1
|
Bannigan K, Larkan NJ, Meurgue ERR, Sze JCH. Characteristics of Occupational Therapy Interventions to Promote Healthy Aging: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e55198. [PMID: 38498043 PMCID: PMC10985599 DOI: 10.2196/55198] [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: 12/05/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Healthy aging is a pressing public health priority. Focusing on what people do every day may be a meaningful approach to lifestyle change, suggesting a need for occupation therapy interventions to promote healthy aging. A preliminary database search was conducted, and no current or underway systematic or scoping reviews on the topic were identified. Developing an overview of studies of occupational therapy interventions to promote healthy aging is a necessary first step to understanding the existing knowledge and increasing the impact of future interventions. This scoping review will build on previously conducted reviews. OBJECTIVE This scoping review will identify the following: (1) what occupational therapy interventions exist for promoting healthy aging in community-dwelling adults? and (2) what are the intervention characteristics, their evaluated outcome, and the impact observed? METHODS This protocol was reviewed by 2 occupational therapists as part of a patient and public involvement consultation. The review will consider all studies and publications of occupational therapy focused on promoting healthy aging in community-dwelling adults who are aged 18 years and older. Databases to be searched are AMED, CINAHL, Cochrane Library, Embase, JBI EBP database, MEDLINE, OAlster, PsycINFO, PsycArticles, ProQuest Dissertations & Theses, ProQuest nursing and allied health source, PubMed, and Science Direct. Studies published in any language will be included. Titles and abstracts will be screened against the inclusion criteria using Covidence (Veritas Health Innovation). Potentially relevant studies will be retrieved in full and assessed against the inclusion criteria. No date limiters will be used. Study selection will be completed by 2 independent reviewers. Data will be extracted using a data extraction tool, including descriptive characteristics of the participants including age, sex, and socioeconomic status. Data will be charted using the TIDieR (Template for Intervention Description and Replication) checklist in alignment with the review objectives. The scoping review will be reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) statement. RESULTS The research began in October 2023, and the results are expected to be published in 2024. CONCLUSIONS This scoping review will produce valuable information about occupation-based interventions to promote healthy aging to support the development of an occupational therapy intervention. TRIAL REGISTRATION Open Science Framework 5k36d; https://osf.io/5k36d/. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55198.
Collapse
Affiliation(s)
- Katrina Bannigan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Nicole Jade Larkan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | | | - Jason Chun Hin Sze
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| |
Collapse
|
2
|
Kent-Marvick J, Gibson B, Bristol AA, St Clair S, Simonsen SE. Tailoring of Health-Promotion Video Messaging for Reproductive-Aged Women at Risk for Developing Cardiometabolic Disease: Qualitative Focus-Groups Study. JMIR Form Res 2024; 8:e52583. [PMID: 38441920 PMCID: PMC10951822 DOI: 10.2196/52583] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Targeting reproductive-aged women at high risk for type 2 diabetes (T2D) provides an opportunity for prevention earlier in the life course. A woman's experiences during her reproductive years may have a large impact on her future risk of T2D. Her risk is 7 to 10 times higher if she has had gestational diabetes (GDM). Despite these risks, T2D is preventable. Evidence-based programs, such as the National Diabetes Prevention Program (DPP), can reduce the risk of developing T2D by nearly 60%. However, only 0.4% of adults with prediabetes have participated in the DPP to date and reproductive-aged women are 50% less likely to participate than older women. In prior work, our team developed a mobile 360° video to address diabetes risk awareness and promote DPP enrollment among at-risk adults; this video was not designed, however, for reproductive-aged women. OBJECTIVE This study aims to obtain feedback from reproductive-aged women with cardiometabolic disease risk about a 360° video designed to promote enrollment in the DPP, and to gather suggestions about tailoring video messages to reproductive-aged women. METHODS Focus groups and a qualitative descriptive approach were used. Women with at least 1 previous pregnancy, aged 18 to 40 years, participated in one of three focus groups stratified by the following health risks: (1) a history of GDM or a hypertensive disorder of pregnancy, (2) a diagnosis of prediabetes, or (3) a BMI classified as obese. Focus-group questions addressed several topics; this report shared findings regarding video feedback. The 3 focus-group discussions were conducted via Zoom and were recorded and transcribed for analysis. Deductive codes were used to identify concepts related to the research question and inductive codes were created for novel insights shared by participants. The codes were then organized into categories and themes. RESULTS The main themes identified were positive feedback, negative feedback, centering motherhood, and the importance of storytelling. While some participants said the video produced a sense of urgency for health-behavior change, all participants agreed that design changes could improve the video's motivating effect on health-behavior change in reproductive-aged women. Participants felt a tailored video should recognize the complexities of being a mother and how these dynamics contribute to women's difficulty engaging in healthy behaviors without stirring feelings of guilt. Women desired a video with a positive, problem-solving perspective, and recommended live links as clickable resources for practical solutions promoting health behavior change. Women suggested using storytelling, both to describe how complications experienced during pregnancy impact long-term health and to motivate health behavior change. CONCLUSIONS Reproductive-aged women require tailored lifestyle-change messaging that addresses barriers commonly encountered by this population (eg, parenting or work responsibilities). Moreover, messaging should prioritize a positive tone that harnesses storytelling and human connection while offering realistic solutions.
Collapse
Affiliation(s)
| | - Bryan Gibson
- School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Alycia A Bristol
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Stephanie St Clair
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Sara E Simonsen
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| |
Collapse
|
3
|
Biresselioglu ME, Savas ZF, Demir MH, Kentmen-Cin C. Tackling climate change at the city level: insights from Lighthouse Cities' climate mitigation efforts. Front Psychol 2024; 14:1308040. [PMID: 38390402 PMCID: PMC10883078 DOI: 10.3389/fpsyg.2023.1308040] [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: 10/05/2023] [Accepted: 12/05/2023] [Indexed: 02/24/2024] Open
Abstract
Introduction The link between lifestyles and Greenhouse Gas (GHG) emissions has prioritized climate mitigation strategies of cities worldwide. As cities have increasingly generated GHG emissions by their industrial and transportation activities, their role in climate mitigation has gained prominence. Cities' climate mitigation policies to reduce the GHG intensity of their residents' daily lives are one of their significant efforts to tackle climate change. Lighthouse Cities (LCs), in particular, have emerged as remarkable actors in promoting lifestyle changes for their residents. Methods This study examines climate mitigation strategies of LCs of Climate CAMPAIGNers project, including Baku, Vilnius, Lahti, Izmir, Trujillo, Athens, Linz, Milan, Cape Town, Dublin, and Skopelos, addressing lifestyle changes by conducting an expert survey in 11 LCs involving 89 respondents. The findings of the expert survey are comparatively analyzed across 11 LCs. Results The results show that experts form Lighthouse Cities identify increasing awareness and information provision as a significant component of climate mitigation policies. Concerning lifestyle changes, strategies toward energy efficiency and sustainable mobility are highlighted as the primary areas to be prioritized. Discussion This study enhances the understanding of cities' capacity to reduce their residents' GHG emissions. The findings can be utilized to identify and tailor policies for supporting the Lighthouse Cities in their climate change mitigation efforts and provide pointers for selecting the lifestyle changes that can be promoted and prioritized in Lighthouse Cities.
Collapse
Affiliation(s)
| | - Zehra Funda Savas
- Sustainable Energy Division, Izmir University of Economics, Izmir, Türkiye
| | - Muhittin Hakan Demir
- Department of Logistics Management, Izmir University of Economics, Izmir, Türkiye
| | - Cigdem Kentmen-Cin
- Department of Political Science and International Relations, Izmir University of Economics, Izmir, Türkiye
| |
Collapse
|
4
|
Chan JKY, Vartanian LR. Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review. Obes Sci Pract 2024; 10:e741. [PMID: 38404933 PMCID: PMC10893879 DOI: 10.1002/osp4.741] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/08/2024] [Accepted: 02/04/2024] [Indexed: 02/27/2024] Open
Abstract
Objective Adherence to lifestyle changes after bariatric surgery is associated with better health outcomes; however, research suggests that patients struggle to follow post-operative recommendations. This systematic review aimed to examine psychological factors associated with adherence after bariatric surgery. Methods PubMed, PsycInfo, and Embase were searched (from earliest searchable to August 2022) to identify studies that reported on clinically modifiable psychological factors related to adherence after bariatric surgery. Retrieved abstracts (n = 891) were screened and coded by two raters. Results A total of 32 studies met the inclusion criteria and were included in the narrative synthesis. Appointment attendance and dietary recommendations were the most frequently studied post-operative instructions. Higher self-efficacy was consistently predictive of better post-operative adherence to diet and physical activity, while pre-operative depressive symptoms were commonly associated with poorer adherence to appointments, diet, and physical activity. Findings were less inconsistent for anxiety and other psychiatric conditions. Conclusions This systematic review identified that psychological factors such as mood disorders and patients' beliefs/attitudes are associated with adherence to lifestyle changes after bariatric surgery. These factors can be addressed with psychological interventions; therefore, they are important to consider in patient care after bariatric surgery. Future research should further examine psychological predictors of adherence with the aim of informing interventions to support recommended lifestyle changes.
Collapse
Affiliation(s)
- Jade K. Y. Chan
- School of PsychologyUNSW SydneySydneyNew South WalesAustralia
| | | |
Collapse
|
5
|
Park Y, King J, Eggleston MM, Elias TI. Critical Lessons in Tailoring Interventions: Listening to WISEWOMAN Participants. Am J Health Promot 2024; 38:90-100. [PMID: 37670568 DOI: 10.1177/08901171231200779] [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] [Indexed: 09/07/2023]
Abstract
PURPOSE To explore perspectives of participants in the WISEWOMAN program in Pennsylvania (PA-WISE) on challenges and facilitators of reducing cardiovascular disease risk as low-income and un-/under-insured middle-aged women. APPROACH Researchers conducted this 2 year qualitative data collection as one component of a broader, 5 year PA-WISE process and outcome evaluation. SETTING Women from across Pennsylvania, primarily from rural communities. PARTICIPANTS Interviewees were low-income, un-/under-insured women aged 40-64 years who had recently participated in PA-WISE-facilitated health coaching and lifestyle programs (HC/LSPs). METHODS – DATA COLLECTION AND ANALYSIS Researchers conducted individual telephone interviews with 38 women from four discrete samples of PA-WISE participants at 4 time points. Three researchers used grounded theory, and an iterative process of line-by-line coding, data display, and reanalysis to identify emerging themes, sub-themes, and their relationships. RESULTS Participants shared the important benefits of specific PA-WISE program traits. However, participants described significant financial constraints, difficult schedules, caregiving responsibilities, and insufficient social support as persistent challenges in their lives, making lifestyle changes in general, and program participation specifically, difficult. CONCLUSION The challenges that low-income and un-/under-insured women identified amplify the importance of having interventions that offer flexibility, options, and tailoring of supports and resources. The timeless challenges articulated by participants in this study completed just before the COVID-19 pandemic, remain relevant to be addressed through the pandemic and beyond.
Collapse
Affiliation(s)
- Yuae Park
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Jennifer King
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Molly M Eggleston
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Thistle I Elias
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| |
Collapse
|
6
|
Sammut R, Grech J, Polosa R, Campagna D, Di Ciaula A, Dugal T, Kenge A, Misra A, Abbas Raza S, Russo C, Somasundaram N, Walicka M, Phoung LD, Prezzavento GC, Casu M, La Rosa GRM, Caponnetto P. Behavioral Therapy for People With Diabetes Who Smoke: A Scoping Review. J Prim Care Community Health 2024; 15:21501319241241470. [PMID: 38654523 PMCID: PMC11041542 DOI: 10.1177/21501319241241470] [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: 02/12/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Tobacco smoking exacerbates diabetes-related complications; its prevalence is notwithstanding substantial. Persons with diabetes face a number of barriers and challenges to quitting such as multiple lifestyle restrictions; tailored interventions are required for smoking cessation. OBJECTIVE To identify research on behavioral interventions for smoking cessation in diabetes. METHODS Studies had to be randomized controlled trials, quasiexperimental or systematic reviews. The behavioral interventions included were: the 5As, Cognitive-Behavioral Therapy, Motivational Interviewing, Contingency Management, Health Coaching and Counselling, as compared to standard care. The outcomes were self-reported and/or biochemically verified smoking cessation. CINAHL Complete, MEDLINE Complete, the Cochrane databases of systematic reviews and randomized controlled trials, PsychInfo and PubMed Central were searched until July, 2023. Keywords used included diabetes, smoking cessation and each of the behavioral interventions included. RESULTS 1615 papers were identified. Three studies on the 5As/brief advice, 4 on Motivational Intervention and 1 on counseling were retained. The results on the 5As and Motivational Interviewing were conflicting. More intensive interventions appear to be more successful in achieving smoking cessation in smokers with diabetes. CONCLUSIONS Future research should focus on the continued development and evaluation of structured smoking cessation interventions based on the 5As, Motivational interviewing and Cognitive Behavioral Therapy.
