101
|
Akinlade KS, Bernard EB, Ogah OS, Rahamon SK. Serum levels of adiponectin, resistin and tumour necrosis factor-alpha in Nigerian men with nuchal fat fold. Diabetes Metab Syndr 2021; 15:102214. [PMID: 34298271 DOI: 10.1016/j.dsx.2021.102214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Factors necessitating the propensity of adults with upper body fat deposition (UBFD) for developing insulin resistance and cardiovascular diseases (CVDs) are poorly understood. Therefore, understanding the roles of adipocytokines in the development of UBFD-associated pathologies could be of clinical importance. AIM To assess the levels of selected adipocytokines in males with nuchal fat fold (NFF). METHODOLOGY Eighty-six males (43 with NFF and 43 without NFF) were enrolled into this study. Serum levels of tumour necrosis factor-alpha (TNF-α), resistin and adiponectin were determined using ELISA. RESULTS Adiponectin level was significantly higher while resistin and TNF-α levels were significantly lower in NFF compared with the controls. TNF-α had significant positive correlation with systolic blood pressure (SBP) while adiponectin had significant positive correlation with the waist-hip ratio (WHR). Stratifying based on the obesity status, the mean body weight, BMI, waist circumference (WC), hip circumference (HC), WHR, neck circumference (NC), NFF and diastolic BP were significantly higher in NFF with obesity compared with those without obesity. However, levels of TNF-α, resistin and adiponectin were similar between the two groups. CONCLUSIONS NFF is associated with elevation in adiponectin level and increased CVD risk. NFF can therefore, serve as an index of early onset of cardiometabolic diseases.
Collapse
Affiliation(s)
- Kehinde Sola Akinlade
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Eni Bassey Bernard
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | | | - Sheu Kadiri Rahamon
- Department of Immunology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| |
Collapse
|
102
|
Lucini D, Pagani E, Capria F, Galliano M, Marchese M, Cribellati S. Evidence of Better Psychological Profile in Working Population Meeting Current Physical Activity Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178991. [PMID: 34501580 PMCID: PMC8430491 DOI: 10.3390/ijerph18178991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
Workplace Health Promotion (WHP) may improve health, productivity and safety and reduce absenteeism. However, although desirable, it is difficult to design tailored (and thus effective) WHP programs, particularly in small-medium companies, which rarely have access to sufficient economic and organizational resources. In this study, 1305 employees filled out an online anonymous lifestyle questionnaire hosted on the website of a non-profit organization, which aims to promote a healthy lifestyle among workers. The data show gender differences regarding stress perception and, in the working population meeting current physical activity recommendations (threshold = 600 MET·min/week), they point out the evidence of a better psychological and nutrition profile, a perception of better job performance, and improved sleep and health quality. Moreover, a unitary index (ranging from 0-100 (with higher scores being healthier)), combining self-reported metrics for diet, exercise and stress, was significantly higher in active employees (67.51 ± 12.46 vs. 39.84 ± 18.34, p < 0.001). The possibility of assessing individual lifestyle in an easy, timely and cost-effective manner, offers the opportunity to collect grouped data useful to drive tailored WHP policies and to have metric to quantify results of interventions. This potentiality may help in creating effective programs and in improving employees' and companies' motivation and attitude towards a feasible WHP.
Collapse
Affiliation(s)
- Daniela Lucini
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano IRCCS, 20135 Milan, Italy
- Correspondence: or ; Tel.: +39-02-619-112-808
| | | | | | | | | | | |
Collapse
|
103
|
Moroney C, O’Leary F, Flood VM. The Med-NKQ: A Reliable Mediterranean Diet Nutrition Knowledge Questionnaire for Cardiovascular Disease. Nutrients 2021; 13:nu13092949. [PMID: 34578825 PMCID: PMC8471340 DOI: 10.3390/nu13092949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022] Open
Abstract
The Mediterranean diet (MD) has significant benefits for cardiovascular disease (CVD), yet clinicians lack reliable tools to measure patient knowledge. This study aimed to develop a short tool to test knowledge of MD related to cardiac health. Themes included foods to reduce CVD risk factors, quantification of servings, and common MD dietary patterns; a maximum score of 42 was determined for correct responses. Content validity was assessed through expert consensus in a Delphi survey. A 70% level of agreement was set for each domain tested. Repeatability was assessed via a test-retest protocol in a sample with self-reported CVD, advertised through social media and administered online. Ten and six of twenty-five invited experts responded to round one and two of the Delphi survey respectively. All items achieved greater than 70% consensus. Twenty people completed the repeatability study. A paired t-test found no significant difference in mean scores between the two test periods (Test one, 28 (standard deviation (SD) 5.4). Test two 29.5, (SD 5.5), p = 0.174) and a Bland-Altman Plot indicated no bias between the two surveys. The Med-NKQ demonstrated good content validity and reliability in people with CVD, and is short and easy to administer, making it practical in clinical and research settings.
Collapse
Affiliation(s)
- Carissa Moroney
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
| | - Fiona O’Leary
- Sydney School of Nursing, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
| | - Victoria M. Flood
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia;
- Western Sydney Local Health District, Research and Education Network, Westmead Hospital, Westmead, NSW 2145, Australia
- Correspondence: ; Tel.: +61-2-9351-9001
| |
Collapse
|
104
|
Moutou KE, England C, Gutteridge C, Toumpakari Z, McArdle PD, Papadaki A. Exploring dietitians' practice and views of giving advice on dietary patterns to patients with type 2 diabetes mellitus: A qualitative study. J Hum Nutr Diet 2021; 35:179-190. [PMID: 34370332 DOI: 10.1111/jhn.12939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dietary guidelines for type 2 diabetes mellitus (T2DM) emphasise weight management and individualised total carbohydrate intake. Evidence on the most effective dietary patterns (DPs) for T2DM management is mixed, potentially leading to variations in the advice that dietitians provide. The present study aimed to explore dietitians' practice of DP advice provision to adults with T2DM, as well as understand their views when advising their patients on the DPs deemed effective for glycaemic management or recommended by current guidelines. METHODS Semi-structured interviews were conducted with 12 UK-registered dietitians, with experience in consulting adults with T2DM. Dietitians were asked for their views on five DPs recommended for glycaemic management of T2DM. Interview transcripts were analysed using deductive and inductive thematic analysis. RESULTS Nine themes were identified that draw attention to DP advice provision practices, the five DPs (low-carbohydrate, low-fat, low-glycaemic index, Mediterranean diet and Dietary Approaches to Stop Hypertension diet), other DPs, the barriers and facilitators to DP advice provision and following this advice, and the factors affecting the provision of DP advice. Participants' current practice of DP advice provision to patients with T2DM was perceived to be individualised and patient-centred. Participants discussed their current practice and perceptions of available evidence and how patients respond to advice on the DPs shown to be effective for glycaemic management. Several barriers to providing advice on specific DPs, including safety and compliance challenges, were identified. Participants also highlighted factors that would facilitate the provision of advice on specific DPs and would help patients to follow this advice, including social support, educational resources and more robust scientific evidence. CONCLUSIONS The findings of the present study provide important insights regarding dietitians' views of promoting whole DPs to patients with T2DM. Emerged barriers and facilitators should be considered when developing future guidance for dietetic practice to support patients with following whole DPs for T2DM management.
Collapse
Affiliation(s)
- Konstantina E Moutou
- School for Policy Studies, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Clare England
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Callum Gutteridge
- School for Policy Studies, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Zoi Toumpakari
- School for Policy Studies, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Paul D McArdle
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Angeliki Papadaki
- School for Policy Studies, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| |
Collapse
|
105
|
Wirth MD, Zhao L, Turner-McGrievy GM, Ortaglia A. Associations between Fasting Duration, Timing of First and Last Meal, and Cardiometabolic Endpoints in the National Health and Nutrition Examination Survey. Nutrients 2021; 13:nu13082686. [PMID: 34444846 PMCID: PMC8397975 DOI: 10.3390/nu13082686] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Research indicates potential cardiometabolic benefits of energy consumption earlier in the day. This study examined the association between fasting duration, timing of first and last meals, and cardiometabolic endpoints using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Cross-sectional data from NHANES (2005–2016) were utilized. Diet was obtained from one to two 24-h dietary recalls to characterize nighttime fasting duration and timing of first and last meal. Blood samples were obtained for characterization of C-reactive protein (CRP); glycosylated hemoglobin (HbA1c %); insulin; glucose; and high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol. Survey design procedures for adjusted linear and logistic regression were performed. Results: Every one-hour increase in nighttime fasting duration was associated with a significantly higher insulin and CRP, and lower HDL. Every one-hour increase in timing of the last meal of the day was statistically significantly associated with higher HbA1c and lower LDL. Every one-hour increase in first mealtime was associated with higher CRP (β = 0.044, p = 0.0106), insulin (β = 0.429, p < 0.01), and glucose (β = 0.662, p < 0.01), and lower HDL (β = −0.377, p < 0.01). Conclusion: In this large public health dataset, evidence for the beneficial effect of starting energy consumption earlier in the day on cardiometabolic endpoints was observed.
Collapse
Affiliation(s)
- Michael D. Wirth
- College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (L.Z.); (A.O.)
- Correspondence: ; Tel.: +1-(803)-576-6736
| | - Longgang Zhao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (L.Z.); (A.O.)
| | - Gabrielle M. Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29209, USA;
| | - Andrew Ortaglia
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (L.Z.); (A.O.)
| |
Collapse
|
106
|
Cary MA, Gyurcsik NC. Differences in adaptive and maladaptive psychosocial responses to chronic pain among adults with varying physical activity levels. Br J Pain 2021; 15:259-269. [PMID: 34381611 PMCID: PMC8339946 DOI: 10.1177/2049463720942535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AIM Chronic pain is a global public health problem that detrimentally impacts people's health and well-being. Physical activity is beneficial and a recommended self-management strategy for adults living with chronic pain. Yet, many of them struggle to meet the public health recommendation of 150+ minutes/week of moderate-vigorous physical activity. Identifying modifiable factors related to physical activity participation is needed. Adaptive (i.e., self-regulatory efficacy to overcome pain and related barriers [SRE-pain], psychological flexibility) and maladaptive (i.e. pain anxiety) responses were the modifiable factors examined in the present study. The purpose was to investigate whether adults living with chronic pain who were sufficiently active, insufficiently active or inactive significantly differed in their adaptive and maladaptive responses to chronic pain. METHODS Adults with self-reported chronic pain for 6+ months (N = 318) completed an online survey that measured physical activity, psychological flexibility, SRE-pain and pain anxiety. Sufficiently active (n = 139), insufficiently active (n = 91) and inactive (n = 88) groups were identified. RESULTS A significant multivariate analysis of covariance (MANCOVA) (p < .001) with univariate follow-up tests illustrated that the sufficiently active individuals reported the highest psychological flexibility and SRE-pain compared to insufficiently active and inactive individuals (p's < .001). Overall, sufficiently active participants responded the most adaptively and least maladaptively to their pain, followed by the insufficiently active. Inactive participants responded the most maladaptively. CONCLUSION Identifying differences in adaptive and maladaptive responses to pain highlights possible modifiable factors to target in future physical activity intervention research that focuses on improving chronic pain self-management.
