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Pfammatter AF, Battalio SL, Olvera C, DeZelar M, Moore D, Scanlan L, Siddique J, Spring B, Chang SH. The EVO study protocol for a randomized controlled evaluation trial of an optimized weight management intervention. Contemp Clin Trials 2022; 116:106750. [PMID: 35378301 PMCID: PMC9133162 DOI: 10.1016/j.cct.2022.106750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/26/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Obesity is a substantial public health concern; however, gold-standard behavioral treatments for obesity are costly and burdensome. Existing adaptations to the efficacious Diabetes Prevention Program (DPP) demonstrate mixed results. Our prior research applying the Multiphase Optimization Strategy (MOST) to DPP identifies a more parsimonious, less costly intervention (EVO) resulting in significant weight loss. OBJECTIVE The aim of the remotely conducted EVO trial is to test the non-inferiority of EVO against DPP. We will conduct economic evaluations alongside the trial to estimate delivery and patient costs, cost-effectiveness, and lifetime healthcare costs of EVO as compared to DPP. Exploratory analyses will examine maintenance, moderators, and mediators of the treatment effect. STUDY DESIGN The EVO trial will recruit nationally to randomize 524 participants with obesity. Participants will receive either EVO or DPP over a 6 month period. EVO participants will be provided online lessons, a smartphone application to self-monitor diet, physical activity, and weight, and attend 12 brief calls with a Health Promotionist. DPP participants will receive the first 6 months of the Center for Disease Control's T2D materials and attend 16 one-hour video call sessions with staff certified in DPP delivery. Weight will be measured at baseline, 3-, 6-, and 12-months. Itemized delivery cost will be collected. Staff and participants will also provide information to estimate costs for intervention-related activities. SIGNIFICANCE The EVO trial could establish evidence supporting dissemination of a scalable, cost-effective behavioral treatment with potential to shift clinical practice guidelines, inform policy, and reduce the prevalence of obesity.
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Affiliation(s)
- Angela Fidler Pfammatter
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
| | - Samuel L Battalio
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Charlie Olvera
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Margaret DeZelar
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Dominique Moore
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Laura Scanlan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Juned Siddique
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Su-Hsin Chang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
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Kee D, O'Conor R, Wisnivesky JP, Wolf MS, Federman AD. Patient characteristics associated with retention in an asthma self-management trial for older adults. J Asthma 2021; 59:1652-1660. [PMID: 34112032 DOI: 10.1080/02770903.2021.1941090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE New self-management interventions are being developed for older adults who suffer from worse asthma morbidity than their younger counterparts, but high rates of study drop out have hampered these efforts and there is limited literature on what factors may influence retention in behavioral intervention studies with older adults. This study analyzed illness beliefs and patient characteristics that may contribute to retention in an asthma self-management trial for older adults. METHODS This is a secondary analysis of data from a randomized controlled trial of a self-management support intervention for adults 60 years and older with persistent, uncontrolled asthma. Multivariable logistic regression was used to evaluate the association of medication and illness beliefs, and other subject characteristics with study retention, which was defined as completion of the research study interview at 6 and 12 months. RESULTS The randomized trial enrolled 388 individuals; 261 (67.3%) completed the 12-month interview. Higher perceived threat of chronic diseases relative to asthma was associated with higher study retention (OR = 1.11, 95% CI = 1.00-1.24) at 12 months. Other variables including asthma beliefs, age, cognitive function, health literacy, and asthma symptoms were not significantly associated with retention. CONCLUSIONS Concern about non-asthma chronic conditions, but no other illness beliefs, or patient characteristics, were associated with retention in an asthma self-management support intervention. Further research, including qualitative studies, is needed to better understand why patients drop out of asthma behavioral intervention studies.