Collapse
Affiliation(s)
| | | | | | | | | | - Tabinda Dugal
- Royal Cornwall Hospital NHS Trust, Treliske, Truro, UK
| | - Andre Kenge
- University of Cape Town, Cape Town, South Africa
| | - Anoop Misra
- Fortis C-DOC Centre for Excellence for Diabetes, Metabolic Disease and Endocrinology, New Delhi, India
| | - Syed Abbas Raza
- Shaukat Khanum Cancer Hospital and Research Centre, Peswhar, Khyber Pakhtunkhwa, Pakistan
| | - Cristina Russo
- Ashford and Saint Peter’s Hospitals NHS Foundation Trust, Cherstey, UK
| | | | - Magdalena Walicka
- Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- National Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | | | | | | | | | | |
Collapse
|
7
|
Diaz MJ, Tran JT, Montanez-Wiscovich M. From the Cochrane Library: Lifestyle changes for treating psoriasis. J Am Acad Dermatol 2024; 90:e35-e37. [PMID: 37717729 DOI: 10.1016/j.jaad.2023.09.023] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023]
Affiliation(s)
- Michael J Diaz
- College of Medicine, University of Florida, Gainesville, Florida.
| | - Jasmine T Tran
- School of Medicine, Indiana University, Indianapolis, Indiana
| | | |
Collapse
|
8
|
Afrin M, Khan SU, Das SC, Huq KATME, Moriyama M. Effectiveness of a Health Education Program for Patients Who Had a Stroke and Their Caregivers by Controlling Modifiable Risk Factors to Reduce Stroke Recurrence in a Tertiary Hospital in Bangladesh: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e51178. [PMID: 38100172 PMCID: PMC10757230 DOI: 10.2196/51178] [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: 07/24/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Stroke is a significant public health concern that causes severe and long-lasting disability. The recurrence of stroke is increasing due to lack of patients' knowledge and compliance with treatment to control modifiable risk factors and lifestyle changes. Health education can be an effective way to increase knowledge about behavioral changes in patients who had a stroke. OBJECTIVE The aim of this study is to evaluate the effectiveness of a health education program in Bangladesh for patients who had their first stroke and their family caregivers in order to reduce the recurrence of stroke by controlling modifiable risk factors. METHODS This is a parallel, open-label, prospective randomized controlled trial conducted at the National Institute of Neurosciences & Hospital in Dhaka, Bangladesh. We enrolled ≥18-year-old patients of both sexes who had a history of first stroke attack (transient ischemic attack, hemorrhagic stroke, lacunar stroke, atherothrombotic stroke, or cardioembolic stroke). We stratified patients into those aged <65 years and those aged ≥65 years and according to types of strokes for randomization. Our estimated sample size was 432. The intervention group receives face-to-face counseling on lifestyle modifications, blood pressure monitoring, and medication compliance-related health education during enrollment and monthly follow-ups. However, the control group receives only usual care from the hospital. The primary end point of this study is the reduction in the stroke recurrence rates at the end of the 12-month follow-up period. The secondary end points are to (1) assess the occurrence of all adverse events such as other cardiac events and all-cause mortality, (2) evaluate the status of the controlling modifiable risk factors such as blood pressure, glycated hemoglobin, and non-high-density lipoprotein cholesterol, (3) assess the knowledge related to stroke by using the investigator-developed questionnaire, (4) evaluate the lifestyle behavior related to stroke by using the investigator-developed questionnaire, (5) assess medication adherence, and (6) evaluate the quality of life of patients who had a stroke and their family caregivers. The evaluation points will be at baseline, 6 months, and 12 months for both groups. RESULTS Patients' enrollment started on October 2022, and follow-up will be completed in March 2024. A total of 432 participants were included in both the intervention (n=216) and control groups (n=216). This study was approved by the institutional review board and the ethics review board of the National Institute of Neurosciences & Hospital (IRB/NINSH/2022/151) on August 30, 2022. CONCLUSIONS Our health education program is expected to reduce the recurrence of stroke and improve the quality of life of patients who have had the first stroke. The results of this study will provide insights into the importance of health education for (self)-management and prevention of stroke. TRIAL REGISTRATION ClinicalTrials.gov NCT05520034; https://clinicaltrials.gov/ct2/show/NCT05520034. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51178.
Collapse
Affiliation(s)
- Mahabuba Afrin
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sharif Uddin Khan
- Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh
| | - Subir Chandra Das
- Department of Neurology, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh
| | - K A T M Ehsanul Huq
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michiko Moriyama
- Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
9
|
Azar KMJ, Sudat S, Huang Q, Pressman AP, Szwerinski NK, Nasrallah C, Venditti EM, Romanelli RJ. Examining paradoxical session attendance and weight loss relationships in a clinic based lifestyle modification intervention. Obes Sci Pract 2023; 9:641-652. [PMID: 38090689 PMCID: PMC10712409 DOI: 10.1002/osp4.696] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 02/01/2024] Open
Abstract
Objective Evaluations of lifestyle modification interventions (LMIs), modeled after the Diabetes Prevention Program, have repeatedly shown a dose-response relationship between session attendance and weight loss. Despite this, not all participants had "average" weight loss experiences. Nearly one-third of LMI participants experienced unexpected, paradoxical outcomes (i.e., high attendance with little weight loss, and low attendance with clinically significant weight loss). Paradoxical weight-loss outcomes were characterized based on session attendance among participants in a group-based LMI in a real-world healthcare setting. This group-based LMI was delivered over 1 year to participants with the possibility of attending up to 25 sessions total. Methods LMI participants identified in 2010-2017 from electronic health records were characterized as having low (<75%) or high (≥75%) session attendance. Weight-loss outcomes were defined as expected (≥5%, high-attendance; <5%, low-attendance) or paradoxical (≥5%, low-attendance; <5%, high-attendance). Paradoxical-outcome-associated characteristics were identified using logistic regression. Results Among 1813 LMI participants, 1498 (82.6%) had low and 315 (17.4%) high session attendance; 555 (30.6%) had paradoxical outcomes, comprising 415 (74.8%) responders (≥5% weight-loss) and 140 (25.2%) non-responders (<5% weight-loss). Among participants with high session attendance, paradoxical non-responders were more likely to be female (odds ratio [OR]: 2.76; 95% confidence interval [CI]: 1.32, 5.77) and have type 2 diabetes (OR: 3.32; 95% CI: 1.01, 10.95). Among low-attendance participants, paradoxical responders were more likely to be non-Hispanic White and less likely to be non-Hispanic Black (OR: 0.35; 95% CI: 0.18, 0.69), non-Hispanic Asian (OR: 0.40; 95% CI: 0.22, 0.73), or Hispanic (OR: 0.53; 95% CI: 0.35, 0.80). Conclusions In a healthcare setting, nearly one-third of LMI participants experienced paradoxical outcomes. More research is needed to understand the facilitators and barriers to weight loss above and beyond session attendance.
Collapse
Affiliation(s)
| | - Sylvia Sudat
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | - Qiwen Huang
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | - Alice P. Pressman
- Sutter HealthCenter for Health Systems ResearchPalo AltoCaliforniaUSA
| | | | | | - Elizabeth M. Venditti
- Department of Psychiatry & Department of EpidemiologyDiabetes Prevention Support CenterUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | |
Collapse
|
10
|
Cohen Rodrigues TR, Breeman LD, Kinik A, Reijnders T, Dusseldorp E, Janssen VR, Kraaijenhagen RA, Atsma DE, Evers AW. Effectiveness of Human-Supported and Self-Help eHealth Lifestyle Interventions for Patients With Cardiometabolic Risk Factors: A Meta-Analysis. Psychosom Med 2023; 85:795-804. [PMID: 37549197 PMCID: PMC10662612 DOI: 10.1097/psy.0000000000001242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/02/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE eHealth is a useful tool to deliver lifestyle interventions for patients with cardiometabolic diseases. However, there are inconsistent findings about whether these eHealth interventions should be supported by a human professional, or whether self-help interventions are equally effective. METHODS Databases were searched between January 1995 and October 2021 for randomized controlled trials on cardiometabolic diseases (cardiovascular disease, chronic kidney disease, type 1 and 2 diabetes mellitus) and eHealth lifestyle interventions. A multilevel meta-analysis was used to pool clinical and behavioral health outcomes. Moderator analyses assessed the effect of intervention type (self-help versus human-supported), dose of human support (minor versus major part of intervention), and delivery mode of human support (remote versus blended). One hundred seven articles fulfilled eligibility criteria and 102 unique ( N = 20,781) studies were included. RESULTS The analysis showed a positive effect of eHealth lifestyle interventions on clinical and behavioral health outcomes ( p < .001). However, these effects were not moderated by intervention type ( p = .169), dose ( p = .698), or delivery mode of human support ( p = .557). CONCLUSIONS This shows that self-help eHealth interventions are equally effective as human-supported ones in improving health outcomes among patients with cardiometabolic disease. Future studies could investigate whether higher-quality eHealth interventions compensate for a lack of human support.Meta-analysis registration: PROSPERO CRD42021269263 .
Collapse
|
11
|
Adam T, Al Sharif AI, Alamri TSM, Al-Nashri RAO, Alluwimi AIM, Samkri AY, Alharthi MA, Moafa AY, Alsaadi NA, Alraimi AMS, Alquzi RHM. The State of Cardiac Rehabilitation in Saudi Arabia: Barriers, Facilitators, and Policy Implications. Cureus 2023; 15:e48279. [PMID: 38058323 PMCID: PMC10695855 DOI: 10.7759/cureus.48279] [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] [Accepted: 11/04/2023] [Indexed: 12/08/2023] Open
Abstract
Cardiovascular disease (CVD) is a critical public health issue in Saudi Arabia, where it is the leading cause of death. The economic burden of CVD in the country is expected to triple by 2035, reaching $9.8 billion. This paper provides an overview of CVD in Saudi Arabia and its risk factors, impact on healthcare, and effects on patients' quality of life. The review emphasizes the potential of cardiac rehabilitation (CR) programs in addressing the CVD epidemic. CR programs have been shown to reduce morbidity, mortality, and hospital readmissions while improving patients' cardiovascular health and overall well-being. However, these programs are underutilized and inaccessible in Saudi Arabia. The paper highlights the urgent need for CR programs in the country and suggests key strategies for implementation. These include increasing patient referrals, tailoring programs to individual needs, enhancing patient education, and making CR accessible through home-based options. Fostering multidisciplinary collaboration and developing tailored guidelines for Arab countries can further enhance the impact of CR programs. In conclusion, this review underscores the vital importance of comprehensive CR programs in Saudi Arabia to combat the rising CVD burden, improve patient quality of life, and align with the goals of the Saudi 2030 Vision for a healthier society.
Collapse
Affiliation(s)
- Tasneem Adam
- Medical Affairs, College of Applied Medical Sciences, King Saud Medical City, Riyadh, SAU
| | - Abdullah I Al Sharif
- Healthcare Planning and Development, Ministry of Health, Kingdom of Saudi Arabia, Riyadh, SAU
- College of Medicine, Alfaisal University, Riyadh, SAU
| | | | - Rawan Ahmad O Al-Nashri
- General Practice, Primary Healthcare Center, General Directorate of Health Affairs, Aseer, SAU
| | | | - Amani Yosef Samkri
- General Practice, Al Aziziah Primary Health Care Center, Ministry of Health, Makkah, SAU
| | | | | | - Nawaf A Alsaadi
- Medical Affairs, College of Medicine, King Saud Medical City, Riyadh, SAU
| | | | | |
Collapse
|
12
|
Jacobson LT, Bakhache N, Dowling J, Okut H, Zackula R, Robbins DC, Stern JE, Grainger DA, Befort C. Electronic Monitoring of Mom's Schedule (eMOMS TM): A Qualitative Study of Experiences in a Lifestyle Change Program with Lactation Support. Am J Health Promot 2023; 37:953-963. [PMID: 37461383 DOI: 10.1177/08901171231189540] [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: 08/19/2023]
Abstract
PURPOSE To elicit feedback from participants who completed the eMOMSTM study, a feasibility randomized controlled trial (NCT04021602), on their perceptions of program strengths and weaknesses. STUDY DESIGN Qualitative - Semi-structured, telephone interview guide using open-ended questions. SETTING Rural Great Plains state, United States. PARTICIPANTS Of 26 individuals who completed the eMOMSTM study, 24 consented to an interview. METHOD Interviews were completed between October 2020 and May 2021. Audio-recordings were transcribed verbatim and organized in Microsoft 365. Data were analyzed using an exploratory, inductive thematic analysis. RESULTS Participants' mean age was 27.5 (± 5.4) years and mean pre-pregnancy BMI was 29.5 kg/m2 (± 2.7). The majority (71%) were non-Hispanic White and 54% had a high school education/some college. Based on specific areas of inquiry, the following themes emerged: convenience of online program access using Facebook, importance of health coach's support and online interaction, positivity toward improving one's health, increased consciousness of health behaviors, diverse lactation educational needs, importance of educational materials on depression, and grief over the loss of birth expectations during COVID-19. CONCLUSION Findings suggest participants' perceived value of a lifestyle change program coupled with lactation education and support delivered using social media. Findings inform future studies to further adapt lifestyle change programs.