Collapse
Affiliation(s)
- Miranda A Cary
- School of Health and Exercise Sciences,
The University of British Columbia Okanagan, Kelowna, BC, Canada
| | | |
Collapse
|
107
|
Simonsson O, Osika W, Carhart-Harris R, Hendricks PS. Associations between lifetime classic psychedelic use and cardiometabolic diseases. Sci Rep 2021; 11:14427. [PMID: 34257396 PMCID: PMC8277805 DOI: 10.1038/s41598-021-93787-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/24/2021] [Indexed: 12/14/2022] Open
Abstract
The objective of the current study was to investigate the associations between lifetime classic psychedelic use and cardiometabolic diseases. Using data from the National Survey on Drug Use and Health (2005-2014), the present study examined the associations between lifetime classic psychedelic use and two types of cardiometabolic disease: heart disease and diabetes. Respondents who reported having tried a classic psychedelic at least once in their lifetime had lower odds of heart disease in the past year (adjusted odds ratio (aOR) = 0.77 (0.65-0.92), p = .006) and lower odds of diabetes in the past year (adjusted odds ratio (aOR) = 0.88 (0.78-0.99), p = .036). Classic psychedelic use might be beneficial for cardiometabolic health, but more research is needed to investigate potential causal pathways of classic psychedelics on cardiometabolic diseases.
Collapse
Affiliation(s)
- Otto Simonsson
- Department of Sociology, University of Oxford, Oxford, UK.
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Solna, Sweden.
| | - Walter Osika
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Solna, Sweden
- Department of Neurobiology, Care Sciences and Society, Center for Social Sustainability, Karolinska Institute, Solna, Sweden
- Northern Stockholm Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | | | - Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, UK
| |
Collapse
|
108
|
Bonten TN, Verkleij SM, van der Kleij RM, Busch K, van den Hout WB, Chavannes NH, Numans ME. Selective prevention of cardiovascular disease using integrated lifestyle intervention in primary care: protocol of the Healthy Heart stepped-wedge trial. BMJ Open 2021; 11:e043829. [PMID: 34244248 PMCID: PMC8273466 DOI: 10.1136/bmjopen-2020-043829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Lifestyle interventions are shown to be effective in improving cardiovascular disease (CVD) risk factors. It has been suggested that general practitioners can play an essential role in CVD prevention. However, studies into lifestyle interventions for primary care patients at high cardiovascular risk are scarce and structural implementation of lifestyle interventions can be challenging. Therefore, this study aims to (1) evaluate (cost-)effectiveness of implementation of an integrated group-based lifestyle programme in primary care practices; (2) identify effective intervention elements and (3) identify implementation determinants of an integrated group-based lifestyle intervention for patients with high cardiovascular risk. METHODS AND ANALYSIS The Healthy Heart study is a non-randomised cluster stepped-wedge trial. Primary care practices will first offer standard care during a control period of 2-6 months, after which practices will switch (step) to the intervention, offering participants a choice between a group-based lifestyle programme or standard care. Participants enrolled during the control period (standard care) will be compared with participants enrolled during the intervention period (combined standard care and group-based lifestyle intervention). We aim to include 1600 primary care patients with high cardiovascular risk from 55 primary care practices in the area of The Hague, the Netherlands. A mixed-methods process evaluation will be used to simultaneously assess effectiveness and implementation outcomes. The primary outcome measure will be achievement of individual lifestyle goals after 6 months. Secondary outcomes include lifestyle change of five lifestyle components (smoking, alcohol consumption, diet, weight and physical activity) and improvement of quality of life and self-efficacy. Outcomes are assessed using validated questionnaires at baseline and 3, 6, 12 and 24 months of follow-up. Routine care data will be used to compare blood pressure and cholesterol levels. Cost-effectiveness of the lifestyle intervention will be evaluated. Implementation outcomes will be assessed using the RE-AIM model, to assesses five dimensions of implementation at different levels of organisation: reach, efficacy, adoption, implementation and maintenance. Determinants of adoption and implementation will be assessed using focus groups consisting of professionals and patients. ETHICS AND DISSEMINATION This study is approved by the Ethics Committee of the Leiden University Medical Center (P17.079). Results will be shared with the primary care group, healthcare providers and patients, and will be disseminated through journal publications and conference presentations. TRIAL REGISTRATION NUMBER NL60795.058.17. Status: pre-results.
Collapse
Affiliation(s)
- Tobias N Bonten
- Department of Public Health and Primary Care, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - Sanne Marije Verkleij
- Department of Public Health and Primary Care, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - Rianne Mjj van der Kleij
- Department of Public Health and Primary Care, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - Karin Busch
- Hadoks Chronische zorg BV, Den Haag, The Netherlands
| | - Wilbert B van den Hout
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - Mattijs E Numans
- Department of Public Health and Primary Care, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| |
Collapse
|
109
|
Delesie M, Desteghe L, Bertels M, Gerets N, Van Belleghem F, Meyvis J, Elegeert I, Dendale P, Heidbuchel H. Motivation of overweight patients with atrial fibrillation to lose weight or to follow a weight loss management program: a cross-sectional study. Acta Cardiol 2021; 76:494-503. [PMID: 33228467 DOI: 10.1080/00015385.2020.1848274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS Overweight increases the risk of recurrence and progression of atrial fibrillation (AF). This study assesses the knowledge of overweight AF patients about the relation between their weight and AF, to gauge their motivation losing weight and/or following weight reduction programs. METHODS A multicenter cross-sectional descriptive study was performed at three Belgian hospitals. A validated self-developed questionnaire was presented to AF patients with a body mass index (BMI) >27 kg/m2 and it addressed: motivation to reduce weight and its related factors; knowledge about the relation between weight and AF; and interest in weight reduction programs. RESULTS One hundred and forty-three patients completed the questionnaire. 75.5% was currently motivated to reduce weight. Multivariate regression analysis showed that a higher BMI, a college/university degree, male gender, without hypertension, previous weight loss attempt(s) and living with a partner, were significantly associated with greater motivation for weight reduction. Only 69.9% of the patients was aware of the positive effect of weight reduction on the progression of AF. A completely home-based/telerehabilitation program was the preferred approach for 57.9% of the patients. CONCLUSIONS AF patients with overweight need to be better informed about overweight as a risk factor for AF. Female AF patients with a lower degree of education, hypertension, living alone, who have never attempted to reduce weight and with a lower but still elevated BMI need more external motivation to lose weight. A tailored weight reduction program (home-based) is the preferred option for patients. This will require further development and validation of telecoaching programs for this patient group.
Collapse
Affiliation(s)
- Michiel Delesie
- Research Group Cardiovascular Diseases, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Lien Desteghe
- Research Group Cardiovascular Diseases, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Heart Center Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Marianne Bertels
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Noor Gerets
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | | | - Jasper Meyvis
- Research Group Cardiovascular Diseases, University of Antwerp, Antwerp, Belgium
| | - Ivan Elegeert
- Department of Cardiology, AZ Groeninge, Kortrijk, Belgium
| | - Paul Dendale
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Heart Center Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Hein Heidbuchel
- Research Group Cardiovascular Diseases, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| |
Collapse
|
110
|
Río-Lanza ABD, Suárez-Álvarez L, Suárez-Vázquez A. Accompanying Patients Aged 65 or Over: How Companions' Health Literacy Affects Value Co-Creation During Medical Encounters. J Aging Health 2021; 33:953-964. [PMID: 34210198 DOI: 10.1177/08982643211029163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: The recent health crisis has led to a tightening of visitor policies during medical consultations. This work studies the relationship between the companion's health literacy (functional, interactive, and critical) and the companion's co-creation of value (co-production and value in use). Methods: Six hypotheses are tested by means of a sample of companions of chronically ill patients over the age of 65, using structural equation modeling. Results: Functional literacy does not predict the co-creation of value through either of its dimensions (co-production and value in use). Interactive literacy has a positive influence on co-production and a negative influence on value in use. Critical literacy only positively influences value in use. Discussion: Merely understanding the health information is not sufficient for the companion to be recognized as a collaborator or "ally" of the doctor. It is necessary to encourage the companion's communication and critical evaluation skills.
Collapse
|
111
|
Flora PK, Lopez P, Mina DS, Jones JM, Brawley LR, Sabiston CM, Ferguson SE, Obadia MM, Auger LE. Feasibility and acceptability of a group-mediated exercise intervention for gynecological cancer survivors. J Psychosoc Oncol 2021; 40:770-789. [PMID: 34185628 DOI: 10.1080/07347332.2021.1939474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Examine feasibility and acceptability of a group-mediated cognitive-behavioral (GMCB) intervention targeting planned, self-managed physical activity (PA). DESIGN Sequential mixed methods, single arm pre-/post-test design with a 4-week follow-up. PARTICIPANTS Post-treatment gynecologic cancer survivors. METHODS Participants attended 8 weekly facilitator-led group sessions and completed assessments at baseline, post-intervention and follow-up. Feasibility was assessed by recruitment rate, retention rate, capture of outcomes, intervention usability and intervention fidelity. Acceptability was examined via qualitative interviews. Preliminary estimates of intervention effectiveness (PA, PA social cognitions and sleep) were collected. FINDINGS 355 participants were approached and 38 consented. Twenty took part in the study and 17 (85%) completed the intervention. Thematic content analysis revealed positive group experiences. Cognitive-behavioral strategies were beneficial. Goal-setting and shared cancer recovery experience facilitated connection among group members. IMPLICATIONS Program acceptability was high among a diverse sample of gynecologic cancer survivors and delivery of the program is feasible to this group of gynecologic cancer survivors. Recruitment challenges were present but study retention was high.
Collapse
Affiliation(s)
- Parminder K Flora
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Paty Lopez
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Jennifer M Jones
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | | | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Sarah E Ferguson
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
| | - Maya M Obadia
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Kinesiology, University of Guelph-Humber, Toronto, Canada
| | - Leslie E Auger
- Kinesiology, University of Guelph-Humber, Toronto, Canada
| |
Collapse
|
112
|
Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, Dendale P, Dorobantu M, Edvardsen T, Folliguet T, Gale CP, Gilard M, Jobs A, Jüni P, Lambrinou E, Lewis BS, Mehilli J, Meliga E, Merkely B, Mueller C, Roffi M, Rutten FH, Sibbing D, Siontis GC. Guía ESC 2020 sobre el diagnóstico y tratamiento del síndrome coronario agudo sin elevación del segmento ST. Rev Esp Cardiol (Engl Ed) 2021. [DOI: 10.1016/j.recesp.2020.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
113
|
Hailu GN, Gebru HB, Siyoum Belay D. Assessment of Healthy Diet and Physical Activity Among Students of Mekelle University, Northern Ethiopia: A Cross-Sectional Study. NUTRITION AND DIETARY SUPPLEMENTS 2021. [DOI: 10.2147/nds.s287278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
114
|
Kosowan L, Katz A, Halas G, Singer A. Patient perspectives on tablet-based technology to collect risk factor information in primary care. BMC FAMILY PRACTICE 2021; 22:103. [PMID: 34039256 PMCID: PMC8157443 DOI: 10.1186/s12875-021-01443-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Primary care provides an opportunity to introduce prevention strategies and identify risk behaviours. Algorithmic information technology such as the Risk Factor Identification Tool (RFIT) can support primary care counseling. This study explores the integration of the tablet-based RFIT in primary care clinics to support exploration of patient risk factor information. METHODS Qualitative study to explore patients' perspectives of RFIT. RFIT was implemented in two primary care clinics in Manitoba, Canada. There were 207 patients who completed RFIT, offered to them by eight family physicians. We conducted one-on-one patient interviews with 86 patients to capture the patient's perspective. Responses were coded and categorized into five common themes. RESULTS RFIT had a completion rate of 86%. Clinic staff reported that very few patients declined the use of RFIT or required assistance to use the tablet. Patients reported that the tablet-based RFIT provided a user-friendly interface that enabled self-reflection while in the waiting room. Patients discussed the impact of RFIT on the patient-provider interaction, utility for the clinician, their concerns and suggested improvements for RFIT. Among the patients who used RFIT 12.1% smoked, 21.2% felt their diet could be improved, 9.3% reported high alcohol consumption, 56.4% reported less than 150 min of PA a week, and 8.2% lived in poverty. CONCLUSION RFIT is a user-friendly tool for the collection of patient risk behaviour information. RFIT is particularly useful for patients lacking continuity in the care they receive. Information technology can promote self-reflection while providing useful information to the primary care clinician. When combined with practical tools and resources RFIT can assist in the reduction of risk behaviours.
