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Egan BM, Mattix-Kramer HJ, Basile JN, Sutherland SE. Managing Hypertension in Older Adults. Curr Hypertens Rep 2024; 26:157-167. [PMID: 38150080 PMCID: PMC10904451 DOI: 10.1007/s11906-023-01289-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE OF REVIEW The population of older adults 60-79 years globally is projected to double from 800 million to 1.6 billion between 2015 and 2050, while adults ≥ 80 years were forecast to more than triple from 125 to 430 million. The risk for cardiovascular events doubles with each decade of aging and each 20 mmHg increase of systolic blood pressure. Thus, successful management of hypertension in older adults is critical in mitigating the projected global health and economic burden of cardiovascular disease. RECENT FINDINGS Women live longer than men, yet with aging systolic blood pressure and prevalent hypertension increase more, and hypertension control decreases more than in men, i.e., hypertension in older adults is disproportionately a women's health issue. Among older adults who are healthy to mildly frail, the absolute benefit of hypertension control, including more intensive control, on cardiovascular events is greater in adults ≥ 80 than 60-79 years old. The absolute rate of serious adverse events during antihypertensive therapy is greater in adults ≥ 80 years older than 60-79 years, yet the excess adverse event rate with intensive versus standard care is only moderately increased. Among adults ≥ 80 years, benefits of more intensive therapy appear non-existent to reversed with moderate to marked frailty and when cognitive function is less than roughly the twenty-fifth percentile. Accordingly, assessment of functional and cognitive status is important in setting blood pressure targets in older adults. Given substantial absolute cardiovascular benefits of more intensive antihypertensive therapy in independent-living older adults, this group merits shared-decision making for hypertension targets.
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Affiliation(s)
- Brent M Egan
- American Medical Association, Improving Health Outcomes, 2 West Washington Street, Suite 601, Greenville, SC, 29601, USA.
| | - Holly J Mattix-Kramer
- Department of Public Health Sciences and Medicine, Loyola University Chicago Loyola University Medical Center, Maywood, IL, USA
| | - Jan N Basile
- Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA
| | - Susan E Sutherland
- American Medical Association, Improving Health Outcomes, 2 West Washington Street, Suite 601, Greenville, SC, 29601, USA
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Cohen Rodrigues TR, de Buisonjé DR, Reijnders T, Santhanam P, Kowatsch T, Breeman LD, Janssen VR, Kraaijenhagen RA, Atsma DE, Evers AW. Human cues in eHealth to promote lifestyle change: An experimental field study to examine adherence to self-help interventions. Internet Interv 2024; 35:100726. [PMID: 38370288 PMCID: PMC10869898 DOI: 10.1016/j.invent.2024.100726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 01/27/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024] Open
Abstract
eHealth lifestyle interventions without human support (self-help interventions) are generally less effective, as they suffer from lower adherence levels. To solve this, we investigated whether (1) using a text-based conversational agent (TCA) and applying human cues contribute to a working alliance with the TCA, and whether (2) adding human cues and establishing a positive working alliance increase intervention adherence. Participants (N = 121) followed a TCA-supported app-based physical activity intervention. We manipulated two types of human cues: visual (ie, message appearance) and relational (ie, message content). We employed a 2 (visual cues: yes, no) x 2 (relational cues: yes, no) between-subjects design, resulting in four experimental groups: (1) visual and relational cues, (2) visual cues only, (3) relational cues only, or (4) no human cues. We measured the working alliance with the Working Alliance Inventory Short Revised form and intervention adherence as the number of days participants responded to the TCA's messages. Contrary to expectations, the working alliance was unaffected by using human cues. Working alliance was positively related to adherence (t(78) = 3.606, p = .001). Furthermore, groups who received visual cues showed lower adherence levels compared to those who received relational cues only or no cues (U = 1140.5, z = -3.520, p < .001). We replicated the finding that establishing a working alliance contributes to intervention adherence, independently of the use of human cues in a TCA. However, we were unable to show that adding human cues impacted the working alliance and increased adherence. The results indicate that adding visual cues to a TCA may even negatively affect adherence, possibly because it may create confusion concerning the true nature of the coach, which may prompt unrealistic expectations.
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Affiliation(s)
| | | | - Thomas Reijnders
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
| | - Prabhakaran Santhanam
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Instiute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St. Gallen, Switzerland
| | - Linda D. Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
| | - Veronica R. Janssen
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
- Department of Cardiology, Leiden University Medical Center, the Netherlands
| | - Roderik A. Kraaijenhagen
- NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, the Netherlands
- Vital10, Amsterdam, the Netherlands
| | - Douwe E. Atsma
- Department of Cardiology, Leiden University Medical Center, the Netherlands
| | - Andrea W.M. Evers
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
- Medical Delta, Leiden University, Technical University of Delft, Erasmus University Rotterdam, the Netherlands
| | - the BENEFIT consortium
- Health, Medical, and Neuropsychology Unit, Leiden University, the Netherlands
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Instiute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St. Gallen, Switzerland
- Department of Cardiology, Leiden University Medical Center, the Netherlands
- NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, the Netherlands
- Vital10, Amsterdam, the Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
- Medical Delta, Leiden University, Technical University of Delft, Erasmus University Rotterdam, the Netherlands
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Yan B, Dietzenbacher E, Los B. The global emission mitigation potential of avoiding waste and product lifespan extension by Chinese households. Heliyon 2024; 10:e24322. [PMID: 38322907 PMCID: PMC10843998 DOI: 10.1016/j.heliyon.2024.e24322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/17/2023] [Accepted: 01/07/2024] [Indexed: 02/08/2024] Open
Abstract
This paper examines the emission mitigation potential of Chinese households' low-carbon behavior by 2030 through a global carbon footprint scenario analysis. The emission reduction effect is estimated by comparing the projected global emissions in 2030 in a lifestyle emulation scenario and a low-carbon scenario, in which Chinese households adopt low-carbon consumption behaviors. Lifestyle emulation is modeled based on what we call "world Engel curves", which describe how the expenditure share of a certain consumption good depends on the total per capita expenditures for household consumption (which depends on income). By including a dynamic link between household lifestyle changes and GDP, we then obtain the emission projections under different scenarios in 2030, based on the historical data for 49 countries from 1995 to 2011 from EXIOBASE. Our results show that adopting a mild low-carbon lifestyle by households helps only little in terms of reducing GHG emissions. Reducing avoidable waste and expanding the lifetime of products are not enough to help meeting the 2 °C goal. More drastic changes are required.
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Affiliation(s)
- Bingqian Yan
- National Academy of Economic Strategy, Chinese Academy of Social Sciences, Beijing, 100006, China
- Faculty of Economics and Business, University of Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands
| | - Erik Dietzenbacher
- Faculty of Economics and Business, University of Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands
| | - Bart Los
- Faculty of Economics and Business, University of Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands
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Filzmoser N, Webber I, Kerr G, Alaa A, El Asmar MI, Karki M, Riboli-Sasco E, El-Osta A. Exploring the link between self-management of migraine and emotional wellbeing: a cross-sectional study of community-dwelling migraine sufferers. BMC Neurol 2024; 24:47. [PMID: 38279088 PMCID: PMC10821553 DOI: 10.1186/s12883-024-03535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/12/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Globally, an estimated 14% of adults live with migraine disease which impacts their physical, emotional and social wellbeing. To target the disease comprehensively, research recommends a multidisciplinary approach to migraine management. Yet, at present, migraine management primarily centers around pharmaceutical treatments. The aim of this study was to investigate the extent to which emotional awareness could influence the uptake of self-care behaviours of community-dwelling adults with migraine. METHODS A cross-sectional online survey explored personal experiences with migraine disease and strategies or behaviours to manage migraine attacks. Chi-squared tests were used to investigate differences in ratings of migraine prevention and management strategies between users and non-users of the strategies. Univariable logistic regressions were used to assess the effectiveness of self-care behaviours to manage or prevent migraine attacks. RESULTS We surveyed 170 community-dwelling adults with migraine in the United Kingdom, Austria, Germany and the United States. Most (85%) respondents had experienced migraine for over five years, where 42% of attacks usually lasted several days. Whereas we did not differentiate between diagnosis by a neurologist or self-diagnosis, the most common diagnoses in the cohort were migraine without aura (38.9%) and migraine with aura (29%). Staying hydrated was the most popular preventative strategy (87%), 70.2% used prescription medication and 64.9% changed their diet and/or supplements. Almost all ( 92.4%) respondents stated that their mood or emotions could trigger their migraine attacks. Keeping a headache or mood diary was the lowest-rated prevention strategy and was rated as "probably ineffective" or causing "no change" in preventing migraine attacks. Over a third (39.7%) kept track of their physical wellbeing and symptoms. Reasons stated for tracking symptoms included to identify triggers (65.8%), show reports to a healthcare professional (59.6%), understand when they must take medication (48.1%), track improvements (67.3%) or deteriorations (67.3%). CONCLUSIONS Migraine management is dominated by pharmaceutical management for acute pain attacks and lifestyle changes for managing migraine long-term. Perception of the effectiveness of those techniques is high, whereas perception of interventions that target the emotional or psychological components of chronic pain management (keeping a mood diary, and mental health support) is mixed. There exists a gap between the recommended biopsychosocial approach and the current state of migraine management.
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Affiliation(s)
- Nicola Filzmoser
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK.
| | - Iman Webber
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK
| | - Gabriele Kerr
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK
| | - Aos Alaa
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK
| | - Marie Iine El Asmar
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK
| | - Manisha Karki
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK
| | - Eva Riboli-Sasco
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK
| | - Austen El-Osta
- Department of Primary Care & Public Health, Self-Care Academic Research Unit (SCARU) Imperial College London, Charing Cross Hospital, London, W6 8RF, UK
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Arntzen E, Jøsendal R, Sandsæter HL, Horn J. Postpartum follow-up of women with preeclampsia: facilitators and barriers - A qualitative study. BMC Pregnancy Childbirth 2023; 23:833. [PMID: 38049716 PMCID: PMC10694896 DOI: 10.1186/s12884-023-06146-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Pregnancy causes physiological changes to the maternal organ systems that can be regarded as a cardiometabolic stress test for women. Preeclampsia, a pregnancy complication characterized by new onset of hypertension in combination with proteinuria or end-organ dysfunction, affects approximately 2-8% of pregnancies. Adverse pregnancy outcomes, including preeclampsia, have been described as a failed stress test and have been consistently linked with increased risk of cardiovascular disease later in life. The postpartum period is therefore often regarded as a window of opportunity for cardiovascular disease prevention. However, we lack knowledge about how women with preeclampsia experience current postpartum care in the Norwegian health system. The aim of this qualitative study is to uncover women's perspectives and preferences regarding postpartum follow-up. METHODS Semi-structured telephone interviews were conducted with 17 women following a six-month lifestyle intervention study. Participants were 9-20 months postpartum, following a pregnancy complicated by preeclampsia. Data were analyzed using Malterud's systematic text condensation. RESULTS We identified five themes, each with 2-3 subthemes, that demonstrate how women with recent preeclampsia experience postpartum follow-up: (1) fear and uncertainty (a body out of balance and facing an uncertain future), (2) a conversation on lifestyle - not really that difficult (preeclampsia as a gateway, a respectful approach, and a desire for more constructive feedback), (3) when your own health is not a priority (a new everyday life, out of focus, and lack of support), (4) motivation for lifestyle changes (an eye opener, lack of intrinsic motivation, and a helping hand), and (5) lack of structured and organized follow-up (there should be a proper system, a one-sided follow-up care, and individual variation in follow-up care). CONCLUSIONS Findings from this study highlight the need for more systematic postpartum follow-up for women after a pregnancy complicated by preeclampsia. Further research is required to explore the potential use of standardized guidelines and routine invitations to postpartum care. Furthermore, exploring health care professionals' experiences is crucial to ensure their engagement in postpartum care after complicated pregnancies.
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Affiliation(s)
- Eirin Arntzen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postbox 8905, NO-7491, Trondheim, Norway
| | - Ranveig Jøsendal
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postbox 8905, NO-7491, Trondheim, Norway
| | - Heidi Linn Sandsæter
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postbox 8905, NO-7491, Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Julie Horn
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postbox 8905, NO-7491, Trondheim, Norway.
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
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Lin RSY, Su JJ, Kim S, Wong AKC, Chan TW, Lee SHC. Psychometric properties of the Chinese version of the Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction scale (MCLHB-DRR) in Chinese community-dwelling older adults. Geriatr Nurs 2023; 54:237-245. [PMID: 37847938 DOI: 10.1016/j.gerinurse.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To assess the psychometric properties of Chinese version of Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction (MCLHB-DRR) scale in Chinese community-dwelling older adults. METHODS A convenience sample of 150 Chinese adults aged ≥50 was recruited from local community facilities. Reliability of MCLHB-DRR was evaluated using internal consistency and test-retest reliability over two weeks. Content validity and construct validity were assessed. Translation process followed Brislin's translation model. RESULTS After excluding two items with poor loadings, the confirmatory factor analysis revealed a good model fit (χ2/df=2.14; CFI=0.91; IFI=0.91; RMSEA=0.087). The scale exhibited good internal consistency (Cronbach's alpha = 0.865), as well as acceptable test-retest reliability (ICC=0.730). CONCLUSIONS The Chinese MCLHB-DRR showed satisfactory psychometric properties, providing valuable insights for promoting dementia risk reduction in Chinese population, considering cultural nuances that shape motivations and knowledge of lifestyle changes.