Collapse
Affiliation(s)
- Lisette T Jacobson
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
- Department of Obstetrics and Gynecology, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Nathalie Bakhache
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Jolynn Dowling
- School of Nursing, Wichita State University, Wichita, KS, USA
| | - Hayrettin Okut
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
- University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Rosey Zackula
- University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - David C Robbins
- Diabetes Institute, University of Kansas Medical Center-Kansas City, Kansas City, KS, USA
| | - Judy E Stern
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Health and the Geisel School of Medicine, Lebanon, NH, USA
| | - David A Grainger
- Department of Obstetrics and Gynecology, University of Kansas School of Medicine-Wichita, Wichita, KS, USA
| | - Christie Befort
- Department of Population Health, University of Kansas School of Medicine-Kansas City, Kansas City, KS, USA
| |
Collapse
|
13
|
Hietbrink EAG, Oude Nijeweme-d'Hollosy W, Middelweerd A, Konijnendijk AAJ, Schrijver LK, Ten Voorde AS, Fokkema EMS, Laverman GD, Vollenbroek-Hutten MMR. A Digital Coach (E-Supporter 1.0) to Support Physical Activity and a Healthy Diet in People With Type 2 Diabetes: Acceptability and Limited Efficacy Testing. JMIR Form Res 2023; 7:e45294. [PMID: 37505804 PMCID: PMC10422172 DOI: 10.2196/45294] [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: 12/23/2022] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND A healthy lifestyle, including regular physical activity and a healthy diet, is increasingly part of type 2 diabetes (T2D) management. As many people with T2D have difficulty living and maintaining a healthy lifestyle, there is a need for effective interventions. eHealth interventions that incorporate behavior change theories and tailoring are considered effective tools for supporting a healthy lifestyle. The E-Supporter 1.0 digital coach contains eHealth content for app-based eHealth interventions and offers tailored coaching regarding physical activity and a healthy diet for people with T2D. OBJECTIVE This study aimed to assess the acceptability of E-Supporter 1.0 and explore its limited efficacy on physical activity, dietary behavior, the phase of behavior change, and self-efficacy levels. METHODS Over a span of 9 weeks, 20 individuals with T2D received daily motivational messages and weekly feedback derived from behavioral change theories and determinants through E-Supporter 1.0. The acceptability of the intervention was assessed using telephone-conducted, semistructured interviews. The interview transcripts were coded using inductive thematic analysis. The limited efficacy of E-Supporter 1.0 was explored using the Fitbit Charge 2 to monitor step count to assess physical activity and questionnaires to assess dietary behavior (using the Dutch Healthy Diet index), phase of behavior change (using the single-question Self-Assessment Scale Stages of Change), and self-efficacy levels (using the Exercise Self-Efficacy Scale). RESULTS In total, 5 main themes emerged from the interviews: perceptions regarding remote coaching, perceptions regarding the content, intervention intensity and duration, perceived effectiveness, and overall appreciation. The participants were predominantly positive about E-Supporter 1.0. Overall, they experienced E-Supporter 1.0 as a useful and easy-to-use intervention to support a better lifestyle. Participants expressed a preference for combining E-Supporter with face-to-face guidance from a health care professional. Many participants found the intensity and duration of the intervention to be acceptable, despite the coaching period appearing relatively short to facilitate long-term behavior maintenance. As expected, the degree of tailoring concerning the individual and external factors that influence a healthy lifestyle was perceived as limited. The limited efficacy testing showed a significant improvement in the daily step count (z=-2.040; P=.04) and self-efficacy levels (z=-1.997; P=.046) between baseline and postintervention. Diet was improved through better adherence to Dutch dietary guidelines. No significant improvement was found in the phase of behavior change (P=.17), as most participants were already in the maintenance phase at baseline. CONCLUSIONS On the basis of this explorative feasibility study, we expect E-Supporter 1.0 to be an acceptable and potentially useful intervention to promote physical activity and a healthy diet in people with T2D. Additional work needs to be done to further tailor the E-Supporter content and evaluate its effects more extensively on lifestyle behaviors.
Collapse
Affiliation(s)
- Eclaire A G Hietbrink
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente (ZGT), Almelo, Netherlands
| | | | - Anouk Middelweerd
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Annemieke A J Konijnendijk
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Office of Research and Innovation, Santeon, Utrecht, Netherlands
| | - Laura K Schrijver
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente (ZGT), Almelo, Netherlands
| | - Anouk S Ten Voorde
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Elise M S Fokkema
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Gozewijn D Laverman
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente (ZGT), Almelo, Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Board of Directors, Medisch Spectrum Twente (MST), Enschede, Netherlands
| |
Collapse
|
14
|
Beasley JM, Johnston EA, Sevick MA, Jay M, Rogers ES, Zhong H, Zabar S, Goldberg E, Chodosh J. Study protocol: BRInging the Diabetes prevention program to GEriatric Populations. Front Med (Lausanne) 2023; 10:1144156. [PMID: 37275370 PMCID: PMC10232977 DOI: 10.3389/fmed.2023.1144156] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/24/2023] [Indexed: 06/07/2023] Open
Abstract
In the Diabetes Prevention Program (DPP) randomized, controlled clinical trial, participants who were ≥ 60 years of age in the intensive lifestyle (diet and physical activity) intervention had a 71% reduction in incident diabetes over the 3-year trial. However, few of the 26.4 million American adults age ≥65 years with prediabetes are participating in the National DPP. The BRInging the Diabetes prevention program to GEriatric Populations (BRIDGE) randomized trial compares an in-person DPP program Tailored for Older AdulTs (DPP-TOAT) to a DPP-TOAT delivered via group virtual sessions (V-DPP-TOAT) in a randomized, controlled trial design (N = 230). Eligible patients are recruited through electronic health records (EHRs) and randomized to the DPP-TOAT or V-DPP-TOAT arm. The primary effectiveness outcome is 6-month weight loss and the primary implementation outcome is intervention session attendance with a non-inferiority design. Findings will inform best practices in the delivery of an evidence-based intervention.
Collapse
Affiliation(s)
- Jeannette M Beasley
- Department of Nutrition and Food Studies, New York University, New York, NY, United States
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Emily A Johnston
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Mary Ann Sevick
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
| | - Melanie Jay
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
- VA New York Harbor Healthcare System, Medicine Service, New York, NY, United States
| | - Erin S Rogers
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
| | - Hua Zhong
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
| | - Sondra Zabar
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Eric Goldberg
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Joshua Chodosh
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, Institute for Excellence in Health Equity, New York University, New York, NY, United States
- VA New York Harbor Healthcare System, Medicine Service, New York, NY, United States
| |
Collapse
|
15
|
Kwok ZCM, Tao A, Chan HYL. Effects of Health Coaching on Cardiometabolic Health in Middle-Aged Adults: A Systematic Review and Meta-analysis. Am J Health Promot 2023; 37:555-565. [PMID: 36322092 DOI: 10.1177/08901171221137332] [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] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To appraise and synthesize evidence on the effects of health coaching as the primary intervention on cardiometabolic health among middle-aged adults. DATA SOURCE Six electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, PubMed, and the Cochrane library) were searched from inception until July 2021. STUDY INCLUSION AND EXCLUSION CRITERIA Randomized controlled trials and controlled clinical trials published in English, reporting health coaching aimed to promote behavioral changes for improving cardiometabolic health among middle-aged adults were included. Studies on health coaching as secondary intervention were excluded. DATA EXTRACTION Two reviewers selected the articles, appraised the study quality, and extracted data independently. All kinds of outcomes related to cardiometabolic health, including health behaviors, psychological and physiological outcomes, were included. DATA SYNTHESIS Meta-analysis was performed if three or more studies reported the same outcomes. Narrative synthesis was performed if pooling of data for meta-analysis was not feasible. RESULTS Eight studies were reviewed. Most studies involved substantial risk of bias. The majority of the participants were women (99.1%). Meta-analysis showed a small but significant effect of health coaching on increasing physical activity (SMD = .34, 95% CI = .08-.60, p = .01, I2 = 0%); however, its effect on perceived barriers to physical activity and depressive symptoms was nonsignificant. Narrative synthesis yielded inconsistent results on diet, smoking, anxiety, goal achievement and self-efficacy for behavioral change, physiological outcomes, and metabolic syndrome severity, and nonsignificant effects on alcohol consumption, sleep quality, perceived benefits of physical activities, and cardiovascular symptoms. CONCLUSIONS Health coaching has significant effects on increasing physical activity among middle-aged adults; however, its effects on health behaviors and risk factors related to cardiometabolic health are inconclusive. Further efforts are warranted to examine how health coaching can improve cardiometabolic health among middle-aged adults.
Collapse
Affiliation(s)
- Zoe Ching-Man Kwok
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - An Tao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Helen Yue-Lai Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
16
|
Wittmann FG, Zülke A, Schultz A, Claus M, Röhr S, Luppa M, Riedel-Heller SG. Beneficial and Impeding Factors for the Implementation of Health-Promoting Lifestyle Interventions-A Gender-Specific Focus Group Study. Int J Environ Res Public Health 2023; 20:3520. [PMID: 36834215 PMCID: PMC9967898 DOI: 10.3390/ijerph20043520] [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] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: The prevalence of dementia increases and so does the number of interventions that address modifiable risk factors for dementia. Recent evidence suggests that there are gender differences in the prevalence of those lifestyle factors as well as in the effectiveness of interventions. This study aims to identify differences in factors that benefit or hinder the effectiveness of interventions since a target group's perspective gets more relevant. (2) Methods: Two focus groups, a female (n = 11) and a male (n = 8) group, were interviewed, audio recorded and transcribed. Qualitative analyses were performed and main- and subcategories were identified. (3) Results: Main differences were observed including aspects of lifestyle changes (e.g., respective diet and importance of an active lifestyle) and gender-typical behavior and perception by relevant healthcare actors. (4) Conclusions: Identified differences might help to address and raise the efficiency of lifestyle interventions. Further, the importance of social aspects and retirement as an auspicious moment to start interventions were identified as relevant by study participants.
Collapse
Affiliation(s)
- Felix G. Wittmann
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Andrea Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Adrian Schultz
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Mandy Claus
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
- Health and Ageing Research Team (HART), School of Psychology, Manawatū Campus, Massey University, Palmerston North 4474, New Zealand
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| |
Collapse
|
17
|
Shvedko AV, Versolker Y, Edelstein OE. Translation and Validation of the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) Questionnaire among the General Israeli Population. Int J Environ Res Public Health 2023; 20:2622. [PMID: 36767987 PMCID: PMC9915287 DOI: 10.3390/ijerph20032622] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The need to promote awareness of dementia prevention is broadly emphasized in Israel. Currently, there is no valid version of a Hebrew questionnaire to assess attitudes and beliefs related to dementia prevention. This study aimed to translate and validate the MCLHB-DRR questionnaire among the general Israeli population. METHODS A total sample of 328 participants between the ages of 50-83 years (mean = 58.7, SD = 6.9) were included in this study. Participants completed the online translated MCLHB-DRR questionnaire. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were conducted to assess the questionnaire's validity. Internal consistency was assessed using Cronbach's alpha. RESULTS The EFA analysis revealed a seven-factor model with 27 items. One item related to perceived barriers and two items related to perceived severity were deleted. The CFA analysis confirmed a good model fit with the deleted items (χ2/df = 2.146, CFI = 0.930, TLI = 0.916, RMSEA = 0.049). Cronbach's alpha values ranged from 0.61 to 0.92. CONCLUSIONS The Hebrew MCLHB-DRR questionnaire is a valid and reliable measurement tool for assessing attitudes and beliefs related to health behaviours and lifestyle changes for dementia risk reduction in Israeli adults over the age of 50.
Collapse
|
18
|
Raisi A, Piva T, Myers J, Zerbini V, Mandini S, Zappaterra T, Mazzoni G, Tonet E, Pavasini R, Campo G, Grazzi G, Visintin EP. Experience and Perceptions among Older Outpatients after Myocardial Infarction following an Exercise Intervention: A Qualitative Analysis from the PIpELINe Trial. Int J Environ Res Public Health 2023; 20:2196. [PMID: 36767563 PMCID: PMC9915135 DOI: 10.3390/ijerph20032196] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Traditional cardiac rehabilitation (CR) programs effectively improve physical performance and outcomes after myocardial infarction (MI). However, older patients are less likely to participate in such programs. The aim of this qualitative analysis was to investigate experiences and perceptions of cardiac outpatients enrolled in an innovative and exercise-based CR program and to identify possible barriers to improving adherence and quality of life. Semi-structured interviews were conducted on a sample of 31 patients (84% male; age 76 ± 6 years) from the Physical Activity Intervention in Elderly after Myocardial Infarction (PIpELINe) trial, after about six months of the event. Three main themes were identified: Personal feelings after the event; lifestyle change and perception of barriers; and relationships with familiars. Participants perceived sensations of fear at the time of their diagnosis and showed awareness of the importance of following specific health suggestions. They reported a significative change in previous habits and highlighted the need for periodic controls. Few of them felt insecure in carrying out daily activities or practicing exercise and reported an unnecessary protection from the family members. These findings will provide valuable insights for the development of a more feasible patient-centered CR model of intervention.