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Affiliation(s)
- Dustin Kee
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel O'Conor
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael S Wolf
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alex D Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Cannon MJ, Masalovich S, Ng BP, Soler RE, Jabrah R, Ely EK, Smith BD. Retention Among Participants in the National Diabetes Prevention Program Lifestyle Change Program, 2012-2017. Diabetes Care 2020; 43:2042-2049. [PMID: 32616617 PMCID: PMC11000538 DOI: 10.2337/dc19-2366] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/28/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess retention in the National Diabetes Prevention Program (DPP) lifestyle change program, which seeks to prevent type 2 diabetes in adults at high risk. RESEARCH DESIGN AND METHODS We analyzed retention among 41,203 individuals who enrolled in Centers for Disease Control and Prevention (CDC)-recognized in-person lifestyle change programs at organizations that submitted data to CDC's Diabetes Prevention Recognition Program during January 2012-February 2017. RESULTS Weekly attrition rates were typically <1-2% but were between 3.5% and 5% at week 2 and at weeks 17 and 18, where session frequency typically transitions from weekly to monthly. The percentage of participants retained through 18 weeks varied by age (45.9% for 18-29 year olds, 53.4% for 30-44 year olds, 60.2% for 45-54 year olds, 66.7% for 55-64 year olds, and 67.6% for ≥65 year olds), race/ethnicity (70.5% for non-Hispanic whites, 60.5% for non-Hispanic blacks, 52.6% for Hispanics, and 50.6% for other), mean weekly percentage of body weight lost (41.0% for ≤0% lost, 66.2% for >0% to <0.25% lost, 72.9% for 0.25% to <0.5% lost, and 73.9% for ≥0.5% lost), and mean weekly physical activity minutes (12.8% for 0 min, 56.1% for >0 to <60 min, 74.8% for 60 to <150 min, and 82.8% for ≥150 min) but not by sex (63.0% for men and 63.1% for women). CONCLUSIONS Our results demonstrate the need to identify strategies to improve retention, especially among individuals who are younger or are members of racial/ethnic minority populations and among those who report less physical activity or less early weight loss. Strategies that address retention after the first session and during the transition from weekly to monthly sessions offer the greatest opportunity for impact.
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Affiliation(s)
- Michael J Cannon
- Translation, Health Education, and Evaluation Branch, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Boon Peng Ng
- College of Nursing and Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL
| | - Robin E Soler
- Translation, Health Education, and Evaluation Branch, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Elizabeth K Ely
- Translation, Health Education, and Evaluation Branch, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | - Bryce D Smith
- Translation, Health Education, and Evaluation Branch, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
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Stolarski M, Waleriańczyk W, Pruszczak D. Introducing Temporal Theory to the Field of Sport Psychology: Toward a Conceptual Model of Time Perspectives in Athletes' Functioning. Front Psychol 2019; 9:2772. [PMID: 30687202 PMCID: PMC6336711 DOI: 10.3389/fpsyg.2018.02772] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 12/24/2018] [Indexed: 11/13/2022] Open
Abstract
Time perspective theory provides a robust conceptual framework for analyzing human behavior in the context of time. So far, the concept has been studied and applied in multiple life domains, such as education, health, social relationships, environmental behavior, or financial behavior; however, its explanatory potential has been completely neglected within the domain of sport. In the present paper we provide a deepened theoretical analysis of the potential role of temporal framing of human experience for sport-related attitudes, emotions, and athletic performance. We propose a conceptual model in which time perspectives influence psychological functioning and performance of athletes via three major mechanisms: (1) magnitude and persistence of sport motivation and resulting athlete engagement, (2) regulation of affective states during sport performance, and (3) appraisal of one's performance and coping with resulting emotions. We support the theoretical considerations based on the major assumptions of time perspective theory with research findings regarding the regulatory role of time perspectives in other life domains. We also highlight potential research paths that would allow us to empirically test the present model and determine the actual role of temporal perspectives in shaping crucial aspects of athletes' psychological functioning, as well as levels of their sport performance.
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Brevers D, Foucart J, Verbanck P, Turel O. Examination of the validity and reliability of the French version of the Brief Self-Control Scale. ACTA ACUST UNITED AC 2017; 49:243-250. [PMID: 29200467 DOI: 10.1037/cbs0000086] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study aims to develop and to validate a French version of the Brief Self-Control Scale (BSCS; Tangney et al., 2004). This instrument is usually applied as a unidimensional self-report measure for assessing trait self-control, which captures one's dispositional ability to resist short-term temptation in order to reach more valuable long-term goals. Data were collected from two independent samples of French-speaking individuals (n1 = 287; n2 = 160). Results indicated that the French version of the BSCS can be treated as unidimensional, like the original questionnaire. Data also showed consistent acceptable reliability and reasonable test-retest stability. Acceptable external validity of constructs was supported by relationships with self-reported measures of impulsivity (UPPS), including urgency, lack of premeditation, and lack of perseverance. Overall, the findings suggest that the average score of the French version of the BSCS is a viable option for assessing trait self-control in French speaking populations.