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Affiliation(s)
- Rose Sin Yi Lin
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, 255 Crittenden Blvd, Rochester, New York, 14620, USA
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Sarang Kim
- Australian Institute of Health and Welfare, 26 Thynne Street, Bruce, ACT, Australia
| | | | - Tsz Wing Chan
- Pamela Youde Nethersole Eastern Hospital, Main Block, Lok Man Rd, Chai Wan, Hong Kong
| | - Sonia Ho Ching Lee
- The Hong Kong Society for Rehabilitation, Units R9-R12, Podium, Wo Che Plaza, Wo Che Estate, Shatin, NT
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Robson M, Riley S, Gagen E, McKeogh D. Love and lifestyle: how 'relational healthism' structures couples' talk of engagement with lifestyle advice associated with a new diagnosis of coronary heart disease. Psychol Health 2023; 38:1606-1622. [PMID: 35187996 DOI: 10.1080/08870446.2022.2033240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 12/17/2021] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Healthy lifestyle change improves outcomes in coronary heart disease (CHD), but is rarely sustained. To better understand barriers to lifestyle change, we examined couples' talk of engaging with lifestyle advice after one partner receives a diagnosis of CHD. DESIGN A longitudinal qualitative design, in which a poststructuralist discourse analysis was performed on 35 interviews, conducted with 22 heterosexual British people in a long term relationship. The interviews occurred over three months after one partner was referred to a cardiac rehabilitation programme designed to support lifestyle change. RESULTS Couples understood their health as a shared practice underpinned by an ideological framework of healthism, creating a form of 'relational healthism'. Practicing relational healthism was not straightforward because the practices of surveillance, control, and discipline related to healthism often contravened relationship norms of support, acceptance and respect for the other's autonomy. Couples struggled to resolve this tension, dynamically adopting, resisting, and occasionally transforming discourses of health and love in ways that worked for and against engagement in lifestyle change. CONCLUSION In foregrounding the discursive and relational contexts of behavioural change engagement, we show the considerable complexity for couples, including costs related to engagement with lifestyle advice.
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Affiliation(s)
- Martine Robson
- Department of Psychology, Aberystwyth University, Aberystwyth, UK
| | - Sarah Riley
- School of Psychology, Massey University, Palmerston North, New Zealand
| | - Elizabeth Gagen
- Department of Geography, Aberystwyth University, Aberystwyth, UK
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Kent-Marvick J, St Clair SL, Bristol AA, Gibson B, Simonsen SE. Perceptions about future health trajectories among women at risk for developing cardiometabolic disease: A qualitative study. Res Sq 2023:rs.3.rs-3386180. [PMID: 37961339 PMCID: PMC10635306 DOI: 10.21203/rs.3.rs-3386180/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background The reproductive years provide a window into future risk for Type 2 Diabetes (T2DM); women's risk is seven to 10 times higher after gestational diabetes (GDM) and two to four times higher after a hypertensive disorder of pregnancy (HDP). Targeting reproductive-aged women at high risk for T2DM could reduce future T2DM incidence. However, little is known about such women's diabetes risk perceptions, or their knowledge or barriers/motivators of lifestyle change-information essential to understanding how to engage these at-risk women in tailored prevention programs promoting long-term health. This study's aims include: among reproductive-aged women at high risk for T2DM, what is/are 1) personal health-risk awareness, 2) lifestyle-change interest, and 3) barriers/motivators of participation in lifestyle-change programs? Methods Women aged 18 to 48 were eligible if they had one of the following health risks: 1) GDM or HDP during pregnancy, 2) prediabetes diagnosis, or 3) BMI classified as obese. Three Zoom focus groups, organized by risk group, were conducted with a total of 20 participants. Qualitative content and thematic analysis were used for the focus group transcriptions. Results Women's personal health-risk awareness was limited and generalized (e.g., being overweight might lead to other risks) and rarely reflected awareness connected to their personal health history (e.g., GDM increases their lifetime risk of T2DM). Participants reported that healthcare providers did not adequately follow or address their health risks. All women expressed interest in making healthy lifestyle changes, including engagement in formal programs, but they shared multiple barriers to healthy behavior change related to being "busy moms." Women emphasized the need for social support and realistic solutions that accounted for the dynamics of motherhood and family life. Common motivators included the desire to maintain health for their families and to set a good example for their children. Conclusions Participants lacked knowledge and were eager for information. Healthcare improvement opportunities include better coordination of care between primary and specialty-care providers, and more frequent communication and education on diabetes-related health risks and long-term health. Formal lifestyle programs should tailor content by providing multiple formats and flexibility of scheduling while leveraging peer support for sustained engagement.
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Sathish T. Precision prevention of type 2 diabetes: An approach to revitalize current lifestyle interventions. Diabetes Res Clin Pract 2023; 200:110722. [PMID: 37207945 PMCID: PMC10427778 DOI: 10.1016/j.diabres.2023.110722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Thirunavukkarasu Sathish
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA.
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Lönn A, Kallings LV, Andersson G, Paulsson S, Wallin P, Eriksson JS, Ekblom-Bak E. Lifestyle-related habits and factors before and after cardiovascular diagnosis: a case control study among 2,548 Swedish individuals. Int J Behav Nutr Phys Act 2023; 20:41. [PMID: 37020317 PMCID: PMC10074688 DOI: 10.1186/s12966-023-01446-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Healthy lifestyle habits are recommended in prevention of cardiovascular disease (CVD). However, there is limited knowledge concerning the change in lifestyle-related factors from before to after a CVD event. Thus, this study aimed to explore if and how lifestyle habits and other lifestyle-related factors changed between two health assessments in individuals experiencing a CVD event between the assessments, and if changes varied between subgroups of sex, age, educational level, duration from CVD event to second assessment and type of CVD event. METHODS Among 115,504 Swedish employees with data from two assessments of occupational health screenings between 1992 and 2020, a total of 637 individuals (74% men, mean age 47 ± SD 9 years) were identified having had a CVD event (ischemic heart disease, cardiac arrythmia or stroke) between the assessments. Cases were matched with controls without an event between assessments from the same database (ratio 1:3, matching with replacement) by sex, age, and time between assessment (n = 1911 controls). Lifestyle habits included smoking, active commuting, exercise, diet, alcohol intake, and were self-rated. Lifestyle-related factors included overall stress, overall health (both self-rated), physical capacity (estimated by submaximal cycling), body mass index and resting blood pressure. Differences in lifestyle habits and lifestyle-related factors between cases and controls, and changes over time, were analysed with parametric and non-parametric tests. Multiple logistic regression, OR (95% CI) was used to analyse differences in change between subgroups. RESULTS Cases had, in general, a higher prevalence of unhealthy lifestyle habits as well as negative life-style related factors prior to the event compared to controls. Nevertheless, cases improved their lifestyle habits and lifestyle factors to a higher degree than controls, especially their amount of active commuting (p = 0.025), exercise (p = 0.009) and non-smoking (p < 0.001). However, BMI and overall health deteriorated to a greater extent (p < 0.001) among cases, while physical capacity (p < 0.001) decreased in both groups. CONCLUSION The results indicate that a CVD event may increase motivation to improve lifestyle habits. Nonetheless, the prevalence of unhealthy lifestyle habits was still high, emphasizing the need to improve implementation of primary and secondary CVD prevention.
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Affiliation(s)
- Amanda Lönn
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Box 5626, S-114 56, Stockholm, Sweden.
- Women's Health and Allied Health Professionals Theme Medical Unit Occupational Therapy and Physiotherapy, Stockholm, Sweden.
| | - Lena V Kallings
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Box 5626, S-114 56, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Gunnar Andersson
- Research Department, HPI Health Profile Institute, Danderyd, Sweden
| | - Sofia Paulsson
- Research Department, HPI Health Profile Institute, Danderyd, Sweden
| | - Peter Wallin
- Research Department, HPI Health Profile Institute, Danderyd, Sweden
| | - Jane Salier Eriksson
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Box 5626, S-114 56, Stockholm, Sweden
| | - Elin Ekblom-Bak
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Box 5626, S-114 56, Stockholm, Sweden
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Huang HC, Szwerinski NK, Nasrallah C, Huang Q, Chopra V, Venditti EM, Azar KMJ, Romanelli RJ. Lifestyle change program engagement in real-world clinical practice: a mixed-methods analysis. Transl Behav Med 2023; 13:168-182. [PMID: 36694916 PMCID: PMC10068905 DOI: 10.1093/tbm/ibac098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Participant engagement in structured lifestyle change programs (LCPs) is essential for adopting behaviors that promote weight loss; however, the challenges to, and facilitators that promote, engagement with such programs are not well understood. We conducted a mixed-methods study among real-world LCP participants to assess factors associated with program engagement and to examine the reasons for withdrawal. Using electronic health records (EHR), we identified LCP eligible participants between 2010 and 2017. Multivariable logistic regression was used to assess associations between program engagement and baseline characteristics. Semi-structured interviews with LCP participants were conducted and thematically analyzed to examine reasons for withdrawal. A total of 1,813 LCP participants were included. The median number of sessions attended was 10 of 21-25 sessions. Highest LCP engagement was associated with factors potentially related to self-efficacy/motivation, such as older age, higher baseline weight, prior healthcare utilization and an absence of a history of smoking or depression. Engagement was also negatively associated with being Non-Hispanic Black versus White. The qualitative analysis of the interviews revealed four general themes pertaining to participants' withdrawal: competing priorities, perceived program effectiveness, characteristics of the program, and facilitator-related factors. Taken together, results from this mixed-methods study suggest that motivation and self-efficacy are important for program engagement; future LCP enhancements should incorporate flexible formats that may help participants manage competing priorities and maximize personal and cultural relevance for all racial/ethnic groups, especially those who have not benefitted fully. Furthermore, participants should be encouraged to set realistic goals to manage expectations.
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Affiliation(s)
- Hsiao-Ching Huang
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Nina K Szwerinski
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | | | - Qiwen Huang
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Vidita Chopra
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Elizabeth M Venditti
- Department of Psychiatry, Diabetes Prevention Support Center, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Epidemiology, Diabetes Prevention Support Center, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Kristen M J Azar
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
| | - Robert J Romanelli
- Sutter Health, Center for Health Systems Research, Palo Alto, CA 94301, USA
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12
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Golovaty I, Ritchie ND, Tuomilehto J, Mohan V, Ali MK, Gregg EW, Bergman M, Moin T. Two decades of diabetes prevention efforts: A call to innovate and revitalize our approach to lifestyle change. Diabetes Res Clin Pract 2023; 198:110195. [PMID: 36470316 PMCID: PMC10079599 DOI: 10.1016/j.diabres.2022.110195] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/07/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
The impact of global diabetes prevention efforts has been modest despite the promise of landmark diabetes prevention trials nearly twenty years ago. While national and regional initiatives show potential, challenges remain to adapt large-scale strategies in the real-world that fits individuals and their communities. Additionally, the sedentary lifestyle changes during the COVID-19 pandemic and guidelines that now call for earlier screening (e.g., US Preventative Task Force) will increase the pool of eligible adults worldwide. Thus, a more adaptable, person-centered approach that expands the current toolkit is urgently needed to innovate and revitalize our approach to diabetes prevention. This review identifies key priorities to optimize the population-level delivery of diabetes prevention based on a consensus-based evaluation of the current evidence among experts in global translational programs; key priorities identified include (1) participant eligibility, (2) intervention intensity, (3) delivery components, (4) behavioral economics, (5) technology, and (6) the role of pharmacotherapy. We offer a conceptual framework for a broader, person-centered approach to better address an individual's risk, readiness, barriers, and digital competency.