Collapse
Affiliation(s)
- Andrea Raisi
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Tommaso Piva
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Jonathan Myers
- Division of Cardiology, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
- Department of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Valentina Zerbini
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Simona Mandini
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
| | - Tamara Zappaterra
- Department of Humanities, University of Ferrara, 44121 Ferrara, Italy
| | - Gianni Mazzoni
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
- Public Health Department, AUSL Ferrara, 44121 Ferrara, Italy
| | - Elisabetta Tonet
- Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy
| | - Rita Pavasini
- Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy
| | - Giovanni Grazzi
- Center for Exercise Science and Sport, University of Ferrara, 44123 Ferrara, Italy
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, University of Illinois at Chicago, Chicago, IL 60612, USA
- Public Health Department, AUSL Ferrara, 44121 Ferrara, Italy
| | | |
Collapse
|
19
|
Kushniruk A, Middelweerd A, van Empelen P, Preuhs K, Konijnendijk AAJ, Oude Nijeweme-d'Hollosy W, Schrijver LK, Laverman GD, Vollenbroek-Hutten MMR. A Digital Lifestyle Coach (E-Supporter 1.0) to Support People With Type 2 Diabetes: Participatory Development Study. JMIR Hum Factors 2023; 10:e40017. [PMID: 36633898 PMCID: PMC9947918 DOI: 10.2196/40017] [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: 06/01/2022] [Revised: 09/29/2022] [Accepted: 11/20/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND A healthy lifestyle, including regular physical activity and a healthy diet, is becoming increasingly important in the treatment of chronic diseases. eHealth interventions that incorporate behavior change techniques (BCTs) and dynamic tailoring strategies could effectively support a healthy lifestyle. E-Supporter 1.0 is an eCoach designed to support physical activity and a healthy diet in people with type 2 diabetes (T2D). OBJECTIVE This paper aimed to describe the systematic development of E-Supporter 1.0. METHODS Our systematic design process consisted of 3 phases. The definition phase included the selection of the target group and formulation of intervention objectives, and the identification of behavioral determinants based on which BCTs were selected to apply in the intervention. In the development phase, intervention content was developed by specifying tailoring variables, intervention options, and decision rules. In the last phase, E-Supporter 1.0 integrated in the Diameter app was evaluated using a usability test in 9 people with T2D to assess intervention usage and acceptability. RESULTS The main intervention objectives were to stimulate light to moderate-vigorous physical activities or adherence to the Dutch dietary guidelines in people with T2D. The selection of behavioral determinants was informed by the health action process approach and theories explaining behavior maintenance. BCTs were included to address relevant behavioral determinants (eg, action control, self-efficacy, and coping planning). Development of the intervention resulted in 3 types of intervention options, consisting of motivational messages, behavioral feedback, and tailor-made supportive exercises. On the basis of IF-THEN rules, intervention options could be tailored to, among others, type of behavioral goal and (barriers to) goal achievement. Data on these variables could be collected using app data, activity tracker data, and daily ecological momentary assessments. Usability testing revealed that user experiences were predominantly positive, despite some problems in the fixed delivery of content. CONCLUSIONS The systematic development approach resulted in a theory-based and dynamically tailored eCoach. Future work should focus on expanding intervention content to other chronic diseases and lifestyle behaviors, enhancing the degree of tailoring and evaluating intervention effects on acceptability, use, and cost-effectiveness.
Collapse
Affiliation(s)
| | - Anouk Middelweerd
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Pepijn van Empelen
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | - Katharina Preuhs
- Department of Child Health, TNO (Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | | | | | - Laura K Schrijver
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Gozewijn D Laverman
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Department of Internal Medicine/Nephrology, Ziekenhuisgroep Twente, Almelo, Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Board of Directors, Medisch Spectrum Twente, Enschede, Netherlands
| |
Collapse
|
20
|
Webber BJ, Wheaton AG, Lu PJ, Whitfield GP. Joint Prevalence of Influenza Preventive Behaviors Among Adults-United States, 2020. J Prim Care Community Health 2023; 14:21501319231191681. [PMID: 37571833 PMCID: PMC10422917 DOI: 10.1177/21501319231191681] [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: 06/10/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION/OBJECTIVES The Centers for Disease Control and Prevention recognizes routine vaccination, sufficient sleep, and adequate physical activity as behavioral approaches to reduce the incidence of influenza. We aimed to determine the joint national prevalence of these health behaviors among U.S. adults, which has not been reported. METHODS We used the 2020 National Health Interview Survey to assess prevalence of receiving influenza vaccination in the past 12 months, obtaining sufficient sleep, and achieving adequate physical activity among U.S. adults (n = 30,312). We calculated the joint prevalence overall and by sociodemographic and health-related variables. RESULTS AND CONCLUSIONS The overall joint prevalence was 8.5% (95% CI, 8.0-9.0). Prevalence was lower among older persons (vs younger); Hispanic and non-Hispanic Black persons (vs non-Hispanic White); current and former smokers (vs never smokers); postpartum women (vs neither pregnant nor postpartum); and those with a history of coronary heart disease, hypertension, stroke, diabetes, and chronic obstructive pulmonary disease (vs not having those respective condition). In addition to recommending annual vaccination, primary care providers might encourage sufficient sleep and adequate physical activity-especially among patients who have increased risk for influenza complications and are less likely to achieve these behaviors.
Collapse
Affiliation(s)
- Bryant J. Webber
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anne G. Wheaton
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Peng-jun Lu
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Geoffrey P. Whitfield
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
21
|
Axén A, Taube E, Sanmartin Berglund J, Skär L. Loneliness in Relation to Social Factors and Self-Reported Health Among Older Adults: A Cross-Sectional Study. J Prim Care Community Health 2023; 14:21501319231198644. [PMID: 37698121 PMCID: PMC10498702 DOI: 10.1177/21501319231198644] [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: 07/27/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Loneliness is described as a public health problem and can be both a consequence of aging and a cause of ill health. Lonely older adults tend to have difficulties making new social connections, essential in reducing loneliness. Loneliness often varies over time, but established loneliness tends to persist. Maintaining good health is fundamental throughout the life course. Social connections change with aging, which can contribute to loneliness. AIM This study aimed to investigate loneliness in relation to social factors and self-reported health among older adults. METHOD A cross-sectional research design was used based on data from the Swedish National Study on Aging and Care, Blekinge (SNAC-B), from February 2019 to April 2021. Statistical analysis consisted of descriptive and inferential analysis. RESULTS Of n = 394 participants, 31.7% (n = 125) stated loneliness. Close emotional connections were necessary for less loneliness. Loneliness was more common among those who did not live with their spouse or partner and met more rarely. Furthermore, seeing grandchildren and neighbors less often increased loneliness, and a more extensive social network decreased loneliness. CONCLUSION This study underlined the importance of social connections and having someone to share a close, emotional connection with to reduce loneliness.
Collapse
Affiliation(s)
- Anna Axén
- Blekinge Institute of Technology, Karlskrona, Sweden
- Malmö University, Malmö, Sweden
| | | | | | - Lisa Skär
- Blekinge Institute of Technology, Karlskrona, Sweden
| |
Collapse
|
22
|
Chouhdry H, Villwock J. Patient Perspective on Adherence to Reflux Lifestyle Modifications: A Qualitative Study. J Prim Care Community Health 2023; 14:21501319231207320. [PMID: 37849281 PMCID: PMC10585988 DOI: 10.1177/21501319231207320] [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: 08/08/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Acid reflux disease is a common condition with recurrent symptoms affecting the quality of life of many Americans. Lifestyle/dietary modification is critical for management of acid reflux disease. Adherence to these recommendations is variable. The purpose of this study was to better understand the experience of patients with reflux disease (GERD/LPR) and explore factors that impact the integration of lifestyle modifications into their daily lives. METHODS Patient with diagnoses of GERD and/or LPR were recruited from an outpatient laryngology clinic and completed the Reflux Symptom Index (RSI) and a semi-structured interview. Interviews were transcribed and underwent thematic analysis. RESULTS Twenty-three patients-mean age and RSI of 61 and 16.1 respectively-were recruited. Four main themes emerged: (1) Care team interaction-focus and quality of physician counseling, useful educational handouts, dietician/nutritionist counseling; (2) Motivation to change-impact on symptom severity, avoiding undesired interventions, and poor health outcomes; (3) Implementing lifestyle changes; and (4) Impact of disease on patient. No patient had seen a dietician. Patients who experienced dietary counseling for other conditions felt reflux-specific counseling with a dietician would be beneficial. While patients found educational material on diet to be helpful, lists of foods to avoid were discouraging; providing a positive list of preferred foods may be more helpful. CONCLUSION Lifestyle modification counseling should incorporate multiple aspects of the patient experience. Patients desire information regarding medication side effects. Educational handouts should include prioritized list of recommended dietary restrictions and acceptable/alternative food options. Referral for dedicated dietician counseling can also be considered to increase understanding of the importance of, and adherence to, lifestyle modification.
Collapse
Affiliation(s)
- Hira Chouhdry
- University of Kansas School of Medicine, Kansas City, KS, USA
| | | |
Collapse
|
23
|
Sijangga MO, Pack DV, Yokota NO, Vien MH, Dryland ADG, Ivey SL. Culturally-tailored cookbook for promoting positive dietary change among hypertensive Filipino Americans: a pilot study. Front Nutr 2023; 10:1114919. [PMID: 37153920 PMCID: PMC10157645 DOI: 10.3389/fnut.2023.1114919] [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: 12/03/2022] [Accepted: 03/31/2023] [Indexed: 05/10/2023] Open
Abstract
Introduction Among all Asian American subgroups, Filipino-Americans have consistently been shown to have the highest rates of hypertension, raising risks of heart attack and stroke. Despite this alarming fact, little has been done to investigate culturally-sensitive interventions to control hypertension rates in this vulnerable population. To address the lack of culturally-relevant lifestyle options for blood pressure management currently available to the Filipino community, this exploratory pilot study used a design thinking approach informed by culinary medicine to develop a culturally-tailored, heart-healthy, and low sodium recipe cookbook for Filipino Americans with hypertension and evaluate its feasibility as a hypertension intervention. Methods Our team developed a cookbook using participatory methods and design thinking, utilizing input from five Filipino culinary experts and a Registered Dietitian. The cookbook incorporates traditional Filipino recipes, excerpts from community members' interviews, and nutrient analyses. Twenty Filipinx-identifying individuals* who self-reported physician-diagnosed hypertension were recruited from Filipino community-based organizations, enrolled into this study, provided with the cookbook, and asked to cook at least one recipe. Pre- and post-intervention surveys were conducted and centered around behavior change and features of the cookbook. Results This study provided evidence for the cookbook's acceptability and feasibility, with participants' open-ended responses revealing that the recipes, nutrition labels, illustrations, and cultural aspects of the cookbook increased motivation to achieve dietary change, including reducing sodium in their diet to improve their blood pressure. Participant responses also indicated positive behavior change as a result of using the cookbook, with participants reporting increased likelihood of adopting recommended actions to lower their BP after utilizing the cookbook ( x ¯ = 80.83%), compared to before ( x ¯ = 63.75%, p < 0.008), according to Hypertension Self-Care Management scaled scores. Discussion In conclusion, the results of this pilot study demonstrated acceptability of this unique cookbook and provide preliminary findings consistent with increased motivation in participants to make dietary changes and improve personal health, drawing attention to the importance of considering future culturally-tailored health interventions. Next steps should include a robust, randomized controlled trial design comparing measured blood pressure outcomes of an intervention vs. control group. *Filipinx is an inclusive term representing the gender identities of all participants in our study.
Collapse
|
24
|
Morris M, Halcomb E, Mansourian Y, Bernoth M. Understanding how general practice nurses support adult lifestyle risk reduction: An integrative review. J Adv Nurs 2022; 78:3517-3530. [PMID: 35775138 PMCID: PMC9796034 DOI: 10.1111/jan.15344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/02/2021] [Revised: 05/18/2022] [Accepted: 06/16/2022] [Indexed: 12/30/2022]
Abstract
AIM To review the literature exploring how general practice nurses support lifestyle risk reduction. DESIGN Integrative literature review. SOURCES CINAHL, Emcare, MEDLINE, Proquest and Scopus were searched for peer-reviewed primary research published in English from 2010 to 2022. METHODS Sixteen papers met the inclusion criteria and were assessed for methodological quality using the Mixed Methods Appraisal Tool. Findings were extracted and thematically analysed. RESULTS Four themes described general practice nurses: (1) Establishing relational connections; (2) Empowering active participation; (3) Engaging mutual motivation and (4) Enabling confident action. General practice nurses used complex interpersonal, risk communication and health coaching skills to build collaborative partnerships that supported patients' self-determination and self-efficacy. While mutual motivation and confidence were reciprocally enabling, gaps in skills, experience and knowledge plus time, resource and role constraints limited general practice nurses' ability to support lifestyle risk reduction. CONCLUSION General practice nurses play a key role in lifestyle risk reduction. Ongoing education, funding, organizational and professional support are needed to enhance their commitment, confidence and capacity. IMPACT What problem did the study address? While general practice nurses play a key role in health promotion and risk reduction, their potential is yet to be fully realized. Research examining methods by which nurses working in general practice support lifestyle risk reduction is limited. What were the main findings? Successful interactions depended on personal, professional, organisational and systemic factors which either enhanced or inhibited relational quality, shared decision-making, mutual commitment, and nurses' confidence and capacity to address lifestyle risks. Targeted professional development and peer mentoring are needed to build proficient practice. Where and on whom will the research have impact? Understanding how general practice nurses support risk reduction can inform policy and identify training and support needs to advance their skills and role. Research exploring synergies between themes may illuminate this process.