Collapse
Affiliation(s)
- Leanne Kosowan
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alan Katz
- Manitoba Centre for Health Policy and Departments of Community Health Science & Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, 408-727 McDermot Ave., Winnipeg, Manitoba, R3E 3P5, Canada.
| | - Gayle Halas
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alexander Singer
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
115
|
Stern D, Blanco I, Olmos LA, Valdivia JJ, Shrestha A, Mattei J, Spiegelman D. Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study. BMC Public Health 2021; 21:973. [PMID: 34022846 PMCID: PMC8141192 DOI: 10.1186/s12889-021-11004-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 05/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Worksite-based nutrition interventions can serve as access points to facilitate healthy eating and translate existing knowledge of cardiometabolic disease prevention. We explored perceptions, facilitators, and barriers for healthy eating in a cafeteria at a large worksite in Mexico City. METHODS We conducted an exploratory qualitative study in a large department store in Mexico City with ~ 1500 employees. We conducted eight focus group discussions (FGD) with 63 employees stratified by job category (sales, maintenance, shipping, restaurant, cafeteria, administrative staff, and sales managers). Employees were invited to participate in the FGD if they were at the store at the day and time of the FGD for their job type. FGDs were audio-recorded, transcribed verbatim and analyzed using the thematic method. This process involved the researches´ familiarizing themselves with the data, generating initial codes, searching for themes, reviewing the themes, defining and naming themes, and then interpreting the data. RESULTS Employees defined healthy eating as eating foods that are fresh, diverse, and prepared hygienically. The most commonly reported facilitators of healthy eating at the worksite were availability of affordable healthy food options and employees' high health awareness. Major barriers to healthy eating included unavailability of healthy foods, unpleasant taste of food, and preference for fatty foods and meat. For lower-wage workers, affordability was a major concern. Other barriers included lack of time to eat work and long working hours. CONCLUSION A broad range of factors affect healthy eating at the cafeteria, some related to nutrition and some related to the employees type of job. Availability of healthy, hygienic, and tasty food at an affordable price could lead to healthier food choices in the worksite cafeteria. These strategies, along with work schedules that allow sufficient time for healthy eating, may help improve dietary behaviors and health of employees.
Collapse
Affiliation(s)
- Dalia Stern
- CONACyT-Center for Research on Population Health, National Institute of Public Health, Cuernavaca, 7ª Cerrada Fray Pedro de Gante # 50, Col. Sección XVI Tlalpan, 14080, Mexico City, Mexico.
- Lown Scholar, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Ilian Blanco
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Lucy A Olmos
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Joel J Valdivia
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Archana Shrestha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Institute of Implementation Science and Health, Kathmandu, Nepal
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Donna Spiegelman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| |
Collapse
|
116
|
Wine Polyphenols and Health: Quantitative Research Literature Analysis. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11114762] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The relationship between wine polyphenols and health has been receiving growing scientific attention in the last few years. To confirm this point, the proposed paper identifies the major contributors to academic journals regarding the relationships between wine polyphenols and health. The endpoints of the proposed study are to provide a comprehensive overview and analysis of the literature regarding the relationships between wine polyphenol and health based on a bibliometric analysis. Bibliometric data were extracted from the Scopus online database using the search string TITLE-ABS-KEY (wine AND polyphenol* AND health OR (“french paradox” OR “cardiovascular disease*” OR atherosclerosis OR microbiota) and analyzed using the VOSviewer bibliometric software to generate bubble maps and to visualize the obtained results. This perspective paper analyzes: (i) the research themes addressing the relationships between wine polyphenols and health; (ii) the major contributors’ origin, e.g., country and/or regions; (iii) the institutions where the research is based; (iv) the authors; and (v) the type of paper. These results represent a useful tool to identify emerging research directions, collaboration networks, and suggestions for more in-depth literature searches.
Collapse
|
117
|
McCormack C, Kehoe B, Hardcastle SJ, McCaffrey N, McCarren A, Gaine S, McCullagh B, Moyna N. Pulmonary hypertension and home-based (PHAHB) exercise intervention: protocol for a feasibility study. BMJ Open 2021; 11:e045460. [PMID: 33972341 PMCID: PMC8112432 DOI: 10.1136/bmjopen-2020-045460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Novel therapies for pulmonary hypertension (PH) have improved survival and slowed disease progression. However, patients still present with symptoms of exertional dyspnoea and fatigue, which impacts their ability to perform activities of daily living, reduces exercise tolerance and impairs their quality of life (QoL). Exercise training has shown to be safe and effective at enhancing QoL and physical function in PH patients, yet it remains an underused adjunct therapy. Most exercise training for PH patients has been offered through hospital-based programmes. Home-based exercise programmes provide an alternative model that has the potential to increase the availability and accessibility of exercise training as an adjunct therapy in PH. The purpose of this study is to investigate the feasibility, acceptability, utility and safety of a novel remotely supervised home-based PH exercise programme. METHODS Single arm intervention with a pre/post comparisons design and a follow-up maintenance phase will be employed. Eligible participants (n=25) will be recruited from the Mater Misericordiae University Hospital PH Unit. Participants will undergo a 10-week home-based exercise programme, with induction training, support materials, telecommunication support and health coaching sessions followed by a 10-week maintenance phase. The primary outcomes are feasibility, acceptability, utility and safety of the intervention. Secondary outcomes will include the impact of the intervention on exercise capacity, physical activity, strength, health-related QoL and exercise self-efficacy. ETHICS AND DISSEMINATION Ethics approval has been obtained from the Mater Misericordiae Institutional Review Board REF:1/378/2032 and Dublin City University Research Ethics DCUREC/2018/246. A manuscript of the results will be submitted to a peer-reviewed journal and results will be presented at conferences, community and consumer forums and hospital research conferences. TRIAL REGISTRATION NUMBER ISRCTN83783446; Pre-results.
Collapse
Affiliation(s)
- Ciara McCormack
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Brona Kehoe
- Department of Sport & Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Sarah J Hardcastle
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | | | - Andrew McCarren
- Insight Centre for Data Analytics, Dublin City University, Dublin, Ireland
| | - Sean Gaine
- Respiratory Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Brian McCullagh
- Respiratory Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| |
Collapse
|
118
|
Qin H, Mayer H, Öztürk B, Badr Eslam R. Patients’ Perspectives With Acute Coronary Syndrome After Percutaneous Coronary Intervention. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
119
|
Maduri C, Sabrina Hsueh PY, Li Z, Chen CH, Papoutsakis C. Applying Contemporary Machine Learning Approaches to Nutrition Care Real-World Evidence: Findings From the National Quality Improvement Data Set. J Acad Nutr Diet 2021; 121:2549-2559.e1. [PMID: 33903081 DOI: 10.1016/j.jand.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 11/28/2022]
Abstract
Using real-world data from the Academy of Nutrition and Dietetics Health Informatics Infrastructure, we use state-of-the-art clustering techniques to identify 2 phenotypes characterizing the episodes of nutrition care observed in the National Quality Improvement (NQI) registry data set. The 2 phenotypes identified from recorded Nutrition Care Process data in the NQI exhibit a strong correspondence with the clinical expertise of registered dietitian nutritionists. For one of these phenotypes, it was possible to implement state-of-the-art classification techniques to predict the nutrition problem-resolution status of an episode of care. Prediction results show that the assessment of nutrition history, number of recorded visits in the episode, and use of nutrition counseling interventions were significantly and positively correlated with problem resolution. Meanwhile, evaluations of nutrition history that were not within the desired ranges were significantly and negatively correlated with problem resolution. Finally, we assess the usefulness of the current NQI data set and data model for supporting the application of contemporary machine learning methods to the data set. We also suggest ways of enhancing the NQI since registered dietitian nutritionists are encouraged to continue to contribute patient cases in this and other registry nutrition studies.
Collapse
Affiliation(s)
- Chandramouli Maduri
- Watson Health Foundational Technology, IBM Cloud and Cognitive Software, Yorktown Heights, NY
| | - Pei-Yun Sabrina Hsueh
- Center for Computational Health, IBM T.J. Watson Research Center, Yorktown Heights, NY
| | - Zhiguo Li
- Center for Computational Health, IBM T.J. Watson Research Center, Yorktown Heights, NY
| | - Ching-Hua Chen
- Center for Computational Health, IBM T.J. Watson Research Center, Yorktown Heights, NY
| | - Constantina Papoutsakis
- Nutrition and Dietetics Data Science Center, Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL.
| |
Collapse
|
120
|
Michaelis M, Witte (née Farian) C, Schüle B, Frick K, Rieger MA. Can Motivational Interviewing Make a Difference in Supporting Employees to Deal with Elevated Blood Pressure? A Feasibility Study at the Workplace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4179. [PMID: 33920894 PMCID: PMC8071336 DOI: 10.3390/ijerph18084179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/30/2021] [Accepted: 04/10/2021] [Indexed: 11/27/2022]
Abstract
Background: To overcome the problem of a high prevalence of undiscovered or untreated arterial hypertension in people of working age, the effects of behavioral change counseling in occupational health (OH) services should be investigated. The technique of motivational interviewing (MI) to support health-related lifestyle changes by physicians and/or occupational nurses ('health coach') has been shown to be successful in patients with chronic diseases. In 2010, we planned a randomized controlled trial (RCT) with employees who suffer from mild arterial hypertension. A preliminary feasibility study was performed in a large manufacturing company in Germany. Methods: All employees with elevated blood pressure measured by the OH-service were invited to undergo validation by 30 self-measurements. Persons with validated elevated values and without medical treatment received either usual hypertension counseling (control group, CG) or intensified MI-counseling (intervention group, IG) by the occupational health physician. Subsequently, the IG received MI-support from the 'health coach' in four telephone counseling sessions. Assessed feasibility factors included organizational processes, the acceptance of the validation procedure and the MI-counseling, and as primary outcome for an RCT the extent to which participants made health-related changes to their lifestyles. Results: Initially, 299 individuals were included in Study Part A (screening). At the end of Study Part B (intervention), out of 34 participants with validated and non-treated mild hypertension, only 7 (IG) and 6 (CG) participants completed the intervention including documentation. The high drop-out rate was due to the frequent lack of willingness to perform the 30 self-measurements at home with their own equipment. Acceptance was little higher when we changed the method to two repeated measurements in the OH service. MI-counseling, especially by the health coach, was evaluated positively. Conclusions: Despite the promising counseling approach, the feasibility study showed that an RCT with previous screening in the operational setting can only be implemented with high financial and personnel effort to reach an appropriate number of subjects. This substantial result could only be achieved through this comprehensive feasibility study, which investigated all aspects of the planned future RCT.