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Affiliation(s)
- Ilya Golovaty
- Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA; General Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA.
| | - Natalie D Ritchie
- Office of Research, Denver Health and Hospital Authority, Denver, CO. Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO. University of Colorado College of Nursing, Aurora, CO, USA
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland; Saudi Diabetes Research Group, King Abdulaziz University Jeddah, Saudi Arabia; Department of International Health, National School of Public Health, Instituto de Salud Carlos III. Madrid, Spain
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Chairman, Dr. Mohan's Diabetes Specialties Centre, Chennai, India
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Michael Bergman
- Division of Endocrinology and Metabolism, Department of Medicine and of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Tannaz Moin
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Health System and HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Los Angeles, CA, USA
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13
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Alsehemi NH, Alharbi AA, Alamri RS, Fatani BA, Alsenan SH, Elbarazi I, Aldhwayan MM. Translation and Validation of the Arabic Version of the Eating Behavior After Bariatric Surgery (EBBS) Questionnaire. Obes Surg 2023. [PMID: 36781595 DOI: 10.1007/s11695-023-06480-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Complications after metabolic and bariatric surgery are common due to the patient's poor commitment to postoperative lifestyle changes. Therefore, intensive follow-up from a multidisciplinary team might improve outcomes. The present study aimed to translate and validate the Eating Behavior after Bariatric Surgery (EBBS) questionnaire into Arabic for use in clinical and research settings. MATERIALS AND METHODS The study followed World Health Organization guidelines for translation and questionnaire adaptation, including forward translation, back translation, pilot testing, and the creation of the final version of the tool. A total of 390 patients who had undergone metabolic and bariatric surgery 3 years ago or more were involved in testing the questionnaire's validity and reliability. RESULTS The mean age of participants was 36 years (range: 20 to 70 years), 56% were females, 94.1% were Saudis, and 56% had bachelor's degrees. The internal consistency of the questionnaire was tested using Cronbach's alpha. One item (alcohol consumption) was excluded during the reliability analysis due to low variance. The reliability analysis results showed that the 10 items were internally consistent, with a Cronbach's α of 0.851. CONCLUSION The validation and reliability of the Arabic-language version of the EBBS questionnaire were found to be satisfactory. The presence of a validated Arabic version of this instrument may help practitioners estimate patients' adherence to dietary and lifestyle recommendations after metabolic and bariatric surgery. Furthermore, the questionnaire may aid in identifying factors that influence the efficacy of these procedures.
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Rosal MC, Lemon SC, Borg A, Lopez-Cepero A, Sreedhara M, Silfee V, Pbert L, Kane K, Li W. The Healthy Kids & Families study: Outcomes of a 24-month childhood obesity prevention intervention. Prev Med Rep 2023; 31:102086. [PMID: 36820371 PMCID: PMC9938323 DOI: 10.1016/j.pmedr.2022.102086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Socioeconomically disadvantaged children experience a high burden of obesity but few interventions address obesity prevention in this population subgroup. The Healthy Kids & Families study tested the effect of a parent-focused community health worker (CHW)-delivered lifestyle intervention to prevent childhood obesity. Participants were child-parent/guardian (Kindergarten to 6th grade at baseline) dyads (n = 247) recruited through schools located in socioeconomically disadvantaged neighborhoods in Worcester, MA, USA. Using a quasi-experimental design, the study tested the impact of Healthy Kids & Families, a theory-based, low-intensity, parent-focused, CHW-delivered intervention to improve children's weight, healthy eating and physical activity. The attention-control comparison condition was a positive parenting intervention. The primary outcome was change in child body mass index (BMI) z-score at 24 months. Secondary outcomes included number of positive child and parent changes in selected diet and physical activity behaviors targeted by the intervention and change in parent BMI. Outcomes were assessed following the intent-to-treat principle and using multivariable generalized linear mixed models. Compared to the attention-control comparison condition, the Healthy Kids & Families intervention led to a greater reduction in children's BMI z-score (β = -0.17, 95 %CI: -1.92 to -0.36; p = 0.057) and a greater number of positive behavior changes among children (β = 0.57, 95 %CI: 0.08-1.06; p = 0.02) at 24 months. There was no significant change in parent outcomes. The Healthy Kids & Families intervention shows promise for obesity prevention among children in socioeconomically disadvantaged communities.
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Affiliation(s)
- Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Stephenie C. Lemon
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Amy Borg
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Meera Sreedhara
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Valerie Silfee
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Weight Watchers International, NY, USA
| | - Lori Pbert
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Kevin Kane
- Health Statistics and Geography Lab, Center for Health Statistics and Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, USA
| | - Wenjun Li
- Health Statistics and Geography Lab, Center for Health Statistics and Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, USA
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15
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Jin L, Zhang N, Zhu J. Healthy lifestyle changes and mental health of healthcare workers during the COVID-19 pandemic in China. Curr Psychol 2022:1-10. [PMID: 35990210 PMCID: PMC9376040 DOI: 10.1007/s12144-022-03562-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 11/03/2022]
Abstract
This study investigated lifestyle changes in physical activity, sleep, and diet among healthcare workers and their impact on their mental health during the COVID-19 pandemic in China. Healthcare workers (N = 589) completed an online survey about demographic and personal characteristics, working experiences, COVID-19-related stressors, lifestyle changes, and mental health (anxiety and depression) about three months after the lift of the lockdown policy in China. Lifestyle Changes (including changes in physical activity, sleep, and diet), Generalized Anxiety Disorder (GAD-7), and Depression (PHQ-9) were used to measure main outcomes. Of the participants, 39.7% (N = 234) had less physical activity, 36.0% (N = 212) slept less, and 41.8% (N = 246) ate healthier than before pandemic. Lower educational level, working within original hospitals, less physical activity and less sleep time was associated with increased anxiety. Working within original hospitals, less physical activity and an unhealthier diet was associated with increased depression. In summary, healthcare workers who became less healthy in lifestyles experienced a higher level of anxiety and depression symptoms during the COVID-19 pandemic. Strategies to promote healthy living and improve mental health among healthcare workers should be developed and implemented both during the ongoing COVID-19 pandemic and beyond.
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Affiliation(s)
- Lefan Jin
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Ning Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310058 China
| | - Junhong Zhu
- Department of Nursing Studies, Zhejiang University School of Medicine, Hangzhou, 310058 China
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16
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Koufakis T, Kotsa K, Papanas N. Remission of type 2 diabetes depends on prompt comprehensive lifestyle changes upon diagnosis: How can this "Road to Damascus" experience be supported? J Integr Med 2022; 20:288-91. [PMID: 35430168 DOI: 10.1016/j.joim.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/01/2022] [Indexed: 12/30/2022]
Abstract
Theoretically, a new diagnosis of type 2 diabetes mellitus (T2DM) requires a dramatic change in an individual's way of life. Weight loss and physical activity can lead to remission of diabetes, which has been associated with a lower risk of developing complications. Today, the importance of a healthy lifestyle is further highlighted by data showing that obesity and diabetes increase the risk of severe complications from coronavirus disease 2019. However, remission rarely occurs in reality, probably due to the inability of people with T2DM to adhere to the intensive lifestyle interventions that are necessary. The complexity of contributing factors may explain why making these changes is so challenging and underscore the fact that there is no magical solution for T2DM. Instead, hard work from both patients and health care providers is needed for the conversion to be achieved. This article calls for more research on the underlying reasons why adhering to a healthy way of life is so difficult for people with diabetes and obesity. Clearly defining these barriers would facilitate the planning of effective policies to promote the adoption of appropriate lifestyle changes early in the course of the disease.
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17
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Suleiman N, Alkasem M, Al Amer Z, Salameh O, Al-Thani N, Hamad MK, Baagar K, Abdalhakam I, Othman M, Dughmosh R, Al-Mohanadi D, Al Sanousi A, Bashir M, Chagoury O, Taheri S, Abou-Samra AB. Qatar Diabetes Mobile Application Trial (QDMAT): an open-label randomised controlled trial to examine the impact of using a mobile application to improve diabetes care in type 2 diabetes mellitus-a study protocol. Trials 2022; 23:504. [PMID: 35710428 PMCID: PMC9205079 DOI: 10.1186/s13063-022-06334-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 04/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background Mobile health (mHealth) is increasingly advocated for diabetes management. It is unclear if mobile applications are effective in improving glycaemic control, clinical outcomes, quality of life and overall patient satisfaction in patients with type 2 diabetes (T2DM). A new mobile application was specifically built for people with T2DM with the help of the local expertise. The objective of the study was to evaluate the effectiveness of the mobile app. Methods The planned study is an ongoing open-label randomised controlled trial in which adults living with T2DM treated with insulin will be randomised 1:1 to the use of this diabetes application versus current standard care. The primary outcome will be the difference in mean HbA1c from baseline to 6 months. Other outcome measures include anthropometric measures, hypoglycaemic events, medication adjustments, number of clinical interactions and missed appointments and patient perceptions of their disease and diabetes self-management. The study will randomise 180 subjects for assessment of the primary outcome. Discussion We hypothesise that the diabetes-specific mobile application will improve glycaemic control, increase patient empowerment for self-management of diabetes and improve interaction between patients and healthcare providers. If the Qatar Diabetes Mobile Application Trial (QDMAT) demonstrates this, it will inform clinical services for the future self-management of T2DM. Trial registration ClinicalTrials.gov Identifier: NCT03998267. Registered on 26 June 2019
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Affiliation(s)
- Noor Suleiman
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar. .,Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar. .,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.
| | - Meis Alkasem
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Zaina Al Amer
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Obada Salameh
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Noora Al-Thani
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Khair Hamad
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Khaled Baagar
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | | | - Manal Othman
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Ragae Dughmosh
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Dabia Al-Mohanadi
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Ali Al Sanousi
- Clinical Information Systems Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Bashir
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Odette Chagoury
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Shahrad Taheri
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - New York, New York, USA
| | - Abdul-Badi Abou-Samra
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - New York, New York, USA
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18
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Kim HW, Kang SY, Kim J. Factors influencing adolescents' healthy pregnancy preparation behavior: a cross-sectional gender comparison applying the health belief model. Reprod Health 2022; 19:90. [PMID: 35382837 PMCID: PMC8985308 DOI: 10.1186/s12978-022-01392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interventions to prepare for a healthy pregnancy from an early age can ensure the health of both mother and child. This study aims to compare the factors associated with healthy pregnancy preparation behavior (HPPB) among male and female adolescents. METHODS A total of 690 Korean adolescents participated in this cross-sectional study from July 11 to August 24, 2018. Determinants of the likelihood of engaging in HPPB were described using hierarchical regression about the importance of and confidence in HPPB, the gender equality related to pregnancy and birth, and the health belief model (HBM) constructs about HPPB. RESULTS Smoking experience (β = - 0.18, p < 0.001 for boys, β = - 0.25, p < 0.001 for girls), and HBM constructs were identified as factors correlated with HPPB in both genders. The significant factors in boys were perceived susceptibility (β = - 0.13, p = 0.005), perceived severity (β = 0.12, p = 0.015), perceived benefits (β = 0.23, p < 0.001), and perceived barriers (β = - 0.18, p < 0.001), whereas the corresponding factors in girls were perceived severity (β = 0.20, p = 0.001), and perceived barriers (β = - 0.23, p < 0.001). The importance of HPPB was identified as a factor only among girls (β = 0.19, p = 0.005), while confidence in HPPB (β = 0.12, p = 0.401), gender equality related to pregnancy and childbirth (β = - 0.20, p = 0.001 for women's responsibility variable, β = 0.14, p = 0.018 for men's responsibility variable), and alcohol (β = - 0.10, p = 0.022) were factors identified only among boys. CONCLUSIONS The gender differences in opinions on HPPB identified in this study can help nurses and community health care professionals recognize issues for which they can develop and implement preventive interventions. For healthy pregnancy preparation, interventions based on HBM constructs and smoking should be presented for both male and female adolescents. Imparting education to females on the importance of HPPB and to males on confidence in HPPB, gender equality related to pregnancy and childbirth, and alcohol consumption, should be emphasized. In addition, as perceived susceptibility may be low in a disease prevention model using the health belief model, it is necessary to prioritize increasing the perceived susceptibility of school-age children as an intervention.
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Affiliation(s)
- Hae Won Kim
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, 03080, Republic of Korea
| | - Saem Yi Kang
- College of Nursing, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Jieun Kim
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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19
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Skoglund G, Nilsson BB, Olsen CF, Bergland A, Hilde G. Facilitators and barriers for lifestyle change in people with prediabetes: a meta-synthesis of qualitative studies. BMC Public Health 2022; 22:553. [PMID: 35313859 PMCID: PMC8935766 DOI: 10.1186/s12889-022-12885-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/22/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The increasing prevalence of type 2 diabetes worldwide is a major global public health concern. Prediabetes is a reversible condition and is seen as the critical phase for the prevention of type 2 diabetes. The aim of this study is to identify and synthesize current evidence on the perceived barriers and facilitators of lifestyle change among people with prediabetes in terms of both initial change and lifestyle change maintenance. METHODS A systematic literature search in six bibliographic databases was conducted in April 2021. Potential studies were assessed for eligibility based on pre-set criteria. Quality appraisal was done on the included studies, and the thematic synthesis approach was applied to synthesize and analyse the data from the included studies. RESULTS Twenty primary studies were included, containing the experiences of 552 individuals. Thirteen studies reported participants perceived facilitators and barriers of lifestyle change when taking part in community-based lifestyle intervention programs, while seven studies reported on perceived facilitators and barriers of lifestyle change through consultations with health care professionals (no intervention involved). Three analytical themes illuminating perceived barriers and facilitators for lifestyle change were identified: 1) the individual's evaluation of the importance of initiating lifestyle change, 2) the second theme was strategies and coping mechanisms for maintaining lifestyle changes and 3) the last theme was the significance of supportive relations and environments in initiating and maintaining lifestyle change. CONCLUSION Awareness of prediabetes and the perception of its related risks affects the motivation for lifestyle change in people at risk of type 2 diabetes; but this does not necessarily lead to lifestyle changes. Facilitators and barriers of lifestyle change are found to be in a complex interplay within multiple ecological levels, including the interpersonal, intrapersonal, environmental and policy level. An integrated understanding and analysis of the perceived barriers and facilitators of lifestyle change might inform people with prediabetes, healthcare professionals, and policy makers in terms of the need for psychological, social, and environmental support for this population.