Collapse
Affiliation(s)
- Maksi Morris
- School of Nursing, Paramedicine and Healthcare Sciences, Faculty of ScienceCharles Sturt UniversityWagga WaggaNSWAustralia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & HealthUniversity of Wollongong, Illawarra Health & Medical Research InstituteWollongongNSWAustralia
| | - Yazdan Mansourian
- School of Information and Communication Studies, Faculty of Arts and EducationCharles Sturt UniversityWagga WaggaNSWAustralia
| | - Maree Bernoth
- School of Nursing, Paramedicine and Healthcare Sciences, Faculty of ScienceCharles Sturt UniversityWagga WaggaNSWAustralia
| |
Collapse
|
25
|
Oblak T, Vidnar N, Pribaković Brinovec R. Integrated Primary Care and Public Health: A Case Study of Multidisciplinary Rehabilitation and Lifestyle Intervention in Persons With Post-COVID-19 Condition. Int J Public Health 2022; 67:1605287. [PMID: 36387291 PMCID: PMC9649427 DOI: 10.3389/ijph.2022.1605287] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Teja Oblak
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia,*Correspondence: Teja Oblak, ; Nataša Vidnar, ; Rade Pribaković Brinovec,
| | - Nataša Vidnar
- Community Health Centre Adolf Drolc Maribor, Maribor, Slovenia,*Correspondence: Teja Oblak, ; Nataša Vidnar, ; Rade Pribaković Brinovec,
| | - Rade Pribaković Brinovec
- Centre for Promotion and Prevention Programme Management, National Institute of Public Health, Ljubljana, Slovenia,*Correspondence: Teja Oblak, ; Nataša Vidnar, ; Rade Pribaković Brinovec,
| |
Collapse
|
26
|
Olusan AA, Barr S, Cobain M, Whelan H. The Development and Evaluation of "Life Age"-a Primary Prevention and Population-Focused Risk Communication Tool: Feasibility Study With a Single-Arm Repeated Measures Design. JMIR Form Res 2022; 6:e37385. [PMID: 36279163 PMCID: PMC9641510 DOI: 10.2196/37385] [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: 02/18/2022] [Revised: 09/15/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Communicating cardiovascular risk to the general population requires forms of communication that can enhance risk perception and stimulate lifestyle changes associated with reduced cardiovascular risk. OBJECTIVE The aim of this study was to evaluate the motivational potential of a novel lifestyle risk assessment ("Life Age") based on factors predictive of both premature mortality and psychosocial well-being. METHODS A feasibility study with a single-arm repeated measures design was conducted to evaluate the potential efficacy of Life Age on motivating lifestyle changes. Participants were recruited via social media, completed a web-based version of the Life Age questionnaire at baseline and at follow-up (8 weeks), and received 23 e-newsletters based on their Life Age results along with a mobile tracker. Participants' estimated Life Age scores were analyzed for evidence of lifestyle changes made. Quantitative feedback of participants was also assessed. RESULTS In total, 18 of 27 participants completed the two Life Age tests. The median baseline Life Age was 1 year older than chronological age, which was reduced to -1.9 years at follow-up, representing an improvement of 2.9 years (P=.02). There were also accompanying improvements in Mediterranean diet score (P=.001), life satisfaction (P=.003), and sleep (P=.05). Quantitative feedback assessment indicated that the Life Age tool was easy to understand, helpful, and motivating. CONCLUSIONS This study demonstrated the potential benefit of a novel Life Age tool in generating a broad set of lifestyle changes known to be associated with clinical risk factors, similar to "Heart Age." This was achieved without the recourse to expensive biomarker tests. However, the results from this study suggest that the motivated lifestyle changes improved both healthy lifestyle risks and psychosocial well-being, consistent with the approach of Life Age in merging the importance of a healthy lifestyle and psychosocial well-being. Further evaluation using a larger randomized controlled trial is required to fully evaluate the impact of the Life Age tool on lifestyle changes, cardiovascular disease prevention, and overall psychosocial well-being.
Collapse
Affiliation(s)
- Adeogo Akinwale Olusan
- Department of Cardiology, Belfast Health and Social Care (HSC) Trust, Belfast, United Kingdom
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Suzanne Barr
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Mark Cobain
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Younger Lives Limited, London, United Kingdom
| | - Holly Whelan
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Younger Lives Limited, London, United Kingdom
| |
Collapse
|
27
|
Turki S, Bouzekri K, Trabelsi T, El Ati J. Assessment of Mediterranean Diet Adherence and Lifestyle Change during COVID-19 National Lockdown in Tunisian Adult Population. Nutrients 2022; 14:nu14194151. [PMID: 36235802 PMCID: PMC9572866 DOI: 10.3390/nu14194151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/12/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
The Mediterranean diet (MD) is a plant-based diet associated with a reduction in the risk of developing COVID-19 comorbidities. Lockdown instigation during the COVID-19 pandemic has affected eating habits and lifestyles, highlighting the need to analyze the healthiness of new consumption patterns. We conducted a survey to assess lifestyle change in Tunisian adults and their MD adherence. A total of 1082 respondents completed a self-administered online survey designed to assess their food and lifestyle habits. Poor overall adherence to MD was observed (mean MEDAS score 6.6, SD 1.07) in a preponderance of the mid-MD adherent subgroup (71.2% of the participants). Location, age, profession, and household welfare proxy were the main determinants of high MD adherence. When adjusting for sociodemographic variables, location and income remained statistically significant. Positive health outcomes were noticed in respondents with high MEDAS scores. Most importantly, binary logistic regression showed that risk of COVID-19 infection decreased as MEDAS score increased for unvaccinated obese participants (OR = 0.63; confidence interval (CI) 0.4–0.98; p = 0.045). Regarding lifestyle changes, confinement had contributed to an overall reduction in cigarette consumption, sleeping hours, and physical activity. Long-term consequences of these changes on health outcomes must be further explored.
Collapse
Affiliation(s)
- Saoussen Turki
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia
- High Institute of Medical Technologies, University Tunis El Manar, 9, Rue Docteur Zouheïr Safi, Tunis 1006, Tunisia
- Correspondence: ; Tel.: +216-25-151789; Fax: +216-71-570725
| | - Khaoula Bouzekri
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia
- High Institute of Medical Technologies, University Tunis El Manar, 9, Rue Docteur Zouheïr Safi, Tunis 1006, Tunisia
| | - Tarek Trabelsi
- INNTA (National Institute of Nutrition and Food Technology), 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia
| | - Jalila El Ati
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia
- INNTA (National Institute of Nutrition and Food Technology), 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia
| |
Collapse
|
28
|
Kodani N, Ohsugi M. The patient-centered diabetes management during the COVID-19 pandemic. Glob Health Med 2022; 4:210-215. [PMID: 36119784 PMCID: PMC9420329 DOI: 10.35772/ghm.2022.01031] [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: 03/25/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
Since December 2019, in the fight against the coronavirus disease 2019 (COVID-19) pandemic, we observed that glycemic control in people with diabetes is easily affected by lifestyle changes. To maintain a good health condition, a patient-centered approach with mental support and close monitoring is required. For these, telemedicine and online continuous glucose monitoring (CGM), are effective systems. Therefore, based on our experience during the two-year period, we reviewed the literature for appropriate actions required for the management of diabetes to prevent COVID-19 infection and avoid unfavorable outcomes in COVID-19 cases. Once infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is a high risk of a poor prognosis in patients with diabetes. Glucocorticoid therapy in severe COVID-19 cases leads to further hyperglycemia. Since good glycemic control has been shown to improve outcomes, strict glycemic control using CGM is recommended. Using CGM data, insulin can be adequately titrated without causing hypoglycemia, and remote data monitoring can reduce the risk of infection for health care professionals, by reducing the frequency of patient contact. Among patients with COVID-19, some are found to have newly-diagnosed diabetes at admission. Those newly diagnosed patients present with a higher risk of poor prognosis compared to those with pre-existing diabetes. Therefore, glycemic status should be evaluated in all patients with COVID-19 admitted to hospitals.
Collapse
Affiliation(s)
- Noriko Kodani
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuru Ohsugi
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
29
|
Christensen JR, Laursen DH, Lauridsen JT, Hesseldal L, Jakobsen PR, Nielsen JB, Søndergaard J, Brandt CJ. Reversing Type 2 Diabetes in a Primary Care-Anchored eHealth Lifestyle Coaching Programme in Denmark: A Randomised Controlled Trial. Nutrients 2022; 14:nu14163424. [PMID: 36014930 PMCID: PMC9414066 DOI: 10.3390/nu14163424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/13/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 12/12/2022] Open
Abstract
The goal of this trial was to investigate whether an eHealth lifestyle coaching programme led to significant weight loss and decreased Haemoglobin A1c (HbA1c) in patients with type 2 diabetes. In an RCT, 170 patients were enrolled from 2018 to 2019 for intervention or control. Inclusion criteria were diagnosed with type 2 diabetes, BMI 30−45 kg/m2, and aged 18−70 years. Exclusion criteria were lacks internet access, pregnant or planning a pregnancy, or has a serious disease. Primary and secondary outcomes were a reduction in body weight and HbA1c. At six months, 75 (75%) patients in the intervention group and 53 (76%) patients in the control group remained in the trial. The mean body weight loss was 4.2 kg (95% CI, −5.49; −2.98) in the intervention group and 1.5 kg (95% CI, −2.57; −0.48) in the control group (p = 0.005). In the intervention group, 24 out of 62 patients with elevated HbA1c at baseline (39%) had a normalized HbA1c < 6.5% at six months, compared to 8 out of 40 patients with elevated HbA1c at baseline (20%) in the control group (p = 0.047). The eHealth lifestyle coaching programme can lead to significant weight loss and decreased HbA1c among patients with type 2 diabetes, compared to standard care.
Collapse
Affiliation(s)
- Jeanette Reffstrup Christensen
- Research Unit of General Practice, Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
- User Perspectives and Community-Based Interventions, Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
- The MOVE Unit, Research Unit of General Practice, The Faculty of Health, Aarhus University, 8000 Aarhus, Denmark
- Correspondence:
| | - Ditte Hjorth Laursen
- Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Jørgen Trankjær Lauridsen
- Department of Economics, The Faculty of Business and Social Sciences, University of Southern Denmark, 5000 Odense, Denmark
| | - Laura Hesseldal
- Research Unit of General Practice, Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
| | - Pernille Ravn Jakobsen
- Research Unit of General Practice, Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
| | - Jesper Bo Nielsen
- Research Unit of General Practice, Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
| | - Carl J. Brandt
- Research Unit of General Practice, Department of Public Health, The Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
- Liva Healthcare, 1434 Copenhagen, Denmark
| |
Collapse
|
30
|
Kohmarn T, Srisurattanamethakul N, Watcharapalakorn A, Poyomtip T, Poolsanam C. Outbreak of COVID-19-Related Myopia Progression in Adults: A Preliminary Study. Clin Optom (Auckl) 2022; 14:125-131. [PMID: 35959467 PMCID: PMC9359493 DOI: 10.2147/opto.s374155] [Citation(s) in RCA: 1] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The COVID-19 pandemic has necessitated specific public health measures, resulting in the alteration of lifestyles, such as increased digital screen time and fewer outdoor activities. Such conditions have increased the progression of myopia in children. However, no investigation of myopia progression in early adulthood has been conducted during this period. Consequently, this study aimed to evaluate the outbreak of COVID-19-related myopia progression among adults at an optometry clinic during the COVID-19 pandemic. MATERIALS AND METHODS This was a retrospective cohort study in which participants aged 18-25 years who first visited (baseline) the optometry clinic between June 2019 and March 2020 were recruited for follow-up from November 2021 to March 2022. Spherical equivalent refraction (SER), uncorrected distance visual acuity (UCDVA), and binocular cross cylinder (BCC) were recorded at baseline and a follow-up visit. Using questionnaires, a survey was conducted to assess the lifestyle changes that transpired during the COVID-19 pandemic. RESULTS In total, 37 participants with a mean age of 22.5±1.4 years were enrolled, of which 89.2% were female. Following the outbreak of the COVID-19 pandemic, most participants self-reported increased daily use of digital devices (89.2%), online education (86.5%), and spending more time at home (94.6%), which increased by approximately 7.6±3.2 hours, 5.9±1.7 hours, and 13.2±7.5 hours, respectively. There were statistically significant differences between SER and BCC at baseline and after approximately 2 years of the COVID-19 pandemic (p < 0.05). The mean two-year myopia progression was -0.59±0.67 D (Maximum = 0.00 D, Minimum = -3.38 D). CONCLUSION This study revealed that myopia could progress during adulthood among those who have lived under public health measures intended to address the COVID-19 pandemic.
Collapse
Affiliation(s)
- Thitika Kohmarn
- Faculty of Optometry, Ramkhamhaeng University, Bangkok, Thailand
| | | | | | - Teera Poyomtip
- Faculty of Optometry, Ramkhamhaeng University, Bangkok, Thailand
| | | |
Collapse
|
31
|
Willems M, de Jong J, Overwijk A, Hilgenkamp TIM, van der Schans CP, Waninge A. Behaviour change techniques used in lifestyle support of adults with mild intellectual disabilities. J Appl Res Intellect Disabil 2022; 35:1327-1335. [PMID: 35734872 DOI: 10.1111/jar.13021] [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: 05/25/2021] [Revised: 03/27/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Professional caregivers are important in the daily support of lifestyle change for adults with mild intellectual disabilities; however, little is known about which behaviour change techniques (BCTs) are actually used. This study aims to gain insight in their use for lifestyle behaviour change using video observations. METHODS Professional caregivers (N = 14) were observed in daily work supporting adults with mild intellectual disabilities. Videos were analysed using the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy and BCTs utilised were coded. RESULTS Twenty one out of 40 BCTs were used by professional caregivers. The BCTs 'Information about others' approval', 'Identification as role model', 'Rewards on successful behaviour', 'Review behavioural goals' and 'Instructions on how to perform the behaviour' were most employed. CONCLUSION Professional caregivers used BCTs to support healthier lifestyle behaviour of adults with mild intellectual disabilities. However, most promising of them as defined previous by professionals were rarely used by professional caregivers.
