depression. Three common patterns were found for both genders: physical inactivity, substance use, and insufficient fruit intake (5.7% for males [M] and 11.6% for females [F]); a sedentary lifestyle only (48.4% for M and 48.9% for F); and a sedentary lifestyle, substance use, and an unhealthy diet (7.6% for M and 20.0% for F). Additionally, two additional unique patterns were found: physical inactivity and unhealthy diet in males (38.3%) and physical inactivity and insufficient fruit intake in females (19.6%). Sociodemographic variables exert different effects on health-risk behaviour patterns as a function of gender. Lower anxiety levels (odds ratio [OR]: 0.892; 95% confidence interval [CI]: 0.823-0.966) and greater depression levels (OR: 1.074; 95% CI: 1.008-1.143) were associated with a sedentary lifestyle, substance use, and unhealthy diet class only in female young adults compared with a sedentary-only class. These findings underscore the need for the implementation of targeted interventions based on gender differences.
Collapse
Affiliation(s)
- Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hua Chen
- School of Nursing, Peking University, Beijing, China
| | - Yi Li
- Medical Informatics Center, Institute of Advanced Clinical Medicine, Peking University, Beijing, China
| | - Yumei Sun
- School of Nursing, Peking University, Beijing, China
| | - Yinzhu Pan
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Qiongying Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, China
| |
Collapse
|
3
|
Burton R, Sharpe C, Sheron N, Henn C, Knight S, Wright VM, Cook M. The prevalence and clustering of alcohol consumption, gambling, smoking, and excess weight in an English adult population. Prev Med 2023; 175:107683. [PMID: 37633599 DOI: 10.1016/j.ypmed.2023.107683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND The aim of this study was to examine the prevalence and clustering of four health risks (increasing-/higher-risk drinking, current smoking, overweight/obesity, and at-risk gambling), and to examine variation across sociodemographic groups in the English adult population. METHODS We analysed data from the 2012, 2015, 2016, and 2018 Health Survey for England (n = 20,698). Prevalence odds ratios (POR) were calculated to examine the clustering of risks. We undertook a multinomial multilevel regression model to examine sociodemographic variation in the clustering of health risks. RESULTS Overall, 23.8% of the adult English population had two or more co-occurring health risks. The most prevalent was increasing-/higher-risk drinking and overweight/obesity (17.2%). Alcohol consumption and smoking were strongly clustered, particularly higher-risk drinking and smoking (POR = 2.68; 95% CI = 2.31, 3.11; prevalence = 1.7%). Higher-risk drinking and at-risk gambling were also clustered (POR = 2.66; 95% CI = 1.76, 4.01), albeit with a very low prevalence (0.2%). Prevalence of multiple risks was higher among men for all risk combinations except smoking and obesity. The odds of multiple risks were highest for men and women aged 35-64 years. Unemployed men and women with lower educational qualifications had a higher odds of multiple risks. The relationship between deprivation and multiple risks depended on the definition of multiple risks, with the clearest socioeconomic gradients seen for the highest risk health behaviours. CONCLUSION An understanding of the prevalence, clustering, and risk factors for multiple health risks can help inform effective prevention and treatment approaches and may support the design and use of multiple behaviour change interventions.
Collapse
Affiliation(s)
- Robyn Burton
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, United Kingdom; Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, United Kingdom.
| | - Casey Sharpe
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, United Kingdom
| | - Nick Sheron
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, United Kingdom; Institute of Liver Studies, Kings College London School of Medicine at King's College Hospital, London, United Kingdom
| | - Clive Henn
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, United Kingdom
| | - Sandy Knight
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, United Kingdom
| | - Virginia Musto Wright
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, United Kingdom
| | - Mark Cook
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, United Kingdom
| |
Collapse
|
4
|
Wolfenden L, Close S, Finch M, Lecathelinais C, Ramanathan S, De Santis KK, Car LT, Doyle J, McCrabb S. Improving academic and public health impact of Cochrane public health reviews: what can we learn from bibliographic metrics and author dissemination strategies? A cross-sectional study. J Public Health (Oxf) 2023; 45:e577-e586. [PMID: 37169549 DOI: 10.1093/pubmed/fdad039] [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: 12/04/2022] [Revised: 03/08/2023] [Accepted: 03/22/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND To facilitate the development of impactful research dissemination strategies, this study aimed to: (i) survey authors of trials included in a sample of Cochrane reviews to describe strategies to disseminate trial findings, and examine their association with academic and policy impacts and (ii) audit academic and policy impact of CPH reviews. METHODS Authors of 104 trials within identified Cochrane reviews completed survey items assessing the dissemination strategies. Field weighted citation (FWCI) data extracted from bibliographic databases served as a measure of academic impact of trials and CPH reviews. Policy and practice impacts of trials were assessed during the survey of trial authors using items based on the Payback Framework, and for CPH reviews using 'policy mention' data collected via Altmetric Explorer. RESULTS Among the included trials, univariate (but not multivariable) regression models revealed significant associations between the use of dissemination strategies (i.e. posts on social media; workshops with end-users; media-releases) and policy or practice impacts. No significant associations were reported between dissemination strategies and trial FWCI. The mean FWCI of CPH reviews suggest that they are cited 220% more than other reviews in their field. CONCLUSIONS Comprehensive dissemination strategies are likely required to maximize the potential the potential impacts of public health research.
Collapse
Affiliation(s)
- Luke Wolfenden
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Cochrane Public Health, Newcastle, NSW 2318, Australia
| | - Shara Close
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2318, Australia
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Meghan Finch
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2318, Australia
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Cochrane Public Health, Newcastle, NSW 2318, Australia
| | - Christophe Lecathelinais
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW 2287, Australia
| | - Shanthi Ramanathan
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2318, Australia
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen 28359, Germany
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 639798, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London SW7 2BX, UK
| | - Jodie Doyle
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2318, Australia
- Cochrane Public Health, Newcastle, NSW 2318, Australia
| | - Sam McCrabb
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2318, Australia
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
- Cochrane Public Health, Newcastle, NSW 2318, Australia
| |
Collapse
|
5
|
Campbell BK, Le T, Pagano A, McCuistian C, Woodward-Lopez G, Bonniot C, Guydish J. Addressing nutrition and physical activity in substance use disorder treatment: Client reports from a wellness-oriented, tobacco-free policy intervention. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100165. [PMID: 37234703 PMCID: PMC10206429 DOI: 10.1016/j.dadr.2023.100165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/30/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023]
Abstract
Introduction Interest in wellness interventions in substance use disorder (SUD) treatment is growing although evidence remains limited. This study evaluated nutrition, physical activity, nutrition and physical activity counseling, and relationships of counseling with wellness behavior before and after a wellness-oriented, tobacco-free policy intervention in 17 residential SUD programs. Methods Clients completed cross-sectional surveys reporting sugar-sweetened beverage consumption, physical activity, and receipt of nutrition and physical activity counseling before (n= 434) and after (n = 422) an 18-month intervention. Multivariable regression models assessed pre-post-intervention differences in these variables and examined associations of nutrition counseling with sugar-sweetened beverage consumption and physical activity counseling with physical activity. Results Post-intervention clients were 83% more likely than pre-intervention clients to report nutrition counseling (p = 0.024). There were no pre-post- differences for other variables. Past week sugar-sweetened beverage consumption was 22% lower among clients reporting nutrition counseling than for those who did not (p = 0.008) and this association did not vary by time (pre/post). There was a significant interaction of physical activity counseling receipt by time on past week physical activity (p = 0.008). Pre-intervention clients reporting physical activity counseling had 22% higher physical activity than those who did not; post-intervention clients reporting physical activity counseling had 47% higher physical activity. Conclusion A wellness policy intervention was associated with increased nutrition counseling. Nutrition counseling predicted lower sugar-sweetened beverage consumption. Physical activity counseling predicted higher physical activity, an association that was greater post-intervention. Adding wellness components to tobacco-related interventions may promote health among SUD clients.
Collapse
Affiliation(s)
- Barbara K. Campbell
- Division of General Internal Medicine & Geriatrics, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA
| | - Thao Le
- Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, Floor 7, San Francisco, CA 94158, USA
| | - Anna Pagano
- Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, Floor 7, San Francisco, CA 94158, USA
| | - Caravella McCuistian
- Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, Floor 7, San Francisco, CA 94158, USA
| | - Gail Woodward-Lopez
- University of California Nutrition Policy Institute, 1111 Franklin St, Fifth Floor, Oakland, CA 94607, USA
| | - Catherine Bonniot
- Smoking Cessation Leadership Center, Division of General Internal Medicine, University of California, San Francisco, 490 Illinois Street I San Francisco, CA 94143, USA
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, 490 Illinois St, Floor 7, San Francisco, CA 94158, USA
| |
Collapse
|
6
|
Mandelli L, Milaneschi Y, Hiles S, Serretti A, Penninx BW. Unhealthy lifestyle impacts on biological systems involved in stress response: hypothalamic-pituitary-adrenal axis, inflammation and autonomous nervous system. Int Clin Psychopharmacol 2023; 38:127-135. [PMID: 36730700 PMCID: PMC10063190 DOI: 10.1097/yic.0000000000000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/12/2022] [Indexed: 02/04/2023]
Abstract
An unhealthy lifestyle has a critical role in the pathogenesis and course of several chronic disorders. It has been hypothesized that lifestyle may also impact biological systems involved in stress response. A global index of unhealthy lifestyle was calculated based on the cumulative presence of five self-reported lifestyle habits (smoking, excessive alcohol use, drug use, low physical activity and short sleep) in 2783 participants (18-65 years) from the Netherlands Study of Depression and Anxiety. The functioning of biological stress systems was based on multiple physiological measures of cortisol, inflammatory cytokines and autonomic cardiac activity. The unhealthy lifestyle index was associated with hyperactivity of hypothalamus-pituitary-adrenal axis and increased inflammation, indicating that with increasing unhealthy habits, the level of biological stress increases. No association with the autonomic nervous system activity was observed; however, the use of drugs increased parasympathetic cardiac activity and significantly impacted on ANS. Results were not impacted by a recent episode of depression or anxiety disorder. An unhealthy lifestyle may unfavorably impact on biological systems involved in stress response, which may underlie progression of several psychiatric as well as somatic chronic disorders.
Collapse
Affiliation(s)
- Laura Mandelli
- Department of Biomedical and Neuromotor science, University of Bologna, Bologna, Italy
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Sarah Hiles
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, Australia
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor science, University of Bologna, Bologna, Italy
| | - Brenda W. Penninx
- Department of Psychiatry, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| |
Collapse
|
7
|
A multiple health behaviour change intervention to prevent depression: A randomized controlled trial. Gen Hosp Psychiatry 2023; 82:86-94. [PMID: 37001428 DOI: 10.1016/j.genhosppsych.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/08/2023] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To examine the effectiveness of a 12-month MHBC intervention in the prevention of onset depression in primary health care (PHC). METHODS Twenty-two PHC centres took part in the cluster-randomized controlled trial. Patients were randomized to receive either usual care or an MHBC intervention. The endpoints were onset of major depression and reduction of depressive symptoms in participants without baseline depression at a 12-month follow-up. RESULTS 2531 patients agreed and were eligible to participate. At baseline, around 43% were smokers, 82% were non-adherent to the Mediterranean diet and 55% did not perform enough physical activity. The intervention group exhibited a greater positive change in two or more behaviours (OR 1.75 [95%CI: 1.17 to 2.62]; p = 0.006); any behaviour (OR 1.58 [95%CI: 1.13 to 2.20]; p = 0.007); and adherence to the Mediterranean diet (OR 1.94 [95%CI: 1.29 to 2.94]; p = 0.002), while this increase was not statistically significant for smoking and physical activity. The intervention was not effective in preventing major depression (OR 1.17; [95% CI 0.53 to 2.59)]; p = 0.690) or reducing depressive symptoms (Mean difference: 0.30; [95% CI -0.77 to 1.36]; p = 0.726) during follow-up. CONCLUSIONS As compared to usual care, the MHBC intervention provided a non-significant reduction in the incidence of major depression. TRIAL REGISTRATION ClinicalTrials.gov, NCT03136211.
Collapse
|
8
|
Association between healthy lifestyle pattern and early onset of puberty: based on a longitudinal follow-up study. Br J Nutr 2022; 128:2320-2329. [PMID: 35236516 DOI: 10.1017/s0007114522000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The present study aimed to explore the association between healthy lifestyle pattern and childhood early onset of puberty. Based on a cohort study in Xiamen of China, a total of 1294 children was followed for three and a half years. Children's lifestyles, including dietary behaviour, physical activity, sleep duration, smoking and drinking behaviour and sedentary behaviour, were collected by questionnaires. Healthy lifestyle pattern was determined mainly according to the recommendations by the Dietary Guidelines for Chinese school-age children and Canadian Guidelines for children and youth. The pubertal development was assessed by clinical examination according to Tanner stages. The association between pre-pubertal lifestyle and early onset of puberty was estimated using linear regression and log-binomial regression. We found that children who adhered to a healthy lifestyle had a 0·36-year delay of the age of puberty onset (coef = 0·36, 95 % CI (0·08, 0·65)) and 53 % lower risk of early onset of puberty (risk ratio = 0·47, 95 % CI (0·27, 0·80)), compared with those who had a poor lifestyle. However, the beneficial effect of favourable lifestyles on the early onset of puberty was found only in boys with normal weight. Boys who adhered to active physical activity and low sedentary behaviour had a relatively delayed age of puberty onset (coef = 0·49, 95 % CI (0·26, 0·72)). This is the first time to find that healthy lifestyle pattern was associated with a substantially lower risk of early onset of puberty, especially in boys with normal weight. Advocating an integrated healthy lifestyle is essential for the development of children.