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Affiliation(s)
- Gyri Skoglund
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, Oslo, Norway.
| | - Birgitta Blakstad Nilsson
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, Oslo, Norway
- Section for Physiotherapy, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Cecilie Fromholt Olsen
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, Oslo, Norway
| | - Gunvor Hilde
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, Oslo, Norway
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20
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Shi J, Chen Z, Wang X, Teng F, Yang Y, Chen H. Dominate others, hurt self: Social dominance orientation predicts depression during the COVID-19 pandemic. Pers Individ Dif 2021; 175:110710. [PMID: 34848904 PMCID: PMC8613708 DOI: 10.1016/j.paid.2021.110710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/14/2020] [Accepted: 01/22/2021] [Indexed: 11/18/2022]
Abstract
The ongoing coronavirus pandemic threatens physical and psychological health. We examined whether social dominance orientation (SDO), a preference for inequality among social groups, contributes to mental health during the pandemic. In particular, we predicted that people high in SDO would experience higher levels of depression than others low in SDO. Our results (N = 2008) showed that SDO was positively associated with depression. In addition, participants' perceived lifestyle changes moderated the association between SDO and depression. We also discuss the theoretical and practical implications of the current work.
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Affiliation(s)
- Jiaxin Shi
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Zhansheng Chen
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Xijing Wang
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Fei Teng
- School of Psychology, South China Normal University, Guangzhou, China
| | - Ying Yang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hao Chen
- Department of Social Psychology, Nankai University, China
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21
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Abstract
This article is an analytical reflection of the personal health journey of a first-year nursing student that was undertaken as part of a first-year unit of study. Focusing on social, physical and psychological aspects of health, it explores the impact of the cessation of exercise on her emotional and physical health and wellbeing. This is relevant to current practice as a result of COVID-19, which reduced opportunities for exercise for many people, whether because of self-isolation and lockdown restrictions on leisure facilities or increased workload and caring responsibilities, all of which affect health and wellbeing. The article is presented in the first person, reflecting the personal analysis it captures.
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22
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Green G, DeFosset AR, Sivashanmugam M, Mosst J, Kuo T. Current practices, facilitators, and barriers experienced by program providers implementing the National Diabetes Prevention Program in Los Angeles County. Transl Behav Med 2021; 11:430-440. [PMID: 32293679 DOI: 10.1093/tbm/ibaa033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Individuals with prediabetes can lower their diabetes risk by participating in the National Diabetes Prevention Program (National DPP), an evidence-based, group lifestyle change program that is taught by a certified lifestyle coach. To date, studies have not explicitly compared National DPP implementation across multiple settings (i.e., types of organizations) to understand comparative setting advantages or challenges to engaging priority groups. The purpose of this study was to gain an in-depth understanding of: (a) the variation in National DPP implementation across clinic, community-based, and digital settings and (b) associated facilitators and barriers. The study focused on three core implementation domains: recruitment, retention, and data reporting. This study used a descriptive, qualitative approach to identify current practices, facilitators, and barriers to National DPP implementation by conducting semistructured key informant interviews in spring 2018 with 12 organizations delivering the National DPP in Los Angeles County. There was a general commonality between in-person settings (clinics and community-based), while the experiences of digital providers were relatively distinct. Recruitment and retention were widely described by all settings as labor- and time-intensive, while data reporting was seen as relatively less burdensome. All respondents reported using multiple recruitment strategies. Lifestyle coaches were seen as key to retention, and they spent substantial time engaging with participants outside of class, which often was not accounted for in program costs. Data reporting was easier for organizations that invested in sophisticated data management systems and had staff with sufficient data experience. This study advances knowledge around the translation of the National DPP in diverse settings in the nation's largest county and highlights opportunities for targeted, setting-specific support.
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Affiliation(s)
- Gabrielle Green
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Amelia R DeFosset
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Megala Sivashanmugam
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Jennifer Mosst
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Tony Kuo
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA.,Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.,Population Health Program, UCLA Clinical and Translational Science Institute, Los Angeles, CA, USA
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Pirotta S, Joham AJ, Moran LJ, Skouteris H, Lim SS. Implementation of evidence-based PCOS lifestyle management guidelines: Perceived barriers and facilitators by consumers using the Theoretical Domains Framework and COM-B Model. Patient Educ Couns 2021; 104:2080-2088. [PMID: 33581970 DOI: 10.1016/j.pec.2021.01.036] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/21/2021] [Accepted: 01/30/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The 2018 Evidence-Based Polycystic Ovary Syndrome (PCOS) Clinical Guidelines recommend lifestyle management as first-line treatment for PCOS, yet implementation of PCOS lifestyle programs into practice is not well understood. OBJECTIVE To complete systematic intervention mapping by identifying the facilitators and barriers to lifestyle management in women with PCOS using the theoretical domains framework (TDF) and the Capacity, Opportunity, Motivation and Behaviour model (COM-B). PATIENT INVOLVEMENT Women (N = 20) in Australian with PCOS were interviewed. METHODS Telephone semi-structured interviews. RESULTS Nine themes mapped onto seven TDF domains and the COM-B. Capability: psychological co-morbidities, knowledge and awareness of lifestyle change and ability to identify and resolve barriers. Opportunity: presence of other medical conditions, access to practical resources and availability of social support. MOTIVATION outcomes expectancies of lifestyle behaviour, personal values, enjoyment and readiness to change and the impact of stress on lifestyle choices. DISCUSSION This is the first study to explore barriers and facilitators to lifestyle change from the perspectives of women with PCOS using the TDF and COM-B. Addressing these themes will facilitate patient-centred care and long-term behaviour change. PRACTICAL IMPLICATIONS May increase the efficacy and effectiveness of PCOS lifestyle programs and reduce the risk of PCOS-associated disease in this population.
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Affiliation(s)
- Stephanie Pirotta
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia.
| | - Anju J Joham
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; Department of Diabetes, Monash Health, Melbourne, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; Warwick Business School, Warwick University, Coventry, UK
| | - Siew S Lim
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia
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Takahara M, Watanabe H, Shiraiwa T, Maeno Y, Yamamoto K, Shiraiwa Y, Yoshida Y, Nishioka N, Katakami N, Shimomura I. Lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 pandemic in Japan. J Diabetes Investig 2021; 13:375-385. [PMID: 33768726 PMCID: PMC8250997 DOI: 10.1111/jdi.13555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/16/2021] [Accepted: 03/23/2021] [Indexed: 12/31/2022] Open
Abstract
AIMS/INTRODUCTION This study aimed to reveal lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Japan. MATERIALS AND METHODS We retrospectively analyzed 1,402 outpatients with diabetes at a clinic in Osaka, Japan, who responded to an interview sheet regarding lifestyle changes during the COVID-19 pandemic between 28 March and 30 May 2020. The association of lifestyle changes with hemoglobin A1c (HbA1c) and weight changes from February to May 2020 was investigated using the linear regression model. We also investigated the association with clinically important change of HbA1c (by ≥0.3%) and bodyweight (by ≥3%), using the cumulative link model. RESULTS Leisure time and other outside physical activities were decreased in one-quarter of patients during the COVID-19 pandemic, whereas the amount of meals and snacks was decreased and increased in approximately 10%, respectively. The change in leisure time physical activities was inversely associated with HbA1c and weight changes, whereas the quantitative change of meals with the decline in eating out and that of snacks were positively associated with HbA1c and weight changes (all P < 0.05). The quantitative change of meals without the decline in eating out was also positively associated with weight change (P = 0.012). The cumulative link model for clinically important HbA1c and weight change showed broadly similar associations, except for that between snacks and bodyweight (P = 0.15). CONCLUSIONS A considerable number of outpatients with diabetes experienced lifestyle changes during the COVID-19 pandemic. The lifestyle changes were associated with HbA1c and weight changes.
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Affiliation(s)
- Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hirotaka Watanabe
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | | | | | | | | | | | | | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Magallanes E, Sen A, Siler M, Albin J. Nutrition from the kitchen: culinary medicine impacts students' counseling confidence. BMC Med Educ 2021; 21:88. [PMID: 33541352 PMCID: PMC7863372 DOI: 10.1186/s12909-021-02512-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/26/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND Although a poor diet is the number one risk factor for early death in the United States and globally, physicians receive little to no training in dietary interventions and lack confidence counseling patients about lifestyle modifications. Innovative, interprofessional strategies to address these gaps include the emergence of culinary medicine, a hands-on approach to teaching the role of food in health outcomes. We sought to assess the impact of a culinary medicine elective on counseling confidence, awareness of an evidence-based approach to nutrition, and understanding of the role of interprofessional teamwork in dietary lifestyle change among medical students at one undergraduate medical school. METHODS We administered pre- and post-course surveys to two cohorts of medical students (n = 64 at pre-test and n = 60 at post-test) participating in a culinary medicine enrichment elective. Chi-square analysis was used to assess the relationship between participation in the course and a positive response to each survey item. RESULTS Compared with the baseline, students participating in culinary medicine were more likely to feel confident discussing nutrition with patients (29% vs 92%; p < 0.001), to feel familiar with the Mediterranean diet (54% vs. 97%; p < 0.001), and to understand the role of dietitians in patient care (37% vs. 93%; p < 0.001). CONCLUSIONS Culinary medicine shows promise as an impactful educational strategy among first-year medical students for increasing counseling confidence, promoting familiarity with evidence-based nutrition interventions, and augmenting understanding of the role of interprofessional engagement to address lifestyle-related disease.
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Affiliation(s)
- Emily Magallanes
- UT Southwestern School of Medicine, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Ahana Sen
- Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Milette Siler
- Moncrief Cancer Institute at UT Southwestern, 400 W. Magnolia Ave, Fort Worth, TX, 76104, USA
| | - Jaclyn Albin
- Departments of Pediatrics and Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
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26
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Yamada M, Sekine M, Tatsuse T, Fujimura Y. Lifestyle, psychological stress, and incidence of adolescent constipation: results from the Toyama birth cohort study. BMC Public Health 2021; 21:47. [PMID: 33407297 PMCID: PMC7789557 DOI: 10.1186/s12889-020-10044-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/10/2020] [Indexed: 12/28/2022] Open
Abstract
Background We aimed to clarify the predisposing factors for adolescent constipation in a longitudinal study, because while factors associated with childhood constipation have been reported, prospective studies on the incidence of constipation are lacking. Methods We enrolled 5540 adolescents aged 12 to 13 years from the Toyama Birth Cohort Study—a community-based prospective study examining children’s health. The incidence of constipation, defined as bowel movement frequency of less than once every 2 days, was surveyed during the three-year period from baseline (grade 4) to follow-up (grade 7). Multivariate logistic regression analyses were performed to explore the association between the incidence of adolescent constipation and their lifestyle variables. Results A total of 261 adolescents (4.7%) developed constipation during the three-year period. Female sex (odds ratio [OR] = 2.62,) overweight (OR = 0.60), and infrequent intake of fruits (OR = 1.50) at baseline were associated with the incidence of constipation. Furthermore, factors related to lifestyle changes and psychological status such as skipping breakfast (OR = 1.73), becoming physically inactive (OR = 1.55), and being persistently irritated (OR = 1.80) were significantly associated with the incidence of constipation. Conclusion Our prospective study demonstrated that female sex, insufficient fruit intake, and deteriorating lifestyles such as skipping breakfast and becoming inactive during the 3-year period were associated with the incidence of adolescent constipation. Beyond anecdotal, maintaining a healthy lifestyle is recommended to reduce the incidence of adolescent constipation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10044-5.