Collapse
Affiliation(s)
- Martina Michaelis
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, 72074 Tübingen, Germany; (C.W.); (M.A.R.)
- Research Centre for Occupational and Social Medicine (FFAS), 79098 Freiburg, Germany
| | - Carmen Witte (née Farian)
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, 72074 Tübingen, Germany; (C.W.); (M.A.R.)
| | - Barbara Schüle
- Occupational Health Service, Daimler AG, 70546 Stuttgart, Germany;
| | - Katrin Frick
- German Academy for Psychology, 10179 Berlin, Germany;
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, 72074 Tübingen, Germany; (C.W.); (M.A.R.)
| |
Collapse
|
121
|
Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, Dendale P, Dorobantu M, Edvardsen T, Folliguet T, Gale CP, Gilard M, Jobs A, Jüni P, Lambrinou E, Lewis BS, Mehilli J, Meliga E, Merkely B, Mueller C, Roffi M, Rutten FH, Sibbing D, Siontis GCM. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021; 42:1289-1367. [PMID: 32860058 DOI: 10.1093/eurheartj/ehaa575] [Citation(s) in RCA: 2773] [Impact Index Per Article: 924.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
122
|
Calvo-Malvar M, Benítez-Estévez AJ, Sánchez-Castro J, Leis R, Gude F. Effects of a Community-Based Behavioral Intervention with a Traditional Atlantic Diet on Cardiometabolic Risk Markers: A Cluster Randomized Controlled Trial ("The GALIAT Study"). Nutrients 2021; 13:1211. [PMID: 33916940 PMCID: PMC8067574 DOI: 10.3390/nu13041211] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/30/2021] [Accepted: 04/03/2021] [Indexed: 12/30/2022] Open
Abstract
The Atlantic diet, the traditional dietary pattern in northern Portugal and northwest Spain, has been related to metabolic health and low ischemic heart disease mortality. The Galiat Study is a randomized controlled trial aimed to assess the effects of the Atlantic diet on anthropometric variables, metabolic profile, and nutritional habits. The dietary intervention was conducted in 250 families (720 adults and children) and performed at a primary care center. Over six months, families randomized to the intervention group received educational sessions, cooking classes, written supporting material, and foods that form part of the Atlantic diet, whereas those randomized to the control group followed their habitual lifestyle. 213 families (92.4%) completed the trial. Adults in the intervention group lost weight as opposed to controls who gained weight (adjusted mean difference -1.1 kg, p < 0.001) and total serum cholesterol (adjusted mean difference -5.2 mg/dL, p = 0.004). Significant differences in favor of the intervention were found in other anthropometric variables and low-density lipoprotein cholesterol, but changes in triglycerides, high-density lipoprotein cholesterol, inflammation markers, blood pressure, and glucose metabolism were not observed. A family-based nutritional intervention based on the Atlantic diet showed beneficial effects on adiposity and the lipid profile.
Collapse
Affiliation(s)
- Mar Calvo-Malvar
- Department of Laboratory Medicine, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- Research Methods Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.S.-C.); (F.G.)
- Primary Care Prevention and Health Promotion Network, Carlos III Health Institute, 28029 Madrid, Spain
| | - Alfonso J. Benítez-Estévez
- Department of Laboratory Medicine, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- Research Methods Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.S.-C.); (F.G.)
- Primary Care Prevention and Health Promotion Network, Carlos III Health Institute, 28029 Madrid, Spain
| | - Juan Sánchez-Castro
- Research Methods Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.S.-C.); (F.G.)
- Primary Care Prevention and Health Promotion Network, Carlos III Health Institute, 28029 Madrid, Spain
- A Estrada Primary Care Center, A Estrada, 36680 Pontevedra, Spain
| | - Rosaura Leis
- Unit of Investigation in Human Nutrition, Growth and Development of Galicia (GALINUT), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, University Clinical Hospital of Santiago (CHUS), 15706 Santiago de Compostela, Spain
- Pediatric Nutrition Research Group, Institute of Sanitary Research of Santiago de Compostela (IDIS), CHUS-USC, 15706 Santiago de Compostela, Spain
- CIBEROBN, (Physiopathology of Obesity and Nutrition) Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain
| | - Francisco Gude
- Research Methods Group, Health Research Institute of Santiago de Compostela, 15706 Santiago de Compostela, Spain; (J.S.-C.); (F.G.)
- Primary Care Prevention and Health Promotion Network, Carlos III Health Institute, 28029 Madrid, Spain
- Clinical Epidemiology and Biostatistics Unit, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| |
Collapse
|
123
|
Relationship between Dietary Patterns and Cardiovascular Disease Risk in Korean Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073703. [PMID: 33916265 PMCID: PMC8038041 DOI: 10.3390/ijerph18073703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the relationship between dietary patterns and the 10-year risk of cardiovascular disease (CVD) in the elderly population in Korea. METHODS Cluster analysis was conducted on the data of 1687 elderly participants (797 men and 890 women) aged ≥65 years from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES), using a 24-h dietary recall survey to assess dietary patterns. Dietary patterns were classified into clusters 1 (typical Korean diet), 2 (high carbohydrate diet), and 3 (healthy diet). The 10-year risk of CVD was calculated based on age, total and HDL-cholesterol levels, systolic blood pressure level, antihypertensive medication use, smoking status, and presence of diabetes. A complex sample general linear model was applied to determine the association between dietary patterns and the 10-year risk of CVD. RESULTS In total, 275 (33.7%), 141 (17.9%), and 381 (48.3%) men, and 207 (22.6%), 276 (30.9%), and 407(46.6%) women were included in clusters 1, 2, and 3, respectively. The 10-year risk of CVD was lower in men in cluster 3 (healthy diet) than in those in cluster 1 (typical Korean diet) (t = 2.092, p = 0.037). Additionally, the 10-year risk of CVD was lower in men who performed strength training than in those who did not (t = 3.575, p < 0.001). There were no significant differences in women. CONCLUSIONS After adjusting for sociodemographic variables, men who consumed a healthy diet had a lower 10-year risk of CVD than those who consumed a typical Korean diet. When organizing nutrition education programs to improve dietary habits in the elderly, content on diets that consist of various food groups to prevent CVD is required. In particular, it is necessary to develop content that emphasizes the importance of healthy eating habits in men.
Collapse
|
124
|
Cox JS, Searle AJ, Hinton EC, Giri D, Shield JPH. Perceptions of non-successful families attending a weight-management clinic. Arch Dis Child 2021; 106:377-382. [PMID: 33139347 DOI: 10.1136/archdischild-2020-319558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study seeks to understand family's perceptions of their care at a paediatric weight management service, with a view to informing service improvement. DESIGN A qualitative service review conducted via semistructured interviews with parents (n=11) and children (n=3) who attended the clinic. The recruitment was open to all, but those who were not succeeding in their weight-loss goals self-selected to participate. Self-Determination Theory was used as a framework to explore families' experiences of the clinic. SETTING Recruitment occurred during clinical appointments and interviews were conducted over the phone in the days following the appointments. PATIENTS The service sees paediatric patients with a body mass index >99th percentile, with comorbidities or safeguarding concerns. INTERVENTIONS The clinic's service includes appointments typically every 2 months, with a multidisciplinary team including consultant endocrinologists, a dietician, a clinical psychologist, a social worker and a clinical nurse specialist. MAIN OUTCOME MEASURES Families' feedback on the multi-disciplinary team (MDT) clinic, and their perceptions of how improvements could be made. RESULTS Families perceive a lack of autonomy, competency and feel a lack of connectivity both in their lives broadly and within their experience at the clinic. CONCLUSIONS Interventions in families struggling with weight improvements should see the clinical team placing more emphasis on working alongside parents to develop young people's sense of self-determination. Expectations must be set that success originates from changes outside of clinical appointments and that the clinical team is in place to support the family's development of sustainable, self-determined lifestyle habits.
Collapse
Affiliation(s)
- Jennifer S Cox
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Aidan J Searle
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Elanor C Hinton
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| | - Dinesh Giri
- Department of Paediatric Endocrinology, Bristol Royal Hospital for Children, Bristol, UK.,Department of Translational Health Sciences, University of Bristol, Bristol, UK
| | - Julian P H Shield
- National Institute for Health Research Bristol Biomedical Research Centre, Nutrition Theme, University of Bristol, Bristol, UK
| |
Collapse
|
125
|
Han G, Han J, Han K, Chung TY, Na KS, Lim DH. Relationships among visual acuity, risk of acute myocardial infarction, and stroke: a nationwide cohort study in south korea. Ophthalmic Epidemiol 2021; 29:57-69. [PMID: 33726622 DOI: 10.1080/09286586.2021.1893340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: Visual impairment (VI) is highly prevalent in the elderly and is associated with functional decline. Previous research demonstrated an association between VI and cardiovascular events, but investigations have yet to be conducted in general population samples. We evaluated the relationship between visual acuity (VA) and development of cardiovascular diseases (CVD) in a nationwide Korean population.Methods: This is a nationwide retrospective cohort study. We used the National Health Information Database of the National Health Insurance Service of Korea to identify subjects who participated in the National Health Insurance Service health screening program in 2012. We monitored 5,941,761 subjects for the development of cardiovascular diseases for a period of 5 years.Results: After adjustments for age, sex, and other covariates, with subjects having a visual acuity better than 20/20 as the reference group, the adjusted hazard ratios (HRs) and 95% confidential intervals (CI) for acute myocardial infarction and stroke were visual acuity between 20/20 and 20/60, 1.073 (95% CI 1.053, 1.094) and 1.151 (95% CI 1.132, 1.171), respectively; for visual acuity between 20/60 and 20/200, 1.236 (95% CI 1.197, 1.277), and 1.336 (95% CI 1.302, 1.371), respectively; and for visual acuity worse than 20/200, 1.325 (95% CI 1.285, 1.366) and 1.383 (95% CI 1.349, 1.418), respectively.Conclusion: Subjects with lower VA had higher risks of acute myocardial infarction and stroke. These results suggest that low VA is an independent risk factor for CVD.