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Affiliation(s)
- Damien Brevers
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Brugmann-campus, Université Libre de Bruxelles, Brussels, Belgium.,Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Erasme Campus, Université Libre de Bruxelles, Brussels, Belgium
| | - Jennifer Foucart
- Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Erasme Campus, Université Libre de Bruxelles, Brussels, Belgium
| | - Paul Verbanck
- Laboratory of Psychological Medicine and Addictology, Faculty of Medicine, Brugmann-campus, Université Libre de Bruxelles, Brussels, Belgium.,Research in Psychology Applied to Motor Learning, Faculty of Motor Sciences, Erasme Campus, Université Libre de Bruxelles, Brussels, Belgium
| | - Ofir Turel
- College of Business and Economics, California State University, Fullerton, CA, USA
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Jiandani D, Wharton S, Rotondi MA, Ardern CI, Kuk JL. Predictors of early attrition and successful weight loss in patients attending an obesity management program. BMC OBESITY 2016; 3:14. [PMID: 26966544 PMCID: PMC4784380 DOI: 10.1186/s40608-016-0098-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/04/2016] [Indexed: 11/10/2022]
Abstract
Background Our objective was to identify factors that are independently associated with early attrition and successful weight loss (WL) in an obesity-management program. Methods Participants were 9,498 patients enrolled in treatment at the Wharton Weight Management Clinic for at least 6 months. Predictors of early attrition (<6 months) and successful WL (≥5 %) were analyzed using relative risk (RR) in men and women separately. Pearson’s correlation was used to determine the relationship between WL and treatment time Weight loss and attrition analysis was restricted to patients who had more than two visits (n = 5415). Results Older individuals had lower early attrition (RR Range:0.74–0.92, P < 0.05) and greater WL success (RR Range:1.40–1.65, P < 0.05) than younger individuals. Males with hypertension and females with depression had greater early attrition (RR Range:1.09–1.20, P < 0.05) and lower WL success (RR Range:0.48–0.57, P < 0.05) than those without these health conditions. Males with lower education had greater early attrition (RR = 1.11[1.03–1.19]) than males with higher education, but did not differ in WL. Females who smoked had greater early attrition (RR = 1.06[1.01–1.11]) than females who did not smoke, but did not differ in WL. Ethnicity was not related to early attrition, however, females of Black and Other ethnicities had lower WL success compared to White females (RR Range:0.58–0.74, P < 0.05). After adjusting for treatment time, all above associations were no longer significant and treatment time remained as the only independent predictor of WL success (P < 0.0001). Conclusion As WL is positively and independently related with treatment time, individuals at risk for early attrition may need alternative treatment options, in order to improve patient retention and improve WL success.
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Affiliation(s)
- Dishay Jiandani
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Sean Wharton
- School of Kinesiology and Health Science, York University, Toronto, Canada ; The Wharton Weight Management Clinic, Toronto, Canada
| | - Michael A Rotondi
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Chris I Ardern
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Jennifer L Kuk
- School of Kinesiology and Health Science, York University, Toronto, Canada ; Room 2002B, Sherman Health Science Research Centre, York University, 4700 Keele St., Toronto, ON M3J 1P3 Canada
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Kroese FM, Adriaanse MA, Vinkers CD, van de Schoot R, de Ridder DT. The effectiveness of a proactive coping intervention targeting self-management in diabetes patients. Psychol Health 2013; 29:110-25. [DOI: 10.1080/08870446.2013.841911] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Efficacy of a self-management intervention for weight control in overweight and obese adults: a randomized controlled trial. J Behav Med 2013; 37:781-92. [DOI: 10.1007/s10865-013-9530-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 08/03/2013] [Indexed: 10/26/2022]
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