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Affiliation(s)
- Masaaki Yamada
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan. 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan. 2630 Sugitani, Toyama, 930-0194, Japan
| | - Takashi Tatsuse
- Department of Epidemiology and Health Policy, School of Medicine, University of Toyama, Toyama, Japan. 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yuko Fujimura
- Department of Community Medicine and Health Promotion, University of Toyama, Toyama, Japan. 2630 Sugitani, Toyama, 930-0194, Japan
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Rasmussen M, Hovhannisyan K, Adami J, Tønnesen H. Characteristics of Patients in Treatment for Alcohol and Drug Addiction Who Succeed in Changing Smoking, Weight, and Physical Activity: A Secondary Analysis of an RCT on Combined Lifestyle Interventions. Eur Addict Res 2021; 27:123-130. [PMID: 33080594 PMCID: PMC8006577 DOI: 10.1159/000510608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 07/07/2020] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Patients addicted to alcohol or drug often have additional unhealthy lifestyles, adding to the high mortality and morbidity in this patient group. Therefore, it is important to consider lifestyle interventions as part of the usual addiction treatment. OBJECTIVE The aim was to identify predictors of successful changes in lifestyle risk factors among patients in treatment for alcohol or drug addiction. METHODS We conducted a secondary analysis of a trial using a 6-week intensive integrated lifestyle intervention: The very integrated program (VIP). Patients were recruited in Addiction Centres Malmö and Psychiatry Skåne, Sweden. The primary outcome was successful changes in lifestyle, measured as quitting tobacco, exercising 30 min per day, and not being over- or underweight after 6 weeks and 12 months. RESULTS A total of 212 patients were included in the RCT, and 128 were included in this secondary analysis: 108 at 6 weeks and 89 at 12 months of follow-up. A total of 69 patients were respondents at both follow-ups. The follow-up rates were 51 and 42%, respectively. More education, having at least 2 lifestyle risk factors and having a high quality of life were predictors of a successful change in lifestyle after 6 weeks. After 12 months, the predictors for a successful outcome were having 3 or more risk factors, while an education level up to 3 years was a negative predictor. CONCLUSIONS Having several unhealthy lifestyles in addition to alcohol and drug addiction was a significant predictor of successful lifestyle changes in the short- and long term after the VIP for lifestyle interventions. Likewise, education was significant. The results should be considered in future development and research among this vulnerable group of patients.
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Affiliation(s)
- Mette Rasmussen
- Department of Health Sciences, Clinical Health Promotion Centre, WHO-CC, Lund University, Lund, Sweden,Clinical Health Promotion Centre, WHO-CC, The Parker Institute, University of Copenhagen, Copenhagen, Denmark,*Mette Rasmussen, Department of Health Sciences, Clinical Health Promotion Unit, WHO-CC, Lund University, Södra Förstadsgatan 35, SE–20502 Malmö (Sweden),
| | - Karen Hovhannisyan
- Clinical Health Promotion Centre, WHO-CC, The Parker Institute, University of Copenhagen, Copenhagen, Denmark
| | | | - Hanne Tønnesen
- Department of Health Sciences, Clinical Health Promotion Centre, WHO-CC, Lund University, Lund, Sweden,Clinical Health Promotion Centre, WHO-CC, The Parker Institute, University of Copenhagen, Copenhagen, Denmark
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28
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Iwasaki S, Shojaku H, Murofushi T, Seo T, Kitahara T, Origasa H, Watanabe Y, Suzuki M, Takeda N. Diagnostic and therapeutic strategies for Meniere's disease of the Japan Society for Equilibrium Research. Auris Nasus Larynx 2020; 48:15-22. [PMID: 33131962 DOI: 10.1016/j.anl.2020.10.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We provided diagnostic and therapeutic strategies for Meniere's disease in accordance with Japanese Clinical Practice Guideline of Meniere's disease and delayed endolymphatic hydrops 2nd ed. Tokyo: Kanehara Shuppan; 2020 edited by the Japan Society for Equilibrium Research. METHODS The Committee for Clinical Practice Guidelines was entrusted with a review of the scientific literature on the above topic. Clinical Questions (CQs) concerning the treatment for Meniere's disease were produced, and the literature according to each of them including CQ was searched. The recommendations are based on the literature review and the expert opinion of a subcommittee. RESULTS Diagnosis criteria of Meniere's disease are classified into Meniere's disease with typical cochlear and vestibular symptoms, and atypical Meniere's disease with either cochlear symptoms or vestibular symptoms. Treatment of Meniere's disease was composed of lifestyle changes, medications such as anti-vertigo drugs and diuretics, middle ear positive pressure treatment, and selective destruction of the vestibule. CONCLUSION Meniere's disease is diagnosed based on clinical histories and examination findings after processes of differential diagnosis. Treatment option of the disease should be selected in order of invasiveness, according to the severity of the disease and the response to each treatment.
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Affiliation(s)
- Shinichi Iwasaki
- Department of Otolaryngology & Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hideo Shojaku
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
| | - Toshihisa Murofushi
- Department of Otolaryngology, Teikyo University Hospital Mizonokuchi, Kawasaki, Japan
| | - Toru Seo
- Department of Otolaryngology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology- Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Hideki Origasa
- Department of Biostatistics and Clinical Epidemiology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yukio Watanabe
- Ohsawano Rehabilitation Facility for the Elderly Kagayaki, Toyama, Japan
| | - Mamoru Suzuki
- Department of Otolaryngology, Tokyo Medical University, Tokyo, Japan
| | - Noriaki Takeda
- Department of Otolaryngology, University of Tokushima School of Medicine, Tokushima, Japan
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Si A. Patterns in the transmission of traditional ecological knowledge: a case study from Arnhem Land, Australia. J Ethnobiol Ethnomed 2020; 16:52. [PMID: 32928240 PMCID: PMC7489046 DOI: 10.1186/s13002-020-00403-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The loss of traditional ecological knowledge in endangered language communities is a cause of concern worldwide. Given the state of current knowledge, it is difficult to say whether language and TEK transmission levels are correlated, i.e. whether the erosion of one is accompanied by erosion of the other. This case study, focusing on a small Indigenous language from northern Australia, represents a first step towards a systematic investigation of this question. METHODS Speakers of the language Kune (which is currently being transmitted to small children in the community) were asked to identify and name a number of common birds and plants known to occur on Kune traditional lands, through a series of audiovisual stimuli. RESULTS There was a weak correlation between speaker age and performance for the plant naming task, but not for the birds. Analysis of the ethnotaxa that were or were not named by individual participants showed that only a small number of plants and birds (approx. 13% and 7% respectively) were known to all participants, while many (approx. 30% and 26% respectively) could only be named by one participant, i.e. the oldest. Edible ethnotaxa were common among the plants and birds that could be named by many people. There was a tendency among younger speakers to use a single umbrella term to label similar-looking species from large genera, such as Acacia, whereas older people would have had distinct labels for each species. CONCLUSIONS Performance in the plant and bird naming tasks was lower than expected for a community where language transmission to younger generations is high. The loss of certain plant and bird names from the active lexicons of some younger Kune speakers may be due to lifestyle change, particularly in terms of food habits, or due to inter-individual differences in life histories. Differences between the transmission of plant and bird names may be due to more frequent interactions with edible plants, as compared to birds.
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Affiliation(s)
- Aung Si
- Institute for Linguistics, University of Cologne, 50923, Cologne, Germany.
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Maxwell-Smith C, Cohen PA, Platell C, Tan J, Saunders C, Nightingale S, Lynch C, Sardelic F, McCormick J, Hardcastle SJ. "To be there for my family" and "Keep my independence": Metropolitan and Non-Metropolitan Cancer Survivors' Health Behaviour Motives. Support Care Cancer 2020; 29:1969-1976. [PMID: 32827055 DOI: 10.1007/s00520-020-05690-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/14/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE Cancer survivors are at risk of comorbidities and mortality, and those living outside of metropolitan areas are particularly susceptible given poorer socioeconomic, health and support resources. As engagement in health behaviours is affected by participants' autonomous motives, investigation of the motives of cancer survivors in metropolitan and non-metropolitan areas could elucidate the values and reasons for practising health behaviours, allowing programs to be tailored to these motives. METHODS Metropolitan (n = 103) and non-metropolitan (n = 80) Australian cancer survivors completed a survey item by describing their motives for physical activity and healthy diet change. Inductive thematic analysis of responses was performed to establish themes across health behaviour motives. RESULTS Analyses revealed four themes: to be able to, longevity, psychological health and appearance. Survivors primarily referred to being able to enjoy family, leisure activities, travel and staying independent, with these motives often linked to longevity. Motives were similar across locations; however, those in non-metropolitan locations reported continuation of work and pain relief more frequently. Female survivors more often reported weight loss. CONCLUSIONS A predominant motive for health behaviour change in cancer survivors across geographical location was the ability to enjoy family and engage in leisure and work activities. Programs aiming to promote health behaviours in cancer survivors might consider framing interventions accordingly by emphasizing benefits of longevity and maintaining independence.
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Affiliation(s)
- Chloé Maxwell-Smith
- School of Psychology, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia. .,Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.
| | - Paul A Cohen
- St John of God Hospital, Subiaco, Western Australia, Australia.,Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Cameron Platell
- St John of God Hospital, Subiaco, Western Australia, Australia.,University of Western Australia Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | - Jason Tan
- Women Centre, West Leederville, Western Australia, Australia
| | - Christobel Saunders
- St John of God Hospital, Subiaco, Western Australia, Australia.,University of Western Australia Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | | | - Craig Lynch
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Frank Sardelic
- Tamara Private Hospital, Tamworth, New South Wales, Australia
| | | | - Sarah J Hardcastle
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.,School of Health and Human Performance, Dublin City University, Dublin, Ireland
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Hansen CB, Pavlovic KMH, Sondergaard J, Thilsing T. Does GP empathy influence patient enablement and success in lifestyle change among high risk patients? BMC Fam Pract 2020; 21:159. [PMID: 32770946 PMCID: PMC7415174 DOI: 10.1186/s12875-020-01232-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
Background Chronic lifestyle-related-diseases can be prevented by healthy lifestyle. Patients at high risk of disease may benefit from targeted health checks in general practice. However, general-practice-based-studies have shown that patient outcome, enablement, and well-being may be influenced by general practitioner (GP) empathy. The aim of this study is to investigate 1) how high risk patients evaluate their GPs’ empathy during a health check consultation, 2) whether the perceived GP empathy is associated with the patient’s enablement in immediate continuation of the health check consultation and 3) the patient’s subsequent lifestyle changes. Methods This study is part of a population based non-randomized feasibility study testing a complex intervention that systematically identifies citizens at high risk of lifestyle-related disease and with health-risk behavior and offers targeted preventive services in the Danish primary care sector. The ultimate aim of the intervention is to improve lifestyle and thereby reduce the risk of lifestyle-related disease. In the feasibility study a random sample of patients aged 30 to 59 years were invited to participate, and to fill in a questionnaire on lifestyle-risk factors. Participants deemed to be at high risk of disease were offered a focused clinical examination and a subsequent health check consultation at the GP. Following each health check consultation GP empathy and patient enablement were assessed using The Care Measure (CARE) and Patient Enablement Instrument (PEI). Patient’s perceived healthy-lifestyle change (y/n) was assessed after three months. The study has been approved by the Danish Data Protection Agency (J.nr 2015–57-0008) and registered at ClinicalTrial. Gov on June 13, 2016. Results Twenty-six GP’s participated in the study. Among 93 patients receiving a health check consultation 60 rated the GPs empathy. The median CARE-score was 40. The PEI median was 5.5 and 44.9% achieved a healthier lifestyle. No association was observed between GP empathy and patient enablement or a perceived healthier lifestyle. Conclusion No statistical significant association between the CARE-score and patient enablement or a perceived healthier lifestyle was observed. Our results contrast previous findings and may to some extent be explained by a small sample size and the selected high-risk group. Trial registration number NCT02797392.
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Affiliation(s)
- Caroline Braad Hansen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | | | - Jens Sondergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Trine Thilsing
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Sevild CH, Niemiec CP, Bru LE, Dyrstad SM, Husebø AML. Initiation and maintenance of lifestyle changes among participants in a healthy life centre: a qualitative study. BMC Public Health 2020; 20:1006. [PMID: 32586299 PMCID: PMC7318496 DOI: 10.1186/s12889-020-09111-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022] Open
Abstract
Background Since the early 2000s, Healthy Life Centres have been established in Norway to promote physical and mental health. Yet to date, little is known about the efficacy of Healthy Life Centres in promoting health behaviour change and maintenance or the factors that underlie these processes. Accordingly, the aim of the current study was to examine the factors that participants in a Healthy Life Centre perceive as relevant for the initiation and maintenance of lifestyle changes toward more physical activity and consumption of a healthier diet. Method Participants were purposely recruited from among adherers in a 12-month multi-method research project at a Healthy Life Centre. Individual, semi-structured interviews were conducted with 8 women and 6 men who were between the ages of 20 and 61 years old. Data were analysed using Systematic Text Condensation. Results Three main themes were derived from this analysis. The first theme focused on the motives behind initiation and maintenance of lifestyle changes along with the importance of a relationally supportive environment to promote perceived competence in pursuing a healthy lifestyle. The second theme focused on strategies for coping with the challenges and potential pitfalls that were associated with various unpleasant experiences and life events. The third theme focused on several specific skills that were helpful to the initiation and maintenance of lifestyle changes. Conclusion The current study enhanced an understanding of the initiation and maintenance of lifestyle changes, although these processes were not disentangled in participants’ experiences. In line with self-determination theory, the results suggested that lifestyle change is more likely to be initiated and maintained when goals are not only achievable but also regulated with autonomous motivation and of intrinsic value. Conversely, lifestyle change is difficult to maintain when motives are external to the self. Further, cognitive and behavioural skills were valuable and necessary in coping with unpleasant emotions. Finally, the critical function of self-regulation skills for making realistic plans and prioritizations in order to balance healthy lifestyle behaviours with the routines of “daily life” while monitoring outcomes was readily apparent. Healthy Life Centres can contribute to these processes in meaningful ways.