Collapse
|
9
|
Hutchesson MJ, Whatnall MC, Yazin N, Fenton S, Duncan MJ, Kay-Lambkin FJ, Burrows TL. Health behavior interventions for university students measuring mental health outcomes: A scoping review. Front Public Health 2022; 10:1063429. [PMID: 36568797 PMCID: PMC9771454 DOI: 10.3389/fpubh.2022.1063429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Many university students have poor mental health, and co-occurring health risk behaviors. Targeting health behavior change in this population may improve mental health outcomes. This scoping review describes the extent and range of randomized controlled trials (RCT) evaluating interventions targeting health risk behaviors and measuring a mental health outcome, among university students. Methods Six electronic databases were searched for RCTs published until the 18th May 2021. Eligible RCTs included university students, evaluated interventions that promoted health behavior change (i.e., dietary intake, physical activity, sedentary behavior, alcohol and drug use, smoking, and sleep), and measured a mental health-related outcome. Results Fifty-nine RCTs met the inclusion criteria that were published from 2000 to 2021, and over half (n = 33) were conducted in the United States. Interventions evaluated within the RCTs (n = 92) predominantly targeted changes to dietary intake (n = 41 interventions), physical activity (n = 39), or alcohol intake (n = 35). Most interventions targeted one (n = 51) or two (n = 27) health behaviors only. Included RCTs considered mental ill health outcomes (n = 24), psychological wellbeing outcomes (n = 20), or both (n = 15). Discussion This scoping review identified a moderate volume of experimental research investigating the impact of health behavior interventions on university students' mental health. There is scope for further research examining health behavior interventions targeting university students, particularly interventions taking a multi-behavioral approach.
Collapse
Affiliation(s)
- Melinda J. Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia,*Correspondence: Melinda J. Hutchesson
| | - Megan C. Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Nazish Yazin
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Mitch J. Duncan
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Frances J. Kay-Lambkin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Tracy L. Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
10
|
Åsberg K, Eldh AC, Löf M, Bendtsen M. A balancing act-finding one´s way to health and well-being: A qualitative analysis of interviews with Swedish university students on lifestyle and behavior change. PLoS One 2022; 17:e0275848. [PMID: 36227904 PMCID: PMC9560508 DOI: 10.1371/journal.pone.0275848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Unhealthy lifestyle behaviors such as unhealthy diets, low physical activity levels, smoking, and harmful alcohol consumption are common in student populations, which constitute a large group of young adults. As unhealthy lifestyle behaviors are associated with future disease and premature mortality, most commonly from cardiovascular disease and cancers, it is from a public health perspective important to understand such behaviors in young adult populations. The objective of this study was to investigate university students' experiences of health, health-related behaviors, and the barriers and facilitators for behavior change in terms of health promotion in everyday life. MATERIALS AND METHODS This qualitative study was conducted at a middle-sized university in Sweden. Students represented different faculties and were recruited via non-probability convenience sampling using means such as the snowball technique and social media. The 21 interviews with 24 students, individually or in groups, were transcribed verbatim prior to a qualitative analysis inspired by phenomenological hermeneutics. RESULTS Our interviews showed that university student life is associated with new health-related challenges, for example study-related stress and procrastination implies a lack of energy to engage in healthy routines such as physical activity, and a limited budget affects food choices. While adapting to a new context, students explore personal strategies such as taking on changes in manageable steps, seeking social support, and avoiding disturbances to maintaining health and quality of life. CONCLUSIONS Experiences of health while becoming and being a university student can be described as a transition-a balancing act of walking a slack line-during which students seek to manage a healthy balance. In the past, interventions have to some extent been designed to address university students' behaviors; however, our study aids an understanding of their needs. Future interventions should highlight the transitions they are experiencing and the challenges of student life.
Collapse
Affiliation(s)
- Katarina Åsberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ann Catrine Eldh
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institute, Solna, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
11
|
Tinner L, Palmer JC, Lloyd EC, Caldwell DM, MacArthur GJ, Dias K, Langford R, Redmore J, Wittkop L, Watkins SH, Hickman M, Campbell R. Individual-, family- and school-based interventions to prevent multiple risk behaviours relating to alcohol, tobacco and drug use in young people aged 8-25 years: a systematic review and meta-analysis. BMC Public Health 2022; 22:1111. [PMID: 35658920 PMCID: PMC9165543 DOI: 10.1186/s12889-022-13072-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Engagement in multiple substance use risk behaviours such as tobacco smoking, alcohol and drug use during adolescence can result in adverse health and social outcomes. The impact of interventions that address multiple substance use risk behaviours, and the differential impact of universal versus targeted approaches, is unclear given findings from systematic reviews have been mixed. Our objective was to assess effects of interventions targeting multiple substance use behaviours in adolescents. METHODS Eight databases were searched to October 2019. Individual and cluster randomised controlled trials were included if they addressed two or more substance use behaviours in individuals aged 8-25 years. Data were pooled in random-effects meta-analyses, reported by intervention and setting. Quality of evidence was assessed using GRADE. Heterogeneity was assessed using between-study variance, τ2 and Ι2, and the p-value of between-study heterogeneity statistic Q. Sensitivity analyses were undertaken using the highest and lowest intra-cluster correlation coefficient (ICC). RESULTS Of 66 included studies, most were universal (n=52) and school-based (n=41). We found moderate quality evidence that universal school-based interventions are likely to have little or no short-term benefit (up to 12 months) in relation to alcohol use (OR 0.94, 95% CI: 0.84, 1.04), tobacco use (OR 0.98, 95% CI: 0.83, 1.15), cannabis use (OR 1.06, 95% CI: 0.86, 1.31) and other illicit drug use (OR 1.09, 95% CI: 0.85, 1.39). For targeted school-level interventions, there was low quality evidence of no or a small short-term benefit: alcohol use (OR 0.90, 95% CI: 0.74-1.09), tobacco use (OR 0.86, 95% CI: 0.66, 1.11), cannabis use (OR 0.84, 95% CI: 0.66-1.07) and other illicit drug use (OR 0.79, 95% CI 0.62-1.02). There were too few family-level (n=4), individual-level (n=2) and combination level (n=5) studies to draw confident conclusions. Sensitivity analyses of ICC did not change results. CONCLUSIONS There is low to moderate quality evidence that universal and targeted school-level interventions have no or a small beneficial effect for preventing substance use multiple risk behaviours in adolescents. Higher quality trials and study reporting would allow better evidence syntheses, which is needed given small benefit of universal interventions can have high public health benefit. TRIAL REGISTRATION Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD011374. DOI: 10.1002/14651858.CD011374.
Collapse
Affiliation(s)
- Laura Tinner
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Jennifer C Palmer
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Deborah M Caldwell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Georgie J MacArthur
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Kaiseree Dias
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rebecca Langford
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - James Redmore
- York Teaching Hospitals NHS Foundation Trust, Wiggington Road, York, UK
| | - Linda Wittkop
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Matthew Hickman
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rona Campbell
- Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| |
Collapse
|
12
|
Cunningham FC, Murphy MG, Ward G, Fagan R, Arley B, Hornby-Turner YC, d'Abbs PH. Impact of an Aboriginal and Torres Strait Islander brief intervention training program on health staff participants' own health behaviours: smoking, nutrition and physical activity. Health Promot J Austr 2022; 33 Suppl 1:235-245. [PMID: 35661321 DOI: 10.1002/hpja.628] [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: 02/02/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/08/2022] Open
Abstract
ISSUE Little research has been conducted on the impact of Aboriginal and Torres Strait Islander brief intervention training programs on health staff participants' own health behaviours. Through the Queensland B.strong program (2017-2020), brief intervention training in smoking cessation, nutrition and physical activity was provided to the Aboriginal and Torres Strait Islander health workforce and other health and community professionals. This study examined the program's impact on participants' own health behaviours. METHODS Data were collected through four surveys (pre-and post-training workshop, and 3-month and 6-month follow-up) of the 1,131 participants in B.strong training workshops from June 2017 to August 2019. Surveys included items on participants' own health behaviours. Pre- and post-workshop surveys were paper-based, and follow-up surveys were completed online. For the analysis of data reported in this paper, paired-samples t-tests were used to assess changes between pre-workshop and 3-month follow-up. RESULTS Statistically significant improvements were found between pre-workshop and 3-month follow-up in the number of serves of vegetables or legumes/beans eaten per day, the number of serves of fruit eaten per day, and in time spent in physical activity. However, there was: no statistically significant change in smoking status, with baseline rates being relatively low; a statistically significant increase in consumption of sugary drinks, and of take-away foods; a non-significant increase in consumption of snack foods; and no significant change in sedentary behaviour of participants. CONCLUSION While some positive changes in participants' own health behaviours in nutrition and physical activity were associated with the B.strong program, there was no change in their smoking behaviour. SO WHAT This study found that some improvements in participants' own health behaviours were associated with the B.strong program. This research may inform future Indigenous brief intervention training programs and health services on how to promote healthy behaviours for health staff themselves.
Collapse
Affiliation(s)
- Frances C Cunningham
- Menzies School of Health Research, John Mathews Building (Building 58), Royal Darwin Hospital Campus, Rocklands Drive, Casuarina NT, Australia
| | - Majella G Murphy
- Molly Wardaguga Research Centre, Charles Darwin University, Level 11, East Tower, 410 Ann St., Brisbane City Qld, Australia
| | - Grace Ward
- Diabetes Australia Queensland, 29 Finchley St., Milton Qld 4064, Australia
| | - Royden Fagan
- Menzies School of Health Research, John Mathews Building (Building 58), Royal Darwin Hospital Campus, Rocklands Drive, Casuarina NT, Australia
| | - Brian Arley
- Menzies School of Health Research, John Mathews Building (Building 58), Royal Darwin Hospital Campus, Rocklands Drive, Casuarina NT, Australia
| | - Yvonne C Hornby-Turner
- College of Medicine and Dentistry, James Cook University, Cairns Qld Australia, Room 003A, E Block, Health and Sciences Building, Nguma-Bada Campus, James Cook University, McGregor Rd., Smithfield Qld, Australia
| | - Peter H d'Abbs
- Menzies School of Health Research, John Mathews Building (Building 58), Royal Darwin Hospital Campus, Rocklands Drive, Casuarina NT, Australia
| |
Collapse
|
13
|
Harmon BE, Leak CL, Zhang H, West NT, Nigg CR. Examination of Associations between Physical Activity and Eating Identities among College-aged Adults Living in Hawai'i. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2022; 81:162-168. [PMID: 35673366 PMCID: PMC9168934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
While physical activity and diet behaviors are correlated, mechanisms underlying associations have rarely been examined. This study examined associations between physical activity identity and eating identity among college-aged adults in Hawai'i to provide guidance for future multiple behavior change interventions. This study was a cross-sectional analysis of data collected between September 2013 and January 2014. Participants were 40 college students attending 4-year and 2-year institutions within the University of Hawai'i system. Total physical activity identity score and dimensions were measured using the Athlete Identity Questionnaire. Eating identity subtypes were measured using the Eating Identity Type Inventory. Associations between physical activity identity total score, 4 physical activity identity dimensions (appearance, importance, competence, and encouragement), and 4 eating identity subtypes (healthy, emotional, meat, and picky) were examined using multiple linear regressions. A significant positive association was found between total physical activity identity score and the healthy eating subtype and a negative association with the picky eating subtype. The physical activity dimension importance had a significant positive association with the healthy eating subtype, appearance a negative association with the emotional eating subtype, and competence a positive association with the meat eating subtype but a negative association with the picky eating subtype. The findings suggest important overlap in identities for physical activity and diet. Measurement of physical activity identity and eating identity as well as tailored intervention strategies should be incorporated into more behavior change research.
Collapse
Affiliation(s)
- Brook E. Harmon
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC (BEH)
| | - Cardella L. Leak
- Research and Performance Management, Memphis-Shelby County Schools, Memphis, TN (CLL)
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN (HZ)
| | - Nathan T. West
- Division of Social and Behavioral Sciences, University of Memphis, Memphis, TN (NTW)
| | - Claudio R. Nigg
- Institute of Sport Science, Department of Sport and Health, University of Bern, Bern, Switzerland (CRN)
| |
Collapse
|
14
|
Health Risk Behaviour Inventory Validation and its Association with Self-regulatory Dispositions. J Clin Psychol Med Settings 2022; 29:861-874. [PMID: 35099679 DOI: 10.1007/s10880-022-09854-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
Abstract
We put forward a validation of the first instrument to measure the big four health risk behaviours (World Health Organization, Global status report on non-communicable diseases 2014, WHO, 2014) in a single assessment, the Health Risk Behaviour Inventory (HRBI) that assesses physical inactivity, unhealthy diet, smoking and alcohol in Italian- and English-speaking samples. Further, we investigate the instrument's association with self-regulatory dispositions, exploring culture and gender differences in Italian and US subgroup samples. Overall, 304 English- and 939 Italian-speaking participants completed the HRBI and the self-regulatory questionnaire. We explored the factorial structure, convergent validity, invariance and association with self-regulatory dispositions using structural equation modelling.The HRBI has a robust factorial structure; it usefully converges with widely used healthy lifestyle measures, and it is invariant across the categories of age, gender and languages. Regarding self-regulatory dispositions, the promotion focus emerges as the most protective factor over physical inactivity, unhealthy diet, smoking and alcohol, whereas the prevention focus is associated mainly with smoking and alcohol reduction. Results are consistent across genders and US subgroup-Italian samples. The HRBI is a valid instrument for assessing the big four health risk behaviours in clinic and research contexts, and among self-regulatory measures, the promotion and prevention foci have the greatest efficacy in eliciting positive health behaviours.