Collapse
Affiliation(s)
- Mariël Willems
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Johan de Jong
- School of Sports Studies, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Annelies Overwijk
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Physical Therapy Department, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
32
|
Hoedjes M, Nijman I, Hinnen C. Psychosocial Determinants of Lifestyle Change after a Cancer Diagnosis: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:2026. [PMID: 35454932 DOI: 10.3390/cancers14082026] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Although cancer survivors may experience health benefits from favorable lifestyle changes, many cancer survivors do not adhere to lifestyle recommendations or make favorable lifestyle changes after cancer diagnosis. This systematic review of the literature aimed to provide an overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. It provides a structured overview of the large variety of determinants of changes in different lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) derived from the 123 included papers (71 quantitative and 52 qualitative). Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors and inform researchers and healthcare professionals about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Abstract The aim of this study is to provide a systematic overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. Four databases (PubMed, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were searched for relevant papers up to October 2021. Of the 9586 references yielded by the literature search, 123 papers were included: 71 quantitative and 52 qualitative papers. Findings showed a large variety of determinants influencing lifestyle change after cancer diagnosis, with differences between lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) and findings from quantitative vs. qualitative studies. Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors. In addition, findings inform researchers involved in the development of health promotion programs about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Favorable lifestyle changes are expected to have beneficial effects on cancer risk and overall health in cancer survivors.
Collapse
|
33
|
Suka M, Shimazaki T, Yamauchi T, Yanagisawa H. Increased Health Risk in Office Workers in the COVID-19 Era: Comparison of One-Year Incidence of Health Problems Before and During the COVID-19 Pandemic. J Occup Environ Med 2022; 64:271-277. [PMID: 35051963 PMCID: PMC9083310 DOI: 10.1097/jom.0000000000002486] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine whether the incidence of health problems increases during the COVID-19 pandemic. METHODS Using the health examination data (April 2018-March 2021) of Japanese workers aged 15 to 64 years, the 1-year incidence of five health problems (overweight, hypertension, hypercholesterolemia, hyperglycemia, and liver damage) and four unhealthy habits (snacking, heavy drinking, physical inactivity, and sleep deprivation) were compared before and during the COVID-19 pandemic. RESULTS The 1-year incidence of overweight, hypertension, hyperglycemia, and liver damage increased by 15% to 65% during the COVID-19 pandemic. Increased weight gain, related to decrease physical activity during the COVID-19 pandemic, was significantly associated with increased incidence of health problems. CONCLUSIONS The COVID-19 pandemic have deteriorated workers' health even without the COVID-19 infection. Lifestyle interventions should be promptly started particularly targeting workers with gained weight to avoid more serious consequences.
Collapse
Affiliation(s)
- Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan (Dr Suka, Dr Shimazaki, and Dr Yamauchi); The Jikei University School of Medicine, Tokyo, Japan (Dr Yanagisawa)
| | | | | | | |
Collapse
|
34
|
Plehhova K, Paquette N, Gould J, Coyle C. Understanding the Patient PPI Journey: Results of a Survey on PPI Treatment Initiation and Patient Experience. J Prim Care Community Health 2022; 13:21501319221088688. [PMID: 35323078 PMCID: PMC8961351 DOI: 10.1177/21501319221088688] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Proton pump inhibitors (PPIs) used in the management of gastro-esophageal reflux disease (GORD) are among the most frequently prescribed classes of drug worldwide. Currently, however, physicians are prescribing PPIs for extended periods, often without an indication, which is not in line with current guidance and therefore preventing appropriate reflux management. Inappropriate or excessive PPI prescribing is becoming increasingly visible, yet there is currently little research available on the impact such current practice has on the patient experience. This study aims to understand patient attitudes toward their PPI treatment and the impact current PPI prescribing patterns have on the patient experience. METHODS An online survey of current and previous users of PPI for GORD was conducted in the UK and Germany. Topics covered included prior steps taken before first consultation with a physician, initial recommendations, PPI treatment initiation and duration, use of PPI, management of reflux whilst taking a PPI, stopping PPI treatment, and patient attitudes. RESULTS Among 566 patient participants (UK, n = 372; Germany, n = 194) 69% to 79% reported being prescribed medication at their first visit to a physician, of which 61% to 68% were prescribed a PPI either alone or combined with another treatment. 41% to 48% of patients answered "don't know" when asked how long they expected to continue taking their PPI. 49% to 50% of patients currently on PPIs also reported having concerns with regards to long-term treatment. 70% of patients recalled being well informed on dosage and treatment regimens. However, other safety and usage information was reported as being less frequently discussed. CONCLUSIONS Although patients reported concerns regarding ongoing long-term PPI treatment, this was not reflected in the prescribing pattern from physicians. More can be done to ensure patients are fully informed about their PPI treatment at consultation. Findings also suggest a disconnect exists between standard treatment guidelines and prescribing patterns, as experienced by patients.
Collapse
Affiliation(s)
| | | | - James Gould
- Reckitt Benckiser Healthcare UK Ltd., Slough, UK
| | - Cathal Coyle
- Reckitt Benckiser Healthcare UK Ltd., Slough, UK
| |
Collapse
|
35
|
Laroia G, Horne BD, Esplin S, Ramaswamy VK. A unified health algorithm that teaches itself to improve health outcomes for every individual: How far into the future is it? Digit Health 2022; 8:20552076221074126. [PMID: 35083061 PMCID: PMC8785270 DOI: 10.1177/20552076221074126] [Citation(s) in RCA: 1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/22/2021] [Accepted: 12/27/2021] [Indexed: 11/23/2022] Open
Abstract
The single biggest factor driving health outcomes is patient behavior. The CHR Model (County Health Rankings Model) weights socioeconomic factors, lifestyle behaviors, and physical environment factors collectively at 80% in driving impact on health outcomes, to the 20% weight for access to and quality of clinical care. Commercial determinants of health affect everyone today and unhealthy choices worsen pre-existing economic, social, and racial inequities. Yet there is a disproportionate focus on therapeutic intervention to the exclusion of shaping patient behaviors to improve healthcare. If the recent pandemic taught us a critically important lesson, it is the imperative to look beyond clinical care. According to the Centers for Disease Control and Prevention (CDC), long-standing systemic health and social inequities put various groups of people at higher risk of getting sick and dying from COVID-19, including many racial and ethnic minority groups. The virus was simply more efficient in detecting such vulnerabilities than the guardians of these physiologies. These insights from the pandemic come at the heel of a confluence of three major accelerants that may radically reshape our approaches to hot-spotting vulnerabilities and managing them before they manifest in a derangement or disease. They are the recent strides in behavioral economics and behavior science; advances in remote monitoring and personal health technologies; and developments in artificial intelligence and data sciences. These accelerants allow us to imagine a previously impossible vision—we can now build and maintain a unified health algorithm for every individual that can dynamically track the two interdependent streams of risk, clinical and behavioral.
Collapse
Affiliation(s)
| | - Benjamin D Horne
- Cardiovascular and Genetic Epidemiology, Intermountain Medical Center Heart Institute, USA.,Division of Cardiovascular Medicine, Department of Medicine, Stanford University, USA
| | - Sean Esplin
- Department of Obstetrics and Gynecology, Intermountain Healthcare Maternal-Fetal Medicine, and University of Utah Health, USA
| | | |
Collapse
|
36
|
Ching SSY, Mok ESB. Adoption of healthy lifestyles among Chinese cancer survivors during the first five years after completion of treatment. Ethn Health 2022; 27:137-156. [PMID: 31238712 DOI: 10.1080/13557858.2019.1634182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/17/2018] [Accepted: 06/07/2019] [Indexed: 06/09/2023]
Abstract
Objectives: The number of cancer survivors is increasing as a result of advances in detection and treatment. Lifestyle is a significant modifiable factor in the development of cancer. Most studies on healthy lifestyles have been conducted in Western countries. Cultural influences on the pursuit of healthy lifestyles among Chinese cancer survivors remain largely unexplored. The objectives of this qualitative study are to explore the experiences of Chinese cancer survivors in adopting healthy lifestyles, with a focus on their goals, the challenges they face, and the influences of Chinese culture.Design: Thirty-two Chinese breast and colorectal cancer survivors in their first five years after treatment were recruited from a hospital in Hong Kong to participate in eight focus groups. Qualitative content analysis was adopted to analyse the data.Results: The adoption of a healthy lifestyle was a strategy through which the participants exercised choice to restore balance in their health after developing cancer. Diet, exercise, psychological well-being, the use of traditional Chinese medicine (TCM) and health/dietary supplements, and attending medical consultations/follow-up visits were the behaviours adopted by the participants, with the goal of improving their health, controlling their cancer and preventing relapse, and managing the residual physical symptoms of their illness. In adopting a healthy lifestyle, the participants encountered challenges such as a lack of reliable and practical instructions from healthcare professionals. Chinese cultural beliefs concerning the nature of food, TCM, minimizing social disturbances, and collaborative control influenced their lifestyle.Conclusions: The cancer survivors adopted a range of healthy lifestyles but encountered challenges. Clarifying the principles of food choice while addressing Chinese beliefs regarding therapeutic food and the use of TCM, clarifying queries about conflicting information, and developing plans according to the needs, and competing demands of survivors can facilitate collaborative control between healthcare professionals and cancer survivors.
Collapse
Affiliation(s)
- S S Y Ching
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - E S B Mok
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| |
Collapse
|
37
|
Teramura A, Kimura Y, Hamada K, Ishimoto Y, Kawamori M. COVID-19-Related Lifestyle Changes among Community-Dwelling Older Adult Day-Care Users: A Qualitative Study. Int J Environ Res Public Health 2021; 19:256. [PMID: 35010515 DOI: 10.3390/ijerph19010256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/17/2022]
Abstract
In Japan, the community-based comprehensive care system is an important initiative. The purpose of this study was to understand COVID-19-related lifestyle changes experienced by older adults who lived in communities and used day-care services. Using a qualitative inductive research method, semi-structured interviews were conducted with 13 older adults who used day-care services in Kyoto City, which assessed lifestyle changes before and after the spread of COVID-19 during March-April 2021. The extracted lifestyle change codes were classified into six categories and 16 subcategories. The data revealed that older adults felt socially isolated and experienced multiple changes in their lives, including limited leisure activities, changes in roles, decreased interpersonal interaction with family and acquaintances, poor diet and sleep quality, and reduced attention to personal appearance and grooming. The findings suggest that during COVID-19, older adults had difficulty adapting to the various changes in their lives and showed a decline in physical and mental functioning. Thus, it is important for day-care facilities to create sustainable spaces in response to the various care needs of community-dwelling older adults whose lifestyles have changed as a result of the COVID-19 situation.
Collapse
|
38
|
Heron N, O'Connor SR, Kee F, Thompson DR, Cupples M, Donnelly M. Refining a primary care shared decision-making aid for lifestyle change: mixed methods study. BJGP Open 2021:BJGPO. [PMID: 34853008 DOI: 10.3399/BJGPO.2021.0100] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/15/2021] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND The important role of primary care in promoting healthy lifestyle behaviours needs informed support. AIM To elicit views on a 39-item shared decision-making (SDM) aid (SHARE-D) for lifestyle change and refine it to improve implementation. DESIGN & SETTING Mixed methods study. METHOD Health professionals, patients, and support workers, with experience of managing, or a history of, cardio- or cerebrovascular disease, were purposively recruited based on age, gender, and urban/rural location (n = 34). Participants completed a survey, rating the importance of including each item in a decision-aid, designed for use by patients with health professionals, and suggesting modifications. Semi-structured interviews (n = 30/34) were conducted and analysed thematically. RESULTS Substantial agreement was observed on rating item inclusion. Based on survey and interview data, 9/39 items were removed; 13 were amended. Qualitative themes were: (i) core content of the decision-aid, (ii) barriers to use, (iii) motivation for lifestyle change, and (iv) primary care implementation. 'Self-reflective' questions and goal setting were viewed as essential components. The paper-based format, length, clarity, and time required were barriers to its use. Optional support considered within the aid was seen as important to motivate change. A digital version, integrated into patient record systems was regarded as critical to implementation. A revised 30-item aid was considered suitable for facilitating brief conversations and promoting patient autonomy. CONCLUSION The SHARE-D decision aid for healthy lifestyle change appears to have good content validity and acceptability. Survey and interview data provided in-depth information to support implementation of a refined version. Further studies should examine its effectiveness.
Collapse
|
39
|
Cohen Rodrigues TR, de Buisonjé DR, Keesman M, Reijnders T, van der Geer JE, Janssen VR, Kraaijenhagen RA, Atsma DE, Evers AWM. Facilitators of and Barriers to Lifestyle Support and eHealth Solutions: Interview Study Among Health Care Professionals Working in Cardiac Care. J Med Internet Res 2021; 23:e25646. [PMID: 34652280 PMCID: PMC8556639 DOI: 10.2196/25646] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/21/2021] [Accepted: 08/10/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) pose a significant health threat and reduce both people's life expectancy and quality of life. Healthy living is a key component in the effective prevention and treatment of CVD. However, health care professionals (HCPs) experience difficulties in supporting lifestyle changes among their patients. eHealth can provide a solution to these barriers. OBJECTIVE This study aims to provide insights into the factors HCPs find important in the support of patients with CVD in the uptake of and adherence to a healthy lifestyle and the perceived facilitators of and barriers to using eHealth to provide lifestyle support to patients with CVD. METHODS In-depth interviews were conducted with 16 Dutch HCPs specializing in lifestyle support in cardiac care. RESULTS We identified 13 themes, of which the first 12 concerned lifestyle support in general and were related to intervention, patient, or health care. Throughout these themes, the use of eHealth reoccurred as a potential facilitator of or solution to barriers to lifestyle support. Our final theme specifically concerned barriers to the adoption and usability of eHealth. CONCLUSIONS HCPs do recognize the potential advantages of eHealth while experiencing barriers to using digital tools. Incorporating their needs and values in the development of lifestyle support programs, especially eHealth, could increase their use and lead to a more widespread adoption of eHealth into health care.