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Affiliation(s)
- Cille H Sevild
- Department of Public Health, University of Stavanger, Stavanger, Norway. .,Center for Health Promotion, Research Unit, Stavanger, Norway.
| | - Christopher P Niemiec
- Department of Public Health, University of Stavanger, Stavanger, Norway.,Department of Psychology, University of Rochester, Rochester, USA.,Centre for Learning Environment, University of Stavanger, Stavanger, Norway
| | - Lars Edvin Bru
- Centre for Learning Environment, University of Stavanger, Stavanger, Norway
| | - Sindre M Dyrstad
- Department of Public Health, University of Stavanger, Stavanger, Norway
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Ozemek C, Tiwari S, Sabbahi A, Carbone S, Lavie CJ. Impact of therapeutic lifestyle changes in resistant hypertension. Prog Cardiovasc Dis 2020; 63:4-9. [PMID: 31756356 DOI: 10.1016/j.pcad.2019.11.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 11/17/2019] [Indexed: 12/25/2022]
Abstract
Hypertensive individuals are at an increased risk of developing heart disease and stroke. Adopting healthy lifestyles, such as being active on ≥4 days per week, weight-loss in the presence of obesity, consuming a diet rich in fruits and vegetables, and sodium below the recommended threshold, avoiding high alcohol consumption and refraining from smoking have been effective lifestyle therapies to prevent or control stage 1 hypertension (HTN). Among the 1 in 3 Americans who have HTN (systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg), 16% are diagnosed with resistant HTN (RHT). Although there are comparatively fewer studies examining the blood pressure lowering effects of therapeutic lifestyle interventions in patients with resistant HTN, the available literature appears promising. This paper reviews key studies that quantify the blood pressure lowering effects of certain therapeutic lifestyles in patients with RHT and highlights areas needing more attention.
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Kugathasan TA, Lecot F, Laberge S, Tremblay J, Mathieu ME. Activate Your Health, a 3-year, multi-site, workplace healthy lifestyle promotion program: study design. BMC Public Health 2019; 19:1140. [PMID: 31426771 DOI: 10.1186/s12889-019-7393-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 11/11/2022] Open
Abstract
Background Workplace Health Promotion Programs (WHPP) have been shown to be an efficient way of improving workers’ health. These programs can be incorporated in the worker’s daily schedule and improve their productivity at work. Improving employees’ health also benefits the employers by increasing their return on investment and lowering healthcare costs. The Activate Your Health program, created by Capsana in 2015, is a WHPP targeting multiple lifestyle habits for a three-year period. This WHPP includes tailored web-based interventions and the support of different health professionals throughout the years. We hypothesize that this approach will yield long-term lifestyle changes. The objective of the current paper is to describe the Activate Your Health program’s design. Methods/design Eleven companies are taking part in this WHPP and had to choose among five different options of this program and all their employees were encouraged to participate. Each option differs by the number and type of interventions included. The limited option, which is considered the control group, only consists in completing a questionnaire regarding their health status, lifestyle habits and behaviors. On the other end, the extensive option receives a combination of multiple interventions: online menus, health challenges, support in creating a healthy work environment, coaching by health professionals (nurse, nutritionist, and kinesiologist), health screening and flexibility assessment, online resources, social health platform, and activity tracking. The remaining options are in between these options and vary by the amount of intervention. Baseline data are already gathered; two other data collection periods will take place after one and 2 years into the program. The primary outcomes of the current program are physical activity and fitness measures, nutritional data, smoking habits, stress and intention to change. Discussion The Activate Your Health program will allow us to compare which combinations of interventions are the most effective. It is expected that the extensive option will be the most advantageous to improve lifestyle habits. The results will indicate the strength and weakness of each intervention and how it could be improved. Trial registration Clinicaltrails.gov, registration number: NCT02933385 (updated on the 26th of March 2019, initially registered on the 5th of October 2016).
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Świątoniowska N, Sarzyńska K, Szymańska-Chabowska A, Jankowska-Polańska B. The role of education in type 2 diabetes treatment. Diabetes Res Clin Pract 2019; 151:237-246. [PMID: 31063855 DOI: 10.1016/j.diabres.2019.04.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/18/2019] [Accepted: 04/01/2019] [Indexed: 12/25/2022]
Abstract
Diabetes mellitus is a major and growing medical problem, affecting patients of all ages worldwide. Diabetes education is an important component of diabetes treatment. The goals of diabetes education include not only providing knowledge and skills, but also changing the patient's behavior, increasing their motivation to comply with therapeutic recommendations, improving their quality of life, establishing a partnership within the treatment process, preparing the patient for self-care, increasing their awareness of cardiovascular risk factors, and increasing their psychological resilience. The education process is affected by a number of factors, primarily the patient's psychological and socio-economic characteristics, as well as educator-related variables. Benefits of diabetes education are mainly observed in terms of patient self-care and metabolic control of diabetes.
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Affiliation(s)
- Natalia Świątoniowska
- Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland.
| | - Kathie Sarzyńska
- Student Research Club at the Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health Science, Wrocław Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland.
| | - Anna Szymańska-Chabowska
- Dept of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska Street, 50-556 Wroclaw, Poland.
| | - Beata Jankowska-Polańska
- Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 5 Bartla Street, 51-618 Wroclaw, Poland.
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Abouzari M, Abiri A, Djalilian HR. Successful treatment of a child with definite Meniere's disease with the migraine regimen. Am J Otolaryngol 2019; 40:440-442. [PMID: 30803806 DOI: 10.1016/j.amjoto.2019.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022]
Abstract
Emerging evidence suggests substantial overlap between the symptoms of Meniere's disease (MD) and migraine-related cochlear/vestibular disorders. We report a 5-year-old girl with a 6-month history of left-sided hearing loss followed by daily episodes of vertigo, headache, and vomiting who met the criteria for definite MD. The patient became symptom-free and gained near normal hearing levels after starting on a 6-week migraine diet/lifestyle regimen with riboflavin and magnesium. We believe that the symptoms of MD may be primarily due to a vestibular migraine phenomenon. Pediatric MD patients may benefit from migraine lifestyle/dietary changes with control of both cochlear and vestibular symptoms.
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Affiliation(s)
- Mehdi Abouzari
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA
| | - Arash Abiri
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA
| | - Hamid R Djalilian
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA; Department of Biomedical Engineering, University of California, Irvine, USA.
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Nogué M, Rambaud J, Fabre S, Filippi N, Jorgensen C, Pers YM. Long-term corticosteroid use and dietary advice: a qualitative analysis of the difficulties encountered by patient. BMC Health Serv Res 2019; 19:255. [PMID: 31027493 PMCID: PMC6486686 DOI: 10.1186/s12913-019-4052-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 03/31/2019] [Indexed: 12/23/2022] Open
Abstract
Background Nearly 1% of the population is currently treated with long-term corticosteroid therapy. When corticosteroids are introduced, information concerning potential adverse effects and recommendations for lifestyle changes aimed at preventing such effects is provided to patients. However, studies have shown patients often do not fully comprehend the information provided and have difficulty implementing the recommended dietary and physical activity advice. In this study, we aim to highlight the difficulties encountered by patients in comprehending and implementing recommendations in the context of long-term corticosteroid use. Such information can be used to better optimize care, particularly concerning adherence to the treatment, the diet, and thus improve the quality of life of patients. Methods We recruited adult patients under long-term corticosteroid (≥ 3 months, ≥ 5 mg/day) treatment from both general medicine and rheumatology practices. We performed a qualitative analysis based on semi-structured interviews of these patients. Transcripts of these interviews were then compiled and analysed using a thematic approach. Results Sixteen patients were included. Analysis of the interviews revealed that patients’ hope for effective corticosteroid treatment was counterbalanced by concerns over potential adverse effects. In some patients, the need to respect a strict and imposed diet induced psychological distress, potentially leading to eating disorders or fear of social exclusion. Furthermore, patient ambivalence toward the therapeutic education was highlighted, as well as the notion of filtering information, conscious or unconscious, as revealed by their lack of recall. The relationship with the physician also affected the treatment experience. Conclusion Our analysis of the personal experience of patients regarding recommended lifestyle changes associated with long-term corticosteroid treatment highlights patient difficulties and suggests different ways of improving therapeutic education. Electronic supplementary material The online version of this article (10.1186/s12913-019-4052-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Muriel Nogué
- Endocrinology therapeutic unit, Lapeyronie, University Hospital Lapeyronie, 371, avenue du doyen Gaston Giraud, 34295, Montpellier, France.
| | | | - Sylvie Fabre
- Mutualist Hospital Beau-Soleil, Montpellier, France
| | - Nathalie Filippi
- Clinical immunology and osteoarticular diseases therapeutic unit, Lapeyronie University Hospital, Montpellier, France
| | - Christian Jorgensen
- Clinical immunology and osteoarticular diseases therapeutic unit, Lapeyronie University Hospital, Montpellier, France
| | - Yves-Marie Pers
- Clinical immunology and osteoarticular diseases therapeutic unit, Lapeyronie University Hospital, Montpellier, France
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Deibert P, Lazaro A, Schaffner D, Berg A, Koenig D, Kreisel W, Baumstark MW, Steinmann D, Buechert M, Lange T. Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis. World J Gastroenterol 2019; 25:1116-1131. [PMID: 30862999 PMCID: PMC6406181 DOI: 10.3748/wjg.v25.i9.1116] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Non-alcoholic steatohepatitis (NASH) has become one of the leading causes of liver disease in the western world. In obese patients weight reduction is recommended. Up to now there are no specific guidelines for weight loss in order to reduce hepatic fat content.
AIM To investigate the effects of a 24-wk guided lifestyle intervention program compared to a meal replacement regimen based on soy protein.
METHODS Twenty-six subjects with NASH participated in a randomized single-center study. They were randomly assigned to either meal replacement group (MR-G) with soy-yogurt-honey preparation or to guided lifestyle change group (LC-G) with endurance activity and nutrition counselling. Serum alanine transaminase (ALT), aspartate transaminase (AST), lipid parameters, and adipokines were measured. Liver fat content and lipid composition were determined by magnetic resonance imaging and magnetic resonance spectroscopy. Body fat mass and lean body mass were assessed using Bod Pod® device. Pre- and post-intervention monitoring of parameters was performed. Statistical analyses were conducted with SPSS software, results were expressed as median (interquartile range).
RESULTS Twenty-two subjects (MR-G, n = 11 and LC-G, n = 11) completed the study (9 women, 13 men; age 52.1 (15.0) years, body mass index (BMI) 32.3 (3.3) kg/m²). In both groups a significant weight loss was achieved (MR-G: -6.4 (3.6) kg, P < 0.01; LC-G: -9.1 (10.4) kg, P < 0.01). BMI dropped in both groups (MR-G: -2.3 (1.5) kg/m2, P = 0.003; LC-G: -3.0 (3.4) kg/m2, P = 0.006). Internal fat and hepatic lipid content were markedly reduced in both groups in comparable amount. There was a strong correlation between reduction in liver fat and decrease in ALT. Likewise, both groups showed an improvement in glycemic control and lipid profile. Changes in adipokines, particularly in adiponectin and leptin were closely related to intrahepatic lipid changes.
CONCLUSION Comprehensive lifestyle intervention and meal replacement regimen have comparable effects on body and liver fat, as well as decrease in markers of hepatic inflammation among NASH patients.
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Affiliation(s)
- Peter Deibert
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Adhara Lazaro
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Denise Schaffner
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Aloys Berg
- Department of Nutrition, Institute for Sports and Sports Science, University of Freiburg, Freiburg D-79106, Germany
| | - Daniel Koenig
- Department of Nutrition, Institute for Sports and Sports Science, University of Freiburg, Freiburg D-79106, Germany
| | - Wolfgang Kreisel
- Faculty of Medicine, Department of Medicine, Division of Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Manfred W Baumstark
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Daniel Steinmann
- University Hospital of Freiburg, Occupational Medicine, Freiburg 79110, Germany
| | - Martin Buechert
- Faculty of Medicine, Department of Radiology - Medical Physics, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Thomas Lange
- Faculty of Medicine, Department of Radiology - Medical Physics, Medical Center, University of Freiburg, Freiburg D-79106, Germany
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Yarborough BJH, Stumbo SP, Cavese JA, Yarborough MT, Green CA. Patient perspectives on how living with a mental illness affects making and maintaining healthy lifestyle changes. Patient Educ Couns 2019; 102:346-351. [PMID: 30205919 PMCID: PMC6377329 DOI: 10.1016/j.pec.2018.08.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To understand the ways that mental health symptoms interfere with achieving health goals. METHODS Individuals with mental illness diagnoses and varying levels of preventive service use were recruited from federally qualified health centers and an integrated health care delivery system and interviewed. Thematic analysis was used to characterize descriptions of how mental illness experiences influenced lifestyle change efforts. RESULTS Three themes described patients' (n = 163) perspectives on barriers to making healthy lifestyle changes: 1) Thinking about making lifestyle changes is overwhelming for individuals already managing the burdens of mental illnesses; 2) Depression makes it difficult to care about a healthy future; and 3) When mental illness symptoms are not adequately treated unhealthy behaviors that provide relief are unlikely to be discontinued. Participants also made suggestions for improving health care delivery to facilitate positive behavior change. CONCLUSION Patients with mental illnesses need their clinicians to be empathic, help them envision a healthier future, address unmet mental health needs, and provide resources. PRACTICE IMPLICATIONS Primary care clinicians should encourage their patients with mental illnesses to make healthy lifestyle changes within the context of a supportive relationship. Lifestyle change can be overwhelming; clinicians should acknowledge progress and provide ongoing tangible support.