Collapse
|
15
|
Edney LC, Roseleur J, Gray J, Koczwara B, Karnon J. Mapping a decade of interventions to address the supportive care needs of individuals living with or beyond cancer: a scoping review of reviews. Support Care Cancer 2022; 30:3793-3804. [PMID: 35029770 DOI: 10.1007/s00520-021-06713-9] [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: 04/14/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Individuals diagnosed with cancer have a range of supportive care needs that are often unmet despite substantial evidence supporting interventions to address them. Addressing this knowledge-translation gap represents a significant opportunity to improve health outcomes. A scoping review of reviews was conducted to map the breadth of evidence for interventions, highlighting those with an existing evidence base, as well as those requiring further research. METHODS Systematic or meta-analytic reviews that examined interventions targeting supportive care needs of adults and children with cancer published between 2009 and 2019 were identified via searches in Medline, PsycINFO, CINAHL, Scopus and Cochrane. RESULTS Five hundred fifty-one systematic reviews, including 250 meta-analyses, of interventions addressing supportive care needs, were included. Most reviews focused on interventions to address the physical and psychosocial needs of individuals with few reviews identified to address practical needs. Interventions using mental health therapies and physical activity were most commonly used to address all supportive care needs, followed by the use of pharmaceutical and medical devices, complementary and alternative therapies, information and education resources, dietary information and specific spirituality and return-to-work interventions. CONCLUSION This scoping review of reviews presents the first broad overview of the literature addressing the supportive care needs of people living with or beyond cancer. It provides a database that health service providers can search to identify appropriate interventions. Results highlight specific research gaps, particularly for practical needs, where reviews are needed. It highlights where a substantial evidence base exists that researchers and policy-makers can consider when implementing interventions.
Collapse
Affiliation(s)
- Laura Catherine Edney
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Jacqueline Roseleur
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.
| | - Jodi Gray
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.,Flinders Medical Centre, Adelaide, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| |
Collapse
|
16
|
Bloom EL, Bogart A, Dubowitz T, Collins RL, Ghosh-Dastidar B, Gary-Webb TL, Troxel W. Longitudinal Associations Between Changes in Cigarette Smoking and Alcohol Use, Eating Behavior, Perceived Stress, and Self-Rated Health in a Cohort of Low-Income Black Adults. Ann Behav Med 2022; 56:112-124. [PMID: 33970236 PMCID: PMC8691395 DOI: 10.1093/abm/kaab029] [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] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Black adults in the U.S. experience significant health disparities related to tobacco use and obesity. Conducting observational studies of the associations between smoking and other health behaviors and indicators among Black adults may contribute to the development of tailored interventions. PURPOSE We examined associations between change in cigarette smoking and alcohol use, body mass index, eating behavior, perceived stress, and self-rated health in a cohort of Black adults who resided in low-income urban neighborhoods and participated in an ongoing longitudinal study. METHODS Interviews were conducted in 2011, 2014, and 2018; participants (N = 904) provided at least two waves of data. We fit linear and logistic mixed-effects models to evaluate how changes in smoking status from the previous wave to the subsequent wave were related to each outcome at that subsequent wave. RESULTS Compared to repeated smoking (smoking at previous and subsequent wave), repeated nonsmoking (nonsmoking at previous and subsequent wave) was associated with greater likelihood of recent dieting (OR = 1.59, 95% CI [1.13, 2.23], p = .007) and future intention (OR = 2.19, 95% CI [1.61, 2.98], p < .001) and self-efficacy (OR = 1.64, 95% CI [1.21, 2.23], p = .002) to eat low calorie foods, and greater odds of excellent or very good self-rated health (OR = 2.47, 95% CI [1.53, 3.99], p < .001). Transitioning from smoking to nonsmoking was associated with greater self-efficacy to eat low calorie foods (OR = 1.89, 95% CI [1.1, 3.26], p = .021), and lower perceived stress (β = -0.69, 95% CI [-1.34, -0.05], p = .036). CONCLUSIONS We found significant longitudinal associations between smoking behavior and eating behavior, perceived stress, and self-rated health. These findings have implications for the development of multiple behavior change programs and community-level interventions and policies.
Collapse
Affiliation(s)
| | | | | | | | | | - Tiffany L Gary-Webb
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | |
Collapse
|
17
|
Åsberg K, Lundgren O, Henriksson H, Henriksson P, Bendtsen P, Löf M, Bendtsen M. Multiple lifestyle behaviour mHealth intervention targeting Swedish college and university students: protocol for the Buddy randomised factorial trial. BMJ Open 2021. [PMCID: PMC8719203 DOI: 10.1136/bmjopen-2021-051044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction The time during which many attend college or university is an important period for developing health behaviours, with potentially major implications for future health. Therefore, it is concerning that many Swedish students excessively consume alcohol, have unhealthy diets, are not physical active and smoke. The potential of digital interventions which integrate support for change of all of these behaviours is largely unexplored, as are the dismantled effects of the individual components that make up digital lifestyle behaviour interventions. Methods and analysis A factorial randomised trial (six factors with two levels each) will be employed to estimate the effects of the components of a novel mHealth multiple lifestyle intervention on alcohol consumption, diet, physical activity and smoking among Swedish college and university students. A Bayesian group sequential design will be employed to periodically make decisions to continue or stop recruitment, with simulations suggesting that between 1500 and 2500 participants will be required. Multilevel regression models will be used to analyse behavioural outcomes collected at 2 and 4 months postrandomisation. Ethics and dissemination The study was approved by the Swedish Ethical Review Authority on 2020-12-15 (Dnr 2020-05496). The main concern is the opportunity cost if the intervention is found to only have small effects. However, considering the lack of a generally available evidence-based multiple lifestyle behaviour support to university and college students, this risk was deemed acceptable given the potential benefits from the study. Recruitment will begin in March 2021, and it is expected that recruitment will last no more than 24 months. A final data set will, therefore, be available in July 2023, and findings will be reported no later than December 2023. Trial registration number ISRCTN23310640; Pre-results.
Collapse
Affiliation(s)
- Katarina Åsberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Oskar Lundgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hanna Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Preben Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Medical Specialist, Motala Hospital, Motala, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
18
|
Contreras-Guillén IA, Leeson S, Gili RV, Carlino B, Xutuc D, Martins MCT, Zapata ME, Segovia-Siapco G, Sabaté J, Pacheco FJ, Pacheco SOS. Development and Usability Study of an Open-Access Interviewer-Administered Automated 24-h Dietary Recall Tool in Argentina: MAR24. Front Nutr 2021; 8:642387. [PMID: 34422876 PMCID: PMC8374600 DOI: 10.3389/fnut.2021.642387] [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: 12/16/2020] [Accepted: 07/13/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Latin American countries show a fast-growing rate of non-communicable diseases (NCDs) and diet is a critical risk factor that must be properly assessed. Automated dietary assessment tools to collect 24-h dietary recalls (24HR) are lacking in Argentina. Objective: This study aimed to develop an open-access automated tool (MAR24) for collecting 24HR using a multiple pass method and a database containing foods and recipes commonly consumed in Argentina. Methods: MAR24 was developed based on data from 1,285 24HR provided by male and female participants aged 18 to 68 years from the six Argentinian geographical regions. The main structure and interface of the tool were designed using Visual Basic for Applications programming language in Excel Microsoft Office 365, integrating the five steps of the United States Department of Agriculture (USDA) Automated Multiple-Pass Method (AMPM) for the application of 24HR in Spanish. The tool underwent alpha testing and expert assessment to address structural and usability issues. Critical feedback and face validation from researchers and experienced dietitians, and repeated testing to collect 24HR were used to adjust and improve the tool. Results: A total of 968 food items and 100 standard Argentinian recipes were added to its database. MAR24 allows the estimation of the nutrient profile of dietary intake. The analytic food composition includes energy and 50 nutrients including water, macronutrients, total dietary fiber, total sugar, 10 minerals, 19 vitamins, eight fatty acids, cholesterol, ethyl alcohol, caffeine, and theobromine. MAR24 includes a user manual and technical manual to guide users to apply changes (e.g., add foods or recipes, or change food designation according to local terms) to fit different research and clinical applications. Conclusions: MAR24 is the first tool that uses the AMPM methodology for 24HR applications in Argentina. The tool may be used in clinical practice and clinical trials for monitoring purposes, and in validation of food frequency questionnaires (FFQ) for nutritional epidemiology studies addressing dietary-associated risk factors for NCDs.
Collapse
Affiliation(s)
- Ismael A Contreras-Guillén
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - Sara Leeson
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - Rocio V Gili
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - Belén Carlino
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - Daniel Xutuc
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - Marcia Cristina Teixeira Martins
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - María E Zapata
- Center for Child Nutrition Studies Dr. Alejandro O'Donnell (CESNI), Ciudad Autónoma de Buenos Aires, Argentina
| | - Gina Segovia-Siapco
- School of Public Health, Center for Nutrition, Healthy Lifestyle and Disease Prevention, Loma Linda University, Loma Linda, CA, United States
| | - Joan Sabaté
- School of Public Health, Center for Nutrition, Healthy Lifestyle and Disease Prevention, Loma Linda University, Loma Linda, CA, United States
| | - Fabio J Pacheco
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| | - Sandaly O S Pacheco
- School of Medicine and Health Sciences, Center for Health Sciences Research, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Entre Ríos, Argentina
| |
Collapse
|
19
|
Profiles of Risky Driving Behaviors in Adolescent Drivers: A Cluster Analysis of a Representative Sample from Tuscany Region (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126362. [PMID: 34208307 PMCID: PMC8296188 DOI: 10.3390/ijerph18126362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022]
Abstract
(1) Background: Research on patterns of risky driving behaviors (RDBs) in adolescents is scarce. This study aims to identify distinctive patterns of RDBs and to explore their characteristics in a representative sample of adolescents. (2) Methods: this is a cross-sectional study of a representative sample of Tuscany Region students aged 14–19 years (n = 2162). The prevalence of 11 RDBs was assessed and a cluster analysis was conducted to identify patterns of RDBs. ANOVA, post hoc pairwise comparisons and multivariate logistic regression models were used to characterize cluster membership. (3) Results: four distinct clusters of drivers were identified based on patterns of RDBs; in particular, two clusters—the Reckless Drivers (11.2%) and the Careless Drivers (21.5%)—showed high-risk patterns of engagement in RDBs. These high-risk clusters exhibited the weakest social bonds, the highest psychological distress, the most frequent participation in health compromising and risky behaviors, and the highest risk of a road traffic accident. (4) Conclusion: findings suggest that it is possible to identify typical profiles of RDBs in adolescents and that risky driving profiles are positively interrelated with other risky behaviors. This clustering suggests the need to develop multicomponent prevention strategies rather than addressing specific RDBs in isolation.
Collapse
|
20
|
Represas-Carrera F, Couso-Viana S, Méndez-López F, Masluk B, Magallón-Botaya R, Recio-Rodríguez JI, Pombo H, Leiva-Rus A, Gil-Girbau M, Motrico E, Martí-Lluch R, Gude F, Clavería A. Effectiveness of a Multicomponent Intervention in Primary Care That Addresses Patients with Diabetes Mellitus with Two or More Unhealthy Habits, Such as Diet, Physical Activity or Smoking: Multicenter Randomized Cluster Trial (EIRA Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5788. [PMID: 34071171 PMCID: PMC8198299 DOI: 10.3390/ijerph18115788] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 12/23/2022]
Abstract
Introduction: We evaluated the effectiveness of an individual, group and community intervention to improve the glycemic control of patients with diabetes mellitus aged 45-75 years with two or three unhealthy life habits. As secondary endpoints, we evaluated the inverventions' effectiveness on adhering to Mediterranean diet, physical activity, sedentary lifestyle, smoking and quality of life. Method: A randomized clinical cluster (health centers) trial with two parallel groups in Spain from January 2016 to December 2019 was used. Patients with diabetes mellitus aged 45-75 years with two unhealthy life habits or more (smoking, not adhering to Mediterranean diet or little physical activity) participated. Centers were randomly assigned. The sample size was estimated to be 420 people for the main outcome variable. Educational intervention was done to improve adherence to Mediterranean diet, physical activity and smoking cessation by individual, group and community interventions for 12 months. Controls received the usual health care. The outcome variables were: HbA1c (main), the Mediterranean diet adherence score (MEDAS), the international diet quality index (DQI-I), the international physical activity questionnaire (IPAQ), sedentary lifestyle, smoking ≥1 cigarette/day and the EuroQuol questionnaire (EVA-EuroQol5D5L). Results: In total, 13 control centers (n = 356) and 12 intervention centers (n = 338) were included with similar baseline conditions. An analysis for intention-to-treat was done by applying multilevel mixed models fitted by basal values and the health center: the HbA1c adjusted mean difference = -0.09 (95% CI: -0.29-0.10), the DQI-I adjusted mean difference = 0.25 (95% CI: -0.32-0.82), the MEDAS adjusted mean difference = 0.45 (95% CI: 0.01-0.89), moderate/high physical activity OR = 1.09 (95% CI: 0.64-1.86), not living a sedentary lifestyle OR = 0.97 (95% CI: 0.55-1.73), no smoking OR = 0.61 (95% CI: 0.54-1.06), EVA adjusted mean difference = -1.26 (95% CI: -4.98-2.45). Conclusions: No statistically significant changes were found for either glycemic control or physical activity, sedentary lifestyle, smoking and quality of life. The multicomponent individual, group and community interventions only showed a statistically significant improvement in adhering to Mediterranean diet. Such innovative interventions need further research to demonstrate their effectiveness in patients with poor glycemic control.