Collapse
Affiliation(s)
- Talia R Cohen Rodrigues
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands
| | - David R de Buisonjé
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands
| | - Mike Keesman
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands
| | - Thomas Reijnders
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands.,Department of Human-Centered Design, Faculty of Industrial Design Engineering, Technical University of Delft, Delft, Netherlands
| | - Jessica E van der Geer
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands
| | - Veronica R Janssen
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands.,Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Roderik A Kraaijenhagen
- NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, Netherlands.,Vital10, Amsterdam, Netherlands
| | - Douwe E Atsma
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Andrea W M Evers
- Health, Medical, and Neuropsychology Unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands.,Medical Delta, Leiden-Delft-Erasmus Universities, Delft, Netherlands
| |
Collapse
|
40
|
Choi M, Raeside R, Hyun K, Partridge SR, Thiagalingam A, Redfern J. Understanding Preferences for Lifestyle-Focused Visual Text Messages in Patients With Cardiovascular and Chronic Respiratory Disease: Discrete Choice Experiment. J Med Internet Res 2021; 23:e26224. [PMID: 34542413 PMCID: PMC8491117 DOI: 10.2196/26224] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/07/2020] [Revised: 02/15/2021] [Accepted: 07/21/2021] [Indexed: 12/04/2022] Open
Abstract
Background Supporting healthy lifestyle changes is a key aim of cardiovascular and pulmonary rehabilitation programs. SMS text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity, and smoking cessation. The optimization of SMS text messaging programs may deliver greater population benefits as mobile phone use becomes ubiquitous. Visual messaging (ie, image-based messages) has the potential to communicate health messages via digital technology and result in enhanced engagement. Objective This study aims to determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation. Methods A discrete choice experiment was conducted in a 4-stage iterative process to elicit patient preferences for visual message features. Attribute and level development yielded 3 attributes (purpose, image type, and web address), and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (on the web) for their preferences regarding the visual message choice sets. Respondents were asked to choose among 16 pairs of visual messages regarding key lifestyle behaviors, namely, physical activity and nutrition. The data were analyzed using a conditional logit model. Results There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with patient preference were gain-framed purpose compared with no purpose (odds ratio [OR] 1.93, 95% CI 1.40-2.65) and real images compared with cartoon images (OR 1.26, 95% CI 1.04-1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42-0.74). Overall, patients preferred positive images that were colorful and engaged with text that supported the image and had a preference for images of real people rather than cartoons. Conclusions A discrete choice experiment is a scientific method for eliciting patient preferences for a visual messaging intervention that is designed to support changes in lifestyle behaviors. SMS text messaging programs that use visual aids may result in greater patient satisfaction by using a gain frame, using real images, and avoiding a loss frame. Further research is needed to explore the feasibility of implementation and the health and behavioral outcomes associated with such visual messaging programs.
Collapse
Affiliation(s)
- Michael Choi
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Rebecca Raeside
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Karice Hyun
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia
| | - Stephanie R Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Westmead Hospital, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Julie Redfern
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia.,Research Education Network, Western Sydney Local Health District, Sydney, Australia
| |
Collapse
|
41
|
Devaraj SM, Rockette-Wagner B, Miller RG, Arena VC, Napoleone JM, Conroy MB, Kriska AM. The Impact of a Yearlong Diabetes Prevention Program-Based Lifestyle Intervention on Cardiovascular Health Metrics. J Prim Care Community Health 2021; 12:21501327211029816. [PMID: 34236004 PMCID: PMC8274083 DOI: 10.1177/21501327211029816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 11/16/2022] Open
Abstract
Introduction The American Heart Association created “Life’s Simple Seven” metrics to estimate progress toward improving US cardiovascular health in a standardized manner. Given the widespread use of federally funded Diabetes Prevention Program (DPP)-based lifestyle interventions such as the Group Lifestyle Balance (DPP-GLB), evaluation of change in health metrics within such a program is of national interest. This study examined change in cardiovascular health metric scores during the course of a yearlong DPP-GLB intervention. Methods Data were combined from 2 similar randomized trials offering a community based DPP-GLB lifestyle intervention to overweight/obese individuals with prediabetes and/or metabolic syndrome. Pre/post lifestyle intervention participation changes in 5 of the 7 cardiovascular health metrics were examined at 6 and 12 months (BMI, blood pressure, total cholesterol, fasting plasma glucose, physical activity). Smoking was rare and diet was not measured. Results Among 305 participants with complete data (81.8% of 373 eligible adults), significant improvements were demonstrated in all 5 risk factors measured continuously at 6 and 12 months. There were significant positive shifts in the “ideal” and “total” metric scores at both time points. Also noted were beneficial shifts in the proportion of participants across categories for BMI, activity, and blood pressure. Conclusion AHA-metrics could have clinical utility in estimating an individual’s cardiovascular health status and in capturing improvement in cardiometabolic/behavioral risk factors resulting from participation in a community-based translation of the DPP lifestyle intervention.
Collapse
Affiliation(s)
- Susan M Devaraj
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | - Rachel G Miller
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Vincent C Arena
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Jenna M Napoleone
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Molly B Conroy
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Andrea M Kriska
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| |
Collapse
|
42
|
Perczel-Forintos D, Kohlné Papp I, Vizin G, Kiss-Leizer M. The motivational role of realistic and unrealistic weight targets in body-weight loss: Experiences with a cognitive behavioral body-weight loss program. Orv Hetil 2021; 162:1119-1128. [PMID: 34252042 DOI: 10.1556/650.2021.32128] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/16/2021] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Bevezetés: Az elhízás korunk egyik legnagyobb kihívása, hiszen a többletsúly számos krónikus betegség kockázati tényezője, és fontos pszichés és szociális következményei vannak. A kezelésben bizonyítottan hatékony a kognitív viselkedésterápiás testsúlycsökkentő program, amelynek során alapvető fontosságú a reális célsúly meghatározása, ugyanis az irreális elvárások megakadályozhatják a hosszú távú sikeres testsúlykontrollt. Célkitűzés: Prospektív kutatásunk kérdése, hogy az elérhető fogyást milyen mértékben befolyásolják a testsúlycélok a kognitív viselkedésterápiás testsúlycsökkentő program során. Feltételeztük, hogy a testsúlycsökkentő csoport résztvevői irreális fogyási elvárásokkal érkeznek, melyek azonban reálisabbá válnak a program végére, és megmaradnak az utánkövetés idejére. Emellett feltételeztük, hogy a testsúlycsökkentő program során az evési magatartás pozitív irányban fog változni. Módszer: A 24 hetes testsúlycsökkentő programban 63, az egyéves utánkövetésben pedig 49 felnőtt vett részt. A résztvevők antropometriai mutatói mellett (testtömeg, testmagasság) az evési magatartást és a testsúlycélokat a Háromfaktoros Evési Kérdőívvel, illetve a Célok és Relatív Testsúlyok Kérdőívvel mértük fel. Eredmények: A résztvevők közel 90%-a elérte a professzionális testsúlycsökkentő módszerek esetében elvárható legalább 5-10%-os fogyást, az evési magatartás pozitív irányban változott, testsúlycéljaik reálisabbak lettek. A fogyás szignifikáns, fordított kapcsolatban volt az aktuális és az álomsúly, az aktuális és a vágyott, valamint az aktuális és az elfogadható testsúly közötti eltéréssel. Következtetés: A kognitív viselkedésterápia széles körben alkalmazható, hatékony testsúlycsökkentő módszer, amelynek sikerében fontos szerepet játszanak a reálisan kitűzött testsúlycélok. Orv Hetil. 2021; 162(28): 1119-1128. SUMMARY INTRODUCTION Obesity has become one of the most challenging issues, as the excess body-weight is a risk factor for numerous chronic diseases and has serious psychological and social consequences. The cognitive behavioral approach to weight loss had been shown an effective treatment, in which realistic weight target setting is essential, because unrealistic expectations can hinder the effort for a successful long-term weight management. OBJECTIVE The objective of our prospective study was to investigate as to how weight loss is influenced by realistic and unrealistic weight targets in a cognitive behavioral weight loss program. We hypothesized that the participants come with unrealistic weight loss expectations, which become more realistic by the end of the program and remain realistic for the follow-up. In addition, a positive change was expected in the eating behavior of the participants during the program. METHOD The program was completed by 63 people, 49 subjects participated in the 1-year follow-up. Anthropometric data were obtained and the participants were asked to fill in the Three-Factor Eating Questionnaire - Revised 21 items and the Goals and Relative Weights Questionnaire. RESULTS According to the results, the program is effective, since nearly 90% of the participants reached at least 5-10% weight loss as expected by professional weight loss methods. Besides weight loss there were positive changes in the participants' eating behavior; weight targets became more realistic. Weight loss was inversely related to the difference between actual and dream, actual and desired as well as between actual and acceptable weight. CONCLUSION Our results in accordance with previous studies show that cognitive behavioral weight loss programs can be effective; however, setting up realistic weight targets can be crucial in successful weight loss. Orv Hetil. 2021; 162(28): 1119-1128.
Collapse
Affiliation(s)
- Dóra Perczel-Forintos
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Klinikai Pszichológia Tanszék, Budapest
| | - Ildikó Kohlné Papp
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Klinikai Pszichológia Tanszék, Budapest
| | - Gabriella Vizin
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Klinikai Pszichológia Tanszék, Budapest.,2 Eötvös Loránd Tudományegyetem, Pedagógiai és Pszichológiai Kar, Pszichológiai Intézet, Budapest
| | - Márton Kiss-Leizer
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Klinikai Pszichológia Tanszék, Budapest
| |
Collapse
|
43
|
Abstract
The prevalence of childhood obesity continues to rise despite decades of clinical and public health efforts. Early identification of children at risk of developing obesity is essential using newer electronic health systems, which move beyond traditional growth charts to provide a wealth of information about body mass index and other relevant parameters such as social determinants of health and comorbid conditions. For children who already have obesity, there are several evidence-based strategies health care providers can use as they work with patients and families to mitigate the effects. First and foremost, providers should address the issue; unfortunately, weight is often not discussed in clinical practice. In addressing the issue, providers should support families through effective, positive relationships. Providers must be aware of their biases; their language should be appropriate and nonstigmatizing. Helpful interventions should focus on behavior, not weight, health, or appearance. Motivational interviewing may be used to promote healthful behaviors: supportive parenting, regular exercise, healthful food choices, minimal screen time, and optimal sleep. There is limited evidence for the efficacy of specific weight loss diets. Both medication and bariatric surgery are indicated for select adolescents who have severe disease unresponsive to behavioral management.
Collapse
Affiliation(s)
- Tara K. Kaufman
- Mayo Clinic, Rochester, MN, USA
- Tara K. Kaufman, Department of Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | | | | |
Collapse
|
44
|
Kaczorowski J, Lussier MT, Girard M, Beaulieu-Carbonneau A. Implementation of Modified Cardiovascular Health Awareness Program for Canadian Adults on a Waiting List for a Family Physician. J Prim Care Community Health 2021; 11:2150132720976484. [PMID: 33243046 PMCID: PMC7708698 DOI: 10.1177/2150132720976484] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular diseases (CVD) prevention program in communities where access to family physicians was not a significant issue. Many Canadians now face sub-optimal access to a regular source of primary care. Centralized waiting lists and prioritization based on urgency of medical need were created to address this problem. We aimed to assess the acceptability, CVD risk profile, and potential benefits of offering a modified version of CHAP to adults on the waiting list. METHODS The implementation was conducted in Laval (Canada) between March and June 2016, targeting individuals 40 years of age or older who were registered on the waiting list (GACO) and had a priority code of 3. Participants were invited through a personalized letter to attend sessions in community health centers. During the sessions, participants completed CVD risk profiles, risk of type 2 diabetes questionnaire (CANRISK); had their blood pressure, height and weight as well as waist circumference measured. They also received targeted healthy lifestyle and patient education materials and were referred to local programs including a medical follow-up, when required. RESULTS A total of 1976 invitation letters were sent resulting in 281 (14.2%) participants. The average age of attendees was 58.1 (SD = 8.2) and a majority were female (58%, n = 163). A third of participants (34.2%, n = 96) had BP ≥140/90 and 11.4% (n = 32) were classified as having a very high risk for developing diabetes. Almost half (41.6%, n = 117) of participants were referred either to health promotion programs offered by local health authorities, to family physicians (4.6%, n = 13) or emergency departments (1.8%, n = 5) for short-term medical assistance. CONCLUSION Despite low participation rate, many adults on a waiting list had elevated risk for CVD and would greatly benefit from having a regular source of primary care.