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Affiliation(s)
- Bobbi Jo H Yarborough
- Kaiser Permanente Northwest Center for Health Research, 3800 North Interstate Avenue, Portland, 97227, OR, USA.
| | - Scott P Stumbo
- Kaiser Permanente Northwest Center for Health Research, 3800 North Interstate Avenue, Portland, 97227, OR, USA
| | - Julie A Cavese
- Kaiser Permanente Northwest Center for Health Research, 3800 North Interstate Avenue, Portland, 97227, OR, USA
| | - Micah T Yarborough
- Kaiser Permanente Northwest Center for Health Research, 3800 North Interstate Avenue, Portland, 97227, OR, USA
| | - Carla A Green
- Kaiser Permanente Northwest Center for Health Research, 3800 North Interstate Avenue, Portland, 97227, OR, USA
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Gandhi S, Gurusamy J, Damodharan D, Ganesan V, Palaniappan M. Facilitators of healthy life style behaviors in persons with schizophrenia-A qualitative feasibility pilot study. Asian J Psychiatr 2019; 40:3-8. [PMID: 30658242 DOI: 10.1016/j.ajp.2019.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/01/2018] [Accepted: 01/07/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Persons with schizophrenia experience high rates of cardio metabolic disorders and have a 20-25% shorter life expectancy than the general population. Health professionals led life style modification behavior programs have shown improvements, in managing aspects of metabolic problems. This study sought to identify the life style modification by exploring (1) facilitators that help persons with schizophrenia to adopt the lifestyle modification behaviors and (2) factors that help to adhere to life style modification behaviors. METHODS A qualitative study utilizing face to face interviews was conducted for five persons (n = 5) diagnosed as schizophrenia (ICD 10) and their caregivers (n = 13) receiving inpatient mental health services in a tertiary level psychiatry centre, in South India. Qualitative data was collected, organized and analyzed with thematic analysis using ATLAS.ti software. RESULTS The study results identified four major themes as facilitators. (1) Factors of increased self- confidence, and personal development. (2) The need for social support and conducive environment; (3) level of self motivation (4) encouragement from health professional and availability of health services. Participants believed that engaging with programs of physical activity, dietary modification, and illness support from family would motivate them to live more healthily. CONCLUSION Individuals with serious mental illnesses such as schizophrenia encounter physical health related problems, facilitators of lifestyle change behavior help them to adhere to change in their routine life. Lifestyle change interventions also motivate individuals to eat healthy diet and exercise regularly to prevent premature mortality.
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Affiliation(s)
- Sailaxmi Gandhi
- Dept of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru
| | - Jothimani Gurusamy
- Dept of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru.
| | - Dinakaran Damodharan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru
| | | | - Marimuthu Palaniappan
- Dept of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru
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Haupt TH, Rasmussen LJH, Kallemose T, Ladelund S, Andersen O, Pisinger C, Eugen-Olsen J. Healthy lifestyles reduce suPAR and mortality in a Danish general population study. Immun Ageing 2019; 16:1. [PMID: 30679937 PMCID: PMC6343248 DOI: 10.1186/s12979-018-0141-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/17/2018] [Indexed: 12/20/2022]
Abstract
Background The plasma level of the inflammatory biomarker soluble urokinase plasminogen activator receptor (suPAR) is a strong predictor of disease development and premature mortality in the general population. Unhealthy lifestyle habits such as smoking or unhealthy eating is known to elevate the suPAR level. We aimed to investigate whether change in lifestyle habits impact on the suPAR level, and whether the resultant levels are associated with mortality. Results Paired suPAR measurements from baseline- and the 5-year visit of the population-based Inter99 study were compared with the habits of diet, smoking, alcohol consumption, and physical activity. Paired suPAR measurements for 3225 individuals were analyzed by linear regression, adjusted for demographics and lifestyle habits. Compared to individuals with a healthy lifestyle, an unhealthy diet, low physical activity, and daily smoking were associated with a 5.9, 12.8, and 17.6% higher 5-year suPAR, respectively. During 6.1 years of follow-up after the 5-year visit, 1.6% of those with a low suPAR (mean 2.93 ng/ml) died compared with 3.8% of individuals with a high suPAR (mean 4.73 ng/ml), P < 0.001. In Cox regression analysis, adjusted for demographics and lifestyle, the hazard ratio for mortality per 5-year suPAR doubling was 2.03 (95% CI: 1.22-3.37). Conclusion Lifestyle has a considerable impact on suPAR levels; the combination of unhealthy habits was associated with 44% higher 5-year suPAR values and the 5-year suPAR was a strong predictor of mortality. We propose suPAR as a candidate biomarker for lifestyle changes as well as the subsequent risk of mortality.
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Affiliation(s)
- Thomas Huneck Haupt
- 1Clinical Research Centre, Amager and Hvidovre Hospital, Hvidovre, Denmark.,2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Line Jee Hartmann Rasmussen
- 1Clinical Research Centre, Amager and Hvidovre Hospital, Hvidovre, Denmark.,2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Kallemose
- 1Clinical Research Centre, Amager and Hvidovre Hospital, Hvidovre, Denmark.,2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,3Department of Orthopedic Surgery, Amager and Hvidovre Hospital, Hvidovre, Denmark
| | - Steen Ladelund
- 1Clinical Research Centre, Amager and Hvidovre Hospital, Hvidovre, Denmark.,2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ove Andersen
- 1Clinical Research Centre, Amager and Hvidovre Hospital, Hvidovre, Denmark.,2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotta Pisinger
- 4Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.,5Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Eugen-Olsen
- 1Clinical Research Centre, Amager and Hvidovre Hospital, Hvidovre, Denmark.,2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Goldberg RB, Bray GA, Marcovina SM, Mather KJ, Orchard TJ, Perreault L, Temprosa M. Non-traditional biomarkers and incident diabetes in the Diabetes Prevention Program: comparative effects of lifestyle and metformin interventions. Diabetologia 2019; 62:58-69. [PMID: 30334082 PMCID: PMC6456055 DOI: 10.1007/s00125-018-4748-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/30/2018] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS We compared the associations of circulating biomarkers of inflammation, endothelial and adipocyte dysfunction and coagulation with incident diabetes in the placebo, lifestyle and metformin intervention arms of the Diabetes Prevention Program, a randomised clinical trial, to determine whether reported associations in general populations are reproduced in individuals with impaired glucose tolerance, and whether these associations are independent of traditional diabetes risk factors. We further investigated whether biomarker-incident diabetes associations are influenced by interventions that alter pathophysiology, biomarker concentrations and rates of incident diabetes. METHODS The Diabetes Prevention Program randomised 3234 individuals with impaired glucose tolerance into placebo, metformin (850 mg twice daily) and intensive lifestyle groups and showed that metformin and lifestyle reduced incident diabetes by 31% and 58%, respectively compared with placebo over an average follow-up period of 3.2 years. For this study, we measured adiponectin, leptin, tissue plasminogen activator (as a surrogate for plasminogen activator inhibitor 1), high-sensitivity C-reactive protein, IL-6, monocyte chemotactic protein 1, fibrinogen, E-selectin and intercellular adhesion molecule 1 at baseline and at 1 year by specific immunoassays. Traditional diabetes risk factors were defined as family history, HDL-cholesterol, triacylglycerol, BMI, fasting and 2 h glucose, HbA1c, systolic blood pressure, inverse of fasting insulin and insulinogenic index. Cox proportional hazard models were used to assess the effects of each biomarker on the development of diabetes assessed semi-annually and the effects of covariates on these. RESULTS E-selectin, (HR 1.19 [95% CI 1.06, 1.34]), adiponectin (0.84 [0.71, 0.99]) and tissue plasminogen activator (1.13 [1.03, 1.24]) were associated with incident diabetes in the placebo group, independent of diabetes risk factors. Only the association between adiponectin and diabetes was maintained in the lifestyle (0.69 [0.52, 0.92]) and metformin groups (0.79 [0.66, 0.94]). E-selectin was not related to diabetes development in either lifestyle or metformin groups. A novel association appeared for change in IL-6 in the metformin group (1.09 [1.021, 1.173]) and for baseline leptin in the lifestyle groups (1.31 [1.06, 1.63]). CONCLUSIONS/INTERPRETATION These findings clarify associations between an extensive group of biomarkers and incident diabetes in a multi-ethnic cohort with impaired glucose tolerance, the effects of diabetes risk factors on these, and demonstrate differential modification of associations by interventions. They strengthen evidence linking adiponectin to diabetes development, and argue against a central role for endothelial dysfunction. The findings have implications for the pathophysiology of diabetes development and its prevention.
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Affiliation(s)
- Ronald B Goldberg
- Division of Endocrinology, Diabetes and Metabolism, Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - George A Bray
- Clinical Obesity, Pennington Biomedical Research Center, Louisiana State University Medical Center, Baton Rouge, LA, USA
| | - Santica M Marcovina
- Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Northwest Lipid Research Labs, Seattle, WA, USA
| | - Kieren J Mather
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Trevor J Orchard
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Leigh Perreault
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marinella Temprosa
- Department of Epidemiology and Biostatistics, Biostatistics Center and Milken Institute School of Public Health, George Washington University, Rockville, MD, USA
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Ulian MD, Aburad L, da Silva Oliveira MS, Poppe ACM, Sabatini F, Perez I, Gualano B, Benatti FB, Pinto AJ, Roble OJ, Vessoni A, de Morais Sato P, Unsain RF, Baeza Scagliusi F. Effects of health at every size® interventions on health-related outcomes of people with overweight and obesity: a systematic review. Obes Rev 2018; 19:1659-1666. [PMID: 30261553 DOI: 10.1111/obr.12749] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/06/2018] [Accepted: 07/12/2018] [Indexed: 02/04/2023]
Abstract
CONTEXT The growing use of interventions based on the Health at Every Size® (HAES®) in obesity management. OBJECTIVE This study aimed to summarize the health-related effects of HAES®-based interventions on people with overweight and obesity. DATA SOURCES MEDLINE (via PubMed), EMBASE, Cochrane Library, LILACS, Google Scholar, OpenGrey and Grey Literature Report. STUDY SELECTION A systematic review of studies published until January 2017 reporting on HAES®-based randomized and non-randomized controlled trials in people with overweight and/or obesity. DATA EXTRACTION Fourteen papers met the inclusion criteria. The assessed studies included the following tests: blood profile, blood pressure, anthropometry, eating behaviour, energy intake, diet quality, psychological and qualitative evaluations. RESULTS The HAES® interventions benefited both the psychological and physical activity outcomes, besides promoting behavioural and qualitative changes in eating habits. On the other hand, the results regarding cardiovascular responses, body-image perception and total energy intake were inconsistent. CONCLUSIONS Despite improving the cardiovascular status, eating behaviours, quality of life and psychological well-being in participants, other large long-term clinical trials should be performed to establish the effectiveness of HAES®-based interventions in improving health for people with overweight and obesity. PROSPERO registration 2017: CRD42017054857.