Collapse
Affiliation(s)
- Francisco Represas-Carrera
- Galicia South Health Research Institute, Hospital Álvaro Cunqueiro, Technical Block, Floor 2, Roal Clara Campoamor nº 341, 36213 Vigo, Spain; (S.C.-V.); (A.C.)
| | - Sabela Couso-Viana
- Galicia South Health Research Institute, Hospital Álvaro Cunqueiro, Technical Block, Floor 2, Roal Clara Campoamor nº 341, 36213 Vigo, Spain; (S.C.-V.); (A.C.)
| | - Fátima Méndez-López
- Aragonese Research Group in Primary Care (GAIAP), Institute of Health Research, Avenue San Juan Bosco, 13, 50009 Zaragoza, Spain; (F.M.-L.); (B.M.); (R.M.-B.)
| | - Bárbara Masluk
- Aragonese Research Group in Primary Care (GAIAP), Institute of Health Research, Avenue San Juan Bosco, 13, 50009 Zaragoza, Spain; (F.M.-L.); (B.M.); (R.M.-B.)
| | - Rosa Magallón-Botaya
- Aragonese Research Group in Primary Care (GAIAP), Institute of Health Research, Avenue San Juan Bosco, 13, 50009 Zaragoza, Spain; (F.M.-L.); (B.M.); (R.M.-B.)
| | - Jose I. Recio-Rodríguez
- San Juan Health Centre, Salamanca Primary Care Research Unit (APISAL), Institute of Biomedical Research of Salamanca (IBSAL), Department of Nursing and Physiotherapy (University of Salamanca), Avenue Portugal 83, 2 Floor, 37005 Salamanca, Spain;
| | - Haizea Pombo
- Ezkerraldea-Enkarterri-Cruces Integrated Health Organisation, Biocruces Bizkaia Health Research Institute Innovation Unit, Plaza de Cruces s/n, 48903 Barakaldo, Spain;
| | - Alfonso Leiva-Rus
- Balearic Islands Health Research Institute (IdISBa), Highway Valldemosa 79, 07120 Palma, Spain;
| | - Montserrat Gil-Girbau
- Research Group in Health Technology Assessment in Primary Care and Mental Health (PRISMA), Research and Development Unit, Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Street Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain;
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, Avenue of the Universities, s/n, 41704 Dos Hermanas, Spain;
| | - Ruth Martí-Lluch
- Girona Research Support Unit, Jordi Gol i Gurina University Institute for Research in Primary Health Care Foundation (IDIAPJGol), Street Maluquer Salvador 11, 17002 Girona, Spain;
| | - Francisco Gude
- Clinical Epidemiology Unit, Research Methods Group, Santiago Institute of Sanitary Research (IDIS), Complejo Hospitalario Universitario de Santiago, Travesía da Choupana, s/n, 157056 Santiago de Compostela, Spain;
| | - Ana Clavería
- Galicia South Health Research Institute, Hospital Álvaro Cunqueiro, Technical Block, Floor 2, Roal Clara Campoamor nº 341, 36213 Vigo, Spain; (S.C.-V.); (A.C.)
| |
Collapse
|
21
|
Barbosa-Medeiros MR, de Pinho L, Rosa Rossi-Barbosa LA, Caldeira AP. Dietary risk behaviors for chronic non-communicable diseases in Brazilian medical students. PSYCHOL HEALTH MED 2021; 27:1693-1703. [PMID: 33899613 DOI: 10.1080/13548506.2021.1916958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
College students in general commonly present unhealthy habits and, as a result, they can develop chronic non-communicable diseases. The present study aimed to assess the prevalence of clustering of dietary risk behaviors for chronic non-communicable diseases and associated factors among medical students. A cross-sectional study was carried out with 231 students in the 1st, 7th and 11th semesters of undergraduate medical courses at three institutions in northern Minas Gerais, Brazil. Information on food intake was obtained through a survey of risk and protection factors for chronic diseases conducted by telephone. Statistical analysis was carried out using Poisson regression with robust variance. With regard to the clustering of dietary risk behaviors for chronic diseases, 30.8% of the students had three or more such behaviors. In the multivariate analysis, it was found that the prevalence of dietary risk behaviors was significantly higher among first-semester students. It is believed that students in other semesters had a lower prevalence of clustering of dietary risk behaviors because they had in-depth knowledge about the benefits of a healthy diet.
Collapse
Affiliation(s)
| | - Lucineia de Pinho
- Department of Medicine, State University of Montes Claros, Montes Claros, Brazil
| | | | | |
Collapse
|
22
|
Brief Report: A Latent Class Analysis of Guideline Compliance Across Nine Health Behaviors. Int J Behav Med 2021; 29:110-115. [PMID: 33846954 DOI: 10.1007/s12529-021-09988-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Prevalence figures for health-related behaviors disguise the existence of behavioral clusters. A growing body of work indicates the potential effectiveness of using simultaneous (versus sequential) approaches to targeting health-related behaviors to make deeper inroads into addressing non-communicable diseases. To inform future interventions designed to simultaneously address multiple risk factors, the aim of the present study was to identify behavioral clusters including nine behaviors relating to smoking, alcohol consumption, nutrition, physical activity, and sleep. METHOD A latent class analysis was applied to a nationally representative sample of 1849 adult Australians. RESULTS Of the four identified segments, one was characterized by a relatively healthy behavioral profile and another demonstrated poor results across multiple lifestyle domains. The other two groups comprised individuals who demonstrated healthy behaviors in some domains (e.g., substance use) but not in others (primarily physical inactivity and junk food consumption, respectively). CONCLUSIONS Results suggest the opportunity to encourage individuals in the latter two groups to build on existing positive behaviors to achieve greater overall compliance with health recommendations. Particularly intensive interventions are likely needed for those in the unhealthiest group to address the potentially reinforcing effects of their multiple unhealthy behaviors.
Collapse
|
23
|
Sánchez Urbano RE, Paredes A, Vargas Chambi FR, Guedes Ruela P, Olivares DEV, Souza Pereira BT, Pacheco SOS, Pacheco FJ. Reception of Dietary and Other Health-Related Lifestyle Advice to Address Non-communicable Diseases in a Primary Care Context: A Mixed-Method Study in Central Argentina. Front Nutr 2021; 8:622543. [PMID: 33585541 PMCID: PMC7873357 DOI: 10.3389/fnut.2021.622543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/04/2021] [Indexed: 11/13/2022] Open
Abstract
An effective way to address risk factors for non-communicable chronic diseases (NCD) and reduce healthcare costs is by using sound health-related advice (HRA) to promote healthy lifestyle habits. In Argentina, however, few studies have examined the context in which HRA is communicated and undertaken by patients at the primary care level. In this study, we assessed the reception of HRA using a mixed-method approach in a central area of Argentina. A total of 1,044 participants from the community were contacted and sociodemographic characteristics, health-related lifestyle factors, and medical history were collected. A calendar with health messages was provided to participants and its usage was assessed after 1 year. Additionally, semi-structured interviews were conducted with 34 patients attending a local primary healthcare center. The results show that HRA was given more frequently to individuals with higher mean age, lower educational level, and to females. Participants with a chronic health condition are at a higher chance of receiving advice to reduce salt intake and maintain a healthy weight. Dietary advice is offered along with other lifestyle recommendations. The use of alcohol and tobacco is usually addressed together. HRA was primarily received in the context of an NCD diagnosis and advice was directed, especially, to risky behaviors. The HRA to increase the intake of fruits and vegetables was mentioned less frequently. Patients at the healthcare center greatly appreciated receiving an HRA, especially when given in a tailored, written, and detailed form, and acknowledged its importance to prevent or control a chronic health condition as part of the medical treatment but showed concern regarding the ability to fully incorporate the advice. Lifestyle recommendations are highly appreciated by patients but are still underutilized since they are offered mostly in the context of illness. The health calendar was shown to be useful to complement health intervention programs at the community level. The findings of our study underscore the acknowledged value of HRA by participants to tackle the risk factors of chronic diseases. If properly used HRA constitutes a simple and highly valued tool to help address patient's needs to prevent and control NCD in Argentina.
Collapse
Affiliation(s)
- Raúl E Sánchez Urbano
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Ariel Paredes
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Frank R Vargas Chambi
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Pedro Guedes Ruela
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - David E V Olivares
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Benicio T Souza Pereira
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Sandaly O S Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Argentina
| | - Fabio J Pacheco
- Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina.,Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Argentina
| |
Collapse
|
24
|
Felton JW, Collado A, Ingram KM, Doran K, Yi R. Improvement of Working Memory is a Mechanism for Reductions in Delay Discounting Among Mid-Age Individuals in an Urban Medically Underserved Area. Ann Behav Med 2020; 53:988-998. [PMID: 30955043 DOI: 10.1093/abm/kaz010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Delay discounting, or the tendency to devalue rewards as a function of their delayed receipt, is associated with myriad negative health behaviors. Individuals from medically underserved areas are disproportionately at risk for chronic health problems. The higher rates of delay discounting and consequent adverse outcomes evidenced among low-resource and unstable environments suggest this may be an important pathway to explain health disparities among this population. PURPOSE The current study examined the effectiveness of a computerized working memory training program to decrease rates of delay discounting among residents of a traditionally underserved region. METHODS Participants (N = 123) were recruited from a community center serving low income and homeless individuals. Subjects completed measures of delay discounting and working memory and then took part in either an active or control working memory training. RESULTS Analyses indicated that participants in the active condition demonstrated significant improvement in working memory and that this improvement mediated the relation between treatment condition and reductions in delay discounting. CONCLUSIONS Results suggest that a computerized intervention targeting working memory may be effective in decreasing rates of delay discounting in adults from medically underserved areas (ClinicalTrials.gov number NCT03501706).
Collapse
Affiliation(s)
- Julia W Felton
- Division of Public Health, Michigan State University, Flint, MI, USA
| | - Anahi Collado
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | | | - Kelly Doran
- School of Nursing, University of Maryland, Baltimore, MD, USA
| | - Richard Yi
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| |
Collapse
|
25
|
Holahan CJ, Holahan CK, Lim S, Powers DA. Living with a Smoker and Multiple Health-Risk Behaviors. Ann Behav Med 2020; 55:287-297. [PMID: 32814951 DOI: 10.1093/abm/kaaa059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Behavioral medicine is showing growing theoretical and applied interest in multiple health-risk behaviors. Compared to engaging in a single health-risk behavior, multiple health-risk behaviors are linked to increased morbidity and mortality. A contextual determinant of multiple risk behaviors may be living with a smoker. PURPOSE This study investigated the role of living with a smoker in predicting multiple health-risk behaviors compared to a single health-risk behavior, as well as whether these multiple risk behaviors occur across both physical activity and dietary domains. Moreover, the study tested these effects across 3 years in longitudinal and prospective (controlling for health-risk behaviors at baseline) analyses. METHODS Participants were 82,644 women (age M = 63.5, standard deviation = 7.36, age range = 49-81) from the Women's Health Initiative Observational Study. Analyses used multinomial and binary logistic regression. RESULTS Living with a smoker was more strongly associated with multiple health-risk behaviors than with a single health-risk behavior. These multiple risk behaviors occurred across both physical activity and dietary domains. The effects persisted across 3 years in longitudinal and prospective analyses. Living with a smoker, compared to not living with a smoker, increased the odds of multiple health-risk behaviors 82% cross-sectionally and, across 3 years, 94% longitudinally and 57% prospectively. CONCLUSIONS These findings integrate research on multiple health-risk behaviors and on living with a smoker and underscore an unrecognized public health risk of tobacco smoking. These results are relevant to household-level interventions integrating smoking-prevention and obesity-prevention efforts.
Collapse
Affiliation(s)
- Charles J Holahan
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Sangdon Lim
- Department of Educational Psychology, University of Texas at Austin, Austin, TX, USA
| | - Daniel A Powers
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
26
|
Borillo CJ, Tamanal JM, Kim CH. Determining the Cut Off Score of the Healthy Lifestyle Screening Tool among High School Students. J Lifestyle Med 2020; 10:92-101. [PMID: 32995336 PMCID: PMC7502896 DOI: 10.15280/jlm.2020.10.2.92] [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: 07/08/2020] [Accepted: 07/17/2020] [Indexed: 11/27/2022] Open
Abstract
Background Several lifestyle factors such as not smoking, drinking alcohol in moderation, eating healthily, regular exercise, and maintaining a normal weight have been known to play an important role in optimal health. A screening tool that has a standardized score that indicates healthy or risky lifestyle behaviors is needed for health promotion. However, such a tool that focuses on lifestyle behaviors have not incorporated scores to summarize the results. The purpose of this study is to develop the cut-off points of the Healthy Lifestyle Screening tool. Methods Data collection in this study was done from 198 Filipino high school students utilizing the Healthy Lifestyle Screening Tool. Results Receiver Operating Curve (ROC) results indicated cut-off score of 98 to separate into low and high score groups. The mean scores for all subcomponents were significantly different in between two groups. The general population fell in the high score category with a mean total score of 105.61 in which 81.31% were categorized in the high score group and 18.61% in the low score group. Subjects in general obtained low mean scores in specific subscale components such as rest (2.46) water (2.66) and exercise (2.78). Conclusion Increasing the total score by working on low scoring components will be beneficial in achieving a healthy lifestyle. This study reinforced the importance of holistic approach regarding health and well-being among high school students.