Collapse
Affiliation(s)
- Gyule Han
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jisang Han
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, Yeouido St. Mary's Hospital, Seoul, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.,Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| |
Collapse
|
126
|
Ryu H, Jung J, Moon J. Effectiveness of a Mobile Health Management Program With a Challenge Strategy for Improving the Cardiovascular Health of Workers. J Occup Environ Med 2021; 63:e132-e137. [PMID: 33395169 DOI: 10.1097/jom.0000000000002130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Workers' cardiovascular health can be influenced by individual willingness to practice healthy behaviors. A mobile health management program with a challenge strategy was administered to promote workers' healthy behaviors among small to medium-sized enterprises. METHODS A 12-week program consisted of health communication with a challenge strategy was administered to the workers. RESULTS The intervention group showed significantly improved scores for cardiovascular disease-related health behavior (Z = -2.44, P = 0.013), the job stress contributing factor of inadequate social support (F = 4.10, P = 0.049), and the cardiovascular disease-related health status of waist circumference (t = 3.22, P = 0.004), body fat (Z = -2.23, P = 0.024), and triglycerides (Z = -3.04, P = 0.001). CONCLUSION This study's significance is its potential for increasing the convenience and joy of participating in intervention programs and acquiring health information through mobile platforms, which are easily accessible to the workers.
Collapse
Affiliation(s)
- Hosihn Ryu
- College of Nursing, Korea University, Seoul, Republic of Korea
| | | | | |
Collapse
|
127
|
Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3176] [Impact Index Per Article: 1058.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
Collapse
|
128
|
Lee MT, Mahtta D, Alam M, Ullah W, Nasir K, Hanif B, Virani SS. Contemporary outcomes studies to identify and mitigate the risk in patients with premature cardiovascular disease. Expert Rev Pharmacoecon Outcomes Res 2021; 21:559-570. [DOI: 10.1080/14737167.2021.1888718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Michelle T. Lee
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
| | - Dhruv Mahtta
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Mahboob Alam
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Waqas Ullah
- Department of Internal Medicine, Abington Jefferson Health, Abington, PA, USA
| | - Khurram Nasir
- Department of Cardiology, Center for Outcomes Research, Houston Methodist Hospital, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Bashir Hanif
- Section of Cardiology, Tabba Heart Institute, Karachi, Pakistan
| | - Salim S. Virani
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
| |
Collapse
|
129
|
Kosowan L, Katz A, Halas G, LaBine L, Singer A. Using Information Technology to Assess Patient Risk Factors in Primary Care Clinics: Pragmatic Evaluation. JMIR Form Res 2021; 5:e24382. [PMID: 33528376 PMCID: PMC7886616 DOI: 10.2196/24382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Tobacco use, physical inactivity, and poor diet are associated with morbidity and premature death. Health promotion and primary prevention counseling, advice, and support by a primary care provider lead to behavior change attempts among patients. However, although physicians consider preventative health important, there is often a larger focus on symptom presentation, acute care, and medication review. OBJECTIVE This study evaluated the feasibility, adoption, and integration of the tablet-based Risk Factor Identification Tool (RFIT) that uses algorithmic information technology to support obtainment of patient risk factor information in primary care clinics. METHODS This is a pragmatic developmental evaluation. Each clinic developed a site-specific implementation plan adapted to their workflow. The RFIT was implemented in 2 primary care clinics located in Manitoba. Perceptions of 10 clinic staff and 8 primary care clinicians informed this evaluation. RESULTS Clinicians reported a smooth and fast transfer of RFIT responses to an electronic medical record encounter note. The RFIT was used by 207 patients, with a completion rate of 86%. Clinic staff reported that approximately 3%-5% of patients declined the use of the RFIT or required assistance to use the tablet. Among the 207 patients that used the RFIT, 22 (12.1%) smoked, 39 (21.2%) felt their diet could be improved, 20 (12.0%) reported high alcohol consumption, 103 (56.9%) reported less than 150 minutes of physical activity a week, and 6 (8.2%) patients lived in poverty. Clinicians suggested that although a wide variety of patients were able to use the tablet-based RFIT, implemented surveys should be tailored to patient subgroups. CONCLUSIONS Clinicians and clinic staff positively reviewed the use of information technology in primary care. Algorithmic information technology can collect, organize, and synthesize individual health information to inform and tailor primary care counseling to the patients' context and readiness to change. The RFIT is a user-friendly tool that provides an effective method for obtaining risk factor information from patients. It is particularly useful for subsets of patients lacking continuity in the care they receive. When implemented within a context that can support practical interventions to address identified risk factors, the RFIT can inform brief interventions within primary care.
Collapse
Affiliation(s)
- Leanne Kosowan
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alan Katz
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Manitoba Centre for Health Policy, Winnipeg, MB, Canada
| | - Gayle Halas
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa LaBine
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alexander Singer
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
130
|
Yi SS, Kanaya AM, Wen M, Russo R, Kandula N. Associations of Neighborhood Factors and Activity Behaviors: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Immigr Minor Health 2021; 23:54-61. [PMID: 32418001 PMCID: PMC8764702 DOI: 10.1007/s10903-020-01021-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Social and built environments may influence physical activity (PA). However, evidence for South Asian Americans (SAA), a group with low PA levels and high cardiometabolic risk, is lacking. We assessed the association between five neighborhood factors and PA behaviors in a community-based cohort of SAA. Data were from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study 2010-2013 (n = 906). Adjusted multivariable models stratified by sex regressing PA behaviors on neighborhood factors were run. Higher neighborhood social cohesion was associated with 17% more PA MET minutes/week in men (p < 0.01), but not in women. Having a park/playground near home was associated with meeting PA guidelines (odds ratio (95% CI): men: 3.14 (1.20-8.24); women: 3.67 (1.17-11.52). Neighborhood factors were associated with favorable PA behaviors in SAA. PA interventions for SAA that increase neighborhood social cohesion or focus on linking individuals with local resources may be effective.
Collapse
Affiliation(s)
- Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
| | - Alka M Kanaya
- Departments of Medicine, Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Ming Wen
- Department of Sociology, The University of Utah, Salt Lake City, UT, USA
| | - Rienna Russo
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Namratha Kandula
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
131
|
Gyurcsik NC, Tupper SM, Brittain DR, Brawley LR, Cary MA, Ratcliffe-Smith D, Blouin JE, Marchant MG, Sessford JD, Hellsten LAM, Arnold BE, Downe P. A proof-of-concept study on the impact of a chronic pain and physical activity training workshop for exercise professionals. Scand J Pain 2021; 21:112-120. [PMID: 33035194 DOI: 10.1515/sjpain-2020-0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/05/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Physical activity is essential for long-term chronic pain management, yet individuals struggle to participate. Exercise professionals, including fitness instructors, and personal trainers, are preferred delivery agents for education and instruction on chronic pain, physical activity, and strategies to use adherence-promoting behavioral skills. However, exercise professionals receive no relevant training during certification or continuing education opportunities to effectively support their participants living with chronic pain. Based on the ORBIT model for early pre-efficacy phases of development and testing of new behavioral treatments, the present Phase IIa proof-of-concept study was conducted. The purpose was to examine the impacts of a newly developed chronic pain and physical activity training workshop on psychosocial outcomes among exercise professionals. Outcomes included knowledge and attitudes regarding chronic pain, attitudes and beliefs about the relationship between pain and impairment, and self-efficacy to educate and instruct participants with chronic pain. METHODS Forty-eight exercise professionals (M age=44.4±11.0 years) participated in a three-hour, in-person workshop that was offered at one of four different locations. Participants completed pre- and post-workshop outcome assessment surveys. RESULTS Mixed MANOVA results comparing time (pre- versus post-workshop) by workshop location (sites 1 to 4) illustrated a significant within-subjects time effect (p<0.001). All outcomes significantly improved from pre- to post-workshop (p's<0.001), demonstrating large effect sizes (partial eta-squared values ranging from 0.45 to 0.59). CONCLUSIONS Findings offer early phase preliminary support for the effectiveness of the chronic pain and physical activity training workshop for exercise professionals. Based on ORBIT model recommendations, findings warrant future phased testing via a pilot randomized clinical trial as well as testing for impacts that trained professionals have on activity adherence among their clients living with chronic pain. Eventual workshop adoption by exercise professional certification organizations would ensure widespread and sustainable access to qualified exercise professionals to help individuals engage in physical activity. By increasing the capacity of available exercise professionals to deliver effective support, active individuals could better manage their chronic pain and live well.
Collapse
Affiliation(s)
- Nancy C Gyurcsik
- University of Saskatchewan, College of Kinesiology, 87 Campus Drive, Saskatoon, SK, Canada
| | - Susan M Tupper
- Pain Quality Improvement and Research for the Saskatchewan Health Authority, Saskatoon, SK, Canada
| | - Danielle R Brittain
- University of Northern Colorado, College of Natural and Health Sciences, Greeley, CO, USA
| | - Lawrence R Brawley
- University of Saskatchewan, College of Kinesiology, 87 Campus Drive, Saskatoon, SK, Canada
| | - Miranda A Cary
- University of British Columbia, School of Health and Exercise Science, Kelowna, BC, Canada
| | - Don Ratcliffe-Smith
- University of Saskatchewan, College of Kinesiology, 87 Campus Drive, Saskatoon, SK, Canada
| | - Jocelyn E Blouin
- University of Saskatchewan, College of Kinesiology, 87 Campus Drive, Saskatoon, SK, Canada
| | - Mackenzie G Marchant
- University of Saskatchewan, College of Kinesiology, 87 Campus Drive, Saskatoon, SK, Canada
| | - James D Sessford
- University of Saskatchewan, College of Kinesiology, 87 Campus Drive, Saskatoon, SK, Canada
| | | | - Bart E Arnold
- University of Saskatchewan, College of Kinesiology, 87 Campus Drive, Saskatoon, SK, Canada
| | - Pamela Downe
- University of Saskatchewan, Department of Archaeology and Anthropology, Saskatoon, SK, Canada
| |
Collapse
|
132
|
Akpa OM, Okekunle AP, Ovbiagele B, Sarfo FS, Akinyemi RO, Akpalu A, Wahab KW, Komolafe M, Obiako R, Owolabi LF, Ogbole G, Fawale B, Fakunle A, Asaleye CM, Akisanya CO, Hamisu DA, Ogunjimi L, Adeoye A, Ogah O, Lackland D, Uvere EO, Faniyan MM, Asowata OJ, Adeleye O, Aridegbe M, Olunuga T, Yahaya IS, Olaleye A, Calys-Tagoe B, Owolabi MO. Factors associated with hypertension among stroke-free indigenous Africans: Findings from the SIREN study. J Clin Hypertens (Greenwich) 2021; 23:773-784. [PMID: 33484599 PMCID: PMC8263562 DOI: 10.1111/jch.14183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/24/2020] [Accepted: 01/03/2021] [Indexed: 01/14/2023]
Abstract
Hypertension is one of the most important risk factors for stroke and cardiovascular diseases (CVD) globally. Understanding risk factors for hypertension among individuals with matching characteristics with stroke patients may inform primordial/primary prevention of hypertension and stroke among them. This study identified the risk factors for hypertension among community-dwelling stroke-free population in Ghana and Nigeria. Data for 4267 community-dwelling stroke-free controls subjects in the Stroke Investigative Research and Education Network (SIREN) study in Nigeria and Ghana were used. Participants were comprehensively assessed for sociodemographic, lifestyle and metabolic factors using standard methods. Hypertension was defined as a previous diagnosis by a health professional or use of an anti-hypertensive drug or mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Logistic regression analysis was used to estimate adjusted odds ratios (aOR) of hypertension and their 95% confidence intervals (CI) at p < .05. Overall, 56.7% of the participants were hypertensive with a higher proportion among respondents aged ≥60 years (53.0%). Factors including physical inactivity (aOR: 9.09; 95% CI: 4.03 to 20.53, p < .0001), diabetes (aOR: 2.70; CI: 1.91 to 3.82, p < .0001), being ≥60 years (aOR: 2.22; 95% CI: 1.78 to 2.77, p < .0001), and family history of CVD (aOR 2.02; CI: 1.59 to 2.56, p < .0001) were associated with increased aOR of hypertension. Lifestyle factors were associated with hypertension in the current population of community-dwelling stroke-free controls in west Africa. Community-oriented interventions to address sedentary lifestyles may benefit this population and reduce/prevent hypertension and stroke among them.