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Affiliation(s)
- M D Ulian
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - L Aburad
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - M S da Silva Oliveira
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - A C M Poppe
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - F Sabatini
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - I Perez
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - B Gualano
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - F B Benatti
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,School of Applied Sciences, Universidade Estadual de Campinas, Limeira, Brazil
| | - A J Pinto
- Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - O J Roble
- Faculty of Physical Education, Universidade Estadual de Campinas, Campinas, Brazil
| | - A Vessoni
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - P de Morais Sato
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - R F Unsain
- Institute of Health and Society, Federal University of Sao Paulo, Santos, Brazil
| | - F Baeza Scagliusi
- School of Public Health, Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
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Nymberg P, Ekvall Hansson E, Stenman E, Calling S, Sundquist K, Sundquist J, Zöller B. Pilot study on increased adherence to physical activity on prescription (PAP) through mindfulness: study protocol. Trials 2018; 19:563. [PMID: 30333052 PMCID: PMC6192071 DOI: 10.1186/s13063-018-2932-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 09/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the Swedish population aged between 50 and 64 years only 7.1% reach the recommended level of physical activity. Physical activity on prescription (PAP) has been used in Sweden since the beginning of the twenty-first century with moderate adherence of approximately 50%. Mindfulness seems to affect motivation to and satisfaction with physical activity. The aim is to test the feasibility of a study in routine care; i.e. to test if mindfulness can improve adherence to PAP, measured by changes in physical activity. METHODS/DESIGN We will include 90 sedentary individuals, aged 40-65 years, from primary health care centres in Sweden. Individuals will be randomised to only PAP, mindfulness and PAP or mindfulness only. The PAP group will be based on patients' preferences. The mindfulness groups will meet once a week for 8 weeks and practise 20 min of individual training per day. There will not be any motivational interview or physical activity on prescription in the group assigned to only mindfulness. The participants will complete the Five Facet Mindfulness Questionnaire, the Insomnia Severity Index and also answer questions concerning their lifestyle. Physical activity will be measured by ACTi Graph GT1X activity monitor at baseline and after 3 and 6 months. Patients with a severe psychological disease, unstable angina or a recent myocardial infarction will be excluded. The main outcome will be adherence to PAP in an ordinary primary health care setting. In this pilot study, we will also evaluate measures such as the recruitment rate, number of dropouts and adherence to mindfulness practice. DISCUSSION This study is the first to explore the effect of mindfulness on adherence to PAP and test the feasibility of the study design. TRIAL REGISTRATION ClinicalTrials.gov, NCT02869854 . Registered on 26 August 2016.
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Affiliation(s)
- Peter Nymberg
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden.
| | - Eva Ekvall Hansson
- Department of Health Sciences, Division of Physiotherapy, Lund University, Baravägen 3, SE-221 00, Lund, Sweden
| | - Emelie Stenman
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Susanna Calling
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Kristina Sundquist
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Jan Sundquist
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
| | - Bengt Zöller
- Lund University/Region Skåne, Centre for Primary Health Care Research, Jan Waldenströmsgata 35, Skåne University Hospital Malmö, University Hospital, SE-205 02, Malmö, Sweden
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45
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Abstract
Objectives Use the Consolidated Framework for Implementation Research to describe the context in which a gestational weight gain (GWG) intervention, embedded within Parents as Teachers (PAT), will be implemented at PAT sites nationwide. Methods Ten site leaders and six parent educators from ten PAT sites in eight states participated in semi-structured interviews and a survey. Audio-recordings and systematic notes were used in a deductive analysis. Scales were descriptively analyzed. Results Surveys demonstrated positive perspectives of PAT+GWG. In interviews, participants described PAT+GWG filling a need for prenatal health education and confidence delivering this content, valued integration of PAT+GWG within the PAT curriculum, and recommended materials to meet their clients' needs. Conclusions Contextual information can help maximize PAT+GWG's impact.
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Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world affecting almost one-fourth of the population. It may progress to nonalcoholic steatohepatitis (NASH), cirrhosis, end-stage liver disease, and liver cancer in the long run. Besides, it may make the natural history in other chronic liver diseases worse too. Furthermore, patients of NAFLD more often suffer from metabolic syndrome, ischemic heart disease, and extrahepatic malignancies than others, leading to a lower overall survival than the general population. Obesity and sedentary lifestyle are among the most important risk factors for NAFLD apart from increasing age, male sex, and certain genetic factors. Due to the rising incidence, possible adverse consequences, and the futile available treatment options, prevention is the key to tackle this health menace. Spreading awareness, adopting a healthy lifestyle with appropriate dietary modifications, regular physical activity are the cornerstones for challenging this unfolding monster. How to cite this article: Nath P, Singh SP. Nonalcoholic Fatty Liver Disease: Time to Take the Bull by the Horns. Euroasian J Hepato-Gastroenterol 2018;8(1):47-51.
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Affiliation(s)
- Preetam Nath
- Department of Gastroenterology, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha India
| | - Shivaram P Singh
- Department of Gastroenterology, Srirama Chandra Bhanja Medical College & Hospital, Cuttack, Odisha, India
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Cheetham M, Van der Graaf P, Khazaeli B, Gibson E, Wiseman A, Rushmer R. "It was the whole picture" a mixed methods study of successful components in an integrated wellness service in North East England. BMC Health Serv Res 2018; 18:200. [PMID: 29566687 PMCID: PMC5863899 DOI: 10.1186/s12913-018-3007-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/14/2018] [Indexed: 11/11/2022] Open
Abstract
Background A growing number of Local Authorities (LAs) have introduced integrated wellness services as part of efforts to deliver cost effective, preventive services that address the social determinants of health. This study examined which elements of an integrated wellness service in the north east of England were effective in improving health and wellbeing (HWB). Methods The study used a mixed-methods approach. In-depth semi-structured interviews (IVs) were conducted with integrated wellness service users (n = 25) and focus groups (FGs) with group based service users (n = 14) and non-service users (n = 23) to gather the views of stakeholders. Findings are presented here alongside analysis of routine monitoring data. The different data were compared to examine what each data source revealed about the effectiveness of the service. Results Findings suggest that integrated wellness services work by addressing the social determinants of health and respond to multiple complex health and social concerns rather than single issues. The paper identifies examples of ‘active ingredients’ at the heart of the programme, such as sustained relationships, peer support and confidence building, as well as the activities through which changes take place, such as sports and leisure opportunities which in turn encourage social interaction. Wider wellbeing outcomes, including reduced social isolation and increased self-efficacy are also reported. Practical and motivational support helped build community capacity by encouraging community groups to access funding, helped navigate bureaucratic systems, and promoted understanding of marginalised communities. Fully integrated wellness services could support progression opportunities through volunteering and mentoring. Conclusions An integrated wellness service that offers a holistic approach was valued by service users and allowed them to address complex issues simultaneously. Few of the reported health gains were captured in routine data. Quantitative and qualitative data each offered a partial view of how effectively services were working.
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Affiliation(s)
- M Cheetham
- Health and Social Care Institute, Constantine Building, Teesside University, Middlesbrough, TS1 3BA, UK. .,Fuse (UKCRC Centre for Translational Research in Public Health), Newcastle University, Newcastle-upon-Tyne, NE2 4AX, UK.
| | - P Van der Graaf
- Health and Social Care Institute, Constantine Building, Teesside University, Middlesbrough, TS1 3BA, UK.,Fuse (UKCRC Centre for Translational Research in Public Health), Newcastle University, Newcastle-upon-Tyne, NE2 4AX, UK
| | - B Khazaeli
- Gateshead Council, Public Health Team, Gateshead, NE8 1NN, UK
| | - E Gibson
- Gateshead Council, Public Health Team, Gateshead, NE8 1NN, UK
| | - A Wiseman
- Gateshead Council, Public Health Team, Gateshead, NE8 1NN, UK
| | - R Rushmer
- Health and Social Care Institute, Constantine Building, Teesside University, Middlesbrough, TS1 3BA, UK.,Fuse (UKCRC Centre for Translational Research in Public Health), Newcastle University, Newcastle-upon-Tyne, NE2 4AX, UK
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48
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Widhalm K, Helk O, Pachinger O. The Viennese EDDY Study as a Role Model for Obesity: Prevention by Means of Nutritional and Lifestyle Interventions. Obes Facts 2018; 11:247-256. [PMID: 29966130 PMCID: PMC6103361 DOI: 10.1159/000481140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/24/2017] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Obesity in children and adolescents is a worldwide dramatic health problem, for which treatment is mostly unsuccessful. Therefore, prevention is the most important measure to tackle this problem. The 'EDDY' study as an interventional cohort study with a 1-year lifestyle intervention aimed to affect the lifestyle and nutrition habits of adolescents by intervention with nutritional training and sports programs to prevent obesity. METHODS Four Viennese schools were cluster-randomized into an intervention group and a control group. A total of 141 pupils aged 11-14 years were included. The intervention group received a comprehensive, age-appropriate training on nutrition and lifestyle exercise intervention for 12 months. Before and after intervention and at two follow-ups, subjects were anthropometrically measured. In addition, knowledge of nutritional issues and eating habits were measured with questionnaires. RESULTS The data imply an improvement of nutrition knowledge, a significant reduction in the consumption of junk food (p = 0.01), sweets (p = 0.001) and salty snacks (p < 0.001) as well as a slight improvement of physical performance after intervention. Although there was a trend for a less increase of body fat in the intervention group, no significant changes could have been shown in the anthropometric data. CONCLUSIONS An age-adjusted lifestyle intervention based on dietary training and exercise can improve the nutritional knowledge and eating habits of school children.
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Affiliation(s)
- Kurt Widhalm
- Austrian Institute for Clinial Nutrition, Vienna, Austria
- Medical University Vienna, Vienna, Austria
- *Univ.-Prof. Dr. Kurt Widhalm, Head of Austrian Academic Institute for Clinical Nutrition, Alserstraße 14/4a, 1090 Vienna, Austria,
| | - Oliver Helk
- Austrian Institute for Clinial Nutrition, Vienna, Austria
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Neumann A, Lindholm L, Norberg M, Schoffer O, Klug SJ, Norström F. The cost-effectiveness of interventions targeting lifestyle change for the prevention of diabetes in a Swedish primary care and community based prevention program. Eur J Health Econ 2017; 18:905-919. [PMID: 27913943 PMCID: PMC5533851 DOI: 10.1007/s10198-016-0851-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 11/21/2016] [Indexed: 05/25/2023]
Abstract
BACKGROUND Policymakers need to know the cost-effectiveness of interventions to prevent type 2 diabetes (T2D). The objective of this study was to estimate the cost-effectiveness of a T2D prevention initiative targeting weight reduction, increased physical activity and healthier diet in persons in pre-diabetic states by comparing a hypothetical intervention versus no intervention in a Swedish setting. METHODS A Markov model was used to study the cost-effectiveness of a T2D prevention program based on lifestyle change versus a control group where no prevention was applied. Analyses were done deterministically and probabilistically based on Monte Carlo simulation for six different scenarios defined by sex and age groups (30, 50, 70 years). Cost and quality adjusted life year (QALY) differences between no intervention and intervention and incremental cost-effectiveness ratios (ICERs) were estimated and visualized in cost-effectiveness planes (CE planes) and cost-effectiveness acceptability curves (CEA curves). RESULTS All ICERs were cost-effective and ranged from 3833 €/QALY gained (women, 30 years) to 9215 €/QALY gained (men, 70 years). The CEA curves showed that the probability of the intervention being cost-effective at the threshold value of 50,000 € per QALY gained was very high for all scenarios ranging from 85.0 to 91.1%. DISCUSSION/CONCLUSION The prevention or the delay of the onset of T2D is feasible and cost-effective. A small investment in healthy lifestyle with change in physical activity and diet together with weight loss are very likely to be cost-effective.
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Affiliation(s)
- Anne Neumann
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.
- Center of Evidence-Based Healthcare, University Hospital, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Lars Lindholm
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Margareta Norberg
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Olaf Schoffer
- Cancer Epidemiology, University Cancer Center, University Hospital, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Stefanie J Klug
- Cancer Epidemiology, University Cancer Center, University Hospital, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Fredrik Norström
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
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Copeland L, McNamara R, Kelson M, Simpson S. The development of a coding system to code planning talk within motivational interviewing. Patient Educ Couns 2017; 100:313-319. [PMID: 27637286 PMCID: PMC5332025 DOI: 10.1016/j.pec.2016.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 09/01/2016] [Accepted: 09/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Understanding mechanisms of motivational interviewing (MI) could improve practice. Planning is important for behavior change, and a component of MI. We aimed to develop a scale to measure planning talk within MI and explore the potential association between planning and weight loss maintenance (WLM). METHODS A literature review and thematic analysis was used to develop the coding system. Reliability was tested using MI examples and a transcript. It was applied to 50 sessions and associations between planning and WLM were analyzed using logistic and linear regression. RESULTS The coding system included: past, continuing, future and hypothetical plans and goal setting, varying on specificity and commitment. The percentage agreement was 86% and 75% for examples and transcript reliability respectively. Frequent planners, potentially decrease their weight 2.8kg(-9.7, 0.6) and BMI 1.2kg/m2(-3.1, 0.4) more compared to less frequent planners. Frequent goal setters increase their BMI(3.6kg/m2, 1.5, 5.7) and weight (9.5kg, 3.4, 15.6) compared to non-goal setters. CONCLUSION It is feasible to measure planning, with acceptable agreement. Limited conclusions for the potential associations were demonstrated. PRACTICE IMPLICATIONS This is the first scale to measure planning, an important aspect of MI which has received less attention.
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Affiliation(s)
- Lauren Copeland
- Division of Population Medicine, Cardiff University, School of Medicine, Cardiff, UK.
| | - Rachel McNamara
- South East Wales Trials Unit, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
| | - Mark Kelson
- South East Wales Trials Unit, Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
| | - Sharon Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, UK.
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