Collapse
Affiliation(s)
- Carmela Jeanette Borillo
- Department of Addiction Science, College of Health Science and Social Welfare, Sahmyook University Graduate School, Seoul, Korea
| | - Jerre Mae Tamanal
- Department of Addiction Science, College of Health Science and Social Welfare, Sahmyook University Graduate School, Seoul, Korea
| | - Cheong Hoon Kim
- Department of Addiction Science, College of Health Science and Social Welfare, Sahmyook University Graduate School, Seoul, Korea
| |
Collapse
|
27
|
Minian N, Corrin T, Lingam M, deRuiter WK, Rodak T, Taylor VH, Manson H, Dragonetti R, Zawertailo L, Melamed OC, Hahn M, Selby P. Identifying contexts and mechanisms in multiple behavior change interventions affecting smoking cessation success: a rapid realist review. BMC Public Health 2020; 20:918. [PMID: 32532233 PMCID: PMC7291527 DOI: 10.1186/s12889-020-08973-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome. Methods This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis. Results Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts. Conclusion In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment). Trial registration PROSPERO registration number: CRD42017064430
Collapse
Affiliation(s)
- Nadia Minian
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Tricia Corrin
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Mathangee Lingam
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Wayne K deRuiter
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, 1403 - 29 Street NW, Calgary, Alberta, T2N 2T9, Canada
| | - Heather Manson
- Public Health Ontario, 480 University Avenue, Toronto, Ontario, M5G 1V2, Canada
| | - Rosa Dragonetti
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Laurie Zawertailo
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Osnat C Melamed
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Margaret Hahn
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada. .,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. .,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
| |
Collapse
|
28
|
Thomas K, Nilsson E, Festin K, Henriksson P, Lowén M, Löf M, Kristenson M. Associations of Psychosocial Factors with Multiple Health Behaviors: A Population-Based Study of Middle-Aged Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041239. [PMID: 32075162 PMCID: PMC7068361 DOI: 10.3390/ijerph17041239] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 12/11/2022]
Abstract
Background: The health behaviors smoking, risky alcohol consumption, insufficient physical activity, and poor diet constitute the main contributors to non-communicable diseases. Clustering of risk behaviors is common and increases the risk of these diseases. Despite health benefits, it is difficult to change health behaviors. Psychosocial factors could play a role in health behavior change, with research showing relationships between unfavorable psychosocial factors and health risk behaviors. However, many studies only investigated one or two health behaviors at a time. The present study, therefore, aimed to investigate associations between a broad range of psychosocial factors and multiple health risk behaviors in a general middle-aged population in Sweden. Methods: A cross-sectional design was used to investigate a random sample from the general population in Sweden (n = 1007, 45–69 years, 50% women). Questionnaire data on health behaviors (smoking, alcohol consumption, physical activity, and fruit/vegetable intake) and psychosocial factors, with both psychological and social resources (social integration, emotional support, perceived control, self-esteem, sense of coherence and trust) and psychological risk factors (cynicism, vital exhaustion, hopelessness and depressiveness), were analyzed. Logistic and ordinal logistic regression were used to analyze associations between psychosocial factors and multiple (0–1, 2 or 3–4) health risk behaviors. Results: A total of 50% of the sample had two health risk behaviors and 18% had three health risk behaviors. After adjusting for age, sex, education, employment status, and immigrant status, eight out of 10 psychosocial factors (exceptions: social integration and self-esteem) showed significant odds ratios (ORs) in the expected directions; low levels of psychosocial resources and high levels of psychosocial risk factors were associated with multiple risk behaviors. The strongest associations with multiple risk behaviors were seen for vital exhaustion (adjusted (adj.) OR 1.28; confidence interval (CI) 1.11–1.46), depressiveness (adj. OR 1.32, CI 1.14–1.52), and trust (adj. OR 0.80, CI 0.70–0.91). When controlling for all psychosocial factors in the same model, only the association with trust remained statistically significant (adj. OR 0.89, CI 0.73–1.00, p = 0.050). Associations with individual health behaviors were fewer and scattered, with no psychosocial factor being related to all four behaviors. Conclusions: Examining associations between a broad range of psychosocial factors and multiple health risk behaviors revealed consistent and significant associations for almost all psychosocial factors. These associations were stronger compared to associations to single health risk behaviors. Our findings support the relevance of considering psychosocial aspects in interventions aimed at health behavior change, especially for people with multiple health risk behaviors.
Collapse
Affiliation(s)
- Kristin Thomas
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
- Correspondence: ; Tel.: +46-1328-2546
| | - Evalill Nilsson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
| | - Karin Festin
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
- Department of Biosciences and Nutrition, Karolinska Institute, 141 83 Huddinge, Sweden
| | - Mats Lowén
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
- Department of Biosciences and Nutrition, Karolinska Institute, 141 83 Huddinge, Sweden
| | - Margareta Kristenson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, SE-581 83 Linköping, Sweden; (E.N.); (K.F.); (P.H.); (M.L); (M.K.)
| |
Collapse
|
29
|
Mayne SL, Virudachalam S, Fiks AG. Clustering of unhealthy behaviors in a nationally representative sample of U.S. children and adolescents. Prev Med 2020; 130:105892. [PMID: 31715216 DOI: 10.1016/j.ypmed.2019.105892] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/27/2019] [Accepted: 11/08/2019] [Indexed: 12/19/2022]
Abstract
Poor diet, low physical activity, sedentary behavior and smoking are modifiable risk factors for chronic diseases that often develop early in life. An improved understanding of how unhealthy behaviors co-occur within individual children across childhood and adolescence could inform the development of more effective prevention approaches. Using data from the 2011-2016 National Health and Nutrition Examination Survey, we calculated weighted prevalence of five unhealthy behaviors - excessive screen time, poor diet quality, low physical activity, fast food consumption, and smoking (adolescents only) - alone and in combination among U.S. children and adolescents, stratified by age group (2-5, 6-11, 12-15, and 16-19 years). Multivariable logistic regression was used to estimate associations between health behavior clustering (≥2 unhealthy behaviors) and sociodemographic characteristics by age group. Among 7714 children and adolescents, the most prevalent behaviors were excessive screen time and poor diet quality. Unhealthy behavior clustering increased significantly with age (from 29.0% for ages 2-5 to 73.9% for ages 16-19 years, p-trend: <0.0001). The most common health behavior combination was excessive screen time and poor diet (from 14.4% prevalence for ages 2-5 to 45.3% for ages 16-19 years). Smoking prevalence was low, but 97% of smokers had ≥1 other unhealthy behavior. Unhealthy behavior clustering was significantly more prevalent among black than white children (ages 2-5 and 6-11) and less prevalent among Hispanic older adolescents (age 16-19). Associations with household characteristics varied by age group. These results provide a population-level understanding of the extent to which unhealthy behaviors co-occur in U.S. children and adolescents.
Collapse
Affiliation(s)
- Stephanie L Mayne
- PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States; Department of Pediatrics and the Leonard Davis Institute of Health Economics, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States.
| | - Senbagam Virudachalam
- PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States; Department of Pediatrics and the Leonard Davis Institute of Health Economics, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Alexander G Fiks
- PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States; Department of Pediatrics and the Leonard Davis Institute of Health Economics, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| |
Collapse
|
30
|
Cox-Martin E, Cox MG, Basen-Engquist K, Bradley C, Blalock JA. Changing multiple health behaviors in cancer survivors: smoking and exercise. PSYCHOL HEALTH MED 2019; 25:331-343. [PMID: 31630537 DOI: 10.1080/13548506.2019.1679849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Research regarding cross-behavioral relationships between the cognitive mechanisms motivating health behavior change is lacking for cancer survivors. This study investigated these relationships to inform the development of multiple health behavior change (MHBC) interventions for this at-risk population. Eligible participants included cancer survivors attending an intake appointment for smoking cessation services. This cross-sectional survey study assessed participants' self-efficacy and motivation (stage of change) for smoking cessation and exercise, as well as self-reported health behaviors. Analyses evaluated cross-behavioral associations between cognitive mechanisms and their relationships with smoking and exercise behaviors. Seventy-six participants completed the survey questionnaire. The correlation between self-efficacy scores for smoking cessation and exercise was statistically significant (r = .45, 95% CI [.09, .67]), as were correlations between self-efficacy and reported levels of exercise ((r = .44, 95% CI [.20, .65]) strenuous); ((r = .36, 95% CI [.12, .59]) moderate), exercise self-efficacy and smoking behavior (r = -.27, 95% CI [-.46, -.05]), and smoking self-efficacy and smoking behavior (r = -0.41, 95% CI [-.61, -.18]). For cancer survivors, associations between exercise self-efficacy and smoking cessation self-efficacy may offer an opportunity to leverage MHBC; specifically, this positive association may facilitate exercise intervention in survivors seeking smoking cessation services..
Collapse
Affiliation(s)
- Emily Cox-Martin
- Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew G Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cathy Bradley
- Department of Health Systems, Management, and Policy, and University of Colorado Cancer Center, University of Colorado School of Public Health, Aurora, CO, USA
| | - Janice A Blalock
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
31
|
Kelishadi R. Life-Cycle Approach for Prevention of Non Communicable Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1121:1-6. [PMID: 31392647 DOI: 10.1007/978-3-030-10616-4_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Non communicable diseases (NCDs) become symptomatic in adulthood, but they mainly origin from early life. As NCDs are the major cause of mortality both in developed and developing countries, global actions are necessary for their life course prevention and control. The main preventable risk factors of NCDs include tobacco use, unhealthy diet, and physical inactivity. These risk factors track from childhood to adulthood; it is well documented that healthy lifestyles play an important role for primordial and primary prevention of NCDs. Sedentary lifestyle, especially prolonged screen time, is a main underlying factor for NCDs. Regarding dietary intake, lower consumption of fruits, vegetables and fibers, as well as higher consumption of fatty and salty foods (fast foods, junk food), and carbonated soft drinks are of most usual habits correlated with increased risk of NCDs.Strategic action areas for the prevention and control of NCDs are health promotion, risk reduction, health systems strengthening for early detection and management of NCD risk factors. Low-cost solutions for reduction the common modifiable risk factors including unhealthy life-cycle are important for guiding policy and priorities of governments and for decreasing the prevalence of NCDs.
Collapse
Affiliation(s)
- Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, USERN Office, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
32
|
Gómez-Gómez I, Motrico E, Moreno-Peral P, Rigabert A, Conejo-Cerón S, Ortega-Calvo M, Recio JI, Bellón JA. Effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression: a study protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2019; 9:e026842. [PMID: 30878992 PMCID: PMC6429884 DOI: 10.1136/bmjopen-2018-026842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/11/2019] [Accepted: 01/25/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Many studies have explored the impact of lifestyle interventions on depression. However, little is known about the effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression. Our objective is to assess the effectiveness of complex multiple-risk lifestyle interventions in reducing depressive symptoms in the adult population by the acquisition of at least two healthy habits-healthy diet, physical activity and/or smoking cessation. For such purpose, a systematic review and meta-analysis of randomised controlled trials will be conducted. METHOD AND ANALYSIS MEDLINE (through Ovid and PubMed), Scopus, Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO, OpenGrey Register (System for Information on Grey Literature in Europe) and the International Clinical Trials Registry Platform will be searched for relevant articles. Additionally, a supplementary manual search will be performed using lists of references, references to expert authors and other systematic reviews and/or meta-analyses. Study selection, data extraction (target habits, country, target populations, conditions and statistical data to name a few) and assessment of the risk of bias will be performed separately by two independent researchers. The primary outcome measure will be the reduction of depression symptoms, as measured by validated instruments. We will calculate pooled standardised mean differences and 95% CIs using random-effect models. Heterogeneity, sensitivity and publication bias will be assessed, and sub-group analysis will be performed. Heterogeneity will be explored by random-effects meta-regression analysis. ETHICS AND DISSEMINATION Ethical approval is not required for this study. The results of this systematic review and meta-analysis will be presented in relevant conferences and published in a peer-review journal. The findings of this study could have important clinical and scientific implications for the improvement of symptoms of depression. PROSPERO REGISTRATION NUMBER CRD42018100253; Pre-results.
Collapse
Affiliation(s)
- Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
| | - Patricia Moreno-Peral
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
- Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain
| | - Alina Rigabert
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Sonia Conejo-Cerón
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
- Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain
| | - Manuel Ortega-Calvo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Seville, Seville, Spain
| | - José-Ignacio Recio
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Juan A Bellón
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
- Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain
- Department of Public Health and Psychiatry, University of Málaga (UMA), Málaga, Spain
- El Palo Health Centre, Andalusian Health Service (SAS), Málaga, Spain
| |
Collapse
|
33
|
Sarma EA, Moyer A, Messina CR, Laroche HH, Snetselaar L, Van Horn L, Lane DS. Is There a Spillover Effect of Targeted Dietary Change on Untargeted Health Behaviors? Evidence From a Dietary Modification Trial. HEALTH EDUCATION & BEHAVIOR 2019; 46:569-581. [PMID: 30808245 DOI: 10.1177/1090198119831756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. The gateway behavior hypothesis posits that change in a health behavior targeted for modification may promote positive changes in other untargeted health behaviors; however, previous studies have shown inconsistent results. Aims. To examine the patterns and predictors of change in untargeted health behaviors in a large health behavior change trial. Method. Using repeated-measures latent class analysis, this study explored patterns of change in untargeted physical activity, alcohol consumption, and smoking behavior during the first year of the Women's Health Initiative dietary modification trial that targeted total fat reduction to 20% kcal and targeted increased fruit and vegetable intake. Participants were healthy postmenopausal women who were randomly assigned to either the low-fat dietary change intervention (n = 8,193) or a control (n = 12,187) arm. Results. Although there were increases in untargeted physical activity and decreases in alcohol consumption and smoking in the first year, these changes were not consistently associated with study arm. Moreover, although the results of the repeated-measures latent class analysis identified three unique subgroups of participants with similar patterns of untargeted health behaviors, none of the subgroups showed substantial change in the probability of engagement in any of the behaviors over 1 year, and the study arms had nearly identical latent class solutions. Discussion and Conclusion. These findings suggest that the dietary intervention did not act as a gateway behavior for change in the untargeted behaviors and that researchers interested in changing multiple health behaviors may need to deliberately target additional behaviors.
Collapse
Affiliation(s)
| | - Anne Moyer
- 1 Stony Brook University, Stony Brook, NY, USA
| | | | | | | | | | | |
Collapse
|
34
|
Mewton L, Champion K, Kay-Lambkin F, Sunderland M, Thornton L, Teesson M. Lifestyle risk indices in adolescence and their relationships to adolescent disease burden: findings from an Australian national survey. BMC Public Health 2019; 19:60. [PMID: 30642325 PMCID: PMC6332686 DOI: 10.1186/s12889-019-6396-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 01/04/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The current study investigates the extent to which an adolescent-specific lifestyle risk factor index predicts indicators of the leading causes of adolescent morbidity and mortality. METHODS Data came from 13 to 17 year-old respondents from the 2013-2014 nationally representative Australian Child and Adolescent Survey of Mental Health and Wellbeing (n = 2314). Indicators of adolescent disease burden included Major Depressive Disorder, psychological distress, self-harm and suicide attempt. Risk factors included risky alcohol use, drug use, unprotected sex, smoking, BMI and sleep duration. The extent to which these risk factors co-occurred were investigated using tetrachoric correlations. Several risk indices were then constructed based on these risk factors. Receiver Operating Characteristic curves determined the precision with which these indices predicted the leading causes of adolescent disease burden. RESULTS Risky alcohol use, drug use, smoking, unprotected sex, and sleep were all highly clustered lifestyle risk factors, whereas BMI was not. A risk index comprising risky alcohol use, drug use, unprotected sex and sleep duration predicted the disease burden outcomes with the greatest precision. 31.9% of the sample reported one or more of these behaviours. CONCLUSIONS This lifestyle risk factor index represents a useful summary metric in the context of adolescent health promotion and non-communicable disease prevention. Lifestyle risk factors were found to cluster in adolescence, supporting the implementation of multiple health behaviour change interventions.