Collapse
Affiliation(s)
- Onoja M Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akinkunmi P Okekunle
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.,The Postgraduate College, University of Ibadan, Ibadan, Nigeria
| | - Bruce Ovbiagele
- School of Medicine, Weill Institute for Neurosciences, University of California, San-Francisco, CA, USA
| | - Fred S Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rufus O Akinyemi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.,Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Albert Akpalu
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Kolawole W Wahab
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Morenikeji Komolafe
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - Reginald Obiako
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Lukman F Owolabi
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Godwin Ogbole
- Department of Radiology, University of Ibadan, Ibadan, Nigeria
| | - Bimbo Fawale
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - Adekunle Fakunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Christianah M Asaleye
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | | | | | - Luqman Ogunjimi
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Shagamu, Nigeria
| | - Abiodun Adeoye
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Okechukwu Ogah
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Dan Lackland
- Medical University of South Carolina, Charleston, SC, USA
| | - Ezinne O Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Osahon J Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Mayowa Aridegbe
- Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Taiwo Olunuga
- Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Isah S Yahaya
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Adeniji Olaleye
- Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Benedict Calys-Tagoe
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Mayowa O Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | |
Collapse
|
133
|
Lucini D, Pagani M. Exercise Prescription to Foster Health and Well-Being: A Behavioral Approach to Transform Barriers into Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:968. [PMID: 33499284 PMCID: PMC7908585 DOI: 10.3390/ijerph18030968] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 12/12/2022]
Abstract
The current literature contains multiple examples of exercise interventions to foster health and to prevent/treat many chronic non-communicable diseases; stress and functional syndromes. On the other hand, sedentariness is increasing and to transform a sedentary subject into a regular exerciser is not only very difficult but considered by some unrealistic in current clinical practice. Ideally a physical activity intervention may be considered actually efficacious when it outgrows the research setting and becomes embedded in a system, ensuring maintenance and sustainability of its health benefits. Physicians need specific skills to improve patients' exercise habits. These range from traditional clinical competencies, to technical competencies to correctly prescribe exercise, to competencies in behavioral medicine to motivate the subject. From a behavioral and medical point of view, an exercise prescription may be considered correct only if the subject actually performs the prescribed exercise and this results in an improvement of physiological mechanisms such as endocrine, immunological and autonomic controls. Here we describe a model of intervention intended to nurture exercise prescription in everyday clinical setting. It aims to a tailored prescription, starts from the subject's assessment, continues defining clinical goals/possible limitations and ends when the subject is performing exercise obtaining results.
Collapse
Affiliation(s)
- Daniela Lucini
- BIOMETRA Department, University of Milan, 20122 Milano, Italy;
- Exercise Medicine Unit, Humanitas Clinical and Research Center, 20089 Rozzano, Italy
| | - Massimo Pagani
- BIOMETRA Department, University of Milan, 20122 Milano, Italy;
| |
Collapse
|
134
|
Associations Between Major Life Changes and Pedometer-Determined Physical Activity Over 4 Years in Middle-Aged Adults in the Cardiovascular Risk in Young Finns Study. J Phys Act Health 2021; 18:199-205. [PMID: 33465763 DOI: 10.1123/jpah.2019-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 10/19/2020] [Accepted: 11/18/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND To examine if major life changes over a 4-year period among 34- to 49-year-old adults (mean = 41.8, SD = 5.0) were associated with a change in physical activity in men (37.7%) and women (62.3%). METHODS Daily steps and aerobic steps (steps that lasted for at least 10 min without interruption at a pace of >60 steps/min) were collected from 1051 participants in 2007 and 2011. Changes in marital status, work status, and residence and the birth of a child were determined from both time points. A latent change score model was used to examine mean changes in daily total steps, aerobic steps, and nonaerobic steps (total steps minus aerobic steps). RESULTS Women who had a first child in the 4-year period had a decrease in their nonaerobic steps (P = .001). Men who divorced in the 4-year period had a decrease in their nonaerobic steps (P = .020), whereas women who recoupled decreased their total steps (P = .030). CONCLUSIONS Counseling for parents having a first child on how to increase physical activity in their everyday life could potentially have an influence on an individual's physical activity.
Collapse
|
135
|
alinejad H, abbassi daloii A, farzanegi P, abdi A. Response of Cardiac Tissue β-catenin and GSK-3β to Aerobic Training and Hyaluronic Acid in Knee OA Model Rats. MEDICAL LABORATORY JOURNAL 2021. [DOI: 10.29252/mlj.15.1.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
136
|
Xie B, Lu Y, Wu L, An Z. Dose-response effect of a large-scale greenway intervention on physical activities: The first natural experimental study in China. Health Place 2021; 67:102502. [DOI: 10.1016/j.healthplace.2020.102502] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 12/19/2022]
|
137
|
Gautam V, S D, Rustagi N, Mittal A, Patel M, Shafi S, Thirunavukkarasu P, Raghav P. Health literacy, preventive COVID 19 behaviour and adherence to chronic disease treatment during lockdown among patients registered at primary health facility in urban Jodhpur, Rajasthan. Diabetes Metab Syndr 2021; 15:205-211. [PMID: 33387854 PMCID: PMC7833282 DOI: 10.1016/j.dsx.2020.12.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/06/2020] [Accepted: 12/11/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Potential role of health literacy in determining adherence to COVID-19 preventive behavior, pharmacological, and lifestyle management among diagnosed patients of chronic diseases during nationwide lockdown is inadequately investigated. METHODS A cross-sectional study was conducted from May-August 2020 among diagnosed patients of chronic diseases residing in a COVID-19 hotspot of urban Jodhpur, Rajasthan, and availing health services from primary care facility. Telephonic interviews of participants were conducted to determine their health literacy using HLS-EU-Q47 questionnaire, adherence to COVID-19 preventive behaviour as per World Health Organization recommendations, and compliance to prescribed pharmacological and physical activity recommendations for chronic disease. RESULTS All the 605 diagnosed patients of chronic diseases availing services from primary care facility were contacted for the study, yielding response rate of 68% with 412 agreeing to participate. Insufficient health literacy was observed for 65.8% participants. Only about half of participants had scored above median for COVID-19 awareness (55.1%) and preventive behavior (45.1%). Health literacy was observed to be significant predictor of COVID-19 awareness [aOR: 3.53 (95% CI: 1.81-6.88)]; COVID-19 preventive behavior [aOR: 2.06, 95%CI; 1.14-3.69] and compliance to pharmacological management [aOR: 3.05; 95% CI: 1.47-6.35] but not for physical activity. CONCLUSION COVID-19 awareness, preventive behavior, and compliance to pharmacological management is associated with health literacy among patients of chronic disease availing services from primary health facility. Focusing on health literacy could thus be an essential strategic intervention yielding long term benefits.
Collapse
Affiliation(s)
- Vaishali Gautam
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Dileepan S
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Neeti Rustagi
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India.
| | - Ankit Mittal
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Mehul Patel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Shazia Shafi
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Prasanna Thirunavukkarasu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| | - Pankaja Raghav
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India
| |
Collapse
|
138
|
Schouw D, Mash R, Kolbe-Alexander T. Changes in risk factors for non-communicable diseases associated with the 'Healthy choices at work' programme, South Africa. Glob Health Action 2020; 13:1827363. [PMID: 33076762 PMCID: PMC7594846 DOI: 10.1080/16549716.2020.1827363] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/18/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Globally 71% of deaths are attributed to non-communicable diseases (NCD). The workplace is an opportune setting for health promotion programs and interventions that aim to prevent NCDs. However, much of the current evidence is from high-income countries. OBJECTIVE The aim of this study was to evaluate changes in NCD risk factors, associated with the Healthy Choices at Work programme (HCWP), at a commercial power plant in South Africa. METHODS This was a before-and-after study in a randomly selected sample of 156 employees at baseline and 137 employees at 2-years. The HCWP focused on food services, physical activity, health and wellness services and managerial support. Participants completed questionnaires on tobacco smoking, harmful alcohol use, fruit and vegetable intake, physical activity, psychosocial stress and history of NCDs. Clinical measures included blood pressure, total cholesterol, random blood glucose, body mass index, waist circumference and waist-to-hip ratio. The 10-year cardiovascular risk was calculated using a validated algorithm. Sample size calculations evaluated the power of the sample to detect meaningful changes in risk factors. RESULTS Paired data was obtained for 137 employees, the mean age was 42.7 years (SD 9.7) and 64% were male. The prevalence of sufficient fruit and vegetable intake increased from 27% to 64% (p < 0.001), those meeting physical activity guidelines increased from 44% to 65% (p < 0.001). Harmful alcohol use decreased from 21% to 5% (p = 0.001). There were clinical and statistically significant improvements in systolic and diastolic blood pressure (mean difference -10.2 mmHg (95%CI: -7.3 to -13.2); and -3.9 mmHg (95%CI: -1.8 to -5.8); p < 0.001) and total cholesterol (mean difference -0.45 mmol/l (-0.3 to -0.6)). There were no significant improvements in BMI. Psychosocial stress from relationships with colleagues, personal finances, and personal health improved significantly. The cardiovascular risk score decreased by 4.5% (> 0.05). CONCLUSION The HCWP was associated with clinically significant reductions in behavioural, metabolic and psychosocial risk factors for NCDs.
Collapse
Affiliation(s)
- Darcelle Schouw
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robert Mash
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Tracy Kolbe-Alexander
- Sport and Exercise Science, School of Health and Wellbeing, University of Southern Queensland, Ipswich, Queensland, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
139
|
Maes I, Van Dyck D, Van Cauwenberg J, Mertens L. Age-related differences in the associations of physical environmental factors and psychosocial factors with accelerometer-assessed physical activity. Health Place 2020; 67:102492. [PMID: 33316601 DOI: 10.1016/j.healthplace.2020.102492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 01/05/2023]
Abstract
The aim of the current study was to examine age-related differences in the associations of physical environmental and psychosocial factors with accelerometer-assessed MVPA across three age groups (adolescents, adults, and older adults). Therefore, data from three studies with a comparable study protocol were combined. Results showed that both physical environmental factors and psychosocial factors were most strongly associated with MVPA in older adults. Consequently, health behavior interventions for older adults should focus on physical environmental factors as well as psychosocial factors. While adolescents and adults may benefit less from such interventions.