Collapse
Affiliation(s)
- Janusz Kaczorowski
- University of Montreal, Montreal, QC, Canada.,CRCHUM, Montreal, QC, Canada
| | | | | | | |
Collapse
|
45
|
Falskog F, Landsem AM, Meland E, Bjorvatn B, Hjelle OP, Mildestvedt T. Patients want their doctors' help to increase physical activity: a cross sectional study in general practice. Scand J Prim Health Care 2021; 39:131-138. [PMID: 33871303 PMCID: PMC8293971 DOI: 10.1080/02813432.2021.1910670] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Inactivity is prevalent in patients presenting in general practice, and the health benefits of increased physical activity (PA) are well known. Few studies have explored whether patients want their general practitioner's (GPs) contribution in facilitating a lifestyle change. OBJECTIVE To identify the characteristics of patients who expect help from their doctor in increasing levels of PA. DESIGN We collected data via questionnaires for this cross-sectional study from general practices. SETTING General practices in Norway, during Spring 2019. SUBJECTS A total of 2104 consecutive patients (response rate 75%) participated. MAIN OUTCOME MEASURES The questionnaire included questions about self-rated health, level of physical activity, the desire to become more physically active, and questions about the role of the GP in increasing the level of physical activity in their patients. We analysed our data using Pearson chi-square and binary logistic regression. RESULTS Female patients were less active, but their motivation to increase activity and their expectations of receiving help from their doctor were similar to males. Younger patients were more motivated for increased activity, and to manage without help from their doctors. Impaired self-rated health (SRH) was associated with inactivity and, at the same time, with the motivation to become more active with help from general practitioners. CONCLUSION Most patients in the GPs' office are physically inactive. This study revealed an important message for GPs: in clinical work, emphasise physical activity for health gains, especially for patients with impaired SRH.Key PointsFour out of five patients attending Norwegian general practice are inactiveMore than 85% of these patients want to increase their physical activity levelMore than 50% would like help from their GP to achieve this goal.
Collapse
Affiliation(s)
- Frida Falskog
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ane M. Landsem
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Ole P. Hjelle
- Faculty of Health and Social Sciences, Department of Nursing and Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Thomas Mildestvedt
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
- CONTACT Thomas Mildestvedt Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, BergenNO 5018, Norway
| |
Collapse
|
46
|
Yeo Y, Han K, Shin DW, Kim D, Jeong SM, Chun S, Choi IY, Jeon KH, Kim TH. Changes in Smoking, Alcohol Consumption, and the Risk of Thyroid Cancer: A Population-Based Korean Cohort Study. Cancers (Basel) 2021; 13:cancers13102343. [PMID: 34066228 PMCID: PMC8150527 DOI: 10.3390/cancers13102343] [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] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 01/23/2023] Open
Abstract
Simple Summary The inverse association between smoking, alcohol intake, and thyroid cancer has been suggested by observational studies. From the representative data in Korea, we identified the epidemiologic evidence to elucidate the true effect between smoking, alcohol intake, and thyroid cancer incidence by exploring the effect of changes in smoking and alcohol consumption habits. Abstract To elucidate potential causality between smoking and alcohol intake on thyroid cancer incidence, we explored the effect of changes in smoking and alcohol consumption habits. From the Korean National Health Insurance database, we identified 4,430,070 individuals who participated in the national health screening program in 2009 and 2011. The level of smoking and alcohol consumption was measured twice, once in 2009 and again in 2011. The risk of thyroid cancer according to their changes was estimated using the Cox proportional hazard model. During the mean follow-up period of 6.32 ± 0.72 years, 29,447 individuals were diagnosed with thyroid cancer. Compared to those who sustained not smoking, non-smokers who initiated smoking to light (adjusted hazard ratio (aHR) 0.96, 95% confidence interval (CI) 0.81–1.15), moderate (aHR 0.90, 95% CI 0.78–1.04), and heavy level (aHR 0.81, 95% CI 0.69–0.96) had a decreased risk of thyroid cancer. Heavy smokers who quit smoking had an increased risk of thyroid cancer (aHR 1.23, 95% CI 1.06–1.42) compared to those who sustained heavy smoking. Change in drinking status was not significantly associated with thyroid cancer risk compared to drinking at the same level, although a non-significant trend of increased risk was noted in quitters. Participants who initiated both smoking and drinking (HR 0.80, 95% CI 0.69–0.93) had a lower risk of thyroid cancer compared with those who continued not to smoke and drink. Our findings provide further evidence that smoking, and possibly alcohol consumption, would have true protective effects on the development of thyroid cancer.
Collapse
Affiliation(s)
- Yohwan Yeo
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea
- Correspondence: (K.H.); (D.-W.S.)
| | - Dong-Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul 06351, Korea
- Department of Digital Health (SAIHST), Sungkyunkwan University, Seoul 06351, Korea
- Correspondence: (K.H.); (D.-W.S.)
| | - Dahye Kim
- Department of Medical Statistics, The Catholic University of Korea, Seoul 06591, Korea;
| | - Su-Min Jeong
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
| | - Sohyun Chun
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
- International Healthcare Center, Samsung Medical Center, Seoul 06351, Korea
| | - In-Young Choi
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (Y.Y.); (S.-M.J.); (S.C.); (I.-Y.C.)
- International Healthcare Center, Samsung Medical Center, Seoul 06351, Korea
| | - Keun-Hye Jeon
- CHA Gumi Medical Center, Department of Family Medicine, Gumi 39295, Korea;
| | - Tae-Hyuk Kim
- Thyroid Center, Samsung Medical Center, Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| |
Collapse
|
47
|
Chen WL, Song SY, Yap KH. The Unintended Consequences of the Pandemic: The New Normal for College Students in South Korea and Taiwan. Front Public Health 2021; 9:598302. [PMID: 34046381 PMCID: PMC8144296 DOI: 10.3389/fpubh.2021.598302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/24/2020] [Accepted: 04/08/2021] [Indexed: 11/23/2022] Open
Abstract
This study attempts to compare the impacts of the coronavirus (COVID-19) pandemic on college students' lifestyles and mental health conditions in South Korea and Taiwan. As the COVID-19 outbreak has spread across the globe, it has brought significant changes to college campuses worldwide. College students have been heavily affected by the closure, as online learning has become increasingly common in higher education institutions. Using data collected from college students in South Korea and Taiwan in the spring of 2020, this study examines the effects of pandemic-related lifestyle changes on mental health conditions for college students in the two countries. The results were 3-fold. First, compared to college students in Taiwan, college students in South Korea reported greater decreases in time spent traveling, being with friends, eating at restaurants, and engaging in part-time employment, and greater increases in online shopping and ordering food for delivery. Second, college students in South Korea reported a higher level of worry, a greater possibility of contact with a person with COVID-19, and a lower level of happiness than did college students in Taiwan. Third, our findings indicate that social activities, including spending time with friends, were positively correlated with mental health conditions in South Korea and Taiwan. Comparing Korean and Taiwanese students' lifestyle changes and mental health conditions amid the pandemic, the study argues that the decrease in socialization and interaction under these new circumstances may be a significant factor that explains an increase in mental health issues in Korean college students compared to Taiwanese students, given the increase in confirmed COVID-19 cases in South Korea and the corresponding greater use of online teaching platforms there than in Taiwan.
Collapse
Affiliation(s)
- Wei-Lin Chen
- Center for Teacher Education, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Sue-Yeon Song
- Institute of Distance Education, Korea National Open University, Seoul, South Korea
| | - Ko-Hua Yap
- Department of Sociology, National Sun Yat-sen University, Kaohsiung, Taiwan
| |
Collapse
|
48
|
Spaggiari G, Santi D, Budriesi G, Dondi P, Cavedoni S, Leonardi L, Delvecchio C, Valentini L, Bondi M, Miloro C, Toschi PF. Eating Behavior after Bariatric Surgery (EBBS) Questionnaire: a New Validated Tool to Quantify the Patients' Compliance to Post-Bariatric Dietary and Lifestyle Suggestions. Obes Surg 2021; 30:3831-3838. [PMID: 32447636 DOI: 10.1007/s11695-020-04723-w] [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: 12/15/2022]
Abstract
PURPOSE In the management of bariatric surgery follow-up, a multidisciplinary approach allows to evaluate the weight loss maintenance and the dietary and lifestyle changes adherence. The main aim of this study is to create and to validate a questionnaire (eating behavior after bariatric surgery (EBBS)) to objectivize the compliance to dietary/lifestyle suggestions after bariatric surgery. MATERIALS AND METHODS An observational retrospective monocentric clinical trial was carried out at the Bariatric Surgery Unit of Modena, Italy. All weight-related data of bariatric surgery patients collected during the multidisciplinary post-surgical path were recorded. EBBS questionnaire and three validated psychological tests were administered. EBBS includes 11 questions concerning food (domain A), drinks (B), behaviors (C), and lifestyle (S). All data analyzed in the study were collected during the same visit. RESULTS In 41 enrolled patients (52.2 + 11.9 years), the total weight loss after surgery was 44.87 + 18.37 kg (- 35.40 + 11.60%), with a weight loss maintenance of 86.92 + 14.30%. The EBBS questionnaire showed a good internal validity (Cronbach's alpha 0.743, Hotelling's T-square test p < 0.001). The S domain was directly related with the percentage of weight loss maintained (p = 0.048), suggesting that the frequent physical activity and the periodic weight self-check are the most predictive behaviors to obtain weight control. None of the psychological questionnaires appeared related to the weight trend. CONCLUSIONS We validated for the first time a 11-item self-filling questionnaire allowing to quantify the adaption to dietary/lifestyle suggestions provided after bariatric surgery. EBBS questionnaire could be a useful tool both in clinical and research setting to monitor the patient's adherence to post-surgical indications and to identify predictive factors for bariatric surgery efficacy.
Collapse
Affiliation(s)
- Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy. .,Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. .,Unit of Endocrinology, Ospedale Civile of Baggiovara, Via P. Giardini 1355, 41126, Modena, Italy.
| | - Giulia Budriesi
- Department of Metabolic Diseases and Clinical Nutrition, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Paola Dondi
- Servizio di Psicologia Ospedaliera, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Sonia Cavedoni
- Servizio di Psicologia Ospedaliera, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Laura Leonardi
- Servizio di Psicologia Ospedaliera, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Carolina Delvecchio
- Servizio di Psicologia Ospedaliera, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Laura Valentini
- Servizio di Psicologia Ospedaliera, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Mario Bondi
- Unit of Endocrinology, Azienda USL of Modena, Modena, Italy
| | - Clelia Miloro
- Department of Metabolic Diseases and Clinical Nutrition, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Patrizia Federica Toschi
- Department of Metabolic Diseases and Clinical Nutrition, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| |
Collapse
|
49
|
Wang Y, Liu M, Chi I. An Evaluation of Self-Care and Caregiving Training Curriculum Content for Chinese Immigrant Caregivers: A Participatory Design Approach. J Appl Gerontol 2021; 40:1818-1827. [PMID: 33501875 DOI: 10.1177/0733464820987920] [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] [Indexed: 11/16/2022] Open
Abstract
Immigrant caregivers face unique difficulties in self-care and caregiving practices in the United States. Our aim was to conduct an evaluation of the content of a training curriculum app designed for Chinese immigrant caregivers based on the Body-Mind-Spirit model. An app prototype was developed, and a sample content was examined by prospective users accessing it on their smartphones. Using a participatory design approach, 22 in-depth interviews were conducted with Chinese immigrant caregivers in Los Angeles in 2019, and feedback for spirituality content was sought from an independent expert. Caregivers provided feedback for three self-care categories-body, mind, and community resources-and two caregiving content categories-knowledge and skills, and community resources. From this feedback, five areas for designing training curriculum content emerged: caregiving stress, lifestyle and health behavior change, access to community resources, death education and end-of-life care, and spiritual care.
Collapse
Affiliation(s)
| | - Mandong Liu
- University of Southern California, Los Angeles, USA
| | - Iris Chi
- University of Southern California, Los Angeles, USA
| |
Collapse
|
50
|
Kumra T, Rajagopal S, Johnson K, Garnepudi L, Apfel A, Crocetti M. Patient Centered Medical Home Cooking: Community Culinary Workshops for Multidisciplinary Teams. J Prim Care Community Health 2021; 12:2150132720985038. [PMID: 33416034 PMCID: PMC7797568 DOI: 10.1177/2150132720985038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 11/16/2022] Open
Abstract
Ideal management of chronic disease includes team based primary care, however primary care medical staff face a lack of training when addressing nutritional counseling and lifestyle prevention. Interactive culinary medicine education has shown to improve knowledge and confidence among medical students. The aim of this study was to determine whether a culinary medicine curriculum delivered to a multidisciplinary team of primary care medical staff and medical students in a community setting would improve self-reported efficacy in nutritional counseling and whether efficacy differed between participant roles. A 4-h interactive workshop that took place within the neighborhood of a primary care medical home was delivered to medical staff and students. Participants completed a voluntary questionnaire before and after the workshop that addressed participants' attitudes and confidence in providing nutritional counseling to patients. Chi-square tests were run to determine statistically significant associations between role of participant and survey question responses. Sign Rank tests were run to determine if pre-workshop responses differed significantly from post-workshop responses. Thirteen of seventeen responses related to attitudes and efficacy demonstrated significant improvement after the workshop compared with prior to the workshop. Significant differences noted between roles prior to the workshop disappear when asking the same questions after the workshop. Delivery of culinary medicine curricula to a primary care medical home team in a community setting is an innovative opportunity to collaboratively improve nutritional education and counseling in chronic disease prevention.
Collapse
Affiliation(s)
- Tina Kumra
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Selvi Rajagopal
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Ariella Apfel
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|