Collapse
Affiliation(s)
- Louise Mewton
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Katrina Champion
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Frances Kay-Lambkin
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Matthew Sunderland
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Louise Thornton
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| | - Maree Teesson
- Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St, Randwick, NSW 2032 Australia
| |
Collapse
|
35
|
Healthy Vegan Lifestyle Habits among Argentinian Vegetarians and Non-Vegetarians. Nutrients 2019; 11:nu11010154. [PMID: 30642046 PMCID: PMC6356967 DOI: 10.3390/nu11010154] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/23/2018] [Accepted: 01/08/2019] [Indexed: 12/16/2022] Open
Abstract
Although current research has contributed to the promotion of whole-food plant-based diets, few studies have examined healthy vegan dietary and lifestyle factors, especially in South America. Therefore, we aimed at investigating the adherence to healthy vegan lifestyle habits among Argentinian vegetarians and omnivorous, using a recently developed vegetarian lifestyle index adapted to the vegan dietary pattern. Also, accessibility of vegetarian foods, and the proportion of household income spent on food were assessed in a cross-sectional approach with 1454 participants. The population was comprised of females (84.9%), singles (55.0%), young-adults (mean age 32.1, standard deviation (SD) = 13.6), employed (50.8%), with high educational levels (50.4%), and low prevalence of both tobacco smoking (7.0%) and frequent alcohol consumption (7.6%). The mean score of adherence to healthy vegan lifestyle habits was 6.64 (SD = 1.72), with higher scores indicating better adherence. Non-vegetarians (5.75; 95% confidence interval (CI), 5.61–5.89) had a significantly lower adjusted mean score compared to semi-(6.32; 95% CI, 6.17–6.47), pesco-(6.99; 95% CI, 6.59–7.39), lacto-ovo-vegetarians (7.10; 95% CI, 6.96–7.24), as well as vegans (8.59; 95% CI, 8.35–8.83). The mean proportion of household income spent on food was significantly lower among vegans compared with other dietary patterns. The whole population that was studied showed a low consumption of whole grains, legumes, vegetables, nuts, and seeds. Although vegans showed a better diet and lifestyle pattern there is a need to improve eating and lifestyle habits to address risk factors for non-communicable diseases in Argentina.
Collapse
|
36
|
MacArthur G, Caldwell DM, Redmore J, Watkins SH, Kipping R, White J, Chittleborough C, Langford R, Er V, Lingam R, Pasch K, Gunnell D, Hickman M, Campbell R. Individual-, family-, and school-level interventions targeting multiple risk behaviours in young people. Cochrane Database Syst Rev 2018; 10:CD009927. [PMID: 30288738 PMCID: PMC6517301 DOI: 10.1002/14651858.cd009927.pub2] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Engagement in multiple risk behaviours can have adverse consequences for health during childhood, during adolescence, and later in life, yet little is known about the impact of different types of interventions that target multiple risk behaviours in children and young people, or the differential impact of universal versus targeted approaches. Findings from systematic reviews have been mixed, and effects of these interventions have not been quantitatively estimated. OBJECTIVES To examine the effects of interventions implemented up to 18 years of age for the primary or secondary prevention of multiple risk behaviours among young people. SEARCH METHODS We searched 11 databases (Australian Education Index; British Education Index; Campbell Library; Cumulative Index to Nursing and Allied Health Literature (CINAHL); Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; Embase; Education Resource Information Center (ERIC); International Bibliography of the Social Sciences; MEDLINE; PsycINFO; and Sociological Abstracts) on three occasions (2012, 2015, and 14 November 2016)). We conducted handsearches of reference lists, contacted experts in the field, conducted citation searches, and searched websites of relevant organisations. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster RCTs, which aimed to address at least two risk behaviours. Participants were children and young people up to 18 years of age and/or parents, guardians, or carers, as long as the intervention aimed to address involvement in multiple risk behaviours among children and young people up to 18 years of age. However, studies could include outcome data on children > 18 years of age at the time of follow-up. Specifically,we included studies with outcomes collected from those eight to 25 years of age. Further, we included only studies with a combined intervention and follow-up period of six months or longer. We excluded interventions aimed at individuals with clinically diagnosed disorders along with clinical interventions. We categorised interventions according to whether they were conducted at the individual level; the family level; or the school level. DATA COLLECTION AND ANALYSIS We identified a total of 34,680 titles, screened 27,691 articles and assessed 424 full-text articles for eligibility. Two or more review authors independently assessed studies for inclusion in the review, extracted data, and assessed risk of bias.We pooled data in meta-analyses using a random-effects (DerSimonian and Laird) model in RevMan 5.3. For each outcome, we included subgroups related to study type (individual, family, or school level, and universal or targeted approach) and examined effectiveness at up to 12 months' follow-up and over the longer term (> 12 months). We assessed the quality and certainty of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS We included in the review a total of 70 eligible studies, of which a substantial proportion were universal school-based studies (n = 28; 40%). Most studies were conducted in the USA (n = 55; 79%). On average, studies aimed to prevent four of the primary behaviours. Behaviours that were most frequently addressed included alcohol use (n = 55), drug use (n = 53), and/or antisocial behaviour (n = 53), followed by tobacco use (n = 42). No studies aimed to prevent self-harm or gambling alongside other behaviours.Evidence suggests that for multiple risk behaviours, universal school-based interventions were beneficial in relation to tobacco use (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.60 to 0.97; n = 9 studies; 15,354 participants) and alcohol use (OR 0.72, 95% CI 0.56 to 0.92; n = 8 studies; 8751 participants; both moderate-quality evidence) compared to a comparator, and that such interventions may be effective in preventing illicit drug use (OR 0.74, 95% CI 0.55 to 1.00; n = 5 studies; 11,058 participants; low-quality evidence) and engagement in any antisocial behaviour (OR 0.81, 95% CI 0.66 to 0.98; n = 13 studies; 20,756 participants; very low-quality evidence) at up to 12 months' follow-up, although there was evidence of moderate to substantial heterogeneity (I² = 49% to 69%). Moderate-quality evidence also showed that multiple risk behaviour universal school-based interventions improved the odds of physical activity (OR 1.32, 95% CI 1.16 to 1.50; I² = 0%; n = 4 studies; 6441 participants). We considered observed effects to be of public health importance when applied at the population level. Evidence was less certain for the effects of such multiple risk behaviour interventions for cannabis use (OR 0.79, 95% CI 0.62 to 1.01; P = 0.06; n = 5 studies; 4140 participants; I² = 0%; moderate-quality evidence), sexual risk behaviours (OR 0.83, 95% CI 0.61 to 1.12; P = 0.22; n = 6 studies; 12,633 participants; I² = 77%; low-quality evidence), and unhealthy diet (OR 0.82, 95% CI 0.64 to 1.06; P = 0.13; n = 3 studies; 6441 participants; I² = 49%; moderate-quality evidence). It is important to note that some evidence supported the positive effects of universal school-level interventions on three or more risk behaviours.For most outcomes of individual- and family-level targeted and universal interventions, moderate- or low-quality evidence suggests little or no effect, although caution is warranted in interpretation because few of these studies were available for comparison (n ≤ 4 studies for each outcome).Seven studies reported adverse effects, which involved evidence suggestive of increased involvement in a risk behaviour among participants receiving the intervention compared to participants given control interventions.We judged the quality of evidence to be moderate or low for most outcomes, primarily owing to concerns around selection, performance, and detection bias and heterogeneity between studies. AUTHORS' CONCLUSIONS Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours, demonstrating that they may be effective in preventing engagement in tobacco use, alcohol use, illicit drug use, and antisocial behaviour, and in improving physical activity among young people, but not in preventing other risk behaviours. Results of this review do not provide strong evidence of benefit for family- or individual-level interventions across the risk behaviours studied. However, poor reporting and concerns around the quality of evidence highlight the need for high-quality multiple- risk behaviour intervention studies to further strengthen the evidence base in this field.
Collapse
Affiliation(s)
- Georgina MacArthur
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Deborah M Caldwell
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - James Redmore
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Sarah H Watkins
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Ruth Kipping
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - James White
- School of Medicine, Cardiff UniversityDECIPHer (Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement), Centre for Trials Research4th Floor Neuadd MeirionnyddCardiffUKCF14 4YS
| | - Catherine Chittleborough
- University of AdelaideSchool of Public HealthLevel 7, 178 North Terrace, Mail Drop DX 650 550AdelaideSouth AustraliaAustralia5005
| | - Rebecca Langford
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Vanessa Er
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Raghu Lingam
- Newcastle UniversityInstitute of Health and SocietyBaddiley‐Clark Building, Richardson RoadNewcastle Upon TyneUKNE2 4AX
| | - Keryn Pasch
- University of TexasDepartment of Kinesiology and Health Education1 University Station, D3700AustinTexasUSA78712
| | - David Gunnell
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Matthew Hickman
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | - Rona Campbell
- University of BristolPopulation Health Sciences, Bristol Medical School39 Whatley RoadBristolUKBS8 2PS
| | | |
Collapse
|
37
|
Heeren GA, Jemmott JB, Marange CS, Rumosa Gwaze A, Batidzirai JM, Ngwane Z, Mandeya A, Tyler JC. Health-Promotion Intervention Increases Self-Reported Physical Activity in Sub-Saharan African University Students: A Randomized Controlled Pilot Study. Behav Med 2018; 44:297-305. [PMID: 28682186 PMCID: PMC6292207 DOI: 10.1080/08964289.2017.1350134] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To evaluate the efficacy of a health-promotion intervention in increasing self-reported physical activity among university students in Sub-Saharan Africa. Randomly selected second-year students at a university in South Africa were randomized to an intervention based on social cognitive theory: health-promotion, targeting physical activity and fruit, vegetable, and fat consumption; or HIV risk-reduction, targeting sexual-risk behaviors. Participants completed assessments via audio computer-assisted self-interviewing pre-intervention and 6 and 12 months post-intervention. A total of 176 were randomized with 171 (97.2%) retained 12 months post-intervention. Generalized-estimating-equations analyses indicated that the health-promotion-intervention participants were more likely to meet physical-activity guidelines than were control participants, post-intervention, adjusting for pre-intervention physical activity (odds ratio [OR] = 3.35; 95% CI: 1.33-8.41). Health-promotion participants reported a greater number of days they did vigorous-intensity (risk ratio [RR] = 2.01; 95% CI: 1.43-2.83) and moderate-intensity (RR = 1.40; 95% CI: 1.01-1.95) aerobic activity, but not strength-building activity (RR = 1.37; 95% CI: 0.091-2.07). The intervention reduced self-reported servings of fried foods (mean difference = -0.31; 95% CI: -0.60, -0.02). The findings suggest that theory-based, contextually appropriate interventions may increase physical activity among university students in Sub-Saharan Africa.
Collapse
Affiliation(s)
- G Anita Heeren
- a St. Joseph's University , Philadelphia , Pennsylvania , USA
| | - John B Jemmott
- a St. Joseph's University , Philadelphia , Pennsylvania , USA
| | | | | | - Jesca Mercy Batidzirai
- b University of Fort Hare , Alice , South Africa
- c University of KwaZulu-Natal , Durban , South Africa
| | - Zolani Ngwane
- d Haverford College , Philadelphia , Pennsylvania , USA
| | | | | |
Collapse
|
38
|
Zabaleta-del-Olmo E, Pombo H, Pons-Vigués M, Casajuana-Closas M, Pujol-Ribera E, López-Jiménez T, Cabezas-Peña C, Martín-Borràs C, Serrano-Blanco A, Rubio-Valera M, Llobera J, Leiva A, Vidal C, Campiñez M, Martín-Álvarez R, Maderuelo JÁ, Recio JI, García-Ortiz L, Motrico E, Bellón JÁ, Moreno-Peral P, Martín-Cantera C, Clavería A, Aldecoa-Landesa S, Magallón-Botaya R, Bolíbar B. Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial. BMC Public Health 2018; 18:874. [PMID: 30005705 PMCID: PMC6045838 DOI: 10.1186/s12889-018-5805-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. METHODS This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level. The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in the routine care of PHC practices according to the conceptual framework of the "5A's". It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community). Incremental cost per quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. The implementation strategy is based on the "Consolidated Framework for Implementation Research", a set of discrete implementation strategies and an evaluation framework. DISCUSSION EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation. TRIAL REGISTRATION ClinicalTrials.gov , NCT03136211 .Retrospectively registered on May 2, 2017.