Collapse
Affiliation(s)
- Iris Maes
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium.
| | - Jelle Van Cauwenberg
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4k3, B-9000, Ghent, Belgium; Research Foundation Flanders (FWO), Egmontstraat 5, 1000, Brussels, Belgium.
| | - Lieze Mertens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000, Ghent, Belgium; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4k3, B-9000, Ghent, Belgium; Research Foundation Flanders (FWO), Egmontstraat 5, 1000, Brussels, Belgium.
| |
Collapse
|
140
|
Protective lifestyle behaviours and lipoprotein particle subclass profiles in a middle-to older-aged population. Atherosclerosis 2020; 314:18-26. [DOI: 10.1016/j.atherosclerosis.2020.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/13/2020] [Accepted: 10/06/2020] [Indexed: 12/29/2022]
|
141
|
Longitudinal effects of a nationwide lifestyle intervention program on cardiometabolic outcomes in Japan: An observational cohort study. Prev Med 2020; 141:106301. [PMID: 33164885 DOI: 10.1016/j.ypmed.2020.106301] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023]
Abstract
The Japanese government launched a nationwide health screening and lifestyle intervention program in 2008 to prevent and reduce metabolic syndrome in at-risk individuals. This study examined the longitudinal effects of the program's lifestyle interventions on metabolic outcomes using health insurance data from one prefecture. The study population comprised 16,317 individuals aged 40-74 years who met the recommendation criteria for the interventions between 2009 and 2015. Participants were categorized into an overall intervention group (comprising a single-session motivational intervention group and a multi-session intensive intervention group) and a non-intervention group. We evaluated the interventions' effects on the initiation of medications for metabolic disorders (hyperlipidemia, hypertension, and hyperglycemia) and metabolic syndrome incidence for 6 years using discrete hazard models that adjusted for sex, age, health screening measurements, and smoking habit. The longitudinal effects on health screening measurements were also evaluated using regression models for repeated measures. The adjusted hazard ratios (aHRs) (95% confidence interval [CI]) for initiation of medications were 0.83 (0.77-0.90), 0.77 (0.71-0.84), and 0.66 (0.57-0.77) for overall, motivational, and intensive interventions, respectively. The aHRs (95%CI) for metabolic syndrome incidence were 0.84 (0.75-0.94), 0.80 (0.71-0.91), and 0.67 (0.51-0.89) for overall, motivational, and intensive interventions, respectively. The interventions reduced body mass index and waist circumference, but had modest effects on blood lipids, blood glucose, and hemoglobin A1c levels; blood pressure was unaffected. These interventions represent an effective strategy to prevent the progression of preclinical metabolic syndrome, but further studies are needed to evaluate their long-term preventive effects on cardiovascular disease and diabetes.
Collapse
|
142
|
Amiri M, Raeisi-Dehkordi H, Sarrafzadegan N, Forbes SC, Salehi-Abargouei A. The effects of Canola oil on cardiovascular risk factors: A systematic review and meta-analysis with dose-response analysis of controlled clinical trials. Nutr Metab Cardiovasc Dis 2020; 30:2133-2145. [PMID: 33127255 DOI: 10.1016/j.numecd.2020.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/22/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Canola oil (CO) is a plant-based oil with the potential to improve several cardiometabolic risk factors. We systematically reviewed controlled clinical trials investigating the effects of CO on lipid profiles, apo-lipoproteins, glycemic indices, inflammation, and blood pressure compared to other edible oils in adults. METHODS AND RESULTS Online databases were searched for articles up to January 2020. Forty-two articles met the inclusion criteria. CO significantly reduced total cholesterol (TC, -0.27 mmol/l, n = 37), low-density lipoprotein cholesterol (LDL-C, -0.23 mmol/l, n = 35), LDL-C to high-density lipoprotein cholesterol ratio (LDL/HDL, -0.21, n = 10), TC/HDL (-0.13, n = 15), apolipoprotein B (Apo B, -0.03 g/l, n = 14), and Apo B/Apo A-1 (-0.02, n = 6) compared to other edible oils (P < 0.05). Compared to olive oil, CO decreased TC (-0.23 mmol/l, n = 9), LDL-C (-0.17 mmol/l, n = 9), LDL/HDL (-0.39, n = 2), and triglycerides in VLDL (VLDL-TG, -0.10 mmol/l, n = 2) (P < 0.05). Compared to sunflower oil, CO improved LDL-C (-0.14 mmol/l, n = 11), and LDL/HDL (-0.30, n = 3) (P < 0.05). In comparison with saturated fats, CO improved TC (-0.59 mmol/l, n = 11), TG (-0.08 mmol/l, n = 11), LDL-C (-0.49 mmol/l, n = 10), TC/HDL (-0.29, n = 5), and Apo B (-0.09 g/l, n = 4) (P < 0.05). Based on the nonlinear dose-response curve, replacing CO with ~15% of total caloric intake provided the greatest benefits. CONCLUSION CO significantly improved different cardiometabolic risk factors compared to other edible oils. Further well-designed clinical trials are warranted to confirm the dose-response associations.
Collapse
Affiliation(s)
- Mojgan Amiri
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamidreza Raeisi-Dehkordi
- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| |
Collapse
|
143
|
Time Course and Determinants of Individual Motivation among Women Enrolled in a Diet and Physical Activity Primary Prevention Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228589. [PMID: 33228006 PMCID: PMC7699275 DOI: 10.3390/ijerph17228589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 11/16/2022]
Abstract
We studied the determinants of motivation among post-menopausal women enrolled in a two-year diet and physical activity primary prevention randomized trial. Participants were requested to grade the importance attached to changing their lifestyle, their confidence about being able to implement the change, and their willingness to be involved in studies focusing on lifestyle. We used multi-adjusted regression to investigate the association between individual characteristics, study arm, and individual motivation at study entry and end. Participants (n = 234) were highly motivated both at entry and throughout the study. Women with pre-existing healthier eating habits and lifestyles (e.g., high consumption of fruit and vegetables, low red meat consumption, and physically active) were more motivated at entry and over the course of the study. Women assigned to any intervention arm were more motivated than those in the control arm. These findings may help enhance adherence to recommendations and improve effectiveness of community-based health promotion campaigns.
Collapse
|
144
|
Radavelli-Bagatini S, Bondonno CP, Sim M, Blekkenhorst LC, Anokye R, Connolly E, Bondonno NP, Schousboe JT, Woodman RJ, Zhu K, Szulc P, Jackson B, Dimmock J, Schlaich MP, Cox KL, Kiel DP, Lim WH, Stanley M, Devine A, Thompson PL, Gianoudis J, De Ross B, Daly RM, Lewis JR, Hodgson JM. Modification of diet, exercise and lifestyle (MODEL) study: a randomised controlled trial protocol. BMJ Open 2020; 10:e036366. [PMID: 33177129 PMCID: PMC7661361 DOI: 10.1136/bmjopen-2019-036366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/18/2020] [Accepted: 05/18/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Most cardiovascular disease (CVD)-related events could be prevented or substantially delayed with improved diet and lifestyle. Providing information on structural vascular disease may improve CVD risk factor management, but its impact on lifestyle change remains unclear. This study aims to determine whether providing visualisation and pictorial representation of structural vascular disease (abdominal aortic calcification (AAC)) can result in healthful diet and lifestyle change. METHODS AND ANALYSIS This study, including men and women aged 60-80 years, is a 12-week, two-arm, multisite randomised controlled trial. At baseline, all participants will have AAC assessed from a lateral spine image captured using a bone densitometer. Participants will then be randomised to receive their AAC results at baseline (intervention group) or a usual care control group that will receive their results at 12 weeks. All participants will receive information about routinely assessed CVD risk factors and standardised (video) diet and lifestyle advice with three simple goals: (1) increase fruit and vegetable (FV) intake by at least one serve per day, (2) improve other aspects of the diet and (3) reduce sitting time and increase physical activity. Clinical assessments will be performed at baseline and 12 weeks. OUTCOMES The primary outcome is a change in serum carotenoid concentrations as an objective measure of FV intake. The study design, procedures and treatment of data will adhere to Standard Protocol Items for Randomized Trials guidelines. ETHICS AND DISSEMINATION Ethics approval for this study has been granted by the Edith Cowan University and the Deakin University Human Research Ethics Committees (Project Numbers: 20513 HODGSON and 2019-220, respectively). Results of this study will be published in peer-reviewed academic journals and presented in scientific meetings and conferences. Information regarding consent, confidentiality, access to data, ancillary and post-trial care and dissemination policy has been disclosed in the participant information form. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trial Registry (ACTRN12618001087246).
Collapse
Affiliation(s)
- Simone Radavelli-Bagatini
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Reindolf Anokye
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Emma Connolly
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - John T Schousboe
- Park Nicollet Osteoporosis Center and Health Partners Institute, and Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, USA
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Kun Zhu
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Ben Jackson
- Faculty of Science, School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - James Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Markus P Schlaich
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Kay L Cox
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Wai H Lim
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Mandy Stanley
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Peter L Thompson
- Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Jenny Gianoudis
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Melbourne, VIC, Australia
| | - Belinda De Ross
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Melbourne, VIC, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Melbourne, VIC, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
145
|
Anokye R, Radavelli-Bagatini S, Bondonno CP, Sim M, Blekkenhorst LC, Connolly E, Bondonno NP, Schousboe JT, Woodman R, Zhu K, Szulc P, Jackson B, Dimmock J, Schlaich MP, Cox KL, Kiel DP, Lim WH, Devine A, Thompson PL, Gianoudis J, De Ross B, Daly RM, Hodgson JM, Lewis JR, Stanley M. Implementation, mechanisms of impact and key contextual factors involved in outcomes of the Modification of Diet, Exercise and Lifestyle (MODEL) randomised controlled trial in Australian adults: protocol for a mixed-method process evaluation. BMJ Open 2020; 10:e036395. [PMID: 33177130 PMCID: PMC7661373 DOI: 10.1136/bmjopen-2019-036395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The Modification of Diet, Exercise and Lifestyle (MODEL) study aims to examine the impact of providing visualisation and pictorial representation of advanced structural vascular disease (abdominal aortic calcification), on 'healthful' improvements to diet and lifestyle. This paper reports the protocol for the process evaluation for the MODEL study. METHODS AND ANALYSIS The overall aim of the process evaluation is to understand the processes that took place during participation in the MODEL study trial and which elements were effective or ineffective for influencing 'healthful' behavioural change, and possible ways of improvement to inform wider implementation strategies. A mixed-method approach will be employed with the use of structured questionnaires and semistructured in-depth interviews. All 200 participants enrolled in the trial will undertake the quantitative component of the study and maximum variation sampling will be used to select a subsample for the qualitative component. The sample size for the qualitative component will be determined based on analytical saturation. Interviews will be digitally recorded and transcribed verbatim. Qualitative data will be analysed thematically and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. ETHICS AND DISSEMINATION The MODEL study process evaluation has received approval from Edith Cowan University Human Research Ethics Committee (Project Number: 20513 HODGSON). Written informed consent will be obtained from all participants before they are included in the study. The study results will be shared with the individuals and institutions associated with this study as well as academic audiences through peer-reviewed publication and probable presentation at conferences. TRIAL REGISTRATION NUMBER ACTRN12618001087246.