Collapse
Affiliation(s)
- Edurne Zabaleta-del-Olmo
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Luis Power Kalea 18, 48014 Bilbao, Spain
| | - Mariona Pons-Vigués
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Marc Casajuana-Closas
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Tomás López-Jiménez
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Carmen Cabezas-Peña
- Deputy Directorate of Health Promotion, Public Health Agency, Department of Health, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005 Barcelona, Spain
| | - Carme Martín-Borràs
- Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, C/Císter 34, 08022 Barcelona, Spain
- Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, C/Padilla 326-332, 08025 Barcelona, Spain
| | - Antoni Serrano-Blanco
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Rubio-Valera
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Llobera
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Alfonso Leiva
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Clara Vidal
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Manuel Campiñez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - Remedios Martín-Álvarez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - José-Ángel Maderuelo
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
| | - José-Ignacio Recio
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, c/Energía Solar 1, Sevilla, Spain
| | - Juan-Ángel Bellón
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
- El Palo Health Center, Andalusian Health Service (SAS), Av. Salvador Allende 159, 29018 Málaga, Spain
- Department of Public Health and Psychiatry, University of Malaga, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - Patricia Moreno-Peral
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
| | - Carlos Martín-Cantera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Ana Clavería
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Susana Aldecoa-Landesa
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
- Primary Health Centre Beiramar, Xerencia de Xestión Integrada Vigo, Servizo Galego de Saúde (SERGAS), Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Rosa Magallón-Botaya
- Instituto de Investigación Sanitaria Aragón, Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Bonaventura Bolíbar
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| |
Collapse
|
39
|
Kouwenhoven-Pasmooij TA, Robroek SJW, Kraaijenhagen RA, Helmhout PH, Nieboer D, Burdorf A, Myriam Hunink MG. Effectiveness of the blended-care lifestyle intervention 'PerfectFit': a cluster randomised trial in employees at risk for cardiovascular diseases. BMC Public Health 2018; 18:766. [PMID: 29921255 PMCID: PMC6009059 DOI: 10.1186/s12889-018-5633-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 05/29/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Web-based lifestyle interventions at the workplace have the potential to promote health and work productivity. However, the sustainability of effects is often small, which could be enhanced by adding face-to-face contacts, so-called 'blended care'. Therefore, this study evaluates the effects of a blended workplace health promotion intervention on health and work outcomes among employees with increased cardiovascular risk. METHODS In this multicentre cluster-randomised controlled trial (PerfectFit), 491 workers in 18 work units from military, police, and a hospital with increased cardiovascular risk were randomised into two intervention groups. The limited intervention (n = 213; 9 clusters) consisted of a web-based Health Risk Assessment with advice. In the extensive intervention (n = 271; 8 clusters), coaching sessions by occupational health physicians using motivational interviewing were added. One cluster dropped out after randomisation but before any inclusion of subjects. Primary outcome was self-rated health. Secondary outcomes were body weight, body mass index (BMI), work productivity, and health behaviours. Follow-up measurements were collected at 6 and 12 months. Effect sizes were determined in mixed effects models. RESULTS At 12 months, the extensive intervention was not statistically different from the limited intervention for self-rated health (4.3%; 95%CI -5.3-12.8), BMI (- 0.81; 95%CI -1.87-0.26) and body weight (- 2.16; 95%CI -5.49-1.17). The within-group analysis showed that in the extensive intervention group body weight (- 3.1 kg; 95% CI -2.0 to - 4.3) was statistically significantly reduced, whereas body weight remained stable in the limited intervention group (+ 0.2 kg; 95% CI -1.4 to 1.8). In both randomised groups productivity loss and physical activity increased and excessive alcohol use decreased significantly at 12 months. CONCLUSIONS There were no effects on self-rated health, body weight, and BMI. However, within the group with web-based tailored Health Risk Assessment including personalized advice body weight reduced significantly. Adding motivational coaching is promising to reduce body weight. TRIAL REGISTRATION Retrospectively registered at the Netherlands Trial Registry with number NTR4894 , at Nov 14 2014.
Collapse
Affiliation(s)
- Tessa A Kouwenhoven-Pasmooij
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Na2818, Postbus 2040, 3000, CA, Rotterdam, The Netherlands. .,Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. .,Department of Occupational Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Suzan J W Robroek
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Pieter H Helmhout
- Staff Joint Health Care Division, Command Service Center, Ministry of Defense, Utrecht, The Netherlands
| | - Daan Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M G Myriam Hunink
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Na2818, Postbus 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA
| |
Collapse
|
40
|
Murawski B, Plotnikoff RC, Rayward AT, Vandelanotte C, Brown WJ, Duncan MJ. Randomised controlled trial using a theory-based m-health intervention to improve physical activity and sleep health in adults: the Synergy Study protocol. BMJ Open 2018; 8:e018997. [PMID: 29439005 PMCID: PMC5829671 DOI: 10.1136/bmjopen-2017-018997] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/18/2017] [Accepted: 11/14/2017] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION There is a need to reduce physical inactivity and poor sleep health in the adult population to decrease chronic disease rates and the associated burden. Given the high prevalence of these risk behaviours, effective interventions with potential for wide reach are warranted. METHODS AND ANALYSIS The aim of this two-arm RCT will be to test the effect of a three month personalised mobile app intervention on two main outcomes: minutes of moderate-to-vigorous-intensity physical activity and overall sleep quality. In addition, between-group changes in health-related quality of life and mental health status will be assessed as secondary outcomes. The pre-specified mediators and moderators include social cognitive factors, the neighbourhood environment, health (BMI, depression, anxiety, stress), sociodemographic factors (age, gender, education) and app usage. Assessments will be conducted after three months (primary endpoint) and six months (follow-up). The intervention will provide access to a specifically developed mobile app, through which participants can set goals for active minutes, daily step counts, resistance training, sleep times and sleep hygiene practice. The app also allows participants to log their behaviours daily and view progress bars as well as instant feedback in relation to goals. The personalised support system will consist of weekly summary reports, educational and instructional materials, prompts on disengagement and weekly facts. ETHICS AND DISSEMINATION The Human Research Ethics Committee of The University of Newcastle, Australia granted full approval: H-2016-0181. This study will assess the efficacy of a combined behaviour intervention, mechanisms of behaviour change and gather high-quality process data, all of which will help refine future trials. Dissemination of findings will include publication in a peer-reviewed journal and presentation at national or international conferences. Participants will receive a plain English summary report of results. TRIAL REGISTRATION NUMBER ACTRN12617000376347; Pre-results.
Collapse
Affiliation(s)
- Beatrice Murawski
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
- School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, Australia
| | - Anna T Rayward
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Corneel Vandelanotte
- School of Health, Medical and Applied Science, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Wendy J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Studies, The University of Queensland, Brisbane, Australia
| | - Mitch J Duncan
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| |
Collapse
|
41
|
Nudelman G, Shiloh S. Connectionism and Behavioral Clusters: Differential Patterns in Predicting Expectations to Engage in Health Behaviors. Ann Behav Med 2018; 52:890-901. [DOI: 10.1093/abm/kax063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gabriel Nudelman
- Faculty of Psychology, Philipps University of Marburg, Marburg, Hesse, Germany
| | - Shoshana Shiloh
- The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
42
|
Singh H, Unger J, Zariffa J, Pakosh M, Jaglal S, Craven BC, Musselman KE. Robot-assisted upper extremity rehabilitation for cervical spinal cord injuries: a systematic scoping review. Disabil Rehabil Assist Technol 2018; 13:704-715. [PMID: 29334467 DOI: 10.1080/17483107.2018.1425747] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstact Purpose: To provide an overview of the feasibility and outcomes of robotic-assisted upper extremity training for individuals with cervical spinal cord injury (SCI), and to identify gaps in current research and articulate future research directions. MATERIALS AND METHODS A systematic search was conducted using Medline, Embase, PsycINFO, CCTR, CDSR, CINAHL and PubMed on June 7, 2017. Search terms included 3 themes: (1) robotics; (2) SCI; (3) upper extremity. Studies using robots for upper extremity rehabilitation among individuals with cervical SCI were included. Identified articles were independently reviewed by two researchers and compared to pre-specified criteria. Disagreements regarding article inclusion were resolved through discussion. The modified Downs and Black checklist was used to assess article quality. Participant characteristics, study and intervention details, training outcomes, robot features, study limitations and recommendations for future studies were abstracted from included articles. RESULTS Twelve articles (one randomized clinical trial, six case series, five case studies) met the inclusion criteria. Five robots were exoskeletons and three were end-effectors. Sample sizes ranged from 1 to 17 subjects. Articles had variable quality, with quality scores ranging from 8 to 20. Studies had a low internal validity primarily from lack of blinding or a control group. Individuals with mild-moderate impairments showed the greatest improvements on body structure/function and performance-level measures. This review is limited by the small number of articles, low-sample sizes and the diversity of devices and their associated training protocols, and outcome measures. CONCLUSIONS Preliminary evidence suggests robot-assisted interventions are safe, feasible and can reduce active assistance provided by therapists. Implications for rehabilitation Robot-assisted upper extremity training for individuals with cervical spinal cord injury is safe, feasible and can reduce hands-on assistance provided by therapists. Future research in robotics rehabilitation with individuals with spinal cord injury is needed to determine the optimal device and training protocol as well as effectiveness.
Collapse
Affiliation(s)
- Hardeep Singh
- a Toronto Rehabilitation Institute-University Health Network , Toronto , ON , Canada.,b Rehabilitation Sciences Institute , University of Toronto , Toronto , ON , Canada
| | - Janelle Unger
- a Toronto Rehabilitation Institute-University Health Network , Toronto , ON , Canada.,b Rehabilitation Sciences Institute , University of Toronto , Toronto , ON , Canada
| | - José Zariffa
- a Toronto Rehabilitation Institute-University Health Network , Toronto , ON , Canada.,b Rehabilitation Sciences Institute , University of Toronto , Toronto , ON , Canada.,c Institute of Biomaterials and Biomedical Engineering , University of Toronto , Toronto , ON , Canada
| | - Maureen Pakosh
- a Toronto Rehabilitation Institute-University Health Network , Toronto , ON , Canada
| | - Susan Jaglal
- a Toronto Rehabilitation Institute-University Health Network , Toronto , ON , Canada.,b Rehabilitation Sciences Institute , University of Toronto , Toronto , ON , Canada.,d Department of Physical Therapy , University of Toronto , Toronto , ON , Canada.,e Department of Health Policy, Management and Evaluation , University of Toronto , Toronto , ON , Canada
| | - B Catharine Craven
- a Toronto Rehabilitation Institute-University Health Network , Toronto , ON , Canada.,b Rehabilitation Sciences Institute , University of Toronto , Toronto , ON , Canada.,f Division of Physical Medicine and Rehabilitation, Faculty of Medicine , University of Toronto , Toronto , ON , Canada
| | - Kristin E Musselman
- a Toronto Rehabilitation Institute-University Health Network , Toronto , ON , Canada.,b Rehabilitation Sciences Institute , University of Toronto , Toronto , ON , Canada.,d Department of Physical Therapy , University of Toronto , Toronto , ON , Canada
| |
Collapse
|
43
|
Champion KE, Newton NC, Spring B, Wafford QE, Parmenter BJ, Teesson M. A systematic review of school-based eHealth interventions targeting alcohol use, smoking, physical inactivity, diet, sedentary behaviour and sleep among adolescents: a review protocol. Syst Rev 2017; 6:246. [PMID: 29208040 PMCID: PMC5717802 DOI: 10.1186/s13643-017-0645-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/24/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Six key behavioural risk factors (risky alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and unhealthy sleep patterns) have been identified as strong determinants of chronic disease, such as cardiovascular disease, diabetes and cancers. School-based interventions targeting these multiple health risk behaviours among adolescents have the potential to halt the trajectory towards later disease, whilst online and mobile technology interventions offer advantages in terms of student engagement, reach and scalability. Despite this, the efficacy of eHealth school-based interventions targeting these six health risk behaviours among adolescents has not been evaluated. The proposed systematic review aims to address this by determining the nature and efficacy of existing eHealth school-based interventions targeting multiple health risk behaviours among adolescents. METHODS A systematic search of the MEDLINE, Embase, PsycINFO and Cochrane Library databases will be conducted to identify eligible published papers. Eligible studies will be randomised controlled trials, including cluster randomised controlled trials, of interventions targeting two or more of the following lifestyle risk behaviours: alcohol use, smoking, poor diet, physical inactivity, sedentary behaviour and sleep. Eligible studies will be those evaluating interventions delivered in a secondary school setting among participants 11-18 years of age, via an eHealth platform (Internet, computers of mobile technology). Two reviewers will independently screen studies for eligibility, extract data and assess the risk of bias. Study outcomes will be summarised in a narrative synthesis, and meta-analyses will be conducted where it is appropriate to combine studies. DISCUSSION It is anticipated that the results from this review will serve to inform the development of future eHealth multiple health behaviour interventions for adolescents by identifying common characteristics of effective programs and highlighting knowledge gaps in the evidence base. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017072163.
Collapse
Affiliation(s)
- Katrina E. Champion
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611 USA
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, NDARC, UNSW Sydney, Sydney, NSW Australia
| | - Nicola C. Newton
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, NDARC, UNSW Sydney, Sydney, NSW Australia
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611 USA
| | - Q. Eileen Wafford
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | | | - Maree Teesson
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, NDARC, UNSW Sydney, Sydney, NSW Australia
| |
Collapse
|
44
|
Nutrient intake and dietary changes during a 2-year multi-domain lifestyle intervention among older adults: secondary analysis of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) randomised controlled trial. Br J Nutr 2017; 118:291-302. [PMID: 28875868 DOI: 10.1017/s0007114517001982] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Advancing age increases the risk for diseases and health concerns like cognitive decline, constituting a major public health challenge. Lifestyle, especially healthy diet, affects many risk factors related to chronic diseases, and thus lifestyle interventions among older adults may be beneficial in promoting successful ageing. We completed a randomised 2-year multi-domain lifestyle intervention trial aiming at prevention of cognitive decline among 631 participants in the intervention and 629 in the control group, aged 60-77 years at baseline. Dietary counselling was one of the intervention domains together with strength exercise, cognitive training and management of CVD risk factors. The aim of this paper was to describe success of the intervention - that is, how an intervention based on national dietary recommendations affected dietary habits as a part of multi-intervention. Composite dietary intervention adherence score comprising nine distinct goals (range 0-9 points from none to achieving all goals) was 5·0 at baseline, and increased in the intervention group after the 1st (P<0·001) and 2nd (P=0·005) year. The difference in change compared with the control group was significant at both years (P<0·001 and P=0·018). Intake of several vitamins and minerals decreased in the control group but remained unchanged or increased in the intervention group during the 2 years. Well-targeted dietary counselling may prevent age-related decline in diet quality and help in preventing cognitive decline.
Collapse
|
45
|
Livingstone KM, McNaughton SA. A Health Behavior Score is Associated with Hypertension and Obesity Among Australian Adults. Obesity (Silver Spring) 2017; 25:1610-1617. [PMID: 28712161 DOI: 10.1002/oby.21911] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/28/2017] [Accepted: 05/29/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate associations between a health behavior score and prevalence of hypertension and overweight/obesity. METHODS Adults (n = 4,609; 19-85 years) were included from the cross-sectional Australian National Nutrition and Physical Activity Survey. A health behavior score was derived based on individuals meeting recommendations for diet quality, smoking, physical activity, sedentary time, and sleep. Poisson regression estimated the prevalence ratio (PR) of hypertension and overweight/obesity by health behavior score. RESULTS Individuals meeting three (PR: 0.67, 95% CI: 0.54-0.86; P = 0.001), four (PR: 0.76, 95% CI: 0.59-0.96; P = 0.024), or five (PR: 0.63, 95% CI: 0.43-0.94; P = 0.024) health behavior recommendations had a lower hypertension PR compared with those meeting zero or one recommendation. The PR of overweight/obesity was lower in individuals meeting three (PR: 0.98, 95% CI: 0.95-1.02; P = 0.019), four (PR: 0.95, 95% CI: 0.91-0.99; P = 0.019), or five (PR: 0.94, 95% CI: 0.90-0.99; P = 0.022) recommendations compared with those meeting zero or one. CONCLUSIONS Hypertension and overweight/obesity prevalence were lower in individuals who had above-average diet quality, never smoked, were physically active, spent less time sedentary, and got adequate sleep. These findings support a holistic approach to public health recommendations.
Collapse
Affiliation(s)
- Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
46
|
Meader N, King K, Wright K, Graham HM, Petticrew M, Power C, White M, Sowden AJ. Multiple Risk Behavior Interventions: Meta-analyses of RCTs. Am J Prev Med 2017; 53:e19-e30. [PMID: 28258777 DOI: 10.1016/j.amepre.2017.01.032] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 12/05/2016] [Accepted: 01/23/2017] [Indexed: 11/17/2022]
Abstract
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease, cancer, or Type 2 diabetes. A systematic review, meta-analysis, and meta-regression of the effectiveness of multiple risk behavior interventions was conducted. EVIDENCE ACQUISITION Six electronic databases including MEDLINE, EMBASE, and PsycINFO were searched to August 2016. RCTs of non-pharmacologic interventions in general adult populations were selected. Studies targeting specific at-risk groups (such as people screened for cardiovascular risk factors or obesity) were excluded. Studies were screened independently. Study characteristics and outcomes were extracted and risk of bias assessed by one researcher and checked by another. The Behaviour Change Wheel and Oxford Implementation Index were used to code intervention content and context. EVIDENCE SYNTHESIS Random-effects meta-analyses were conducted. Sixty-nine trials involving 73,873 individuals were included. Interventions mainly comprised education and skills training and were associated with modest improvements in most risk behaviors: increased fruit and vegetable intake (0.31 portions, 95% CI=0.17, 0.45) and physical activity (standardized mean difference, 0.25; 95% CI=0.13, 0.38), and reduced fat intake (standardized mean difference, -0.24; 95% CI=-0.36, -0.12). Although reductions in smoking were found (OR=0.78, 95% CI=0.68, 0.90), they appeared to be negatively associated with improvement in other behaviors (such as diet and physical activity). Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change. But most studies assessed simultaneous rather than sequential change in risk behaviors; therefore, comparisons are sparse. Follow-up period and intervention characteristics impacted effectiveness for some outcomes. CONCLUSIONS Interventions comprising education (e.g., providing information about behaviors associated with health risks) and skills training (e.g., teaching skills that equip participants to engage in less risky behavior) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity. Although on average smoking was reduced, it appeared changes in smoking were negatively associated with changes in other behaviors, suggesting it may not be optimal to target smoking simultaneously with other risk behaviors.
Collapse
Affiliation(s)
- Nick Meader
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Kristelle King
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Hilary M Graham
- Department of Health Sciences, University of York, York, United Kingdom
| | - Mark Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chris Power
- Population, Policy, and Practice, UCL Institute of Child Health, London, United Kingdom
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Amanda J Sowden
- Centre for Reviews and Dissemination, University of York, York, United Kingdom.
| |
Collapse
|
47
|
Cassidy S, Chau JY, Catt M, Bauman A, Trenell MI. Low physical activity, high television viewing and poor sleep duration cluster in overweight and obese adults; a cross-sectional study of 398,984 participants from the UK Biobank. Int J Behav Nutr Phys Act 2017; 14:57. [PMID: 28454540 PMCID: PMC5408822 DOI: 10.1186/s12966-017-0514-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/19/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND An unhealthy lifestyle is one of the greatest contributors to obesity. A number of behaviours are linked with obesity, but are often measured separately. The UK Biobank cohort of >500,000 participants allows us to explore these behaviours simultaneously. We therefore aimed to compare physical activity, television (TV) viewing and sleep duration across body mass index (BMI) categories in a large sample of UK adults. METHODS UK Biobank participants were recruited and baseline measures were taken between 2007 and 2010 and data analysis was performed in 2015. BMI was measured objectively using trained staff. Self-report questionnaires were used to measure lifestyle behaviours including the international physical activity questionnaire (IPAQ-short form) for physical activity. During data analysis, six groups were defined based on BMI; 'Underweight' (n = 2026), 'Normal weight' (n = 132,372), 'Overweight (n = 171,030), 'Obese I' (n = 67,903), 'Obese II' (n = 18,653) and 'Obese III' (n = 7000). The odds of reporting unhealthy lifestyle behaviours (low physical activity, high TV viewing or poor sleep duration) were compared across BMI groups using logistic regression analysis. RESULTS Overweight and obese adults were more likely to report low levels of physical activity (≤967.5 MET.mins/wk) ('Overweight'-OR [95% CI]: 1.23 [1.20 to 1.26], 'Obese I' 1.66 [1.61-1.71], 'Obese II' 2.21 [2.12-2.30], and 'Obese III' 3.13 [2.95 to 3.23]) compared to 'Normal weight' adults. The odds of reporting high TV viewing (3 h/day) was greater in 'Overweight' (1.52 [1.48 to 1.55]) and obese adults ('Obese I' 2.06 [2.00-2.12], 'Obese II' 2.69 [2.58-2.80], 'Obese III' 3.26 [3.07 to 3.47]), and poor sleep duration (<7, >8 h/night) was higher in 'Overweight' (1.09 [1.07 to 1.12]) and obese adults ('Obese I' 1.31 [1.27-1.34], 'Obese II' 1.50 [1.44-1.56], 'Obese III' (1.78 [1.68 to 1.89]) compared to the 'Normal weight' group. These lifestyle behaviours were clustered, the odds of reporting simultaneous low physical activity, high TV viewing and poor sleep (unhealthy behavioural phenotype) was higher than reporting these behaviours independently, in overweight and obese groups. 'Obese III' adults were almost six times more likely (5.47 [4.96 to 6.05]) to report an unhealthy behavioural phenotype compared to the 'Normal weight' group. CONCLUSIONS Overweight and obese adults report low levels of physical activity, high TV viewing and poor sleep duration. These behaviours seem to cluster and collectively expose individuals to greater risk of obesity. Multiple lifestyle behaviours should be targeted in future interventions.
Collapse
Affiliation(s)
- Sophie Cassidy
- Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| | - Josephine Y. Chau
- Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre D17, Level 6 The Hub, University of Sydney, Sydney, NSW 2006 Australia
| | - Michael Catt
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre D17, Level 6 The Hub, University of Sydney, Sydney, NSW 2006 Australia
| | - Michael I. Trenell
- Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| |
Collapse
|
48
|
Olivares DEV, Chambi FRV, Chañi EMM, Craig WJ, Pacheco SOS, Pacheco FJ. Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030251. [PMID: 28257087 PMCID: PMC5369087 DOI: 10.3390/ijerph14030251] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 02/08/2023]
Abstract
Global health agencies estimate an increase of chronic diseases in South America. Nevertheless, few studies have investigated chronic diseases and their risk factors in the perspective of multimorbidity. This research aimed to identify these aspects in a primary health care setting of central Argentina. The Pan America version of the STEP wise approach surveillance (STEPS) instrument of the World Health Organization was applied to 1044 participants, 365 men and 679 women, with a mean age of 43 years. High prevalence of overweight (33.5%), obesity (35.2%), central obesity (54%), dyslipidemia (43.5%), metabolic syndrome (21.1%), low intake of fruit and vegetables (91.8%), low levels of physical activity (71.5%), risky alcohol consumption (28%), and smoking (22.5%) were detected. Hypertension and diabetes were the most prevalent chronic conditions and the total prevalence of multimorbidity was 33.1%, with 2, 3, 4, 5 and 6 chronic conditions found in 19.9%, 9.1%, 2.6%, 1.1% and 0.4% of the population, respectively. Multimorbidity affected 6.4% of the young, 31.7% of the adults, and 60.6% of the elderly, and was more prevalent among women, and in participants with lower levels of education. Having multimorbidity was significantly associated with obesity, central obesity, and higher concentrations of total blood cholesterol, low-density lipoprotein cholesterol, triglycerides, and glucose. A website was made available to the participants in order to share the experimental results and health-promoting information.
Collapse
Affiliation(s)
- David E V Olivares
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Frank R V Chambi
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Evelyn M M Chañi
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Winston J Craig
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Department of Public Health, Nutrition and Wellness, School of Health Professions, Andrews University, Berrien Springs, MI 49104, USA.
| | - Sandaly O S Pacheco
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| | - Fabio J Pacheco
- Center for Health Sciences Research, School of Medicine & Health Sciences, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
- Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, 25 de Mayo 99, Entre Ríos 3103, Argentina.
| |
Collapse
|
49
|
Sahli J, Maatoug J, Harrabi I, Ben Fredj S, Dendana E, Ghannem H. Effectiveness of a Community-Based Intervention Program to Reduce Hypertension Prevalence Among Adults: Results of a Quasiexperimental Study With Control Group in the Region of Sousse, Tunisia. Glob Heart 2017; 11:131-7. [PMID: 27102030 DOI: 10.1016/j.gheart.2016.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND High blood pressure is preventable and is directly related to lifestyle habits such as an unbalanced diet, low levels of physical activity, and tobacco use. OBJECTIVES This quasiexperimental study aimed to assess the effectiveness of a 3-year community intervention targeting healthy lifestyle promotion in reducing hypertension prevalence among adults. METHODS A quasiexperimental design was used to evaluate the effectiveness of a 3-year intervention for healthy lifestyle that was implemented between 2010 and 2013 in a community of adults in the region of Sousse in Tunisia. The population study was randomly selected in both intervention and control groups at pre-assessment and post-assessment. After considering a type 1 error α of 5%, a type 2 error β of 20%, and a change in the prevalence of various risk factors of 6% between pre-intervention and post-intervention, the sample size was fixed to 2,000 adults in intervention and control areas. RESULTS The intervention group was composed of 940 and 1,001 adults, and the control group was composed of 940 and 976, respectively, at pre-assessment and post-assessment. The prevalence of hypertension decreased in the intervention group globally from 37.3% to 33.7% but not significantly (p = 0.1). In the control group, this proportion increased from 31.1% to 33.4% without significant difference (p = 0.28). In the intervention group, after stratification for age, a significant decrease (p = 0.007) in the prevalence of hypertension was observed for participants younger than 40 years old: it decreased from 22.8% to 16.2%. In the control group, it increased from 14% to 15.4% (p = 0.52). In intervention group, a significant decrease of the hypertension from 31.4% to 26% (p = 0.03) was observed among nonobese participants after stratification for weight status. No significant change was observed in the control group. CONCLUSIONS This study showed the feasibility and effectiveness of a community-based intervention to reduce the prevalence of hypertension in the context of a developing country.
Collapse
Affiliation(s)
- Jihene Sahli
- Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Jihene Maatoug
- Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia.
| | - Imed Harrabi
- Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Sihem Ben Fredj
- Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Emna Dendana
- Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
| | - Hassen Ghannem
- Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
| |
Collapse
|
50
|
Lowe A, Gee M, McLean S, Littlewood C, Lindsay C, Everett S. Physical activity promotion in physiotherapy practice: a systematic scoping review of a decade of literature. Br J Sports Med 2016; 52:122-127. [DOI: 10.1136/bjsports-2016-096735] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 01/17/2023]
Abstract
BackgroundThe health benefits of physical activity (PA) have been extensively documented. Globally PA levels are low with only a small proportion of the population reaching recommended levels. Insufficient PA is seen as a major public health problem with high cost to society. Physiotherapists work with people to manage long-term conditions and are well placed to deliver individual interventions to increase PA. Despite this, little is known about the evidence that exists in this field.MethodsThis scoping review comprises a comprehensive search of key databases using predetermined search terms. This is supplemented with a parallel search that incorporated novel social media strands. In line with current guidance, a robust screening process took place using agreed inclusion and exclusion criteria.Results31 studies met the inclusion criteria. The number of studies published annually increased over the decade. Ireland and USA yielded the largest number of publications with only 1 study from the UK. The target populations included physiotherapists and service users from a range of clinical populations. The studies were mainly quantitative and observational in design with a predominance of studies that scoped attitudes, perceptions, barriers and current practice.ConclusionsThis reconnaissance has shown the state of the evidence to be sparse and disparate. However, the sharp rise in published work in recent years is encouraging. The predominance of scoping studies and the clear social, economic and political drivers for change in this area highlights a need for more pragmatic, interventional studies that can inform clinical practice.
Collapse
|