Collapse
Affiliation(s)
- Reindolf Anokye
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Simone Radavelli-Bagatini
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Emma Connolly
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - John T Schousboe
- Park Nicollet Osteoporosis Center and Health Partners Institute and Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, USA
| | - Richard Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Kun Zhu
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Pawel Szulc
- INSERM UMR1033, University of Lyon, Lyon, France
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia
| | - James Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Markus P Schlaich
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Kay L Cox
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew Senior Life, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Wai H Lim
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Peter L Thompson
- Department of Cardiology, University of Western Australia, Perth, Western Australia, Australia
| | - Jenny Gianoudis
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Belinda De Ross
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Mandy Stanley
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| |
Collapse
|
146
|
Cassinat RA, Bruening M, Crespo NC, Gutiérrez M, Chavez A, Ray F, Vega-López S. Effects of a Community-Based Pilot Intervention on Home Food Availability among U.S. Households. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8327. [PMID: 33187084 PMCID: PMC7697825 DOI: 10.3390/ijerph17228327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022]
Abstract
The purpose of this study was to assess the effects of a pilot community-based behavioral intervention on the home food environment in U.S. households. Parents (21 females, 2 males; age = 36 ± 5.5 years; 78% Hispanic) of elementary school-aged children attended a 10-week dietary improvement behavioral intervention targeting an increase in fruit and vegetable consumption and a reduction in sugar intake. Home food availability of fruit, vegetables, and sugar-laden foods and beverages were assessed before and after the intervention using a modified version of the Home Food Inventory. Relative to baseline, the intervention resulted in significant increases in fruit availability (7.7 ± 3.2 items vs. 9.4 ± 3.1 items; p = 0.004) and low sugar cereal (2.3 ± 1.4 types vs. 2.7 ± 1.4 types; p = 0.033). There was a significant reduction in sugar-sweetened beverage availability (3.2 ± 1.9 types vs. 1.7 ± 1.3 types; p = 0.004). There was a significant increase in the number of households with accessible ready-to-eat vegetables and fruit, and a significant reduction in available prepared desserts, and candy (p < 0.01). There were no significant changes in the availability of vegetables and sugar-laden cereals. The current intervention resulted in positive changes in the home food environment. Further research to confirm these results in a randomized controlled trial is warranted.
Collapse
Affiliation(s)
- Rachel A. Cassinat
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA; (R.A.C.); (M.B.); (M.G.); (A.C.)
| | - Meg Bruening
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA; (R.A.C.); (M.B.); (M.G.); (A.C.)
| | - Noe C. Crespo
- School of Public Health, San Diego State University, 9245 Sky Park Ct. Suite 224, San Diego, CA 92123, USA;
| | - Mónica Gutiérrez
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA; (R.A.C.); (M.B.); (M.G.); (A.C.)
| | - Adrian Chavez
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA; (R.A.C.); (M.B.); (M.G.); (A.C.)
| | - Frank Ray
- City of Phoenix, Parks and Recreation Department, 212 E. Alta Vista Rd., Phoenix, AZ 85402, USA;
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, 550 North 3rd Street, Phoenix, AZ 85004, USA; (R.A.C.); (M.B.); (M.G.); (A.C.)
- Southwest Interdisciplinary Research Center, Arizona State University, 201 N. Central Ave, Room 3346, Phoenix, AZ 85004, USA
| |
Collapse
|
147
|
Smith J, Griffiths LA, Band M, Hird-Smith R, Williams B, Bold J, Bradley E, Dilworth R, Horne D. Early Intervention in Psychosis: Effectiveness and Implementation of a Combined Exercise and Health Behavior Intervention Within Routine Care. Front Endocrinol (Lausanne) 2020; 11:577691. [PMID: 33193094 PMCID: PMC7649318 DOI: 10.3389/fendo.2020.577691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022] Open
Abstract
Aim Young people with psychosis have higher rates of obesity, premature cardiovascular disease, and death compared to non-psychotic peers in the general population due to changes in metabolic regulation linked to antipsychotic medication and adverse health risk behaviors. The aim of this paper is to outline the development, implementation, and evaluation of a combined 12-week exercise and health behavior intervention delivered as part of an Early Intervention in Psychosis (EIP) routine service, within the UK. Methods Participants (n = 27) completed a 12-week combined intervention program, engaging in weekly, 90-min sessions comprising a healthy behavior education session (45 min), followed by a facilitated exercise session (45 min). Anthropometric data from participants (n = 26) were collected at baseline, 12 weeks, and 12 months post-intervention. Health behaviors and clinical measurements were assessed at baseline and 12 months. Results Mean baseline data suggests participants were at an increased health risk on entry to the program, with elevated values in mean body mass index (BMI; 70% overweight/obese), waist circumference, resting heart rate, and triglycerides. Fifty percent reported smoking daily, 64% ate < 5 fruits/vegetables per day, and 52% of participants were prescribed highly obesogenic antipsychotic medications (i.e., Olanzapine). At 12 weeks and 12 months, no changes were observed in mean BMI, waist circumference or any other clinical variable (p > 0.05). At 12 months, participants reported a positive impact on health behaviors including improved diet, increased physical activity levels, and cessation of substance use (n = 2), alcohol use (n = 2), and smoking (n = 4). Focus groups captured participant experiences, engagement with and satisfaction with the program, including challenges/barriers to program adherence. Conclusions The 12-week exercise and health behaviors program supported participants to attenuate their physical health risk which was sustained at 12-month follow-up. Self-reported positive health behavior changes are likely to have contributed to the prevention of excessive weight gain in this high-risk period. The evaluation was designed to have validity for a "real world EIP setting" and reflect the complexity of delivery to this participant group. Evaluation findings influenced subsequent commissioning of the physical health intervention as an ongoing element of routine EIP care within the participant site.
Collapse
Affiliation(s)
- Jo Smith
- School of Allied Health and Community, University of Worcester, Worcester, United Kingdom
| | - Lisa A. Griffiths
- Department of Nutrition, Food and Exercise Science, Florida State University, Tallahassee, FL, United States
| | - Marie Band
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Rachael Hird-Smith
- School of Allied Health and Community, University of Worcester, Worcester, United Kingdom
| | - Briony Williams
- School of Allied Health and Community, University of Worcester, Worcester, United Kingdom
| | - Justine Bold
- School of Allied Health and Community, University of Worcester, Worcester, United Kingdom
- Centre for Medical Education, Medical School, Cardiff University, Cardiff, United Kingdom
| | - Eleanor Bradley
- School of Allied Health and Community, University of Worcester, Worcester, United Kingdom
| | - Richard Dilworth
- School of Allied Health and Community, University of Worcester, Worcester, United Kingdom
| | - Dominic Horne
- School of Allied Health and Community, University of Worcester, Worcester, United Kingdom
| |
Collapse
|
148
|
Lianov L. Getting from Here to There: Motivational Interviewing and Other Techniques to Promote Healthy Aging. Clin Geriatr Med 2020; 36:719-732. [PMID: 33010906 DOI: 10.1016/j.cger.2020.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Successful health behavior change relies on the autonomy of the individual who is driven toward personally meaningful, positive goals. The medical practitioner and health care team can use several techniques to facilitate such change effectively, including motivational interviewing, cognitive behavioral restructuring, appreciative inquiry, and positive psychology techniques. Older adults can be supported to make change, and may have greater capacity to maintain those changes due to increased levels of conscientiousness. Positive psychology approaches may be effective in older adults, due to evidence that, as individuals age, they tend to prioritize activities that bring them satisfaction and emotional well-being.
Collapse
|
149
|
Abstract
PURPOSE OF REVIEW To review the current evidence supporting the use of digital health technologies in cardiovascular disease (CVD) care. RECENT FINDINGS Studies have evaluated the impact of the use of digital health technologies to improve CVD outcomes through several modalities: text-messaging programmes, smartphone applications (apps) and wearable devices. Text-messaging programmes are to date the most studied type of digital health interventions, and studies have demonstrated reduced CVD risk and improved medication adherence. Literature supporting the use of smartphone apps is also growing but remains limited, with some studies favouring the use of health apps but others showing negative results. Wearable devices are the latest type of technology investigated, and studies have shown positive outcomes in terms of physical activity and detection of arrhythmias. Digital health is a growing and evolving area of investigation. To date, the scientific evidence overall supports the use of such technologies in CVD care and management. Future research using new models are needed to continue to evaluate these new technologies.
Collapse
Affiliation(s)
- Karla Santo
- Academic Research Organization, Hospital Israelita Albert Einstein, Av. Albert Einstein 627, Bloco A, 2o subsolo, São Paulo, SP CEP 05652-900 Brazil
- Westmead Applied Research Centre, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Cardiovascular Division, The George Institute for Global Health, Sydney, Australia
| | - Julie Redfern
- Westmead Applied Research Centre, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Cardiovascular Division, The George Institute for Global Health, Sydney, Australia
| |
Collapse
|
150
|
DeHaven MJ, Gimpel NA, Gutierrez D, Kitzman-Carmichael H, Revens K. Designing health care: A community health science solution for reducing health disparities by integrating social determinants and the effects of place. J Eval Clin Pract 2020; 26:1564-1572. [PMID: 32157768 DOI: 10.1111/jep.13366] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND In the United States chronic illnesses have become a way of life for multiple generations - they are the number one cause of death and disability (accounting for more than 70% of deaths), 60% of American adults have at least one chronic disease, and 40% have multiple chronic conditions. Although multiple factors contribute to the growth in chronic disease prevalence, a major factor has been overreliance on health care systems for promoting health and preventing disease. Large health care systems are ill equipped for this role since they are designed to detect, treat, and manage disease, not to promote health or address the underlying causes of disease. METHODS Improving health outcomes in the U.S. will require implementing broad-based prevention strategies combining biological, behavioral, and societal variables that move beyond clinical care. According to community medicine, clinical care alone cannot create, support, or maintain health. Rather, health can only ensue from combining clinical care with epidemiology and community organization, because health is a social outcome resulting from a combination of clinical science, collective responsibility, and informed social action. RESULTS During the past 20 years, our team has developed an operational community medicine approach known as community health science. Our model provides a simple framework for integrating clinical care, population health, and community organization, using community-based participatory research (CBPR) practices for developing place-based initiatives. In the present paper, we present a brief overview of the model and describe its evolution, applications, and outcomes in two major urban environments. CONCLUSION The paper demonstrates means for integrating the social determinants of health into collaborative place-based approaches, for aligning community assets and reducing health disparities. It concludes by discussing how asset-based community development can promote social connectivity and improve health, and how our approach reflects the emerging national consensus on the importance of place-based population system change.
Collapse
Affiliation(s)
- Mark J DeHaven
- Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Nora A Gimpel
- Community Health, UT Southwestern Medical Center, Dallas, Texas
| | | | | | - Keri Revens
- Research and Evaluation, Camino Community Center, Charlotte, North Carolina
| |
Collapse
|